Ebook Body Mass Index And Obesity Among Adults In Finland
The negative effects of obesity on health are beyond dispute. Excessive body fat represents a strong risk factor for several diseases, the most important of which ones are type 2 diabetes, hypertension, cardiovascular diseases and osteoarthritis (Pi-Sunyer 1991, World Health Organization 2000). Most of these deleterious effects are more likely if the excess body fat is mainly stored in the upper body, with abdominal visceral fat being the most critical when evaluating the health risks of obesity (Pi-Sunyer 1991, Björntorp 1993, World Health Organization 2000). Moreover, obesity is associated with disability and poor perceived health (Wolk and Rössner 1996, Manderbacka et al. 1998, Doll et al. 2000, Ford et al. 2001).
Obesity not only has wide-reaching medical consequences but also has social and economic implications (Seidell 1995a, Wolf and Colditz 1996). Obese subjects are more likely to have frequent sick leaves and to be prematurely pensioned (Rissanen et al. 1990, Moens et al. 1999). In addition, subjects overweight in adolescence have been shown to complete fewer years of education and to be less likely to get married than their normal-weight counterparts (Gortmaker et al. 1993). In women, overweight has been associated with lower household income (Gortmaker et al. 1993, Sarlio-Lähteenkorva and Lahelma 1999) and unemployment (Sarlio-Lähteenkorva and Lahelma 1999). Stigmatization and impaired well-being of obese subjects have been established in several studies (Crocker et al. 1993, Myers and Rosen 1999).
The obesity-related burden for society is considerable as well. Estimations of economic costs incurred range from 2% to 7% of total health care costs, which means that obesity represents one of the largest expenditures in health care budgets (Seidell 1995a, Wolf and Colditz 1996, 1998, Swinburn et al. 1997). In Finland, the corresponding figure is similarly estimated to range from 1.4% to 7% (Pekurinen et al. 2000).
Obesity has been suggested to be a major avoidable contributor to the costs of illness in the United States (Colditz 1992, Wolf and Colditz 1996). Nevertheless, its prevalence continues to increase, not only in the United States but worldwide (Popkin and Doak 1998). Thus, obesity is also an escalating health problem in European countries (Seidell 1995b, World Health Organization 2000), including Finland, where its high prevalence and increasing trend were already observed in the 1970s (Rissanen et al. 1988). The mean body mass index (BMI) continued to increase steadily in men during the 1980s and the early 1990s, whereas in women, BMI trends reversed in the early 1980s and then seemed to level off (Pietinen et al. 1996).
Difficulties in treating obesity and maintaining weight loss are well documented. Indeed, prevention appears to be the most promising way of overcoming this growing epidemic (Bouchard 1996, Gill 1997). However, interventions aimed at prevention of obesity or weight gain are scarce and few studies have been done (Glenny et al. 1997, Hardeman et al. 2000). Thus, limited information is available for formulating effective obesity prevention strategies. When planning prevention policies, more knowledge is needed about factors being attributed to this escalating problem (James 1995). Monitoring changes in BMI and in the prevalence of obesity over time are essential for evaluating strategies and actions for the prevention and management of obesity.
This thesis describes changes in body weight and obesity among Finnish adults both overall and by age and socioeconomic factors over a 15-year period, partly also over a 25-year period. The specific objective was to identify possible risk groups for undesirable trends in obesity. The associations of lifestyle factors with obesity and BMI, and their consistency over time were investigated as well.
Contents
Abstract
List of original publications
Abbreviations
1. Introduction
2. Review of the literature
2.1. Definitions and classification of obesity
- 2.1.1. BMI as a measure for assessing obesity
2.1.2. Abdominal obesity
2.1.3. Other anthropometric measures for assessing obesity
2.2. Prevalence and trends in obesity
- 2.2.1. Obesity in Finland
2.2.2. Obesity elsewhere in Europe
2.2.3. Obesity in countries outside Europe
2.3. Factors associated with BMI and obesity
- 2.3.1. Demographic factors: gender, age and ethnicity
2.3.2. Sociocultural factors: education and family situation
2.3.3. Dietary intake, physical activity, alcohol consumption and smoking
3. Aims of the study
4. Subjects and methods
4.1. Participants
4.2. Measurements
- 4.2.1. Anthropometric measurements
4.2.2. Questionnaire
4.3. Statistical methods
5. Results
5.1. BMI and prevalence of obesity
- 5.1.1. Age
5.1.2. Education
5.1.3. Occupation
5.1.4. Lifestyle factors
5.2. Waist-to-hip ratio
- 5.2.1. Age
5.2.2. Education
5.2.3 Factors associated with abdominal obesity
6. Discussion
6.1. Overall changes in BMI and obesity
6.2. The most adverse trends in the extremes of the age range
6.3. Education, occupation and obesity
6.4. Lifestyle factors
6.5. Future prospects
7. Conclusions
8. Acknowledgements
9. References
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