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Long Term Trends and Racial/Ethnic Disparities in the Prevalence of Obesity

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Abstract

Obesity is an epidemic associated with higher rates of hypertension, diabetes, and cardiovascular diseases. However, significant racial disparities in the prevalence of obesity have been reported. To evaluate racial disparities and trends in the prevalence of obesity and obesity-related diseases. A population-based retrospective cohort study utilized data from the 1985 to 2011 California Behavioral Risk Factor Survey. Trends in obesity prevalence were stratified by age, sex, race/ethnicity, and socioeconomic factors. Multivariate logistic regression models evaluated independent predictors of obesity. The prevalence of obesity in significantly increased from 1985 to 2011 (8.6 vs. 22.8 %, p < 0.001). This increase was seen among men and women, and among all race/ethnic, age, and socioeconomic groups. Hypertension and diabetes also increased during this time period (hypertension 20.7–35.9 %; diabetes 4.2–11.2 %). Obesity prevalence was highest in blacks and Hispanics, and lowest in Asians (blacks 33.3 %; Hispanics 28.8 %; Asians 9.0 %; p < 0.001). Obesity prevalence was associated with lower education level, lower income, and unemployment status. After adjustments for age, sex, co morbidities, and surrogates of socioeconomic status, the increased risk of obesity in blacks and Hispanics persisted (blacks OR 1.51; Hispanics OR 1.18), whereas Asians were less likely to be obese (OR 0.37). While the overall prevalence of obesity increased from 1985 to 2011, significant racial/ethnic disparities in obesity have developed, with the highest prevalence seen in blacks and Hispanics, and the lowest seen in Asians.

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References

  1. Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA, 307(5), 483–490.

    Article  PubMed  Google Scholar 

  2. Flegal, K. M., Carroll, M. D., Kit, B. K., & Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA, 307(5), 491–497.

    Article  PubMed  Google Scholar 

  3. Ogden, C. L., Lamb, M. M., Carroll, M. D., & Flegal, K. M. (2010). Obesity and socioeconomic status in adults: United States, 2005–2008. NCHS Data Brief, 50, 1–8.

    PubMed  Google Scholar 

  4. Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. (2010). Prevalence and trends in obesity among US adults, 1999–2008. JAMA, 303(3), 235–241.

    Article  CAS  PubMed  Google Scholar 

  5. Flegal, K. M., Carroll, M. D., Kuczmarski, R. J., & Johnson, C. L. (1998). Overweight and obesity in the United States: Prevalence and trends, 1960–1994. International Journal of Obesity and Related Metabolic Disorders, 22(1), 39–47.

    Article  CAS  PubMed  Google Scholar 

  6. Adams, K. F., Schatzkin, A., Harris, T. B., et al. (2006). Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. New England Journal of Medicine, 355(8), 763–778.

    Article  CAS  PubMed  Google Scholar 

  7. Must, A., Spadano, J., Coakley, E. H., Field, A. E., Colditz, G., & Dietz, W. H. (1999). The disease burden associated with overweight and obesity. JAMA, 282(16), 1523–1529.

    Article  CAS  PubMed  Google Scholar 

  8. Flegal, K. M., Graubard, B. I., Williamson, D. F., & Gail, M. H. (2007). Impact of smoking and preexisting illness on estimates of the fractions of deaths associated with underweight, overweight, and obesity in the US population. American Journal of Epidemiology, 166(8), 975–982.

    Article  PubMed  Google Scholar 

  9. Stewart, S. T., Cutler, D. M., & Rosen, A. B. (2009). Forecasting the effects of obesity and smoking on US life expectancy. New England Journal of Medicine, 361(23), 2252–2260.

    Article  CAS  PubMed  Google Scholar 

  10. Jee, S. H., Sull, J. W., Park, J., et al. (2006). Body-mass index and mortality in Korean men and women. New England Journal of Medicine, 355(8), 779–787.

    Article  CAS  PubMed  Google Scholar 

  11. Isomaa, B., Almgren, P., Tuomi, T., et al. (2001). Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care, 24(4), 683–689.

    Article  CAS  PubMed  Google Scholar 

  12. Kiernan, M., & Winkleby, M. A. (2000). Identifying patients for weight-loss treatment: An empirical evaluation of the NHLBI obesity education initiative expert panel treatment recommendations. Archives of Internal Medicine, 160(14), 2169–2176.

    Article  CAS  PubMed  Google Scholar 

  13. Haffner, S. M., D’Agostino, R., Saad, M. F., et al. (1996). Increased insulin resistance and insulin secretion in nondiabetic African-Americans and Hispanics compared with non-Hispanic whites. The Insulin Resistance Atherosclerosis Study. Diabetes, 45(6), 742–748.

    CAS  Google Scholar 

  14. Haffner, S. M., Stern, M. P., Hazuda, H. P., Mitchell, B. D., & Patterson, J. K. (1990). Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA, 263(21), 2893–2898.

    Article  CAS  PubMed  Google Scholar 

  15. Brown, C. D., Higgins, M., Donato, K. A., et al. (2000). Body mass index and the prevalence of hypertension and dyslipidemia. Obesity, 8(9), 605–619.

    Article  CAS  Google Scholar 

  16. Droyvold, W. B., Midthjell, K., Nilsen, T. I., & Holmen, J. (2005). Change in body mass index and its impact on blood pressure: A prospective population study. International Journal of Obesity (London), 29(6), 650–655.

    Article  CAS  Google Scholar 

  17. US Census Bureau: State and County QuickFacts. Data derived from Population Estimates, American Community Survey, Census of Population and Housing, State and County Housing Unit Estimates, County Business Patterns, Nonemployer Statistics, Economic Census, Survey of Business Owners, Building Permits. http://www.census.gov/. Accessed 3 July 2013.

  18. The Center for Continuing Study of the California Economy. http://www.ccsce.com/index.php. Accessed 3 July 2013.

  19. Davis, B., Induni, M., & Gutierrez, M. (2012).California behavioral risk factor survey SAS dataset documentation and technical report: 1984–2011. Survey Research Group, California Department of Public Health.

  20. Waksberg, J. S. (1978). Sampling methods for random digit dialing. Journal of American Statistical Association, 73, 40–46.

    Article  Google Scholar 

  21. Flegal, K. M., Shepherd, J. A., Looker, A. C., et al. (2009). Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. American Journal of Clinical Nutrition, 89(2), 500–508.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Bouchard, D. R., Porneala, B., Janssen, I., et al. (2013). Risk of type 2 diabetes and cumulative excess weight exposure in the Framingham Offspring Study. Journal of Diabetes and its Complications, 27(3), 214–218.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Sung, K. C., Jeong, W. S., Wild, S. H., & Byrne, C. D. (2012). Combined influence of insulin resistance, overweight/obesity, and fatty liver as risk factors for type 2 diabetes. Diabetes Care, 35(4), 717–722.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Beltrán-Sánchez H, Harhay MO, Harhay MM, McElligott S. (2013). Prevalence and trends of metabolic syndrome in the adult US population, 1999–2010. Journal of the American College of Cardiology PMID: 23810877.

  25. Esposito K, Chiodini P, Capuano A, et al. (2013) Colorectal cancer association with metabolic syndrome and its components: A systematic review with meta-analysis. Endocrine. PMID: 23546613.

  26. Bardou, M., Barkun, A. N., & Martel, M. (2013). Obesity and colorectal cancer. Gut, 62(6), 933–947.

    Article  CAS  PubMed  Google Scholar 

  27. Turati, F., Talamini, R., Pelucchi, C., et al. (2013). Metabolic syndrome and hepatocellular carcinoma risk. British Journal of Cancer, 108(1), 222–228.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Reeves, K. W., McLaughlin, V., Fredman, L., Ensrud, K., & Cauley, J. A. (2012). Components of metabolic syndrome and risk of breast cancer by prognostic features in the study of osteoporotic fractures cohort. Cancer Causes and Control, 23(8), 1241–1251.

    Article  PubMed Central  PubMed  Google Scholar 

  29. National Center for Health Statistics. Centers for Disease Control and Prevention. http://www.cdc.gov/nchs/fastats/lcod.html. Accessed 9 July 2013.

  30. Jackson, C. L., Szklo, M., Yeh, H. C., et al. (2013). Black-white disparities in overweight and obesity trends by educational attainment in the United States, 1997–2008. Journal of Obesity, 2013, 140743.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Taveras, E. M., Gillman, M. W., Kleinman, K. P., Rich-Edwards, J. W., & Rifas-Shiman, S. L. (2013). Reducing racial/ethnic disparities in childhood obesity: The role of early life risk factors. JAMA Pediatrics, 3, 1–7.

    Google Scholar 

  32. Kershaw, K. N., Albrecht, S. S., & Carnethon, M. R. (2013). Racial and ethnic residential segregation, the neighborhood socioeconomic environment, and obesity among blacks and Mexican Americans. American Journal of Epidemiology, 177(4), 299–309.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Zhang, H., & Rodriguez-Monguio, R. (2012). Racial disparities in the risk of developing obesity-related diseases: A cross-sectional study. Ethnicity and Disease, 22(3), 308–316.

    PubMed  Google Scholar 

  34. Ghirardelli, A., Quinn, V., & Foerster, S. B. (2010). Using geographic information systems and local food store data in California’s low-income neighborhoods to inform community initiatives and resources. American Journal of Public Health, 100(11), 2156–2162.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Acheampong, I., & Haldeman, L. (2013). Are nutrition knowledge, attitudes, and beliefs associated with obesity among low-income Hispanic and African American women caretakers? Journal of Obesity, 2013, 123901.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Jones-Smith, J. C., Gordon-Larsen, P., Siddiqi, A., & Popkin, B. M. (2012). Is the burden of overweight shifting to the poor across the globe? Time trends among women in 39 low- and middle-income countries (1991–2008). International Journal of Obesity (London), 36(8), 1114–1120.

    Article  CAS  Google Scholar 

  37. Babey, S. H., Hastert, T. A., Wolstein, J., & Diamant, A. L. (2010). Income disparities in obesity trends among California adolescents. American Journal of Public Health, 100(11), 2149–2155.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Aloia, J. F., Vaswani, A., Mikhail, M., & Flaster, E. R. (1999). Body composition by dual-energy X-ray absorptiometry in black compared with white women. Osteoporosis International, 10(2), 114–119.

    Article  CAS  PubMed  Google Scholar 

  39. Fernandez, J. R., Heo, M., Heymsfield, S. B., et al. (2003). Is percentage body fat differentially related to body mass index in Hispanic Americans, African Americans, and European Americans? American Journal of Clinical Nutrition, 77(1), 71–75.

    CAS  PubMed  Google Scholar 

  40. Rahman, M., Temple, J. R., Breitkopf, C. R., & Berenson, A. B. (2009). Racial differences in body fat distribution among reproductive-aged women. Metabolism, 58(9), 1329–1337.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  41. Kohli S, Lear SA. (2012). Differences in subcutaneous abdominal adiposity regions in four ethnic groups. Obesity (Silver Spring) PMID: 23703792.

  42. Nazare, J. A., Smith, J. D., Borel, A. L., et al. (2012). Ethnic influences on the relations between abdominal subcutaneous and visceral adiposity, liver fat, and cardiometabolic risk profile: The international study of prediction of intra-abdominal adiposity and its relationship with cardiometabolic risk/intra-abdominal adiposity. American Journal of Clinical Nutrition, 96(4), 714–726.

    Article  CAS  PubMed  Google Scholar 

  43. Palaniappan, L. P., Wong, E. C., Shin, J. J., Fortmann, S. P., & Lauderdale, D. S. (2011). Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index. International Journal of Obesity (London), 35(3), 393–400.

    Article  CAS  Google Scholar 

  44. Van Hulst A, Gauvin L, Kestens Y, Barnett TA. (2013). Neighborhood built and social environment characteristics: A multilevel analysis of associations with obesity among children and their parents. International Journal of Obesity (London). PMID: 23736374.

  45. Slack T, Myers CA, Martin CK, Heymsfield SB. (2013). The geographic concentration of U.S adult obesity prevalence and associated social, economic, and environmental factors. Obesity (Silver Spring). PMID: 23630100.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Liver Transplant Program, Department of Medicine, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA

    Robert J. Wong, Christina Chou & Aijaz Ahmed

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  1. Robert J. Wong
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  2. Christina Chou
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  3. Aijaz Ahmed
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Correspondence to Aijaz Ahmed.

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Wong, R.J., Chou, C. & Ahmed, A. Long Term Trends and Racial/Ethnic Disparities in the Prevalence of Obesity. J Community Health 39, 1150–1160 (2014). https://doi.org/10.1007/s10900-014-9870-6

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  • DOI: https://doi.org/10.1007/s10900-014-9870-6

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