Obesity and its relation to cardiovascular disease risk factors in Canadian adults. Canadian Heart Health Surveys Research Group

B A Reeder, A Angel, M Ledoux, S W Rabkin, T K Young, L E Sweet
Canadian Medical Association Journal: CMAJ 1992 June 1, 146 (11): 2009-19

OBJECTIVE: To describe the distribution of weight and abdominal obesity among Canadian adults and to determine the association of obesity with other risk factors for cardiovascular disease.

DESIGN: Population-based cross-sectional surveys. Survey nurses administered a standard questionnaire and recorded two blood pressure measurements during a home visit. At a subsequent visit to a survey clinic two further blood pressure readings were made, anthropometric measurements recorded and a blood specimen taken for plasma lipid determination.

SETTING: Nine Canadian provinces, from 1986 to 1990.

PARTICIPANTS: A probability sample of 26,293 men and women aged 18 to 74 years was selected from the health insurance registration files of each province. Anthropometry was performed on 17,858 subjects.

OUTCOME MEASURES: Body mass index (BMI), ratio of waist to hip circumference (WHR), mean plasma lipid levels, prevalence of high blood pressure (diastolic greater than or equal to 90 mm Hg or patient on treatment) and self-reported diabetes mellitus.

MAIN RESULTS: The prevalence of obesity (BMI greater than or equal to 27) increased with age and was greater in men (35%) than in women (27%). Abdominal obesity was likewise higher in men and increased with both age and BMI. The prevalence of high blood pressure was greater in those with higher BMI, especially in those with a high WHR. Although total plasma cholesterol levels increased only modestly with BMI, levels of low density lipoprotein (LDL) cholesterol and triglycerides and the ratio of total cholesterol to high density lipoprotein (HDL) cholesterol increased steadily, while HDL-cholesterol decreased consistently with increasing BMI. High total cholesterol levels (greater than or equal to 5.2 mmol/L) were more prevalent among people with high BMI, especially those with a high WHR. The prevalence of diabetes increased with BMI among those 35 years or older, especially those with abdominal obesity. About half of men and two-thirds of women who were obese were trying to lose weight.

CONCLUSION: Obesity remains common among Canadian adults. There is a need for broad-based programs that facilitate healthy eating and activity patterns for all age groups. Health professionals should incorporate measurement of BMI and WHR into their routine examinations of patients to enhance their evaluation of health risk.

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