Overweight, obesity and fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) | Public Health Nutrition | Cambridge Core (original) (raw)

Abstract

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Objective:

To describe anthropometric characteristics of participants of the European Prospective Investigation into Cancer and Nutrition (EPIC).

Design:

A cross-sectional analysis of baseline data of a European prospective cohort study.

Subjects:

This analysis includes study populations from 25 centres in nine European countries. The British populations comprised both a population-based and a ‘health-conscious’ group. The analysis was restricted to 83 178 men and 163 851 women aged 50–64 years, this group being represented in all centres.

Methods:

Anthropometric examinations were undertaken by trained observers using standardised methods and included measurements of weight, height, and waist and hip circumferences. In the ‘health-conscious’ group (UK), anthropometric measures were predicted from self-reports.

Results:

Except in the ‘health-conscious’ group (UK) and in the French centres, mean body mass index (BMI) exceeded 25.0 kg m-2. The prevalence of obesity (BMI≥30 kg m-2) varied from 8% to 40% in men, and from 5% to 53% in women, with high prevalences (>25%) in the centres from Spain, Greece, Ragusa and Naples (Italy) and the lowest prevalences (<10%) in the French centres and the ‘health-conscious’ group (UK). The prevalence of a large waist circumference or a high waist-to-hip ratio was high in centres from Spain, Greece, Ragusa and Naples (Italy) and among women from centres in Germany and Bilthoven (The Netherlands).

Conclusions:

Anthropometric measures varied considerably within the EPIC population. These data provide a strong base for further investigation of anthropometric measures in relation to the risk of chronic diseases, especially cancer.

References

1World Health Organization (WHO). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. WHO Technical Report Series No. 894. Geneva: WHO, 2000.Google Scholar

2National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults – the evidence report. Obes. Res. 1998; 6(Suppl. 2): 51S–209S.Google Scholar

3Seidell, JC, Kahn, HS, Williamson, DF, Lissner, L, Valdez, R. Report from a Centers for Disease Control and Prevention Workshop on use of adult anthropometry for public health and primary care health care. Am. J. Clin. Nutr. 2001; 73: 123–6.CrossRefGoogle Scholar

4Seidell, JC. Obesity, insulin resistance and diabetes – a worldwide epidemic. Br. J. Nutr. 2000; 83(Suppl. 1): S5–8.CrossRefGoogle ScholarPubMed

5Rodriguez, C, Patel, AV, Calle, EE, Jacobs, EJ, Chao, A, Thun, MJ. Body mass index, height and prostate cancer mortality in two large cohorts of adult men in the United States. Cancer Epidemiol. Biomark. Prev. 2001; 10: 345–53.Google ScholarPubMed

6Hsing, AW, Deng, H, Sesterhenn, IA, Mostofi, FK, Stanczyk, FZ, Benichou, J, et al. Body size and prostate cancer: a population-based case–control study in China. Cancer Epidemiol. Biomark. Prev. 2000; 9: 1335–41.Google ScholarPubMed

7Ford, ES. Body mass index and colon cancer in a national sample of adult US men and women. Am. J. Epidemiol. 1999; 150: 390–8.CrossRefGoogle Scholar

8Caan, BJ, Coates, AO, Slattery, ML, Potter, JD, Quesenberry, CP Jr, Edwards, SM. Body size and the risk of colon cancer in a large case–control study. Int. J. Obes. Relat. Metab. Disord. 1998; 22: 178–84.CrossRefGoogle Scholar

9Goodman, MT, Hankin, JH, Wilkens, LR, Lyu, LC, McDuffie, K, Liu, LQ, et al. Diet, body size, physical activity, and the risk of endometrial cancer. Cancer Res. 1997; 57: 5077–85.Google ScholarPubMed

10Stoll, BA. Adiposity as a risk determinant for postmenopausal breast cancer. Int. J. Obes. Relat. Metab. Disord. 2000; 24: 527–33.CrossRefGoogle ScholarPubMed

11Sonnenschein, E, Toniolo, P, Terry, MB, Bruning, PF, Kato, I, Koenig, KL, et al. Body fat distribution and obesity in pre- and postmenopausal breast cancer. Int. J. Epidemiol. 1999; 28: 1026–33.CrossRefGoogle ScholarPubMed

12Van den Brandt, P, Spiegelman, D, Yuan, SS, Adami, HO, Beesom, L, Folsom, AR, et al. Pooled analysis of prospective cohort studies on height, weight and breast cancer risk. Am. J. Epidemiol. 2000; 152: 514–27.CrossRefGoogle ScholarPubMed

13Murphy, TK, Calle, EE, Rodriguez, C, Kahn, HS, Thun, MJ. Body mass index and colon cancer mortality in a large prospective study. Am. J. Epidemiol. 2000; 152: 847–54.CrossRefGoogle Scholar

14Huang, Z, Willet, WC, Colditz, GA, Hunter, DJ, Manson, JE, Rosner, B, et al. Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses’ Health Study. Am.J.Epidemiol. 1999; 150: 1316–24.CrossRefGoogle ScholarPubMed

15Vainio, H, Bianchini, F, Cheney, J, eds. IARC Handbook of Cancer Prevention.Vol.6.Weight Control and Physical Activity. Lyon: IARC Press, 2002.Google Scholar

16Chow, WH, Gridley, G, Fraumeni, JF, Jarvholm, B. Obesity, hypertension and the risk of kidney cancer in men. N.Engl.J.Med. 2000; 343(18): 1305–11.CrossRefGoogle ScholarPubMed

17Chow, WH, Blot, WJL, Vaughan, TL, Risch, HA, Gammon, MD, Stanford, JL, et al. Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J.Natl.Cancer Inst. 1998; 90: 150–5.CrossRefGoogle ScholarPubMed

18Rimm, EB, Stampfer, MJ, Giovannucci, E, Ascherio, A, Spiegelman, D, Colditz, GA, et al. Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am.J.Epidemiol. 1995; 141: 1117–27.CrossRefGoogle ScholarPubMed

19Visscher, TLS, Seidell, JC, Menotti, A, Blackburn, H, Nissinen, A, Feskens, EJM, et al. Underweight and overweight in relation to mortality among men aged 40–59 and 50–59 years. Am.J.Epidemiol. 2000; 151: 660–6.CrossRefGoogle Scholar

20Lahmann, PH, Lissner, L, Gullberg, B, Berglund, G. A prospective study of adiposity and all-cause mortality: The Malmö Diet and Cancer Study. Obes.Res. 2002; 10: 361–9.CrossRefGoogle Scholar

21Larsson, B, Svärdsudd, K, Welin, L, Wilhelmsen, L, Björntorp, P, Tibblin, G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13-year follow-up of participants in the study of men born in 1913. Br.Med.J. 1984; 288: 1401–4.CrossRefGoogle Scholar

22Hartz, AJ, Rupley, DC, Rimm, AA. The association of girth measurements with disease in 32,856 women. Am.J.Epidemiol. 1984; 119: 71–80.CrossRefGoogle ScholarPubMed

23Gupta, R, Majumdar, S. Correlation of waist–hip ratio with coronary heart disease and risk factor prevalence in a rural male population. Indian Heart J. 1994; 46: 145–8.Google Scholar

25Riboli, E, Hunt, KJ, Slimani, N, Ferrari, P, Norat, T, Fahey, M, et al. European Prospective Investigation into Cancer and Nutrition (EPIC) study: study populations and data collection. Public Health Nutr. 2002; 5(6B): 1113–24.CrossRefGoogle Scholar

26Lohman, TG, Roche, AF, Martorell, R. Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetics Books, 1991.Google Scholar

27De Groot, CPGM, Sette, S, Zajkás, G, Carbajal, A, Amorim Cruz, JA. Nutritional status: anthropometry. Eur.J.Clin.Nutr. 1991; 45(Suppl.3): 43–52.Google ScholarPubMed

28Lean, MEJ, Han, TS, Morrison, CE. Waist circumference as a measure for indicating need for weight management. Br.Med.J. 1995; 311: 158–61.CrossRefGoogle ScholarPubMed

29Slimani, N, Kaaks, R, Ferrari, P, Casagrande, C, Clavel-Chapelon, F, Lotze, G, et al. European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics. Public Health Nutr. 2002; 5(6B): 1125–45.CrossRefGoogle ScholarPubMed

30Molarius, A, Seidell, JC, Sans, S, Tuomilehto, J, Kuulasmaa, K. Waist and hip circumferences, and waist–hip ratio in 19 populations of the WHO MONICA Project. Int.J.Obes.Relat.Metab.Disord. 1999; 23: 116–25.CrossRefGoogle Scholar

31Gutiérrez-Fisac, JL, Banegas Banegas, JR, Rodriguez Artalejo, F, Regidor, E. Increasing prevalence of overweight and obesity among Spanish adults, 1987–1997. Int.J.Obes.Relat.Metab.Disord. 2000; 24: 1677–82.CrossRefGoogle ScholarPubMed

32Pagano, R, La Vecchia, C. Overweight and obesity in Italy, 1990–91. Int.J.Obes.Relat.Metab.Disord. 1994; 18: 665–9.Google ScholarPubMed

33Aranceta, J, Perez-Rodrigo, C, Serra-Majem, L, Ribas, L, Quiles Izquierdo, J, Vioque, J, et al. Spanish Collaborative Group for the Study of Obesity in Spain.Influence of sociodemographic factors in the prevalence of obesity in Spain.The SEEDO'97 study of obesity. Eur.J.Clin.Nutr. 2001; 55: 430–5.CrossRefGoogle Scholar

34Seidell, JC, Cigolini, M, Charzewska, J, Ellsinger, B-M, Di Biase, G. Fat distribution in European women: a comparison of anthropometric measurements in relation to cardiovascular risk factors. Int.J.Epidemiol. 1990; 19: 303–8.CrossRefGoogle ScholarPubMed

35Molarius, A, Seidell, JC. Selection of anthropometric indicators for classification of abdominal fatness – a critical review. Int.J.Obes. 1998; 22: 719–22.CrossRefGoogle ScholarPubMed

36Molarius, A, Seidell, JC, Sans, S, Tuomilehto, J, Kuulasmaa, K. Educational level, relative body weight and changes in their association over 10 years: an international perspective from the WHO MONICA project. Am.J.Public Health 2000; 90: 1260–8.Google ScholarPubMed

37Lahti-Koski, M, Pietinen, P, Mämmistö, S, Vartiainen, E. Trends in waist-to-hip ratio and its determinants in adults in Finland from 1987–1997. Am.J.Clin.Nutr. 2000; 72: 1436–1444.CrossRefGoogle Scholar

38Lissner, L, Björkelund, C, Heitmann, BL, Lapidus, L, Björntorp, P, Bengtsson, C. Secular increases in waist–hip ratio among Swedish women. Int.J.Obes.Relat.Metab.Disord. 1998; 22: 1116–20.CrossRefGoogle ScholarPubMed

39World Health Organization (WHO). WHO Health Report 2000. Geneva: WHO, 2000.Google Scholar