The relative importance of socioeconomic indicators in explaining differences in BMI and waist:hip ratio, and the mediating effect of work control, dietary patterns and physical activity

Abstract

Socioeconomic differences in overweight are well documented, but most studies have only used one or two indicators of socioeconomic position (SEP). The aim of the present study was to explore the relative importance of indicators of SEP (occupation, education and income) in explaining variation in BMI and waist:hip ratio (WHR), and the mediating effect of work control and lifestyle factors (dietary patterns, smoking and physical activity). The Oslo Health Study, a cross-sectional study, was carried out in 2000-1, Oslo, Norway. Our sample included 9235 adult working Oslo citizens, who attended a health examination and filled in two complementary FFQ with , 20 % missing responses to food items. Four dietary patterns were identified through factor analysis, and were named 'modern', 'Western', 'traditional' and 'sweet'. In multivariate models, BMI and WHR were inversely associated with education (P,0·001/P, 0·001) and occupation (P¼ 0·002/P,0·001), whereas there were no significant associations with income or the work control. The 'modern' (P, 0·001) and the 'sweet' (P,0·001) dietary patterns and physical activity level (P, 0·001) were inversely associated, while the 'Western' dietary pattern (P,0·001) was positively associated with both BMI and WHR. These lifestyle factors could not fully explain the socioeconomic differences in BMI or WHR. However, together with socioeconomic factors, they explained more of the variation in WHR among men (21 %) than among women (7 %).

Dietary patterns associated with anthropometric indicators of abdominal fat in adults

“…The percentage of variance explained found in the three dietary patterns was consistent with that identified in other studies (for example Neumann et al 23 35.6%, and Cunha et al 24 34.9% ) and lower than the values observed by other studies, such as Sieri et al 13 (30%) and Kjøllesdal et al 25 (20%). While a positive association was observed between the "Western" and "regional traditional" dietary patterns and abdominal fat, no significant association was found between the "prudent" pattern and anthropometric indicators of abdominal fat.…”

“…Eating habits are influenced by cultural, social and demographic factors 9 . Lifestyle changes, socioeconomic factors and easy access to processed foods have all contributed to changes in eating habits over time leading to a high intake of protein, fat and refined carbohydrates 23,25,27 .…”

Central obesity is associated with lower intake of whole-grain bread and less frequent breakfast and lunch: results from the HUNT study, an adult all-population survey

“…The energy density of these dietary items may be a factor behind the associations. Our finding of a less frequent intake of chocolate and candy in people with central obesity, compared with those without central obesity, is in line with recent reports (Halkjaer et al 2009;Kjollesdal et al 2010;O'Neil et al 2011). Whether this finding can be explained as reverse causation is not known.…”

“…Dietary results reported in terms of body mass index (BMI) are not identical to those of waist circumference or waist/hip ratio (WHR) (Halkjaer et al 2006(Halkjaer et al , 2009Kahn et al 1997;Kjollesdal et al 2010;Krachler et al 2006;Newby et al 2003;Togo et al 2001). Central obesity is more closely related to metabolic and health parameters than BMI, as reported for cardiovascular disease (Lee et al 2008; van Dijk et al 2012), stroke (Walker et al 1996), type 2 diabetes (Wei et al 1997), and all-cause mortality (Bigaard et al 2005), especially among older adults (Price et al 2006;Srikanthan et al 2009).…”

Padrões alimentares estimados por técnicas multivariadas: uma revisão da literatura sobre os procedimentos adotados nas etapas analíticas

“…Concerning the criteria used to group the foods obtained from collecting food intake data (step before the input of data in the multivariate techniques), 22% (n = 42) used preexisting groups from the FFQ, 14% (n = 26) adopted as a criterion the nutritional composition, 26% (n = 46) did not present any information about the used criteria, and remaining 38% (n = 75) reported: official agencies/dietary 164,172,187,191,193,198,203,204) 168,170,[174][175][176]178,179,183,184,[186][187][188][190][191][192][193]198,199,204,205) On the basis of the names of the foods 25 (42) 14 (24) 143,144,148,156,160,162,163,169,171,172,181,182,185,192,194) PCA: principal component analysis; FA: factor analysis; RRR: reduced regression rank; CVD: cardiovascular diseases; FFQ: Food Frequency Questionnaire; 24HR: 24-hour dietary recall. *Combination of two or more criteria within the same characteristic.…”