Do associations between education and obesity vary depending on the measure of obesity used? A systematic literature review and meta-analysis

Abstract

Background Consistent evidence suggests a relationship between lower educational attainment and total obesity defined using body mass index (BMI); however, a comparison of the relationships between educational attainment and total obesity (BMI ≥30 kg/m 2 ) and central obesity (waist circumference (WC) > 102 cm for men and WC > 88 cm for women) has yet to be carried out. This systematic literature review (SLR) and meta-analyses aimed to understand whether i) the associations between education and obesity are different depending on the measures of obesity used (BMI and WC), and ii) to explore whether these relationships differ by gender and region. Methods Medline, Embase and Web of Science were searched to identify studies investigating the associations between education and total and central obesity among adults in the general population of countries in the Organisation for Economic Co-operation and Development (OECD). Meta-analyses and meta-regression were performed in a subset of comparable studies (n=36 studies; 724,992 participants). Results 86 eligible studies (78 cross-sectional and eight longitudinal) were identified. Among women, most studies reported an association between a lower education and total and central obesity. Among men, there was a weaker association between lower education and central than total obesity (OR central vs total obesity in men 0.79 (95% CI 0.60, 1.03)). The association between lower education and obesity was stronger in women compared with men (OR women vs men 1.66 (95% CI 1.32, 2.08)). The relationship between lower education and obesity was less strong in women from Northern than Southern Europe (OR Northern vs Southern Europe in women 0.37 (95% CI 0.27, 0.51)), but not among men. Conclusions Associations between education and obesity differ depending on whether total or central obesity is used among men, but not in women. These associations are stronger among women than men, particularly in Southern European countries.

The level of students’ physical development depending on the ethno-territorial variability of morpho-functional features

“…Such difference can be explained by the level of education of our sample. It's approved that prevalence of obesity significantly decreased with level of education [34,35].…”

Dietary acrylamide and incident osteoporotic fractures: an 8-year prospective cohort study

“…These findings were expected, since in this study a high acrylamide intake reflects a propensity to an unhealthy diet, rich in fried and roasted food, common in North American obese people and in younger populations [ 29 – 31 ]. Moreover, it has been reported that North American women more frequently consume healthy food such as vegetables and fruits than men [ 32 ] and that there is a strong consistent relationship between low socio-economic factors, as low scholar education, in early life and increased obesity in adulthood [ 33 ]. Furthermore, diets rich in fruit and vegetables have been shown to decrease the risk of the incidence of hip fractures [ 34 , 35 ].…”

The association between lower socioeconomic position and functional limitations is partially mediated by obesity in older adults with symptomatic knee osteoarthritis: Findings from the English Longitudinal Study of Ageing

“…Obese knee OA patients also have a higher need for knee JRS ( 20 ) and at a younger age ( 21 ) than non-obese knee OA patients. As the association between SEP and obesity is gender specific ( 22 ), the mediating effect of obesity for the relationship between SEP and OA disease progression may also differ by gender. Longitudinal studies are needed to understand how SEP and obesity interact in the progression of OA over time.…”