Obesity, confidant support and functional health: cross-sectional evidence from the EPIC-Norfolk cohort

Abstract

OBJECTIVE:To investigate the association between body mass index (BMI) and functional health according to age and the support available from a close confidant. DESIGN: A cross-sectional population-based study. PARTICIPANTS: A total of 20 921 participants in the European Prospective Investigation into Cancer and Nutrition, aged 41-80 y resident in Norfolk, England. MEASUREMENTS: Standardised clinic-based assessment of BMI, self-reported functional health status assessment (according to the anglicised Short Form 36 (SF-36) Health Survey questionnaire) and the availability (and quality) of a close confiding relationship. RESULTS: Self-reported physical functioning declined steadily with increasing age. Obesity (BMI Z30) was strongly associated with self-reported physical functional health, equivalent to being 11 y older for men and 16 y older for women (after adjustment that included prevalent chronic physical conditions and cigarette smoking). This adverse effect of obesity on physical functional health was found to increase with age for both men and women. Perceived inadequacy of a confiding relationship was associated with reduced physical functional capacity, equivalent to being 4 y older for men and 5 y older for women. For those with markedly inadequate confidant relationships, the impact of obesity on physical functional capacity was approximately constant by age. For those not critical of the adequacy of their confiding relationships, the impact of obesity was least for those younger but rose to equivalent levels as those with markedly inadequate confidant relationships among older participants. CONCLUSIONS: The availability of a close confidant relationship (perceived as uncritical and characterised by the absence of shared negative interactions) may delay the impact of obesity in reducing physical functional capacity.

Respiratory function and self-reported functional health: EPIC-Norfolk population study

“…The study population's observed summary scores for functional health outcome are comparable with two other UK studies, the health survey for England and the Omnibus Survey in Great Britain, but with a slightly lower mean PCS score compared with the Oxford Health Life Survey (OHLS) [42]. However, OHLS comprises a younger cohort and the mean observed scores for the younger (41-65 yrs) EPIC-HLEQ cohort and expected mean scores age-sex standardised to population norms from OHLS were similar [44]. It is likely that the current study population had a narrow range of physical and mental health than would be expected in a general population, as those who were severely compromised physically or mentally would be less likely to participate in the study contributing some selection bias towards healthier people.…”

Fruit and vegetable consumption and self-reported functional health in men and women in the European Prospective Investigation into Cancer–Norfolk (EPIC–Norfolk): a population-based cross-sectional study

“…Nevertheless, the characteristics of this population are comparable with national samples, except for a slightly lower prevalence of smokers 18 , and there was still a wide range of social class and educational status. Moreover, comparison between EPIC-HLEQ mean SF-36 scores and mean scores of age -sex standardised to UK population norms from the Health Survey for England, the Omnibus Survey in Great Britain and the Oxford Healthy Life Survey showed comparable results 21 . In all models, the variables were included simultaneously with quartiles of total fruit and vegetables categories.…”

“…They were created by aggregating across the eight SF-36 subscales after transforming to Z-scores and multiplying by their respective factor score coefficients and standardised as T-scores with mean of 50 and standard deviation (SD) of 10 21 .…”

Occupational social class, risk factors and cardiovascular disease incidence in men and women: a prospective study in the European Prospective Investigation of Cancer and Nutrition in Norfolk (EPIC-Norfolk) cohort

“…It is possible that we may have selected a health conscious study cohort, particularly in the lower social classes, and thus there may be some attenuation of the socioeconomic differential in our results. However the range of socioeconomic circumstances of the participants was wide [12,48], and in terms of anthropometric variables, serum lipids and blood pressure [11] and of physical and mental functional health [49], the cohort was similar to the general resident population in England, although there were fewer current smokers. Selection of a more health conscious cohort would mean that the external generalisability of the study results may be affected, but the internal validity of the study results should not be affected.…”