Obesity in 70-year-old Swedes: Secular changes over 30 years

Abstract

OBJECTIVE: Secular increases in obesity have been widely reported in middle-aged adults, but less is known about such trends among the elderly. The primary purpose of this paper is to document the most recent wave of the obesity epidemic in population-based samples of 70-y-old men and women from Göteborg. Additionally, we will investigate the influences of physical activity, smoking and education on these secular trends. POPULATIONS AND METHODS: Five population-based samples of 3702 70-y-olds (1669 men and 2033 women) in Göteborg, Sweden, born between 1901 and 1930, were examined in the Gerontological and Geriatric Population Studies (H70) between 1971 and 2000. Cohort differences in anthropometric measures were the main outcomes studied. Physical activity, smoking habits and education were assessed by comparable methods in all cohorts. Subsamples of the women in the latest two cohorts (birth years 1922 and 1930) were also part of the Prospective Population Study of Women in Göteborg. In these women, it was possible to examine body mass index (BMI) and waist-to-hip circumference ratio (WHR) longitudinally since 1968. RESULTS AND CONCLUSIONS: Significant upward trends were found for height, weight, BMI, waist circumference (WC), WHR, prevalence of overweight (BMIZ25 kg/m 2 ) and obesity (BMIZ30 kg/m 2 ) across cohorts in both sexes. In 2000, 20% of the 70-y-old men born in 1930 were obese, and the largest increment (almost doubling) had occurred between the early 1980s and the early 1990s. In 70-y-old women the prevalence of obesity was 24% in 2000, a 50% increase compared to the cohort born 8 y earlier. BMI increased over time in all physical activity, smoking and education groups, with the exception of neversmoking men. Although 70-y-old women in 2000 were heavier than cohorts examined 8 y previously, data from the women studied longitudinally revealed that these differences were already present in earlier adulthood. In conclusion, the elderly population is very much part of the obesity epidemic, although secular trends in BMI were detected slightly earlier in men than in women. The health implications of these secular trends should be focused on in future gerontological research.

Birth cohort differences in anthropometric measures in the older elderly: the Bambuí cohort study of aging (1997 and 2008)

“…In both 1997 and 2008, prevalence of overweight (BMI ≥ 27kg/m 2 ) was greater among women (37.3% in 1997 and 38.9% in 2008) than among men in the same years (respectively, 16% and 32.7%). Comparable prevalences were also even encountered in studies that used different classifications for overweight/obesity in older adults, such as Eiben et al 23 , which considered obesity as given by BMI ≥ 30kg/m 2 , and Menezes & Marucci 24 , which assessed overweight/obesity in terms of BMI percentiles. It is argued that such differences are probably due to biological considerations relating to men's greater tendency to accumulate lean mass and, among women, relating to menopause accompanied by increased weight and adiposity 3 .…”

“…A study in Finland on BMI trend by birth cohort demonstrated that obesity affected middle-aged men more, but had limited impact on women: from 1972 to 1997, BMI was observed to increase 1.96 units among men and only 0.32 among women 28 . In that same direction, a study in Sweden of a population in their 70s, born between 1901 and 1930, investigating differences in anthropometric measurements among different cohorts, found higher mean weight, BMI, WC, prevalence of overweight (BMI ≥ 25kg/m 2 ) and obesity (BMI ≥ 30kg/ m 2 ) in more recent cohorts for both sexes, although the impact was greater among the men 23 . As in our study, however, other authors studying different birth cohorts have identified differences in BMI among men only 29,30 .…”

“…Despite the scarcity of international and Brazilian studies examining the evolution of body composition over time 5,6,7,21,22 , particularly in the elderly population 23 , some comparisons can be made. The findings of this study are consistent with the literature as regards the greater prevalence of overweight and obesity among women.…”

“…Considering that schooling 12 and sex 23,24 are associated with nutritional status, the anthropometric profile of the study population was ascertained in two birth cohorts (1916-1926 and 1927-1937), and adjusted for sex and years of schooling.…”

Secular trends in diet among elderly Swedes – cohort comparisons over three decades

“…Our most recent data on later-born 70-year-olds are reassuring in the sense that most subjects appear adequately nourished and even better off than earlier-born cohorts. However, a worrying trend towards increasing overweight was also observed, particularly in men 19 .…”