Waist circumference (WC), body mass index (BMI), and disability among older adults in Latin American and the Caribbean (LAC)

Abstract

Purpose To examine the association between waist circumference (WC) and body mass index (BMI) on disability among older adults from Latin America and the Caribbean. Methods Cross-sectional, multicenter city study of 5,786 subjects aged 65 years and older from the Health, Well-Being and Aging in Latin America and the Caribbean Study (SABE) (1999-2000). Sociodemographic variables, smoking status, medical conditions, BMI, WC, and activities of daily living (ADL) were obtained. Results Prevalence of high WC (>88 cm) in women ranged from 48.5% (Havana) to 72.7% (Mexico City), while among men (>102 cm) it ranged from 12.5% (Bridgetown) to 32.5% (Santiago). The associations between WC and ADL disability were “J” shaped, with higher risks of ADL disability observed above 110 cm for women in Bridgetown, Santiago, Havana, and Montevideo. The association in Sao Paulo is plateau with higher risk above 100 cm, and the association in Mexico City is closer to linear. Among men the associations were “U” (Bridgetown, Sao Paulo, and Havana), “J” shaped (Montevideo), plateau (Santiago), and closer to linear in Mexico City (Figure 3). When WC and BMI were analyzed together, we found that participants from Sao Paolo, Santiago, Havana, and Montevideo in the overweight or obese category with high WC were significantly more likely to report ADL disability after adjusting for all covariates. Conclusion The findings of this study suggests that both general and abdominal adiposity are associated with disability and support the use of WC in addition to BMI to assess risk of disability in older adults.

Twelve-year weight change, waist circumference change and incident obesity: The Australian diabetes, obesity and lifestyle study

“…This is not surprising as the majority of participants with a BMI in the obese range also had a high risk WC although a significant proportion with a high risk WC had BMI in the normal and overweight range (Appendix, Supporting Information). This discordance between WC and BMI has been poorly described by others in the literature (25)(26)(27). One Australian study found that 6.5% of men and 22% of women aged 18-65 years with acceptable BMI (<25 kg/m 2 ) had excessive WC ( 94 cm for men and 80 cm for women) (25).…”

Social determinants of breast cancer in the Caribbean: a systematic review

“…Proportion and regression for obesity across monthly income: <1000 (32.5%, reference), 1000–3000 (26.1%, OR 0.75, 95% CI 0.50-1.13), 3001–6000 (41.8%, OR 1.83, 95% CI 1.19–2.80), >6000 (34.4%, OR 1.66, 0.95–2.92). Multivariate ORs comparing prevalence in women above vs below the poverty line were significant for overweight and obesity.Morales, 2013 [66]Case–control1,12621+PopulationPuerto Rico/Education C /Regression for breast cancer: grades 1–8 (crude OR 5.77, 95% CI 2.9-11.7; adjusted OR 3.38, 95% CI 1.5-5.7; p  = 0.003), grades 9–12 (crude OR 1.72, 95% CI 1.3–2.2; adjusted OR 1.33, 95% CI 0.9–1.9; p  = 0.086) (ref: associate or higher degree).Marital status C Regression for breast cancer: divorced (crude OR 3.59, 95% CI 2.1–5.8; adjusted OR 2.57, 95% CI 1.4–4.4; p  = 0.002), single (crude OR 2.11, 95% CI 1.2–3.6; adjusted OR 1.36, 95% CI 0.7–2.6; p  = 0.421), widow (crude OR 2.74, 95% CI 1.5–5.0; adjusted OR 2.08, 95% CI 1.1–4.0; p  = 0.039) (ref: married).Nam, 2012 [55] (a)Cross-sectional5,78665+Region/communityBarbados, CubaEducation O //Barbados: Mean years of education: low waist circumference (5.1 ± 0.2), high waist circumference (5.2 ± 0.2). p  > 0.01.…”

“…Proportions and CI obesity: Hispanic white (43.5%, 26.5–61.4), Hispanic black (35.6%, 23.0–48.2), nonhispanic black immigrant (44.3%, 37.9–50.7), nonhispanic black USVI-born (38.8%, 29.9–47.7).van Leeuwaarde, 2011 [70]Registry-based/(all)PopulationSuriname/Ethnicity I /Proportions and incidence rates (per 100,000 per year) of breast cancer: Creole (37.2%, 35.7), Maroons (1.9%, 2.2), Hindu (29.4%, 18.2), Javanese (17.9%, 20.8), Chinese (1.9%, not given), mixed (7.4%, 10.1), Dutch (1.4%, not given), other (2.9%, not given). Note these proportions also reflect the ethnography of the general Suriname population.Varona, 2011 [45] (a)Cross-sectional22,85115+PopulationCubaIncome – perception of economic situationAge Alc //Proportions and CI of females consuming alcohol in past 30 days across age group: 15–19 (11.4%, 8.9–13.9), 20–39 (14.6%, 13.2–15.9), 40–59 (9.3%, 8.0–10.5), >59 (2.7%, 1.8–3.6).Education Alc Proportions and CI of females consuming alcohol in past 30 days: primary school (4.8%, 3.8–5.7), middle school (10.7%, 9.4–12.1), high school (13.9%, 12.4–15.4), university (13.2%, 10.8–15.7).Ethnicity Alc Proportions and CI of females consuming alcohol in past 30 days: white (8.2%, 7.3–9.0), mestizo (14.7%, 12.9–16.5), black (14.9%, 12.3–17.6).Income Alc Proportions and CI of females consuming alcohol in past 30 days: excellent (8.4%, 2.3–14.6), good (11.8%, 10.0–13.6), fair (10.2%, 9.2–11.1), poor (9.2%, 7.4–10.9), very poor (10.9%, 7.6–14.1).Marital status Alc Proportions and CI of females consuming alcohol in past 30 days: unmarried (14.1%, 12.3–16.0), married or cohabiting (10.0%, 9.0–10.9), divorced or separated (12.0%, 9.9–14.0), widowed (2.5%, 1.4–3.7).Occupation Alc Proportions and CI of females consuming alcohol in past 30 days: manager (18.8%, 13.8–23.7), administrator (14.7%, 10.5–18.8), upper-level technician (13.1%, 10.1–16.1), middle-level technician (12.6%, 10.0–16.1), labourer (14.0%, 10.5–17.2), service worker (16.0%, 13.2–18.8).• (a) - Articles are components of larger studies: (Block, [40]) - Grenada Heart Project [100] ; ((Blum, [41]), (Ohene, [44])) - Caribbean Youth Health Survey [101]; (Brathwaite, [47]) - 2001 Bahamas Living Conditions Survey [102] ; ((Nam, [55]), (Kim, [42])) – [Health, Wellbeing and Aging] [103]; (Dubois, [49]) - Jamaica Youth Risk and Resiliency Behaviour Survey of 2007 [104] ; (Ferguson, [50]) - Jamaica Birth Cohort [105] ; (Laborde, [53]) - Behavioral Risk Factor Surveillance System […”

“…• (a) - Articles are components of larger studies: (Block, [40]) - Grenada Heart Project [100] ; ((Blum, [41]), (Ohene, [44])) - Caribbean Youth Health Survey [101]; (Brathwaite, [47]) - 2001 Bahamas Living Conditions Survey [102] ; ((Nam, [55]), (Kim, [42])) – [Health, Wellbeing and Aging] [103]; (Dubois, [49]) - Jamaica Youth Risk and Resiliency Behaviour Survey of 2007 [104] ; (Ferguson, [50]) - Jamaica Birth Cohort [105] ; (Laborde, [53]) - Behavioral Risk Factor Surveillance System [106] ; (Mendez, [54]) - International Collaborative Study on Hypertension in Blacks [107] ; (Nemesure, [67]) - The Barbados National Cancer Study [67]; (Pérez-Ríos, [61]) - Puerto Rico Reproductive Health Survey [108] ; (Varona, [45]) – 2011 National Survey on Risk Factors and Chronic Diseases [109]• Social determinants listed under “Risk Factors” are designated as “Alc” for alcohol; “Bf” for limited breastfeeding; “O” for overweight/obesity; and “PI” for physical inactivity• Social determinants listed under “Frequency” are designated as “I” for incidence and “C” for numbers of cases• All social determinants listed under “Outcome” are examined by mortality…”

“…Studies examining education and occupation tended towards a negative relationship [47, 50–53, 55]. All but one study (examining elderly) reported overweight/obesity to be associated with lower levels of individual education [47, 50–53], as well as maternal and paternal education [50].…”