[ Diabetes Solutions ]

Adult obesity in Canada: Measured height and weight

The interactive map, created by The 10 and 3, combines seven health indicators from Statistics Canada’s 2013 Health Profile: asthma, diabetes, cancer, smoking, access to doctors, overweight population and mental health. We examined whether receipt of testing for colorectal, cervical and breast cancer, as well as diabetes and high cholesterol, differs by neighbourhood-level socio-economic and recent immigrant status. Oakoak now lives in Yellowknife, where she watches her diet, passing on dessert and opting not to cave in to a craving for pizza hot from an oven over lunch at a downtown women’s centre. Of the insulin initiators, 52% were female and 68% were aged ≥60 years. Prior to 2008 respondents were asked “Do you have arthritis or rheumatism, excluding fibromyalgia?” In 2008, the word “rheumatism” was removed from the question. A substantial proportion of South Asian (18%) and white (9%) women had serum Mg 10 h). Self-reported hypertension prevalence has increased by approximately 2-fold over nearly 2 decades.

High waist circumference was the most prevalent risk factor (92%) and high blood pressure was the least prevalent (58%) (Chart 2). Sleep apnea is associated with serious health conditions that include: hypertension, ischemic heart disease, irregular heart beat, heart failure, cerebrovascular disease, depression, and type 2 diabetes. When those who were classified as obese were combined with those who were overweight, 61.8% of men (8.2 million) and 46.2% of women (6.1 million)  had an increased health risk because of excess weight. The obesity rate of every age group except 65 to 74 rose during this period (Chart 1). The most striking increases were among people younger than 35 and 75 or older. The paradoxical finding that South Asians had a high diabetes incidence but low mortality calls for further studies to clarify the underlying mechanisms of risk and outcome differences. Quality of care and outcomes in Type 2 diabetic patients: a comparison between general practice and diabetes clinic.

The selected respondent must answer the survey. In 2004, men and women were equally likely to be obese: 22.9% and 23.2%, respectively. Bortolin said no matter what the data shows, the way to a healthier community is to encourage activity as part of daily life — not just for fun. A higher percentage of women than men were in Class III (Table 1, Chart 3). For both sexes, obesity rates were lowest at ages 18 to 24 (10.7% of men and 12.1% of women), and peaked around 30% among 45- to 64-year-olds (Chart 4). The percentage of seniors who were obese was lower at about 25%. With a few notable exceptions, obesity rates did not vary greatly by province (Chart 5).

In 2004, men’s rate was significantly above the national level (22.9%) in Newfoundland and Labrador (33.3%) and Manitoba (30.4%). Women’s rate surpassed the national figure (23.2%) in Newfoundland and Labrador (34.5%), Nova Scotia (30.3%) and Saskatchewan (32.9%). While Canada’s obesity rates have, for the most part, been based on self-reported data, the United States has derived rates from actual measurements of height and weight since the early 1960s. Compared to the general adult population, Canadian adults who reported being diagnosed with sleep apnea were: 2.5 times more likely to report having diabetes; 1.8 times more likely to report hypertension; 2.2 times more likely to report heart disease; and, 2.2 times more likely to report a mood disorder such as depression, bipolar disorder, mania or dysthymia. http://www.statcan.gc.ca/pub/82-003-x/2008003/article/10680-eng.pdf. Most of this difference was attributable to the situation among women. Whereas 23.2% of Canadian women were obese, the figure for American women was 32.6%.

As well, each obesity category (Class I, II and III) accounted for a higher percentage of American than Canadian women (Table 3). Fisher ES, Wennberg DE, Stukel TA, et al. The obesity rate of Canadian men was 22.9%, significantly below the age-adjusted American rate of 26.7%. However, this was mainly a reflection of Class III obesity: American men were much more likely to have a BMI of 40 or more. The percentages of Canadian and American men whose BMI put them in Class I or II were statistically similar. American men aged 18 to 24, 35 to 44 and 65 to 74 were more likely than their Canadian counterparts to be obese (Chart 7). The racial make-up of the two countries might explain some of the differences, as research has shown that obesity rates vary by ethnic origin.13 Nonetheless, when obesity rates of White Americans and Canadians are compared, White women in the United States were significantly more likely than those in Canada to be obese: 30.3% versus 24.8% (Table 3) (see Definitions).

However, the percentages of White American and Canadian men who were obese did not differ. As might be expected, the likelihood of being obese was related to diet and exercise. Men and women who ate fruit and vegetables less than three times a day were more likely to be obese than were those who consumed such foods five or more times a day (Chart 8). Although other factors may be driving this relationship, the association persisted when age and socio-economic status were taken into account. Another study has also shown obesity to be independently associated with infrequent consumption of fruit and vegetables.14 However, because the CCHS data are cross-sectional, the direction of this relationship cannot be determined (see Limitations). Physical activity, too, was related to the prevalence of obesity. 4.

For example, 27.0% of sedentary men were obese, compared with 19.6% of active men. Among women, obesity rates were high not only for those who were sedentary, but also for those who were moderately active (Chart 9). These relationships remained statistically significant when adjustments were made to account for age and socio-economic status. Diabetes Medicine 23(4): 337. About a quarter of married men and women aged 25 or older were obese. The rate was significantly higher among women who were widowed (30.0%). By contrast, the percentages of married, separated/divorced, widowed and never-married men who were obese were not significantly different.

The association between education and obesity was not straightforward. Men aged 25 to 64 with no more than secondary graduation had significantly high obesity rates, compared with men who were postsecondary graduates (Chart 11). Among women, those with less than secondary graduation were more likely than postsecondary graduates to be obese. As well, the obesity rate of women who had some, but had not completed, postsecondary education was high. Men in lower-middle income households were less likely to be obese than were those in the highest income households. For women, those in middle and upper-middle income households had significantly elevated obesity rates, compared with women in the highest income households (Chart 12). When age was taken into account, the results for men persisted, but for women, only those in middle-income households had a significantly high obesity rate.

Being overweight or obese is a risk factor for a number of chronic conditions. Analysis of CCHS data reveals associations between excess weight and high blood pressure, diabetes, and heart disease. In 2004, less than 10% of men and women whose BMI was in the normal range reported having high blood pressure. The figure rose to just over 15% among those who were overweight, and to more than 20% among those who were obese (Chart 13, Table 4). Even when age, marital status, education, household income, smoking status and leisure-time physical activity were taken into account, excess weight was strongly associated with reporting high blood pressure (Table 5) (see Limitations). A high BMI is a risk factor for type 2 diabetes.15 Just 2.1% of men whose BMI was in the normal range reported having diabetes; the figure was 3.7% among overweight men, and almost tripled (to at least 11%) among those who were obese (Chart 14). The pattern was similar for women.

And even when the effects of the other factors were taken into consideration, men and women who were obese had significantly high odds of reporting diabetes (Table 5). The prevalence of heart disease increased with BMI among men. While 2.8% of men with a normal BMI reported having heart disease, the figure was 6.0% among men who were overweight and almost 8% among those who were obese (Chart 15). Even when age, marital status, education, household income, smoking, and leisure-time physical activity were taken into account, the association between BMI and heart disease among men remained (Table 5). For women, the prevalence of heart disease did not differ significantly by BMI, except for those in obese Class I who were slightly more likely to have it than were women whose BMI was in the normal range. But when the other demographic, socio-economic and lifestyle factors were considered, this relationship disappeared. The author thanks Wayne Millar for his help in producing the variance estimates for the 1978/79 Canada Health Survey and the 1999-2002 National Health and Nutrition Survey based on SUDAAN.

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