Urban-rural differences in BMI in low- and middle-income countries: the role of socioeconomic status
Urban-rural differences in BMI in low- and middle-income countries: the role of socioeconomic status
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DOI：
10.3945/ajcn.112.045997
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发表时间：
2013-02-01
影响因子：
7.1
通讯作者：
Subramanian, S. V.
中科院分区：
文献类型：
--
作者：
Neuman, Melissa;Kawachi, Ichiro;Subramanian, S. V.
背景资料：城市化通常被认为是中低收入国家（LMICs）BMI增加的主要原因，而LMICs的城市居民往往比农村居民拥有更高的BMI。然而，城乡差异可能是由社会经济地位（SES）的差异驱动的。目的：使用在38个LMIC的2个时间点收集的全国代表性数据，我们评估了调整个人和家庭水平SES措施前后城市居住和BMI之间的关联。设计：我们对678，471名年龄在15-49岁之间的非妊娠女性的全国代表性样本进行了横断面分析，其中225名，在1991年至2004年进行的前一轮调查中，有312名妇女，在1998年至2010年进行的后一轮调查中，有453 159名妇女。我们使用具有国家固定效应的线性和有序多项式分析来获得汇总估计和国家分层分析。结果：我们发现欠发达国家的平均BMI（kg/m（2））在城市地区通常较高（财富指数调整前与城市居住相关的BMI过高：1.55; 95%CI：1.52，1.57）。然而，考虑SES后，城市关联减弱（调整后的关联：0.44; 95%CI：0.41，0.47）。个人和家庭层面的SES措施独立和正相关的BMI.Conclusion：城市居住和肥胖之间的关联在LMICs主要是由较高的个人和社区层面的SES在城市地区，这表明，城市居住可能不会导致体重增加在发展中国家。美国临床营养杂志2013;97：428-36。
Background: Urbanization is often cited as a main cause of increasing BMIs in low-and middle-income countries (LMICs), and urban residents in LMICs tend to have higher BMIs than do rural residents. However, urban-rural differences may be driven by differences in socioeconomic status (SES).bjective: Using nationally representative data collected at 2 time points in 38 LMICs, we assessed the association between urban residence and BMI before and after adjustment for measures of individual-and household-level SES.Design: We conducted a cross-sectional analysis of nationally representative samples of 678,471 nonpregnant women aged 15-49 y, with 225,312 women in the earlier round of surveys conducted between 1991 and 2004 and 453,159 women in the later round conducted between 1998 and 2010. We used linear and ordered multinomial analysis with a country fixed effect to obtain a pooled estimate and a country-stratified analysis.Results: We found that mean BMI (kg/m(2)) in less-developed countries was generally higher within urban areas (excess BMI associated with urban residence before wealth index adjustment: 1.55; 95% CI: 1.52, 1.57). However, the urban association was attenuated after SES was accounted for (association after adjustment: 0.44; 95% CI: 0.41, 0.47). Individual-and household-level SES measures were independently and positively associated with BMI.Conclusion: The association between urban residence and obesity in LMICs is driven largely by higher individual-and community-level SES in urban areas, which suggests that urban residence alone may not cause increased body weight in developing countries. Am J Clin Nutr 2013;97:428-36.