The spread of obesity in a large social network over 32 years
The spread of obesity in a large social network over 32 years
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DOI：
10.1056/nejmsa066082
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发表时间：
2007-07-26
影响因子：
158.5
通讯作者：
Fowler, James H.
中科院分区：
文献类型：
--
作者：
Christakis, Nicholas A.;Fowler, James H.
背景：在过去的30年里，肥胖症的流行程度大幅上升。我们对肥胖在人与人之间传播的性质和程度进行了量化分析，认为这可能是导致肥胖流行的一个因素。方法：作为弗雷明翰心脏研究的一部分，我们评估了1971年至2003年重复评估的由12067人组成的紧密相连的社会网络。所有受试者的体重指数均可获得。我们使用纵向统计模型来检验一个人的体重增加是否与他或她的朋友、兄弟姐妹、配偶和邻居的体重增加有关。结果：肥胖人群(体重指数[体重除以身高的平方，米]，大于或等于30)在所有时间点都存在于网络中，并且集群扩展到三个分离程度。这些群体似乎并不完全归因于肥胖者之间有选择地形成社会关系。如果一个人的朋友在给定的时间间隔内变胖，他或她变胖的几率增加57%(95%可信区间[CI]，6到123)。在成对的成年兄弟姐妹中，如果一个兄弟姐妹变得肥胖，另一个变得肥胖的机会增加40%(95%可信区间，21到60)。如果一方肥胖，另一方肥胖的可能性增加37%(95%可信区间为7至73)。这些影响在邻近地理位置的邻居中看不到。同性别的人对彼此的影响相对较大。结论：网络现象似乎与肥胖的生物学和行为学特征有关，肥胖似乎是通过社会关系传播的。这些发现对临床和公共卫生干预具有重要意义。
ackground: The prevalence of obesity has increased substantially over the past 30 years. We performed a quantitative analysis of the nature and extent of the person-to-person spread of obesity as a possible factor contributing to the obesity epidemic.Methods: We evaluated a densely interconnected social network of 12,067 people assessed repeatedly from 1971 to 2003 as part of the Framingham Heart Study. The body-mass index was available for all subjects. We used longitudinal statistical models to examine whether weight gain in one person was associated with weight gain in his or her friends, siblings, spouse, and neighbors.Results: Discernible clusters of obese persons (body-mass index [the weight in kilograms divided by the square of the height in meters], greater/equal 30) were present in the network at all time points, and the clusters extended to three degrees of separation. These clusters did not appear to be solely attributable to the selective formation of social ties among obese persons. A person's chances of becoming obese increased by 57% (95% confidence interval [CI], 6 to 123) if he or she had a friend who became obese in a given interval. Among pairs of adult siblings, if one sibling became obese, the chance that the other would become obese increased by 40% (95% CI, 21 to 60). If one spouse became obese, the likelihood that the other spouse would become obese increased by 37% (95% CI, 7 to 73). These effects were not seen among neighbors in the immediate geographic location. Persons of the same sex had relatively greater influence on each other than those of the opposite sex. The spread of smoking cessation did not account for the spread of obesity in the network.Conclusions: Network phenomena appear to be relevant to the biologic and behavioral trait of obesity, and obesity appears to spread through social ties. These findings have implications for clinical and public health interventions.