Obesity Prevalence by Age Group and 5-year Changes in Adults Residing in Rural Wisconsin

doi:10.1016/S0002-8223(00)00229-7

Journal of the American Dietetic Association

Volume 100, Issue 7, July 2000, Pages 784-790

https://doi.org/10.1016/S0002-8223(00)00229-7 Get rights and content

Abstract

Objective To estimate the prevalence of overweight and obesity and weight changes over a 5-year period in a rural adult population by age group.

Subjects Residents of Marinette County, Wis: 613 women and 352 men.

Methods Age, body weight, and height data were collected during October and December 1997 in a volunteer convenience sample of white men and women (aged 20 to 74 years). Age groups in 10-year increments were defined by age in 1992. Weights obtained from medical and employment records from 1992 by medical personnel, as well as self-reported weights, were recorded for 1992 to assess weight changes from 1992 to 1997.

Results In 1992 women and men had mean body weights of 72.1 and 88.4 kg, respectively. By 1997, the average weight for women in the same data set was 79.3 and that for men was 96.4 kg, a gain of 7.3 and 7.9 kg, respectively. For both women and men, those in the youngest age group (age 20 to 30 years) experienced the greatest 5-year increase in body weight: 11.0 and 12.1 kg, respectively; the next largest increase occurred in the second youngest group (age 30 to 40 years). The majority of the normal-weight subjects (58%, 229 of 393) moved into an overweight or obese category, the overweight and obese generally gained weight, and only 20 of 572 overweight or obese individuals moved from an unhealthful to a healthful body weight during the 5 years.

Applications/conclusions The data indicate a need for community-wide weight-gain prevention programs for young adult men and women in rural areas. Weight-reduction treatment programs should be geared toward older adults, as most have already attained an unhealthful weight, which is likely to increase. J Am Diet Assoc. 2000; 100:784-790.

Section snippets

Subjects

Marinette County has a population that is almost entirely white and predominantly of German, Polish, Scandinavian, French, and Irish ancestry (15). Seventy-four percent of the area's adults have a high-school education: 10% are college graduates (15). Eighty percent have always lived in the county. Per capita income is $10,420. In 1989,12% of individual residents and 9% of families lived below the poverty level (15).

The study included adult residents living within a 50-mile radius of Coleman, a

Results

Between 1992 and 1997, the women and men had a mean weight gain of 7.3 and 7.9 kg, respectively (Table 3). For both women and men, those in the youngest age group (20 to 30 years) experienced the greatest 5-year increase in body weight: 11 kg or more. The next greatest 5-year increase occurred in the 30- to 40-year age groups.

Discussion

This study estimated prevalence, distribution by age group in 10-year increments, 5-year changes in body weight, and the proportion of adults who are overweight and obese in a rural Wisconsin white population. The purpose of the study was to gauge weight changes with time to more accurately evaluate weight-control programs that are 5 years and longer. Our main finding was the alarming increase in body weight and in the proportion of overweight and obese people, especially in younger (20- to

Applications

■ Knowledge of obesity prevalence and incidence in defined communities by gender and age group enables health planners and professionals to identify and prevent those at particular risk from developing the condition and experiencing its associated health and economic consequences.

■ In this rural Wisconsin farming area, young adults showed the greatest 5-year weight gains, even though they had not attained their highest adult weights. This early period of adult life is a time when many people

References (22)

A.M. Wolf et al.
Social and economic effects of body weight in the United States
Am J Clin Nutr.
(1996)
K.J. Greenlund et al.
Differences in cardiovascular disease risk factors in black and white young adultscomparison among five communities of the CARDIA and the Bogalusa heart studies. Coronary artery risk development in young adults
Ann Epidemiol.
(1998)
L.A. Vaughan et al.
Food acquisition habits, nutrient intakes, and anthropometric data of Havasupi adults
J Am Diet Assoc.
(1997)
R.J. Roberts
Can self-reported data accurately describe the prevalence of overweight?
Public Health.
(1995)
L.L. White et al.
Weight, body image, and weight control practices of Navajo Indiansfindings from the Navajo Health and Nutrition Survey
J Nutr.
(1997)
A. Giuliano et al.
Prevalence of chronic disease risk and protective behaviors among American Indian women living on the Hopi reservation
Ann Epidemiol.
(1998)
G.L. Jensen et al.
Nutrition risk screening characteristics of rural older personsrelation to functional limitations and health care charges
Am J Clin Nutr.
(1997)
F.X. Pi-Sunyer
Medical hazards of obesity
Ann Intern Med.
(1993)
J.M. McGinnis et al.
Actual causes of death in the United States
JAMA.
(1993)
A.M. Wolf et al.
Current estimates of the economic cost of obesity in the United States
Obes Res.
(1998)

Methods for voluntary weight loss and control

Ann Intern Med.

(1993)

Cited by (22)

A life course perspective on BMI in rural America
2021, Health and Place
Citation Excerpt :
Our outcome measure is BMI when the respondent is between the ages of 18 and 33. We focus on this age range as the most significant weight gain typically occurs when men and women are in their twenties (Nelson et al., 2008; Rothacker and Blackburn, 2000). BMI is calculated as kilograms divided by meters-squared (kg/m2).
Rural Americans are substantially more likely to be obese than their urban counterparts. A life course perspective offers insights into how growing up in rural areas may affect weight in young adulthood. Using data from the Panel Survey of Income Dynamics, this study follows the residential trajectories of 3157 respondents since birth. Living in a rural area during the critical period of early childhood (before age two) is predictive of higher BMI, while residence in later childhood and adolescence is not. Improving the health and wellbeing of rural mothers and infants could potentially help address the roots of rural obesity.
Accumulated exposure to rural areas of residence over the life course is associated with overweight and obesity in adulthood: a 25-year prospective cohort study
2017, Annals of Epidemiology
Citation Excerpt :
One study by Lewis et al. [31] examined 10-year increases in weight and found that the largest gains were seen among those in their 20s, as compared to those in their 30s. Furthermore, other studies have shown that younger adults living in rural areas gain more weight compared to those living in rural areas in mid-adulthood and in older adulthood [32,33]. Again, this could be due to differences in health behaviors and lifestyles, or to social or cultural norms apparent in rural areas.
This prospective cohort study investigated whether body mass index (BMI) and weight status in mid-adulthood were predicted by trajectories of urban-rural residence from childhood to adulthood.
Participants aged 7–15 years in 1985 (n = 8498) were followed up in 2004–2006 (n = 3999, aged 26–36 years) and 2009–2011 (n = 3049, aged 31–41 years). Area of residence (AOR) was classified as urban or rural at each time point. BMI and/or weight status was calculated from self-reported weight and height (2009–2011). We tested which of three life-course models (“accumulation,” “sensitive period,” “mobility”) best explained the AOR-BMI and/or weight status association using a novel life-course modeling framework.
Accumulation and sensitive period models best described the effect of AOR on mid-adulthood BMI and weight status. Those with greater accumulated exposure to rural areas had a higher BMI (β = 0.29 kg/m² per time in a rural area, P = .005) and were more likely obese (relative risk = 1.13 per time in a rural area, P = .002). Living in rural areas at ages 26–30 years was also associated with a higher BMI and obesity in mid-adulthood.
Greater cumulative exposure to rurality and exposure during the “sensitive period” of young adulthood is associated with obesity in middle-aged adults. This study highlights the important contribution of context to the development of obesity over the life course.
No increase in prevalence of barrett's oesophagus in a surgical series of obese patients referred for laparoscopic gastric banding
2011, Digestive and Liver Disease
Citation Excerpt :
Obesity has dramatically increased over the past few decades in Western societies [1–4].
Obesity is a risk factor for gastroesophageal reflux and oesophageal adenocarcinoma. However, only a few studies have examined obesity and lifestyle risk factors in relation to Barrett's oesophagus. In this prospective study we assessed the presence of oesophagitis and Barrett's oesophagus in obese patients selected for laparoscopic gastric banding.
1049 obese patients were referred for laparoscopic gastric banding (233 males; mean age 41.0 ± 10.7 years). oesophagogastroduodenoscopy was performed before surgery to check for upper gastrointestinal tract disorders, especially hiatal hernia, signs of inflammation and/or erosions and/or ulcers of the oesophageal mucosa, and Barrett's epithelium.
Mean body mass index was 45.15 ± 6.46 kg/m². Overall 86/1049 (8.2%) patients had endoscopic signs of oesophagitis: 84 grade A, 1 grade B and 1 grade C, according to the Los Angeles classification. Hiatal hernia was detected in 127 patients (12.1%), with a mean size of 2.1 ± 0.7 cm (range 1–4 cm); of these, 38 (29.9%) had oesophagitis (37 grade A and 1 grade B). No patients had any visible length of columnar epithelium.
We could not confirm a high prevalence of Barrett's oesophagus in this series of obese patients.
The relation between body mass and gastro-oesophageal reflux
2004, Best Practice and Research: Clinical Gastroenterology
Obesity has, among physicians, since long been considered to cause gastro-oesophageal reflux. The evidence in support of this belief has been scarce, however. During the last few years some population-based studies have addressed this clinically important issue. These studies demonstrated a clear and dose-dependent association between increasing degrees of overweight and gastro-oesophageal reflux. The mechanisms by which obesity causes reflux are unknown, although there is some limited data suggesting that hiatal hernia may be the causal link between obesity and reflux. Moreover, some evidence has been presented showing that obesity is clearly a stronger risk factor among women than among men, and that the relation between overweight and reflux is substantially augmented by postmenopausal hormone therapy. The data so far available point in the direction of oestrogens, the activity of which is strengthened by increasing body mass, being responsible for this effect. If the results are repeated in future studies, postmenopausal therapy might be avoided among obese females suffering from severe reflux. Weight-reduction seems to reduce the risk of symptomatic gastro-oesophageal reflux disease, indicating that such strategy might be a useful tool in the treatment of reflux.
Elevated intakes of calcium and vitamin D without added calories and fat in overweight adults: A crossover study in Wisconsin
2002, Current Therapeutic Research - Clinical and Experimental
Background: Calcium plays an essential role in nerve conduction, muscle contraction, blood clotting, membrane permeability, and other vital functions. The recommended daily value (RDV) of calcium (1000 mg for most people) generally is not met by US adults. A plan is needed for adults to increase consumption of calcium and vitamin D (RDV 400 IU for most, depending on exposure to sunlight; vitamin D is necessary for calcium absorption), without added calories or excessive exposure of skin to damaging sunlight.
Objective: The purpose of this 8-day study was to assess the effects, if any, of a daily meal-replacement shake on total daily calcium and vitamin D intakes in overweight men and women.
Methods: Overweight (body mass index ≥25 kg/m²) patients who were neither dieting nor following a prescribed diet plan were recruited from 2 neighboring villages in northern Wisconsin. Each patient completed daily food and beverage diaries on each of 8 study days (typical weekdays). On 4 control days, patients consumed their typical diets. On 4 active days, the first meal of the day was a meal-replacement, ready-to-drink shake. Control and active days were alternated to better allow for eating-pattern variation during the week. Quantities of nutrients were determined and averaged for each patient, and differences in quantities of nutrient intakes were analyzed.
Results: One hundred seventeen patients (84 females [mean age ± SD, 47.0 ± 13 years], 33 males [mean age ± SD, 49.9 ± 16 years]) were enrolled. Daily calcium intakes were increased by ∼30% and vitamin D intakes were approximately doubled for both females and males on active days compared with control days. Only 40% of patients met the RDV for calcium on control days compared with >85% on active days.
Conclusion: Replacing 1 meal per day with a meal-replacement shake may provide enough daily calcium and vitamin D for overweight or obese individuals to meet RDVs without increasing caloric or fat intake or sun exposure.
Liquid meal replacement vs traditional food: A potential model for women who cannot maintain eating habit change
2001, Journal of the American Dietetic Association
Citation Excerpt :
The results of this 1-year study indicate that meal replacements may be a useful tool for long-term weight and fat control for patients unable to change their eating habits. Future studies should last longer than 1 year (1,16) and include a parallel control group from the same geographical area matched for age, BMI, gender, and race to control for area-specific background rates of weight change (27). Unfortunately, because this was an actual-use study, where intervention was kept at a minimum, physical activity and compliance with diet instructions were not monitored.

View all citing articles on Scopus

View full text

Obesity Prevalence by Age Group and 5-year Changes in Adults Residing in Rural Wisconsin

Abstract

Section snippets

Subjects

Results

Discussion

Applications

Am J Clin Nutr.

Ann Epidemiol.

J Am Diet Assoc.

Public Health.

J Nutr.

Ann Epidemiol.

Am J Clin Nutr.

Medical hazards of obesity

Ann Intern Med.

Actual causes of death in the United States

JAMA.

Current estimates of the economic cost of obesity in the United States

Obes Res.

Methods for voluntary weight loss and control

Ann Intern Med.