Slowing down of adult body mass index trend increases in England: a latent class analysis of cross-sectional surveys (1992 to 2010).

Matthew Sperrin, Iain Buchan, Vanessa Higgins, Alan David Marshall, Andrew Renehan

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    39 Citations (Scopus)

    Abstract

    BACKGROUND:
    The prevalence of excess body weight, commonly measured as body mass index (BMI)≥25 kg m(-2), has increased substantially in many populations worldwide over the past three decades, but the rate of increase has slowed down in some western populations.

    OBJECTIVE:
    We address the hypothesis that the slowing down of BMI trend increases in England reflects a majority sub-population resistant to further BMI elevation.

    DESIGN:
    Pseudo-panel data derived from annual cross-sectional surveys, the Health Surveys for England (1992-2010). Trends in median BMI values were explored using regression models with splines, and gender-specific mixture model (latent class analysis) were fit to take an account of increasing BMI distribution variance with time and identify hidden subgroups within the population.

    SUBJECTS:
    BMI was available for 164 155 adults (men: 76 382; women: 87 773).

    RESULTS:
    Until 2001, the age-adjusted yearly increases in median BMI were 0.140 and 0.139 kg m(-2) for men and women, respectively, decreasing thereafter to 0.073 and 0.055 kg m(-2) (differences between time periods, both P-values<0.0001). The mixture model identified two components--a normal BMI and a high BMI sub-population--the proportions for the latter were 23.5% in men and 33.7% in women. The remaining normal BMI populations were 'resistant' with minimal increases in mean BMI values over time. By age, mean BMI values in the normal BMI sub-population increased greatest between 20 and 34 years for men; for women, the increases were similar throughout age groups (slope differences, P<0.0001).

    CONCLUSION:
    In England, recent slowing down of adult BMI trend increases can be explained by two sub-populations--a high BMI sub-population getting 'fatter' and a majority 'resistant' normal BMI sub-population. These findings support a targeted, rather than a population-wide, policy to tackle the determinants of obesity.
    Original languageEnglish
    Pages (from-to)818-24
    Number of pages6
    JournalInternational Journal of Obesity
    Volume38
    Issue number6
    DOIs
    Publication statusPublished - 2014

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