Prevalence of obesity and associated factors in the Brazilian population: a study of data from the 2013 National Health Survey

Ferreira, Arthur Pate de Souza; Szwarcwald, Célia Landmann; Damacena, Giseli Nogueira

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Revista Brasileira de Epidemiologia

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ORIGINAL ARTICLES • Rev. bras. epidemiol. 22 • 2019 • https://doi.org/10.1590/1980-549720190024 copy

Prevalence of obesity and associated factors in the Brazilian population: a study of data from the 2013 National Health Survey

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Introduction:

The prevalence of obesity is increasing at an alarming rate in many countries. Unhealthy eating and sedentary lifestyle are the main risk factors for obesity. The objective of this study was to determine the prevalence of obesity and identify the associated factors in the Brazilian adult population on the basis of data collected in the 2013 National Health Survey.

Method:

We analyzed the data from a sample of 59,402 adult subjects, excluding pregnant women. Body mass index (BMI) was calculated by means of weight and height measurements. Obesity was defined as BMI ≥30 kg/m². Logistic regression models were used to identify the factors associated with obesity.

Results:

The prevalence of obesity was 16.8% for men and 24.4% for women. Advanced age (over 50 years), low education level (no schooling or incomplete elementary school), African Brazilian and living with partner were risk factors for obesity. Leisure time physical activity and the habit of watching more than 4 hours of television per day showed significant effects for both sexes. Regarding the referred morbidity, in obese people, the chances of having a diagnosis of hypertension, diabetes, or some non-communicable chronic disease were higher. Obese men and women had significantly increased systolic blood pressure.

Conclusion:

Our findings emphasize the importance of public policies for the prevention of obesity and for the promotion of healthy habits in Brazilian society.

Keywords:
Obesity; Anthropometry; Health surveys; Lifestyle; Morbidity; Brazil

Age bracket (years)	Males				Females
	Overweight		Obesity		Overweight		Obesity
	%	95%CI	%	95%CI	%	95%CI	%	95%CI
18 to 29	42.1	(40.2 - 44.0)	11.0	(9.7 - 12.5)	39.0	(37.2 - 40.9)	14.4	(13.0 - 15.8)
30 to 39	60.0	(57.8 - 62.1)	16.9	(15.5 - 18.4)	56.7	(55.0 - 58.5)	23.1	(21.6 - 24.7)
40 to 49	63.2	(61.1 - 65.3)	20.7	(18.9 - 22.6)	65.9	(63.9 - 67.9)	27.4	(25.6 - 29.2)
50 to 59	63.4	(60.9 - 65.8)	20.0	(18.2 - 22.1)	69.3	(67.4 - 71.1)	31.4	(29.5 - 33.5)
60 to 69	61.9	(58.9 - 64.8)	19.9	(17.3 - 22.9)	69.5	(67.0 - 72.0)	30.0	(27.7 - 32.4)
70 and older	50.3	(46.7 - 53.8)	13.7	(11.4 - 16.3	61.5	(58.8 - 64.1)	24.2	(21.9 - 26.7)
Total	56.5	(55.4 - 57.5)	16.8	(16.1 - 17.6)	58.9	(58.0 - 59.8)	24.4	(23.7 - 25.2)

Variables			Males			Females			Males			Females
Variables			OR*	95%CI	p-value	OR*	95%CI	p-value	OR**	95%CI	p-value	OR**	95%CI	p-value
Age bracket	18-29	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
	30-39	1.64	(1.38 - 1.96)	< 0.001	1.79	(1.55 - 2.07)	< 0.001	1.46	(1.21 - 1.76)	< 0.001	1.71	(1.48 - 1.80)	< 0.001
	40-49	2.11	(1.78 - 2.50)	< 0.001	2.25	(1.94 - 2.62)	< 0.001	1.91	(1.60 - 2.29)	< 0.001	2.11	(1.80 - 2.46)	< 0.001
	50-59	2.03	(1.68 - 2.44)	< 0.001	2.73	(2.35 - 3.18)	< 0.001	1.90	(1.55 - 2.33)	< 0.001	2.53	(2.16 - 2.96)	< 0.001
	60-69	2.01	(1.61 - 2.52)	< 0.001	2.56	(2.18 - 3.00)	< 0.001	2.00	(1.58 - 2.54)	< 0.001	2.38	(2.02 - 2.82)	< 0.001
	70+	1.28	(1.00 - 1.64)	0.049	1.91	(1.59 - 2.28)	< 0.001	1.39	(1.06 - 1.82)	0.016	1.78	(1.47 - 2.16)	< 0.001
Schooling	A	0.72	(0.64 - 0.81)	<0.001	1.49	(1.37 - 1.62)	<0.001	0.97	(0.83 - 1.12)	0.654	1.33	(1.19 - 1.48)	< 0.001
	B	0.76	(0.64 - 0.89)	0.001	1.22	(1.07 - 1.39)	0.003	0.94	(0.79 - 1.12)	0.467	1.20	(1.04 - 1.38)	0.011
	C	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
Race/color	White	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
	Black	0.89	(0.74 - 1.06)	0.196	1.19	(1.04 - 1.36)	0.013	1.09	(0.91 - 1.31)	0.347	1.19	(1.03 - 1.38)	0.017
	Brown	0.72	(0.64 - 0.81)	< 0.001	0.93	(0.86 - 1.01)	0.094	0.90	(0.79 - 1.02)	0.084	0.94	(0.86 - 1.02)	0.163
Living with partner	Yes	1.57	(1.41 - 1.75)	< 0.001	1.2	(1.11 - 1.30)	< 0.001	1.27	(1.13 - 1.42)	< 0.001	1.21	(1.11 -1.32)	< 0.001
Living with partner	No	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
SEL	A/B	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
	C	0.71	(0.63 - 0.80)	< 0.001	1.31	(1.19 - 1.45)	< 0.001	0.77	(0.67 - 0.89)	< 0.001	1.24	(1.10 - 1.39)	< 0.001
	D/E	0.38	(0.33 - 0.44)	< 0.001	1.08	(0.97 - 1.21)	0.150	0.42	(0.34 - 0.51)	< 0.001	0.92	(0.80 - 1.05)	0.221

Variables		Males			Females			Males			Females
Variables		OR*	95%CI	p-value	OR*	95%CI	p-value	OR**	95%CI	p-value	OR**	95%CI	p-value
FLV	Yes	1.14	(1.01 - 1.28)	0.033	0.96	(0.87 - 1.05)	0.329	1.07	(0.95 - 1.21)	0.262	0.97	(0.88 - 1.06)	0.514
FLV	No	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
Abusive and frequent consumption of alcohol	Yes	0.96	(0.80 - 1.15)	0.648	0.91	(0.74 - 1.13)	0.397	0.99	(0.82 - 1.18)	0.876	1.02	(0.83 - 1.26)	0.840
Abusive and frequent consumption of alcohol	No	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
Obesity at 20 years old^a	Yes	4.28	(2.82 - 6.48)	< 0.001	3.14	(2.32 - 4.24)	< 0.001	4.34	(2.90 - 6.48)	< 0.001	3.08	(2.27 - 4.19)	< 0.001
Obesity at 20 years old^a	No	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
Physical activity during leisure	Yes	0.88	(0.82 - 0.95)	0.001	0.92	(0.86 - 0.97)	0.002	0.87	(0.81 - 0.94)	< 0.001	0.96	(0.90 - 1.02)	0.160
Physical activity during leisure	No	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
Physical activity at work^b	Yes	0.75	(0.68 - 0.84)	< 0.001	0.87	(0.79 - 0.96)	0.006	0.77	(0.69 - 0.86)	< 0.001	0.91	(0.82 - 1.00)	0.051
Physical activity at work^b	No	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
Hours of TV (more than 4 hours per day)	Yes	1.19	(1.02 - 1.38)	0.025	1.24	(1.13 - 1.36)	< 0.001	1.21	(1.04 - 1.41)	0.014	1.24	(1.13 - 1.37)	< 0.001
Hours of TV (more than 4 hours per day)	No	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-

Conditions		Males			Females
Conditions		OR*	95%CI	p-value	OR*	95%CI	p-value
Self-evaluation of health (moderate, bad or very bad)	Yes	1.36	(1.22 - 1.52)	< 0.001	1.39	(1.27 - 1.16)	< 0.001
Self-evaluation of health (moderate, bad or very bad)	No	1.00	-	-	1.00	-	-
Difficulty walking	Yes	1.33	(1.04 - 1.69)	0.023	1.62	(1.37 - 1.91)	< 0.001
Difficulty walking	No	1.00	-	-	1.00	-	-
Angina symptoms	Yes	1.43	(1.19 - 1.71)	< 0.001	1.47	(1.32 - 1.64)	< 0.001
Angina symptoms	No	1.00	-	-	1.00	-	-
Diagnosis of hypertension	Yes	2.84	(2.48 - 3.25)	< 0.001	2.40	(2.19 - 2.64)	< 0.001
Diagnosis of hypertension	No	1.00	-	-	1.00	-	-
Diagnosis of diabetes	Yes	2.36	(1.91 - 2.92)	< 0.001	1.83	(1.58 - 2.11)	< 0.001
Diagnosis of diabetes	No	1.00	-	-	1.00	-	-
Diagnosis of depression	Yes	1.42	(1.12 - 1.81)	0.004	1.25	(1.10 - 1.43)	0.001
Diagnosis of depression	No	1.00	-	-	1.00	-	-
Diagnosis of some NCD	Yes	1.80	(1.60 - 2.02)	< 0.001	1.67	(1.53 - 1.82)	< 0.001
Diagnosis of some NCD	No	1.00	-	-	1.00	-	-

Variables		Systolic arterial pressure (mmHg)						Diastolic arterial pressure (mmHg)
		Males			Females			Males			Females
		Beta	95%CI	p-value	Beta	95%CI	p-value	Beta	95%CI	p-value	Beta	95%CI	p-value
Age bracket	1	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
	2	1.67	(0.98 - 2.36)	< 0.001	3.72	(3.09 - 4.34)	< 0.001	4.19	(3.66 - 4.72)	< 0.001	3.63	(3.16 - 4.10)	< 0.001
	3	4.63	(3.83 - 5.43)	< 0.001	9.02	(8.24 - 9.79)	< 0.001	6.96	(6.38 - 7.54)	< 0.001	6.36	(5.84 - 6.87)	< 0.001
	4	10.14	(8.94 - 11.34)	< 0.001	12.72	(11.85 - 13.59)	< 0.001	8.84	(8.11 - 9.58)	< 0.001	6.48	(5.89 - 7.08)	< 0.001
	5	11.34	(9.86 - 12.82)	< 0.001	18.33	(17.17 - 19.48)	< 0.001	6.30	(5.42 - 7.18)	< 0.001	5.03	(4.33 - 5.73)	< 0.001
	6	14.34	(12.74 - 15.94)	< 0.001	22.58	(21.24 - 23.91)	< 0.001	2.57	(1.61 - 3.53)	< 0.001	2.56	(1.78 - 3.34)	< 0.001
MH	Yes	5.95	(4.60 - 7.30)	< 0.001	9.48	(8.51 - 10.45)	< 0.001	2.30	(1.51 - 3.10)	< 0.001	3.69	(3.11 - 4.26)	< 0.001
MH	No	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-
Obesity	Yes	5.64	(4.67 - 6.61)	< 0.001	3.78	(3.07 - 4.49)	< 0.001	3.11	(2.52 - 3.70)	< 0.001	2.04	(1.63 - 2.46)	< 0.001
Obesity	No	1.00	-	-	1.00	-	-	1.00	-	-	1.00	-	-

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[1] Corresponding author: Arthur Pate de Souza Ferreira. Avenida Brasil, 4.365, Pavilhão Haity Moussatché, Manguinhos, CEP: 21040-360, Rio de Janeiro, RJ, Brazil. E-mail: arthurpaterj@gmail.com