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Population-level trends in the distribution of body mass index in Canada, 2000–2014

  • Quantitative Research
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Abstract

Objective

Research studying population-level body mass index (BMI) trends document increases in mean or prevalence of overweight/obese but less consideration has been given to describing the changing distribution of BMI. The objective of this research was to perform a detailed analysis of changes in the BMI distribution in Canada.

Methods

Using data from the CCHS (2000–2014), we analyzed distributional parameters of BMI for 492,886 adults aged 25–64 years. We further stratified these analyses for women and men, education level, and region of residence.

Results

Mean BMI has increased for most subgroups of the Canadian population. Mean BMI values were higher for men, while standard deviation (SD) of the BMI distribution was systematically higher in women. Increases in mean BMI were accompanied with increases in SD of BMI across cycles. Across survey cycles, the 95th percentile increased more than 10 times more rapidly compared to the 5th percentile, showing a very unequal change between extreme values in the BMI distribution over time. There was a relationship between SD with BMI, but these relations were generally not different between educational categories and regions. This suggests that the growing inter-individual inequalities (i.e., dispersion) in BMI were not solely attributable to socioeconomic and demographic factors.

Conclusions

This study supports the hypothesis that the simultaneous increases in mean BMI and SD of the BMI distribution are occurring, and suggests the need to move beyond the mean-centric paradigm when studying a complex public health phenomenon such as population change in BMI.

Résumé

Objectif

Les recherches populationnelles portant sur l’évolution de l’indice de masse corporelle (IMC) rapportent une augmentation de la moyenne et de la prévalence de l’embonpoint/obésité, mais accordent moins d’intérêt aux changements distributionnels. L’objectif de cette recherche était de réaliser une analyse détaillée des changements distributionnels de l’IMC au Canada.

Méthodologie

À partir des données de l’ESCC (2000–2014), nous avons analysé les paramètres distributionnels de l’IMC de 492,886 adultes âgés de 25 à 64 ans. Les analyses ont été stratifiées entre les femmes et les hommes, le niveau d’instruction et la région de résidence.

Résultats

L’IMC moyen a augmenté pour la majorité des sous-groupes de la population canadienne. Les valeurs de l’IMC moyen étaient plus élevées pour les hommes, alors que celles de l’écart-type (É-T) de la distribution de l’IMC étaient systématiquement plus élevées chez les femmes. L’augmentation de l’IMC moyen était accompagnée d’une augmentation de l’É-T de l’IMC à travers les cycles. À travers les cycles de l’enquête, le 95ème percentile augmentait plus de dix fois plus rapidement que le 5ème percentile, révélant un changement très inégal entre les valeurs extrêmes de la distribution de l’IMC dans le temps. Il y avait une relation entre l’É-T et l’IMC, mais de façon générale, ces relations n’étaient pas différentes entre les catégories du niveau d’instruction et de la région de résidence. Ceci suggère que la croissance des inégalités interindividuelles de l’IMC n’est pas uniquement attribuable à des facteurs socioéconomiques et démographiques.

Conclusions

Cette étude supporte l’hypothèse que la croissance de l’IMC moyen et de l’É-T de la distribution de l’IMC se produisent de façon simultanée et suggère le besoin d’aller au-delà du paradigme de recherche centré sur la moyenne pour l’étude de phénomènes de santé publique complexes comme celui de l’évolution de l’IMC à l’échelle des populations.

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Funding

This research was partly funded by the Fonds de recherche du Québec-Santé (FRQS), the Centre de recherche en aménagement et développement (CRAD) of Laval University, and the Evaluation Platform on Obesity Prevention of the Quebec Heart and Lung Institute.

Author information

Authors and Affiliations

  1. Quebec Heart and Lung Institute, 2725, chemin Sainte-Foy, Quebec, G1V 4G5, Canada

    Alexandre Lebel & Pierre Gagnon

  2. Graduate School of Land Management and Regional Planning, Laval University, Pavillon Félix-Antoine-Savard, Quebec, Canada

    Alexandre Lebel

  3. Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA

    S. V. Subramanian & Fahad Razak

  4. Quebec National Institute of Public Health, Quebec, Canada

    Denis Hamel

  5. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, Canada

    Fahad Razak

  6. Institute for Health Policy and Evaluation, University of Toronto, Toronto, Canada

    Fahad Razak

Authors
  1. Alexandre Lebel
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  2. S. V. Subramanian
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  3. Denis Hamel
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  4. Pierre Gagnon
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  5. Fahad Razak
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Corresponding author

Correspondence to Alexandre Lebel.

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The authors declare that they have no conflict of interest.

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Lebel, A., Subramanian, S.V., Hamel, D. et al. Population-level trends in the distribution of body mass index in Canada, 2000–2014. Can J Public Health 109, 539–548 (2018). https://doi.org/10.17269/s41997-018-0060-7

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  • DOI: https://doi.org/10.17269/s41997-018-0060-7

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