Obesity and the risk of developing chronic diseases in middle-aged and older adults: Findings from an Australian longitudinal population survey, 2009–2017

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Abstract

Background

Overweight and obesity impose a significant health burden in Australia, predominantly the middle-aged and older adults. Studies of the association between obesity and chronic diseases are primarily based on cross-sectional data, which is insufficient to deduce a temporal relationship. Using nationally representative panel data, this study aims to investigate whether obesity is a significant risk factor for type 2 diabetes, heart diseases, asthma, arthritis, and depression in Australian middle-aged and older adults.

Methods

Longitudinal data comprising three waves (waves 9, 13 and 17) of the Household, Income and Labour Dynamics in Australia (HILDA) survey were used in this study. This study fitted longitudinal random-effect logistic regression models to estimate the between-person differences in the association between obesity and chronic diseases.

Results

The findings indicated that obesity was associated with a higher prevalence of chronic diseases among Australian middle-aged and older adults. Obese adults (Body Mass Index [BMI] ≥ 30) were at 12.76, 2.05, 1.97, 2.25, and 1.96, times of higher risks of having type 2 diabetes (OR: 12.76, CI 95%: 8.88–18.36), heart disease (OR: 2.05, CI 95%: 1.54–2.74), asthma (OR: 1.97, CI 95%: 1.49–2.62), arthritis (OR: 2.25, 95% CI: 1.90–2.68) and depression (OR: 1.96, CI 95%: 1.56–2.48), respectively, compared with healthy weight counterparts. However, the study did not find any evidence of a statistically significant association between obesity and cancer. Besides, gender stratified regression results showed that obesity is associated with a higher likelihood of asthma (OR: 2.64, 95% CI: 1.84–3.80) among female adults, but not in the case of male adults.

Conclusion

Excessive weight is strongly associated with a higher incidence of chronic disease in Australian middle-aged and older adults. This finding has clear public health implications. Health promotion programs and strategies would be helpful to meet the challenge of excessive weight gain and thus contribute to the prevention of chronic diseases.

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Most cited references 43

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Health Effects of Overweight and Obesity in 195 Countries over 25 Years.

Ashkan Afshin, Mohammad Forouzanfar, Marissa Reitsma … (2018)

Background While the rising pandemic of obesity has received significant attention in many countries, the effect of this attention on trends and the disease burden of obesity remains uncertain. Methods We analyzed data from 67.8 million individuals to assess the trends in obesity and overweight prevalence among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body mass index (BMI), by age, sex, cause, and BMI level in 195 countries between 1990 and 2015. Results In 2015, obesity affected 107.7 million (98.7-118.4) children and 603.7 million (588.2- 619.8) adults worldwide. Obesity prevalence has doubled since 1980 in more than 70 countries and continuously increased in most other countries. Although the prevalence of obesity among children has been lower than adults, the rate of increase in childhood obesity in many countries was greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million (2.7- 5.3) deaths globally, nearly 40% of which occurred among non-obese. More than two-thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden of high BMI has increased since 1990; however, the rate of this increase has been attenuated due to decreases in underlying cardiovascular disease death rates. Conclusions The rapid increase in prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem.

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The epidemiology of obesity

Yu Chooi, Cherlyn Ding, Faidon Magkos (2018)

Obesity is a complex multifactorial disease. The worldwide prevalence of overweight and obesity has doubled since 1980 to an extent that nearly a third of the world's population is now classified as overweight or obese. Obesity rates have increased in all ages and both sexes irrespective of geographical locality, ethnicity or socioeconomic status, although the prevalence of obesity is generally greater in older persons and women. This trend was similar across regions and countries, although absolute prevalence rates of overweight and obesity varied widely. For some developed countries, the prevalence rates of obesity seem to have levelled off during the past few years. Body mass index (BMI) is typically used to define overweight and obesity in epidemiological studies. However, BMI has low sensitivity and there is a large inter-individual variability in the percent body fat for any given BMI value, partly attributed to age, sex, and ethnicity. For instance, Asians have greater percent body fat than Caucasians for the same BMI. Greater cardiometabolic risk has also been associated with the localization of excess fat in the visceral adipose tissue and ectopic depots (such as muscle and liver), as well as in cases of increased fat to lean mass ratio (e.g. metabolically-obese normal-weight). These data suggest that obesity may be far more common and requires more urgent attention than what large epidemiological studies suggest. Simply relying on BMI to assess its prevalence could hinder future interventions aimed at obesity prevention and control.

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Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies.

Andrew G. Renehan, Margaret Tyson, Matthias Egger … (2008)

Excess bodyweight, expressed as increased body-mass index (BMI), is associated with the risk of some common adult cancers. We did a systematic review and meta-analysis to assess the strength of associations between BMI and different sites of cancer and to investigate differences in these associations between sex and ethnic groups. We did electronic searches on Medline and Embase (1966 to November 2007), and searched reports to identify prospective studies of incident cases of 20 cancer types. We did random-effects meta-analyses and meta-regressions of study-specific incremental estimates to determine the risk of cancer associated with a 5 kg/m2 increase in BMI. We analysed 221 datasets (141 articles), including 282,137 incident cases. In men, a 5 kg/m2 increase in BMI was strongly associated with oesophageal adenocarcinoma (RR 1.52, p<0.0001) and with thyroid (1.33, p=0.02), colon (1.24, p<0.0001), and renal (1.24, p <0.0001) cancers. In women, we recorded strong associations between a 5 kg/m2 increase in BMI and endometrial (1.59, p<0.0001), gallbladder (1.59, p=0.04), oesophageal adenocarcinoma (1.51, p<0.0001), and renal (1.34, p<0.0001) cancers. We noted weaker positive associations (RR <1.20) between increased BMI and rectal cancer and malignant melanoma in men; postmenopausal breast, pancreatic, thyroid, and colon cancers in women; and leukaemia, multiple myeloma, and non-Hodgkin lymphoma in both sexes. Associations were stronger in men than in women for colon (p<0.0001) cancer. Associations were generally similar in studies from North America, Europe and Australia, and the Asia-Pacific region, but we recorded stronger associations in Asia-Pacific populations between increased BMI and premenopausal (p=0.009) and postmenopausal (p=0.06) breast cancers. Increased BMI is associated with increased risk of common and less common malignancies. For some cancer types, associations differ between sexes and populations of different ethnic origins. These epidemiological observations should inform the exploration of biological mechanisms that link obesity with cancer.

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Author and article information

Contributors

Syed Afroz Keramat:

ORCID: https://orcid.org/0000-0001-8747-9891

Role: ConceptualizationRole: SoftwareRole: Writing – original draft

Khorshed Alam: Role: SupervisionRole: Writing – review & editing

Rezwanul Hasan Rana: Role: ConceptualizationRole: Writing – original draft

Rupok Chowdhury:

ORCID: https://orcid.org/0000-0002-7801-4600

Role: MethodologyRole: Writing – original draft

Fariha Farjana: Role: Data curationRole: Writing – original draft

Rubayyat Hashmi: Role: MethodologyRole: SoftwareRole: Writing – review & editing

Jeff Gow: Role: SupervisionRole: Writing – review & editing

Stuart J. H. Biddle: Role: SupervisionRole: Writing – review & editing

David Meyre: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS One

Journal ID (publisher-id): plos

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 16 November 2021

Publication date Collection: 2021

Volume: 16

Issue: 11

Electronic Location Identifier: e0260158

Affiliations

[1 ] Economics Discipline, Social Science School, Khulna University, Khulna, Bangladesh

[2 ] School of Business, University of Southern Queensland, Toowoomba, QLD, Australia

[3 ] Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia

[4 ] The Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia

[5 ] School of Accounting, Economics, and Finance, University of KwaZulu-Natal, Durban, South Africa

McMaster University, CANADA

Author notes

Competing Interests: The authors have declared that no competing interests exist.

* E-mail: syed.afroz@ 123456econ.ku.ac.bd

Author information

Syed Afroz Keramat https://orcid.org/0000-0001-8747-9891

Rupok Chowdhury https://orcid.org/0000-0002-7801-4600

Article

Publisher ID: PONE-D-21-14337

DOI: 10.1371/journal.pone.0260158

PMC ID: 8594821

PubMed ID: 34784404

SO-VID: fdff65b7-d9e8-4415-aefc-abc60286e473

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 30 April 2021

Date accepted : 3 November 2021

Page count

Figures: 4, Tables: 4, Pages: 16

Funding

The authors received no specific funding for this work.

Custom metadata

Data Availability The data used for the study were collected by the Melbourne Institute of Applied Economic and Social Research. There are some restrictions on accessing this data and it is not available to the public. Those interested in accessing this data should contact the Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, VIC 3010, Australia (Tel: +61 3 8344 2073 or Fax: +61 3 9347 6739).

Obesity and the risk of developing chronic diseases in middle-aged and older adults: Findings from an Australian longitudinal population survey, 2009–2017

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Most cited references 43

Health Effects of Overweight and Obesity in 195 Countries over 25 Years.

The epidemiology of obesity

Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies.

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