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Relationship between body mass index, serum cholesterol, leisure-time physical activity, and diet in a Mediterranean Southern-Europe population

Published online by Cambridge University Press:  09 March 2007

Helmut Schröder ,
Jaume Marrugat ,
Roberto Elosua  and
Maribel I. Covas
Helmut Schröder*
Affiliation:
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM, c/Doctor Aiguder 80, 08003 Barcelona, Spain Department of Nutrition, Sports Medicine Barcelona, Barcelona, Spain
Jaume Marrugat
Affiliation:
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM, c/Doctor Aiguder 80, 08003 Barcelona, Spain
Roberto Elosua
Affiliation:
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM, c/Doctor Aiguder 80, 08003 Barcelona, Spain
Maribel I. Covas
Affiliation:
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM, c/Doctor Aiguder 80, 08003 Barcelona, Spain
*
*Corresponding author: Dr Helmut Schröder, fax +34 93 2213237, email hschroeder@imim.es
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Abstract

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The aim of the present study was to determine the relationship of BMI with other cardiovascular risk factors, leisure-time physical activity and diet. Participants were recruited in a cross-sectional population-based survey in a southern-Europe Mediterranean population (Spain); cardiovascular risk factors were measured, and leisure-time physical activity and diet intake were evaluated. Linear regression analysis adjusted for several confounders showed a significant, direct association of BMI and total cholesterol (P<0·005) and LDL-cholesterol (P<0·006), in men. HDL-cholesterol was inversely related to BMI in both sexes (P<0·0001). Higher BMI was more frequent in less-active men (P<0·04) but not in women. BMI increased significantly (P<0·0001) by 1·92 kg/m2 with each 4·18 MJ consumed in men but not in women. Dietary intakes of carbohydrate (P<0·03), total fat (P<0·03) and saturated fatty acids (P<0·02) were directly associated with BMI in men but not in women, in whom protein intake was correlated (P<0·001) with BMI. Linear regression models including dietary components explained up to 10·6 and 21·1 % of BMI variability in men and women, respectively. Sex differences in the association of BMI with total cholesterol, and LDL-cholesterol, may account for the lower risk for CHD in women compared with men of similar BMI reported in the literature for the southern-Europe Mediterranean region. An increases of BMI may be more deleterious in populations in which it is accompanied by other risk factors such as a higher intake of total fat and, particularly, of saturated fatty acids, or lower leisure-time physical activity.

Keywords

Body mass indexNutrient intakeCoronary heart diseaseLeisure-time physical activity
Type
Research Article
Information
British Journal of Nutrition , Volume 90 , Issue 2 , August 2003 , pp. 431 - 439
Copyright
Copyright © The Nutrition Society 2003

References

Anderson, AJ, Sobocinski, KA, Freedman, DS, Barboriak, JJ, Rimm, AA & Gruchow, HW (1988) Body fat distribution, plasma lipids and lipoproteins. Arteriosclerosis 8, 88–94.CrossRefGoogle ScholarPubMed
Anonymous (1991) Prediction of coronary heart disease in Europe. The 2nd report of the WHO-ERICA Project. ERICA Research Group. Eur Heart J 21, 291–297.Google Scholar
Aranceta, J, Perez, RC & Serra, ML (1998) Prevalence of obesity in Spain: the SEEDO'97 study. Spanish Collaborative Group for the Study of Obesity. Med Clin (Barc) 111, 441–445.Google Scholar
Assman, G & Schulte, H (1992) Obesity and hyperlipidemia: Results from the prospective cardiovascular and Munster (PROCAM) study. In Obesity, pp. 502–511 [Bjorntop, P and Brodoff, , editors]. New York, NY: J.B. Lippincott.Google Scholar
Astrup, A (1993) Dietary composition, substrate balances, and body fat in subjects with predisposition of obesity. Int J Obes 17, S32–S36.Google Scholar
Astrup, A, Ryan, L, Grunwald, GK et al. (2000) The role of dietary fat in body fatness: evidence from a preliminary meta-analysis of ad libitum dietary intervention studies. Br J Nutr 83, Suppl. 1, S25–S32.CrossRefGoogle ScholarPubMed
Bianchini, F, Kaaks, R & Vainio, H (2002) Overweight, obesity, and cancer risk. Lancet Oncol 3, 565–574.CrossRefGoogle ScholarPubMed
Caroll, KK (1998) Obesity as a risk factor for certain types of cancer. Lipids 33, 1055–1059.CrossRefGoogle Scholar
Chambless, L, Keil, U & Dobson, A (1997) Population versus clinical view of case fatality from acute coronary heart disease: results from the WHO MONICA Project 1985–1990. Multinational MONItoring of Trends and Determinants in CArdiovascular Disease. Circulation 96, 3849–3859.CrossRefGoogle ScholarPubMed
Colditz, GA, Willett, WC & Stampfer, MJ (1990) Weight as a risk factor for clinical diabetes in women. Am J Epidemiol 132, 501–513.CrossRefGoogle ScholarPubMed
Deslypere, JP (1995) Obesity and cancer. Metabolism 44, Suppl. 3, 24–27.CrossRefGoogle ScholarPubMed
Donato, K & Hegsted, DM (1985) Efficiency of utilization of various sources of energy for growth. Proc Natl Acad of Sci USA 82, 4866–4870.CrossRefGoogle ScholarPubMed
Dreon, DM, Frey-Hewitt, B, Ellsworth, N, Williams, PT, Terry, RB & Wood, PD (1988) Dietary fat:carbohydrate ratio and obesity in middle-aged men. Am J Clin Nutr 47, 995–1000.CrossRefGoogle ScholarPubMed
Elosua, R, Garcia, M, Aguilar, A, Molina, L, Covas, MI & Marrugat, J (2000) Validation of the Minnesota Leisure Time Physical Activity Questionnaire in Spanish Women. Investigators of the MARATDON Group. Med Sci Sports Exerc 32, 1431–1437.CrossRefGoogle ScholarPubMed
Elosua, R, Marrugat, J, Molina, L, Pons, S & Pujol, E (1994) Validation of the Minnesota Leisure Time Physical Activity Questionnaire in Spanish men. The MARATHOM Investigators. Am J Epidemiol 139, 1197–1209.CrossRefGoogle ScholarPubMed
Ernst, ND, Obarzanek, E, Clark, MB, Briefel, RR, Brown, CD & Donato, K (1992) Cardiovascular health risks related to overweight. J Am Diet Assoc 97, S47–S51.CrossRefGoogle Scholar
Ferrannini, E (1995) Physiological and metabolic consequences of obesity. Metabolism 44, Suppl. 3, 15–17.CrossRefGoogle ScholarPubMed
Ferro-Luzzi, A & Martino, L (1996) Obesity and physical activity. Ciba Found Symp 201, 207–221.Google ScholarPubMed
Flegal, KM, Carroll, MD, Kuczmarski, RJ & Johnson, CL (1998) Overweight and obesity in the United States: prevalence and trends 1960–1994. Int J Obes Relat Metab Disord 22, 39–47.CrossRefGoogle ScholarPubMed
Flegal, KM, Carroll, MD, Ogden, CL & Johnson, CL (2002) Prevalence and trends in obesity among US adults 1999–2000. JAMA 288, 1723–1727.CrossRefGoogle ScholarPubMed
Goldberg, GR, Black, AE & Jebb, SA (1991) Critical evaluation of energy intake data using fundamental principles of energy physiology 1: Derivation of cut-off values to identify under recording. Eur J Clin Nutr 45, 569–581.Google Scholar
Gonzales, CA, Pera, G, Quirós, JR (2000) Types of fat intake and body mass index in a Mediterranean country. Public Health Nutr 3, 329–336.CrossRefGoogle Scholar
Gutiérrez-Fisac, JL, Banegas Banegas, JRRotriguez Artalejo, F & Regidor, E (2000) Increasing prevalence of overweight and obesity among Spanish adults, 1987–1997. Int J Obes Relat Metab Disord 24, 1677–1682.CrossRefGoogle ScholarPubMed
Jung, RT (1997) Obesity as a disease. Br Med Bull 53, 307–321.CrossRefGoogle ScholarPubMed
Klesges, RC, Eck, LH, Isbell, TR, Fulliton, W & Hanson, CL (1990) Smoking status: effects on the dietary intake, physical activity, and body fat of adult men. Am J Clin Nutr 51, 784–789.CrossRefGoogle ScholarPubMed
Klör, HU, Hauenschild, A, Holbach, I, Schnell-Kretschmer, H & Stroh, S (1997) Nutrition and cardiovascular disease. Eur J Med Res 2, 243–257.Google ScholarPubMed
Lamon-Fava, S, Wilson, PWF & Schaefer, EJ (1996) Impact of body mass index on coronary heart disease risk factors in men and woman. Arterioscler Thromb Vasc Biol 16, 1509–1515.CrossRefGoogle Scholar
Lichtman, SW, Pisarska, K & Berman, ER (1992) Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. New Engl J Med 327, 1893–1898.CrossRefGoogle ScholarPubMed
Linder, MC (1985) Metabolismo energético, consumo de alimentos y gasto corporal (Energy metabolism, food consumption, and energy expenditure). In: Nutricion Aspectos Bioquimicos Meta-bolicos y Clinicos pp. 243–266 [Linder, MC, editor] Pamplona Spain: EUSNA.Google Scholar
Macdiarmid, JI, Vail, A, Cade, JE & Blundell, JE (1998) The sugar-fat relationship revisited: differences in consumption between men and women of varying BMI. Int J Obes Relat Metab Disord 22, 1053–1061.CrossRefGoogle ScholarPubMed
McNamara, DJ & Howell, WH (1992) Epidemiologic data linking diet hyperlipidemia and arteriosclerosis. Sem Liver Dis 12, 347–355.CrossRefGoogle ScholarPubMed
Manson, JE, Colditz, GA & Stampfer, MJ (1990) A prospective study of obesity and risk of coronary heart disease in women. New Eng J Med 322, 882–889.CrossRefGoogle ScholarPubMed
Masiá, R, Pena, A & Marrugat, J (1998) High prevalence of cardiovascular risk factors in Gerona, Spain, a province with low myocardial infarction disease. J Epidemiol Community Health 52, 707–715.CrossRefGoogle Scholar
Moore, MS (2000) Interactions between physical activity and diet in the regulation of body weight. Proc Nutr Soc 59, 193–198.CrossRefGoogle ScholarPubMed
National Institute of Diabetes and Digestive and Kidney Diseases (2000) Overweight, obesity, and health risk. National Task force on the prevention and treatment of obesity. Arch Intern Med 160, 898–904.CrossRefGoogle Scholar
Obarzanek, E, Schreiber, GB & Crawford, PB (1994) Energy intake and physical activity in relation to indexes of body fat: the National Heart, Lung, and Blood Institute Growth and Health Study. Am J Clin Nutr 60, 15–22.CrossRefGoogle ScholarPubMed
Perez, G, Pena, A, Sala, J, Roset, P, Masia, R & Marrugat, J (1998) Acute myocardial infarction case fatality, incidence and mortality rates in a population registry in Gerona, Spain, 1990–1992. Int J Epidemiol 27, 599–604.CrossRefGoogle Scholar
Pi-Sunyer, FX (1993) Medical hazards of obesity. Ann Intern Med 119, 655–660.CrossRefGoogle ScholarPubMed
Rabkin, SW, Chen, Y, Leiter, L, Liu, L & Reeder, BA (1997) Risk factor correlates of body mass index. Canadian Heart Health Surveys Research Group. CMAJ 157, Suppl. 1, S26–S31.Google ScholarPubMed
Ravussin, E, Valencia, ME, Esparza, J, Bennett, PH & Schulz, LO (1994) Effects of traditional lifestyle on obesity in Pima Indians. Diabetes Care 17, 1067–1074.CrossRefGoogle ScholarPubMed
Rodríguez Artalejo, F, Banegas, JR, Graciani, MA, Hernández Vecino, R & Rey Calero, J (1996) El consumo de alimentos y nutrientes en España en el periodo 1940–1988. Análisis de su consistencia con la dieta mediterránea (Food and nutrient consumption in Spain in the period 1940–1988. Analysis of its consistency with the Mediterranean diet). Med Clin (Barc) 106, 161–168.Google Scholar
Rodríguez Artalejo, F, Lopez Garcia, E, Gutierrez-Fisac, JL, Banegas Banegas, JR, Lafuente Urdinguio, PJ & Domínguez Rojas, V (2002) Changes in the prevalence of overweight and obesity and their risk factors in spain, Prev Med 34, 72–81.CrossRefGoogle ScholarPubMed
Rosenbaum, M, Leibel, RL & Hirsch, J (1997) Obesity. N Engl Med 337, 437–439.CrossRefGoogle ScholarPubMed
Schmitz, K, French, SA & Jeffery, RW (1997) Correlates of changes in leisure time physical activity over 2 years: The Healthy Worker Project. Prev Med 26, 570–579.CrossRefGoogle ScholarPubMed
Schröder, H, Covas, MI, Marrugat, J, Pena, A, Alcántara, M & Masiá, R (2001) Use of a three-day estimated food record, a 72-hour recall, and a food frequency questionnaire for dietary assessment in a Mediterranean Spanish population. Clin Nutr 20, 429–437.CrossRefGoogle Scholar
Schulte, H, Cullen, P & Assmann, G (1999) Obesity, mortality and cardiovascular disease in the Munster Heart Study (PROCAM). Atherosclerosis 144, 199–209.CrossRefGoogle ScholarPubMed
Seidell, JC (1995 a) Obesity in Europe: scaling an epidemic. Int J Obes Relat Metab Disord 19, Suppl. 3, S1–S4.Google ScholarPubMed
Seidell, JC (1995 b) The impact of obesity on health status: some implications for health care costs. Int J Obes Relat Metab Disord 19, Suppl., S13–S16.Google ScholarPubMed
Seidell, JC (1995) Obesity in Europe. Obes Res 3, Suppl. 2, 89s–93s.CrossRefGoogle ScholarPubMed
Seidell, JC (1998) Dietary fat and obesity: an epidemiologic perspective. Am J Clin Nutr 67, Suppl., 546S–550S.CrossRefGoogle ScholarPubMed
Siervogel, RM, Wisemandle, W, Maynard, LM, Guo, SS, Chumlea, WC & Towne, B (2000) Lifetime overweight status in relation to serial changes in body composition and risk factors for cardiovascular disease: The Fels Longitudinal Study. Obes Res 8, 422–430.CrossRefGoogle ScholarPubMed
Trichopoulou, A, Gnardellis, C, Benetou, V, Lagiou, P, Bamia, C & Trichopoulos, D (2002) Lipid, protein and carbohydrate intake in relation to body mass index. Eur J Clin Nutr 56, 37–43.CrossRefGoogle ScholarPubMed
Willet, WC (1998) Is dietary fat a major determinant of body fat? Am J Clin Nutr 67, Suppl., 556S–562S.CrossRefGoogle Scholar
World Health Organization (1998) Report of the WHO Consultation on Obesity. Obesity: Preventing and Managing the Global Epidemic. Geneva: WHO.Google Scholar