Abstract
Objectives
To investigate the temporal trends in the mortality burden attributed to overweight and obesity in Canada between 1985 and 2000.
Design
Overweight and obesity prevalence data from six cross-sectional national population surveys, including the 1985 and 1990 Health Promotion Surveys, 1994, 1996 and 1998 National Population Health Surveys, and 2000 Canadian Community Health Survey, in conjunction with one published prospective cohort study on overweight, obesity and mortality.
Participants
Adults 20–64 years of age.
Main Outcome Measure
The number of deaths attributable to overweight and obesity at the national and provincial levels. Attributable deaths were estimated using the Population Attributable Risk (PAR), which combined the prevalence data with the relative risks of mortality associated with overweight and obesity. A two-way sensitivity analysis was conducted by simultaneously varying the population prevalences and relative risk estimates by ±10%.
Results
Between 1985 and 2000, the national PAR for overweight and obesity increased from 5.1% to 9.3%, and the annual number of deaths attributable to overweight and obesity increased from 2,514 (966–4,061) to 4,321 (2,114–6,542). Cumulatively, 57,181 (25,075–89,227) deaths were attributed to overweight and obesity between 1985 and 2000. Although overweight- and obesity-related mortality is increasing in every province, the problem is particularly pronounced in Eastern Canada.
Conclusions
Overweight and obesity are important public health problems in Canada, accounting for approximately 57,000 deaths over the last 15 years. Immediate and sweeping public health campaigns and interventions are required to slow or reverse the recent trends.
Résumé
Objectifs
Analyser les tendances temporelles du fardeau que l’embonpoint et l’obésité ont fait peser sur les chiffres de la mortalité au Canada entre 1985 et 2000.
Conception
Les données sur la prévalence de l’embonpoint et de l’obésité proviennent de six enquêtes transversales nationales sur la population, à savoir: l’Enquête promotion santé (1985 et 1990), l’Enquête nationale sur la santé de la population (1994, 1996 et 1998) et l’Enquête sur la santé dans les collectivités canadiennes (2000), ainsi que d’une étude prospective de cohortes, publiée, portant sur l’embonpoint, l’obésité et la mortalité.
Participants
Des adultes de 20 à 64 ans.
Principal indicateur des résultats
Le nombre de décès attribuables à l’embonpoint et à l’obésité à l’échelle nationale et provinciale. Les décès attribuables ont été estimés selon la méthode de la fraction étiologique du risque, en combinant les données sur la prévalence aux risques relatifs de mortalité associés à l’embonpoint et à l’obésité. Nous avons mené une analyse de sensibilité bidirectionnelle en modifiant simultanément de ±10% les taux de prévalence dans la population et les estimations du risque relatif.
Résultats
Entre 1985 et 2000, la fraction étiologique du risque d’embonpoint et d’obésité à l’échelle nationale est passée de 5,1% à 9,3%, et le nombre annuel de décès attribuables à l’embonpoint et à l’obésité, de 2 514 (966–4 061) à 4 321 (2 114–6 542). Au total, 57 181 décès (25 075–89 227) ont été attribués à l’embonpoint et à l’obésité entre 1985 et 2000. Bien que la mortalité liée à l’embonpoint et à l’obésité soit en hausse dans toutes les provinces, le problème est particulièrement grave dans l’est du Canada.
Conclusions
L’embonpoint et l’obésité sont d’importants problèmes de santé publique au Canada et ont causé quelque 57 000 décès au cours des 15 dernières années. Des campagnes de santé publique et des mesures d’intervention immédiates et radicales sont nécessaires pour ralentir ou inverser les tendances récentes.
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