Online Program

Obesity. where individual and environmental context converge

Wednesday, November 6, 2013 : 8:35 a.m. - 8:55 a.m.

Nico Rizzo, PhD, med Dr, M.Sc., School of Public Health, Loma Linda University, Loma Linda, CA
Samuel Soret, PhD, MPH, School of Public Health, Center for Community Resilience, Loma Linda University, Loma Linda, CA
Background: More information is needed to examine the relationship between individual and environmental factors contributing to obesity. Objective: To analyze the interactions between individual level obesity and county level obesity prevalence in the U.S. Methods: Cross-sectional study of 94693 from the Adventist Health Study-2. Public domain obesity data at the county level were merged with individual-level data from the AHS-2. Individual-level data on obesity, socio-demographics and life style factors of interest (e.g., diet and physical activity) were extracted from the AHS-2 cohort. Three types of obesity prevalence estimates were employed in the analysis: (1) county-level estimates produced by the CDC for the general population; (2) county-level estimates based on the AHS-2 subject-level BMI data; and (3) individual-level estimates for the AHS-2 subjects based on individual BMI. Descriptive mapping and spatial analyses were implemented to explore associations between (2) and (1). Logistic regression was used to assess the association between (3) and (1). Analysis was adjusted for socio-demographics and other relevant factors. Results: Spatial analyses showed that obesity prevalence in the AHS-2 followed geographically that of the background population (P<0.001). Covariate adjusted logistic regression analysis confirmed these results and additionally showed that individual level physical activity >45 min/day (OR 0.7, P<0.001) and plant rich dietary patterns (OR 0.5, P<0.001) had an independent effect in lowered risk of obesity on an individual level. Conclusions: Individuals are more likely to be obese in environments with a higher obesity prevalence. However, individual lifestyle practices such as physical activity and dietary choices can modulate obesity outcomes in high risk environments.

Learning Areas:

Chronic disease management and prevention
Public health or related research

Learning Objectives:
Describe the relationship between individual risk of obesity and geospatial obesity prevalence. Discuss the importance of individual lifestyle factors and the environment on obesity. Describe how individual lifestyle factors and geospatial context may interact in health outcomes such as obesity.

Keyword(s): Obesity, Environment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted and published research on physical activity and dietary pattern and their association with chronic diseases and obesity in large publicly funded cohort studies in the U.S. and Europe. My research interests include the etiology of cardio-metabolic disease and epigenetics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.