Alta prevalencia de obesidad en una población laboral en España

What is a "high" prevalence of obesity? Two rapid reviews and a proposed set of thresholds for classifying prevalence levels

Categories such as "low" and "high" have been used for several decades to describe the prevalence of stunting and wasting in populations of children aged under 5 years. They provide support for public health risk assessment and policy-making, including alerting health departments and aid agencies to national trends and local needs. In the light of the need for monitoring progress to meet globally agreed targets for overweight and obesity, the classification of their prevalence will be a valuable to aid in policy development, to target resources, and to promote public health interventions. This paper reviews the current use of categories to describe obesity prevalence in policy, advocacy, and research literature. Where prevalence categories have been formally proposed, this paper compares their application on large-scale datasets. The paper then develops a set of recommended threshold values to classify prevalence levels for overweight and obesity among children under age 5 years, children aged 5-19 years, and adults.

[Health risk behaviors by occupation in working population in Spain]

OBJECTIVE

This study aims to analyze the variations in the prevalence of different health risk behaviors according to occupation in working population in Spain.

METHOD

Cross-sectional study with data from the Spanish National Health Survey of 2017. The analysis includes adults between 18 and 65 years with employment at the time of the survey. Health risk behaviors are obesity, physical inactivity in free time, tobacco consumption and excessive alcohol consumption. The primary explanatory variable is the occupation, using the National Classification of Occupations of 2011. Sociodemographic characteristics are gender, age, country of birth and educational level. The prevalences (P) of risk behaviors have been calculated, as well as the odd and adjusted odds ratios (aOR).

RESULTS

The highest figures of obesity are observed in operators of installations and machinery and assemblers (P: 20.0%; ORa: 1.26; A95%CI: 1.04-1.52). The higher level of physical inactivity during free time appears in elementary occupations (P: 83.4%; ORa: 1.70; A95%CI: 1.45-1.99). Tobacco consumption is higher in operators of installations and machinery and assemblies (P: 37.4%; ORa: 1.22; A95%CI: 1.05-1.43). Excessive alcohol consumption appears to a greater extent on skilled workers in the agricultural sector, livestock, forestry and fisheries (P: 3.9%; ORa: 1.51; A95%CI: 0.83-2.75).

CONCLUSIONS

The results indicate a greater relationship between risk behaviors for health and manual or lower-skilled occupations.

Relationships between work, lifestyles, and obesity: cross-sectional study based on the 2017 Spanish National Health Survey

AIMS

Overweight and obesity are affected by factors such as dietary transgressions and lack of exercise, as well as less obvious factors such as shift work and sedentary working. (i) To explore the associations between overweight and obesity (O/O) with working conditions such as type of job position, and work shifts; (ii) to know the associations between O/O with lifestyles (physical activity, eating habits, and tobacco and alcohol consumption).

METHODS AND RESULTS

A cross-sectional, population-based design was used based on the Spanish National Health Survey. The final sample consisted of 9097 workers aged between 18 and 65. The influence of the explanatory variables on the outcome variable (body mass index) was examined using logistic regression. The prevalence of O/O increased by 4% for every additional year of age (P < 0.001) and was 3.1 times more frequent among men (P < 0.001). It also was 20% higher in night work or rotating shifts (P < 0.01), and 14.9% lower in sedentary job positions (P < 0.05). Low consumption of the following foods was significantly associated with a reduction in O/O: meat (16.2%), fish (75.4%), cured meats (35.1%), dairy products (33.3%), and snacks (47.1%).

CONCLUSION

Age, men, engaging in moderate or low levels of physical activity, being an ex-smoker, working during the night or rotating shifts, holding a non-sedentary job position, having a low to moderate consumption of pasta, potatoes, and rice, a moderate consumption of bread and cereals, as well as dairy products, vegetables, sugary foods, and fast food, have been significantly associated with a higher prevalence of O/O. No relationships were identified between the consumption of alcohol, fruit, eggs, pulses, and sugary soft drinks.

Health workers: cardiovascular risk and occupational stress

Background

Work might cause severe physical stress associated with emotional overload, especially among hospital employees.

Objective

To identify risk factors for cardiovascular diseases and occupational stress among employees of a teaching hospital.

Method

Cross-sectional study conducted with 45 employees of a philanthropic health institution in the central area of Rio Grande do Sul, Brazil. Data collection was performed to analyze anthropometric variables, blood pressure, biochemical markers and indicators of health and occupational stress.

Results

60.0% of the participants reported sedentary behavior. Analysis of non-modifiable risk factors showed that 55.6% of the sample had family history (mother and father) of hypertension, 22.2% of myocardial infarction and stroke and 13.3% of diabetes. Body mass index categories overweight and obesity predominated (55.5%); 73.4% of the sample was categorized as with moderate-to-high risk to health based on the waist-to-hip ratio; the body fat percentage was above normal or indicated tendency to obesity for 73.3% of the participants. About 71.1% of the sample exhibited excellent or normal blood pressure. Total cholesterol was high or borderline for 88.9% of the sample. On assessment of occupational risk, 55.5% of the participants were categorized as with intermediate degree of exposure.

Conclusion

The results point to the relevance of health policies to promote lifestyle changes in and outside the workplace with consequent impact on the physical and mental state of workers.

Prevalence of impaired fasting glucose and type 1 and 2 diabetes mellitus in a large nationwide working population in Spain

INTRODUCTION

To report the prevalence of impaired fasting glucose (IFG), undiagnosed and diagnosed diabetes, and their association to occupational categories in a representative sample of working population in Spain.

MATERIALS AND METHODS

A cross-sectional study of workers who attended routine medical check-ups from January 2007 to December 2007. A structured questionnaire was completed, and physical examinations and routine serum biochemical tests were performed. IFG was defined as fasting glucose levels ranging from 100 to 125 mg/dl with no diagnosis of T1DM or T2DM; T1DM was defined as previous diagnosis of T1DM; and T2DM as previous diagnosis of T2DM, treatment with oral antidiabetic drugs or insulin or fasting glucose levels ≥126 mg/dl, according to ADA criteria.

RESULTS

Of the 371,997 participants (median age 35 [interquartile range 29-44] years), 72.4% were male. Raw prevalence rates (95% CI) of IFG, undiagnosed (UKDM), and previously known type 2 (KDM2) and type 1 (KDM1) diabetes were 10.4% (10.3-10.5%), 1.3% (1.2-1.3%), 1.1% (1.1-1.2%), and 0.3% (0.3-0.3%), respectively. With the exception of KDM1, prevalence of these conditions increased with age and was greater among manual/blue-collar workers (12.1%, 1.5%, 1.3% and 0.3%, respectively) as compared to non-manual/white-collar workers (7.3%, 0.8%, 0.8% and 0.3%, respectively). Age- and sex-adjusted prevalence rates of IFG, UKDM and KDM2 were 13.1%, 2.0% and 2.4%, respectively.

DISCUSSION

In this sample of Spanish working population, impaired glycemic profiles were common. Prevalence rates of IFG and T2DM were high among blue-collar workers (except for T1DM). These data emphasize the need for earlier structured preventive schemes.

[Obesity and cancer: «Dangerous friendship»]

Obesity and cancer are one of the most important health problems is Spain. Between 23 and 28% of the adult population in Spain are obese, 39% are overweight and 36% have abdominal obesity. The association between obesity and type 2 diabetes mellitus, hypertension, dyslipidemia and sleep obstructive apnea is well known. On the contrary, the association between obesity and cancer is less known, because the recent evidence on it. Several prospective studies have shown during the last years the strong relationship between obesity and cancer of colon, breast in post-menopausal women, endometrial, kidney and pancreas as well as esophageal adenocarcinoma. Furthermore there is recent evidence showing that liver, gallbladder, thyroid and ovarian cancer as well as leukemia, multiple myeloma and Hodgkin lymphomas are probably associated with obesity, yet more studies are needed. A better knowledge of the relation between cancer and obesity will allow improving the prevention strategies against cancer, a more efficient early detection, and a more suitable treatment of obesity and overweight. Although the mechanisms of carcinogenesis of obesity are not well established, avoiding overweight and obesity are considered one of the best approaches to reduce the risk of cancer. Therefore the general population must be aware that cancer is one of the most important hazards associated with the current obesity epidemic in our society.