Abstract
This thesis reports on the association between estimates of the amount and distribution of fat mass with aspects of morbidity in Dutch adults. A literature review on the current insights into these associations is included. The results of several cross-sectional and retrospective cohort studies are presented. The prevalence of severe overweight, defined as a Body Mass Index (BMI=kg/m 2) higher than 30 kg/m 2, is about 6% in women and 4% in men, while about 34% of the men and 24% of the women are moderately overweight (BMI 25-30 kg/m 2). Among overweight persons, especially when severely overweight, the prevalence and incidence of various chronic disorders and use of aspects of medical care was higher than in non-overweight persons. For gout and arteriosclerotic disease, overweight appeared to be a risk factor at lower levels of BMI in men than in women. The incidence was particularly high in men with an initial BMI between 27-30 kg/m 2. The association between BMI and subjective health was more pronounced in women than in men. This was true for certain somatic as well as psychosomatic complaints. Fat distribution, as measured with the waist-hip circumference ratio or waist-thigh circumference ratio, was shown to be related to the prevalence of certain chronic disorders in men and women. These associations were independent of age and BMI. A study in which Computed Tomography scans, taken at the level of the L4 vertebra, were related to anthropometric measurements, revealed that correlations of circumference ratios with the amount of intra-abdominal fat were higher than with subcutaneous abdominal fat.
It is concluded that overweight is related to aspects of morbidity but that it may be particularly relevant to include fat distribution measurements in the evaluation of health risks in overweight subjects.
Original language | English |
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Qualification | Doctor of Philosophy |
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Award date | 3 Oct 1986 |
Place of Publication | Wageningen |
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DOIs | |
Publication status | Published - 3 Oct 1986 |
Keywords
- obesity
- overweight
- adipose tissue
- public health
- health care