obesity in canada
tjepkema m (2006) adult obesity. toronto, canada: statistics canada 9–25 p .
obesity rates among children and youth in canada have nearly tripled in the last 30 years .
significant increases in self - reported obesity in canada have also been reported between 2003 and 2008 .
( 17) health canada, “ the government of canada reaffirms its commitment to combat canada’s rising obesity levels, ” news release, 6 july 2005 .
variance partition and specific - level change in variance in the usa and canada .
birmingham cl, muller jl, palepu a, et al. the cost of obesity in canada .
the obesity in canada report is a joint partnership between the public health agency of canada (phac) and canadian institute for health information (cihi) .
obesity rates in canada have tripled between 1985 and 2011, according to a study from memorial university in st. john' s .
obesity, childless rates high among sask. adults, stats canada says | ctv regina news
legislative approaches, together with environmental modifications, can be an effective means of reversing the growing problem of obesity in canada .
there was a 350 per cent increase in obesity class 2 and a 433 per cent increase in obesity class 3 overall .
this paper provides information on the phenomenon of overweight and obesity in canada in terms of measurement, prevalence, causes, health implications and economic burden .
gorber sc, tremblay ms (2009) the bias in self - reported obesity from 1976 to 2005: a canada - us comparison. obesity 18: 354–361 .
bmi by income and education for women and men in the usa and canada, 2009 .
( 8) michael tjepkema, adult obesity in canada: measured height and weight, statistics canada, 2005, and margot shields, overweight canadian children and adolescents, statistics canada, 2005. note that the results presented in tjepkema (2005) are for adults ages 18 and over .
the cost in health care spending, and in lost productivity due to obesity, is estimated to be between $ 4. 6 billion and $ 7. 1 billion in canada annually .
canada is facing an obesity epidemic, with a substantial and rising prevalence of overweight and obese adults and children .
across canada, adult obesity rates vary from 5. 3% in richmond, bc to 35. 9% in the mamawetan / keewatin / athabasca region of sk .
in 2007 / 08 self - reported obesity in canada varied across provinces and territories, from a low of 12. 8% in british columbia to a high of 25. 4% in newfoundland and labrador (figure 4). estimates of obesity in 2007 / 08 were found to be significantly higher than in 2005 in canada overall as well as in alberta and ontario, and significantly higher in 2005 than 2003 in newfoundland and labrador (figure 4). because of sample size limitations for measured obesity, calculations of obesity by province and health region were based on self - reported data .
legislative approaches could be implemented in canada at three levels — government, corporate and school / youth .
bmi range by income and education category for women and men in the usa and canada, 2009 .
the seminal work on the cost of obesity in canada, published in the canadian medical association journal in 1999, estimated the total direct cost of obesity in canada in 1997 to be approximately $ 1. 8 billion, or 2. 4% of the total health care expenditures for all diseases in canada. table 4 compares the results of this and other studies of the cost of obesity and physical inactivity in canada, noting key variations in the parameters used. (15) while the results vary depending on the types of costs included, the specific health impacts considered and the definitions used, it is clear that the impact of relatively high levels of obesity and physical inactivity are not inconsequential .
( 3) a discussion of the limitations of the bmi is contained in: health canada, canadian guidelines for body weight classification in adults, ottawa, 2003, and kim d. raine, overweight and obesity in canada: a population health perspective, ottawa, 2004 .
about one in four adults in this country or about 6. 3 million people, were classified as obese in 2011 - 2012, according to statistics canada .
competing interests: none declared for james douketis and katherine morrison. david lau owns common shares in glaxosmithkline and eli lilly. he is a consultant to abbott laboratories, ltd. , astrazeneca canada inc. , merck frosst canada inc. , bristol - myers squibb canada, eli lilly canada inc. , oryx pharmaceuticals inc. , pfizer canada inc. , sanofi - aventis canada inc. , servier canada inc. and solvay pharma inc. ; and has received speaker fees from abbott laboratories, ltd. , astrazeneca canada inc. , glaxosmithkline, merck frosst canada inc. , merck / schering, eli lilly canada inc. , sanofi - aventis canada inc. and novo nordisk canada inc. ; research grants from astrazeneca canada inc. , bristol myers squibb, dainippon pharmaceuticals, glaxosmithkline, pfizer canada inc. , and sanofi - aventis canada inc. ; and travel assistance to attend international meetings from abbott laboratories, ltd. , astrazeneca canada inc. and sanofi - aventis canada inc. irene hramiak is a consultant to glaxosmithkline inc. and is on a national advisory board for abbott laboratories ltd. , eli lilly, novo nordisk, sanofi - aventis canada inc. and glaxosmithkline inc. she has received honoraria for speaking engagements from merck frosst canada ltd. , glaxosmithkline inc. and novo nordisk and has received a travel grant from novo nordisk. arya sharma is a consultant to abbott laboratories ltd. , boehringer ingelheim, novartis, sanofi - aventis canada inc. and merck frosst canada ltd. he has received speaker fees from abbott laboratories ltd. , boehringer ingelheim, astrazeneca canada inc. , novartis and merck frosst canada ltd. and travel assistance from abbott laboratories ltd. , boehringer ingelheim, merck frosst canada ltd. , novartis and sanofi - aventis canada inc. ehud ur has received speaker fees from sanofi - aventis canada inc. , abbott laboratories, ltd. , glaxosmithkline and novo nordisk; research grants from glaxosmithkline and novo nordisk; and travel assistance from sanofi - aventis canada inc. , abbott laboratories, ltd .
the above statements are among the 21 recommendations released today in a ground - breaking report entitled obesity in canada: a whole - of - society approach for a healthier canada, which was written following an intensive study conducted between february 2014 and june 2015 .
there is a more than a six - fold variation in self - reported obesity across health regions in canada, and the variation among oecd countries is more than 10 - fold .
shields m, carroll md, ogden cl (2011) adult obesity prevalence in canada and the united states. center for disease control and prevention 8 .
statistics canada numbers show saskatchewan also has the highest obesity rate of all the provinces in canada. data from the canadian community health survey shows that 26. 7 per cent of canadians are considered to be obese in 2015. in saskatchewan, that number sits at 45. 9 per cent .
hi there, canada. have you been carrying a few extra pounds lately ?
obesity is more prevalent in older age groups, up to approximately 65 years .
on the basis of measured height and weight from multiple sources during 2007 - 2009, more than one in four adults in canada are obese .
the higher rates of obesity in atlantic canada, meanwhile — 30. 4 per cent of people in newfounland and labrador are considered obese — have been attributed to a lack of physical activity, the canadian press reported in 2013 .
while bmi is trusted as an obesity measure by both health canada and the world health organization, there are questions about its efficacy .
greyhound canada says it is ending passenger bus and freight services in saskatchewan, alberta and manitoba and cancelling all but one route in b. c .
source: health canada, canadian guidelines for body weight classification in adults, ottawa, 2003, p. 3 .
source: analysis of the 2007 / 08 canadian community health survey, statistics canada .
1. because of the health impact of the rising prevalence and incidence of overweight and obesity in canada, we recommend implementing strategies directed at the prevention and treatment of overweight and obesity in children, adolescents and adults [ grade a, level 3 ] .
regional differences in obesity (portable document format (pdf), 109. 63kb )
in recent decades, obesity has become a worldwide issue. the world health organization (
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rates of overweight and obesity in aboriginal population is considerably higher than the rest of canada (adults: 70% ; children under 11 years of age: 62. 5 %) .
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canada ranks fifth for the number of obese adults and sixth for obese children among industrialized countries .
mélisa leclerc director of communications senate of canada 613 - 996 - 2751 melisa. leclerc @ urltoken
obesity is associated with health risks such as diabetes, high blood pressure and cancer, with costs in canada between $ 4. 6 billion and $ 7. 1 billion (associated press )
for the first time in more than a generation, overweight rates among canadian children are falling — raising hopes canada may become one of the first countries to turn the childhood obesity epidemic around .
despite steady progress in the management of obesity, its prevalence continues to rise. to date, population interventions have tended to focus on individual risk factors and have been largely ineffective. hence, sweeping prevention and intervention strategies are required to slow, and hopefully reverse, the alarming increase in obesity prevalence in canada and globally .
sharma would like to see the potential drivers of obesity addressed, such as how our biology may be programmed towards obesity in the womb or the role of gut microbes in explaining differences in how people absorb calories at different rates .
in addition, a study published last week showed that while rates of childhood obesity and overweight plateaued in the u. s. , there has been no decline in any age group. overall, rates of overweight and obesity combined in children remained at about 30 per cent, a rate that would be higher using who criteria. “thus, canada appears to be faring better than the u. s. in the war on obesity, ” sharma and rodd write in the canadian medical association journal .
public pressure to combat obesity has resulted in several legislative interventions in several developed countries. however, whether these initiatives are feasible and effective is questionable. in this article, we provide an overview of legislative approaches that could be implemented in canada. we first look at why a public health approach is necessary .
almost a fifth of the world' s adults with obesity, or 118 million people, live in australia, canada, ireland, new zealand, u. k. and u. s .
audience relations, cbc p. o. box 500 station a toronto, on canada, m5w 1e6
department of community health sciences, university of calgary, calgary, alberta, canada. duttond @ urltoken
the steep rise in obesity over the past few decades is due to responses to an obesogenic environment .
the proportion of overweight tends to be higher in rural areas than in metropolitan areas. in particular, in all the canadian regions considered, obesity has been found to be most prevalent among boys in small town regions of 2, 500 to 19, 999 .
). after age 65, the prevalence of obesity declines. a similar pattern of lower obesity among the youngest and oldest age groups was also found in the 2004
between 1981 and 2007 / 09, obesity rates roughly doubled among both males and females in most age groups in the adult and youth categories .
reported associations between socioeconomic status (ses) and obesity are inconsistent depending on gender and geographic location. globally, these inconsistent observations may hide a variation in the contextual effect on individuals' risk of obesity for subgroups of the population. this study explored the regional variability in the association between ses and bmi in the usa and in canada, and describes the geographical variance patterns by ses category .
individuals, counties, and states in the usa, and individuals, health regions, and provinces in canada. to facilitate reading when comparing countries, we re - labeled the hierarchy as
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this article is no longer available through pubmedcentral canada. you may continue to access the article at: urltoken
epstein lh, paluch ra, gordy cc, et al. decreasing sedentary behaviors in treating pediatric obesity .
the study' s authors reported the number of people with obesity surpassed the number of those underweight in 2004 for women and in 2011 for men .
variation in obesity was also observed at the health region level in 2007 / 08. obesity estimates ranged from a low of 5. 3% in urban / suburban richmond, british columbia, to a high of 35. 9% in the northern mamawetan / keewatin / athabasca region of saskatchewan (
bans on obesogenic foods and ingredients, especially trans fats, represent another government - level legislative intervention proposed to curb the obesity epidemic. in 2003, denmark was the first to implement limits on trans fats in processed foods; new york city followed in 2007. 13 formal evaluations of these interventions are pending. in canada, the city of calgary has banned the use of trans fats in its restaurants, 21 and health canada implemented the trans fat monitoring program in 2007 as one of the task force on trans fat’s recommendations. 23
55. the screening criteria for obesity - related health consequences should be assessed in the clinical setting for sensitivity, specificity and clinical value in improving the health of children with obesity [ grade c, level 4 ] .
( 11) health canada, canadian guidelines for body weight classification in adults, ottawa, 2003, table 1, p. 7. also see: f. xavier pi - sunyer, “the obesity epidemic: pathophysiology and consequences of obesity, ” obesity research, vol. 10, supp. 2, december 2002, pp. 97s - 104s .
lyznicki jm, young dc, riggs ja, et al. obesity: assessment and management in primary care .
there is increasing awareness of the role that governments, corporations and educators can play in preventing and reducing obesity .
newfoundland and labrador and new brunswick had the highest rates of obesity, while rates were lower in western provinces .
mclaren l (2011) socioeconomic status and obesity. the oxford handbook of the social science of obesity. london. pp. 276–288 .
. they indicate that measured obesity ranges from 3. 4% in japan to 34. 3% in the united states, a 10 - fold difference .
. this gradient in regional variance is not present in canada however. yet it is possible these patterns may be linked to local differences in the spatial distribution of resources promoting active living and healthy eating or other resources associated with the adults' weight status
this section was created by content works, postmedia’s commercial content division, on behalf of an innovative medicines canada company .
obesity, defined as a bmi of 30 or higher is associated with health risks such as diabetes, high blood pressure and cancer and associated with an annual cost in canada between $ 4. 6 and $ 7. 1 billion .
shields, margot, tjepkema, michael. 2006. “ trends in adult obesity. ” health reports. vol. 17, no. 3. august. statistics canada catalogue no. 82 - 003. p. 53–59. urltoken
shields, margot, tjepkema, michael. 2006. “ regional differences in obesity. ” health reports. vol. 17, no. 3. august. statistics canada catalogue no. 82 - 003. p. 61–67. urltoken
the prevalence of adult obesity has risen significantly in many countries over the last decades with increases in average body mass index (bmi, kg / m 2) being greatest in wealthier countries [ 1 ], [ 2 ]. the mean worldwide bmi has increased at a rate of approximately 0. 5 kg / m 2 per decade, reaching 1 kg / m 2 per decade in wealthier nations like the usa and canada [ 2 ]. usa and canada have among the highest average bmi [ 2 ] and the usa has a higher prevalence between the two [ 3 ] – [ 5 ]. however, trends in obesity prevalence are similar between the two countries, increasing from 15% in the 1970' s to 32% in 2005 in the usa, and from 12% to 29% in canada [ 6 ]. differences in the ses - bmi relationships have also been reported by geographic location [ 3 ], [ 7 ], with respect to a shift of the burden of obesity towards lower ses groups in developing countries with increasing gross national products [ 3 ], [ 8 ]. although this shift in burden is not always clear in the usa and canada, the difference in prevalence is obvious where canadians tend to be less obese for both genders and all age categories [ 5 ] .
for all health regions). studies have found that the prevalence of obesity tends to be lower in more urban regions, one study showing that obesity was significantly below the national average in montreal, toronto and vancouver on the basis of 2003
in terms of regional differences in the prevalence of obesity, results from the 2004 canadian community health survey suggest that obesity rates did not vary greatly by province in 2004, with the following exceptions. (8) prevalence of obesity among men was significantly higher than the national rate in both newfoundland and labrador (33. 3 %) and manitoba (30. 4 %). for women, the prevalence of obesity significantly exceeded the national rate in newfoundland and labrador (34. 5 %), saskatchewan (32. 9 %) and nova scotia (30. 3 %). for children ages 2 to 17, the prevalence of obesity was significantly higher than the national rate in newfoundland and labrador (17 %) and new brunswick (13 %). raine notes, however, that “… surveillance of behavioural determinants of obesity in canada is currently unable to explain the regional variations in prevalence. ” (9 )
goodman e, whitaker rc. a prospective study of the role of depression in the development and persistence of adolescent obesity .
source: based on figures provided in the gpi atlantic cost of obesity reports for each province, prepared by ronald colman .
the high cost of food in canada' s north has long been a topic of discussion — cases of water have been known to cost as much as $ 105 .
acknowledgements: financial assistance for the development of these guidelines was generously provided in the form of arm' s - length grants - in - aid from abbott laboratories ltd. , astrazeneca canada inc. , glaxosmithkline inc. , merck frosst canada ltd. , pfizer canada inc. , hoffmann–la roche ltd. , johnson and johnson medical products, sanofi - aventis canada inc. and unilever canada inc. sponsors were not involved in any aspect of the guidelines development, the literature interpretation, the decision to publish or any other aspect of publication of the guidelines. the funds were used for conference calls and for organization of and travel to meetings for the members of the steering committee and expert panel committee. none of the members of these committees received any financial or in - kind remuneration for their contribution to this work .
( 10) peter t. katzmarzyk and ian janssen, “the economic costs associated with physical inactivity and obesity in canada: an update, ” canadian journal of applied physiology, vol. 29, no. 1, 2004, p. 104 .
tjepkema, michael. 2006. “ adult obesity. ” health reports. vol. 17, no. 3. august. statistics canada catalogue no. 82 - 003. p. 9. urltoken
tjepkema, michael. 2006. “ adult obesity. ” health reports. vol. 17, no. 3. august. statistics canada catalogue no. 82 - 003. p. 9–24. urltoken
source: statistics canada, canadian community health survey, 2000 - 2001, 2003, and canadian community health survey, 2004 .
reilly jj, mcdowell zc. physical activity interventions in the prevention and treatment of paediatric obesity: systematic review and critical appraisal .
in order to shed light on these issues, this study analyzed and compared ses - bmi associations in the usa and in canada for both women and men. specific objectives were to: 1) describe how variance in bmi is distributed at the individual, regional, and subnational levels, 2) globally assess and compare the ses - bmi associations between the usa and canada, 3) describe geographic variations in bmi within countries, and 4) characterize the geographic patterns of bmi variance by ses group .
although obesity has traditionally been conceptualized as a physical problem for physicians to treat, 8 there is increasing awareness of the role that governments, corporations and educators can play in preventing and reducing obesity. a number of legislative initiatives have already been implemented in canada, but they require monitoring and assessment. community - based interventions have failed in the past because they were inadequately supported by legislative measures that provided an impact at the societal level .
obesity should no longer be viewed as a cosmetic or body - image issue. there is compelling evidence that overweight people are at increased risk of a variety of health problems, including type 2 diabetes, hypertension, dyslipidemia, coronary artery disease, stroke, osteoarthritis and certain forms of cancers. it has recently been estimated that about 1 in 10 premature deaths among canadian adults 20–64 years of age is directly attributable to overweight and obesity. in addition to affecting personal health, the increased health risks translate into an increased burden on the health care system. the cost of obesity in canada has been conservatively estimated to be $ 2 billion a year or 2. 4% of total health care expenditures in 1997. 3 thus, the continuing epidemic of obesity in canada is exacting a high toll on the health of the population .
bray ga, greenway fl. current and potential drugs for treatment of obesity .
another report released by statistics canada in early 2005 presents an alarming outlook for overweight and obesity in canada should current trends continue. the study found that approximately one - third of people who were classified as normal weight in 1994 - 1995 had become overweight by 2002 - 2003, and nearly one - quarter of those who were initially overweight were classified as obese after the eight - year period. conversely, only 10% of those who were overweight in 1994 - 1995 had progressed to a normal weight range by 2002 - 2003. (6 )
these canadian guidelines on the prevention and management of obesity were developed to address the need for evidence - based recommendations for the management of obesity at the individual and population levels, to identify gaps in knowledge and to establish an agenda for future research in this area .
albert sg, mooradian ad. low - dose recombinant human growth hormone as adjuvant therapy to lifestyle modifications in the management of obesity .
researchers say they are especially concerned about the massive increase in the extreme ends of the obesity spectrum – class 2 and class 3 .
the rising prevalence of overweight and obesity in canada is not restricted to the adult population; data for children mirror the trend among adults. although prevalence data for children may vary due to the use of multiple methodologies in the literature, the trends are consistent in showing rapidly increasing rates of overweight and obesity among canadian children. (7) according to one methodology, rates of overweight (including obesity) among children ages 7 to 13 increased by 200% - 300% between 1981 and 2001, though they appear to have stabilized somewhat in recent years (see table 3) .
40. obesity prevention should take a multisector approach— similar to that used for tobacco control in canada. prevention efforts should invest in and target all age groups and span life from infancy to old age. innovative ways to provide access and programs to less economically viable citizens should be developed [ grade c, level4 ] .
). the gradient was not observed in canada. although the mean bmi varies by ses and gender, the variation of bmi by ses and gender is relatively constant at all levels .
tous les manuscrits ainsi que tout le contenu demeurent accessibles sur pubmed central (é. - u .) et europe pubmed central. environ 3000 manuscrits des chercheurs financés par les instituts de recherche en santé du canada (irsc) ont aussi été transférés au dépôt numérique du conseil national de recherches du canada (cnrc) et formeront la collection des instituts de recherche en santé du canada 2009 - 2017 .
at 13. 7 per cent, the northwest territories had the second - worst food security rate in canada in 2011 - 2012, behind nunavut at 36. 7 per cent, and ahead of yukon at 12. 4 per cent .
citation: lebel a, kestens y, clary c, bisset s, subramanian sv (2014) geographic variability in the association between socioeconomic status and bmi in the usa and canada. plos one 9 (6): e99158. urltoken
garriguet, didier. 2008. “ obesity and the eating habits of the aboriginal population. ” health reports. vol. 19, no. 1. march. statistics canada catalogue no. 82 - 003. urltoken
the following is an overview of an historical study and more recent survey results on the prevalence of overweight and obesity among canadians. regardless of the specific studies or surveys used, the statistics are consistent in showing increasing rates of overweight and obesity in canadian society over time .
is defined as weight in kilograms divided by the square of the height in meters (table 1) .
chagnac a, weinstein t, herman m, et al. the effects of weight loss on renal function in patients with severe obesity .
ford es, mokdad ah (2008) epidemiology of obesity in the western hemisphere. journal of clinical endocrinology & metabolism 93: s1–s8 .
the economic costs of obesity are estimated at $ 4. 6 billion in 2008, up about 19% from $ 3. 9 billion in 2000, based on costs associated with the eight chronic diseases most consistently linked to obesity. estimates rise to close to $ 7. 1 billion when based on the costs associated with 18 chronic diseases linked to obesity .
a number of clinical practice guidelines on the assessment and management of obesity have been published in the past. these have been largely based on consensus statements by expert panels. moreover, most of these guidelines focus on individuals rather than on communities and the population as a whole. recognizing these deficiencies, obesity canada — a not - for - profit organization founded in 1999 to improve the health of canadians by decreasing the occurrence of obesity — convened a panel of experts to determine whether a comprehensive set of guidelines could be developed to address not only the management but also the prevention of obesity in both adults and children. members of the steering committee and expert panel unanimously agreed on an evidence - based approach. through the process of developing these guidelines, which began in the spring of 2004, members of the steering committee and expert panel identified major gaps in knowledge regarding obesity treatment and prevention. considerable research is required in many areas to optimize management and to prevent the increasing prevalence of overweight and obesity in canada. the authors' recommendations range from the need for enhanced surveillance and population - based data to new research on the biological, social, cultural and environmental determinants of obesity as well as research on effective treatment strategies, policies and interventions .
a summary of key lessons learned from the international literature on obesity prevention and management .
note: all studies consider the cost of obesity and physical inactivity among adults only .
obesity tends to be more prevalent among males than females; however, this depends to some extent on the age group and whether obesity is self - reported or measured .
mclaren l (2007) socioeconomic status and obesity. epidemiologic reviews 29: 29–48 .
globally, the number of men and women with obesity rose from 105 million in 1975 to 641 million in 2014, a british led team reported in this week' s issue of the lancet medical journal. obesity is determined by body mass index, which is based on height and weight. a score over 30 is considered obese .
ezzati' s team also made projections, saying if post - 2000 trends continue, the global obesity prevalence will reach 18 per cent in men and surpass 21 per cent in women by 2025 .
shields, margot. 2006. “ overweight and obesity among children and youth. ” health reports. vol. 17, no. 3. august. statistics canada catalogue no. 82 - 003. p. 27–42. urltoken
( 2) obesity: preventing and managing the global epidemic, report of a who consultation on obesity, 3 - 5 june 1997, executive summary, p. 2 .
distribution of the household population by adult body mass index (bmi) - health canada (hc) classification, by sex and age group .
19. when treating obesity in children, we suggest using family - oriented behaviour therapy [ grade b, level 1 49 – 53 ] .
le petit, christel, berthelot, jean–marie. 2006. “ obesity—a growing issue. ” health reports. vol. 17, no. 3. august. statistics canada catalogue no. 82 - 003. p. 43–50. urltoken
shields, margot, tremblay, mark s. 2008. “ sedentary behaviour and obesity among canadian adults. ” health reports. vol. 19, no. 2. june. statistics canada catalogue no. 82 - 003. urltoken
giskes k, avendaňo m, brug j, kunst ae (2010) a systematic review of studies on socioeconomic inequalities in dietary intakes associated with weight gain and overweight / obesity conducted among european adults. obesity reviews 11: 413–429 .
several measures have already been implemented in canada to limit access to junk food in schools. the ontario provincial government has mandated the replacement of food and beverages in vending machines with healthy and nutritious alternatives that meet criteria specified by dietitians of canada with respect to fat, fibre, sodium, calcium, and vitamin and mineral contents. 37 the new brunswick provincial government banned junk food from vending machines in elementary schools in 2005. some districts have also banned the sale of sugary and unhealthy foods from their schools and vending machines, or banned vending machines altogether. 13, 33
this change in lifestyle is most evident in the south pacific. on the list of
fattest
countries, eight of the top 10 are in the pacific region .
leiter la, abbott d, campbell nr, et al. lifestyle modifications to prevent and control hypertension. 2. recommendations on obesity and weight loss. canadian hypertension society, canadian coalition for high blood pressure prevention and control, laboratory centre for disease control at health canada, heart and stroke foundation of canada. cmaj 1999; 160 (9 suppl): s7 - 12 .
reviews addressing the association between socioeconomic status (ses) and obesity report inconsistent findings [ 7 ], [ 9 ], [ 10 ]. the most consistent finding is the inverse social gradient for obesity in women in the developed world [ 11 ]. the usa and canada are no exception; obesity prevalence is not consistently associated to educational attainment, although prevalence tends to be lower among college graduates in both countries. income has been found to be negatively associated with obesity, for women [ 12 ], [ 13 ], but non - significant or even positive for men [ 14 ]. racial disparities have been observed in the usa only, with higher prevalence among the black population [ 13 ], [ 15 ] .
- screening for obesity - related conditions (e. g. , dyslipidemia, diabetes )
king d (2011) the future challenge of obesity. the lancet 378: 743–744 .
prus sg (2011) comparing social determinants of self - rated health across the united states and canada. social science & medicine 73: 50–59 .
4. we recommend measuring waist circumference in all adults to assess obesity - related health risks [ grade a, level 3 5, 6 ] .
however, change in vpc was not identical between subsamples. although the level - specific changes (δσ 2) were relatively similar between countries at the individual level (4. 5% to 7. 1 %), much more heterogeneity was found at the geographic levels. reduction in variance at the subnational level was greater in the usa (57. 5% for women and 23. 1% for men) than in canada (28. 3% and 23. 8% respectively). at the regional level, reduction in variance was greater in canada (61. 9% and 53. 8 %) than in the usa (26. 8% and 10. 8 %) .
obesity has traditionally been considered a medical “problem” for physicians to treat. 8 according to the 2006 canadian clinical practice guidelines on the management and prevention of obesity in adults and children, the monitoring of weight in patients at risk for obesity should be an integral part of primary care. 6 however, minimal attention is often given to long - term weight management by primary care physicians. 9, 10
mcgrail km, van doorslaer e, ross na, sanmartin c (2009) income - related health inequalities in canada and the united states: a decomposition analysis. american journal of public health 99: 1856–1863 .
about one in five adults worldwide will have obesity by 2025 if current trends continue, say public health experts who are calling for changes to food policy .
in addition to studies focused on the cost of obesity and inactivity nationwide, gpi atlantic commissioned a series of reports between 2000 and 2001 that estimated the direct and indirect costs of obesity in individual provinces. (16) figures 4 and 5 present comparative results from the eight provincial reports produced. in absolute terms, the less - populated provinces tended to have lower costs of obesity, as one might expect. however, figure 5 demonstrates that these same provinces also tended to spend a larger share of their provincial health care budgets on obesity - related expenditures .
after age 54, the rate of obesity was about the same for men and women. among both sexes, those aged 18 to 19 had the lowest obesity rate (chart 3) .
veerman jl, barendregt jj (2010) population interventions for obesity. epidemiology 21: 274 .
2. because of the lack of adequate information on the prevalence of obesity and related risk factors in canada, particularly among subgroups of the population, we recommend the creation of a national surveillance system that incorporates, at a minimum, measurements of height, weight and waist circumference [ grade a, level3 ] .
canadian diabetes association clinical practice guidelines expert committee. canadian diabetes association 2003 clinical practice guidelines for the prevention and management of diabetes in canada. can j diabetes 2003: 27 (suppl 2): s1 - 152 .
as with trans fats, sodium is an ingredient often present in excess in junk and processed foods that may also directly contribute to the obesity epidemic by enhancing the palatability and overconsumption of these foods. thus, it has been proposed that reducing the amount of sodium in processed and junk foods, thereby making them less palatable, may help reduce the obesity epidemic. 14, 27
table 3 presents the distribution of the variance for the subnational, regional, and individual levels. most of the variance was at the individual level. the variance partition coefficient (vpc) showed that the proportion of bmi variation at the geographic levels was slightly higher for women in the usa than in canada (4. 0% and 3. 3% respectively). for men, the difference was greater in the usa (4. 9 %) than in canada (2. 4 %). when adjusting for age, race, education, income and living in an urban environment, about 1% of this higher - level variance was explained among women in both countries. this represents the portion of the bmi variance distributed at the regional and subnational levels that is explained by the geographic distribution of age, race, education, income and living in an urban environment. for men, adding these variables explained only 0. 4% of the contextual variance in the usa and 0. 9% in canada .
figure 1 shows the 95% ci of bmi means by education and income category. the reference category (young, highest income, graduate studies, white, living in an urban environment) had a higher bmi in the usa than in canada, both for women and men. for women, associations were similar in both countries: the lower the household income or education level, the higher the bmi. this gradient, however, was stronger in the usa .
what factors influence body weight, and in particular overweight and obesity? at the most fundamental level, overweight and obesity result from an imbalance between caloric intake and usage. in support of this perspective, health and nutrition experts cite increasingly sedentary lifestyles resulting from urban planning and technological changes in the way we work; they also point to increasing portion sizes and the poor availability of nutritional food choices in schools and workplaces. however, “there is no consensus as to whether the current obesity epidemic in north america is primarily the result of high levels of physical inactivity or high dietary intake of energy - dense foods, and it is likely that both dietary intake and physical inactivity have played a role in the increasing prevalence of overweight and obesity. ” (10 )
since academic systems between and within countries are not uniform, educational attainment categories were based on the number of completed school years, and on diplomas earned. in the usa, the “no high school diploma” category includes those who never went to school up to those who stopped after 11 years of schooling; in canada, this category includes also those who had been thirteen years at school but had no diploma. the “high school” category includes grade 12 or the equivalent in the usa; in canada, this category includes only those who successfully finished high school (secondary - 5 diploma or 13 th year completed). the “college” category includes those who had completed one to three years of college or technical school in the usa; in canada it includes all those who did some post - secondary, with or without a college diploma, including those who received a university certificate (only one year at the university). finally in the usa, the “graduate studies” category includes at least four years spent at college and graduation; in canada, this category includes those with a baccalaureate diploma or higher. we used the same educational attainment category label, although slight differences in their meaning exist between both countries .
shields, margot, connor gorber, sarah, tremblay, mark s. 2008. “ effects of measurement on obesity and morbidity. ” health reports. vol. 19, no. 2. june. statistics canada catalogue no. 82 - 003. urltoken
the study population includes adults from both the usa and canada. table 1 presents the sample size for the brfss and cchs. observations with missing information regarding bmi, age, education, race, household size were removed as well as all pregnant women (10. 4% in the usa and 13. 8% in canada). observations for which income information was missing were kept by using a missing income category. mean bmi for excluded individuals was the same for all categories (average difference less than 0. 1 kg / m 2) except for canadian women for whom the mean bmi was 0. 85 kg / m 2 higher. study samples were reduced to participants living in contiguous and continental states in the usa, and in the 10 provinces of canada – thereby excluding territories .
without societal changes, a substantial and steadily rising proportion of adults will succumb to the medical complications of obesity; indeed, the medical burden of obesity already threatens to overwhelm health services. the spectrum of problems seen in both developing and developed countries is having so negative an impact that obesity should be regarded as today’s principal neglected public health problem. (2 )
in 2014, 20. 2% of canadians aged 18 and older, roughly 5. 3 million adults, reported height and weight that classified them as obese. the rate of obesity among men increased to 21. 8% in 2014 from 20. 1% in 2013, and is the highest obesity rate for men reported since 2003 (in 2003, 16. 0% of males were obese). among women, the rate of obesity in 2014 (18. 7 %) was an increase over 2013 and also up significantly from 2003 when it was 14. 5% (chart 1) .
summerbell cd, ashton v, campbell kj, et al. interventions for treating obesity in children. cochrane database syst rev 2003; (3): cd001872 .
source: based on figures provided in the gpi atlantic cost of obesity reports for each province, prepared by ronald colman, . compiled by the library of parliament .
wing rr, jeffery rw. outpatient treatments of obesity: a comparison of methodology and clinical results .
freedman ds (2011) obesity - united - states, 1988–2008. center for disease control and prevention
this study underlines how bmi varies by country, region, gender and ses. lower socioeconomic groups within some regions show a much higher variation in bmi than in other regions. above the bmi regional mean, important variation patterns of bmi by ses and place of residence were found in the usa. no such pattern was found in canada. this study suggests that a change in the mean does not necessarily reflect the change in the variance. analyzing the variance by ses may be a good way to detect subtle influences of social forces underlying social inequalities .
the cause of obesity is complex and multifactorial. within the context of environmental, social and genetic factors, at the simplest level obesity results from long - term positive energy balance — the interaction of energy intake and energy expenditure. the rapid increase in the prevalence of obesity over the past 20 years is a result of environmental and cultural influences rather than genetic factors. with progressive improvements in the standard of living in developed and developing countries, overnutrition and sedentary lifestyle have supplanted physical labour and regular physical activity, which has resulted in positive energy balance and overweight .
stamatakis ka, leatherdale st, marx cm, yan y, colditz ga, et al. (2012) where is obesity prevention on the map? : distribution and predictors of local health department prevention activities in relation to county - level obesity prevalence in the united states. journal of public health management and practice 18: 402–411 .
shields, margot, connor gorber, sarah, tremblay, mark s. 2008. “ estimates of obesity based on self–report versus direct measures. ” health reports. vol. 19, no. 2. june. statistics canada catalogue no. 82 - 003. urltoken
to encourage thoughtful and respectful conversations, first and last names will appear with each submission to cbc / radio - canada' s online communities (except in children and youth - oriented communities). pseudonyms will no longer be permitted .
sources: c. laird birmingham et al. , “the cost of obesity in canada, ” canadian medical association journal, vol. 160, no. 4, february 1999, pp. 483 - 488; peter t. katzmarzyk, norman gledhill, and roy j. shephard, “the economic burden of physical inactivity in canada, ” canadian medical association journal, vol. 163, no. 11, november 2000, pp. 1435 - 1440; and katzmarzyk and janssen (2004), pp. 90 - 115. table prepared by the library of parliament .
( 5) peter t. katzmarzyk, “ the canadian obesity epidemic: an historical perspective, ” obesity research, vol. 10, no. 7, july 2002, pp. 666 - 674 .
all analyses were performed using mlwin 2. 27 with the iterated generalized least squares (igls) estimation method and the standardized sampling weights provided by cdc or statistics canada .
the objective of this study was to determine if the prevalence of overweight and obesity is associated with neighbourhood walkability. the analysis tested whether a dose - response relationship between the street smart walk score® and various measures of physical activity, overweight, and obesity existed in a large, population - based sample of adults in urban and suburban ontario .
the growing problem of obesity in canada can be reversed only with an integrated approach involving both the public health and medical models. stakeholders at all levels must be involved to achieve the greatest overall impact. there is a greater need than ever for strong political will to effect these complex societal changes, and for champions at all levels of government to step forward and do so in new, innovative and effective ways .
obesity rates surged 200 per cent between 1985 and 2011 among canadian adults over age 18. (cbc )
mckeown - eyssen g (2006) methodologic issues for the study of obesity. epidemiology 17: 134–135 .
by following canada' s food guide, your family will be able to meet their energy and nutrient needs. keep your fridge stocked with foods from all four food groups .
ogden cl, lamb mm, caroll md, flegal km (2010) obesity and socioeconomic status in adults: united - states, 2005–2008. center for disease control and prevention
michimi a, wimberly mc (2010) spatial patterns of obesity and associated risk factors in the conterminous u. s. american. journal of preventive medicine 39: 1–12 .
our exploratory analyses provided new insights on the geographic variability of the association between bmi, education, and income in the usa and in canada, as well as the distribution of its associated variance. this paper shows how ses - bmi associations vary geographically beyond individual level associations. the current knowledge on obesity would particularly benefit from a repeated cross - sectional or longitudinal application of this modeling strategy. this could reveal how the variance in ses - bmi associations evolves through both space and time .
because obesity is increasingly viewed as a societal issue, members of the steering committee and expert panel unanimously agreed to include chapters on the prevention of obesity in children and adults at the population level, as well as implications of the guidelines for health policy - makers and other interested parties .
( 14) larissa roux and cam donaldson, “economics and obesity: costing the problem or evaluating solutions? ” obesity research, vol. 12, no. 2, february 2004, pp. 173 - 179 .
the situation was very different for men. the average bmi of the reference category was about two points higher than for women in both countries. income was not associated with bmi in the usa, and a positive association was observed in canada –higher income levels translating into higher bmis. concerning the education level, an inversed u - shaped relation was observed in the usa where respondents with graduated studies and those without high school diploma had the lowest bmi, while those with some college education had the highest (figure 1c). in canada, only the most educated men had a slightly, but significantly, different bmi than all other categories, with an average 0. 5 kg / m 2 lower.
obesity in canada is a growing health concern , which is " expected to surpass smoking as the leading cause of preventable morbidity and mortality … and represents a burden of can $ 3.96 ( us$ 3.04 / € 2.75 ) billion on the canadian economy each year . " 
obesity in canada is a growing health concern, which is " expected to surpass smoking as the leading cause of preventable morbidity and mortality … and represents a burden of can $ 3.96 (us$ 3.04 / € 2.75) billion on the canadian economy each year. "
obesity in canada is a growing health concern, which is " expected to surpass smoking as the leading cause of preventable morbidity and mortality … and represents a burden of can $ 3.96 (us$ 3.04 / € 2.75) billion on the canadian economy each year. "