TY - JOUR
T1 - Lower Prevalence of Body Fat-Defined Obesity at Higher Altitudes in Peruvian Adults
AU - Woolcott, Orison O.
AU - Seuring, Till
AU - Castillo, Oscar A.
N1 - Publisher Copyright:
© Mary Ann Liebert, Inc.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - Woolcott, Orison O., Till Seuring, and Oscar A. Castillo. Lower prevalence of body fat-defined obesity at higher altitudes in Peruvian adults. High Alt Med Biol. 24:214–222, 2023. Background: Previous studies have reported a lower prevalence of obesity (defined as a body mass index [BMI] ≥30 kg/m2) in populations from higher altitudes. Since BMI does not distinguish fat mass and fat-free mass, it is unclear whether there is an inverse association between altitude and body fat-defined obesity. Methods: We performed an analysis of cross-sectional data to examine the association between altitude and body fat-defined obesity (as opposed to BMI-defined obesity) using individual-level data from a nationally representative sample of the Peruvian adult population living between 0 and 5,400 m altitude. Body fat-defined obesity was diagnosed using the relative fat mass (RFM), an anthropometric index validated to estimate whole-body fat percentage. RFM cutoffs for obesity diagnosis were ≥40% for women and ≥30% for men. We utilized Poisson regression to estimate the prevalence ratio and confidence intervals (CIs) as the measure of the association, adjusting for age, cigarette use, and diabetes. Results: Analysis comprised 36,727 individuals (median age, 39 years; 50.1% women). In rural areas, for a one-km increase in altitude, the prevalence of body fat-defined obesity decreased by 12% among women (adjusted prevalence ratio: 0.88; 95% CI, 0.86 − 0.90; p<0.001) and 19% among men (adjusted prevalence ratio: 0.81; 95% CI, 0.77 − 0.86; p<0.001), on average, when all the other variables were held constant. The inverse association between altitude and obesity was less strong in urban areas than in rural areas but remained significant among women (p = 0.001) and men (p<0.001). However, the relationship between altitude and obesity in women who live in urban areas appears to be nonlinear. Conclusions: In Peruvian adults, the prevalence of body fat-defined obesity was inversely associated with altitude. Whether this inverse association is explained by altitude per se or confounded by socioeconomic or other environmental factors, or differences in race/ethnicity or lifestyle, warrants further investigation.
AB - Woolcott, Orison O., Till Seuring, and Oscar A. Castillo. Lower prevalence of body fat-defined obesity at higher altitudes in Peruvian adults. High Alt Med Biol. 24:214–222, 2023. Background: Previous studies have reported a lower prevalence of obesity (defined as a body mass index [BMI] ≥30 kg/m2) in populations from higher altitudes. Since BMI does not distinguish fat mass and fat-free mass, it is unclear whether there is an inverse association between altitude and body fat-defined obesity. Methods: We performed an analysis of cross-sectional data to examine the association between altitude and body fat-defined obesity (as opposed to BMI-defined obesity) using individual-level data from a nationally representative sample of the Peruvian adult population living between 0 and 5,400 m altitude. Body fat-defined obesity was diagnosed using the relative fat mass (RFM), an anthropometric index validated to estimate whole-body fat percentage. RFM cutoffs for obesity diagnosis were ≥40% for women and ≥30% for men. We utilized Poisson regression to estimate the prevalence ratio and confidence intervals (CIs) as the measure of the association, adjusting for age, cigarette use, and diabetes. Results: Analysis comprised 36,727 individuals (median age, 39 years; 50.1% women). In rural areas, for a one-km increase in altitude, the prevalence of body fat-defined obesity decreased by 12% among women (adjusted prevalence ratio: 0.88; 95% CI, 0.86 − 0.90; p<0.001) and 19% among men (adjusted prevalence ratio: 0.81; 95% CI, 0.77 − 0.86; p<0.001), on average, when all the other variables were held constant. The inverse association between altitude and obesity was less strong in urban areas than in rural areas but remained significant among women (p = 0.001) and men (p<0.001). However, the relationship between altitude and obesity in women who live in urban areas appears to be nonlinear. Conclusions: In Peruvian adults, the prevalence of body fat-defined obesity was inversely associated with altitude. Whether this inverse association is explained by altitude per se or confounded by socioeconomic or other environmental factors, or differences in race/ethnicity or lifestyle, warrants further investigation.
KW - altitude
KW - BMI
KW - body fat
KW - obesity
KW - relative fat mass
KW - RFM
UR - http://www.scopus.com/inward/record.url?scp=85171807953&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/361d4836-1e7a-366b-b4ef-6372d716d201/
U2 - 10.1089/ham.2022.0097
DO - 10.1089/ham.2022.0097
M3 - Article
C2 - 37327017
AN - SCOPUS:85171807953
SN - 1527-0297
VL - 24
SP - 214
EP - 222
JO - High Altitude Medicine and Biology
JF - High Altitude Medicine and Biology
IS - 3
ER -