The association of education with body mass index and waist circumference in the EPIC-PANACEA study.
Silke Hermann
(1)
,
Sabine Rohrmann
(1, 2)
,
Jakob Linseisen
(1, 3)
,
Anne May
(4, 5)
,
Anton Kunst
(6)
,
Herve Besson
(4, 7)
,
Dora Romaguera
(8)
,
Noemie Travier
(9)
,
Maria-Jose Tormo
(10, 11, 12)
,
Esther Molina
(12, 13)
,
Miren Dorronsoro
(12, 14)
,
Aurelio Barricarte
(12, 15)
,
Laudina Rodríguez
(16)
,
Francesca Crowe
(17)
,
Kay-Tee Khaw
(18)
,
Nicholas Wareham
(7)
,
Petra van Boeckel
(5)
,
H Bas Bueno-De-Mesquita
(5)
,
Kim Overvad
(19, 20)
,
Marianne Uhre Jakobsen
(20)
,
Anne Tjønneland
(21)
,
Jytte Halkjær
(21)
,
Claudia Agnoli
(22)
,
Amalia Mattiello
(23)
,
Rosario Tumino
(24)
,
Giovanna Masala
(25)
,
Paolo Vineis
(26, 27)
,
Androniki Naska
(28)
,
Philippos Orfanos
(28)
,
Antonia Trichopoulou
(28, 29)
,
Rudolf Kaaks
(1)
,
Manuela Bergmann
(30)
,
Annika Steffen
(30)
,
Bethany van Guelpen
(31)
,
Ingegerd Johansson
(32)
,
Signe Borgquist
(33)
,
Jonas Manjer
(34)
,
Tonje Braaten
(35)
,
Guy Fagherazzi
(36)
,
Françoise Clavel-Chapelon
(36)
,
Traci Mouw
(8)
,
Teresa Norat
(8)
,
Elio Riboli
(8)
,
Sabina Rinaldi
(37)
,
Nadia Slimani
(37)
,
Petra Peeters
(4)
1
Division of Cancer Epidemiology
2 Social and Preventive Medicine Institute
3 Institute of Epidemiology
4 Julius Centre for Health Sciences and Primary Care
5 RIVM - National Institute for Public Health and the Environment [Bilthoven]
6 AMC - Academic Medical Center - Academisch Medisch Centrum [Amsterdam]
7 Medical Research Council
8 Department of Epidemiology & Public Health
9 Unit of Nutrition, Environment and Cancer
10 Epidemiology Service
11 Preventive Medicine and Public Health Unit
12 CIBERESP - CIBER Epidemiología y Salud Pública
13 Andalusian School of Public Health [Granada]
14 Public Health Department of Gipuzkoa
15 Public Health Institute of Navarra
16 Public Health and Participation Directorate
17 Cancer Epidemiology Unit
18 Department of Public Health and Primary Care
19 Department of Cardiology
20 Department of Clinical Epidemiology
21 Danish Cancer Society
22 Nutritional Epidemiology Unit
23 Department of Clinical and Experimental Medicine
24 Cancer Registry and Histopathology Unit
25 Molecular and Nutritional Epidemiology Unit
26 ISI Foundation Institute for Scientific Interchange
27 Environmental Epidemiology
28 Department of Hygiene and Epidemiology
29 Hellenic Health Foundation
30 DifE - Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
31 Department of Medical Biosciences and Pathology
32 Department of Odontology
33 Department of Oncology
34 Department of Surgery
35 Institute of Community Medicine
36 E3N - Nutrition, hormones et cancer: épidémiologie et prévention
37 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
2 Social and Preventive Medicine Institute
3 Institute of Epidemiology
4 Julius Centre for Health Sciences and Primary Care
5 RIVM - National Institute for Public Health and the Environment [Bilthoven]
6 AMC - Academic Medical Center - Academisch Medisch Centrum [Amsterdam]
7 Medical Research Council
8 Department of Epidemiology & Public Health
9 Unit of Nutrition, Environment and Cancer
10 Epidemiology Service
11 Preventive Medicine and Public Health Unit
12 CIBERESP - CIBER Epidemiología y Salud Pública
13 Andalusian School of Public Health [Granada]
14 Public Health Department of Gipuzkoa
15 Public Health Institute of Navarra
16 Public Health and Participation Directorate
17 Cancer Epidemiology Unit
18 Department of Public Health and Primary Care
19 Department of Cardiology
20 Department of Clinical Epidemiology
21 Danish Cancer Society
22 Nutritional Epidemiology Unit
23 Department of Clinical and Experimental Medicine
24 Cancer Registry and Histopathology Unit
25 Molecular and Nutritional Epidemiology Unit
26 ISI Foundation Institute for Scientific Interchange
27 Environmental Epidemiology
28 Department of Hygiene and Epidemiology
29 Hellenic Health Foundation
30 DifE - Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
31 Department of Medical Biosciences and Pathology
32 Department of Odontology
33 Department of Oncology
34 Department of Surgery
35 Institute of Community Medicine
36 E3N - Nutrition, hormones et cancer: épidémiologie et prévention
37 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
Sabine Rohrmann
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Jakob Linseisen
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Anne May
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Anton Kunst
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Herve Besson
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Maria-Jose Tormo
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Esther Molina
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Miren Dorronsoro
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Aurelio Barricarte
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Petra van Boeckel
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H Bas Bueno-De-Mesquita
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Kim Overvad
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Amalia Mattiello
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Paolo Vineis
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Antonia Trichopoulou
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Manuela Bergmann
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Annika Steffen
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Bethany van Guelpen
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Guy Fagherazzi
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Françoise Clavel-Chapelon
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Sabina Rinaldi
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Nadia Slimani
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Petra Peeters
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Résumé
BACKGROUND: To examine the association of education with body mass index (BMI) and waist circumference (WC) in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHOD: This study included 141,230 male and 336,637 female EPIC-participants, who were recruited between 1992 and 2000. Education, which was assessed by questionnaire, was classified into four categories; BMI and WC, measured by trained personnel in most participating centers, were modeled as continuous dependent variables. Associations were estimated using multilevel mixed effects linear regression models. RESULTS: Compared with the lowest education level, BMI and WC were significantly lower for all three higher education categories, which was consistent for all countries. Women with university degree had a 2.1 kg/m2 lower BMI compared with women with lowest education level. For men, a statistically significant, but less pronounced difference was observed (1.3 kg/m2). The association between WC and education level was also of greater magnitude for women: compared with the lowest education level, average WC of women was lower by 5.2 cm for women in the highest category. For men the difference was 2.9 cm. CONCLUSION: In this European cohort, there is an inverse association between higher BMI as well as higher WC and lower education level. Public Health Programs that aim to reduce overweight and obesity should primarily focus on the lower educated population.
Domaines
Santé publique et épidémiologie
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