1. The association of education with body mass index and waist circumference in the EPIC-PANACEA study
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Amalia Mattiello, Marianne Uhre Jakobsen, Noémie Travier, Dora Romaguera, Rosario Tumino, Jakob Linseisen, Kim Overvad, Giovanna Masala, Rudolf Kaaks, Aurelio Barricarte, Petra H.M. Peeters, Sabina Rinaldi, Silke Hermann, Petra G. Van Boeckel, Jytte Halkjær, Miren Dorronsoro, Bethany Van Guelpen, Esther Molina, Ingegerd Johansson, Francesca L. Crowe, Anne M. May, Paolo Vineis, Anton E. Kunst, Nadia Slimani, Claudia Agnoli, Signe Borgquist, Philippos Orfanos, H. Bas Bueno-de-Mesquita, Traci Mouw, Antonia Trichopoulou, Françoise Clavel-Chapelon, Elio Riboli, Teresa Norat, Manuela M. Bergmann, Kay-Tee Khaw, Tonje Braaten, Androniki Naska, Laudina Rodríguez, Sabine Rohrmann, Hervé Besson, Guy Fagherazzi, Annika Steffen, Anne Tjønneland, María José Tormo, Jonas Manjer, Nicholas J. Wareham, Division of Cancer Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Social and Preventive Medicine Institute, Universität Zürich [Zürich] = University of Zurich (UZH), Institute of Epidemiology, Helmholtz Centre Munich, Julius Centre for Health Sciences and Primary Care, University Medical Center [Utrecht], National Institute for Public Health and the Environment [Bilthoven] (RIVM), Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), Medical Research Council, Institute of Metabolic Science-Epidemiology Unit, Department of Epidemiology & Public Health, Imperial College London, Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology-Environment and Cancer, Epidemiology Service, Murcia Health Council, Preventive Medicine and Public Health Unit, Murcia Medical School, CIBER Epidemiología y Salud Pública (CIBERESP), CIBER de Epidemiología y Salud Pública (CIBERESP), Andalusian School of Public Health [Granada], Public Health Department of Gipuzkoa, Public Health Institute of Navarra, Public Health and Participation Directorate, Health and Health Care Services Council, Cancer Epidemiology Unit, University of Oxford, Department of Public Health and Primary Care, University of Cambridge [UK] (CAM), Department of Cardiology, Aarhus University Hospital, Department of Clinical Epidemiology, Danish Cancer Society, Institute of Cancer Epidemiology, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Clinical and Experimental Medicine, University of Naples Federico II = Università degli studi di Napoli Federico II, Cancer Registry and Histopathology Unit, Department of Oncology-Civile - M.P.Arezzo Hospital, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), ISI Foundation Institute for Scientific Interchange, Environmental Epidemiology, Department of Hygiene and Epidemiology, University of Athens Medical School [Athens], Hellenic Health Foundation, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DifE), Leibniz Association, Department of Medical Biosciences and Pathology, Umeå University, Department of Odontology, Department of Oncology, Lund University Hospital, Department of Surgery, Malmö University Hospital, Institute of Community Medicine, University of Tromsø (UiT), Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993-2004, Research Directorate-General 2005-.', Ligue contre le Cancer, Societé 3M, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center, Federal Ministry of Education and Research (Germany), Danish Cancer Society (Denmark), Health Research Fund (FIS) of the Spanish Ministry of Health, The participating regional governments and institutions (Spain), Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, the Wellcome Trust (United Kingdom), Greek Ministry of Health and Social Solidarity, Hellenic Health Foundation and Stavros Niarchos Foundation (Greece), Italian Association for Research on Cancer, National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports, Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (the Netherlands), Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skane (Sweden), Norwegian Cancer Society (Norway)., BMC, Ed., University of Zurich, Rohrmann, S, University of Oxford [Oxford], Università degli studi di Napoli Federico II, [Hermann,S, Rohrmann,S, Linseisen,J, Kaaks,R] German Canc Res Ctr, Div Canc Epidemiol, D-6900 Heidelberg, Germany. [Linseisen,J] Helmholtz Ctr Munich, Inst Epidemiol, Neuherberg, Germany. [May,AM., Besson,H, Peeters,PH.M.] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. [May,AM., van Boeckel,PG.A., Bueno-de-Mesquita,H.B] Natl Inst Publ Hlth & Environm RIVM, Bilthoven, Netherlands. [Kunst,A] Univ Amsterdam, Acad Med Ctr, Amsterdam, Netherlands. [Besson,H, Wareham,NJ.] MRC, Inst Metab Sci, Epidemiol Unit, Cambridge, England. [Romaguera,D, Mouw,T, Norat,T, Riboli,E] Univ London Imperial Coll Sci Technol & Med, Dept Epidemiol & Publ Hlth, London, England. [Travier,N] IDIBELL, Catalan Inst Oncol, Unit Nutr Environm & Canc, Barcelona, Spain. [Tormo,MJ] Murcia Hlth Council, Epidemiol Serv, Murcia, Spain. [Tormo,MJ] Murcia Med Sch, Prevent Med & Publ Hlth Unit, Murcia, Spain. [Molina,E] Andalusian Sch Publ Hlth, Granada, Spain. [Dorronsoro,M] Publ Hlth Dept Gipuzkoa, San Sebastian, Spain. [Barricarte,A] Publ Hlth Inst Navarra, Pamplona, Spain. [Rodriguez,L] Hlth & Hlth Care Serv Council, Publ Hlth & Participat Directorate, Asturias, Spain. [Crowe,FL.] Univ Oxford, Canc Epidemiol Unit, Oxford, England. [Khaw,K-T] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England. [Overvad,K] Aarhus Univ Hosp, Aalborg Hosp, Dept Cardiol, Aalborg, Denmark. [Overvad,K, Jakobsen,MU] Aarhus Univ Hosp, Dept Clin Epidemiol, Aalborg, Denmark. [Tjonneland,A, Halkjaer,J] Danish Canc Soc, Inst Canc Epidemiol, Copenhagen, Denmark. [Agnoli,C] Fdn IRCCS Ist Nazl Tumori, Nutr Epidemiol Unit, Milan, Italy. [Mattiello,A] Univ Naples Federico 2, Dept Clin & Expt Med, Naples, Italy. [Tumino,R] Civile MP Arezzo Hosp, Dept Oncol, Canc Registry & Histopathol Unit, Ragusa, Italy. [Masala,G] Canc Res & Prevent Inst ISPO, Mol & Nutr Epidemiol Unit, Florence, Italy. [Vineis,P] ISI Fdn, Turin, Italy. [Naska,A, Orfanos,P, Trichopoulou,A] Univ Athens, Sch Med, Dept Hyg & Epidemiol, Athens, Greece. [Bergmann,MM., Steffen,A] German Inst Human Nutr Potsdam Rehbrucke, Nuthetal, Germany. [Van Guelpen,B] Umea Univ, Dept Med Biosci, Umea, Sweden. [Johansson,I] Umea Univ, Dept Odontol, Umea, Sweden. [Borgquist,S] Univ Lund Hosp, Dept Oncol, Lund, Sweden. [Manjer,J] Malmo Univ Hosp, Dept Surg, Malmo, Sweden. [Braaten,T] Univ Tromso, Inst Community Med, Tromso, Norway. [Fagherazzi,G, Clavel-Chapelon,F] Paris S Univ, Inst Gustave Roussy, Villejuif, France. [Fagherazzi,G, Clavel-Chapelon,F] INSERM, ERI20, Villejuif, France. [Besson,H, Rinaldi,S, Slimani,N] Int Agcy Res Canc, Lyon, France. [Rohrmann,S] Univ Zurich, Inst Social & Prevent Med, Zurich, Switzerland, European Commission: Grant no DG Sanco, project number: 2005328. The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993-2004, Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, Faculteit der Geneeskunde, APH - Amsterdam Public Health, and Public and occupational health
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Male ,Epidemiology ,Body Mass Index ,VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811 ,0302 clinical medicine ,Prospective Studies ,Public, Environmental & Occupational Health ,MESH: Middle Aged ,3. Good health ,MESH: Health Status Disparities ,MESH: Waist Circumference ,Socioeconomic status ,Waist circumference ,Public Health ,Waist Circumference ,Cohort study ,VDP::Medisinske Fag: 700::Helsefag: 800::Medisinsk/odontologisk etikk, atferdsfag, historie: 805 ,Waist ,Pes corporal ,Education ,MESH: Body Mass Index ,VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811 ,03 medical and health sciences ,MESH: Sex Factors ,cohort study ,Humans ,Aged ,Science & Technology ,MESH: Humans ,Prevention ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,MESH: Adult ,Body weight ,medicine.disease ,Obesity ,Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Biometry::Anthropometry::Body Mass Index [Medical Subject Headings] ,Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Prospective Studies [Medical Subject Headings] ,ENERGY-INTAKE ,OXFORD PARTICIPANTS ,PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SCI ,Educació ,MESH: Educational Status ,Body mass index ,MESH: Female ,Demography ,Gerontology ,Overweight ,SOCIOECONOMIC-STATUS ,030212 general & internal medicine ,2. Zero hunger ,MESH: Aged ,education ,Bmi ,Cohort Study ,Epic ,Socioeconomic Status ,lcsh:Public aspects of medicine ,Public Health, Global Health, Social Medicine and Epidemiology ,Middle Aged ,Circumference ,CANCER ,PREVALENCE ,European Prospective Investigation into Cancer and Nutrition ,Europe ,OBESITY ,Educational Status ,Female ,medicine.symptom ,Life Sciences & Biomedicine ,Research Article ,Adult ,VDP::Medical disciplines: 700::Health sciences: 800::Medical/dental ethics, behavioural sciences, history: 805 ,030209 endocrinology & metabolism ,610 Medicine & health ,socioeconomic status ,BMI ,Sex Factors ,Eating disorders and obesity ,Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Size::Waist Circumference [Medical Subject Headings] ,medicine ,ddc:610 ,Nutrition ,OVERWEIGHT ,business.industry ,Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Demography::Health Status::Health Status Disparities [Medical Subject Headings] ,Health Status Disparities ,ADULTS ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,2739 Public Health, Environmental and Occupational Health ,MESH: Prospective Studies ,MESH: Male ,PHYSICAL-ACTIVITY ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,WEIGHT STATUS ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,MESH: Europe ,EPIC ,business - Abstract
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.
- Published
- 2011
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