title: Overweight and health problems of the lower extremities: osteoarthritis, pain and disability.
abstract: OBJECTIVE
  To examine the association between overweight and health problems of the lower extremities, i.e. osteoarthritis (OA), pain and disability.
  
  
  METHODS
  Cross-sectional data from the Dutch population-based Musculoskeletal Conditions & Consequences Cohort (DMC3), comprising a random sample from the Dutch population aged >25 years (n 3664), were analysed using multivariate logistic regression. Overweight was defined as BMI > or = 25.0 kg/m2, moderate overweight as 25.0 kg/m2 < or = BMI < 30.0 kg/m2 and obesity as BMI > or = 30.0 kg/m2. Health problems of the lower extremities were: (i) self-reported OA of the hip or knee as told by a doctor; (ii) presence of self-reported chronic pain (>3 months) of the lower extremities; and (iii) disabilities in mobility as measured by the Euroqol questionnaire (EQ-5D).
  
  
  RESULTS
  Moderate overweight was associated with self-reported OA of the hip or knee (OR = 1.7; 95 % CI 1.4, 2.1), chronic pain of the lower extremities at one or more location(s) (OR = 1.6; 95 % CI 1.3, 1.9) and disability in mobility (OR = 1.7; 95 % CI 1.4, 2.0). For obesity these odds were higher: 2.8 (95 % CI 2.1, 3.7), 2.5 (95 % CI 1.9, 3.2) and 3.0 (95 % CI 2.3, 3.9), respectively. Also, among those with OA, moderate overweight and obesity were associated with disability in mobility.
  
  
  CONCLUSIONS
  There is a strong association between overweight/obesity and health problems of the lower extremities, i.e. OA, pain and disability. The increasing prevalence of overweight and obesity worldwide urges for public health action not only for diabetes and heart disease, but also OA.
authors.affiliation: Centre for Prevention and Health Research, National Institute of Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Tukker
authors.forename: T L S
authors.initials: TL
authors.lastname: Visscher
authors.forename: H S J
authors.initials: HS
authors.lastname: Picavet
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D010003:Osteoarthritis / Q000453:epidemiology / Q000209:etiology*; D050177:Overweight / Q000150:complications* / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology / Q000209:etiology*