title: No strong temporal relationship between obesity and multisite pain--results from a population-based 20-year follow-up study.
abstract: BACKGROUND
  Multisite pain and obesity are cross-sectionally related and are common conditions that may influence each other through socio-demographic, lifestyle and/or health-related factors. The aim of the present study was to examine the cross-sectional and prospective associations between overweight/obesity and multisite pain in a general population.
  
  
  METHODS
  In a 20-year population-based prospective cohort study, persons aged 20-62 years in 1990 participated in postal surveys in 1990, 1994, 2004 and 2010 (n = 855). Multisite pain was defined as reporting ≥ 2 number of pain sites (NPS) on the Standardized Nordic Questionnaire. Overweight was defined as body mass index (BMI) 25-30 kg/m(2) and obesity as BMI ≥ 30 kg/m(2). To exploit all measurement times, generalized estimating equation analyses adjusting for age, sex, educational and occupational status, smoking, sleep quality, mental distress and physical activity were employed.
  
  
  RESULTS
  The mean age was 41 years at baseline and 57% were women. Overweight/obesity and NPS were significantly associated cross-sectionally. Being overweight/obese was associated with reporting future NPS ≥ 2 [overweight: odds ratio (OR), 1.40, 95% confidence interval (CI), 1.12-1.75, obese: OR, 1.54, 95% CI, 1.04-2.28]. Having NPS ≥ 2 was not associated with becoming overweight, but increased the OR for future obesity (OR 1.27, 95% CI, 1.02, 1.59). Smoking was a confounder in this relationship.
  
  
  CONCLUSIONS
  Being overweight or obese was associated with future multisite pain, although the magnitude of the association was small and the dose-response relationship observed in cross-sectional analyses disappeared in prospective analyses. There was less evidence that having multisite pain was a predictor of future overweight/obesity.
authors.affiliation: National Resource Center for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Magnusson
authors.forename: N
authors.initials: N
authors.lastname: Østerås
authors.forename: P
authors.initials: P
authors.lastname: Mowinckel
authors.forename: B
authors.initials: B
authors.lastname: Natvig
authors.forename: K B
authors.initials: KB
authors.lastname: Hagen
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D059352:Musculoskeletal Pain / Q000150:complications* / Q000453:epidemiology; D009664:Norway / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D050177:Overweight / Q000150:complications / Q000453:epidemiology; D010147:Pain Measurement; D011153:Population; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires