title: Prevalence and associated factors of obesity among Panamanian adults. 1982-2010.
abstract: BACKGROUND
  In Central America, there has been a marked increase in obesity in the last 30 years. Over this time frame, in Panama, there have been lifestyle changes associated with economic development and urbanization that may have facilitated increases in body weight. The aim of the study is to describe the change in the prevalence of obesity in the country since 1982 and to analyze the association of obesity with gender, place of residence and socioeconomic factors.
  
  
  METHODS
  We analyzed three nationally representative cross-sectional studies and one sub-national study of Panamanian adults that evaluated anthropometric and socioeconomic variables; ENPA-1982 (n = 11 611), ENV-II 2003 (n = 14 737), ENV-III 2008 (n = 15 484), PREFREC-2010 (n  = 3 590). We also evaluated one nationally representative study that evaluated people's perception of their body weight, ENSCAVI-2007 (n = 25 748).
  
  
  RESULTS
  In 1982, the prevalence in males of a body mass index (BMI) ≥ 30 kg/m2 was 3.8% (3.3-4.2) and in females 7.6% (6.9-8.2). In 2003, the prevalence in males increased to 14.4% (13.6-15.2) and in females to 21.8% (20.8-22.7). In 2008, the prevalence in males was 16.9% (16.0-17.7) and in females it was 23.8% (22.8-24.7). Nevertheless, in 2007, the national perception of being obese was only 4% among males and 6.7% among females. The highest prevalence of obesity was noted in urban areas. Female gender and higher income were found to be positively associated with obesity. Income level was positively associated with abdominal obesity in men but not in women.
  
  
  CONCLUSIONS
  There has been a marked increase of obesity in Panama in the last 3 decades. Initiatives to control this problem will have to take into consideration the observed gender difference and the lifestyle changes that have contributed to the rise of this problem.
authors.affiliation: Gorgas Memorial Institute for Health Studies, Panamá City, Panamá
authors.forename: Morris
authors.initials: M
authors.lastname: Sasson
authors.affiliation: Gorgas Memorial Institute for Health Studies, Panamá City, Panamá
authors.forename: Marcos
authors.initials: M
authors.lastname: Lee
authors.affiliation: Gorgas Memorial Institute for Health Studies, Panamá City, Panamá
authors.forename: Carmen
authors.initials: C
authors.lastname: Jan
authors.affiliation: Department of Nutrition, Ministry of Health, Panamá City, Panamá
authors.forename: Flavia
authors.initials: F
authors.lastname: Fontes
authors.affiliation: Gorgas Memorial Institute for Health Studies, Panamá City, Panamá
authors.forename: Jorge
authors.initials: J
authors.lastname: Motta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D010176:Panama / Q000453:epidemiology; D015995:Prevalence; D011634:Public Health; D017678:Sex Distribution; D012959:Socioeconomic Factors; D055815:Young Adult