title: Obesity and associated lifestyle in a large sample of multi-morbid German primary care attendees.
abstract: BACKGROUND
  Obesity and the accompanying increased morbidity and mortality risk is highly prevalent among older adults. As obese elderly might benefit from intentional weight reduction, it is necessary to determine associated and potentially modifiable factors on senior obesity. This cross-sectional study focuses on multi-morbid patients which make up the majority in primary care. It reports on the prevalence of senior obesity and its associations with lifestyle behaviors.
  
  
  METHODS
  A total of 3,189 non-demented, multi-morbid participants aged 65-85 years were recruited in primary care within the German MultiCare-study. Physical activity, smoking, alcohol consumption and quantity and quality of nutritional intake were classified as relevant lifestyle factors. Body Mass Index (BMI, general obesity) and waist circumference (WC, abdominal obesity) were used as outcome measures and regression analyses were conducted.
  
  
  RESULTS
  About one third of all patients were classified as obese according to BMI. The prevalence of abdominal obesity was 73.5%. Adjusted for socio-demographic variables and objective and subjective disease burden, participants with low physical activity had a 1.6 kg/m2 higher BMI as well as a higher WC (4.9 cm, p<0.001). Current smoking and high alcohol consumption were associated with a lower BMI and WC. In multivariate logistic regression, using elevated WC and BMI as categorical outcomes, the same pattern in lifestyle factors was observed. Only for WC, not current but former smoking was associated with a higher probability for elevated WC. Dietary intake in quantity and quality was not associated with BMI or WC in either model.
  
  
  CONCLUSIONS
  Further research is needed to clarify if the huge prevalence discrepancy between BMI and WC also reflects a difference in obesity-related morbidity and mortality. Yet, age-specific thresholds for the BMI are needed likewise. Encouraging and promoting physical activity in older adults might a starting point for weight reduction efforts.
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, Leipzig, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Sikorski
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.affiliation: Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
authors.affiliation: Department of Medical Sociology, Social Medicine and Health Economics, Hamburg-Eppendorf University Medical Center, Hamburg, Germany.
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.affiliation: Department of Medical Biometry and Epidemiology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schön
authors.affiliation: Institute of General Practice, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany.
authors.forename: Juliana J
authors.initials: JJ
authors.lastname: Petersen
authors.affiliation: Department of General Practice, Jena University Hospital, Jena, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Gensichen
authors.affiliation: Department of General Practice, Medical Faculty, University of Dusseldorf, Dusseldorf, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Fuchs
authors.affiliation: Department of Psychiatry, Technical University of Munich, München, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Bickel
authors.affiliation: Institute for Biometry, Hannover Medical School, Hannover, Germany.
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.affiliation: Department of Primary Medical Care, Hamburg-Eppendorf University Medical Center, Hamburg, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Hansen
authors.affiliation: Department of Primary Medical Care, Hamburg-Eppendorf University Medical Center, Hamburg, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: van den Bussche
authors.affiliation: Department of Primary Medical Care, Hamburg-Eppendorf University Medical Center, Hamburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Scherer
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009017:Morbidity; D056128:Obesity, Abdominal / Q000453:epidemiology* / Q000503:physiopathology*; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D055105:Waist Circumference / Q000502:physiology