title: Role of overweight and obesity in low back disorders among men: a longitudinal study with a life course approach.
abstract: OBJECTIVE
  To assess the association between being overweight or obese with low back pain (LBP) and clinically defined low back disorders across the life course.
  
  
  METHODS
  A longitudinal and cross-sectional study.
  
  
  METHODS
  A nationwide health survey supplemented with data from records of prior compulsory military service.
  
  
  METHODS
  Premilitary health records (baseline) were searched for men aged 30-50 years (n=1385) who participated in a national health examination survey (follow-up).
  
  
  METHODS
  Height and weight were measured at baseline and follow-up, and waist circumference at follow-up. Weight at the ages of 20, 30, 40 and 50 years were ascertained, when applicable. Repeated measures of weight were used to calculate age-standardised mean body mass index (BMI) across the life course. The symptom-based outcome measures at follow-up included prevalence of non-specific and radiating LBP during the previous 30 days. The clinically defined outcome measures included chronic low back syndrome and sciatica.
  
  
  RESULTS
  Baseline BMI (20 years) predicted radiating LBP in adulthood, with the prevalence ratio (PR) being 1.26 (95% CI 1.08 to 1.46) for one SD (3.0 kg/m(2)) increase in BMI. Life course BMI was associated with radiating LBP (PR=1.23; 95% CI 1.03 to 1.48 per 1 unit increment in Z score, corresponding to 2.9 kg/m(2)). The development of obesity during follow-up increased the risk of radiating LBP (PR=1.91, 95% CI 1.03 to 3.53). Both general and abdominal obesity (defined as waist-to-height ratio) were associated with radiating LBP (OR=1.64, 95% CI 1.02 to 2.65 and 1.44, 95% CI 1.02 to 2.04). No associations were seen for non-specific LBP.
  
  
  CONCLUSIONS
  Our findings imply that being overweight or obese in early adulthood as well as during the life course increases the risk of radiating but not non-specific LBP among men. Taking into account the current global obesity epidemic, emphasis should be placed on preventive measures starting at youth and, also, measures for preventing further weight gain during the life course should be implemented.
authors: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Heikki
authors: H
authors: Frilander
authors: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Svetlana
authors: S
authors: Solovieva
authors: Department of Statistics and Health Economics, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Pertti
authors: P
authors: Mutanen
authors: Department of Orthopaedics and Trauma Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland University of Tampere, Seinäjoki, Finland.
authors: Harri
authors: H
authors: Pihlajamäki
authors: Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland.
authors: Markku
authors: M
authors: Heliövaara
authors: Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Eira
authors: E
authors: Viikari-Juntura
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D006801:Humans; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D056128:Obesity, Abdominal / Q000150:complications; D050177:Overweight / Q000150:complications*; D055815:Young Adult
keywords: EPIDEMIOLOGY