Large heterogeneity of the obesity epidemic in Danish adults

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Abstract
Objective: To examine to what extent the obesity epidemic is a general phenomenon in adults by assessing the secular change, by birth cohort and age, in the prevalence of obesity and median body mass index (BMI) in Danish men and women measured between 1964 and 1994.Design: Multiple cross-sectional population surveys.Setting: The greater Copenhagen area of Denmark.Subjects: The study included 17 065 men (30 336 observations) and 13 417 women (24 065 observations), aged 20–84 years.Main outcome measures: Trends in median BMI and prevalence of obesity estimated from measured height and weight in 10-year age groups.Results: In general the prevalence of obesity was increasing, although in an irregular way: among men in two phases, during the 1970s and 1990s and among women only during the 1990s. Great heterogeneity was observed between birth cohorts and age groups. There was only little indication of an increasing trend in obesity prevalence for women, except for the 55–64-year-olds. In men, the prevalence of obesity was increasing in all age groups except in the youngest ones, and it was statistically significant only for men aged 35–74 years. There was no significant linear change in median BMI in any group, except for an increasing trend among men aged 50 years and above.Conclusion: Although the overall Danish trend for obesity prevalence, similar to trends world-wide, showed a marked increase, the trend was very heterogeneous and generally neither uniform nor significantly positive; the changes were irregular, different among men and women, and different in the different age and birth cohorts. The obesity problem in middle-aged and older men of certain birth cohorts poses a specific public health challenge. Future studies of determinants behind the heterogeneity in the development of the obesity epidemic may provide clues to its causes.