Population-wide changes in reported lifestyle are associated with redistribution of adipose tissue

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Abstract
Aims: The Northern Sweden MONICA project 1986—2004 demonstrated a marked increase in average body mass, an unchanged prevalence of diabetes, and a decrease in myocardial infarctions and lately also in stroke. This study estimates the relative importance of time-trends in lifestyle on average waist and hip circumference on a population level. Methods: From a series of independent cross-sectional surveys, a study population of 2,831 men and 2,976 women was formed. Associations between lifestyle factors and waist and hip circumference were estimated. Partial regression coefficients for every level of the lifestyle factors were multiplied by the differences in the proportion of the population reporting the corresponding levels of the respective lifestyle factors in 1986 and 2004. The sum of the product terms for each item represents the respective estimated impact of change in waist and hip circumference. Results: Lifestyle trends associated with changes in hip circumference were (women/men): higher education level (+4.0 mm/+2.4 mm), fewer smokers (+0.4 mm/+0.9 mm), a slight increase in alcohol consumption (+0.4 mm/+0.3 mm), and more saturated fat from meat in women (-0.9 mm) and more fibre from grains in men (+0.6 mm). Average waist circumference was influenced by increased levels of physical activity (-2.2 mm/-4.6 mm), fewer female smokers (-0.3 mm), and a higher intake of saturated fatty acids from meat among men (+1.8 mm). Conclusions: We identified physical activity and the intake of meat and whole-grain products as prime candidates for lifestyle interventions in northern Sweden.