Non-linear relationship between body mass index and self-rated health in older Korean adults: body image and sex considerations
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OBJECTIVES: The purpose of this study was to investigate the association between body mass index (BMI) and self-rated health (SRH) in older adults aged over 65 years while examining the influence of self-perceived body image (SBI) and sex. METHODS: Raw data were obtained from the Korea Community Health Survey, which included BMI measurements of Koreans aged over 65 years (n=59,628). Non-linear relationships between BMI and SRH were analyzed separately for each sex using restricted cubic splines while controlling for SBI and other confounding variables. RESULTS: Men showed a reverse J-shaped association, while women showed a J-shaped association between BMI and poor SRH. However, including SBI in the model changed this association for men to an inverted U-shape showing a negative direction, with the highest risk of poor SRH observed in the underweight to overweight range. For women, a nearly linear positive relationship was observed. Regardless of BMI, those who perceived their weight as not “exactly the right weight” had a higher risk of poor SRH than those who perceived their weight as “exactly the right weight” in both men and women. Older men who thought they were much too fat or too thin had similar highest risks of poor SRH, whereas older women who thought they were too thin had the highest risk of poor SRH. CONCLUSIONS: The findings of this study emphasize the importance of considering sex and body image perceptions when assessing the relationship between BMI and SRH in older adults, especially in men.
Abstract
OBJECTIVES: The purpose of this study was to investigate the association between body mass index (BMI) and self-rated health (SRH) in older adults aged over 65 years while examining the influence of self-perceived body image (SBI) and sex. METHODS: Raw data were obtained from the Korea Community Health Survey, which included BMI measurements of Koreans aged over 65 years (n=59,628). Non-linear relationships between BMI and SRH were analyzed separately for each sex using restricted cubic splines while controlling for SBI and other confounding variables. RESULTS: Men showed a reverse J-shaped association, while women showed a J-shaped association between BMI and poor SRH. However, including SBI in the model changed this association for men to an inverted U-shape showing a negative direction, with the highest risk of poor SRH observed in the underweight to overweight range. For women, a nearly linear positive relationship was observed. Regardless of BMI, those who perceived their weight as not “exactly the right weight” had a higher risk of poor SRH than those who perceived their weight as “exactly the right weight” in both men and women. Older men who thought they were much too fat or too thin had similar highest risks of poor SRH, whereas older women who thought they were too thin had the highest risk of poor SRH. CONCLUSIONS: The findings of this study emphasize the importance of considering sex and body image perceptions when assessing the relationship between BMI and SRH in older adults, especially in men.
참고문헌 (31)
- Jylhä M, "What is self-rated health and why does it predict mortality? Towards a unified conceptual model", Soc Sci Med, 69, pp.307~316 (2009)
- Benyamini Y, "Views on aging : older adults’ self-perceptions of age and of health", Eur J Ageing, 17, pp.477~487 (2019)
- Bamia C, "Self-rated health and all-cause and cause-specific mortality of older adults : individual data meta-analysis of prospective cohort studies in the CHANCES Consortium", Maturitas, 103, pp.37~44 (2017)
- Stanojevic Jerkovic O, "Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey", Eur J Public Health, 27(suppl_2), pp.74~79 (2017)
- Sperlich S, "Trends in self-rated health among the elderly population in Germany from 1995 to 2015-the influence of temporal change in leisure time physical activity", BMC Public Health, 20, pp.113~ (2020)
- Jung JG, "Changes in poor self-rated health status among elderly Koreans over 10 years : Community Health Survey 2008-2017", Geriatr Gerontol Int, 20, pp.1190~1195 (2020)
- Goya Wannamethee S, "Overweight and obesity and the burden of disease and disability in elderly men", Int J Obes Relat Metab Disord, 28, pp.1374~1382 (2004)
- Wang L, "Body mass index and waist circumference predict health-related quality of life, but not satisfaction with life, in the elderly", Qual Life Res, 27, pp.2653~2665 (2018)
- Ackerman IN, "Obesity and increased burden of hip and knee joint disease in Australia : results from a national survey", BMC Musculoskelet Disord, 13, pp.254~ (2012)
- Rossi-Izquierdo M, "Impact of obesity in elderly patients with postural instability", Aging Clin Exp Res, 28, pp.423~428 (2016)
- Himes CL, "Effect of obesity on falls, injury, and disability", J Am Geriatr Soc, 60, pp.124~129 (2012)
- Hulman A, "Body mass index trajectories preceding first report of poor self-rated health : a longitudinal case-control analysis of the English Longitudinal Study of Ageing", PLoS One, 14, pp.e0212862~ (2019)
- Lee HL, "Factors affecting trajectory patterns of self-rated health(SRH)in an older population--a community-based longitudinal study", Arch Gerontol Geriatr, 54, pp.e334~e341 (2012)
- Girón P, "Determinants of self-rated health in Spain : differences by age groups for adults", Eur J Public Health, 22, pp.36~40 (2012)
- Sung ES, "The relationship between body mass index and poor self-rated health in the South Korean population", PLoS One, 15, pp.e0219647~ (2020)
- Herman KM, "Self-rated health and life satisfaction among Canadian adults : associations of perceived weight status versus BMI", Qual Life Res, 22, pp.2693~2705 (2013)
- Kwon S, "Body mass index, perceived weight, and self-rated health among South Korean adults: conjoint effect on health?", AIMS Public Health, 4, pp.513~525 (2017)
- Tang K, "The association between self-rated health and different anthropometric and body composition measures in the Chinese population", BMC Public Health, 17, pp.317~ (2017)
- Jackson SE, "Weight perceptions in older adults : findings from the English Longitudinal Study of Ageing", BMJ Open, 10, pp.e033773~ (2020)
- 김영택, "지역사회건강조사의 조사 기획과 수행", 대한의사협회지, 55(1), pp.74~83 (2012), 대한의사협회
- Kuczmarski MF, "Effects of age on validity of self-reported height, weight, and body mass index : findings from the Third National Health and Nutrition Examination Survey, 1988-1994", J Am Diet Assoc, 101, pp.28~34 (2001)
- 서미혜, "Prevalence of Obesity and Incidence of Obesity-Related Comorbidities in Koreans Based on National Health Insurance Service Health Checkup Data 2006–2015", Journal of Obesity & Metabolic Syndrome, 27(1), pp.46~52 (2018), 대한비만학회
- Yang Wha Kang, "Korea Community Health Survey Data Profiles", Osong Public Health and Research Perspectives, 6(3), pp.211~217 (2015), 질병관리청
- Benyamini Y, "Gender differences in processing information for making self-assessments of health", Psychosom Med, 62, pp.354~364 (2000)
- Desquilbet L, "Dose-response analyses using restricted cubic spline functions in public health research", Stat Med, 29, pp.1037~1057 (2010)
- Yamazaki K, "Is there an obesity paradox in the Japanese elderly population? A community-based cohort study of 13 280 men and women", Geriatr Gerontol Int, 17, pp.1257~1264 (2017)
- Bosello O, "Obesity paradox and aging", Eat Weight Disord, 26, pp.27~35 (2021)
- Hellgren MI, "Association between body mass index and self-rated health : a Swedish population-based longitudinal study", Scand J Public Health, 49, pp.369~376 (2021)
- Noh JW, "Body mass index and self-rated health in East Asian countries : comparison among South Korea, China, Japan, and Taiwan", PLoS One, 12, pp.e0183881~ (2017)
- Marques-Vidal P, "Differing trends in the association between obesity and self-reported health in Portugal and Switzerland. Data from national health surveys 1992-2007", BMC Public Health, 12, pp.588~ (2012)
- "Elderly population" (2021)[URL]