BMC Public Health (Mar 2011)

The association of education with body mass index and waist circumference in the EPIC-PANACEA study

  • Vineis Paolo,
  • Masala Giovanna,
  • Tumino Rosario,
  • Mattiello Amalia,
  • Agnoli Claudia,
  • Halkjær Jytte,
  • Tjønneland Anne,
  • Jakobsen Marianne,
  • Overvad Kim,
  • Bueno-de-Mesquita H Bas,
  • van Boeckel Petra GA,
  • Wareham Nicholas J,
  • Khaw Kay-Tee,
  • Crowe Francesca L,
  • Rodríguez Laudina,
  • Barricarte Aurelio,
  • Dorronsoro Miren,
  • Molina Esther,
  • Tormo Maria-Jose,
  • Travier Noemie,
  • Romaguera Dora,
  • Besson Herve,
  • Kunst Anton,
  • May Anne M,
  • Linseisen Jakob,
  • Rohrmann Sabine,
  • Hermann Silke,
  • Naska Androniki,
  • Orfanos Philippos,
  • Trichopoulou Antonia,
  • Kaaks Rudolf,
  • Bergmann Manuela M,
  • Steffen Annika,
  • Van Guelpen Bethany,
  • Johansson Ingegerd,
  • Borgquist Signe,
  • Manjer Jonas,
  • Braaten Tonje,
  • Fagherazzi Guy,
  • Clavel-Chapelon Françoise,
  • Mouw Traci,
  • Norat Teresa,
  • Riboli Elio,
  • Rinaldi Sabina,
  • Slimani Nadia,
  • Peeters Petra HM

DOI
https://doi.org/10.1186/1471-2458-11-169
Journal volume & issue
Vol. 11, no. 1
p. 169

Abstract

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Abstract Background To examine the association of education with body mass index (BMI) and waist circumference (WC) in the European Prospective Investigation into Cancer and Nutrition (EPIC). Method This study included 141,230 male and 336,637 female EPIC-participants, who were recruited between 1992 and 2000. Education, which was assessed by questionnaire, was classified into four categories; BMI and WC, measured by trained personnel in most participating centers, were modeled as continuous dependent variables. Associations were estimated using multilevel mixed effects linear regression models. Results Compared with the lowest education level, BMI and WC were significantly lower for all three higher education categories, which was consistent for all countries. Women with university degree had a 2.1 kg/m2 lower BMI compared with women with lowest education level. For men, a statistically significant, but less pronounced difference was observed (1.3 kg/m2). The association between WC and education level was also of greater magnitude for women: compared with the lowest education level, average WC of women was lower by 5.2 cm for women in the highest category. For men the difference was 2.9 cm. Conclusion In this European cohort, there is an inverse association between higher BMI as well as higher WC and lower education level. Public Health Programs that aim to reduce overweight and obesity should primarily focus on the lower educated population.

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