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

Silke Hermann 1 Sabine Rohrmann 1, 2, * Jakob Linseisen 1, 3 Anne May 4, 5 Anton Kunst 6 Herve Besson 4, 7 Dora Romaguera 8 Noemie Travier 9 Maria-Jose Tormo 10, 11, 12 Esther Molina 12, 13 Miren Dorronsoro 12, 14 Aurelio Barricarte 12, 15 Laudina Rodríguez 16 Francesca Crowe 17 Kay-Tee Khaw 18 Nicholas Wareham 7 Petra van Boeckel 5 H Bas Bueno-De-Mesquita 5 Kim Overvad 19, 20 Marianne Jakobsen 20 Anne Tjønneland 21 Jytte Halkjær 21 Claudia Agnoli 22 Amalia Mattiello 23 Rosario Tumino 24 Giovanna Masala 25 Paolo Vineis 26, 27 Androniki Naska 28 Philippos Orfanos 28 Antonia Trichopoulou 28, 29 Rudolf Kaaks 1 Manuela Bergmann 30 Annika Steffen 30 Bethany van Guelpen 31 Ingegerd Johansson 32 Signe Borgquist 33 Jonas Manjer 34 Tonje Braaten 35 Guy Fagherazzi 36 Françoise Clavel-Chapelon 36 Traci Mouw 8 Teresa Norat 8 Elio Riboli 8 Sabina Rinaldi 37 Nadia Slimani 37 Petra Peeters 4
* Corresponding author
1 Division of Cancer Epidemiology
2 Social and Preventive Medicine Institute
3 Institute of Epidemiology
4 Julius Centre for Health Sciences and Primary Care
5 RIVM - National Institute for Public Health and the Environment [Bilthoven]
6 AMC - Academic Medical Center - Academisch Medisch Centrum [Amsterdam]
7 Medical Research Council
8 Department of Epidemiology & Public Health
9 Unit of Nutrition, Environment and Cancer
10 Epidemiology Service
11 Preventive Medicine and Public Health Unit
12 CIBERESP - CIBER Epidemiología y Salud Pública
13 Andalusian School of Public Health [Granada]
14 Public Health Department of Gipuzkoa
15 Public Health Institute of Navarra
16 Public Health and Participation Directorate
17 Cancer Epidemiology Unit
18 Department of Public Health and Primary Care
19 Department of Cardiology
20 Department of Clinical Epidemiology
21 Danish Cancer Society
22 Nutritional Epidemiology Unit
23 Department of Clinical and Experimental Medicine
24 Cancer Registry and Histopathology Unit
25 Molecular and Nutritional Epidemiology Unit
26 ISI Foundation Institute for Scientific Interchange
27 Environmental Epidemiology
28 Department of Hygiene and Epidemiology
29 Hellenic Health Foundation
30 DifE - Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
31 Department of Medical Biosciences and Pathology
32 Department of Odontology
33 Department of Oncology
34 Department of Surgery
35 Institute of Community Medicine
36 E3N - Nutrition, hormones et cancer: épidémiologie et prévention
37 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
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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Silke Hermann, Sabine Rohrmann, Jakob Linseisen, Anne May, Anton Kunst, et al.. The association of education with body mass index and waist circumference in the EPIC-PANACEA study.. BMC Public Health, BioMed Central, 2011, 11 (1), pp.169. ⟨10.1186/1471-2458-11-169⟩. ⟨inserm-00615511⟩

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