BMI may overestimate the prevalence of obesity among women of lower socioeconomic status.

OBJECTIVE: Our objective was to examine gender differences in height and weight associated with socioeconomic status (SES) and the consequent effect on body mass index in a multiethnic society. RESEARCH METHODS AND PROCEDURES: A cross-sectional study, the First Israeli National Health and Nutrition Survey, was performed on a representative population sample of 3246 adults 25 to 64 years of age, between the years 1999 to 2001. Height and weight were measured, and BMI and other weight-height indices were calculated. SES was assessed by income and education. RESULTS: Age-adjusted height was significantly lower at lower levels of SES among both women and men (p<0.001). As opposed to men, women of lower SES were heavier than those of higher SES, and the mean age-adjusted weight was 4.6 kg higher among those of lower SES (p<0.001). Thus, using the standard index of BMI, the prevalence of obesity was significantly higher among shorter women. DISCUSSION: In this group of Israeli adults, the unfavorable effect of low SES on BMI was evident among women, partly due to their decreased height combined with increased weight common in this socioeconomic sector. Since BMI is only partly independent of height, it may overestimate the prevalence of obesity among women of lower SES. Alternative measures for classifying obesity in the lower SES groups that put less emphasis on height may be considered and studied.

Overweight and obesity prevalence in Israel: findings of the first national health and nutrition survey (MABAT).

BACKGROUND: The prevalence of obesity has increased considerably in many countries in recent decades. OBJECTIVE: To describe the prevalence of overweight and obesity in the Israeli population, based on findings of the first national health and nutrition survey (MABAT). METHODS: This cross-sectional survey was carried out during 1999-2000. MABAT is based on a representative sample (n = 3,246) of the general Israeli population aged 25-64 years. The current study population comprised those with complete data on measured weight and height (n = 2,781). Participants were interviewed in person and had their weight and height measured by the interviewer. RESULTS: Over 50% of the study participants were women (n = 1,410); 76% were Jews and 24% Arabs. Most participants had an education of at least 12 years (72%). Body mass index > or = 30.0 was more prevalent in women compared to men (P < 0.001) in both population groups (Jews and Arabs). Obesity rates increased with age and reached 22.4% for men and 40.4% for women aged 55-64 years. Lower education was associated with higher obesity rates, with lowest rates observed for Jewish women with an academic education (13.6%) and highest rates observed for Arab women with a basic education (57.3%). Multiple logistic regression analyses showed age to be a significant risk factor in men. Age, education and origin (Arab, and the former Soviet Union for Jews) were significant risk factors for obesity in women. CONCLUSIONS: Obesity rates in Israel are high and comparable to those in the United States. Of special concern is the subgroup of older Arab women (55-64 years), whose obesity rates reached 70%.

Correlates of osteoporosis among Jewish and Arab women aged 45-74 in Israel: national women's health interview survey.

OBJECTIVE: To determine the prevalence and correlates of osteoporosis among middle-aged and elderly Jewish and Arab women in Israel. DESIGN: A cross-sectional study on a random sample of Israeli women, carried out through telephone interviews. Questions included physician-diagnosed osteoporosis, demographic and lifestyle variables, medical conditions, and present and past use of estrogen-containing medications. Body mass index (BMI) was calculated from reported height and weight. SETTING: A national population-based survey conducted from March through August 1998. PARTICIPANTS: A national random sample of 888 women aged 45-74. MAIN RESULTS: The overall prevalence of self-reported osteoporosis was estimated at 13.7%. The rates increased abruptly from about 5.8% at ages 45-59 to 19.6% at ages 60-64, and reached 27.7% at ages 70-74. Between ages 45-59, the rates were higher among Arab women, whereas in the older group they were higher among Jewish women. There was a marked increase following menopause. After adjustment for potential confounders, at ages 45-59, osteoporosis was positively associated with menopause and BMI, whereas at ages 60-74, it was positively associated with age and family history of osteoporosis, and negatively associated with BMI. CONCLUSIONS: The prevalence of physician-diagnosed osteoporosis in Israel among women aged 45-74 is estimated to be 13.7%, which is similar to that for the United States. The association of osteoporosis with risk factors is age-dependent, and in particular, age-BMI interaction on osteoporosis requires further investigation.

Factors predicting current use of hormone replacement therapy among menopausal Jewish women in Israel. The National Women's Health Interview Survey, 1998.

BACKGROUND: Despite the controversy regarding the risks and benefits of hormone replacement therapy, studies in various countries report a two- to threefold increase in the use of HRT during the last decade. OBJECTIVES: To estimate the prevalence of HRT use among post-menopausal Jewish women in Israel and to determine the variables predicting current HRT use. METHODS: A cross-sectional telephone survey was conducted in 1998 on a random sample of Jewish women aged 45-74. Of 935 women who were located and eligible, 704 (75%) were interviewed by means of a structured questionnaire. RESULTS: A total of 589 women (85%) were peri-menopausal or post-menopausal. Ninety-nine of them (16.8%) were currently using HRT and 78 (13.2%) were past users. Higher rates of current use were found among women who had undergone hysterectomy and/or oophorectomy (38%) than among all other women (13.5%). Among naturally menopausal women the highest rate of current use (25.6%) was found in those aged 55-59. A multiple logistic regression showed that the variables associated with current HRT use among naturally menopausal women were: having a regular gynecologist (odds ratio 3.6, 95% confidence interval 1.7-7.5), visiting a gynecologist during the past year (OR 2.9, 95% CI 1.4-6.0), experiencing symptoms of menopause (OR 2.0, 95% CI 1.01-3.8), having more than a high-school education (OR 1.9, 95% CI 1.04-3.6), and a lower body mass index (OR 0.91, 95% CI 0.85-0.99). CONCLUSIONS: The factors associated with HRT use may be markers for other socioeconomic or psychological characteristics. The disparities noted between population subgroups may be indicative of differences in awareness or in the delivery of preventive healthcare services to women in Israel, and as such need to be addressed by the health system.