Recent trends in adult body mass index and prevalence of excess weight: Data from the Canadian Primary Care Sentinel Surveillance Network

Hamidreza Goodarzynejad; Christopher Meaney; Paula Brauer; Michelle Greiver; Rahim Moineddin; Alan A. Monavvari

doi:10.46747/cfp.6802128

Article Figures & Data

Figures

Tables

Download figure
Open in new tab
Figure 1.
Flowchart illustrating specific inclusion and exclusion criteria applied to the CPCSSN database to obtain our analytic samples
Download figure
Open in new tab
Figure 2.
Time series plot of average BMI for the study period in the whole cohort
Download figure
Open in new tab
Figure 3.
Time series plot of average BMI for the study period stratified by age categories for female patients
Download figure
Open in new tab
Figure 4.
Time series plot of average BMI for the study period stratified by age categories for male patients

Tables

Figures

View popup

Table 1.

Estimates of the percentage of BMI classes in the CPCSSN data sample, stratified by study year: N= 587 752 BMI measurements.

		PREVALENCE ESTIMATE (95% CI), %
YEAR	N	UNDERWEIGHT^{^*} (BMI < 18.5 KG/M²)	NORMAL WEIGHT^{^*} (BMI 18.5-24.9 KG/M²)	OVERWEIGHT^{^*} (BMI 25-29.9 KG/M²)	OBESE CLASS I^{^*} (BMI 30-34.9 KG/M²)	OBESE CLASS II^{^*} (BMI 35-39.9 KG/M²)	OBESE CLASS III^{^*} (BMI ≥ 40 KG/M²)
2011	117 217	1.4 (1.3 to 1.4)	31.7 (31.4 to 32.0)	34.8 (34.5 to 35.1)	19.7 (19.4 to 19.9)	8.1 (7.9 to 8.3)	4.4 (4.3 to 4.5)
2012	105 564	1.4 (1.3 to 1.5)	31.0 (30.7 to 31.3)	34.8 (34.5 to 35.0)	20.0 (19.8 to 20.3)	8.3 (8.1 to 8.5)	4.5 (4.4 to 4.7)
2013	98 351	1.4 (1.3 to 1.5)	29.9 (29.6 to 30.1)	34.8 (34.5 to 35.1)	20.5 (20.2 to 20.7)	8.7 (8.5 to 8.9)	4.8 (4.7 to 4.9)
2014	95 309	1.4 (1.3 to 1.5)	29.1 (28.9 to 29.4)	34.6 (34.3 to 34.9)	20.8 (20.5 to 21.1)	9.0 (8.8 to 9.2)	5.1 (5.0 to 5.3)
2015	97 008	1.3 (1.2 to 1.4)	28.2 (27.9 to 28.5)	34.3 (34.0 to 34.6)	21.3 (21.1 to 21.6)	9.4 (9.2 to 9.6)	5.5 (5.3 to 5.6)
2016	74 303	1.4 (1.3 to 1.5)	26.4 (26.1 to 26.8)	33.9 (33.6 to 34.3)	22.4 (22.1 to 22.7)	10.0 (9.8 to 10.2)	5.8 (5.7 to 6.0)

BMI—body mass index, CPCSSN—Canadian Primary Care Sentinel Surveillance Network.
↵* World Health Organization BMI classes.¹⁶

View popup

Table 2.

Estimates of the percentage of BMI classes in the CPCSSN data sample, stratified by age and sex, 2011

	PREVALENCE ESTIMATE (95% CI), %
AGE GROUP, Y	UNDERWEIGHT^{^*} (BMI < 18.5 KG/M²)	NORMAL WEIGHT^{^*} (BMI 18.5-24.9 KG/M²)	OVERWEIGHT^{^*} (BMI 25-29.9 KG/M²)	OBESE CLASS I^{^*} (BMI 30-34.9 KG/M²)	OBESE CLASS II^{^*} (BMI 35-39.9 KG/M²)	OBESE CLASS III^{^*} (BMI ≥ 40 KG/M²)
Total cohort
• 18-24	5.1 (4.6 to 5.6)	57.8 (56.7 to 58.9)	22.1 (21.1 to 23.0)	9.0 (8.3 to 9.6)	4.0 (3.5 to 4.4)^{^†}	2.2 (1.8 to 2.5)
• 25-34	2.3 (2.0 to 2.6)^{^†}	44.8 (43.9 to 45.7)	28.1 (27.3 to 28.9)^{^†}	13.6 (13.0 to 14.2)	6.6 (6.2 to 7.1)^{^†}	4.6 (4.8 to 5.0)^{^†}
• 35-44	1.3 (1.1 to 1.5)	36.0 (35.2 to 36.7)	31.6 (30.9 to 32.3)^{^†}	17.5 (16.9 to 18.1)	8.2 (7.8 to 8.6)^{^†}	5.4 (5.1 to 5.8)^{^†}
• 45-54	0.9 (0.8 to 1.0)	29.6 (29.0 to 30.2)^{^†}	35.1 (34.5 to 35.7)^{^†}	20.5 (20.0 to 21.0)	8.9 (8.5 to 9.2)^{^†}	5.1 (4.8 to 5.3)^{^†}
• 55-64	0.7 (0.6 to 0.8)	24.1 (23.5 to 24.6)^{^†}	36.9 (36.3 to 37.5)^{^†}	23.4 (22.9 to 23.9)	10.0 (9.6 to 10.3)^{^†}	5.1 (4.8 to 5.3)^{^†}
• 65-74	0.6 (0.5 to 0.7)	22.3 (21.7 to 22.9)^{^†}	40.1 (39.4 to 40.8)	24.3 (23.6 to 24.9)^{^†}	8.9 (8.3 to 9.1)^{^†}	4.0 (3.8 to 4.3)^{^†}
•≥ 75	1.5 (1.3 to 1.7)	28.9 (28.1 to 29.7)^{^†}	42.2 (41.3 to 43.0)	19.9 (19.1 to 20.6)^{^†}	5.8 (5.4 to 6.2)^{^†}	1.8 (1.6 to 2.1)^{^†}
• All	1.4 (1.3 to 1.4)	31.7 (31.4 to 32.0)^{^†}	34.8 (34.5 to 35.1)	19.7 (19.4 to 19.9)^{^†}	8.1 (7.9 to 8.3)^{^†}	4.4 (4.3 to 4.5)^{^†}
Men
• 18-24	3.6 (2.8 to 4.4)	55.7 (53.6 to 57.8)	25.8 (24.0 to 27.7)	9.5 (8.3 to 10.8)	3.5 (2.8 to 4.3)	1.8 (1.3 to 2.4)
• 25-34	1.2 (0.8 to 1.6)	33.9 (32.1 to 35.6)^{^†}	37.6 (35.5 to 39.0)	17.5 (16.1 to 18.9)	6.8 (5.9 to 7.7)^{^†}	3.3 (2.7 to 4.0)^{^†}
• 35-44	0.5 (0.3 to 0.6)	20.0 (18.9 to 21.1)^{^†}	41.4 (40.0 to 42.7)	24.5 (23.3 to 25.7)^{^†}	8.6 (7.9 to 9.4)	5.1 (4.5 to 5.7)^{^†}
• 45-54	0.4 (0.3 to 0.5)	17.3 (16.6 to 18.1)^{^†}	42.1 (41.1 to 43.1)	26.4 (25.5 to 27.3)	9.6 (9.0 to 10.2)^{^†}	4.2 (3.8 to 4.6)^{^†}
• 55-64	0.3 (0.2 to 0.4)	15.8 (15.1 to 16.5)^{^†}	42.0 (41.1 to 42.9)	28.0 (27.1 to 28.8)	9.9 (9.4 to 10.5)^{^†}	4.1 (3.7 to 4.4)^{^†}
• 65-74	0.2 (0.1 to 0.3)	16.2 (15.4 to 17.0)^{^†}	44.7 (43.6 to 45.8)	27.4 (26.4 to 28.4)^{^†}	8.5 (7.9 to 9.1)^{^†}	3.0 (2.6 to 3.4)
•≥ 75	0.7 (0.4 to 0.9)	23.6 (22.4 to 24.8)^{^†}	47.9 (46.6 to 49.3)	21.2 (20.1 to 22.3)^{^†}	5.4 (4.8 to 6.0)^{^†}	1.2 (0.9 to 1.5)
• All	0.6 (0.5 to 0.7)	20.7 (20.4 to 21.1)^{^†}	42.0 (41.5 to 42.5)	24.8 (24.3 to 25.2)^{^†}	8.4 (8.1 to 8.7)^{^†}	3.5 (3.4 to 3.7)^{^†}
Women
• 18-24	5.7 (5.1 to 6.3)	58.6 (57.3 to 59.9)^{^†}	20.7 (19.6 to 21.7)	8.8 (8.0 to 9.5)	4.1 (3.6 to 4.7)	2.3 (1.9 to 2.7)
• 25-34	2.6 (2.3 to 2.9)	47.9 (46.9 to 48.9)^{^†}	25.5 (24.6 to 26.3)	12.5 (11.9 to 13.2)	6.6 (6.1 to 7.1)^{^†}	4.9 (4.5 to 5.4)^{^†}
• 35-44	1.7 (1.4 to 1.9)	42.6 (41.7 to 43.4)	27.6 (26.8 to 28.4)	14.6 (14.0 to 15.2)	8.0 (7.5 to 8.5)	5.6 (5.2 to 6.0)^{^†}
• 45-54	1.2 (1.0 to 1.3)	37.0 (36.3 to 37.8)^{^†}	30.9 (30.1 to 31.6)	16.9 (16.3 to 17.5)	8.4 (8.0 to 8.9)^{^†}	5.6 (5.2 to 6.0)^{^†}
• 55-64	1.0 (0.8 to 1.1)	30.4 (29.6 to 31.1)^{^†}	33.0 (32.3 to 33.8)^{^†}	19.8 (19.2 to 20.5)	9.9 (9.4 to 10.4)^{^†}	5.9 (5.5 to 6.2)^{^†}
• 65-74	1.0 (0.8 to 1.2)	27.3 (26.4 to 28.2)^{^†}	36.3 (35.4 to 37.3)	21.7 (20.8 to 22.5)	8.9 (8.3 to 9.4)^{^†}	4.9 (4.5 to 5.4)^{^†}
•≥ 75	2.1 (1.8 to 2.4)	32.7 (31.6 to 33.8)^{^†}	38.0 (36.8 to 39.1)	18.9 (18.0 to 19.8)^{^†}	6.1 (5.5 to 6.7)^{^†}	2.3 (1.9 to 2.6)
• All	1.8 (1.7 to 1.9)	38.1 (37.7 to 38.4)^{^†}	30.6 (30.3 to 31.0)	16.7 (16.4 to 17.0)^{^†}	7.9 (9.7 to 8.1)^{^†}	5.0 (4.8 to 5.1)^{^†}

BMI—body mass index, CCHS—Canadian Community Health Survey, CPCSSN—Canadian Primary Care Sentinel Surveillance Network.
↵* World Health Organization BMI classes.¹⁶
↵† Estimates that are statistically significantly different from the 2011 CCHS results. “Corrected” CCHS estimates were used when comparing CPCSSN estimates with CCHS estimates.

View popup

Table 3.

Estimates of the percentage of BMI classes in the CPCSSN data sample stratified by age and sex, 2016

	PREVALENCE ESTIMATE (95% CI), %
AGE GROUP, Y	UNDERWEIGHT^{^*} (BMI < 18.5 KG/M²)	NORMAL WEIGHT^{^*} (BMI 18.5-24.9 KG/M²)	OVERWEIGHT^{^*} (BMI 25-29.9 KG/M²)	OBESE CLASS I^{^*} (BMI 30-34.9 KG/M²)	OBESE CLASS II^{^*} (BMI 35-39.9 KG/M²)	OBESE CLASS III^{^*} (BMI ≥ 40 KG/M²)
Total cohort
• 18-24	5.2 (4.5 to 5.8)	49.6 (48.1 to 51.2)^{^†}	24.8 (23.5 to 26.2)	11.1 (10.1 to 12.1)	5.7 (5.0 to 6.4)	3.5 (3.0 to 4.1)
• 25-34	2.1 (1.7 to 2.4)	37.8 (36.6 to 38.9)^{^†}	29.3 (28.2 to 30.4)^{^†}	16.7 (15.8 to 17.6)^{^†}	8.1 (7.4 to 8.7)	6.1 (5.5 to 6.7)
• 35-44	1.2 (1.0 to 1.5)	29.3 (28.4 to 30.3)^{^†}	30.6 (29.6 to 31.6)^{^†}	21.4 (20.5 to 22.3)^{^†}	10.4 (9.7 to 11.0)	7.1 (6.6 to 7.6)
• 45-54	0.8 (0.7 to 1.0)	24.2 (23.5 to 24.9)^{^†}	32.5 (31.7 to 33.3)	23.7 (23.0 to 24.4)^{^†}	11.6 (11.1 to 12.2)	7.2 (6.7 to 7.6)
• 55-64	1.0 (0.9 to 1.2)	22.6 (22.0 to 23.2)^{^†}	34.7 (34.0 to 35.4)	24.1 (23.5 to 24.7)^{^†}	11.1 (10.6 to 11.6)	6.5 (6.2 to 6.9)
• 65-74	0.9 (0.8 to 1.1)	19.4 (18.7 to 20.0)^{^†}	36.8 (36.0 to 37.6)^{^†}	26.4 (25.6 to 27.1)^{^†}	10.8 (10.3 to 11.4)	5.7 (5.3 to 6.1)
• ≥ 75	1.6 (1.4 to 1.9)	26.8 (26.0 to 27.7)^{^†}	40.0 (39.1 to 41.0)	21.2 (20.4 to 22.0)^{^†}	7.6 (7.1 to 8.1)	2.7 (2.4 to 3.0)
• All	1.4 (1.3 to 1.5)	26.4 (26.1 to 26.8)^{^†}	33.9 (33.6 to 34.3)^{^†}	22.4 (22.1 to 22.7)^{^†}	10.0 (9.8 to 10.2)	5.8 (5.7 to 6.0)
Men
• 18-24	4.7 (3.6 to 5.8)	47.0 (44.4 to 49.6)^{^†}	26.6 (24.3 to 28.9)	12.8 (11.0 to 14.5)^{^†}	5.8 (4.6 to 7.0)	3.2 (2.3 to 4.1)
• 25-34	1.6 (1.0 to 2.1)	28.1 (26.0 to 30.2)^{^†}	35.8 (33.5 to 38.1)	20.8 (18.9 to 22.7)^{^†}	8.4 (7.1 to 9.7)	5.4 (4.3 to 6.5)
• 35-44	0.6 (0.3 to 0.9)	18.0 (16.5 to 19.5)^{^†}	37.6 (35.7 to 39.4)	27.1 (25.4 to 28.8)^{^†}	10.0 (8.9 to 11.2)	6.8 (5.8 to 7.7)
• 45-54	0.5 (0.3 to 0.7)	14.7 (13.7 to 15.7)^{^†}	36.6 (35.3 to 37.9)^{^†}	28.8 (27.6 to 30.1)^{^†}	12.7 (11.8 to 13.6)	6.7 (6.0 to 7.4)
• 55-64	0.5 (0.3 to 0.6)	15.4 (14.6 to 16.2)^{^†}	38.9 (37.8 to 39.9)^{^†}	28.4 (27.3 to 29.4)^{^†}	11.3 (10.6 to 12.0)	5.7 (5.2 to 6.2)
• 65-74	0.5 (0.4 to 0.7)	13.9 (13.1 to 14.7)^{^†}	41.4 (40.2 to 42.5)	29.6 (28.5 to 30.7)^{^†}	10.3 (9.6 to 11.0)	4.3 (3.8 to 4.8)
• ≥ 75	0.7 (0.5 to 0.9)	22.7 (21.5 to 24.0)^{^†}	44.5 (43.0 to 45.9)	23.3 (22.1 to 24.6)^{^†}	6.7 (6.0 to 7.5)	2.1 (1.6 to 2.5)
• All	0.8 (0.7 to 0.9)	18.5 (18.0 to 18.9)^{^†}	39.0 (38.4 to 39.5)^{^†}	26.7 (26.2 to 27.2)^{^†}	10.1 (9.8 to 10.4)	5.0 (4.7 to 5.2)
Women
• 18-24	5.4 (4.5 to 6.3)	51.2 (49.2 to 53.1)^{^†}	23.8 (22.1 to 25.5)	10.2 (9.0 to 11.4)	5.7 (4.8 to 6.6)	3.8 (3.0 to 4.5)
• 25-34	2.2 (1.8 to 2.6)	41.1 (39.7 to 42.5)^{^†}	27.1 (25.9 to 28.3)	15.2 (14.3 to 16.2)	8.0 (7.2 to 8.7)	6.3 (5.7 to 7.0)
• 35-44	1.5 (1.2 to 1.8)	34.2 (33.0 to 35.3)^{^†}	27.6 (26.5 to 28.7)	19.0 (18.0 to 19.9)^{^†}	10.5 (9.8 to 11.3)	7.2 (6.6 to 7.9)
• 45-54	1.1 (0.8 to 1.3)	30.4 (29.4 to 31.4)^{^†}	29.8 (28.8 to 30.8)	20.4 (19.5 to 21.3)^{^†}	11.0 (10.3 to 11.6)	7.5 (6.9 to 8.0)
• 55-64	1.5 (1.2 to 1.7)	28.4 (27.5 to 29.3)^{^†}	31.3 (30.4 to 32.3)^{^†}	20.7 (19.9 to 21.5)^{^†}	10.9 (10.3 to 11.5)	7.2 (6.7 to 7.7)
• 65-74	1.3 (1.0 to 1.5)	24.4 (23.4 to 25.3)^{^†}	32.7 (31.7 to 33.8)	23.4 (22.4 to 24.4)	11.3 (10.6 to 12.0)	6.9 (6.4 to 7.5)
• ≥ 75	2.4 (2.0 to 2.8)	30.1 (28.9 to 31.3)^{^†}	36.5 (35.2 to 37.7)	19.5 (18.5 to 20.6)^{^†}	8.3 (7.5 to 9.0)	3.2 (2.8 to 3.7)
• All	1.8 (1.7 to 1.9)	31.8 (31.4 to 32.2)^{^†}	30.5 (30.1 to 31.0)	19.5 (19.1 to 19.9)^{^†}	10.0 (9.7 to 10.3)	6.4 (6.2 to 6.6)

BMI—body mass index, CCHS—Canadian Community Health Survey, CPCSSN—Canadian Primary Care Sentinel Surveillance Network.
↵* World Health Organization BMI classes.¹⁶
↵† Estimates that are statistically significantly different from the 2016 CCHS results. “Corrected” CCHS estimates were used when comparing CPCSSN estimates with CCHS estimates.

View popup

Table 4.

Fitted autoregressive linear mixed-effects model of BMI (kg/m²) as a function of baseline age, sex, and centred time: The intercept term in the following model corresponds to the expected BMI value for a female patient, aged 18-24 y, measured in the middle of the study (approximately January 1, 2014). Random intercept variance was 31.35, residual variance was 4.12, and the AR1 working correlation parameter was 0.41.

VARIABLES	β	SE	P VALUE
Intercept (constant)	25.68	0.03	< .0001
Male sex	1.02	0.02	< .0001
Age^{^*} groups, y
• 18-24	Reference	-	-
• 25-34	1.28	0.03	< .0001
• 35-44	2.12	0.03	< .0001
• 45-54	2.60	0.03	< .0001
• 55-64	2.72	0.03	< .0001
• 65-74	2.59	0.03	< .0001
• ≥ 75	2.06	0.04	< .0001
Centred time, y	0.06	0.002	< .0001

AR1—first-order autoregression, β—regression coefficient, BMI—body mass index, SE—standard error.
↵* Age calculated from birth date to January 1, 2011 (study baseline).