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CIHI: Increased activity and healthier eating can improve obesity rates, but aren't the only factors at play

Comprehensive new report examines how obesity varies across Canada, who's most at risk and possible actions to address it

June 20, 2011 - Eliminating all physical inactivity among Canadian adults (defined as less than 15 minutes of low-impact activity a day) could avert the equivalent of 646,000 cases of obesity in women and 405,000 cases in men, according to an analysis included in a comprehensive joint report released today by the Canadian Institute for Health Information (CIHI) and the Public Health Agency of Canada (PHAC). Similarly, improving poor-quality diets—as measured by the frequency of fruit and vegetable consumption—could result in the equivalent of 265,000 fewer cases of obesity among men and 97,000 fewer cases of obesity among women. However, people's ability to achieve higher physical activity levels and healthier eating habits is influenced by many interconnected factors.

"Not surprisingly, this report shows that improving lifestyle behaviours, such as healthy eating and physical activity, can have a significant impact on reducing the waistlines and improving the health of Canadians. However, obesity is complex, and there are many other factors that contribute beyond lifestyle habits," says Jeremy Veillard, Vice President of Research and Analysis at CIHI. "By shedding light on the factors most closely associated with obesity and how they play out across Canada, policy-makers and health providers can better target prevention and treatment options to meet the needs of the population."

"Reducing obesity levels and promoting healthy weights is critical to the prevention of ill health," says Dr. Judith Bossé, Assistant Deputy Minister, Public Health Agency of Canada. "Obesity increases the risk of a number of chronic conditions, including type 2 diabetes, hypertension and some forms of cancers. That's why we're examining options to address the factors that lead to obesity, and we are working with various levels of government, non-governmental organizations and other stakeholders on this issue."

Obesity in Canada provides an overview of the prevalence of obesity among adults, children and youth, and Aboriginal Peoples (First Nations, Métis and Inuit peoples); the determinants and impact of obesity across the country; as well as Canadian and international lessons learned in obesity prevention and reduction. Based on measured height and weight, more than 1 in 4 adults in Canada and just less than 1 in 11 children are considered obese. Between 1981 and 2009, obesity based on measured height and weight data roughly doubled across all age groups and tripled for youth (age 12 to 17).

Obesity rates vary widely across Canada; multiple factors contributing

Across Canadian health regions, there is a six-fold variation in adult obesity rates, ranging from lows of 5.3% of the population in Richmond, British Columbia, and 6.2% in Vancouver, B.C., to highs of 32.1% in Kings County, Prince Edward Island, and 35.9% in the Mamawetan/Keewatin/Athabasca region of Saskatchewan. This variation mirrors the differences in obesity rates seen across developed countries in the Organisation for Economic Co-operation and Development (OECD).

However, the CIHI–PHAC report found that regional variations across Canada were not due to lifestyle factors alone. In fact, only 50% of the populations in both Mamawetan/Keewatin/Athabasca and Richmond reported being physically inactive.

Regional differences in obesity may be related to the following:

• Population base: In 2008, 17% of non-Aboriginal adults self-reported being obese, compared with 26% of off-reserve Aboriginal adults. Obesity was also found to vary within Aboriginal Peoples populations. Among children age 6 to 14, for example, 17% of Métis, 20% of off-reserve First Nations and 25.6% of Inuit populations were estimated to be obese. However, in First Nations populations, community consumption of traditional foods was associated with lower obesity levels.
• Gender and income: Women in higher income brackets were significantly less likely to be obese than their lower-income counterparts—a difference not found for men. This trend was seen for all Canadian women, although it was most pronounced among Aboriginal females, where 16.3% of Aboriginal women in households making $100,000 or more were considered obese, compared with 26.8% of Aboriginal women in households with incomes of less than $20,000 a year.
• Material and social resources where people live: Variations in obesity by socio-economic status were much more pronounced in some regions than in others. In Halifax, Nova Scotia, for example, 11% of the population in the highest socio-economic range was obese, compared with close to 26% in the lowest socio-economic areas. Similarly, in Thunder Bay, Ontario, 10% of the population in the highest socio-economic areas was obese, compared with 20% in the lowest socio-economic areas. While most cities had a gap, it was not always significant. Some cities, like Vancouver, B.C., and Oshawa, Ontario, showed almost no difference in obesity between the highest and lowest socio-economic areas. In addition, research summarized in the report has shown that access to recreational facilities and food retail outlets and the price of nutritious foods can all have an association with obesity.

Quick facts on obesity in Canada

• Physical inactivity had the strongest association with obesity at the population level for both men and women. The equivalent of 646,000 cases of obesity in women and 405,000 cases of obesity in men could be altered or averted if inactive populations became active.
• Eliminating the consumption of a poor-quality diet, as measured by the frequency of low fruit and vegetable consumption, could result in the equivalent of 265,000 fewer men being obese and 97,000 fewer women being obese.
• Based on measured height and weight, more than 1 in 4 adults in Canada and just less than 1 in 11 children are considered obese.
• Between 1981 and 2009, obesity rates roughly doubled across all age groups and tripled for youth (age 12 to 17), though self-reported rates have remained relatively stable overall since 2000.
• Across Canadian health regions, there is a six-fold difference in obesity rates; this is a range similar to that seen across developed countries.
• Adult obesity rates varied from lows of 5.3% in Richmond, B.C., and 6.2% in Vancouver, B.C., to highs of 32.1% in Kings County, P.E.I., and 35.9% in the Mamawetan/Keewatin/Athabasca region of Saskatchewan.
• In 2008, 17% of non-Aboriginal adults self-reported being obese, compared with 26% of off-reserve Aboriginal adults. Obesity was also found to vary between First Nations, Inuit and Métis populations. Among children age 6 to 14, for example, 20% of off-reserve First Nations, 25.6% of Inuit and 17% of Métis were estimated to be obese.
• Women in higher income brackets were significantly less likely to be obese than their lower-income counterparts. This trend was most pronounced among Aboriginal females: 16.3% of Aboriginal females in households making $100,000 or more are obese, compared with 26.8% of Aboriginal females in households with incomes of less than $20,000 a year.

About CIHI

The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada's federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI's goal: to provide timely, accurate and comparable information. CIHI's data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health. www.cihi.ca