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2011 HSR&D National Meeting Abstract

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2011 National Meeting

1047 — Obesity, Overweight, and their Life Course Trajectories in Veterans and Non-Veterans: Findings from NHANES

Koepsell TD (Seattle Epidemiologic Research and Information Center (ERIC) and University of Washington), Littman AJ (Seattle ERIC and University of Washington), Forsberg CW (Seattle ERIC)

The U.S. epidemic of obesity and overweight has not spared Veterans. National telephone surveys suggest higher prevalence of overweight (but not obesity) among Veterans compared with demographically similar non-Veterans, based on self-reported height and weight. We sought to: (a) refine this comparison with measures from in-person examinations; (b) describe differences in life-course trends in obesity between Veterans and non-Veterans; and (c) compare self-reported behaviors related to weight control.

We used 1999-2008 data from the National Health and Nutrition Examination Survey (NHANES), comparing 3,768 Veterans and 21,974 non-Veterans on: a) anthropometric measures of adiposity and dual-photon X-ray absorptiometry (DXA); b) life course of self-reported body mass index (BMI); and c) weight control behaviors. Analysis used model-based direct adjustment to control for confounding and accounted for the complex NHANES sampling design.

Based on BMI, Veterans were about equally likely to be obese ( > = 30 kg/m^2), but more likely to be overweight (25-29.9 kg/m^2) by both self-report and direct measurement (p < 0.05 only by self-report). On waist-stature ratio, a similar pattern was observed. Veterans tended to have larger waist circumference than demographically similar non-Veterans, with more Veterans in the largest two categories. But on DXA, Veterans were LESS likely to have > = 35% body fat than demographically similar non-Veterans. Life-course trends in self-reported BMI suggested a possible burst of weight gain after military discharge. Overweight Veterans were somewhat more likely to report trying to lose or maintain weight than were overweight non-Veterans.

Despite the results of comparisons based on BMI, Veterans may, on average, have less excess body fat than non-Veterans--a pattern not revealed by standard anthropometric measures. However, they tend to have relatively larger waist circumference.

VA clinicians should avoid over-interpreting a borderline-overweight BMI as indicating excess body weight in a Veteran, as percent body fat may well be normal. Prevention programs might try to prevent a burst of weight gain in those recently discharged from the military.

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