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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)

Objectives:
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.

Methods:
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.

Results:
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.

Implications:
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.

Impacts:
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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