REGIONAL AND RURAL-URBAN DIFFERENCES IN OBESITY IN CANADA

Objective: To describe regional and rural-urban differences in weight and weight loss patterns in Canadian adults. Design: Population-based, cross-sectional surveys. Setting: Nine Canadian provinces (excluding Nova Scotia) from 1986 to 1992. Participants: A probability sample of 27 120 men and women aged 18 to 74 years was selected using the health insurance registration files in each province. Anthropometry was perf ormed on 18 043 participants (67%). Outcome measures: Region of Canada (Atlantic, central, western); rural or urban residence (rural if part icipant resided in a community whose population was < 10 000, urban if population greater than or equal to 10 000); body mass index (BMI, kg /m(2)); percentage of participants trying to lose weight; reasons for trying to lose weight; level of leisure-time physical activity. Result s: Overall, mean BMI values in rural men (26.1 kg/m(2)) and women (25. 3 kg/m(2)) were not significantly different from urban counterparts (2 5.7 kg/m(2) and 24.8 kg/m(2), respectively). Similarly, obesity (BMI g reater than or equal to 27 kg/m(2)) was as prevalent in rural men (37% ) and women (30%) as in urban participants (34% and 28%, respectively) . However, a difference was observed in western Canada where 41% of ru ral and 34% of urban men were obese (odds ratio [OR], adjusted for age and education = 1.29; 95% confidence interval [CI] 1.06, 1.57), as we re 35% of rural and 25% of urban women (OR, adjusted for age and educa tion = 1.47; 95% Cl 1.17, 1.84). Among men in western Canada, the rura l-urban differences were greatest in the 25-64 year age group, whereas in women the differences were present at all ages. Overall, in Canada , urban men (26%) are more likely than rural men (23%) to be trying to lose weight; the reverse was true for women (39% and 42%, respectivel y). Conclusion: Considerable regional and rural-urban differences are seen in the patterns of weight and weight loss in Canada. A fuller und erstanding of the underlying behavioural determinants of these differe nces is needed. On the basis of such an understanding, effective progr ams to promote healthy weights for individuals and communities in thes e areas might be developed.