Prevalence of overweight and obesity in a rural southern Italy population and relationships with total and cardiovascular mortality: the Ventimiglia di Sicilia project

OBJECTIVE: We investigated the prevalence of overweight and obesity and the ir relationships with the main cardiovascular risk factors in the populatio n of Ventimiglia di Sicilia, a rural village in Southern Italy characterize d by low cholesterol levels and by a low incidence of early coronary heart disease mortality. We related all deaths to body weight and fat distributio n during an 8 y follow-up. DESIGN: Cross-sectional and prospective observational study. SUBJECTS: A total of 835 free-living individuals, 363 males and 472 females , of age between 20 and 69 y. MEASUREMENTS: In all participants body weight, waist-to-hip ratio (WHR), ca rdiovascular risk factors and plasma lipids were measured. During the follo w-up, total and cardiovascular deaths were registered. RESULTS: We found a high overall prevalence of subjects with overweight or obesity (respectively 45.0% and 27.7%), with great differences among classe s of age. As expected, body weight and fat distribution were associated wit h diabetes, hypertension, dyslipidemia and with a worsening of lipid profil e. During the follow-up we registered 37 total and 11 cardiovascular deaths . All-cause and cardiovascular mortality risks were, respectively, 1.64 (95 % CI 0.65-4.15) and 2.71 (95% CI 0.29-25.26) in subjects with a body mass i ndex (BMI) of 27-29.99 kg/m(2) and 2.45 (95% CI 1.03-5.87) and 5.36 (95% CI 1.41-62.01) in subjects with a BMI of greater than or equal to 30 kg/m(2) in comparison with participants with a BMI of < 27 kg/m(2), and 3.48 (95% C I 1.46-8.30) and 4.55 (95% CI 1.12-18.40) in subjects with a WHR higher tha n the median in comparison with individuals with a WHR lower than the media n. CONCLUSION: The Ventimiglia di Sicilia Study highlights the great importanc e of overweight and obesity as a public health issue in a rural population and indicates that it is necessary to consider the impact of body weight an d fat distribution on both total and CHD mortality.