(ECHORN) Cohort Study - Wiley Online Library

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2University of the West Indies, Cave Hill Campus, Bridgetown, Barbados ... Institutes on Minority Health and Health Disparities (NIH/NIMHD), grant number:.

Obesity and Weight Misperception among Adults in the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study Saria Hassan,1 Temitope Ojo,1 Deron Galusha,1 Josefa L. Martinez-Brockman,1 O. Peter Adams,2 Rohan Maharaj,3 Cruz Nazario,4 Maxine Nunez,5 Marcella Nunez-Smith1 1

Yale University, School of Medicine, New Haven, CT, USA University of the West Indies, Cave Hill Campus, Bridgetown, Barbados 3 University of the West Indies, St. Augustine, Trinidad 4 University of Puerto Rico, San Juan, Puerto Rico 5 University of the Virgin Islands, Charlotte Amalie, St. Thomas 2

Keywords: Caribbean, Obesity, Perception, ECHORN Running Title: Weight Misperception in the ECHORN Cohort Study Corresponding Author: Saria Hassan 100 Church Street South, Suite 200A New Haven, CT 06519 Telephone: 203-785-5440 Fax: 203-785-5114 Email: [email protected] Word Count: 3830 Funding: This work is supported by a grant from the National Institutes of Health/National Institutes on Minority Health and Health Disparities (NIH/NIMHD), grant number: 5U54MD01071 Disclosure: The authors declare no conflicts of interest.

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/osp4.280 This article is protected by copyright. All rights reserved.

Abstract Objective: Prior studies have suggested that weight misperception – underestimating one’s actual weight – may be associated with reduced engagement in weight loss programs, decreasing the success of initiatives to address obesity and obesity-related diseases. The purpose of this study was to examine the factors associated with weight misperception among Eastern Caribbean adults and its influence on engagement in weight control behavior. Methods: Data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study were analyzed (adults aged 40 and older, residing in the US Virgin Islands, Puerto Rico, Barbados, and Trinidad). Weight misperception is defined as participants who under-assess their weight measured by body mass index (BMI). Multivariable logistic regression (n=1803 participants) was used to examine the association of weight misperception with BMI category, age, gender, education, history of non-communicable disease and attempt to lose weight. Results: Weight misperception was common, with 54% of overweight (BMI 25-29kg/m2), and 23% of obese class I (BMI 30-34.9kg/m2) participants under-assessing their actual weight. Participants with higher levels of education, versus lower, had decreased odds of weight misperception (OR 0.5, p

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