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Spotlight on Canada

Obesity in Canada 2011

A joint report released by the Canadian Institute for Health Information and the Public Health Agency of Canada, entitled ‘Obesity in Canada 2011’, examines how obesity rates vary across Canada, who is most at risk and possible actions to address it. Based on body mass index (BMI) calculations, the study reports that more than one in four adults (estimates range from 24.3%-25.4%) in Canada and just less than one in 11 children are considered obese.

A shop full of Canadian maple syrup. Photo: Flickr/Mayanais

Between 1981 and 2009, obesity based on BMI data roughly doubled across all adult age groups and tripled for children (age 12 to 17). Alarmingly, the report states that ‘not only has the prevalence of obesity increased over time, but obesity is becoming more severe and fitness levels are decreasing as well’.

Unsurprisingly, the report shows that improving lifestyle behaviours, such as healthy eating and physical activity, can have a significant impact on reducing the waistlines and improving the health of Canadians.

"However, obesity is complex, and there are many other factors that contribute beyond lifestyle habits,” says Jeremy Veillard, Vice President of Research and Analysis at CIHI. “By shedding light on the factors most closely associated with obesity and how they play out across Canada, policy-makers and health providers can better target prevention and treatment options to meet the needs of the population.”

Regional and ethnic variation

New analyses from the research shows a variation in self-reported obesity across health regions within Canada is large, ranging from a low of 5.3% in urban/suburban Richmond, British Columbia, to a high of 35.9% in the northern Mamawetan/Keewatin/Athabasca region of Saskatchewan (see Figure 1 below). Among both adults and youth, the proportion of overweight tends to be higher in rural areas than in metropolitan areas. In particular, in all the Canadian regions considered, obesity has been found to be most prevalent among boys in small town regions of 2,500 to 19,999.

Figure 1: Prevalence of obesity in Canadian provinces

Furthermore, the investigation demonstrates that self-reported obesity remains more prevalent among Aboriginal peoples than in the Canadian non-Aboriginal adult population. For example, 25.7% among off-reserve Aboriginal adults compared with 17.4% among non-Aboriginal adults in Canada.

On-reserve First Nations groups tend to have a higher prevalence still, with over one-third (36.0%) estimated as obese, based on 2002/03 data. Self-reported obesity among adults is similar for Inuit, off-reserve First Nations, and Métis populations (23.9%, 26.1% and 26.4%, respectively), whereas childhood obesity varies from 16.9% among Métis to 20.0% among off-reserve First Nations to 25.6% among Inuit.

Sex and age

For both men and women, the report shows that the prevalence of obesity generally increases with each successive age group up to age 65. After age 65, the prevalence of obesity declines. In the 2007/08, obesity was more prevalent among men than women, with the exception of the oldest age group (Figure 2).

Figure 2: Prevalence of obesity by age

Based on direct measures, findings from the 2007-2009 CHMS show that, while obesity increased with age, it was not always higher among men than women. For example, in the population aged 20 to 39, 19% of males and 21% of females were obese, and among those aged 40 to 59, 27% of males and 24% of females were obese.

Distribution of BMI

There has been a marked shift in the distribution of BMI over time, the greatest increases occurring in the heaviest weight classes (Figure 3 below). For example, the proportion of adults falling into obese class I (BMI 30.0-34.9) increased from 10.5% in 1978/79 to 15.2% in 2004. The proportion in obese class II (BMI 35.0-39.0) doubled between 1978/79 and 2004, increasing from 2.3% to 5.1%. The proportion falling into obese class III (BMI≥40) , while small, also appears to have increased over time.

Figure 3: Distribution of BMI Categories by Sex, Ages 18 to 79, 2007-2009

In 1978/79 obese class III made up 0.9% of the population and increased three-fold, to 2.7%, by 2004. Although females appear more likely than males to be within the normal weight group and less likely to be in the overweight group, they are more likely to fall into obese classes II and III.

Socio-economic status

Variations in obesity by socio-economic status were much more pronounced in some regions than in others. In Halifax, Nova Scotia, for example, 11% of the population in the highest socio-economic range was obese, compared with close to 26% in the lowest socio-economic areas. Similarly, in Thunder Bay, Ontario, 10% of the population in the highest socio-economic areas was obese, compared with 20% in the lowest socio-economic areas. While most cities had a gap, it was not always significant.

Some cities, like Vancouver, BC, and Oshawa, Ontario, showed almost no difference in obesity between the highest and lowest socio-economic areas. In addition, research summarized in the report has shown that access to recreational facilities and food retail outlets and the price of nutritious foods can all have an association with obesity.

Gender and income

The report also notes that women in higher income brackets were significantly less likely to be obese than their lower-income counterparts, a difference not found for men. This trend was seen for all Canadian women, although it was most pronounced among Aboriginal females, where 16.3% of Aboriginal women in households making C$100,000 or more were considered obese, compared with 26.8% of Aboriginal women in households with incomes of less than C$20,000 a year.

Costs

It has been estimated that obesity costs the Canadian economy approximately C$4.6 billion in 2008, up C$735 million (19%) from C$3.9 billion in 2000 (this estimate is limited to those costs associated with the eight chronic diseases most consistently linked to obesity, an additional study using comparable methodology and looking at 18 chronic diseases estimated the cost to be even higher, at close to C$7.1 billion).

“Reducing obesity levels and promoting healthy weights is critical to the prevention of ill health,” says Dr Judith Bossé, Assistant Deputy Minister, Public Health Agency of Canada.

“Obesity increases the risk of a number of chronic conditions, including type 2 diabetes, hypertension and some forms of cancers. That’s why we’re examining options to address the factors that lead to obesity, and we are working with various levels of government, non-governmental organisations and other stakeholders on this issue.”

The report ‘Obesity in Canada’ is available to download from the Public Health Agency of Canada.