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Modifiable Risk Factors - Overweight/Obesity

Key findings

 

The proportion of adults who are overweight or obese has been increasing for decades.[1] More recently, in 2017, approximately 63% of Ontarians ages 18 and older were overweight or obese. This rate was significantly higher in men than women, rural residents than urban residents, Canadian-born residents than immigrants, and those with high-school or lower education compared with post-secondary graduates. The rates did not differ by household income quintile.

Why is this important to Ontarians?

  • Modifiable risk factors are behaviours and exposures that can lower or raise a person’s risk of cancer and that can be changed. Evidence confirms strong associations between adult body fatness and the risk of certain cancers. According to the comprehensive World Cancer Research Fund/American Institute for Cancer Research review, there is convincing evidence that adult body fatness increases the risk of developing colorectal and post-menopausal breast cancers, and probable evidence that they increase the risk of prostate cancer.[2]
  • In Ontario, 8.2% of colorectal cancer cases and 8.0% of female breast cancer cases can be attributed to overweight or obesity in 2010.[3]
  • Reporting on risk factor prevalence in Ontario is important to effectively monitor trends over time, support the development of health promotion and disease prevention strategies, and evaluate outcomes of provincial interventions.

See Modifiable Risk Factors Methodology for technical information.

Report date: April 2019
Data source: Canadian Community Health Survey, 2015–2017 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Population Health and Prevention)
Notes:

  1. Estimates are adjusted to the age distribution of the 2011 Canadian population.
  2. Overweight and obese is defined by Body Mass Index (BMI) values, corrected to adjust for underestimation of BMI based onself-reported height and weight by Canadian Community Health Survey survey respondents.
  3. Overweight and obese (adults ages 18 years and older): BMI 25 or greater.

 

Report date: April 2019
Data source: Canadian Community Health Survey, 2015–2017 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Population Health and Prevention)
Notes:

  1. Estimates are adjusted to the age distribution of the 2011 Canadian population.
  2. Overweight and obese is defined by Body Mass Index (BMI) values, corrected to adjust for underestimation of BMI based on self-reported height and weight by Canadian Community Health Survey survey respondents.
  3. Overweight and obese (adults ages 25 years and older): BMI 25 or greater.
  4. Secondary graduate category includes those with some post-secondary education.
Data Table 1. Percentage of Ontario adults (ages 18 and older) who were overweight or obese, by sex, 2015 to 2017
 

2015
Estimate (%)

2015
Lower 95% Confidence Interval (%)

2015
Upper 95% Confidence Interval (%)

2016
Estimate (%)

2016
Lower 95% Confidence Interval (%)

2016
Upper 95% Confidence Interval (%)
2017
Estimate (%)

2017
Lower 95% Confidence Interval (%)

2017
Upper 95% Confidence Interval (%)

Both sexes 60.5 59.0 62.0 61.9 60.5 63.3 62.8 61.3 64.2
Male 66.4 64.2 68.5 68.2 66.3 70.1 68.4 66.5 70.3
Female 54.6 52.6 56.7 55.6 53.5 57.7 57.0 54.8 59.1

Report date: April 2019
Data source: Canadian Community Health Survey, 2015–2017 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Population Health and Prevention)
Notes:

  1. Estimates are adjusted to the age distribution of the 2011 Canadian population.
  2. Overweight and obese is defined by Body Mass Index (BMI) values, corrected to adjust for underestimation of BMI based onself-reported height and weight by Canadian Community Health Survey survey respondents.
  3. Overweight and obese (adults ages 18 years and older): BMI 25 or greater.

 

Data Table 2. Percentage of Ontario adults (ages 25 and older) who were overweight or obese, by selected socio-demographic factors, 2015 to 2017 combined
  overweight or obese, Estimate (%) overweight or obese, Lower 95% Confidence Interval (%) overweight or obese, Upper 95% Confidence Interval (%)
Residence - rural 71.7 70.0 73.3
Residence - urban 63.4 62.4 64.4
Household income quintile - Q1 (lowest) 62.6 60.3 64.8
Household income quintile - Q2 65.4 63.1 67.7
Household income quintile - Q3 64.6 62.5 66.7
Household income quintile - Q4 64.2 62.3 66.1
Household income quintile - Q5 (highest) 63.8 61.7 65.9
Education status - less than secondary 70.3 66.9 73.8
Education status - secondary graduate 68.8 66.8 70.8
Education status - post-secondary graduate 62.2 61.1 63.4
Immigration status - <=10yrs in Canada 60.6 56.0 65.2
Immigration status - >10yrs in Canada 60.1 57.6 62.5
Immigration status - Canadian born 66.9 65.9 67.9

Report date: April 2019
Data source: Canadian Community Health Survey, 2015–2017 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Population Health and Prevention)
Notes:

  1. Estimates are adjusted to the age distribution of the 2011 Canadian population.
  2. Overweight and obese is defined by Body Mass Index (BMI) values, corrected to adjust for underestimation of BMI based on self-reported height and weight by Canadian Community Health Survey survey respondents.
  3. Overweight and obese (adults ages 25 years and older): BMI 25 or greater.
  4. Secondary graduate category includes those with some post-secondary education.
  5. Bolded estimates are significantly different from the rates in: urban areas for analyses by urban/rural residence; income quintile 5 (Q5) for analyses by income quintile; post-secondary graduate for analyses by education status; and Canadian born for analyses by immigration status.
Table 1: International Comparisons: Percentage of adults who were overweight or obese
Country Estimates, both sexes (percentage) Estimates, men (percentage) Estimates, women (percentage)
Netherlands[4] 47.6 50.2 45.0
Sweden[5] 49.9 56.6 42.9
United States[6] 65.1 71.2 59.3

Notes:

  1. Overweight and obesity defined (adults): Body Mass Index (BMI) 25 or greater based on self-reported weight and height.
  2. There are slight differences in the year and age groups for each region’s data: Netherlands (2016 data of individuals ages 15 or older); Sweden (2018 data of individuals ages 16 and older); and United States (2018 data of individuals ages 18 and older).

Results

  • Between 2015 and 2017, the proportion of Ontario adults ages 18 and older who were overweight or obese increased each year, from 60.5% in 2015 to 62.8% in 2017. Men were significantly more likely to be overweight or obese than women.
  • From 2015 to 2017, rates of overweight or obesity in Ontario adults ages 25 and older were higher in rural residents (71.7%) compared with urban residents (63.4%); higher in less educated persons (about 70%) than in post-secondary graduates (62.2%); and higher in Canadian-born residents (66.9%) compared with immigrants (about 60%). Rates did not differ significantly by household income quintile.

Comparisons

Getting comparable data and measures from other jurisdictions is a challenge. Be aware of the different data definitions, methodologies and years used in indicators measured outside Ontario. Jurisdictional comparison is still useful to provide a rough indication of how well Ontario is doing relative to other provinces and countries.

  • The rate of overweight or obesity in Ontario (62.8% in 2017) is higher than self-reported rates from the Netherlands (47.6% in 2016)[4] and Sweden (49.9% in 2018).[5] Ontario’s rate is lower than that reported in the United States in 2016 (65.1%).[6]

Opportunities

  • This indicator needs improvement because the rates of overweight or obesity have been increasing and show differences by socio-demographic factors. Exposure to some risk factors is higher in particular social, economic or geographic populations. Populations facing health inequities experience higher incidence and mortality rates for certain cancers.
  • Obesity is a complex issue with multiple causes and contributors. Eating a diet rich in vegetables and fruit, and participating in moderate-to-vigorous physical activity contribute to maintaining a healthy weight. Those actions also provide independent health benefits to prevent chronic disease, specifically cancer.
  • Evidence shows that healthy public policy and community-wide programs work better to reduce the prevalence of modifiable risk factors at a population-level than those that focus on changing individuals’ behaviours. Prevention policies and programs to reduce the prevalence of unhealthy eating and physical inactivity may also help reduce the prevalence of overweight and obesity.
  • The Prevention System Quality Index is a series of reports that monitor population-level policies and programs that can reduce cancer risk factors and exposures in the Ontario population. The reports include evidence-based recommendations to strengthen cancer prevention in Ontario.[7]

References

  1. Public Health Agency of Canada and the Canadian Institute for Health Information. Obesity in Canada: A joint report from the Public Health Agency of Canada and the Canadian Institute for Health Information [Internet]. Her Majesty the Queen in Right of Canada; 2011 [cited 2019 May 10]. Available from: https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/hp-ps/hl-mvs/oic-oac/assets/pdf/oic-oac-eng.pdf
  2. World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report [Internet]. 2018 [cited 2019 May 17]. Available from: https://www.wcrf.org/dietandcancer
  3. Cancer Care Ontario. Cancer Risk Factors in Ontario: Healthy Weights, Healthy Eating and Active Living. Toronto: Queen’s Printer for Ontario; 2015.
  4. Organization for Economic Co-operation and Development [Internet]. 2016 [cited 2019 May 17]. Available from: https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT
  5. Swedish Living Conditions Survey [Internet] 2018 [cited 2019 May 17]. Available from: http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__LE__LE0101__LE0101H/LE0101BMI01/
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  6. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. Chronic Disease Indicators (CDI) Data [Internet]. 2016 [cited 2019 May 10]. Available from: https://nccd.cdc.gov/cdi.
  7. Cancer Care Ontario. Prevention System Quality Index: health equity. Toronto: Queen's Printer for Ontario; 2018.