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Increasing body weight and risk of limitations in activities of daily living: a systematic review and meta‐analysis
Author(s) -
Backholer K.,
Wong E.,
FreakPoli R.,
Walls H. L.,
Peeters A.
Publication year - 2012
Publication title -
obesity reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.845
H-Index - 162
eISSN - 1467-789X
pISSN - 1467-7881
DOI - 10.1111/j.1467-789x.2011.00970.x
Subject(s) - overweight , meta analysis , obesity , confidence interval , body mass index , medicine , gerontology , longitudinal study , demography , relative risk , activities of daily living , cross sectional study , subgroup analysis , physical therapy , pathology , sociology
Summary This study examined the relationship between normal weight, overweight and obesity class I and II+, and the risk of disability, which is defined as impairment in activities of daily living (ADL). Systematic searching of the literature identified eight cross‐sectional studies and four longitudinal studies that were comparable for meta‐analysis. An additional four cross‐sectional studies and one longitudinal study were included for qualitative review. Results from the meta‐analysis of cross‐sectional studies revealed a graded increase in the risk of ADL limitations from overweight (1.04, 95% confidence interval [CI] 1.00–1.08), class I obesity (1.16, 95% CI 1.11–1.21) and class II+ obesity (1.76, 95% CI 1.28–2.41), relative to normal weight. Meta‐analyses of longitudinal studies revealed a similar graded relationship; however, the magnitude of this relationship was slightly greater for all body mass index categories. Qualitative analysis of studies that met the inclusion criteria but were not compatible for meta‐analysis supported the pooled results. No studies identified met all of the pre‐defined quality criteria, and subgroup analysis was inhibited due to insufficient comparable studies. We conclude that increasing body weight increases the risk of disability in a graded manner, but also emphasize the need for additional studies using contemporary longitudinal cohorts with large numbers of obese class III individuals, a range of ages and with measured height and weight, and incident ADL questions.