Abstract

Objective: Obesity has been considered as one of the major causes of the onset of chronic diseases such as hypertension, diabetes, and dyslipidemia. Regarding the factors associated with obesity, many studies have focused on education level and investigated this relationship because of the possibility that a level of formal education being established at early adulthood influences their health throughout life. Previous studies conducted in the United States and European countries reported that low education level was associated with obesity risk. However, few studies have examined this relationship in Japan. Therefore, this study clarified the relationship between education level and obesity among healthy Japanese people. Design and Method: This cross-sectional mail survey was conducted in 2020 that involved all community residents with municipal National Health Insurance aged 40–64 years in five cities in three areas of A Prefecture, Japan. This survey included 33,902 community residents, and 12,446 (36.7%) agreed to participate in the survey. After exclusion of those with regular visits to medical institutions (n = 8,174) and those with missing data (n = 714), the analysis included 3,558 participants. Information on education level and obesity was obtained using a self-administered questionnaire. Body mass index (BMI) was calculated as self-reported weight (kg) divided by self-reported height squared (m2). According to the recommendation on Asia-Pacific criteria of obesity status given by the World Health Organization of the Western Pacific Region, we defined obesity as when an individual has a BMI of at least 25 kg/m2. The study protocol was approved by the Institutional Review Boards. Results: In this study, 23.6% were categorized as obesity. Additionally, 9.7% were categorized as low education level (< = 9 years of education), 43.2% as medium education level (> 9 years, < = 12 years), and 47.1% as high education level (> 12 years). The proportions of those with obesity were 20.5% in those with high education level, 25.3% in those with medium education level, and 31.0% in those with low education level (p < 0.001). After adjusting for confounding factors, the multivariable-adjusted odds ratios and 95% confidence intervals for obesity were 1.33 (1.12–1.58) in those with medium education level and 1.61 (1.22–2.12) in those with low education level (p for trend < 0.001), compared with those with high education level. Conclusions: Education level was associated with being obesity among healthy Japanese people.

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