Association between obesity and injury among Taiwanese adults

Background: Obesity is one main threat to public health and also as a risk factor for chronic diseases. The relationship between increasing body mass index (BMI) and the rate of injury was circumstantiated from Western countries. However, due to heterogeneity in culture, life style and physical activity practice, the findings of western societies may not be generalizable to oriental countries. The aim of this retrospective cohort study is to evaluate the relationships between BMI, occurrence of injury, and the injury-related expenditures among Taiwanese adults.

Methods: Our study sample consisted of 12,250 adults aged 18 years or older from the 2001 National Health Interview Survey (NHIS), who had consented to the linking of their survey responses with their NHI claims records. Cox proportional hazards regression and the two-part model were be used.

Results: The results show that a linear association was observed between BMI and injury. Relative to normal weight adults, the hazard ratios (HR) of injury were 1.23 (95% CI: 1.10-1.38) for obese class II adults and 1.10 (95% CI: 1.04-1.17) for obese class I adults, after adjusting for gender, age, race, household income, education, smoking, alcohol consumption. For obese class II adults, the adjusted expenditure was 12.1% greater than normal weight adults.

Conclusion: There is a strong positive relationship between body weight gain and increased risk of injury. Our findings suggest that promote wellness programs about the adverse effects of obesity may reduce not only the risk of injury, but also the injury-related expenditures among obese adults.