Age, income and lack of exercise are factors most linked to obesity in Brazil, according to study

Six out of ten Brazilians are overweight and around 600 million people across the world are obese, according to Brazil’s national statistics agency, IBGE, and the World Health Organization. Faced with this global public health problem, Fundação Getulio Vargas’ Sao Paulo School of Economics (FGV EESP) carried out an unprecedented study of obesity in Brazil, using a multidimensional approach, integrating different factors that can lead to this disease. Through statistical analysis, the study found that age, socioeconomic conditions and lack of physical activity are the main factors associated with the prevalence of obesity in Brazil.

The project used data from IBGE’s National Health Survey and Household Budget Survey. Through an unparalleled approach, the goal of the research was to support the creation of public health policies, deepening knowledge about this subject and mapping the most effective measures to combat obesity worldwide.

Currently, according to National Health Survey figures, the obesity rate in Brazil is 20.1%. However, researchers from FGV EESP project that by 2030, the rate will reach 24.5% if the present trend continues.

Although obesity has grown in both rich and poor countries, the study found a larger imbalance between energy intake and energy expenditure in low-income populations. According to the study, poor people are more vulnerable as they tend to consume cheaper, nutrient-poor, calorie-dense foods. In addition, poor education limits access to nutritional information, impacting these people’s eating habits.

Marcio Holland, a researcher and the coordinator of FGV EESP’s study, explains that many people believe that obesity is mainly associated with the consumption of certain foods. However, this study indicates that this factor is of little relevance if a broader picture is taken.

“When comparing normal-weight and overweight individuals, there are no statistically significant differences in caloric intake, as the average difference is just 5 kilocalories. The most relevant factors linked to being overweight are lifestyle, way of working and whether people live in an urban area,” he says.

Childhood obesity and population aging

The study found that childhood obesity is closely associated with the prevalence of this disease throughout a person’s life. Research suggests that the hormones found in breast milk can help babies feel full, which may lower their risk of developing chronic diseases like obesity. Accordingly, an early end to breastfeeding, a way of life associated with certain means of transport and a highly sedentary lifestyle are some of the multidimensional causes that contribute to childhood obesity.

“The older you are, the more likely you are to become obese. Our country’s population is growing old fast. On average, our population is ageing three times faster than the populations of other countries that already have an older society. In recent decades, there has been a sharp reduction in our youth population and Brazil took just 50 years to make the same transition that took 150 years in France,” Holland says.

Obesity affects men and women differently

According to National Health Survey data, 22% of women and 18% in men are obese in Brazil, while 39% of men and 34% of women are overweight.

“This is very interesting data, as overweight men tend to experience greater health risks than obese women. This is because men usually accumulate extra weight in their abdomen region, which increases the risk of cardiovascular diseases,” Holland explains.

Therefore, the researcher believes that the World Health Organization’s classification for normal weight and excess weight could be changed in order to categorize men and women in a way that reflects their different levels of risk. “In this way, it would be possible to avoid or reduce gender bias related to this disease,” he says.

“People’s life expectancy has increased considerably in the last 50 years, and contrary to the prevailing wisdom, people’s diets have improved a lot in general. This improvement has been accompanied by greater access to health care, vaccines and drinking water, as well as several other factors that have increased people’s life expectancy. These conditions have led people to become taller, stronger, bigger and bulkier, and current obesity indicators may not reflect this evolution,” Holland notes.

Does obesity cause other diseases?

It is well known that hypertension, diabetes and high cholesterol can be up to twice as prevalent in obese people. Figures from the National Health Survey indicate that these diseases are 41.5%, 13.4% and 21.7% more common among the obese, respectively.

In addition, some respiratory diseases, such as asthma and bronchitis, are also more common among people considered obese (5.9%) than among people in the normal weight range (4.7%). The same applies to problems related to mobility, including arthritis and spine or back problems, which affect 11.3% and 24.9% of obese people, respectively. However, Holland warns that this correlation deserves a more careful look.

“Many people often say that obesity causes other diseases, such as hypertension, diabetes and numerous types of cancer. However, obesity is not necessarily the cause of these other diseases. It may merely be associated with them,” he says, adding that his study looked at the following question: If obesity is associated with other diseases, what factors are associated with the occurrence of obesity in the first place?

Impact of diet

Although lifestyle, age group and socioeconomic issues are the most relevant factors indicating whether a person will become obese, the study also found statistically significant differences regarding the consumption of certain foods, such as meat, bread, candies, flour and pasta, oil and fat.

Consumption of legumes, such as beans and peas, and oilseeds, such as peanuts and chestnuts, is associated with a lower chance of putting on weight (approximately 4.1% and 2.7%, respectively). On the other hand, consumption of animal protein raises the chance of gaining weight by between 3.3% and 7.2%, depending on the type.

“Regular consumption of the traditional Brazilian dish of rice and beans does not pose a risk of gaining weight. However, another Brazilian custom, barbecues featuring red meat, has a very strong association with being overweight or obese, especially if combined with lack of exercise and alcohol consumption,” the researcher notes.

Holland adds that despite the risks posed by these different items, the weekly diet of people of normal weight and those who are overweight and obese did not show any statistically significant differences. For example, the weekly frequency of consumption of fish or natural fruit juice is very similar across groups defined by different body mass index categories.

“It is necessary to be careful not to define the foods most likely to cause obesity as the main cause of it. We also need to look at the other factors identified in our study,” he says.

Lifestyle and non-food factors

As well as looking at Brazilian people’s lifestyle, Professor Holland believes it is necessary to observe these facts from a global perspective. He says that some factors, such as globalization and the importation of ways of life from other cultures, especially the American way of life, which has been embraced by Brazilians, also have an influence when it comes to obesity.

“Cultural norms such as time spent watching television, especially given the rise of streaming services, have promoted a sedentary lifestyle, which is associated with weight gain. This factor comes on top of genetic and psychosocial issues, as well as treatments that people may have undergone, among other numerous factors,” Holland says.

Methodology

This study was only possible because nowadays the academic community can analyze large databases using technology tools such as machine learning and big data.

“We compared body mass index profiles (normal weight, overweight and obese) and cross-checked this data with people’s income, gender and consumption profile. By looking at these links, we were able to identify the factors that are genuinely more closely related to obesity,” Holland says, adding that static data should not be used to build rules but merely indicates the variables to be analyzed.

The researcher argues that most Brazilian research in this area has looked for a causative factor, instead of taking a more integrated perspective. In Holland’s view, there is no single villain, but a combination of values that lie behind the prevalence of this disease.

“For example, if we consider sugar consumption as a possible cause of obesity, it is clear that researchers will find a close correlation. However, if we statistically observe other factors such as age, gender and physical activity, the ‘sugar consumption’ factor may decline in relative importance, so we need to avoid this false causality and start to consider that obesity is not caused by a single type of food, but the whole food system, lifestyles, urbanization, globalization and countless other factors,” he argues.

Public policies

This study may also help managers create public policies based on scientific evidence. In the past, the government has taken measures to try to reduce the incidence of obesity in the country, such as taxing certain products that can cause weight gain.

“Currently, the tax on some items associated with obesity, such as sweetened beverages, is around 37% to 45%. In this study, we analyzed the effectiveness of taxing these products and sought to understand their consumption by Brazilian families. We realized that this type of taxation has had a trivial impact on reducing obesity, as the disease’s incidence has continued to grow even after several years of high taxation,” Holland says.

The researcher adds that if a soft drink is expensive, consumers are likely to replace it with another high-calorie drink. “We need to think about public policies that treat obesity in a multidimensional way, addressing health care, physical activity and consumption of calories, all at the same time. You cannot treat each factor on its own. No single product will make you lose or gain weight. There are several factors that lead people to gain weight,” he argues.

In light of this, the study also mapped public policies on obesity across the world, and product labeling stood out. Holland points out that this type of measure corroborates FGV EESP’s study, as both are based on biases in education and awareness of ways of consuming, as a way of trying to reduce obesity.

“It is important to warn the population about nutrition and weight control, and for people to know how overweight they are. Therefore, investing in awareness through labels, having the support of the media to report on this subject and having public policies that ban certain products at schools are examples of meaningful actions, as long as they are treated in an integrated manner and not in isolation,” Holland says. 

Investing in public policies to promote active transport, such as cycling and walking, improving bike lanes and sidewalks, and limiting portion sizes and types of food consumed in restaurants are other examples that could be part of a multidimensional approach to prevent the disease, as adopted in other countries.

To see the full study, click here.