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Obes Facts. 2010 Oct;3(5):320-7. doi: 10.1159/000321398. Epub 2010 Oct 4.

Risk factors for adult overweight and obesity: the importance of looking beyond the 'big two'.

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Department of Human Nutrition, University of Copenhagen, Copenhagen, Denmark.



To compare two traditional (high dietary lipid intake and non-participation in high-intensity physical exercise, namely the 'Big Two' factors) versus three nontraditional (short sleep duration, high disinhibition eating behavior, and low dietary calcium intake) risk factors as predictors of excess body weight and overweight/obesity development.


Adult participants aged 18-64 years of the Quebec Family Study were selected for cross-sectional (n = 537) and longitudinal (n = 283; 6-year follow-up period) analyses. The main outcome measure was overweight/obesity, defined as a BMI ≥ 25 kg/m(2).


We observed that both the prevalence and incidence of overweight/obesity was best predicted by a combination of risk factors. However, short sleep duration, high disinhibition eating behavior and low dietary calcium intake seemed to contribute more to the risk of overweight and obesity than high dietary lipid intake and non-participation in high-intensity physical exercise. Globally, the risk of being overweight or obese was two-fold higher for individuals having the three nontraditional risk factors combined (OR 6.05; 95% CI 4.26-7.88) compared to those reporting a high percentage of lipids in their diet together with no vigorous physical activity in their daily schedule (OR 2.95; 95% CI 2.18-3.73). Furthermore, the risk of overweight/obesity was also higher for the combination of any two of the nontraditional risk factors than for the combination of the 'Big Two' factors.


These results are concordant with previous reports showing that obesity is a multifactorial condition, and emphasize the importance of looking beyond reported measures of the 'Big Two' factors.

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