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A cross-sectional analysis of physical activity and obesity indicators in European participants of the EPIC-PANACEA study

International Journal of Obesity volume 33, pages 497–506 (2009)Cite this article

Abstract

Objectives:

Cross-sectional data suggest a strong association between low levels of physical activity and obesity. The EPIC-PANACEA (European Prospective Investigation into Cancer-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of home And obesity) project was designed to investigate the associations between physical activity and body mass index (BMI) and waist circumference based on individual data collected across nine European countries.

Methods:

In the European Prospective Investigation into Cancer and Nutrition (EPIC), 519 931 volunteers were recruited between 1992 and 2000, of whom 405 819 had data on main variables of interest. Height, body weight and waist circumference were measured using standardized procedures. Physical activity was assessed using a validated four-category index reflecting a self-reported usual activity during work and leisure time. The associations between physical activity and BMI and waist circumference were estimated using multilevel mixed effects linear regression models, adjusted for age, total energy intake, smoking status, alcohol consumption and educational level.

Results:

A total of 125 629 men and 280 190 women with a mean age of 52.9 (s.d. 9.7) and 51.5 (s.d. 10.0) years, respectively were included. The mean BMI was 26.6 kg/m2 (s.d. 3.6) in men and 25.0 kg/m2 (s.d. 4.5) in women. Fifty percent of men and 30% of women were categorized as being active or moderately active. A one-category difference in the physical activity index was inversely associated with a difference of 0.18 kg/m2 in the mean BMI (95% confidence interval, CI, 0.11, 0.24) and 1.04-cm (95% CI 0.82, 1.26) difference in waist circumference in men. The equivalent figures for women were 0.31 kg/m2 (95% CI 0.23, 0.38) and 0.90 cm (95% CI 0.71, 1.08), respectively.

Conclusions:

Physical activity is inversely associated with both BMI and waist circumference across nine European countries. Although we cannot interpret the association causally, our results were observed in a large and diverse cohort independently from many potential confounders.

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Acknowledgements

This publication arises from the project PANACEA, which has received funding from the European Union, in the framework of the Public Health Programme (project number: 2005328). The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004; Research Directorate-General 2005; Ligue contre le Cancer, Societé 3M, Mutuelle Générale de l'Education Nationale, Institut National de la Santé de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center, Federal Ministry of Education and Research (Germany); Danish Cancer Society (Denmark); Health Research Fund (FIS) of the Spanish Ministry of Health, The participating regional governments and institutions (Spain); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, The Wellcome Trust (UK); Greek Ministry of Health, Greek Ministry of Education (Greece); Italian Association for Research on Cancer, National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports, Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (The Netherlands); Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skane (Sweden) and the Norwegian Cancer Society (Norway).

Author information

Authors and Affiliations

  1. Medical Research Council, Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK

    H Besson, U Ekelund, J Luan, S Sharp & N J Wareham

  2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    H Besson, A M May & P H Peeters

  3. Center for Nutrition and Health, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    A M May, H B Bueno-de-Mesquita & S W van den Berg

  4. Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology IDIBELL, Barcelona, Spain

    N Travier, A Agudo & C Gonzalez

  5. Epidemiology Methods and Support Group, International Agency for Research on Cancer, Lyon, France

    N Slimani & S Rinaldi

  6. Lifestyle, environment and cancer group, International Agency for Research on Cancer, Lyon, France

    M Jenab

  7. Division of Epidemiology, Public Health and Primary Care, Imperial College, London, UK

    T Norat, T Mouw, P Vineis, E Riboli & P H Peeters

  8. Division of Cancer Epidemiology, Nutritional Epidemiology Unit, German Cancer Research Center, Heidelberg, Germany

    S Rohrmann & R Kaaks

  9. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany

    M Bergmann & H Boeing

  10. ERI 20 Nutrition, Hormones and Cancer, INSERM- Institut Gustave Roussy, Villejuif, France

    F Clavel-Chapelon & M C Boutron-Ruault

  11. Department of Cardiology and Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg, Denmark

    K Overvad

  12. Department of Occupational Therapy and Physiotherapy, Aarhus University Hospital, Aalborg, Denmark

    E L Andreasen

  13. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    N Føns Johnsen & J Halkjaer

  14. Population Health Service, Health Information Section Public Health Directorate Asturias, Oviedo, Spain

    L Rodriguez

  15. Granada Cancer Registry, Andalusian School of Public Health and CIBER de Epidemiología y Salud Pública (CIBERESP), Granada, Spain

    M J Sanchez

  16. Public Health Division of Gipuzkoa, CIBER en Epidemiología y Salud Pública (CIBERESP), San Sebastian, Spain

    L Arriola

  17. Epidemiology, Prevention and Promotion Health Service, Institute of Public Health Navarra, Pamplona, Spain

    A Barricarte

  18. Epidemiology Department, Murcia Health Council, CIBER en Epidemiología y Salud Pública (CIBERESP), Murcia, Spain

    C Navarro

  19. Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, UK

    T J Key & E A Spencer

  20. Department of Hygiene and Epidemiology, Medical School, University of Athens, Athens, Greece

    P Orfanos, A Naska & A Trichopoulou

  21. Hellenic Health Foundation, Athens, Greece

    P Orfanos, A Naska & A Trichopoulou

  22. Department of Surgery, Malmö University Hospital, Malmö, Sweden

    J Manjer

  23. Department of Clinical Sciences, Nutrition Epidemiology, Lund University, Malmö, Sweden

    E Wirfält

  24. Institute of Community Medicine, University of Tromsø, Tromsø, Norway

    E Lund

  25. Molecular and Nutritional Epidemiology Unit, ‘I S P O (Cancer Research and Prevention Institute)’, Florence, Italy

    D Palli

  26. Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    C Agnoli

  27. Department of Biomedical Sciences and Human Oncology, University of Torino, Torino, Italy

    P Vineis

  28. Department of Clinical and Experimental Medicine, Federico II University of Naples, Naples, Italy

    S Panico

  29. Cancer Registry, Azienda Ospedaliera ‘Civile M.P. Arezzo’, Ragusa, Italy

    R Tumino

  30. EPOS -IASIS, R&D, Biomedical Research, Nicosia, Cyprus

    A D Odysseos

Authors
  1. H Besson
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  2. U Ekelund
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  8. N Slimani
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  10. M Jenab
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  23. C Gonzalez
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  24. L Rodriguez
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  26. L Arriola
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  28. C Navarro
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  29. T J Key
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  30. E A Spencer
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  31. P Orfanos
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  32. A Naska
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  34. J Manjer
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  36. E Lund
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  37. D Palli
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  38. C Agnoli
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  39. P Vineis
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  40. S Panico
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  41. R Tumino
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  42. H B Bueno-de-Mesquita
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  43. S W van den Berg
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  44. A D Odysseos
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  45. E Riboli
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  46. N J Wareham
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  47. P H Peeters
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Corresponding author

Correspondence to H Besson.

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Besson, H., Ekelund, U., Luan, J. et al. A cross-sectional analysis of physical activity and obesity indicators in European participants of the EPIC-PANACEA study. Int J Obes 33, 497–506 (2009). https://doi.org/10.1038/ijo.2009.25

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  • DOI: https://doi.org/10.1038/ijo.2009.25

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