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Initial Report on Public Health
Healthy Body Mass Index
Narrative

The healthy body mass index indicator estimates the age-standardized proportion of people age 18 years and older whose self reported height and weight denote a healthy body mass index (BMI). BMI is calculated using the person's weight in kilograms divided by their height in squared metres. The World Health Organization considers a BMI in the range of 18.5-24.9 to be healthy for most adults. 78

A healthy body weight is associated with good health. Excess weight can lead to:

  • coronary artery disease
  • stroke
  • hypertension
  • colon cancer
  • post menopausal breast cancer
  • type 2 diabetes
  • gall bladder disease
  • osteoarthritis 79

Chronic diseases such as the above are the leading causes of death in Ontario. 80

Obesity is strongly linked with type 2 diabetes, which itself is associated with other health problems such as heart disease, stroke, blindness and kidney failure. Type 2 diabetes is a major cost driver of Ontario's health care system. 81 Diabetes is the single most significant contributor to renal disease and vision loss and a leading cause of heart disease, stroke, and non-traumatic limb amputations. 82

There are many contributing factors to obesity, including:

  • over eating
  • low activity levels
  • genetics
  • body metabolism
  • socio-economic status
  • psychological/emotional factors

Unhealthy weights - both overweight and obesity - are a global public health priority. Overweight and obesity now are such a serious public health concern that they are known as 'the new tobacco'. 83, 84, 85

The increased prevalence of overweight and obese young people is of concern because overweight and obesity may persist into adulthood. 86, 87, 88, 89 To address these issues, and in response to the Chief Medical Officer of Health’s report, Healthy Weights, Healthy Lives, 90 the Ministry of Health Promotion launched the Healthy Eating Active Living (HEAL) Action Plan in 2006. 91

Public health units play a significant role in chronic disease prevention and health promotion related to healthy weights, proper nutrition and physical activity.

Public health works with individuals to build food skills and promote healthy behaviours, and with communities to promote food security and awareness of healthy eating. Efforts also are made to influence policy makers and community partners to address issues related to the existing community infrastructure, environment, and community spaces so that people have options that support them to be active and to access healthy foods.

In 2007, 47% of individuals age 18 years and older had a healthy BMI. Based on 36 public health units in Ontario, the highest proportion of individuals age 18 years and older with a healthy BMI was 55% and the lowest was 33%.

Indicator Definition

Definition:

The healthy body mass index indicator estimates the age-standardized proportion of people age 18 years and older whose self reported height and weight denote a healthy body mass index (BMI). BMI is calculated using the person's weight in kilograms divided by their height in metres squared. The International Standard for BMI is: <18.5 (underweight), 18.5-24.9 (acceptable weight), 25-29.9 (overweight), and 30 or higher (obese). The World Health Organization considers a BMI in the range of 18.5-24.9 to be healthy for most adults.

Classification BMI Category Risk of developing health problems
Underweight <18.5 Increased
"Normal or Healthy" Weight, Acceptable Weight Range 18.5 - 24.9 Least
Overweight 25.0 - 29.9 Increased
Obese
   Class I
   Class II
   Class III
 
30.0 - 34.9
35.0 - 39.9
≥ 40.0
 
High
Very high
Extremely high

Data Source(s):

Numerator: Canadian Community Health Survey 2007, Statistics Canada, Ontario Share File distributed by the Ministry of Health and Long-Term Care
Denominator: Canadian Community Health Survey 2007, Statistics Canada, Ontario Share File distributed by the Ministry of Health and Long-Term Care

Formula:

Weighted number of respondents age 18+ years (excluding pregnant women and breastfeeding women) with BMI of 18.5-24.9

Weighted number of respondents age 18+ years (excluding pregnant women and breastfeeding women)
x 100

Notes:

  • CCHS excludes pregnant women, as well as women age 18-49 years who did not answer the pregnancy question. The index is calculated for those age 18 years and over, excluding pregnant and lactating women, as well as persons less than 3 feet tall or greater than 6 feet 11 inches. 130 There was an additional exclusion of women who were currently breastfeeding (MEX_05=1), and respondents who chose 'Not applicable' (96) or Not Stated (99) responses in the indicator calculation
  • Numerator: HWTDISW = Normal or healthy weight (2)
  • Denominator: HWTDISW = Underweight (1), Normal or healthy weight (2), Overweight (3), and Obese (4-6)
  • Age groups in years used for direct age-standardization: 18-34, 35-49, 50-64, 65-74, 75+
  • Direct age-standardization to the 1991 Canadian population

78 World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. WHO Technical Report Series #894. Geneva: World Health Organization; 2000. Table 2.1: Classification of adults according to BMI, p. 9. Retrieved August 11, 2009 from: http://whqlibdoc.who.int/trs/WHO_TRS_894_(part1).pdf.
79 Luo W, Morrison H, de Groh M, et al. The burden of adult obesity in Canada. Chronic Dis Can. 2007;27(4):135-44.
80 Statistics Canada. Leading causes of death in Canada - 2005 [Internet]. 84-215-X. Ottawa, ON: Statistics Canada, 2009. Table 3-6: Ten leading causes of death, by sex and geography, 2005 - Ontario. Retrieved April 20, 2009 from: http://www.statcan.gc.ca/pub/84-215-x/2009000/tbl/t019-eng.pdf.
81 Ontario. Ministry of Health and Long-Term Care. Ontario launches Diabetes Strategy [press release]. July 22, 2008. Retrieved April 20, 2009 from: http://www.newswire.ca/en/releases/archive/July2008/22/c6499.html.
82 Public Health Agency of Canada. Living with diabetes. National diabetes fact sheet. Ottawa: Public Health Agency of Canada; 2008. Retrieved August 6, 2009 from: http://www.phac-aspc.gc.ca/publicat/2008/ndfs-fnrd-08/ndfs_lwd-fnrd_vad-eng.php.
83 Heart and Stroke Foundation of Canada. 2004 Annual Report Card on Canadians' Health. Ottawa: Heart and Stroke Foundation of Canada; 2004.
84 Nathan SA, Develin E, Grove N, Zwi AB. An Australian childhood obesity summit: the role of data and evidence in 'public' policy making. Aust New Zealand Health Policy. 2005 Jul 20;2:17. Retrieved April 20, 2009 from: http://www.anzhealthpolicy.com/content/pdf/1743-8462-2-17.pdf.
85 Jillings C, Samis S. Is fat the new tobacco? Strategies for addressing the obesity epidemic in Canada. 12th EUPHA conference: urbanisation and health: new challenges in health promotion and prevention. Eur J Public Health. 2004; 14(Suppl 1): 35.
86 Lobstein T, Baur L, Uauy R; IASO International Obesity TaskForce. Obesity in children and young people: a crisis in public health. Obes Rev. 2004;5 Suppl 1:4-104.
87 Guo SS, Wu W, Chumlea WC, Roche AF. Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. Am J Clin Nutr. 2002;76(3):653-8. Retrieved August 6, 2009 from: http://www.ajcn.org/cgi/reprint/76/3/653.pdf.
88 Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;337(13):869-73. Retrieved August 6, 2009 from: http://content.nejm.org/cgi/reprint/337/13/869.pdf.
89 Koplan JP, Liverman CT, Kraak VI. Preventing childhood obesity: health in the balance. Washington, DC: National Academies Press; 2005.
90 Basrur SV. 2004 Chief Medical Officer of Health report: healthy weights, healthy lives. Toronto, ON: Queen’s Printer for Ontario; 2004. Available from: http://www.health.gov.on.ca/english/public/pub/ministry_reports/
cmoh04_report/healthy_weights_112404.pdf
.
91 Ministry of Health Promotion. Ontario’s action plan for healthy eating and active living. Toronto, ON: Queen’s Printer for Ontario; 2006. Retrieved April 20, 2009 from: http://www.mhp.gov.on.ca/english/health/HEAL/actionplan-EN.pdf.
130 Statistics Canada. Health indicators [Internet]. 82-221-X., no. 1. Ottawa, ON: Minister of Industry; 2008. p. 21. Retrieved April 20, 2009 from: http://www.statcan.gc.ca/pub/82-221-x/82-221-x2008001-eng.pdf.

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