Alarmingly high prevalence of obesity in Curacao: data from an interview survey stratified for socioeconomic status

OBJECTIVE: The aim of the article is to report the prevalence of obesity, abdominal fatness and waist circumference in different socioeconomic classes in Curacao. DESIGN: In 1993/1994 a health interview survey (the Curacao Health Study) was carried out among a random sample (n = 2248, response rate = 85%) of the adult non-institutionalized population of Curacao. METHODS: We analyzed the association between obesity (BMI greater than or equal to 30), abdominal fatness (waist hip ratio (WHR) greater than or equal to 0.95 for men, WHR greater than or equal to 0.80 for women) waist circumference (WC greater than or equal to 100 cm for men, WC greater than or equal to 91 cm for women) and socioeconomic status (SES) by age adjusted logistic regressions, for men and women separately. RESULTS: The prevalence of obesity was about 27%: 36% of the women and 19% of the men were obese. An at risk WHR was reported among 62.2% of the women and among 20.4% of the men. A WC above the cut-off point was reported for 44.3% women and 25.3% men. Compared to women of higher SES, the lower SES women have a two to three times higher risk of a BMI, WHR or WC exceeding the cut-off points. Among men, no statistically significant difference between an increased BMI, WHR or WC and SES factors was found. The overlap between the three measures is large, about 56% of the women scored similarly on all three measurements. Among men the overlap is even greater (73%). CONCLUSIONS: The prevalence of obesity in Curacao is alarming. Low SES women are at the greatest risk of an increased BMI, WHR or WC. The obesity figures can be placed between industrialized societies and less modernized cultures. Action and additional research on the prevention of obesity in Curacao are deemed necessary. The cut-off points in our study for WC in the non-white population are preliminary and need to be elucidated further.