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BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Obesity | Research article

Effect of national culture on BMI: a multilevel analysis of 53 countries

Authors: Mohd Masood, Akash Aggarwal, Daniel D. Reidpath

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

To investigate the association between national culture and national BMI in 53 low-middle- and high-income countries.

Methods

Data from World Health Survey conducted in 2002–2004 in low-middle- and high-income countries were used. Participants aged 18 years and over were selected using multistage, stratified cluster sampling. BMI was used as an outcome variable. Culture of the countries was measured using Hofstede’s cultural dimensions: Uncertainty avoidance, individualism, Power Distance and masculinity. The potential determinants of individual-level BMI were participants’ sex, age, marital status, education, occupation as well as household-wealth and location (rural/urban) at the individual-level. The country-level factors used were average national income (GNI-PPP), income inequality (Gini-index) and Hofstede’s cultural dimensions. A two-level random-intercepts and fixed-slopes model structure with individuals nested within countries were fitted, treating BMI as a continuous outcome variable.

Results

A sample of 156,192 people from 53 countries was included in this analysis. The design-based (weighted) mean BMI (SE) in these 53 countries was 23.95(0.08). Uncertainty avoidance (UAI) and individualism (IDV) were significantly associated with BMI, showing that people in more individualistic or high uncertainty avoidance countries had higher BMI than collectivist or low uncertainty avoidance ones. This model explained that one unit increase in UAI or IDV was associated with 0.03 unit increase in BMI. Power distance and masculinity were not associated with BMI of the people. National level Income was also significantly associated with individual-level BMI.

Conclusion

National culture has a substantial association with BMI of the individuals in the country. This association is important for understanding the pattern of obesity or overweight across different cultures and countries. It is also important to recognise the importance of the association of culture and BMI in developing public health interventions to reduce obesity or overweight.
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Metadata
Title
Effect of national culture on BMI: a multilevel analysis of 53 countries
Authors
Mohd Masood
Akash Aggarwal
Daniel D. Reidpath
Publication date
01-12-2019
Publisher
BioMed Central
Keywords
Obesity
Obesity
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7536-0

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