Overweight and obesity in a Swiss city: 10-year trends
Open accessAbstract
Background: Increased rates of overweight/obesity have been reported in recent years in developed countries. This population study of healthy subjects evaluated the changes in overweight/obesity prevalence in 2003, compared with 1993, and determined the association of age, sex and leisure-time activity with body mass index (BMI), fat-free mass index (FFMI) and fat mass index (FMI). Design: Two transversal samples of convenience. Participants: Healthy volunteers (1993, n = 802; 2003, n = 1631). Methods: Fat-free mass was determined using the bioelectrical impedance multiple regression equation. Multivariable linear regression, including confounding variables (age, sex, leisure-time activity), was used to model the body composition evolution between the 1993 and the 2003 subjects. Results: BMI and FMI were higher in 2003 than in 1993, P < 0.001. FFMI was not higher in 2003 than in 1993, P = 0.38. More subjects were overweight/obese in 2003 than in 1993 (27.5 versus 17.2%, chi-square P < 0.001), and had a high FFMI (30.2 versus 21.8%, chi-square P < 0.001) and high FMI (28.0 versus 20.3%, chi-square P < 0.001). Multivariate linear regressions showed that leisure-time activity was negatively, and sex, age and inclusion year were positively associated with BMI, FFMI and FMI (the exception was a negative association with sex) (P < 0.001). Conclusion: Overweight prevalence increased between 1993 and 2003 in a Swiss city, and was associated with a higher fat mass. This observation remained statistically significant after adjustment for age, sex and leisure-time activity.
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Written from the paper’s full text.
TL;DR
In two cross-sectional convenience samples of healthy adults in Geneva, Switzerland, overweight/obesity prevalence was higher in 2003 than in 1993 (27.5% vs 17.2%), with higher BMI and fat mass index but not unadjusted fat-free mass index. The 10-year increase remained statistically significant after adjustment for age, sex, and leisure-time activity.
Key findings
- Overweight/obese prevalence rose from 17.2% in 1993 to 27.5% in 2003 (chi-square P < 0.001); high FMI rose from 20.3% to 28.0% and high FFMI from 21.8% to 30.2% (both P < 0.001).
- Mean BMI was 22.7 ± 2.6 vs 23.4 ± 3.1 kg m⁻² (P < 0.001), and mean FMI was 4.9 ± 2.0 vs 5.7 ± 2.1 kg m⁻² (P < 0.001); mean FFMI did not differ significantly unadjusted (17.8 ± 2.0 vs 17.7 ± 2.2 kg m⁻², P = 0.38), though adjusted FFMI became statistically significant.
- In multivariable linear regression, leisure-time activity was negatively associated with BMI, FFMI, and FMI; age and inclusion year (2003 vs 1993) were positively associated with all three indices; men had higher BMI and FFMI but lower FMI than women (mostly P < 0.001; leisure-time activity with FFMI P = 0.03).
- Sedentary subjects had higher mean BMI and FMI than active subjects in both years (e.g., 2003 men BMI 25.0 ± 3.0 vs 24.1 ± 2.6 kg m⁻²; women 23.0 ± 3.3 vs 22.0 ± 2.8 kg m⁻², P < 0.05).
Methods
- Design: two transversal samples of convenience of healthy volunteers aged 20–74 in Geneva, Switzerland: 1993 n = 802 and 2003 n = 1631; nonrandom recruitment via advertisements, trade fairs, fun runs, public administration staff, and leisure clubs; exclusions included acute pathologies, physical handicap, and conditions interfering with bioelectrical impedance analysis; participants were exclusively Caucasian.
- Measurements: height and weight; whole-body resistance by BIA at 50 kHz and 0.8 mA; FFM from a validated multiple regression equation; BF = weight − FFM; BMI, FFMI, and FMI derived; FFMI/FMI cut-offs from prior healthy subjects (n = 5635). Leisure-time activity was assessed by questionnaire; active was >3 h/week of moderate/high intensity (≥4 METs) for >2 months, sedentary was <3 h/week.
- Analysis: unpaired t-tests, chi-square tests, and multivariable linear regression modeling body composition with age, sex, leisure-time activity, and cohort year.
Limitations
- Stated: the main limitation is two transversal measurements in two distinct samples of convenience, so the observed body composition evolution could be accidental, although recruitment conditions and measurement procedures were similar.
- Stated: socio-economic level was not assessed; the study did not adjust for smoking, menopausal status, diet, alcohol, or other lifestyle determinants; whole-body composition did not determine fat distribution (intraabdominal vs subcutaneous).
- Evident from the text: the nonrandom convenience sample, exclusively Caucasian participants, and exclusion of unhealthy volunteers limit generalizability to the general Swiss population.
Model-written summary. Check it against the paper before relying on it.
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Registry
Cites
Statistics
Claims the paper makes
1 of 37 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured
- Interpretationcitation
The overweight and obesity rates among sedentary subjects in 2003 were similar to those reported in a random Swiss survey.
“which is similar to overweight and obesity rates of 29 and 8%, respectively, reported in a random survey in Switzerland 25 .”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [25] source
The Abstract (p. 2) describes German overweight and obesity surveys, and the activity-related passage (p. 5) compares obesity among more and less active Germans. Neither reports a random Swiss survey or Swiss rates of 29% overweight and 8% obesity; searches for Switzerland and those figures found no supporting passage. (LLM, conf=0.75)
Experimental — accuracy not yet measured
- Findingown data
The 2003 cohort included significantly more women than the 1993 cohort.
“On the other hand, the 2003 cohort included significantly more women than the 1993 cohort.”
Quote in the paperNot a substantial claim - Findingown data
In multivariable linear regression, leisure-time activity was negatively associated with BMI, FFMI and FMI.
“Multivariate linear regressions showed that leisure-time activity was negatively, and sex, age and inclusion year were positively associated with BMI, FFMI and FMI (the exception was a negative association with sex) (P , 0.001).”
- Also stated in: § Sedentary and active cohorts · plain
“The multivariate regression model (Table 2) shows that leisure-time activity was negatively associated with all body composition indices.”
Quote in the paperSubstantial claim - Also stated in: § Sedentary and active cohorts · plain
- Findingown data
There was no significant difference in the proportion of active versus sedentary participants between 1993 and 2003.
“There was no significant difference in the number of active compared with sedentary study participants between 1993 and 2003 (Table 1).”
Quote in the paperNot a substantial claim - Findingown data
Mean BMI was higher in 2003 than in 1993 among healthy volunteers in Geneva.
“BMI and FMI were higher in 2003 than in 1993, P , 0.001.”
- Also stated in: § Comparison of 1993 and 2003 cohort · plain
“The mean BMI was significantly higher in 2003 (P , 0.001) (Fig. 1).”
Quote in the paperSubstantial claim - Also stated in: § Comparison of 1993 and 2003 cohort · plain
- Findingown data
The prevalence of high fat mass index was higher in 2003 (28.0%) than in 1993 (20.3%).
“and high FMI (28.0 versus 20.3%, chi-square P , 0.001).”
- Also stated in: § Comparison of 1993 and 2003 cohort · plain
“The FMI was significantly higher in 2003 than in 1993 and a greater number of subjects had a high FMI in 2003 (28.0%) compared with 1993 (20.3%, chi-square P , 0.001) (Table 1).”
Quote in the paperSubstantial claim - Also stated in: § Comparison of 1993 and 2003 cohort · plain
- Findingown data
The prevalence of low and high/very high FMI was similar to the prevalence of low and overweight/obese BMI.
“The prevalence of low and high/very high FMI was similar to the prevalence of low and overweight/obese BMI.”
Quote in the paperSubstantial claim - Findingown data
In multivariable linear regression, inclusion year (2003 versus 1993) was positively associated with BMI, FFMI and FMI.
“Multivariate linear regressions showed that leisure-time activity was negatively, and sex, age and inclusion year were positively associated with BMI, FFMI and FMI (the exception was a negative association with sex) (P , 0.001).”
- Also stated in: § Sedentary and active cohorts · plain
“Age and year of inclusion were associated with an increase in all three body composition indices.”
Quote in the paperSubstantial claim - Also stated in: § Sedentary and active cohorts · plain
- Findingown data
Mean age was significantly higher in 2003 (41.4 years) than in 1993 (38.1 years).
“Mean age was significantly higher in 2003 (41.4 ^11.8 years) than in 1993 (38.1 ^12.5 years).”
Quote in the paperNot a substantial claim - Findingown data
The prevalence of overweight or obesity was higher in 2003 (27.5%) than in 1993 (17.2%).
“More subjects were overweight/obese in 2003 than in 1993 (27.5 versus 17.2%, chi-square P , 0.001)”
- Also stated in: § Comparison of 1993 and 2003 cohort · plain
“A greater number of subjects were overweight/obese in 2003 (27.5%) compared with 1993 (17.2%, chi-square P , 0.001).”
Quote in the paperSubstantial claim - Also stated in: § Comparison of 1993 and 2003 cohort · plain
- Findingown data
In multivariable linear regression, age was positively associated with BMI, FFMI and FMI.
“Multivariate linear regressions showed that leisure-time activity was negatively, and sex, age and inclusion year were positively associated with BMI, FFMI and FMI (the exception was a negative association with sex) (P , 0.001).”
- Also stated in: § Sedentary and active cohorts · plain
“Age and year of inclusion were associated with an increase in all three body composition indices.”
Quote in the paperNot a substantial claim - Also stated in: § Sedentary and active cohorts · plain
- Findingown data
After adjustment for age, sex and activity level, the body composition indices were only slightly different from the unadjusted results.
“After adjustment for the relevant covariates (age, sex and level of activity), the body composition indices were only slightly different from the unadjusted results (BMI 22.”
Quote in the paperNot a substantial claim - Findingown data
Mean fat mass index was higher in 2003 than in 1993.
“BMI and FMI were higher in 2003 than in 1993, P , 0.001.”
- Also stated in: § Comparison of 1993 and 2003 cohort · plain
“The FMI was significantly higher in 2003 than in 1993 and a greater number of subjects had a high FMI in 2003 (28.0%) compared with 1993 (20.3%, chi-square P , 0.001) (Table 1).”
Quote in the paperSubstantial claim - Also stated in: § Comparison of 1993 and 2003 cohort · plain
- Findingown data
Mean BMI was higher in sedentary subjects than in active subjects in both 2003 and 1993.
“The mean BMI was significantly higher in sedentary subjects in both 2003 and 1993 (men, 25.0 ^3.0 and 23.7 ^2.6 kg m 22 ; women, 23.0 ^3.3 and 22.6 ^3.3 kg m 22 ) than in the active cohort (men, 24.1 ^2.6 and 22.9 ^2.6 kg m 22 ; women, 22.0 ^2.8 and 20.6 ^1.9 kg m 22 , respectively, P , 0.05).”
Quote in the paperNot a substantial claim - Findingown data
Mean FMI was higher in sedentary subjects than in active subjects in 2003 and 1993.
“Similarly, the mean FMI was significantly higher in the sedentary subjects (men, 5.5 ^2.0 and 4.8 ^1.8 kg m 22 ; women, 6.9 ^2.2 and 6.7 ^2.3 kg m 22 ) than in the active cohort (men, 4.6 ^1.7 and 4.7 ^1.4 kg m 22 ; women, 5.7 ^1.6 and 6.0 ^2.0 kg m 22 , P , 0.001) in 2003 and 1993, respectively.”
Quote in the paperNot a substantial claim - Findingown data
The prevalence of high fat-free mass index was higher in 2003 (30.2%) than in 1993 (21.8%).
“and had a high FFMI (30.2 versus 21.8%, chi-square P , 0.001)”
- Also stated in: § Comparison of 1993 and 2003 cohort · plain
“However, significantly more subjects had a high FFMI in 2003 (30.2%) than in 1993 (21.8%, chi-square P , 0.001).”
Quote in the paperNot a substantial claim - Also stated in: § Comparison of 1993 and 2003 cohort · plain
- Findingown data
Mean fat-free mass index was not significantly higher in 2003 than in 1993 in the unadjusted analysis.
“FFMI was not higher in 2003 than in 1993, P ¼ 0.38.”
- Also stated in: § Comparison of 1993 and 2003 cohort · plain
“The FFMI was not significantly higher in 2003 compared with 1993.”
Quote in the paperNot a substantial claim - Also stated in: § Comparison of 1993 and 2003 cohort · plain
- Findingown data
The prevalence of high and very high FMI was underestimated by 1-2% by BMI.
“Overall the prevalence of high and very high FMI was underestimated by 1-2% by BMI.”
Quote in the paperSubstantial claim - Premisecitation
Use of FFMI and FMI permits comparison of subjects of different heights.
“The use of the fatfree mass index (FFMI) and fat mass index (FMI), similarly to BMI (weight/height 2 , kg m 22 ), permits comparison of subjects of different heights 13 .”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [13] source
- Study design and conductnone given
The study did not adjust for smoking, menopausal status and other lifestyle determinants such as diet and alcohol.
“Our study did not adjust for smoking, menopausal status and other lifestyle determinants (diet, alcohol).”
Quote in the paperNot a substantial claim - Interpretationown data
The authors are confident that they captured a real evolution of body composition in the Geneva population across a 10-year period.
“We are thus confident that we captured a real evolution of body composition in the Geneva population across a 10-year period.”
Quote in the paperSubstantial claim- Rests on an assumption: The two samples of convenience are representative of the Geneva population for estimating body composition trends.
- Study design and conductown data
FFMI and FMI cut-offs were derived from polynomial regression equations for BMI cut-offs from healthy subjects (n=5635).
“Ranges of FFMI and FMI were derived from polynomial regression equations for each of the BMI cut-offs (18.5, 25 and 30 kg m 22 ) from our healthy subjects (n ¼ 5635) 21 .”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [21] source
- Interpretationown data
Higher weights and BMI did not necessarily have a negative effect on body composition in active subjects, in view of the higher prevalence of high FFMI and low FMI.
“This suggests that the higher weights and BMI, at least within the limits of change reported in this study, did not necessarily have a negative effect on body composition in active subjects in view of the higher prevalence of high FFMI and low FMI (data not shown).”
Quote in the paperSubstantial claim - Interpretationown data
The higher prevalence of overweight/obesity in 2003 than 1993 resulted partly in a higher prevalence of high FFMI in active subjects.
“Our study showed that the higher prevalence of overweight/obesity in 2003 than 1993 resulted partly in a higher prevalence of high FFMI in active subjects.”
Quote in the paperSubstantial claim - Study design and conductreasoning
Coefficients associated with time of measurement captured the evolution of body composition adjusted for sex, age and leisure-time activity between two samples of convenience recruited in similar conditions.
“Coefficients associated with the time of measurement therefore captured the evolution of body composition adjusted for sex, age and leisure-time activity between two samples of convenience, recruited in similar conditions.”
Quote in the paperSubstantial claim - Premisecitation
Higher lean tissue reserves are thought to protect against detrimental effects of malnutrition, such as sarcopenia and frailty in older subjects.
“higher lean tissue reserves are thought to protect from detrimental effects of malnutrition, such as sarcopenia and frailty in older subjects 15,28”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationcitation
Excess body fat is poorly estimated by BMI in sedentary subjects or those with chronic diseases.
“This finding suggests that excess body fat is poorly estimated by BMI in sedentary subjects or those with chronic diseases.”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationown data
Sedentary subjects are at risk of becoming obese.
“On the other hand, sedentary subjects are at risk of becoming obese.”
Quote in the paperSubstantial claim - Interpretationreasoning
Leisure-time activity appears to counteract some of the negative effects of high BMI.
“Thus leisure-time activity appears to counteract some of the negative effects of high BMI.”
Quote in the paperSubstantial claim - Interpretationown data
In healthy, physically active subjects, BMI provides a good estimation of fatness.
“This suggests that in healthy, physically active subjects, BMI provides a good estimation of fatness.”
Quote in the paperSubstantial claim - Interpretationreasoning
Rates of overweight and obesity in this study were lower because subjects with health-related problems were excluded.
“Rates of overweight and obesity in this study were lower because of exclusion of subjects with healthrelated problems (recent hospitalisation, chronic disease).”
Quote in the paperNot a substantial claim - Interpretationown data
The higher prevalence of overweight/obesity in 2003 than 1993 suggests that overall rates of overweight and obesity are on the rise in Switzerland.
“This suggested that overall rates of overweight and obesity are on the rise in Switzerland.”
Quote in the paperSubstantial claim
- May combine two claims. 18
- The quote only partly states this claim. 1
- Classified as probably not a substantial claim. 19
May combine two claims.
Findingown dataFFMI was not significantly higher in active than in sedentary subjects in 1993 and in men in 2003, but was significantly higher in sedentary than active women in 1993.
“FFMI was not significantly higher in 1993 in active than in sedentary subjects (men, 18.9 ^1.2 and 18.9 ^1.4 kg m 22 ; women, 15.6 ^1.0 and 16.0 ^1.4 kg m 22 , P .0.05) and in 2003 in men (19.3 ^1.4 and 19.5 ^1.6 kg m 22 , P .0.05), but was significantly higher in sedentary than active women in 1993 (16.0 ^1.4 and 15.6 ^1.0 kg m 22 , P ¼ 0.02).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn 2003, 27.6% of sedentary subjects were overweight and 5.4% were obese.
“The study showed that 27.6 and 5.4% of sedentary subjects, respectively, were considered overweight and obese in 2003”
Quote in the paperNot a substantial claimThe quote only partly states this claim.
Findingown dataAfter adjustment for age, sex and leisure-time activity, the difference in FFMI between 1993 and 2003 became statistically significant.
“However, the difference between the 1993 and the 2003 cohort concerning the FFMI became statistically significant when adjusted values were used.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn multivariable linear regression, male sex was positively associated with BMI and FFMI and negatively associated with FMI.
“Multivariate linear regressions showed that leisure-time activity was negatively, and sex, age and inclusion year were positively associated with BMI, FFMI and FMI (the exception was a negative association with sex) (P , 0.001).”
- Also stated in: § Sedentary and active cohorts · plain
“Men had a significantly higher BMI and FFMI, and a significantly lower FMI than women.”
Quote in the paperNot a substantial claim- Also stated in: § Sedentary and active cohorts · plain
May combine two claims.
Findingown dataMean BMI, FMI and FFMI were significantly higher in 2003 than in 1993 in sedentary and active men and women, except for non-significant differences in sedentary women.
“The mean BMI, FMI and FFMI were significantly higher in 2003 than in 1993 in sedentary and active men and women (except for non-significant differences in sedentary women).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataOverall prevalence of overweight/obesity was 10% higher and prevalence of high FMI was 8.0% higher in 2003 than in 1993.
“Overall the prevalence of overweight/obesity was 10% higher and the prevalence of high FMI was 8.0% higher in 2003 than in 1993.”
- Also stated in: § Conclusion · plain
“Overall the prevalence of overweight/obesity was 10% higher and the prevalence of high FMI was 8.0% higher in 2003 than in 1993 in a sample of convenience recruited in a Swiss city, and was mainly associated with an increase in fat mass.”
Quote in the paperSubstantial claim- Also stated in: § Conclusion · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataActive subjects expended at least 720 kcal/week on leisure-time activity.
“Our active subjects expended at least 720 kcal week 21 (180 min week 21 at 4 METS) on leisure-time activity.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductnone givenThe study consisted of two transversal measurements made in two distinct samples of convenience.
“The main limitation of the study is that it consisted of two transversal measurements, made in two distinct samples of convenience.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationcitationLower rates of obesity in active subjects suggest that leisure-time activity had a positive effect on BMI and weight, and support a relationship between physical inactivity and the development of overweight and obesity.
“The lower rates of obesity in the active subjects also suggest that leisure-time activity had a positive effect on BMI and weight, and support a relationship between physical inactivity and the development of overweight and obesity 34 .”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] source
Probably not a substantial claim: may not pass S4 (based).
PremisereasoningDirect measurement of fat-free mass and body fat permits a more precise determination of whether morbidity and mortality are associated with the lean or fat body compartment.
“The direct measurement of fat-free mass (FFM) and body fat (BF) permits a more precise determination of whether morbidity and mortality are associated with the lean or fat body compartment.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataThe protocol was approved by the Geneva University Hospital Ethics Committee and subjects gave written informed consent.
“The protocol to perform BIA measurements and obtain physical activity, health status and medication data was approved by the Geneva University Hospital Ethics Committee, and study subjects gave written informed consent.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenWhole-body composition measurements did not determine fat distribution, i.e. did not identify intra-abdominal versus subcutaneous obesity.
“Whole-body composition measurements in our study did not determine fat distribution, i.e. did not identify intraabdominal versus subcutaneous obesity.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn long-term studies, weight gain has been associated with low physical activity levels.
“In long-term studies, weight gain has been associated with low physical activity levels 14 .”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [14] source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationNumerous studies have documented higher muscle mass and lower body fat in men than in women.
“Numerous studies have documented higher muscle mass and lower body fat in men than in women 15,32 .”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [15] source
- cites [32]
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningIt is possible that the body composition evolution observed between the two cohorts is accidental.
“It is therefore possible that the body composition evolution observed between the two cohorts is accidental.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn previous studies, low recreational activity reported at follow-up was strongly associated with major weight gain (>13 kg over the preceding 10 years).
“In previous studies 14 , low recreational activity reported at follow-up survey was strongly associated with major weight gain (. 13 kg over the preceding 10 years).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [14] source
May combine two claims.
Study design and conductreasoningRecruitment conditions and measurement procedures were similar between the two cohorts.
“However, the recruitment conditions and the measurement procedures were similar.”
- Also stated in: § Subjects · plain
“Identical procedures and measurements were used for both data collection points.”
Quote in the paperSubstantial claim- Also stated in: § Subjects · plain
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationcitationLeisure-time activity may preserve functional status and lean body mass and contribute to reduced fat accumulation through increased energy expenditure.
“Leisuretime activity may, through the effects of increased energy expenditure, preserve both functional status and lean body mass, and contribute to reduce fat accumulation 33 .”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [33] source
May combine two claims.
PremisecitationOther studies have reported body composition changes over time but are limited in length of follow-up or number of subjects.
“Although other studies 15 -17 have reported body composition changes over time, these studies are limited in length of follow-up or number of subjects.”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationFat-free mass was calculated using a previously validated multiple regression equation.
“The FFM was calculated by the following previously validated multiple regression equation 20”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [20] source
May combine two claims.
InterpretationreasoningThe rate of overweight in Switzerland is gradually approaching that seen in the USA and Western Europe, but obesity rates remain slightly lower than in other developed countries.
“Thus the rate of overweight in Switzerland is gradually approaching that seen in the USA and Western Europe, but obesity rates remain slightly lower than in other developed countries.”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn epidemiological studies, both low and high BMI have been associated with increased morbidity.
“In epidemiological studies, both low and high BMI have been associated with increased morbidity 6 -9”
Quote in the paperNot a substantial claim0 of 4 sources checkedMay combine two claims.
Interpretationown dataThe association of age and inclusion year with BMI increase was stronger than the beneficial effects of leisure-time activity, resulting in higher BMI and FMI in both sedentary and active cohorts in 2003 than 1993 and higher FFMI in 2003.
“The association of age and year of inclusion (2003 versus 1993) with BMI increase was higher than the beneficial effects of leisure-time activity and thus resulted in higher BMI and FMI in both the sedentary and active cohort in 2003 than 1993 and also resulted in higher FFMI in 2003.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe study did not assess socio-economic level.
“The socio-economic level was not assessed; however, we do not believe that it affected the prevalence of obesity.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Socio-economic level did not affect the prevalence of obesity in this study.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationLee et al. found that fit but overweight men had similar all-cause mortality to physically fit men of above normal weight and lower risk than unfit normal weight men.
“Lee et al. 36 found that fit but overweight men (BMI $ 27.8 kg m 22 ) had a similar rate of all-cause mortality to physically fit men of above normal weight and had a lower risk of all-cause mortality than unfit, normal weight men.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [36] source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAllison et al. evaluated a hypothetical model in which death increased linearly with body fat and decreased linearly with fat-free mass.
“Allison et al. 6 evaluated a hypothetical model in which death increased linearly with BF and decreased linearly with FFM.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationPhysical activity expending 1000 kcal/week has been associated with a 30% reduction in all-cause mortality, and a slightly favourable effect has been noted with as low as 500 kcal/week.
“Physical activity expending 1000 kcal week 21 has been associated with a 30% reduction in all-cause mortality rates, and a slightly favourable effect on all-cause mortality has been noted with physical activity as low a 500 kcal week 21 (Kesaniemi et al. 35 ).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Kesaniemi et al. 35
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationHaapanen et al. found that increased physical activity was associated with small body mass gain and low physical activity, and decreasing activity during 10-year follow-up was strongly associated with large body mass gain.
“Haapanen et al. 34 found that increased physical activity was associated with small body mass gain and low physical activity, and, in particular, decreasing levels of activity during a 10-year follow-up period was strongly associated with large body mass gain.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [34] source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationUnfit men had substantially higher cardiovascular disease mortality than fit men in each BMI group.
“Unfit men had substantially higher cardiovascular disease mortality than fit men in each BMI group 36 .”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [36] source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationHeitman et al. suggested that the apparent U-shaped association between BMI and total mortality may result from compound risk functions from body fat and fat-free mass.
“Heitman et al. 7 suggested that the apparent U-shaped association between BMI and total mortality may be the result of compound risk functions from BF and FFM, e.g. total mortality was a linear function of high BF and low FFM.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [7] source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationNumerous studies have shown a J- or U-shaped relationship between BMI and mortality and a U-shaped relationship between BMI and health care expenditure.
“Numerous studies have shown a J-or U-shaped relationship between BMI and mortality 6,37,38 and a Ushaped relationship between BMI and expenditure on health care 39 .”
Quote in the paperNot a substantial claim0 of 4 sources checked
The paper relies on this without support.
No previously published studies report body composition trends over a 10-year period.
“There are no previously published studies that report body composition trends over a 10-year period.”
The paper relies on this without support.
The long-term effects of leisure-time activity on fat-free mass and body fat are not well known.
“However, the long-term effects of leisure-time activity on FFM and BF are not well known.”
The authors state this as an assumption.
Demographic composition and leisure habits could have changed over the 10-year interval.
“It was reasonable to postulate that changes in demographic composition and leisure habits could have occurred in a 10-year time frame.”
The authors state this as an assumption.
Socio-economic level did not affect the prevalence of obesity in this study.
“The socio-economic level was not assessed; however, we do not believe that it affected the prevalence of obesity.”
The paper relies on this without support.
The two samples of convenience are representative of the Geneva population for estimating body composition trends.
“We are thus confident that we captured a real evolution of body composition in the Geneva population across a 10-year period.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Active subjects' FMI is described as increasing despite lower reported means
MajorThe text says mean FMI was higher in 2003 for active men and women, but its listed means decrease from 4.7 to 4.6 for active men and from 6.0 to 5.7 for active women.
“The mean BMI, FMI and FFMI were significantly higher in 2003 than in 1993 in sedentary and active men and women (except for non-significant differences in sedentary women).”
“active cohort (men, 4.6 ^1.7 and 4.7 ^1.4 kg m 22 ; women, 5.7 ^1.6 and 6.0 ^2.0 kg m 22 , P , 0.001) in 2003 and 1993, respectively.”
Conflicting significance statements for 1993 women's FFMI
MajorThe same active-versus-sedentary comparison for women in 1993 is assigned both P > 0.05 and P = 0.02.
“women, 15.6 ^1.0 and 16.0 ^1.4 kg m 22 , P .0.05”
“but was significantly higher in sedentary than active women in 1993 (16.0 ^1.4 and 15.6 ^1.0 kg m 22 , P ¼ 0.02).”
Six subjects are not less than 0.01% of the sample
MinorThe study includes 2,433 subjects, so six subjects represent about 0.247%, not less than 0.01%.
Reported 0.01 · recomputed 0.246609
“Only six (, 0.01%) sedentary and active subjects had BMI .35 kg m 22 .”
Abstract's P < 0.001 claim conflicts with the activity-FFMI result
MinorThe abstract assigns P < 0.001 to the reported regression associations, but Table 2 gives P = 0.03 for the association between leisure-time activity and FFMI.
“Multivariate linear regressions showed that leisure-time activity was negatively, and sex, age and inclusion year were positively associated with BMI, FFMI and FMI (the exception was a negative association with sex) (P , 0.001).”
“Leisure-time activity | 20.97 | 21.2, 20.8 ,0.001 | 20.13 | 20.2, 20.0 | 0.03 | 20.89 | 21.0, 20.7 ,0.001 | | |”
1993 active men's mean BMI does not equal FFMI plus FMI
MinorFor 1993 active men, the reported mean FFMI is 18.9 and mean FMI is 4.7; these sum to 23.6, rather than the reported mean BMI of 22.9.
Reported 22.9 · recomputed 23.6
“men, 24.1 ^2.6 and 22.9 ^2.6 kg m 22”
1993 active women's mean BMI does not equal FFMI plus FMI
MinorFor 1993 active women, the reported mean FFMI is 15.6 and mean FMI is 6.0; these sum to 21.6, rather than the reported mean BMI of 20.6.
Reported 20.6 · recomputed 21.6
“women, 22.0 ^2.8 and 20.6 ^1.9 kg m 22”
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Flagged first, then by citations
2 of the 44 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
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Cited by
Sorted by citations
New obesity body mass index threshold for self-reported data
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“Discussion The prevalence of obesity in the population of Lausanne was lower than in neighboring countries [12,13] but higher than previous estimations for Switzerland [14,15], probably due to differences in age.”
ResultInfluentialIs thinness more prevalent than obesity in Portuguese adolescents?
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“table 4”
RELATIONSHIP BETWEEN BODY WATER COMPARTMENTS AND INDEXES OF ADIPOSITY IN SEDENTARY YOUNG ADULT GIRLS
Mehdizadeh, R. (2012) · Redalyc (Universidad Autónoma del Estado de México) · Cited by 3 · see citing works
Changes of Body Mass Index among Young Men in Brazil over Two Decades
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Circadian Modulation of Protein Catabolism: Insight from a Population Study
Kafader, M. L., Sare, S., Zandonà, M., Giorno, R. D., Garo, M. L., Bonetti, S., & Gabutti, L. (2026) · Nutrients · doi:10.3390/nu18101594 · Cited by 1 · see citing works
“Bioimpedance-derived indices, including BMI and FMI, reflected expected values [33] and sex-specific patterns of body composition [34].”
- Authors
- Kyle, U. G., Kossovsky, M. P., Genton, L., & Pichard, C.
- Affiliations
- University Hospital of Geneva (CH)
- Corresponding author
- Pichard, Claude
- Venue
- Public Health Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2007-09
- Volume
- 10
- Issue
- 9
- Pages
- 914-919
- ISSN
- 1368-9800 (ISSN-L)
- 1475-2727
- OpenAlex
- W2036644698
- Cited by
- 9
- References
- 44
- Citations by year
- 2026: 1 · 2012: 2
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Public Health Nutrition (publishedVersion)
- PubMed (publishedVersion)
- reroDoc Digital Library (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- overweight, obesity, prevalence trends, body mass index, fat-free mass index, fat mass index, body composition, leisure-time physical activity
- MeSH terms
- Adipose Tissue, Adult, Age Factors, Aged, Body Composition, Female, Humans, Leisure Activities, Male
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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