Cited by 9Obesity, Physical Activity, DietBody Composition Measurement TechniquesPhysical Activity and Health

Overweight and obesity in a Swiss city: 10-year trends

Open access
Kyle, Ursula G, Kossovsky, Michel P, Genton, Laurence, Pichard, Claude·2007·Public Health Nutrition

Abstract

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.

AI snapshot

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.

Integrity signals

Registry

Crossref · 10.1017/s136898000765798x

Cites

42 of 42 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

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
  • 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
  • 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 data

    FFMI 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 claim
  • May combine two claims.

    Findingown data

    In 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 claim
  • The quote only partly states this claim.

    Findingown data

    After 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 claim
  • May combine two claims.

    Findingown data

    In 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
  • May combine two claims.

    Findingown data

    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.

    “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 claim
  • May combine two claims.

    Findingown data

    Overall 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
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Active 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 claim
  • May combine two claims.

    Study design and conductnone given

    The 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 claim
  • May combine two claims.

    Interpretationcitation

    Lower 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).

    Premisereasoning

    Direct 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 claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The 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 claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Whole-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 claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In 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.

    Premisecitation

    Numerous 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 conductreasoning

    It 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 claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In 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 conductreasoning

    Recruitment 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
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    Leisure-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.

    Premisecitation

    Other 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 checked
    • cites [15] source
    • cites [16] source
    • cites [17] source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Fat-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.

    Interpretationreasoning

    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.

    “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 checked
    • cites [2] source
    • cites [26] source
    • cites [27] source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In 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 checked
    • cites [6] source
    • cites [7] source
    • cites [8]
    • cites [9] source
  • May combine two claims.

    Interpretationown data

    The 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 claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The 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.

    Premisecitation

    Lee 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).

    Premisecitation

    Allison 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.

    Premisecitation

    Physical 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.

    Premisecitation

    Haapanen 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).

    Premisecitation

    Unfit 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).

    Premisecitation

    Heitman 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.

    Premisecitation

    Numerous 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
    • cites [6] source
    • cites [37] source
    • cites [38] source
    • cites [39] source
31 of 31
  • 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.”
5 of 5

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

    Major

    The 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.

  • Conflicting significance statements for 1993 women's FFMI

    Major

    The same active-versus-sedentary comparison for women in 1993 is assigned both P > 0.05 and P = 0.02.

  • Six subjects are not less than 0.01% of the sample

    Minor

    The study includes 2,433 subjects, so six subjects represent about 0.247%, not less than 0.01%.

    Reported 0.01 · recomputed 0.246609

  • Abstract's P < 0.001 claim conflicts with the activity-FFMI result

    Minor

    The 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.

  • 1993 active men's mean BMI does not equal FFMI plus FMI

    Minor

    For 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

  • 1993 active women's mean BMI does not equal FFMI plus FMI

    Minor

    For 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

6 of 6

Cites

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

  1. 2002, Prevalence of Overweight and Obesity Among Adults: United States [online]
  2. Groscurth, 2003, [Is the Swiss population gaining body weight? Body mass index in insurance applications between 1950 and 1990], Schweizerische Rundschau fur Medizin Praxis, 92, 2191

Cited by

Sorted by citations

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
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
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

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

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