Overweight and obesity mortality trends in Canada, 1985-2000.

OBJECTIVES To investigate the temporal trends in the mortality burden attributed to overweight and obesity in Canada between 1985 and 2000. DESIGN Overweight and obesity prevalence data from six cross-sectional national population surveys, including the 1985 and 1990 Health Promotion Surveys, 1994, 1996 and 1998 National Population Health Surveys, and 2000 Canadian Community Health Survey, in conjunction with one published prospective cohort study on overweight, obesity and mortality. PARTICIPANTS Adults 20-64 years of age. MAIN OUTCOME MEASURE The number of deaths attributable to overweight and obesity at the national and provincial levels. Attributable deaths were estimated using the Population Attributable Risk (PAR), which combined the prevalence data with the relative risks of mortality associated with overweight and obesity. A two-way sensitivity analysis was conducted by simultaneously varying the population prevalences and relative risk estimates by +/-10%. RESULTS Between 1985 and 2000, the national PAR for overweight and obesity increased from 5.1% to 9.3%, and the annual number of deaths attributable to overweight and obesity increased from 2,514 (966-4,061) to 4,321 (2,114-6,542). Cumulatively, 57,181 (25,075-89,227) deaths were attributed to overweight and obesity between 1985 and 2000. Although overweight- and obesity-related mortality is increasing in every province, the problem is particularly pronounced in Eastern Canada. CONCLUSIONS Overweight and obesity are important public health problems in Canada, accounting for approximately 57,000 deaths over the last 15 years. Immediate and sweeping public health campaigns and interventions are required to slow or reverse the recent trends.