Population-level trends in the distribution of body mass index
in Canada, 2000–2014
S. V. Subramanian
Received: 23 September 2017 /Accepted: 22 February 2018
The Canadian Public Health Association 2018
Objective Research studying population-level body mass index (BMI) trends document increases in mean or prevalence of
overweight/obese but less consideration has been given to describing the changing distribution of BMI. The objective of this
research was to perform a detailed analysis of changes in the BMI distribution in Canada.
Methods Using data from the CCHS (2000–2014), we analyzed distributional parameters of BMI for 492,886 adults aged 25–
64 years. We further stratified these analyses for women and men, education level, and region of residence.
Results Mean BMI has increased for most subgroups of the Canadian population. Mean BMI values were higher for men, while
standard deviation (SD) of the BMI distribution was systematically higher in women. Increases in mean BMI were accompanied
with increases in SD of BMI across cycles. Across survey cycles, the 95th percentile increased more than 10 times more rapidly
compared to the 5th percentile, showing a very unequal change between extreme values in the BMI distribution over time. There
was a relationship between SD with BMI, but these relations were generally not different between educational categories and
regions. This suggests that the growing inter-individual inequalities (i.e., dispersion) in BMI were not solely attributable to
socioeconomic and demographic factors.
Conclusions This study supports the hypothesis that the simultaneous increases in mean BMI and SD of the BMI distribution are
occurring, and suggests the need to move beyond the mean-centric paradigm when studying a complex public health phenom-
enon such as population change in BMI.
Objectif Les recherches populationnelles portant sur l’évolution de l’indice de masse corporelle (IMC) rapportent une augmen-
tation de la moyenne et de la prévalence de l’embonpoint/obésité, mais accordent moins d’intérêt aux changements
distributionnels. L’objectif de cette recherche était de réaliser une analyse détaillée des changements distributionnels de l’IMC
Méthodologie À partir des données de l’ESCC (2000–2014), nous avons analysé les paramètres distributionnels de l’IMC de
492,886 adultes âgés de 25 à 64 ans. Les analyses ont été stratifiées entre les femmes et les hommes, le niveau d’instruction et la
région de résidence.
Electronic supplementary material The online version of this article
(https://doi.org/10.17269/s41997-018-0060-7) contains supplementary
material, which is available to authorized users.
* Alexandre Lebel
Quebec Heart and Lung Institute, 2725, chemin Sainte-Foy,
Quebec G1V 4G5, Canada
Graduate School of Land Management and Regional Planning, Laval
University, Pavillon Félix-Antoine-Savard, Quebec, Canada
Department of Social and Behavioral Sciences, Harvard School of
Public Health, Boston, MA, USA
Quebec National Institute of Public Health, Quebec, Canada
Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University
of Toronto, Toronto, Canada
Institute for Health Policy and Evaluation, University of Toronto,
Canadian Journal of Public Health