Socioeconomic, Temporal and Regional Variation in Body Mass Index among 188,537 Swiss Male Conscripts Born between 1986 and 1992

<div><p>Background</p><p>Rising levels of overweight and obesity are important public-health concerns worldwide. The purpose of this study is to elucidate their prevalence and trends in Switzerland by analyzing variations in Body Mass Index (BMI) of Swiss conscripts.</p><p>Methods</p><p>The conscription records were provided by the Swiss Army. This study focussed on conscripts 18.5–20.5 years of age from the seven one-year birth cohorts spanning the period 1986–1992. BMI across professional status, area-based socioeconomic position (abSEP), urbanicity and regions was analyzed. Two piecewise quantile regression models with linear splines for three birth-cohort groups were used to examine the association of median BMI with explanatory variables and to determine the extent to which BMI has varied over time.</p><p>Results</p><p>The study population consisted of 188,537 individuals. Median BMI was 22.51 kg/m² (22.45–22.57 95% confidence interval (CI)). BMI was lower among conscripts of high professional status (−0.46 kg/m²; 95% CI: −0.50, −0.42, compared with low), living in areas of high abSEP (−0.11 kg/m²; 95% CI: −0.16, −0.07 compared to medium) and from urban communities (−0.07 kg/m²; 95% CI: −0.11, −0.03, compared with peri-urban). Comparing with Midland, median BMI was highest in the North-West (0.25 kg/m²; 95% CI: 0.19–0.30) and Central regions (0.11 kg/m²; 95% CI: 0.05–0.16) and lowest in the East (−0.19 kg/m²; 95% CI: −0.24, −0.14) and Lake Geneva regions (−0.15 kg/m²; 95% CI: −0.20, −0.09). Trajectories of regional BMI growth varied across birth cohorts, with median BMI remaining high in the Central and North-West regions, whereas stabilization and in some cases a decline were observed elsewhere.</p><p>Conclusions</p><p>BMI of Swiss conscripts is associated with individual and abSEP and urbanicity. Results show regional variation in the levels and temporal trajectories of BMI growth and signal their possible slowdown among recent birth cohorts.</p></div

Annual change in median BMI (95% confidence intervals) estimated from the second multivariable quantile regression model of Swiss conscripts across birth cohort and region of residence.

<p>Model adjusted for professional status, tertile of median Swiss-SEP index of postcode of residence, degree of urbanicity of community of residence and linear splines for birth-year period and interaction of region with birth-year period.</p

Distribution of Body Mass Index (BMI) (mean, standard deviation (SD), median and inter-quartile range (IQR)) and frequencies of major BMI categories across year of birth and contextual variables of Swiss conscripts.

<p>Distribution of Body Mass Index (BMI) (mean, standard deviation (SD), median and inter-quartile range (IQR)) and frequencies of major BMI categories across year of birth and contextual variables of Swiss conscripts.</p

Kha’s jewellery: a, b) Kha wears a wide collar (double arrow), large ear-rings (arrows) and a large heart scarab on a metal rod (arrowhead); c) the hands laid on the pelvis.

<p>Six finger rings are visible. F. Femoral bone. Imaging parameters: a): 80kv, 8mAs; b): 100kV, 10mAs; c): 70kV, 5mAs.</p

Kha: The right elbow shows an obvious enthesopathy of the insertion of triceps brachii muscle (arrow).

<p>Arrowhead: A golden foil was wrapped around his upper arm (funerary jewellery). F: humeral bone. U: ulnar bone. R: radial bone. Imaging parameters: 70kV, 3,2mAs.</p

Reconstructed gas chromatography-mass spectrometry (GC-MS) total ion chromatogram (TIC) of the trimethylsilylated total lipid extract of (a) Kha, mummy wrappings (from base of feet) and (b) Merit, mummy wrappings (from base of feet).

<p>Peak identities (‘n’ indicates carbon chain length; where shown, i indicates degree of unsaturation): filled triangles, C_n:i indicates fatty acids; filled squares, C_n indicates α,ω-dicarboxylic acids. C_3:0 2,3-di-OH indicates 2,3-dihydroxypropanoic acid (glyceric acid); C_4:0 3,4-di-OH indicates 3,4-dihydroxybutanoic acid (2-deoxytetronic acid); C_16:0 9,10-di-OH (t) indicates 9,10-dihydroxyhexadecanoic acid (threo isomer); C_18:1 10-oxo indicates a 10-oxo-octadecenoic acid; C_18:0 10-oxo indicates 10-oxo-octadecanoic acid; C_18:0 9,10-di-OH (t+e) indicates 9,10-dihydroxyoctadecanoic acid (threo and erythro isomers); C_18:0 11,12-di-OH indicates 11,12-dihydroxyoctadecanoic acid; C_18:2 DAGs indicate octadecadienoyl diglycerides. The letters ms represent monosaccharides and the letters ds represent disaccharides; DHA represents dehydroabietic acid.</p

Merit. a) frontal and b) lateral view of the vertebral column and the pelvis.

<p>A massive post-mortal disruption of the vertebrae (double arrows) and ribs are visible. The left hip is luxated (red double arrow). No degenerative were observed. Merit wears a fine bracelet on her lower arm (arrow).</p

Merit’s total skeleton reconstruction.

<p>Merit’s total skeleton reconstruction.</p

Reconstructed gas chromatography-mass spectrometry (GC-MS) total ion chromatogram (TIC) of the trimethylsilylated total lipid extract of (a) Kha, black coating on his outer coffin and (b) Merit, black coating on her outer coffin.

<p>Peak identities (‘n’ indicates carbon chain length; where shown, i indicates degree of unsaturation): filled triangles, C_n:i indicates fatty acids; filled pentagons indicate sesquiterpenoids and their derivatives. The letters ms represent a monosaccharide. Also shown are the structures of two aromatic acids identified: 4-hydroxybenzoic acid and terephthalic acid; and the structures of six Pistacia triterpenoid compounds identified: 22,23,24,25,26,27-hexakisnor-dammaran-3,20-dione, 24,28-bisnor-olean-17-en-3-one, 28-nor-olean-17-en-3-one, moronic acid, oleanonic acid and isomasticadienonic acid.</p

Digital X-raying of Kha (upper); the mummy of Merit (lower).

<p>Merit’s coffin, which is too large for her size and originally belonged to her husband.</p