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Obesity, confidant support and functional health: cross-sectional evidence from the EPIC-Norfolk cohort

International Journal of Obesity volume 28, pages 748–758 (2004)Cite this article

Abstract

OBJECTIVE: To investigate the association between body mass index (BMI) and functional health according to age and the support available from a close confidant.

DESIGN: A cross-sectional population-based study.

PARTICIPANTS: A total of 20 921 participants in the European Prospective Investigation into Cancer and Nutrition, aged 41–80 y resident in Norfolk, England.

MEASUREMENTS: Standardised clinic-based assessment of BMI, self-reported functional health status assessment (according to the anglicised Short Form 36 (SF-36) Health Survey questionnaire) and the availability (and quality) of a close confiding relationship.

RESULTS: Self-reported physical functioning declined steadily with increasing age. Obesity (BMI ≥30) was strongly associated with self-reported physical functional health, equivalent to being 11 y older for men and 16 y older for women (after adjustment that included prevalent chronic physical conditions and cigarette smoking). This adverse effect of obesity on physical functional health was found to increase with age for both men and women. Perceived inadequacy of a confiding relationship was associated with reduced physical functional capacity, equivalent to being 4 y older for men and 5 y older for women. For those with markedly inadequate confidant relationships, the impact of obesity on physical functional capacity was approximately constant by age. For those not critical of the adequacy of their confiding relationships, the impact of obesity was least for those younger but rose to equivalent levels as those with markedly inadequate confidant relationships among older participants.

CONCLUSIONS: The availability of a close confidant relationship (perceived as uncritical and characterised by the absence of shared negative interactions) may delay the impact of obesity in reducing physical functional capacity.

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Acknowledgements

We thank the participants and general practitioners who took part in this study and staff associated with the research programme. EPIC-Norfolk is supported by programme grants from the Cancer Research Campaign and Medical Research Council with additional support from the Stroke Association, the British Heart Foundation, the Department of Health, the Food Standards Agency and the Wellcome Trust, and the Europe Against Cancer Programme of the Commission of the European Communities.

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Authors and Affiliations

  1. Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK

    P G Surtees & N W J Wainwright

  2. Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK

    P G Surtees & N W J Wainwright

  3. Clinical Gerontology Unit, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK

    K-T Khaw

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Correspondence to P G Surtees.

Appendix

Appendix

In the CPQ,41 three types of support were described: confiding/emotional support (seven items), practical support (three items) and negative aspects of the relationship with the closest person (four items). CPQ items included in the HLEQ are shown below according to support category type. Two original confiding/emotional support CPQ items were combined to form question (c) below in the HLEQ. This section of the HLEQ was introduced with the question:

Question: Of your spouse/partner, relatives, friends and acquaintances, is there someone you have felt the closest to during the past 12 months; someone from who you can obtain support, either emotional or practical?

Response: yes/no

Confiding/emotional support items (4):

(a) How much in the last 12 months did this person make you feel good about yourself?

(b) How much in the last 12 months did you share interests, hobbies and fun with this person?

(c) How much in the last 12 months did you confide in this person, so much that you trusted them with your most personal worries and problems?

(d) How much in the last 12 months did he/she talk about his/her personal worries with you?

Items concerned with negative aspects of the relationship (4):

(e) How much in the last 12 months did this person give you worries, problems and stress?

(f) How much in the last 12 months would you have liked to have confided more in this person?

(g) How much in the last 12 months did talking to this person make things worse?

(h) How much in the last 12 months would you have liked more practical help with major things from this person?

Items concerned with practical support (2):

(i) How much in the last 12 months did you need practical help from this person with major things (eg look after you when ill, help with money, children)?

(j) How much in the last 12 months did this person give you practical help with major things?

Response: a great deal/quite a lot/a little/not at all.

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Surtees, P., Wainwright, N. & Khaw, KT. Obesity, confidant support and functional health: cross-sectional evidence from the EPIC-Norfolk cohort. Int J Obes 28, 748–758 (2004). https://doi.org/10.1038/sj.ijo.0802636

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