OBJECTIVES:

Obesity is a modern-world pandemic, associated with other metabolic cardiovascular risk factors (CVRF; hypertension, dyslipidemia, diabetes/prediabetes) and cardiovascular mortality/morbidity burden (CVD). We assessed obesity’s association with demographic/socio-economic/lifestyle factors and other CVRF and its long-term impact on CVD burden.

METHODS:

Data derived from the Nationwide Survey EMENO (2013-2016). Sample was selected by the multistage stratified random sampling method. 6006 participants were assessed at home visits; blood tests, physical examination, anthropometric and blood pressure measurements were performed by trained physicians; 4765 had available weight/height measurements. Through a simulation study reproducing EMENO structure we estimated CVD events over a 10-year period under a scenario without (status-quo) and with an intervention which would have achieved a mean of 6kg/4kg weight reduction among obese/overweight individuals (BMI-scenario).

RESULTS:

Estimated prevalence of underweight (BMI<18.5kg/m²), normal-weight (18.5-24.9), overweight (25-29.9) and obese (≥ 30) was 1.1%, 29.1%, 37.7% and 32.1% respectively. Obesity prevalence was lower in women up to age 40 and higher at older ages; It co-existed with the other CVRF; among obese participants, only 18.9% had no other CVRF. The difference in proportion of having at least one disease between obese and non-obese was larger at younger ages. Higher educational level, higher income, better Mediterranean diet adherence and increased physical activity were independently associated with lower odds of being obese. The 10-year estimated cumulative median CVD cases (95% credible interval) were 1,662,164 (1,640,747-1,685,353) under the BMI scenario and 1,638,695 (1,616,748-1,660,700) under status-quo; a difference of 23,469 avertable cases.

CONCLUSIONS:

Obesity is alarmingly high in Greek adults, and it co-exists with other metabolic diseases; It should thus be recognized as a public health threat. Socioeconomic factors are among its most important associates. Focused interventions aiming to reduce BMI should be urgently taken as, even a low-scale feasible intervention could lead to thousands of averted CVD cases.