Key result
Every 200 m altitude increase is linked to ~10% lower odds of obesity globally.
Why the study?
Previous studies suggesting that living at high altitude decreases obesity risk were limited to single-country analyses, lacking multi-country examination in low- and middle-income countries.
Does living at higher altitude reduce BMI and obesity risk in reproductive age women in low- and middle-income countries?
Cross-Sectional (n=1,583,456)
Yes
Does living at higher altitude reduce BMI and obesity risk in reproductive age women in low- and middle-income countries?
Odds Ratio: 0.9 (95% CI 0.87–0.95)
While higher altitude is generally associated with slightly lower BMI and obesity risk globally, this relationship is not universal and varies significantly in strength and direction across different countries.
Higher-altitude lower obesity odds in reproductive-age women should not yet change practice; cross-sectional data leaves open causality and country variation for prospective study.
OBJECTIVES: Studies suggest that living at high altitude decreases obesity risk, but this research is limited to single-country analyses. We examine the relationship between altitude and body mass index (BMI) among women living in a diverse sample of low- and middle-income countries. MATERIALS AND METHODS: Using Demographic and Health Survey data from 1 583 456 reproductive age women (20-49 years) in 54 countries, we fit regression models predicting BMI and obesity by altitude controlling for a range of demographic factors-age, parity, breastfeeding status, wealth, and education. RESULTS: (95% CI -0.220, -0.104) reduction in BMI and lower odds of obesity (OR 0.90, 95% CI 0.87, 0.95) for every 200 m increase in altitude. However, countries vary dramatically in whether they exhibit a negative or positive association between altitude and BMI (34 countries negative, 20 positive). Mixed findings also arise when examining odds of obesity. DISCUSSION: We show that past findings of declining obesity risk with altitude are not universal. Increasing altitude predicts slightly lower BMIs at the global level, but the relationship within individual countries varies in both strength and direction.
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Maxfield et al. (2024) conducted a cross-sectional in Obesity (n=1,583,456). Altitude was evaluated on Obesity (OR 0.90, 95% CI 0.87-0.95). Every 200 m increase in altitude was associated with lower odds of obesity globally (OR 0.90; 95% CI 0.87-0.95), though the relationship varied in strength and direction across individual countries.
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