Scottish Health Survey 2015 - volume 1: main report

Findings and trends of the Scottish Health Survey 2015, providing information on the health of people living in Scotland.

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References and Notes

1 World Health Organisation. Fact Sheet No 311 Obesity and Overweight. WHO, Geneva, 2012.

2 Moody A. Adult anthropemetric measures, overweight and obesity. Chapter 10 in Craig R, Mindell J (eds). Health Survey for England 2012. Volume 1: Health, social care and lifestyles. Health and Social Care Information Centre, Leeds, 2013.

3 Flegal KM, Kit BK, Orpana H, Graubard B I. Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories. Journal of the American Medical Association 2013:209 (1): 71-82. 2013

4 Oude Luttikhuis H. et al. Interventions for treating obesity in children. Cochrane Database of Systematic Reviews 1, CD001872. 2009

5 Summerbell CD et al. Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews 3, CD001871. 2005

6 Nathan BM and Moran A. Metabolic complications of obesity in childhood and adolescence: more than just diabetes. Current Opinion in Endocrinology Diabetes and Obesity. 15(1): 21-29. 2008

7 Scottish Intercollegiate Guidelines Network Management of Obesity - A National Clinical Guideline. SIGN guideline no. 115. Edinburgh: SIGN, 2010.

8 Grant, I., Fischbacher, C., and Whyte, B. Obesity in Scotland - An Epidemiology Briefing. Edinburgh: NHS National Services Scotland/Scottish Public Health Observatory. 2007.

9 Anstey KJ, Cherbuin N, Budge M, and Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obesity Reviews 12(5): e426-37. 2011

10 Xu WL, Atti AR, Gatz M, Pedersen NL, Johansson B, and Fratiglioni L. Midlife overweight and obesity increase late-life dementia risk: a population-based twin study. Neurology 76(18): 1568-74. 2011

11 Loef M and Walach H. Midlife obesity and dementia: meta-analysis and adjusted forecast of dementia prevalence in the United States and China. Obesity 21(1): e51-5. 2013

12 Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight. Edinburgh: the Scottish Government, 2010.

13 SPICe Briefing - Obesity in Scotland. January 2015. Edinburgh: Scottish Parliament.

14 Health Analytical Services Scottish Government and Information and Statistics Division, NHS National Services Scotland. Indicators to Monitor Progress of the Obesity Route Map. Edinburgh: Scottish Government. 2011.

15 Available from:

16 Obesity Indicators 2014: Monitoring Progress for the Prevention of Obesity Route Map. Edinburgh, Scottish Government, 2014.

17 Parkinson J. Establishing a Core Set of National, Sustainable Mental Health Indicators for Children and Young People in Scotland: Final Report. Glasgow: NHS Health Scotland. 2012.

18 See:

19 See:

20 Keith SW, Fontaine KR, Pajewski NM, Metha, T, Allison D. Use of self-reported height and weight biases the body mass index-mortality association. International Journal of Obesity. 2011; 35:401-8.

21 Merrill RM, Richardson JS. Validity of Self-Reported Height, Weight and Body Mass Index: Findings from the National Health and Nutrition Examination Survey, 2001-2006. Preventing Chronic Disease, 2009; 61-10.

22 See:

23 The Frankfort Plane is an imaginary line passing through the external ear canal and across the top of the lower bone of the eye socket, immediately under the eye. Participants' heads are positioned with the Frankfort Plane in a horizontal position when height is measured using a stadiometer as a means of ensuring that, as far as possible, the measurements taken are standardised.

24 These cut-offs differ to those used in the previous surveys. In 1995 and 1998 the normal weight range was defined as 20-25 kg/m2, in 2003 it was changed to 18.5-25 kg/m2. From 2008 onwards the ranges are defined as set out below. This brings the definition in line with WHO recommendations. The impact of the change of definition is very marginal as very few people have a BMI measurement that is exactly 18.5, 25, 30 or 40 kg/m2.

2003 2008 onwards
Underweight 18.5 or under Less than 18.5
Normal weight Over 18.5 - 25 18.5 to less than 25
Overweight Over 25 - 30 25 to less than 30
Obese Over 30 - 40 30 to less than 40
Morbidly obese Over 40 40+

25 For a full review of obesity measures see: National Institute of Health and Clinical Excellence (2006). CG43 Obesity: Full Guideline, Section 2: Identification and Classification. See:

26 Romero-Corral, A. et al (2008). Accuracy of body mass index in diagnosing obesity in the adult general population. International Journal of Obesity 32: 959-966.

27 Lean M, Han T, Morrison C. Waist circumference as a measure for indicating need for weight management. BMJ 1995; 311:158-61.

28 Schneider HJ, Friedrich N, Klotsche J et al. The predictive value of different measures of obesity for incident cardiovascular events and mortality. The Journal of Clinical Endocrinology & Metabolism 201; 95(4):1777-1785.

29 National Institutes of Health. Third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda, Md: National Institutes of Health 2001. NIH Publication 01-3670.

30 A high waist circumference of 94 cm for men is equivalent to one of 94.6cm following the interviewer protocol. A very high waist circumference of 102 cm is equivalent to one of 102.75cm. A high waist circumference of 80cm for women is equivalent to one of 82.4cm following the interviewer protocol. A very high waist circumference of 88cm is equivalent to one of 91.35cm.

31 Flegal KM. Waist circumference of healthy men and women in the United States. Int J Obes. 2007;31:1134-9.

32 Bellizzi MC, Dietz WH. Workshop on childhood obesity: summary of the discussion. American Journal of Clinical Nutrition 1999; 70:173S-175

33 Daniels SR, Khoury PR and Morrison JA. The utility of body mass index as a measure of body fatness in children and adolescents: Differences by race and gender. Pediatrics 99: 804-807. 1997.

34 Cole T, Freeman JV and Preece MA. Body mass index reference curves for the UK. Archives of Disease in Childhood. 73, 25-29. 1990.

35 Cole T, Freeman JV and Preece MA. British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalised likelihood. Statistics in Medicine. 17, 407-429. 1998.

36 Reilly JJ. Assessment of childhood obesity: National reference data or international approach? Obesity Research 10: 838-840. 2002.

37 Reilly JJ, Wilson ML, Summerbell CD, and Wilson DC. Obesity: diagnosis, prevention, and treatment; evidence based answers to common questions. Archives of Disease in Childhood 86: 392-395. 2002.

38 Jotangia D, Moody A, Stamatakis E, et al. Obesity Among Children Under 11. London: Department of Health in collaboration with the Health and Social Care Information Centre. 2005.

39 Reilly J, Dorosty A, and Emmett P. Prevalence of overweight and obesity in British children: cohort study. British Medical Journal. 319: 1039. 1999.

40 Bundred P, Kitciner D and Buchan I. Prevalence of overweight and obese children between 1989 and 1998: population based series of cross sectional studies. British Medical Journal 322: 1-4. 2001.

41 Rudolf MCJ, Sahota P, Barth JH, and Walker J. Increasing prevalence of obesity in primary school children: cohort study. British Medical Journal 322: 1094-1095. 2001.

42 This method has been developed by ISD Scotland, full details of the procedure are available on request from the Scottish Government Scottish Health Survey Team.

43 See:

44 Gray L, and Leyland AH. Chapter 7: Obesity. Rutherford L, Hinchliffe S and Sharp C [Eds]. Scottish Health Survey 2012 - Volume 1 Main Report. Edinburgh, Scottish Government. 2013.


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