The Association Among Overweight, Obesity, and Low Back Pain in U.S. Adults: A Cross-Sectional Study of the 2015 National Health Interview Survey

Trent Peng, MS, DC

Abstract
Objective
The purpose of this study was to explore the association between obesity (via body mass index [BMI]) and presence of low back pain (LBP) in a representative sample of US adults, aged ≥18 years.

Methods
This cross-sectional study used data from 32 060 respondents to the 2015 National Health Interview Survey. Body mass index (kg/m2) was calculated using reported height and weight and expressed as normal weight (<25 kg/m2), overweight (25 to <30 kg/m2), or obese (≥30 kg/m2); 3-month prevalence of reported LBP was the targeted outcome. Weighted univariate and multivariable logistic regression (adjusting for age, sex, race/ethnicity, education, and leisure-time physical activity) were performed. Interaction by sex and race/ethnicity was also explored. Results Findings suggest a statistically significant association between BMI categories and LBP. The adjusted odds ratios (95% confidence interval) of LBP in overweight and obese participants were higher than those in normal weight participants: 1.21 (1.11-1.32) and 1.55 (1.44-1.67), respectively. Both sex and race/ethnicity statistically significantly modified the association between BMI and LBP. Compared with normal weight white men (reference), odds ratios (95% confidence interval) of LBP were higher among obese white men, obese white women, and obese nonwhite women (1.28 [1.10, 1.48], 1.58 [1.36, 1.84], and 1.36 [1.16, 1.60], respectively), and lower in overweight, nonwhite men, and normal weight nonwhite men and women (0.80 [0.68, 0.94], 0.62 [0.51, 0.76], and 0.73 [0.61, 0.87], respectively). Conclusion Overweight and obesity were associated with increased odds of LBP. However, the measures of associations varied in magnitude and direction by race and sex groups. Journal Abstract

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