Evidence map›Paper›PMID 42231308›Full record

ArticleBMC public health2026

Country-specific differences in the association between obesity risk factors in two high-income countries: a cross-sectional analysis from the Prospective Urban Rural Epidemiology (PURE) study.

Christina E Lundberg, Martin Adiels, Victoria Miller, Paul Poirier, Sumathy Rangarajan, Martin Lindgren, Jon Edqvist, Hassan Mir, Koon K Teo, Philip Joseph and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Christina E LundbergDepartment of Food and Nutrition and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden, and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Läroverksgatan 5, Gothenburg, SE-405 30, Sweden. christina.lundberg@gu.se.
Martin AdielsSchool of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Victoria MillerPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada and Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Paul PoirierFaculté de pharmacie, Université Laval, and Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Canada.
Sumathy RangarajanPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
Martin LindgrenDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Jon EdqvistDepartment of Medicine Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, Östra Hospital, Region Västra Götaland, Gothenburg, Sweden.
Hassan MirDivision of Cardiology, University of Ottawa Heart Institute, University of Ottawa, Ottawa, Canada.
Koon K TeoPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada and Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Philip JosephPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Hamilton, ON, Canada.
Scott A LearFaculty of Healthy Sciences, Simon Fraser University, Burnaby, Canada and Centre for Heart Lung Innovation, Vancouver, Canada.
Darryl P LeongPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Hamilton, ON, Canada.
Salim YusufPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Hamilton, ON, Canada.
Gilles R DagenaisQuebec Heart and Lung Institute, Clinical Research Center, Laval University, Québec City, Qc, Canada.
Annika RosengrenDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough Sweden and Canada are high-income countries with similar social structures, obesity prevalence is significantly higher in Canada. This study explored country-specific differences in the association between socioeconomic and behavioural risk factors for obesity in Sweden and Canada, using data from the Prospective Urban Rural Epidemiological (PURE) study.

methodsThis cross-sectional study included 9 790 adults aged 34-60 years from Canada (n = 6 652, 55% women) and Sweden (n = 3 138, 54% women). The Boruta algorithm was used to identify relevant factors that were associated with obesity among individual with normal weight (body mass index [BMI]: 18.5-<25 kg/m

resultsMore Canadians than Swedes had obesity (26 vs. 16%, p-value: <0.001). Ultra-processed food (UPF) and the Alternative Healthy Eating Index (AHEI-2010) score were identified as the main drivers of obesity risk. The highest UPF intake group was strongly associated with obesity in both Canada (OR = 2.31 [CI = 1.57-3.37]) and Sweden (OR = 2.83 [CI = 2.30-3.49]). Canadian men had higher UPF intake and were found to have a significantly higher risk of obesity (p for interaction: 0.032 and 0.021 for middle and highest tertiles), compared to Swedish males. Among women, low socioeconomic status (rural residence (OR = 2.30 [CI = 1.66-3.17] vs. OR = 1.42 [CI = 1.19-1.70]), low income (OR = 4.75 [CI = 2.71-8.95] vs. OR = 2.62 [CI = 2.16-3.18]), not working (OR = 2.24 [CI = 1.51-3.29] vs. OR = 1.32 [CI = 1.07-1.63]), and unskilled occupation (OR = 5.08 [CI = 3.05-8.45] vs. OR = 1.78 [CI = 1.38-2.28]) was more strongly associated with obesity in Sweden than in Canada.

conclusionsThis study highlights important differences in obesity-related risk factors between Sweden and Canada. UPF consumption, the AHEI-2010 score and socioeconomic disadvantage emerged as key drivers of obesity, with notable sex- and country-specific patterns. These findings underscore the importance of tailored, context-specific public health strategies to address obesity in different national settings.

Indexed as

Developed CountriesObesityAdultCanadaCross-Sectional StudiesFemaleHumansMaleMiddle AgedPrevalenceProspective StudiesRisk FactorsRural PopulationSocioeconomic Disparities in HealthSocioeconomic FactorsSwedenDietary intakeObesityPURE studyRisk factorsSocioeconomic status

Identifiers

PMID42231308
PMCPMC13231536

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.