Obesity in wheelchair users with long-standing spinal cord injury: prevalence and associations with time since injury and physical activity

Study design: Secondary analysis of cross-sectional data from the ALLRISC cohort study. Objectives: To investigate the prevalence of obesity and its association with time since injury (TSI) and physical activity (PA) in wheelchair users with long-standing (TSI > 10 years) spinal cord injury (SCI). Setting: Community, The Netherlands. Methods: Wheelchair users with SCI (N = 282) in TSI strata (10-19, 20-29, and >= 30 years) and divided in meeting SCI-specific exercise guidelines or not. Waist circumference (WC) and body mass index (BMI) were assessed. Participants were classified as being obese (WC > 102 cm for men, WC > 88 cm for women; BMI >= 25 kg/m(2)) or not. Logistic regression analyses were performed to investigate the associations between obesity and TSI and PA. Results: Almost half of the participants (45-47%) were classified as obese. TSI was significantly associated with obesity, the odds of being obese were 1.4 higher when having a 10 years longer TSI. Furthermore, the odds of being obese were 2.0 lower for participants who were meeting the exercise guidelines. Conclusions: The prevalence of obesity is high in people with long-standing SCI. Those with a longer TSI and individuals who do not meet the exercise guidelines are more likely to be obese and need to be targeted for weight management interventions.