An Epidemiological Study of Overweight and Obesity Among Women in an Urban Area of North India

Background:Obesity is a complex, multi-factorial chronic disease. Overweight and obesity are the fifth leading risk for global deaths.Objectives:To find the prevalence and risk factors for obesity in women aged 20-60 years in Ludhiana city.Methods:The present study is a community based cross sectional study carried out in an urban area of Ludhiana among women aged 20-60 years. Among the study population of 324 women, a pre-designed and pre-tested questionnaire was used to record the socio-demographic and anthropometric profile of women. Chi square test and logistic regression was used to find the association of obesity and hypertension with socio-demographic variables.Results:The prevalence of overweight and obesity was 12.7% and 29.6% respectively. Obesity was found to be more common among middle-aged Punjabi housewives belonging to upper socio-economic strata. There was strong association between overweight/obesity and hypertension.     

Overweight and Obesity in Postpartum Hispanic Women

Overweight and obesity vary in prevalence among particular groups, and are especially problematic for childbearing Hispanic women. The complex interaction between physical changes associated with pregnancy, role changes accompanying birth, and family and cultural values related to childbearing are superimposed upon the underlying mechanisms that create or perpetuate obesity. In this article we review biological and behavioral research on obesity in postpartum Hispanic women to identify critical components for intervention studies focused on weight management. Recommendations are offered for health care providers and researchers.     

Nutritional Disparities among Women in Urban India

The paper presents a wealth quartile analysis of the urban subset of the third round of Demographic Health Survey of India to unmask intra-urban nutrition disparities in women. Maternal thinness and moderate/severe anaemia among women of the poorest urban quartile was 38.5% and 20% respectively and 1.5-1.8 times higher than the rest of urban population. Receipt of pre- and postnatal nutrition and health education and compliance to iron folic acid tablets during pregnancy was low across all quartiles. One-fourth (24.5%) of households in the lowest urban quartile consumed salt with no iodine content, which was 2.8 times higher than rest of the urban population (8.7%). The study highlights the need to use poor-specific urban data for planning and suggests (i) routine field assessment of maternal nutritional status in outreach programmes, (ii) improving access to food subsidies, subsidized adequately-iodized salt and food supplementation programmes, (iii) identifying alternative iron supplementation methods, and (iv) institutionalizing counselling days.Key words: Sl Anthropometry, Equation, Gestational age, New Ballard Score, Newborn, India     

Correlates of Physical Activity Engagement among Pregnant Women with Overweight and Obesity

BackgroundExcess weight during pregnancy increases risk for adverse obstetrical outcomes. Physical activity (PA) may buffer these effects, although it is unclear what factors are associated with PA in women who begin pregnancy with overweight/obesity. The present study sought to characterize the demographic and psychological correlates of PA among women with prepregnancy overweight/obesity.MethodsPregnant women (N = 249; mean age, 28.48 ± 5.48 years; mean body mass index, 34.13 ± 7.07 kg/m²) at 12–20 weeks of gestation (mean, 15.68 ± 2.44 weeks of gestation) completed ratings of perceived stress and depressive symptoms and were interviewed using the pregnancy version of the Eating Disorders Examination. The Paffenbarger Physical Activity Survey was administered via interview to estimate energy expenditure. Continuous outcomes were evaluated via linear regression, while logistic regression was conducted to assess likelihood of meeting PA guidelines.ResultsMean weekly duration of moderate to vigorous PA was 109.50 ± 248.17 minutes, with 21% of women meeting federal PA guidelines of 150 minutes or more. Higher perceived stress (β = –0.217; p = .02) and eating psychopathology (β = –0.213; p < .01) were associated with lower total energy expenditure. Black women reported lower expenditure specifically from walking compared with White women (β = –0.180; p = .03). Depressive symptoms were not associated with PA. No estimate of PA predicted body mass index.ConclusionsPregnant women with overweight/obesity engage in modest amounts of PA early in pregnancy, although few meet PA guidelines. Greater perceived stress and eating psychopathology were associated with lower PA engagement. These factors should be monitored by obstetrics providers to identify women who may particularly benefit from counseling about PA during pregnancy.     

Underweight,Overweight and Obesity among Reproductive Bangladeshi Women: A Nationwide Survey

The double burden of malnutrition is becoming more prevalent among Bangladeshi women. Underweight, overweight, and obesity were examined among women aged 15–49 years using the 2017–2018 Bangladesh Demographic and Health Survey (BDHS). A dataset of 20,127 women aged 15–49 years with complete Body Mass Index (BMI) measurements were extracted and categorized as underweight, normal weight, overweight, and obesity. A multiple logistic regression that adjusts for clustering and sampling weights was used to examine underweight, overweight, and obesity among reproductive age Bangladeshi women. Our analyses revealed that the odds of being overweight and obese were higher among women who completed primary and secondary or more levels of education, rich households, breastfeeding women, and women exposed to media (newspapers and television (TV). Women from the poorest households were significantly more likely to be underweight (AOR = 3.86, 95%CI: 2.94–5.07) than women from richer households. The likelihood of being underweight was higher among women with no schooling, adolescent women, and women not using contraceptives. Conclusions: Overweight and obesity was higher among educated and affluent women while underweight was higher among women from low socioeconomic status, indicating that tailored messages to combat overweight and obesity should target educated and affluent Bangladeshi women while improving nutrition among women from low socioeconomic status.     

Association of Overweight and Obesity with Breast Cancer in India

Background:

In women, cancer of the breast is one of the most common incident cancer and cause of death from cancer. Anthropometric factors of weight, height, and body mass index (BMI) have been associated with breast cancer risk.

Objectives:

To study the association of overweight and obesity with breast cancer in India.

Materials and Methods:

A hospital-based matched case-control study was conducted. Three hundred and twenty newly diagnosed breast cancer patients and three hundred and twenty normal healthy individuals constituted the study population. The subjects in the control group were matched individually with the patients for their age ±2 years and socioeconomic status. Anthropometric measurements of weight and height were recorded utilizing the standard equipments and methodology. The paired ‘t’ test and univariate logistic regression analysis were carried out.

Results:

It was observed that the patients had a statistically higher mean weight, body mass index, and mid upper arm circumference as compared to the controls. It was observed that the risk of breast cancer increased with increasing levels of BMI. Overweight and obese women had Odd''s redio of 1.06 and 2.27, respectively, as compared to women with normal weight.

Conclusions:

The results of the present study revealed a strong association of overweight and obesity with breast cancer in the Indian population.     

Socio-Economic,Demographic and Lifestyle Determinants of Overweight and Obesity among Adults of Northeast India

Background

Overweight and obesity are the accumulation of high body adiposity, which can have detrimental health effects and contribute to the development of numerous preventable non-communicable diseases. This study aims to evaluate the effect of socio-economic, demographic and lifestyle factors on the prevalence of overweight and obesity among adults belonging to the Rengma-Naga population of North-east India.

Methods

This cross-sectional study was conducted among 826 Rengma-Naga individuals (males: 422; females: 404) aged 20–49 years from the Karbi Anglong District of Assam, using a two-stage stratified random sampling. The socio-economic, demographic and lifestyle variables were recorded using structured schedules. Height and weight were recorded and the Body Mass Index (BMI) was calculated using standard procedures and equation. The WHO (2000) cut-off points were utilized to assess the prevalence of overweight (BMI ≥23.00–24.99 kg/m²) and obesity (BMI ≥25.00 kg/m²). The data were analysed using ANOVA, chi-square analysis and binary logistic regression analysis using SPSS (version 17.0).

Results

The prevalence of overweight and obesity were 32.57% (males: 39.34%; females: 25.50%) and 10.77% (males: 9.95%; females: 11.63%), respectively. The binary logistic regression analysis showed that age groups (e.g., 40–49 years), education (≥9^th standard), part-time occupation and monthly income (≥Rs.10000) were significantly associated with overweight and obesity (p<0.05).

Conclusions

Age, education occupation and income appear to have higher associations with overweight and obesity among adults. Suitable healthcare strategies and intervention programmes are needed for combating such prevalence in population.     

Prevalence of Underweight,Overweight and Obesity among Adults in Urban Bissau,Western Africa

Overweight and obesity affect a large proportion of the population and are important causes of death in both developed and low- and middle-income countries. In Guinea-Bissau, there are no previous population-based studies assessing this phenomenon. Therefore, we aimed to quantify the prevalence of underweight, overweight, and obesity among adults in Bissau. A stratified and cluster sample of 935 adults was assembled in 2021 and was evaluated using standardized questionnaires and anthropometric measurements, following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance. Underweight, obesity, and overweight were defined by body mass index based on the World Health Organization definitions. The prevalence of overweight and obesity was 48.7% among women and 25.0% among men. The proportion of women with abdominal obesity was 14 times higher than it was in men (35.3% vs. 2.5%). The prevalence of overweight and obesity increased with age and income. Underweight was more prevalent in the age group of 18 to 24 years (18.4% in women and 28.9% in men) and was less frequent among individuals with higher socioeconomic status. In conclusion, the prevalence of overweight and obesity is similar to the trends that are observed in many other urbanized populations in Africa and is already a major public health issue in urban Guinea-Bissau.     

超重及肥胖孕妇的营养代谢状况

目的:使用营养代谢分析的方法,了解正常孕妇和超重及肥胖孕妇的营养状况。方法:随机选取妊娠26周以上的孕妇178人,依据孕前体重指数(BMI=Kg/m2)分3组,利用人体代谢分析仪(间接测热法)测量孕妇基础代谢所消耗的能量(BEE),通过膳食调查了解孕妇的实际摄入量,对正常、超重和肥胖孕妇的营养状况进行分析、比较,观察超重及肥胖孕妇的营养代谢特点,同时将此方法得出的结论与血中营养素的含量进行比较。结果:①肥胖及超重孕妇存在以高胆固醇为主的高脂血症,同时其低密度脂蛋白也高于正常孕妇(P<0.01)。与正常组相比,超重及肥胖组甘油三脂有所增高,高密度脂蛋白有所降低,但差异无显著性。②肥胖妇女的基础能量消耗(BEE)和全日总能量消耗(TEE)均高于正常孕妇,差异有统计学意义(P<0.01)。③肥胖孕妇的碳水化合物和蛋白质的摄入量明显高于正常孕妇,差异有统计学意义(P<0.05)。但其脂肪的摄入量低于正常孕妇,从而造成营养的失衡。④无论正常孕妇还是超重及肥胖孕妇均存在钙、铁、锌、VitB1、VitB2、叶酸、Vi-tA的摄入量不足。其中超重及肥胖孕妇在镁、VitB1、VitB2、VitA的实际摄入量与理想摄入量的差值上,即缺余值上与正常体重孕妇相比存在统计学意义(P<0.05)。结论:我国孕妇的营养摄入存在不平衡现象,而超重及肥胖孕妇的问题更为突出。个性化的监测及营养指导,对超重及肥胖孕妇减少不良妊娠合并症和妊娠结局可能起到积极的作用。     

Carbohydrate Intake and Overweight and Obesity among Healthy Adults

Background

Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence.

Objective

To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults.

Design

We used a cross-sectional analysis.

Subjects/setting

The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis.

Main outcome measures

Outcome variables were body mass index (BMI; calculated as kg/m²) and overweight or obesity status (dichotomous) defined as BMI ≥25 compared with BMI <25 based on measured height and weight. Diet was evaluated by 24-hour dietary recall based on the Automated Multi-Pass Method.

Statistical analyses performed

Weighted regression models with bootstrapping and cubic splines were used. Outcome variables were BMI and overweight or obesity, and predictors were daily nutrient intake. Adjustment for total energy intake, age, leisure time energy expenditure, sex, smoking, education, and income adequacy was performed.

Results

Risk of overweight and obesity was decreased in all quartiles of carbohydrate intake compared to the lowest intake category (multivariate odds ratio quartile 2=0.63; 95% confidence interval: 0.49 to 0.90; odds ratio quartile 3=0.58; 95% confidence interval: 0.41 to 0.82; odds ratio quartile 4=0.60; 95% confidence interval: 0.42 to 0.85). Spline analyses revealed lowest risk among those consuming 290 to 310 g/day carbohydrates.

Conclusions

Consuming a low-carbohydrate (approximately <47% energy) diet is associated with greater likelihood of being overweight or obese among healthy, free-living adults. Lowest risk may be obtained by consuming 47% to 64% energy from carbohydrates.     

Maternal Nutrition and Birth Size among Urban Affluent and Rural Women in India

Background: Varying results of worldwide intervention programs to pregnant mothers necessitate the need to understand the relationship between maternal nutrition and birth size among well nourished and undernourished mothers.

Objective: To examine this relationship among urban affluent mothers and to compare the findings with those on rural Indian mothers.

Subjects: Data collected on urban affluent mothers (n = 236) was compared with rural mothers (n = 633).

Design: Mothers were contacted at 18 ± 2 and 28 ± 2 wk of gestation for anthropometry, dietary intakes [24-hr recall, Food Frequency Questionnaire (FFQ)] and after delivery for neonatal anthropometry.

Results: Despite large differences in nutritional status of urban and rural mothers ( pre-pregnant weight 55.9 ± 9.2 Vs 41.5 ± 5.2 kg, respectively) maternal fat intakes at 18 wk were associated with birth weight (p < 0.05), length (p < 0.01) and triceps skin fold thickness (p < 0.05) of the newborn in urban and rural mothers. Consumption of fruits was associated with birth length (p < 0.05) in urban (18wk) and with birth weight (p < 0.01) and length (p < 0.01) in rural (28wk) mothers, when their energy intakes were low. Maternal consumption of milk too, was associated with newborn's triceps (p < 0.01) in urban (28wk) while with birth weight (p < 0.05) and length (p < 0.05) in rural (18wk) mothers. The findings mainly underscore the importance of consumption of micronutrient rich foods, when energy intakes are limiting during pregnancy, for improving birth size.

Conclusions: Creating nutritional awareness and motivating rural mothers for consuming micronutrient rich foods like green leafy vegetables and seasonal fruits that are easily available in rural areas, will be a much affordable solution for combating the problem of low birth weight rather than waiting for improvement in the existing nationwide programs for pregnant women.     

The Psychosocial Factors Related to Obesity: A Study Among Overweight,Obese, and Morbidly Obese Women in India

Psychosocial factors among overweight, obese, and morbidly obese women in Delhi, India were examined. A follow-up survey was conducted of 325 ever-married women aged 20–54 years, systematically selected from 1998–99 National Family Health Survey samples, who were re-interviewed after 4 years in 2003. Information on day-to-day problems, body image dissatisfaction, sexual dissatisfaction, and stigma and discrimination were collected and anthropometric measurements were obtained from women to compute their current body mass index. Three out of four overweight women (BMI between 25 and 29.9 kg/m²) were not happy with their body image, compared to four out of five obese women (BMI of 30 kg/m² or greater), and almost all (95 percent) morbidly obese women (BMI of 35 kg/m² or greater) (p < .0001). It was found that morbidly obese and obese women were five times (adjusted odds ratio [aOR] 5.29, 95% confidence interval [CI] 2.02–13.81, p < .001) and two times (aOR 2.30, 95% CI 1.20–4.42, p < .001), respectively, as likely to report day-to-day problems; twelve times (aOR 11.88, 95% CI 2.62–53.87, p < .001) and three times, respectively, as likely (aOR 2.92, 95% CI 1.45–5.88, p = .001) to report dissatisfaction with body image; and nine times (aOR 9.41, 95% CI 2.96–29.94, p < .001) and three times (aOR 2.93, 95% CI 1.03–8.37, p = .001), respectively, as likely to report stigma and discrimination as overweight women.     

Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity

Obesity is a risk factor for NAFLD. However, not all people with obesity have an excessive intrahepatic fat content. Adherence to a high-quality dietary pattern may also promote liver health in obesity. A cross-sectional study of 2967 women with overweight and obesity was carried out to assess the association between a Mediterranean diet and fatty liver. All women underwent clinical examination, anthropometric measurements, blood sampling, ultrasound measurements of abdominal visceral and subcutaneous fat, and assessment of adherence to the Mediterranean diet using the 14-item MEDAS questionnaire. Fatty liver index (FLI), NAFLD fatty liver steatosis (NAFLD-FLS) and hepatic steatosis index (HSI) were calculated. In women with obesity, the MEDAS score was inversely associated with FLI (β = −0.60, 95% CI: −1.04, −0.16, p = 0.008), NAFLD-FLS (β = −0.092, 95% CI: −0.134, −0.049, p < 0.001) and HSI (β = −0.17, 95% CI: −0.30, −0.04, p = 0.011). Stronger associations were observed in premenopausal women with obesity. Mediterranean diet was inversely associated with NAFLD-FLS in women with overweight, independently of menopausal status. In conclusion, Mediterranean diet is associated with a better liver status in women with overweight and obesity. This may have a public health impact and be useful in drafting nutritional guidelines for NAFLD.     

温州市城区居民超重和肥胖流行现状分析

目的了解温州城区居民的超重和肥胖流行情况,为开展肥胖防治工作提供科学依据。方法采用多阶段抽样方法,抽取温州市3个城区9个街道4106名≥35岁的人作为调查对象。结果人群标化超重率为35.13%,标化肥胖率为8.36%。随着年龄的增长,超重和肥胖患病率呈上升趋势,随着文化程度增高呈下降趋势。家务及离退休人员的超重及肥胖患病率较高,服务行业及干部职员超重和肥胖患病率较低。结论温州市超重、肥胖患病率处于全国大城市水平,其患病率受年龄、职业和文化程度的影响。     

呼伦贝尔地区1536名居民超重、肥胖及腹型肥胖现况调查

目的了解呼伦贝尔蒙古族地区居民超重、肥胖和腹型肥胖现况。方法对呼伦贝尔地区18岁以上居民1536人进行问卷调查,测量身高、体重和腰同,按照中国肥胖问题T作组给出的判断标准进行评价和分析。结果呼伦贝尔蒙古族地区居民超重检出率为男性37．7％,女性31．5％,肥胖检出率为男性29．O％,女性18．1％,腹型肥胖检出率为男性63．9％,女性43．8％,男性均显著高于女性;随年龄增长,超重、肥胖和腹型肥胖检出率呈上升趋势;蒙古族中超重、肥胖和腹型肥胖检出率分别为34．6％,24．9％和53．5％,汉族中超重、肥胖和腹型肥胖检出率分别为34．3％,18．7％和48．9％,肥胖检出率及男性腹型肥胖检出率蒙古族高于汉族。结论呼伦贝尔蒙古族地区居民超重、肥胖和腹型肥胖检出率较高,且不同年龄、性别和民族的居民间存在差异。     

Long-term Health and Economic Impact of Preventing and Reducing Overweight and Obesity in Adolescence

PurposeUsing data from the 2000 National Medical Expenditure Panel Survey and estimates from published studies, this study projected the long-term health and economic impacts of preventing and reducing overweight and obesity in today's adolescents.MethodsWe developed a body mass index progression model to project the impact of a 1% point reduction in both overweight and obese adolescents aged 16–17 years at present on the number of nonoverweight, overweight, and obese adults at age 40 years. We then estimated its impact on the lifetime medical costs and quality-adjusted life years (QALYs) after age 40. Medical costs (in 2007 dollars) and QALYs were discounted to age 17 years.ResultsA 1% point reduction in both overweight and obese adolescents ages 16–17 years at present could reduce the number of obese adults by 52,821 in the future. As a result, lifetime medical care costs after age 40 years would decrease by $586 million and lifetime QALYs would increase by 47,138. In the worst case scenario, the 1% point reduction would lower medical costs by $463 million and increase QALYs by 34,394; in the best case scenario, it would reduce medical costs by $691 million and increase QALYs by 57,149.ConclusionsObesity prevention in adolescents goes beyond its immediate benefits; it can also reduce medical costs and increase QALYs substantially in later life. Therefore, it is important to include long-term health and economic benefits when quantifying the impact of obesity prevention in adolescents.     

The Effect of Motivational Interviewing on Women with Overweight and Obesity Before Conception

ObjectiveTo investigate the efficacy of motivational interviewing (MI) to elicit change in eating and physical activity behaviors in women with overweight and obesity before conception.DesignA randomized controlled trial was conducted. The participants were randomly divided into intervention and comparison groups. Data were gathered using the Three-Factor Eating Questionnaire Revised 18-item version (TFEQ-R18), International Physical Activity Questionnaire (IPAQ), and Stages of Change checklist.SettingPrimary health centers of Tabriz, Iran.ParticipantsThe participants were 70 women with overweight or obesity, aged 18–35 years, who were referred for preconception care.Intervention(s)The intervention group received 6 MI sessions, and the comparison group received routine preconception care.Main Outcome Measure(s)Variables of primary outcomes were eating behavior measures and physical activity levels 8 weeks after intervention.AnalysisIndependent t test, ANCOVA, Fisher exact test, Mann-Whitney U test, and Wilcoxon test were used.ResultsThe MI had a positive effect on physical activity in the moderate and vigorous levels in the intervention group (P = .01, P = .02, respectively). After the intervention, the mean score of cognitive restraint in the intervention group was higher than in the comparison group (adjusted mean difference, 16.9; 95% CI, 10.8 to 23.0; P < .001), whereas there were no significant differences between the 2 groups in terms of emotional and uncontrolled eating (P = .33 and P = .25, respectively).Conclusions and ImplicationsThe MI had a positive effect on physical activity and eating behavior change, except for uncontrolled and emotional eating. Future studies to examine differences between overweight and women with obesity and within other populations is warranted.     

北京市城区居民超重状况及影响因素研究

目的调查北京市城区居民体重超重状况及超重的影响因素,为制定超重干预方案提供科学依据.方法随机抽取北京市城区2284个居委会中12216名15～69岁的人群作为研究对象,由调查员入户进行一对一的问卷调查,由调查对象自报身高体重.结果北京市城区居民的身高体重指数为23.6004±3.3469.女性、离退休、年龄在45岁以上、有不良婚姻经历者、高血压患者的平均身高体重指数都在24以上.年龄在45～64岁、小学以下文化程度及离退休者的超重率(BMI>25)均在40%以上.年龄在45～64岁、已婚、中学以下文化程度、酗酒和高血压患者超重的危险性明显大于其他人群.结论北京市城区居民的身高体重指数接近正常值的上限,大多数人群的超重率高达1/3左右或以上.中老年人、已婚、文化程度较低、酗酒和高血压患者的超重危险性明显大于其他人群.