The association between high parity and obesity in women living in South-eastern Turkey

Double Burden of Underweight and Overweight among Women in South and Southeast Asia: A Systematic Review and Meta-analysis

The double burden of malnutrition (DBM) is characterized by the coexistence of underweight and overweight individuals in a population. The objective of this study was to assess the level of DBM, as well as its main determinants, in women in South and Southeast Asia. We searched scientific literature databases, including PubMed, EMBASE, CINAHL, and Google Scholar; gray literature; and reference lists from primary research published between 1969 and September 30, 2017. In total, 128 studies met our inclusion criteria, representing data of ∼5 million women >15 y of age from South and Southeast Asia. The findings show that prevalence rates of underweight and overweight varied by study from 7.0% to 61.0% and 1.0% to 64.0%, respectively. For the total study period, the pooled prevalence of underweight and overweight was 28% (95% CI: 25%, 31%) and 17% (95% CI: 15%, 19%) in South Asia, respectively, and 20% (95% CI: 15%, 26%) and 20% (95% CI: 15%, 24%) in Southeast Asia, respectively. In both regions, underweight was more prevalent in rural areas, among women of the youngest age group (15-19 y), and among those in the poorest wealth quintile. In contrast, overweight was higher in urban areas, among women of older age, and among those in the wealthiest households. This study also found that prevalence of overweight has recently exceeded that for underweight in this population.

Double burden of underweight and overweight among Bangladeshi adults differs between men and women: evidence from a nationally representative survey

Objective

To estimate the prevalence of underweight and overweight among Bangladeshi adults and to determine if the double burden of underweight and overweight differs by gender and other socio-economic characteristics of individuals.

Design

We used data from the Bangladesh Demographic and Health Survey 2011. Multinominal logistic regression was used to examine associations between the different nutritional statuses of individuals and related determinants. Interaction effect was checked between gender and various socio-economic factors.

Setting

Nationwide, covering the whole of Bangladesh.

Subjects

Individuals aged >18 years (women, n 16 052; men, n 5090).

Results

Underweight was observed among 28·3 % of men and 24·4 % of women, whereas overweight was observed among 8·4 % of men and 16·9 % of women. The odds of being overweight were significantly lower among urban men (OR=0·46; 95 % CI 0·37, 0·57) compared with urban women, whereas the odds of being underweight were significantly higher among urban men (OR=1·33; 95 % CI 1·07, 1·64) compared with urban women. The odds of being overweight were lower among higher educated men (OR=0·48; 95 % CI 0·39, 0·58) and men of rich households (OR=0·45; 95 % CI 0·37, 0·54) compared with higher educated women and women of rich households, respectively.

Conclusions

There are important gender differences in the prevalence of underweight and overweight among the adult population in Bangladesh. Women with higher education, in rich and urban households have higher chances of being overweight and lower chances of being underweight compared with their male counterparts.

Relationship between maternal obesity and prenatal, metabolic syndrome, obstetrical and perinatal complications of pregnancy in Indiana, 2008-2010

BACKGROUND

Obesity is a serious medical condition affecting more than 30% of Indiana, and 25% of Unites States pregnant women. Obesity is related to maternal complications, and significantly impacts the health of pregnant women. The objective of this study was to describe the relationship between maternal complications and pre-pregnancy maternal weight.

METHODS

Using logistic regression models, we analyzed 2008 to 2010 birth certificate data, for 255,773 live births abstracted from the Indiana Vital Statistics registry. We examined the risk of reproductive factors, obstetrical complications and perinatal (intrapartum) complications for underweight, healthy weight, overweight and obese women for this population.

RESULTS

Women who received prenatal care were more likely to be obese [adjusted odds ratio (AOR) = 1.82 (1.56-2.13)]. While women with parity of zero (0) were less likely to be obese [AOR = 0.89, 95% CI (0.86-0.91)]. Women giving birth to twins [AOR = 1.25, 95% CI (1.17- 1.33)], women delivering by Caesarian section [AOR = 2.31, 95% CI ( 2.26-2.37)], and women who previously had a Caesarian section [AOR = 1.95, 95% CI (1.88-2.02)] were more likely to be obese. There was evidence of metabolic like complication in this population, due to obesity. Obesity was significantly associated with obstetrical conditions of the metabolic syndrome, including pre-pregnancy diabetes, gestational diabetes, pre-pregnancy hypertension, pregnancy-induced hypertension and eclampsia [AOR = 5.12, 95% CI (4.47-5.85); AOR = 3.87, 95% CI (3.68-4.08); AOR = 7.66, 95% CI (6.77-8.65); AOR = 3.23, 95% CI (3.07-3.39); and AOR = 1.77, 95% CI (1.31-2.40), respectively. Maternal obesity modestly increased the risk of induction, epidural, post-delivery bleeding, and prolonged labor [AOR = 1.26, 95% CI (1.23-1.29); AOR = 1.15, 95% CI (1.13-1.18); AOR = 1.20, 95% CI (1.12-1.28); and AOR = 1.44, 95% CI (1.30-1.61)], respectively. Obese women were less likely to have blood transfusions [AOR = .74, 95% CI (0.58-96)], vaginal tears [AOR = 0.51, 95% CI (0.44-0.59)], or infections [AOR = 86, 95% CI (0.80-0.93)].

CONCLUSIONS

Our results suggest that maternal obesity in Indiana, like other populations in the USA, is associated with high risks of maternal complications for pregnant women. Pre-pregnancy obesity prevention efforts should focus on targeting children, adolescent and young women, if the goal to reduce the risk of maternal complications related to obesity, is to be reached.

Shifting of undernutrition to overnutrition and its determinants among women of reproductive ages in the 36 low to medium income countries

OBJECTIVE

Objectives are to examine the shift away from undernutrition towards overnutrition for low to medium income countries (LMIC) and investigate the potential determinants of this shift using the nationally representative survey data.

DESIGN AND SUBJECTS

We analysed cross-sectional, representative samples of 540,290 women aged 20-49 years drawn from the Demographic and Health Surveys (DHS) at two time points in 36 LMIC. The ratio of overweight-to-underweight at earliest and latest survey was calculated for each country to illustrate the relative magnitude of the shifting of underweight to overweight. Potential determinants of underweight (BMI < 18.5) and overweight (BMI ≥ 25) were examined.

RESULTS

In the latest DHS compared to the earliest DHS (mean duration 10 years), the prevalence of underweight significantly declined for one in two countries and the prevalence of overweight significantly increased for 80% of the listed countries. The annual increase of overweight was two folds higher than annual decline of underweight (6.4% vs. 3.3%). Although higher socio-demographic factors were associated with shifting of underweight towards overweight, over time, the risk of the highly educated, wealthy, and urban women being overweight was weakening.

CONCLUSIONS

Findings of this study suggest that among women of child-bearing age there was a large shift away from undernutrition to overnutrition for most of the LMIC. Overtime, the contribution of higher education, wealth and urbanisation to being overweight was decreasing in the LMIC.

Relationship between diabetes mellitus, hypertension and obesity, and health-related quality of life in Gaziantep, a central south-eastern city in Turkey

AIMS AND OBJECTIVES

The main goal of nursing care should be to increase health-related quality of life as well as improve the medical status of patients with chronic disease. For this reason, this study aims to evaluate and compare the health-related quality of life of patients with diabetes mellitus, hypertension and obesity in Gaziantep, a south-eastern city in Turkey.

BACKGROUND

Diabetes mellitus, hypertension and obesity are the most decisive factors in terms of adversely affecting health-related quality of life.

DESIGN

A cross-sectional, descriptive design was used.

METHOD

In this study, the research population included a total of 1601 diabetes mellitus, hypertension and obesity patients. To evaluate health-related quality of life of patients, Short Form-36 (SF-36) was used. Student's t-test, one-way anova and chi-square analyses were used for comparisons between groups.

RESULTS

In total, 18·1% of patients had combined obesity, hypertension and diabetes mellitus; 16·1% had hypertension and diabetes mellitus. Approximately 16·1% had only hypertension; 15·4% had obesity and hypertension; 13·3% had diabetes mellitus; 12·7% had obesity and diabetes mellitus; and 8·4% had obesity. The health-related quality of life physical component mean scores of patients with combined obesity and hypertension were lower than that of the other groups (p < 0·05). Health-related quality of life physical component mean scores were determined as 34·5 (SD 0·4), and mental component mean scores were determined as 43·9 (SD 4·4). Health-related quality of life physical component mean scores of moderately active patients were higher, while older age and lower educational and income levels had a negative effect on health-related quality of life (p < 0·05).

CONCLUSION

Diabetes, hypertension and obesity decrease patient health-related quality of life while physical activity increases it. The coexistence of obesity and hypertension, in particular, has a more negative effect on health-related quality of life.

RELEVANCE TO CLINICAL PRACTICE

Patients with hypertension, obesity and diabetes mellitus need professional support from nurse. Frequent health-related quality of life evaluation and support is required for chronic patients, especially for those who are older, have lower educational and income levels and those with more than one chronic disease.

Overweight and obesity in pregnancy do not adversely affect neonatal outcomes: new evidence

We studied neonatal outcomes of infants of obese mothers in a cohort of 6,125 deliveries, using logistic multivariate analysis to remove the role of potential confounding variables. Although, as in previous reports, the crude unadjusted prevalence of several adverse neonatal outcomes was higher in these infants, the multivariable analysis revealed that only two outcomes remained significantly associated with maternal overweight and obesity: neonatal macrosomia (adjusted odds ratios aOR 1.4, p < 0.001) and meconium aspiration syndrome (aOR 1.6, p = 0.05), indicating that the unadjusted association with the other outcomes was caused by confounding factors. Nonetheless, as macrosomia is associated with increased health risks both to the mothers and their infants, and maternal obesity with considerable maternal morbidity during pregnancy, these results should not lead to complacency, but instead encourage better prevention of obesity in general and during pregnancy in particular.

Parity is associated with increased waist circumference and other anthropometric indices of obesity

BACKGROUND

There is growing interest in the effect of childbearing on the development of chronic medical conditions. In the present study we aim at seeing whether parity is associated with increased waist circumference (WC) and other anthropometric indices of obesity, or not, in a sample of Iraqi women.

METHODS

This was a cross sectional study conducted during the period from January 2006 to the end of December 2007. Subjects were women attending two primary health care centers in a rural district population in Basrah (Abu-Al-khasib district), Iraq.

RESULTS

A total of 9135 women with a mean age of 46.4+/-15.5 years were included in the study. The mean weight was 69.9+/-16.9 kg and the mean WC was 92.7+/-15.0 cm with 78.9% of women having WC >or=80 cm. The mean and the standard deviation of other anthropometric variables were 27.0+/-6.25 for body mass index (BMI), 0.57+/-0.09 for waist-to-height ratio (WHtR) and 0.89+/-0.08 for waist-to-hip ratio (WHpR). Body weight, WC, BMI, WHpR, and WHtR progressively and significantly increased with increasing parity (p<0.001). Increasing age and higher number of births were associated with a consistent significant increase in the risk of increasing WC. While the reverse was true with respect to education, the risk of increased WC significantly decreased with the increase in education. The risk of increased WC was higher among housewives compared to employed women. On multiple logistic regression analyses of parity and risk of increasing WC, the number of births remained significantly and independently associated with increased WC after adjustment for a range of potential confounders (age, BMI, employment, education, and marital status). However, when parity was analyzed as a dichotomous variable (parous versus nulliparous), no significant association was found (p>0.05).

CONCLUSION

Parity was associated with increased WC and other anthropometric indices of obesity in a sample of rural Iraqi women attending two primary health care centers.

Body size preference and body weight perception among two migrant groups of non-Western origin

Objectives

To evaluate body size preference, body weight perception and their relationship with actual weight in two migrant groups of non-Western origin, Turks and Moroccans; additionally, to study the association between body size preference and acculturation.

Design

Cross-sectional study.

Setting

Amsterdam, The Netherlands.

Subjects and methods

Males and females (18–30 years) were randomly selected from the population registry (n 451); participants, or at least one of their parents, were born in Turkey or Morocco. Body size preference was assessed using seven silhouette drawings and body weight perception was assessed by asking participants’ opinion of own weight. Acculturation variables were generation status and two scale measures, cultural orientation and social contacts.

Results

Participants showed preference for a thin body size. The discrepancy between ideal and current size was significant in women but not men (P < 0·001). Perceived current body size was correlated with BMI (Spearman’s correlation coefficient 0·60, P < 0·001 (men) and 0·73, P < 0·001 (women)). Among overweight participants (BMI = 25·0–29·9 kg/m2), 63–82 % of men and 35 % of women perceived themselves as ‘average’. Paying attention to own body weight was associated with a discrepancy between ideal and current size among women and with perceiving oneself as ‘overweight’ among men. Body size preference was not significantly associated with the three acculturation variables.

Conclusion

We did not observe a preference for large body sizes in these two non-Western migrant groups. Similar to Western populations, most women wished to be thinner than they were. This was not the case among men, the majority of whom were also unaware of being overweight.