Prevalence and risk factors of obesity and overweight in adult Saudi population

The prevalence of sedentary behavior among university students in Saudi Arabia

BACKGROUND

A considerable body of research has demonstrated that reducing sitting time benefits health. Therefore, the current study aimed to explore the prevalence of sedentary behavior (SB) and its patterns.

METHODS

A total of 6975 university students (49.1% female) were chosen randomly to participate in a face-to-face interview. The original English version of the sedentary behavior questionnaire (SBQ) was previously translated into Arabic. Then, the validated Arabic version of the SBQ was used to assess SB. The Arabic SBQ included 9 types of SB (watching television, playing computer/video games, sitting while listening to music, sitting and talking on the phone, doing paperwork or office work, sitting and reading, playing a musical instrument, doing arts and crafts, and sitting and driving/riding in a car, bus or train) on weekdays and weekends.

RESULTS

SBQ indicated that the total time of SB was considerably high (478.75 ± 256.60 and 535.86 ± 316.53 (min/day) during weekdays and weekends, respectively). On average, participants spent the most time during the day doing office/paperwork (item number 4) during weekdays (112.47 ± 111.11 min/day) and weekends (122.05 ± 113.49 min/day), followed by sitting time in transportation (item number 9) during weekdays (78.95 ± 83.25 min/day) and weekends (92.84 ± 100.19 min/day). The average total sitting time of the SBQ was 495.09 ± 247.38 (min/day) and 58.4% of the participants reported a high amount of sitting time (≥ 7 hours/day). Independent t-test showed significant differences (P ≤ 0.05) between males and females in all types of SB except with doing office/paperwork (item number 4). The results also showed that male students have a longer daily sitting time (521.73 ± 236.53 min/day) than females (467.38 ± 255.28 min/day). Finally, 64.1% of the males reported a high amount of sitting time (≥ 7 hours/day) compared to females (52.3%).

CONCLUSION

In conclusion, the total mean length of SB in minutes per day for male and female university students was considerably high. About 58% of the population appeared to spend ≥7 h/day sedentary. Male university students are likelier to sit longer than female students. Our findings also indicated that SB and physical activity interventions are needed to raise awareness of the importance of adopting an active lifestyle and reducing sitting time.

The Effect of Ramadan Intermittent Fasting on Food Intake, Anthropometric Indices, and Metabolic Markers among Premenopausal and Postmenopausal Women: A Cross-Sectional Study

Background and objectives: Ramadan intermittent fasting (RIF) is a monthlong practice in which Muslims fast during the whole day from sunrise to sunset. During this month, fasting people change their dietary behavior and alter their eating hours from day to night. The objective of the current study was to examine the effect of RIF on dietary consumption, anthropometric indices, and metabolic markers in healthy premenopausal (PRE-M) and postmenopausal (POST-M) Saudi women. Materials and Methods: The study included 62 women (31 PRE-M, 21-42 years, and 31 POST-M, 43-68 years). A structured questionnaire was used to collect socioeconomic data. Physical activity, anthropometric, dietary, and biochemical assessments were assessed before and at the end of the third week of Ramadan. Results: Socioeconomic data varied among participants. For both groups, observing RIF was associated with significantly (at either p ≤ 0.01 or p ≤ 0.05) lower intake of calories, macronutrients, minerals (excluding Na), and vitamins than before RIF. For the PRE-M group, the percentage of overweight participants decreased significantly (p ≤ 0.01) during Ramadan, while the percentage of obese participants remained unchanged. In contrast, for the POST-M group, the percentage of overweight participants increased significantly (p ≤ 0.05) during Ramadan, but dropped at the end of Ramadan. Following RIF, waist-to-hip ratio, body fat, and fat mass (FM) decreased in both groups. High-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), triglycerides (TG), and blood pressure (SBP, DBP) were generally maintained at acceptable normal levels in most participants before and at the end of RIF. However, low-density lipoprotein cholesterol (LDL-C) at the end of RIF was significantly lower than before, particularly in POST-M women. Age, occupation, and monthly income were the most important predictors for the changes in nutritional status and body fat upon RIF. Conclusions: observing RIF by PRE-M and POST-M Saudi women was associated with significant improvements in variable health indicators, with a few exceptions, and may help lower risk factors for chronic diseases, particularly among POST-M women. However, further studies with a larger sample size are required to determine and confirm the exact effect of RIF on these groups.

Prevalence and associated risk factors of overweight and obesity among adult population in Dubai: a population-based cross-sectional survey in Dubai, the United Arab Emirates

OBJECTIVE

To study the prevalence of overweight and obesity and determine the associated risk factors among adults in Dubai.

DESIGN AND SETTING

A cross-sectional survey with a multistage, stratified random sampling design was conducted in the Emirate of Dubai in 2019.

PARTICIPANTS

The study included 2142 adults aged 18+ years in the Emirate of Dubai.

RESULTS

The overall prevalence of obesity, which was defined as body mass index (BMI) ≥30 kg/m², was 17.8%. The highest obesity rates were reported among women (21.6%) and the United Arab Emirates (UAE)-nationals (39.6%). Moreover, 39.8% of the population was overweight (BMI ≥25-29.9 kg/m²). Multivariate logistic regression showed associations between obesity and age, sex, nationality, hypertension and occupation. Obesity increases with age, with the highest risk at age group 50-59 years (OR 4.30; 95% CI 1.57 to 11.78) compared with the reference group (18-24 years). Females had a higher risk of obesity than males (OR 1.62; 95% CI 1.10 to 2.38). Compared with those in the reference group (Western and others), UAE nationals, other Arabs and Asians were more likely to be obese ((OR 2.08; 95% CI 1.18 to 3.67), (OR 3.61; 95% CI 2.41 to 5.44) and (OR 1.98; 95% CI 1.12 to 3.50), respectively). Clerical and service workers (OR 4.50; 95% CI 2.54 to 8.00) and elementary and unskilled occupation categories (OR 2.57; 95% CI 1.56 to 4.25) had higher risks of obesity than the reference group (professionals), p<0.01). Hypertensive individuals had a higher risk of obesity than normotensive individuals (OR=3.96; p<0.01).

CONCLUSIONS

Obesity and overweight are highly prevalent among adults in Dubai and are remarkably associated with sociodemographic and behavioural risk factors. Comprehensive strategic initiatives are urgently needed to control obesity in the high-risk populations in the Emirate of Dubai.

Magnitude and risks of overweight/obesity among adults in Welkite town, Southern Ethiopia: A community based cross-sectional study

Background

Currently, adult overweight/obesity affects a high proportion of the population in low and middle-income countries, mostly in urban areas. Although some studies have been conducted on overweight/obesity in Ethiopia, most of them have focused on school children and adolescents, and there is limited evidence of overweight/obesity among adults at the community level. Therefore, the present study aimed to assess the magnitude of overweight/obesity and risk factors among adults in Welkite town, Southern Ethiopia.

Methods

A Community-based cross-sectional study was done among 524 adults aged 18 and more years in Welkite town, Southern Ethiopia, from February through March 2020. A multistage sampling technique was undertaken to recruit study participants. An interviewer-guided structured questionnaire was used for data collection. Overweight or obesity was identified using body mass index. The bivariate and multivariate analyses were employed to see an association using binary logistic regression.

Results

The magnitude of overweight and obesity was 22.2% (95% CI: 0.19, 0.26). Being female (AOR = 2.40, 95% CI: 1.34, 4.27), age group 30–47 years (AOR = 3.26, 95% CI: 1.52, 6.97) and 48–66 years (AOR = 2.56, 95% CI: 1.07, 6.08), average monthly income (AOR = 2.64, 95% CI: 1.51, 4.60), had own transport (AOR = 2.48, 95% CI: 1.03, 5.93), eating meat ≥ four times per week (AOR = 3.33, 95% CI: 1.03, 10.74), not involve vigorous-intensity activity (AOR = 2.96, 95% CI: 1.55, 5.64), spent sitting or reclining ≥181 minutes per day (AOR = 1.88, 95% CI: 1.08, 3.26), and consuming alcohol (AOR = 2.23, 95% CI: 1.29, 3.82) were risks for overweight and obesity.

Conclusions

The magnitude of overweight and obesity among adults was high. Factors such as being female, increasing age, physical inactivity, having own transportation, high average monthly income, eating meat, sitting or reclining more and equal to 181+ minutes per day, and consumption of alcohol increased the risk of overweight and obesity significantly. Hence, preventive interventions focusing on females, age groups of 30-66yrs, encouraging Physical activity, reducing meat frequency, and reducing alcohol consumption are essential to prevent the emergence of adulthood overweight/obesity.

Structural model of the relationship between physical activity and students’ quality of life: Mediating role of body mass index and moderating role of gender

Background

As a country’s future leaders and pioneers, University students must live with healthy habits. In order to achieve a healthy lifestyle, Physical activity and Quality of Life can serve as suitable indices to study. The purpose of the study was to clarify how physical activity (PA), Body mass index (BMI) and gender relate to the quality of life (QOL) of students of Medical Sciences University by using a structural equation model.

Methods

The research was a cross-sectional study. The number of participants was 225 students of the University. The participants answered three questionnaires, including Demographic, International Physical Activity Questionnaire (IPAQ short form), and Quality of Life Questionnaire (SF-12), BMI was calculated by anthropometric measures, as well. The Structural equation model (SEM) method was employed. The Fitness of the proposed pattern was measured using the following indexes: chi-square/degree of freedom ratio (CMIN/DF), Normed Fit Index (NFI), comparative fit index (CFI), the goodness of fit index (GFI), and standardized root mean squared residual (SRMR). In the analysis the significant level was considered as P < 0.05.

Results

PA (r = -0.726, P<0.001) and QOL (r = -0.405, P<0.001) have significantly inverse relationship with BMI, whereas the QOL and PA were proven to be positively related (r = 0.357, P<0.001). Moreover, the results signify gender as a moderator in the relationship between PA and QOL (Δχ² (10) = 19.903, P = 0.030) and also the mediatory role of BMI among students. BMI affects the QOL in men (P < 0.001, β = -0.307) more in compare to women women (P = 0.324, β = -0.158).

Conclusion

Study findings supported the research hypothesis. Gender exhibited moderating role in the relationship between PA and QOL, considering the mediating role of BMI.

Prevalence of Obesity and Overweight among Adults in the Middle East Countries from 2000 to 2020: A Systematic Review and Meta-Analysis

BACKGROUND

Obesity has become a significant public health issue worldwide, and it is a major risk factor for many noncommunicable diseases. This systematic review aimed to identify the prevalence of obesity and overweight in the Middle East region and different countries in this region.

MATERIALS AND METHODS

PubMed, Google Scholar, and MEDLINE databases were searched from 2000-2020 to identify relevant studies in the Middle East area. The survey was carried out using combinations of Medical Subject Headings (Mesh) keywords like "body mass index", "obesity", "overweight", "prevalence", "Middle-East", and "Countries in the Middle East area". Analysis of the data was done using STATA-14, and a random-effects model was used to estimate the pooled prevalence.

RESULTS

A total of 101 studies with 698905 participants have been identified that met inclusion criteria for this meta-analysis. The pooled estimates of the prevalence of obesity and overweight in the Middle East area were 21.17 (95% CI: 17.05-26.29) and 33.14 (95% CI: 26.87-40.87), respectively. The findings showed that obesity prevalence increased with age so that the highest prevalence of obesity and overweight was observed in people >40 years old. Obesity prevalence in the Middle East area remained steady between 2000-2006 and 2014-2020 (23%). During these time intervals, the prevalence of overweight decreased from 34.83 (95% CI: 32.40-37.45) to 32.85 (95% CI: 31.39-34.38).

CONCLUSIONS

Despite the relative stabilization of the overweight and obesity trend in the Middle East, current interventions to combat the overweight epidemic need to be maintained and strengthened because the prevalence of overweight and obesity in this region is still very high. The prevalence of obesity increases with age so that people over 40 have the highest percentage of obesity and overweight. Therefore, implementing intervention programs to prevent and control obesity and overweight in the Middle East is essential.

Gabr S. The Relationships of Watching Television, Computer Use, Physical Activity, and Food Preferences to Body Mass Index: Gender and Nativity Differences among Adolescents in Saudi Arabia

BACKGROUND

Adolescents and ethnic subgroups have been identified at high risks of overweight and its associated complications. Although some studies have investigated overweight, obesity, nutritional status, physical activity, and associated factors among Saudi students, no studies have examined these characteristics among non-Saudi students or compared non-Saudi to Saudi adolescent students. The objective of this study was to compare differences between Saudi and non-Saudi adolescent students regarding time spent watching television, using computers, engaging in physical activity, and their food preferences. The relationships between these lifestyle behaviors and body mass index by Saudi nativity and gender were tested.

METHODS

Students aged 12 to 18 years (n = 214) from various schools in Riyadh, Saudi Arabia, completed a self-administered questionnaire that included questions about demographic and anthropometric characteristics, daily after-school routine, physical activity, watching television, using computers, and food preferences. Non-parametric (Mann-Whitney U) tests assessed the statistical differences between Saudi and non-Saudi respondents, and males and females were separately tested.

RESULTS

Saudi boys who reported physical activity two to five times per week, the most television time, the most computer time, and the highest frequency of eating fast food and drinking soft drinks had a significantly higher mean body mass index than the non-Saudi boys in their categories. However, there were no significant differences found between the Saudi and non-Saudi girls.

CONCLUSIONS

High levels of sedentary and low levels of physical activities as well as high consumption of high-fat fast foods and high-sugar drinks threaten the health of Saudi adolescents. Cultural differences in lifestyle between Saudi and non-Saudi families should be considered when developing programs to improve knowledge, attitudes, and behaviors regarding diet quality and physical activity. The objective of this study is more important in the current situation where increased time spent on computers and mobile phones due to online teaching in schools or working from home, decreased physical activity due to precautionary lockdowns, and unchecked eating patterns while spending more time in sedentary activities in homes has become our COVID-19 pandemic lifestyle in all the age groups. A similar study should be replicated on a large scale to study the effect of this lifestyle on our lives in all the age groups.

The association of dietary behaviors and practices with overweight and obesity parameters among Saudi university students

Background

Western dietary habits, coupled with a sedentary lifestyle, are potential contributors to the prevalence and rapid increase in the incidence of obesity in Saudi Arabia. This study aimed to investigate the association between students' weight status and their eating behaviors and practices. Another aim was to assess students' awareness of the health risks associated with obesity.

Methods

A cross-sectional survey was conducted among a sample of 416 (53% male and 47% female) undergraduate students, aged 18–26 years old, between January 6 and April 6, 2019, from colleges of Health Sciences at Jazan University in the Kingdom of Saudi Arabia (K.S.A). Students completed a self‐administered questionnaire and recorded their measured anthropometric parameters.

Results

The prevalence of overweight (20.4%) and obesity (14.9%) were relatively high among the participants. There were statistically significant associations between Body Mass Index (BMI) and the different settings of food consumption (i.e., dining on a table (or) in the Islamic way: squatting on the ground) (p<0.001)). BMI was also associated with students' dietary habits regarding consuming food, snacks, and drinking carbonated beverages while watching television (p<0.001), as well as consuming the same pattern of food/drink while watching television, playing video games on mobile phones or computers (p<0.001). Nearly most of the students were oblivious to the fact that metabolic syndrome, reproductive disorders, respiratory disorders along with liver and gallbladder diseases are some of the health risks associated with obesity.

Conclusion

The prevalence of obesity and overweight were reasonably high in our study sample and were affected by several factors related to students' eating behaviors and practices. This warrants the need for rigorous and frequent health education interventions on healthy eating behaviors, dietary practices, with an emphasis on the importance of adopting an active, healthy lifestyle.

Correlation between breast cancer and lifestyle within the Gulf Cooperation Council countries: A systematic review

BACKGROUND

In the six Gulf Cooperation Council countries (GCCCs), Bahrain, Saudi Arabia, Kuwait, Oman, Qatar and the United Arab Emirates, breast cancer (BC) is the greatest cause of cancer incidence and mortality. Obesity and physical inactivity are established risk factors for BC globally and appear to be more of a problem in high income countries like the GCCCs.

AIM

To determine whether obesity and physical inactivity are associated with BC incidence in the GCCCs using the United Kingdom as a comparator.

METHODS

This systematic review was carried out according to PRISMA guidelines. A cancer registry and a statistical data search was done to identify the BC incidence over the past two decades and the prevalence of obesity and physical inactivity in the GCCCs. Additionally, a systematic search of the databases, MEDLINE, Web of Science, and PubMed between 1999 and 2019 was performed to determine whether obesity and physical inactivity are risk factors for BC in the GCCCs. All papers were critically appraised according to their research methods and were assessed for quality and risk of bias.

RESULTS

BC was the top malignancy in each GCC country. Women tended to be diagnosed with BC at a younger age than women in the United Kingdom. The greatest 10-year increase in BC incidence was seen in Saudi Arabia (54.2%), approximately seven times the rate of increase seen in the United Kingdom (7.6%). The prevalence of obesity and physical inactivity was greater in all the GCCCs in comparison to the United Kingdom. A total of 155 full studies were reviewed of which 17 were included. Of those, eight looked at the prevalence of obesity and physical inactivity in the Gulf States and nine looked at these as risk factors for BC. Only one study found an association between BC and obesity (odds ratio = 2.29). No studies looked solely at the link between physical inactivity and BC.

CONCLUSION

The prevalence of obesity and physical inactivity was high within the GCCCs, but the majority of the included studies found no positive correlation between obesity or physical inactivity and BC. A high proportion of women in this study were pre-menopausal which could contribute to the negative findings.

Prevalence and Sociodemographic Factors of Overweight and Obesity among Pakistani Adults

Background

Obesity is a serious public health problem that is growing alarmingly worldwide. The main objective of this study is to examine the current prevalence of overweight and obesity among Pakistani adults and to identify the sociodemographic factors that are associated with overweight and obesity.

Methods

Secondary data from a population-based household survey (the Pakistan Panel Household Survey) were used for this study. A total of 10,063 participants (3,916 men and 6,147 women) were included. Overweight and obese individuals were identified using the World Health Organization-recommended cutoffs for body mass index (kg/m²). Along with descriptive statistics, the Pearson chi-square test was used to investigate the association among categorical variables. Odds ratios (ORs) along with 95% confidence intervals (CIs) were estimated using univariate logistic regression analysis to evaluate the most significantly associated risk factors for overweight/obesity.

Results

The mean age and body mass index of the participants were 38.2 years and 22.9 kg/m², respectively. Overall, 22.8% of the participants (23.9% of the women and 21.1% of the men) were overweight, and 5.1% (6.3% of the women and 3.2% of the men) were obese. Sociodemographic factors, such as sex, marital status, and residential area, were significantly associated with body mass index categories. Women (OR, 1.34; 95% CI, 1.23-1.47; P<0.01), ever-married individuals (OR, 1.92; 95% CI, 1.70-2.16; P<0.01), and individuals living in urban areas (OR, 1.23; 95% CI, 1.12-1.35; P<0.01) were more likely to become overweight/obese than their counterparts.

Conclusion

We have found the excess weight problem to be quite high in the Pakistani adult population. The government and other health agencies should take initiatives in launching programs about nutritional awareness for adults to prevent obesity.

Prevalence of overweight and obesity in United Arab Emirates Expatriates: the UAE National Diabetes and Lifestyle Study

OBJECTIVE

To describe current prevalence of obesity and related non-communicable diseases (NCDs) in expatriates living in the United Arab Emirates (UAE).

METHODS

We used data from the cross-sectional UAE National Diabetes and Lifestyle Study (UAEDIAB), which surveyed adult expatriates living in the UAE for at least 4 years. We report crude prevalence of overweight and obesity, indicated by gender and ethnicity-specific body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) cut-offs, by lifestyle and biomedical characteristics, as well as age and sex-adjusted odds ratios.

RESULTS

Out of a total of 3064 recruited expatriates (response rate 68%), 2724 had completed all stages of the UAEDIAB study. Expatriates were; 81% men, mean age 38 years (range 18-80), 71% South East Asians, and 36% university graduates. In this sample, the prevalence of overweight and obesity, by BMI, were 43.0 and 32.3%, respectively. 52.4 and 56.5% of participants were at a substantially increased risk according to WC and WHR, respectively. The prevalence of diabetes, hypertension and hypercholesterolemia were 15.5, 31.8, and 51.7%, respectively, with the prevalence of each being higher in those with obesity.

CONCLUSION

Prevalence of obesity and associated NCDs are extremely high in UAE expatriates. Without comprehensive prevention and management, levels of disease will continue to increase and productivity will fall.

Effects of potentially modifiable risk factors on the health of adults in the Eastern Province of KSA

Objectives

The purpose of this study was to investigate the association between selected major modifiable risk factors including life style habits, household income and smoking on health.

Methods

This cross-sectional study was conducted during 2015-2016 among 104 healthy men aged 38 ± 8 years. The data were collected using a self-administered questionnaire that enquired about clinical information about blood pressure and body mass index. Venous blood samples were taken to assess the fasting blood glucose (FBG), lipid profile, high density lipoprotein and triglyceride.

Results

Current smoking status and consumed energy drinks were significantly positive risk factors for increased systolic blood pressure and FBG, respectively. Participants with monthly income of more than 10,000 Saudi Riyals showed significantly lower diastolic pressure than those with lower income. However, there was a significant decrease in body weight among those who consumed vegetables.

Conclusion

This study highlights the effect of major modifiable risk factors on health. There is a great need for improving and enhancing a healthy lifestyle behaviour.

Prevalence of obesity, central obesity, and associated socio-demographic variables in Syrian women using different anthropometric indicators

The prevalence of overweight and obesity is increasing globally in both developing and developed countries, especially, those with rapid cultural and social changes. The aims of current study were twofold: (a) to examine, for the first time in Syria, the prevalence of overweight, obesity and central obesity in Syrian women and obesity-related socio-demographic determinants, and (b) to establish a base line data about obesity related determinants needed to develop appropriate treatment and prevention strategies. Cross-sectional study with a randomly representative sample of 923 women aged 18-60 years was conducted. Waist (WC) and hip circumference (HC) were measured, and body mass index (BMI) waist-to-hip ratio (WHR) were calculated. Socio-demographic data were collected with a designed questionnaire. The overall prevalence of overweight and obesity in Syrian women as defined by BMI were 31% and 43%, respectively. The overall central obesity as defined by WC and WHR were 53% and 33%, respectively. The prevalence of obesity and central obesity were increased with age. WC and HC were strongly correlated with BMI. The mean BMIs and other anthropometric measurements were significantly higher in married, house wife, less educated, high parity, and low physical activity women. The results of this study indicate an increased rates of overweight, overall, and central obesity in Syrian women. Also, central obesity as defined by WC is higher than BMI derived obesity. In conclusion, WC is more appropriate to be used for obesity assessment, where, BMI underestimates the obesity prevalence among middle-age women. Development of appropriate treatment and prevention strategies are urgently needed to combat with increasing rate of obesity among Syrian women.

Exposure to famine in early life and the risk of obesity in adulthood in Qingdao: Evidence from the 1959-1961 Chinese famine

BACKGROUND AND AIMS

We aimed to evaluate the association between famine exposure during early life and obesity and obesity_max (obese at the highest weight) in adulthood.

METHODS AND RESULTS

Data were from two population-based cross-sectional surveys conducted in 2006 and 2009 in Qingdao, China. A total of 8185 subjects born between 1/1/1941 and 12/31/1971 were categorized into unexposed (born between 01/01/1962 and 12/31/1971), fetal/infant exposed (born between 01/01/1959 and 12/31/1961), childhood exposed (born between 01/01/1949 and 12/31/1958) and adolescence exposed (born between 01/01/1941 and 12/31/1948) according to their age when exposed to the Chinese famine from 1959 to 1961. Obesity was defined as BMI (body mass index) ≥28.0 and obesity_max was defined as BMI_max (BMI at the highest weight) ≥28.0. We compared fetal/infant exposed, childhood exposed and adolescence exposed to the unexposed using logistic regression models to assess the effect of famine exposure on later obesity and obesity_max. Fetal/infant exposed (OR = 1.59, P < 0.001), childhood exposed (OR = 1.42, P < 0.01) and adolescence exposed (OR = 1.86, P < 0.01) all had higher risks of obesity than the unexposed. Exposure groups were more likely to be obese at their highest weight than the unexposed, and ORs (95%CIs) for obesity_max in the fetal/infant exposed, childhood exposed and adolescence exposed were 1.49(1.20-1.86), 1.24(1.02-1.49) and 1.64 (1.40-1.93), respectively. Similar results were found in both men and women.

CONCLUSION

Exposure to famine in early life was associated with increased risks of obesity and obesity_max in adulthood. Preventing undernutrition in early life appears beneficial to reduce the prevalence of later obesity.

An update on overweight and obesity in rural Northeast China: from lifestyle risk factors to cardiometabolic comorbidities

Background

Not enough is known about the prevalence of overweight and obesity in rural China in the current decade. We aim to update our knowledge of the prevalence of obesity and its associated risk factors and comorbidities in a large population sample in rural Northeast China.

Methods

A population-based survey of 11,579 participants aged 35 years and older was conducted in rural areas of Liaoning Province during 2012–2013. Anthropometric measurements, information on health-related variables and blood biochemical indexes were collected by well-trained personnel.

Results

The prevalence of general obesity and overweight was found to be 7.8% and 37.2%, respectively. The overall prevalence of abdominal obesity was 15.1%. Female gender, ethnic minority, middle-school education and a family income of 5,000–20,000 CNY per year were found to be risk factors for general obesity, while older age, female gender, ethnic minority and longer sleep duration (>8 h/d) increased the risk of abdominal obesity, after adjusting for confounders. Overweight and obese participants had significantly higher risks to develop prehypertension, hypertension, high LDL-C and low HDL-C compared with normal weight participants, while abdominal obesity was associated with increased risks of diabetes and high TG after adjusted for multiple factors. Compared with participants with a normal BMI and no abdominal obesity, the participants classified as abdominally obese and normal BMI; as abdominally obese and overweight; and abdominally obese and generally obese each had a progressive increase in the odds of hypertension (OR: 1.961, 95% CI: 1.154 to 3.331, OR: 2.744, 95% CI: 2.126 to 3.541, and OR: 8.990, 95% CI: 5.858 to 13.795, respectively) and high TG (OR: 3.165, 95% CI: 2.183 to 4.588, OR: 3.980, 95% CI: 3.332 to 4.755, and OR: 4.340, 95% CI: 3.574 to 5.271, respectively).

Conclusions

The prevalence of obesity in rural Northeast China exhibited a remarkably increasing upwards trend. General and abdominal obesity were associated with different subtypes of cardiometabolic comorbidities, the combined effects of which on the comorbidities dramatically increased.

Prevalence of Obesity and Associated Risk Factors in a Turkish Population (Trabzon City, Turkey)

OBJECTIVE

To estimate the prevalence of overweight and obesity (general and central) in the Trabzon Region and its associations with demographic factors (age, sex, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, and obesity), lifestyle factors (smoking habits, physical activity, and alcohol consumption), and hypertension in the adult population.

RESEARCH METHODS AND PROCEDURES

A sample of households was systematically selected from the central province of Trabzon and its five towns, namely, Sürmene, Vakfikebir, Maçka, Hayrat, and Tonya. A total of 5016 subjects (2728 women and 2288 men) were included in the study. Individuals more than 20 years old were selected from their family health cards. Demographic factors, socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure and diastolic blood pressure levels were measured for all subjects. Study procedures were carried out in the local health centers in each town over an 8-month period. Obesity was defined as BMI > or = 30 kg/m2 and overweight as BMI = 25.0 to 29.9 kg/m2.

RESULTS

The prevalence of obesity was 23.5%: 29.4% in women and 16.5% in men. The combined prevalence of both overweight and obesity was 60.3%. The prevalence of abdominal obesity was 29.4%: 38.9% among women and 18.1% among men. The prevalence of obesity increased with age, being highest in the 60- to 69-year-old age group (40.8%) but lower again in the 70+ age group. Obesity was associated positively with marital status, parity, cessation of cigarette smoking, alcohol consumption, and household income and inversely with level of education, cigarette use, and physical activity. Also, obesity was associated positively with hypertension.

DISCUSSION

In the Trabzon Region, 60.3% of the adult population presents with some excess weight. Obesity is a major public health problem that requires generalized interventions to prevent it among the adult population.

Overweight and Obesity among Palestinian Adults: Analyses of the Anthropometric Data from the First National Health and Nutrition Survey (1999-2000)

Background. A cross-sectional survey was designed to provide a baseline data on the prevalence and distribution of overweight and obesity and their associations among adults in Palestine. Methods. A random representative sample of 3617 adults aged 18-64 years was collected between October 1999 and October 2000. Results. The prevalence of overweight was 35.5% in women and 40.3% in men, obesity was 31.5% in women and 17.5% in men. Adults aged 45-54 years old were significantly more likely to be obese (29.2% in men and 50.2% in women) or overweight (48.1% in men and 37.2% in women). When compared with women, men showed significantly more normal BMI level (40.5% versus 31.6%; P < 0.05). Cut-off points for a high waist circumference and high waist-to-hip ratio identified 57.8% and 47.2% of the population, respectively, to be at an increased and high risk for cardiovascular disease. Sociodemographic factors (age, sex, educational level, and marital status) were also found to be significantly related to BMI. Conclusion. Obesity and overweight are enormous public health problems in Palestine. Population-based research at the national level to investigate the social and cultural factors associated with high prevalence of overweight and obesity among Palestinian adults should be implemented.

Food-based dietary guidelines for the arab gulf countries

The concept of food-based dietary guidelines (FBDG) has been promoted by several international organizations. However, there are no FBDG for the countries in the Arab region. As the Arab Gulf countries share similar a socioeconomic and nutrition situation, an attempt was made to develop FBDG for these countries. This paper summarizes the steps taken to develope such guidelines by the Arab Center for Nutrition. The FBDG were developed through 6 steps: (1) determination of the purpose and goals for establishing FBDG, (2) characteristics of FBDG, (3) determination of the food consumption patterns, (4) review the current nutrition situation, (5) determination of the lifestyle patterns that are associated with diet-related diseases and (6) formulating the FBDG. The FBDG consist of 14 simple and practical pieces of advice taking into consideration the sociocultural status and nutritional problems in the Arab Gulf countries. The FBDG can be a useful tool in educating the public in healthy eating and prevention of diet-related chronic diseases.

Vitamin D in the Persian Gulf: integrative physiology and socioeconomic factors

Countries of the Persian Gulf region--Bahrain, Iran, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates--have become increasingly modernized, resulting in a transformation of lifestyle based on technology, sedentary activity, lack of sunlight, and unhealthy dietary patterns. These factors have led to a higher prevalence not only of vitamin D undernutrition, but also chronic obesity, insulin resistance, prediabetes, and type 2 diabetes. This review explores the integrative physiologic effects of vitamin D with socioeconomic factors and propose a hypothesis-driven model for their contributions to obesity and diabetes in the Persian Gulf. Further research into these interactions may ultimately lead to novel preventive strategies and therapies for metabolic disorders in this geographic region.

Overweight and obesity in eastern mediterranean region: prevalence and possible causes

The objective of this paper was to explore the prevalence of overweight and obesity among various age groups as well as discuss the possible factors that associated with obesity in the Eastern Mediterranean Region (EMR). A systematic review of published papers between 1990 and 2011 was carried out. Obesity reached an alarming level in all age groups of the EMR countries. The prevalence of overweight among preschool children(<5 years) ranged from 1.9% to 21.9%, while the prevalence of overweight and obesity among school children ranged from 7% to 45%. Among adults the prevalence of overweight and obesity ranged from 25% to 81.9%. Possible factors determining obesity in this region include: nutrition transition, inactivity, urbanization, marital status, a shorter duration of breastfeeding, frequent snacking, skipping breakfast, a high intake of sugary beverages, an increase in the incidence of eating outside the home, long periods of time spent viewing television, massive marketing promotion of high fat foods, stunting, perceived body image, cultural elements and food subsidize policy. A national plan of action to overcome obesity is urgently needed to reduce the economic and health burden of obesity in this region.

Prevalences of overweight, obesity, hyperglycaemia, hypertension and dyslipidaemia in the Gulf: systematic review

OBJECTIVES

To examine the prevalence of risk factors for diabetes and its complications in the Co-operation Council of the Arab States of the Gulf (GCC) region.

DESIGN

Systematic review.

SETTING

Co-operation Council of the Arab States of the Gulf (GCC) states (United Arab Emirates, Bahrain, Saudi Arabia, Oman, Qatar, Kuwait).

PARTICIPANTS

Residents of the GCC states participating in studies on the prevalence of overweight and obesity, hyperglycaemia, hypertension and dyslipidaemia.

MAIN OUTCOME MEASURES

Prevalences of overweight, obesity and hyperglycaemia, hypertension and hyperlipidaemia.

RESULTS

Forty-five studies were included in the review. Reported prevalences of overweight and obesity in adults were 25-50% and 13-50%, respectively. Prevalence appeared higher in women and to hold a non-linear association with age. Current prevalence of impaired glucose tolerance was estimated to be 10-20%. Prevalence appears to have been increasing in recent years. Estimated prevalences of hypertension and dyslipidaemia were few and used varied definitions of abnormality, making review difficult, but these also appeared to be high and increasing,

CONCLUSIONS

There are high prevalences of risk factors for diabetes and diabetic complications in the GCC region, indicative that their current management is suboptimal. Enhanced management will be critical if escalation of diabetes-related problems is to be averted as industrialization, urbanization and changing population demographics continue.

Obesity and eating habits among college students in Saudi Arabia: a cross sectional study

Background

During the last few decades, the Kingdom of Saudi Arabia (KSA) experienced rapid socio-cultural changes caused by the accelerating economy in the Arabian Gulf region. That was associated with major changes in the food choices and eating habits which, progressively, became more and more "Westernized". Such "a nutritional transition" has been claimed for the rising rates of overweight and obesity which were recently observed among Saudi population. Therefore, the objectives of the current work were to 1) determine the prevalence of overweight and obesity in a sample of male college students in KSA and 2) determine the relationship between the students' body weight status and composition and their eating habits.

Methods

A total of 357 male students aged 18-24 years were randomly chosen from College of Health Sciences at Rass, Qassim University, KSA for the present study. A Self-reported questionnaire about the students' eating habits was conducted, and their body mass index (BMI), body fat percent (BF%), and visceral fat level (VFL) were measured. Data were analyzed using SPSS statistical software, and the Chi-square test was conducted for variables.

Results

The current data indicated that 21.8% of the students were overweight and 15.7% were obese. The total body fat exceeded its normal limits in 55.2% of the participants and VFL was high in 21.8% of them. The most common eating habits encountered were eating with family, having two meals per day including breakfast, together with frequent snacks and fried food consumption. Vegetables and fruits, except dates, were not frequently consumed by most students. Statistically, significant direct correlations were found among BMI, BF% and VFL (P < 0.001). Both BMI and VFL had significant inverse correlation with the frequency of eating with family (P = 0.005 and 0.007 respectively). Similar correlations were also found between BMI and snacks consumption rate (P = 0.018), as well as, between VFL and the frequency of eating dates (P = 0.013).

Conclusions

Our findings suggest the need for strategies and coordinated efforts at all levels to reduce the tendency of overweight, obesity and elevated body fat, and to promote healthy eating habits in our youth.

Estimation of insulin resistance in non-diabetic normotensive Saudi adults by QUICKI, HOMA-IR and modified QUICKI: a comparative study

BACKGROUND AND OBJECTIVES

Identification of insulin resistance (IR) in the general population is important for developing strategies to reduce the prevalence of non-insulin-dependent diabetes mellitus (NIDDM). We used the original and a modified version of the Quantitative Insulin Sensitivity Check Index (QUICKI, M-QUICKI), and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to divide non-diabetic normotensive adults into high- (HIR) and low-insulin-resistant (LIR) subgroups to investigate similarities and differences in their characteristics.

SUBJECTS AND METHODS

Three hundred fifty-seven healthy adults aged 18-50 years were recruited randomly from health centers in Jeddah in a cross-sectional study design. Anthropometric and demographic information was taken. Insulin, glucose, lipid profile and free fatty acid were determined in fasting blood samples. M-QUICKI, HOMA-IR and QUICKI were calculated. Reported cut-off points were used to identify HIR subjects, who were then matched for age and sex to others in the study population, resulting in 3 HIR and 3 LIR subgroups.

RESULTS

Two hundred nine subjects satisfied the selection criteria. M-QUICKI correlated significantly (P=.01) with HOMA-IR and QUICKI values. Increased adiposity was the common characteristic of the three HIR subgroups. HIR subgroups identified using M-QUICKI (97 subjects) and HOMA (25 subjects), but not QUICKI (135 subjects), had statistically different biochemical characteristics compared to corresponding LIR sub-groups.

CONCLUSION

Adiposity, but not sex, is a risk factor for IR in the studied population. Further studies are needed to choose the most appropriate index for detecting IR in community-based surveys.

Prevalence of overweight and obesity among adult females in the United Arab Emirates

The purpose of this present study was to investigate the prevalence of overweight and obesity in adult females in the United Arab Emirates. A total number of 724 females, age 20-90 years, were recruited from the seven Emirates. The sample was divided into three age groups, 20 to <30 years, 30 to <60 years and >60 years. Height, weight and mid-upper-arm circumference were measured in each subject. Overweight and obesity were defined as a body mass index of 25.0-29.9 kg/m2 and >30 kg/m2, respectively. The prevalence of overweight and obesity were 27% and 16%, respectively. The age group between 30 and <60 years had the highest prevalence of overweight (33%) and obesity (24%). In conclusion, the findings from our study suggest that a high proportion of adult females in the United Arab Emirates are overweight and obese. The consequences of this are a serious concern for public health and need to be addressed.

Factors associated with obesity in an adult Mediterranean population: influence on plasma lipid profile

OBJECTIVE

The aim of the study was to identify factors associated with obesity, and their influence on plasma lipid profile in an adult Mediterranean population.

DESIGN

The data were obtained from a cross-sectional epidemiological survey.

SETTING

The study population resided in Andalusia, a western Mediterranean region in southern Spain.

SUBJECTS

The survey was carried out with a random sample of 3421 subjects (1747 men, 1674 women) between 25 and 60 years of age. Blood samples were obtained for biochemical assays in a random subsample of 340 subjects (167 men, 173 women).

INTERVENTIONS

Food consumption was assessed by 48-h recall. Height, weight, triceps, biceps, subscapular and suprailiac skinfolds, mid-upper arm, waist (WC) and hip circumferences, glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides were measured. Information about lifestyles was obtained with a questionnaire.

RESULTS

Of the adult population we studied, 18.9% were obese (body mass index [BMI] > or = 30 kg/m2). A larger proportion of men than women were overweight, but the opposite was found for obesity. Mean plasma lipid values were not modified significantly by obesity or lifestyle factors, and were within the normal range. Sex, age, physical exercise and lower educational level were associated directly with the risk of obesity, and smoking was associated inversely with the risk of obesity. In obese smokers WC and waist-hip ratio were larger, and levels of HDL-cholesterol were lower (p < 0.05) than in obese nonsmokers. Glucemia was higher in obese persons who consumed alcohol (p < 0.05) than in obese persons who did not consume alcohol. The risk of hypercholesterolemia and high levels of LDL-cholesterol was associated only with age, and the risk of low levels of HDL-cholesterol was associated only with high WC.

CONCLUSION

Our results provide an estimate of the prevalence of obesity in the adult population in southern Spain, and of the associated factors. Sex, age, leisure-time physical exercise and educational level appear to influence obesity. Only age and WC but not BMI were associated with a risk of dyslipidemia. No dietary associations were observed between energy or macronutrient intake and plasma lipid concentrations in overweight or obese persons.

High cardiovascular risk in young Saudi males: cardiovascular risk factors, diet and inflammatory markers

BACKGROUND

The relationship between coronary risk score (CRS), individual coronary risk factors and the serum inflammatory markers, high sensitivity C-reactive protein (hsCRP), ceruloplasmin (Cp), and soluble intercellular adhesion molecule-1 (sICAM-1) was studied in 140 Saudi males without clinically evident coronary heart disease (CHD).

METHODS

One hundred forty subjects without clinically evident CHD were categorized into age tertiles. Demographic data together with an estimate of CRS using Framingham and PROCAM algorithms were obtained, and serum lipid profile, glucose, hsCRP, sICAM-1, and Cp were measured. Macronutrient intake was assessed by a questionnaire. The relationship between CRS, biochemical markers and diet was assessed by univariate and multivariate analysis.

RESULTS

There was no significant difference in median hsCRP, sICAM-1 or Cp between the age groups. Serum Cp was positively associated with age (r=0.224, p<0.01) and FRS score (r=0.174, p<0.05). Serum sICAM-1 was negatively associated with PROCAM score (r=-0.183, p<0.05). sICAM-1 was positively associated with HDL cholesterol (r=0.36, p<0.0001) among non-diabetics and negatively associated (r=-0.397, p<0.05) among diabetic subjects. Age and dietary intake of saturated fatty acids together explained 7.9% of the variation in serum Cp level in a stepwise multiple regression model. Similarly 6.5% of the variation in serum sICAM-1 level was explained by the total cholesterol/HDL-C ratio. The youngest tertile of the group (<30 y) had the highest dietary intake of energy, fat and saturated fatty acids (p<0.05), and also had a high prevalence of obesity, smoking and sedentary lifestyle.

CONCLUSION

We have demonstrated that there is a high prevalence of coronary risk factors and poor dietary intake within a Saudi male population, and that dietary factors are associated with serum sICAM-1 and ceruloplasmin but not hsCRP concentrations in this group.