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

The Association between Marital Status and Obesity: A Systematic Review and Meta-Analysis

BACKGROUND

Obesity was included in the International Classification of Diseases in 1990 as a chronic disease characterized by the excessive accumulation of body fat and a body mass index (BMI) greater than 30 kg/m2.

AIM

This systematic review was aimed to examine the role of marital status in determining body mass index and the risk of obesity.

METHODS

We performed a systematic literature search using three databases (PubMed (Medline), Embase, and Google Scholar) with the search query.

RESULTS

Of the 105 studies included in the systematic review, 76 studies (72%) reported a greater risk of obesity in married individuals compared to unmarried individuals. A meta-analysis of 24 studies included a total population of 369,499 participants: 257,257 married individuals (40,896 of whom had obesity) and 112,242 comparison subjects (single, divorced, or widowed individuals, 15,084 of whom had obesity). Odds ratios for obesity found a significant pooled odds ratio for obesity in married individuals compared with controls (OR 1.70; 95% CI 1.38-2.10). The socioeconomic environment was not the same throughout the period of studies analyzed. The odds of obesity in married individuals during economic crises was greater than during the period between crises: OR 2.56 (95% CI 2.09-3.13) during crises vs. OR 1.55 (95% CI 1.24-1.95) between crises.

CONCLUSION

The results of this review confirm the importance of considering marital status in determining the risk of obesity.

Body-mass index and obesity in infertile couples in southwest China

To investigate body mass index (BMI) of infertile couples and analyze its related influencing factors in Southwest China, so as to prevent and control the obesity. We analyzed the data of a total number of 8877 infertile couples who received treatment in our assisted reproductive center from October 2012 to March 2022. The mean age and BMI of men and women were 33.5 years, 23.9 kg/m2 and 31.6 years, 21.9 kg/m2. The prevalence of overweight (BMI 25-29.9) was 30.9% in men and 14.7% in women, 3.7% of men and 1.6% of women were obese (BMI ≥ 30), while 3.6% of men and 10.8% of women were underweight (BMI<18.5). Multivariable linear regression analysis indicated that the age and educational background of both women and men had an impact on BMI. In our study, the proportion of male obesity and overweight is much higher than that of female. On the other hand, the proportion of females with low weight was higher than that of males. The age and educational background of men and women have a certain correlation with BMI.

Examination of relationship factors between psychological resilience and social support in adolescent obesity

PURPOSE

Childhood obesity is one of the most severe public health problems, and psychiatric conditions have been associated with obesity. In this study, we aimed to investigate psychological resilience and possible related factors in adolescents with obesity.

METHOD

The study included 90 adolescents with obesity and 100 healthy adolescents of similar age. Data were collected using a sociodemographic information form, the Child and Youth Resilience Measure-28 (CYRM-28), and the Multidimensional Scale of Perceived Social Support. Scale scores were compared by Pearson's correlation coefficient test with SPSS-23. Multiple linear regression was performed to describe the relationships between variables.

RESULTS

The adolescents participating in the study were similar in terms of age and gender. Psychological resilience and social support in the obesity group were lower than in the control group (p < 0.05). A negative relationship was found between body mass index (BMI) and resilience levels of adolescents with obesity, and a positive relationship was found between social support and resilience levels (p = 0.027 and p < 0.001, respectively). The perceived family and significant other social support subscale scores of adolescents in the obesity group were significantly lower than in the control group (p = 0.037 and p = 0.023, respectively). The most related variable with the CYRM-28 was the level of perceived social support: standardized β = 0.409; t(151) = 5.626; p < 0.001.

CONCLUSION

A higher BMI has a negative effect on psychological resilience, and family support tends to be lower in these cases. New studies are needed to clarify whether this result is one of the causes of obesity or one of its consequences.

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.

What factors drive gender differences in the body mass index? Evidence from Turkish adults

In recent years, studies show that obesity has become an important health condition, especially among adults. The first aim of this study is to examine socio-demographic and behavioural factors on body mass index distribution of male and female adults over 20 years old in Turkey. The second aim is to determine the body mass index disparity by gender and the socio-demographic and behavioural factors that might wider or narrow it. This study adopts unconditional quantile regression and decomposition methods, and the data set covers the Turkish Health Surveys for 2014, 2016, and 2019. The findings document that high level of body mass index are associated with being married, aging, and physical inactivity. Interestingly, employment status has different contributions on the body mass index of males and females. The results also claim a body mass index gap among males and females as a result of differences in some potential socio-demographic and behavioural factors, and the gap gets higher at the upper and lower quantiles of BMI distribution. This study may provide a clear understanding for policymakers on how to design efficacious obesity policies considering the differences in the effect of socio-demographic and behavioural factors on the distribution of body mass index across females and males. The results suggest that the Ministry of Health should specifically target different groups for males and females and should reduce the differences in socio-demographic and behavioural determinants between females and males to prevent and reduce obesity prevalence in Turkey.

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.

Associated patient demographic characteristics and disease-related self-care behaviors with diabetes: a mediation model

Objective

The burden of diabetes is increasing rapidly in Turkey; however, there is insufficient information regarding the interrelated factors of diabetes. This study aims to fill this gap by investigating associated characteristics and self-care behaviors of patients with diabetes.

Methods

Path analysis was used to test interrelated factors of diabetes. Data were obtained from a cross-sectional, population-based study (Turkey Health Survey) from 2014. The determined sample size was 9,740 households, and 26,075 individuals were interviewed. There were 19,129 persons who reported having diabetes. Age and gender characteristics and disease-related self-care behaviors of individuals were collected through a self-reported questionnaire. Goodness-of-fit indices were used to assess model fit.

Results

The results demonstrated that patient characteristics, self-care behaviors, and diabetes are causally interrelated (p < 0.0001). Blood glucose monitoring mediated the interrelationships between patient demographic characteristics and diabetes. The model fit indices indicated a good fit of the path model to the data (goodness-of-fit index = 0.96; comparative fit index = 0.89; incremental fit index = 0.89; normed fit index = 0.89). The fight against the increasing prevalence of diabetes mandates enhancing self-care behaviors of individuals with diabetes, including regular blood glucose monitoring and the inculcation of healthy dietary habits.

Conclusions

The results can guide health policy makers to promote patient-centered management of diabetes in the age of the escalating burden of this disease.

Physical inactivity in nine European and Central Asian countries: an analysis of national population-based survey results

Background

Physical inactivity is a major risk factor for non-communicable diseases. However, recent and systematically obtained national-level data to guide policy responses are often lacking, especially in countries in Eastern Europe and Central Asia. This article describes physical inactivity patterns among adults in Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan.

Methods

Data were collected using the Global Physical Activity Questionnaire drawing nationally representative samples of adults in each country. The national prevalence of physical inactivity was calculated as well as the proportional contribution to total physical activity (PA) during work, transport and leisure-time. An adjusted logistic regression model was applied to analyze the association of age, gender, education, household status and income with physical inactivity.

Results

National prevalence of physical inactivity ranged from 10.1% to 43.6%. The highest proportion of PA was registered during work or in the household in most countries, whereas the lowest was during leisure-time in all countries. Physical inactivity was more likely with older age in eight countries, with female gender in three countries, and with living alone in three countries. There was no clear pattern of association with education and income.

Conclusion

Prevalence of physical inactivity is heterogeneous across the region. PA during leisure-time contributes minimally to total PA in all countries. Policies and programs that increase opportunities for active travel and leisure-time PA, especially for older adults, women and people living alone will be an essential part of strategies to increase overall population PA.

Akkermansia muciniphila, a New Generation of Beneficial Microbiota in Modulating Obesity: A Systematic Review

Obesity is a complex syndrome and is recognized as the ultimate pathway of many chronic diseases. Studies using Akkermansia muciniphila supplementation strategy have proved to be effective for the prevention and treatment of obesity and other metabolic disorders. Although there are studies that support the protective effect of this strategy, the effects on the prevention of obesity on humans are not clear yet and need more investigation. The aim of this study is to investigate the effect of A. muciniphila administration on modulating obesity. This systematic review was generated from articles published within the last 10 years. All articles were in English and included animal subjects. The review relied on the search engines Google Scholar, Pub Med, Web of Science and Medline using the following keywords: A. muciniphila, next-generation probiotic, new-generation probiotic, obesity, fat mass, body fat and lipid profile. The search has revealed 804 articles with relevant key words. After the exclusion of irrelevant articles, 10 studies were selected based on the criteria. These studies were randomized controlled trials that have shown that A. muciniphila modulates obesity by regulating metabolism and energy hemostasis and improving insulin sensitivity and glucose hemostasis. In addition, studies showed this microorganism enhances low grade inflammation by different mechanisms.

Association between alcohol intake and overweight and obesity: a systematic review and dose-response meta-analysis of 127 observational studies

Several studies have assessed the relationship between alcohol intake and overweight/obesity; however, the reported results are inconsistent. Therefore, the present systematic review and dose-response meta-analysis of observational studies was designed to investigate the association between alcohol intake and general and abdominal obesity among the adults. Literature search was conducted in the PubMed/Medline and Web of Science databases up to August 2020. Odds ratio (OR), risk ratio (RR), or hazard ratio (HR) with 95% confidence interval (95% CI) were used to pool effect size. To conduct dose-response meta-analysis, amount of alcohol intake was classified into three categories including light (<14 g/d), moderate (14-28 g/d), and heavy (>28 g/d). In the present study, 127 eligible studies were included. In cohort studies, there was no significant association between alcohol drinking and risk of overweight (OR: 0.93, 95% CI: 0.46 to 1.89), obesity (OR: 0.84, 95% CI: 0.52 to 1.37), overweight/obesity (OR: 1.15, 95% CI: 0.84 to 1.58), and abdominal obesity (OR: 1.13, 95% CI: 0.90 to 1.41). In cross-sectional studies, alcohol intake was associated with the increased odds of overweight (OR: 1.11, 95% CI: 1.05 to 1.18), overweight/obesity (OR: 1.23, 95% CI: 1.11 to 1.37), and abdominal obesity (OR: 1.19, 95% CI: 1.09 to 1.29); but not obesity (OR: 1.03, 95% CI: 0.95 to 1.12). Results of dose-response analysis indicated that heavy alcohol drinking was positively associated with odds of overweight (OR: 1.12, 95% CI: 1.01 to 1.24), overweight/obesity (OR: 1.32, 95% CI: 1.16 to 1.51), and abdominal obesity (OR: 1.25, 95% CI: 1.12 to 1.38) compared to non- or light alcohol drinking. There was no publication bias among studied on outcomes of interest. In conclusion, our results revealed alcohol drinkers, especially heavy alcohol drinkers, had increased odds of overweight, overweight/obesity, and abdominal obesity than non-alcohol drinker or light alcohol drinkers among cross-sectional studies but not cohort studies.

Prevalence of Overweight and Obesity, and Its Associated Factors Among Health-care Workers, Teachers, and Bankers in Arusha City, Tanzania

BACKGROUND

Tanzania is one of the developing countries experiencing an increasing trend of overweight and obesity among adults. Working adults have been identified as a high-risk group more exposed to the predictors of overweight and obesity than the general population. However, limited studies have been done in this group. This study aimed to identify the prevalence of overweight and obesity and its associated risk factors among health-care workers, teachers, and bankers in Arusha city council.

SUBJECTS AND METHODS

A descriptive cross-sectional study was conducted among health-care workers, teachers, and bankers. A total of 305 working adults aged 18-60 years participated in the study. A modified World Health Organization (WHO) STEPwise approach for chronic disease risk factor surveillance was used to collect data about socio-demographic characteristics, lifestyle behaviors, dietary practices and anthropometric measurement. The Global Physical Activity Questionnaire (GPAQ) was used to collect information about level of physical activities. The anthropometric measurement and level of physical activities were calculated and ranked according to WHO guidelines.

RESULTS

Overall, 68.9% (31.1% overweight and 37.8% obese) of working adults were overweight or obese. Age (adjusted odds ratio [AOR=7.73; 95% CI: 1.93-30.87]), gender (AOR=2.60; 95% CI: 1.30-5.21), marital status (AOR=2.47; 95% CI: 1.11-5.50), years spent with the current institution (AOR=4.59; 95% CI: 1.38-17.80), using private car or public transport to and from work (AOR=2.43; 95% CI: 1.10-5.39) and sedentary work (AOR=2.43; 95% CI: 1.04-5.71), were significant factors associated with overweight or obesity.

CONCLUSION

The study identified a higher prevalence of overweight and obesity in Tanzania compared with previous studies. The results from this study are useful for the education sector, financial institutions and health sector on designing workplace wellness programs to reduce the burden of overweight and obesity among this working category.

Gender and Exercise in Relation to Obesity in Greek Elderly Population

Purpose: The prevalence of sarcopenic obesity is increasing in older adults (>65 years) and older. Sarcopenic obesity is also related to reduced muscle synthesis, due to low physical activity levels. The purpose of the present study is to investigate possible risk factors, and effects of habitual activity status on different types of obesity in an elderly population. Methods: One hundred and two (n = 102) free living participants, aged >60 years, were randomly selected from Rehabilitation Centers for the Elderly in Thessaloniki and from municipal gymnasiums of Thessaloniki, Greece with a mean age of 68.11 ± 6.40 years. The response rate of the participants was 51%. For the purpose of this study, all the participants selected were healthy and did not receive any medication. Specifically, 46 subjects (19 men and 27 women) were members of Rehabilitation Centers for the Elderly in Thessaloniki, while 56 individuals (31 men and 25 women were members of the municipal gymnasiums of Thessaloniki and exercised 2 to 3 times per week). Anthropometric measurements were taken for all subjects. Body composition was assessed with bioelectrical impedance. Body Mass Index (BMI) was categorized according to the World Health Organization (WHO) (2000) standards. Central obesity was defined as a waist circumference of >102 cm in men and >88 cm in women. All participants completed a specific questionnaire regarding their health status, physical activity and previous weight status. Risk of sarcopenic obesity was diagnosed in the participants with co-existing sarcopenia and obesity resulting in high fat mass concurrent with low lean body mass. Results: Women had more than double risk of developing abdominal obesity (OR:2.133, 95% CI: 0.963–4.725) compared to men. More specifically, 69.6% of the elders who did not exercise regularly had central obesity (men: 52.6% and women: 81.5%), while 38.2% of the exercised elders (men: 36.7% and women: 40%) had central obesity. Sedentary elders demonstrated an increased risk of obesity according to body fat (%BF) (OR: 1.259, 95% CI: 0.576–2.750), double the risk of obesity according to body mass (OR: 2.074, 95% CI: 0.765–5.622), and triple the risk of having central obesity (OR: 3.701, 95% CI: 1.612–8.494) compared to those who exercised. Conclusion Exercise appears to have a protective role against all modes of obesity and thus possibly against obesity-related co-morbidities in the elderly.

Quantifying gender inequalities in obesity: findings from the Turkish population-based Balcova Heart Study

OBJECTIVES

Sparse evidence is available to explain obesity variations between genders in the Turkish population. To our knowledge, no previous study has analysed the magnitude of gender differences in obesity using common social determinants of health. We aimed to quantify gender inequalities in obesity in terms of education, employment status, occupation and perceived income in a Turkish population.

STUDY DESIGN

The study design used is a cross-sectional study.

METHODS

Population-based data from the Balcova Heart Study (n = 16,080) were analysed. Logistic regression models were used to calculate the crude and adjusted odds ratios (ORs) when comparing obesity prevalence in women vs men within each category of social determinants.

RESULTS

Women had a higher risk of being obese than men (adjusted OR [aOR] = 2.04 [95% confidence interval {CI}: 1.7-2.1]). Gender inequality in obesity decreased as the level of education increased, from 'primary school' (aOR = 2.5 [95% CI: 2.2-2.8]) to 'university' (aOR = 0.9 [95% CI: 0.6-1.1]). Women had a higher risk of obesity within the 'unemployed' category compared with men (aOR = 2.2 [95% CI: 1.6-3.0]). Gender inequality in obesity decreased with a higher perception of income, from 'low' (aOR = 2.1 [95% CI: 1.6-3.0]) to 'high' (aOR = 1.5 [95% CI: 1.2-2.0]).

CONCLUSIONS

These findings highlight the fact that gender inequalities in obesity are greatest within populations of low education, unemployment and lower perception of income. Reduced gender inequality in obesity prevalence was seen for the subpopulation with professional occupations, with women having decreased odds of obesity compared with men. Conversely, unemployed women had increased odds of obesity compared with unemployed men. Increasing the status of women should be prioritised in policies to tackle obesity in the Turkish population and in similar developing populations elsewhere.

Prevalence and predictors of overweight and obesity among women in the Gaza strip-Palestine: a cross-sectional study

BACKGROUND

The prevalence of overweight and obesity among women of childbearing age is considered a public health concern. Few studies have been conducted in the Gaza Strip to determine the magnitude of overweight and obesity. This study aimed to determine the prevalence of overweight and obesity along with their associated factors among women in the Gaza Strip.

METHODS

A cross-sectional study was conducted to recruit a total of 357 mothers aged 18-50 years. Interviews were carried out among mothers to collect sociodemographic information, nutritional information, and physical activity. Anthropometric measurements [height, weight and waist circumference (WC)] were conducted with the mothers. Body Mass Index (BMI) was computed to determine the prevalence of overweight and obesity. Multinomial logistic regression was used to examine the associated factors of overweight and obesity.

RESULTS

The combined prevalence of overweight and obesity among mothers was (64.1%). The results of multinomial logistic regression showed the risk of overweight and obesity increased with age, the highest risk being in mothers aged > 33.0 years (OR = 2.7, 95% CI: (1.06,6.86)), and (OR = 5.72, 95% CI: (2.07,15.78)), respectively, compared to mothers aged < 33.0 years. Moreover, mothers with medium and high educational levels had a slightly higher risk of obesity (OR = 0.31, 95% CI: (0.15,0.64)), and (OR = 0.32, 95% CI: (0.12,0.82)) respectively than mothers with low educational level. Household income was positively associated with overweight and obesity. Mothers exposed to higher monthly income were more likely to be overweight or obese (OR = 2.64, 95% CI: (1.20, 5.83)), and (OR = 3.06, 95% CI: (1.28,7.29)), respectively. Nutrition knowledge was significantly associated with a high prevalence of obesity (OR = 1.20, 95% CI: (1.03,1.38)).

CONCLUSIONS

This study showed a higher prevalence of overweight and obesity among Palestinian women than previous studies. Age, educational level, monthly income, and nutrition knowledge were associated with the prevalence of overweight and obesity, compared to other variables that were not associated with overweight and obesity such as location, work status, physical activity, and sitting hours. Urgent action is needed to tackle overweight and obesity among women. Effective intervention is required to increase nutrition knowledge among women to improve their eating behaviors.

Epidemiologic Profile of Overweight and Obesity in Abidjan, Ivory Coast: A Cross-Sectional Study

Background:

In sub-Saharan Africa, the prevalence of overweight and obesity is high, and it is estimated to increase within the next ten years. In Ivory Coast, the rise in and public health consequences of overweight and obese people are evident. Moreover, data concerning this status are scarce, old, local, and describe only a small sample of the population.

Objective:

This study has been conducted in order to describe the epidemiologic profile of overweight and obese people in Ivory Coast and identify the potential risk factors of obesity.

Methods:

From January 2014 to July 2017, 2,643 patients aged 17–70 years old from Abidjan of Ivory Coast were recruited. Statistical analysis was carried out using SPSS 20.0. Chi-square test and binary logistic regression analysis were used to identify risk factors for overweight and obesity.

Results:

Most of our patients were females (86.3%) with an estimated average age of 43.7 ± 12.19 years. Among 2,643 patients recruited in this study, 83.3% were obese and 87.2% were affected by central abdominal obesity. Binary logistic regression analysis identified seven factors significantly associated with overweight and obesity, including females (OR: 2.06; 95% CI [1.58–2.68]), >54 years old of age (OR: 3.71; 95% CI [1.84–7.50]), occupation of salesperson and traders (OR: 2.42; 95% CI [1.78–3.29]), ethnic group of North Mande ethnicity (OR: 1.47; 95% CI [1.07–2.02]), family history of obesity (OR: 1.96; 95% CI [1.46–2.63]), ≥150 minutes of sport practice (OR:0.72; 95% CI [0.55–0.96]), and parous females (OR: 1.63; 95% CI [1.11–2.38]).

Conclusions:

Overall, gender (female), older age, and occupation were associated with greater risks of overweight and obesity in patients. Ethnic group, pregnancy and family history of obesity posed a lower but significant risk for obesity. More sport practice played a protective role against the acquisition of overweight and obesity.

Overweight, underweight, and obesity among male long-distance professional drivers in Iran

OBJECTIVE

Long-distance professional drivers, as an occupational group, are hypothesized to have a higher risk of overweight and obesity. The aim of this study was to estimate the prevalence and risk factors of overweight, underweight, and obesity in long-distance professional drivers.

METHODS

A cross-sectional study was conducted on 36 625 male long-distance professional drivers age ≥20 years, from April 2013 to Sept. 2016. Drivers were interviewed and underwent clinical and laboratory examinations including measures of blood pressure (BP), blood tests, anthropometric data, and visual and hearing acuity. The mean (standard deviation [SD]) age of participants was 41.9 (10.2) years with a mean (SD) duration of a professional driving of 15.3 (9.6) years and mean (SD) body mass index (BMI) was 25.7 (4.0) kg/m2 .

RESULTS

The prevalence of overweight and obesity was 39.1% (95% confidence interval (CI) 38.6, 39.6) and 10.8% (95% CI 10.5, 11.1), respectively. A total percentage of 2.7 (95% CI 2.5, 2.9) were underweight. A total percentage of 10.6 had BMI 30-40 kg/m2 and 0.2% had BMI ≥40 kg/m2 . Using a stepwise binary logistic regression model for overweight, underweight, and obesity, age had a significant independent relationship with underweight, overweight, and obesity. Duration of work, BP, fasting plasma glucose, triglyceride, and cholesterol had significant independent positive association and smoking had a negative association with overweight/obesity when other covariates were considered.

CONCLUSIONS

These findings indicate that overweight and obesity are prevalent among long-distance professional drivers in Iran and appears to be similar to the general population.

Prevalence and Predictors of Obesity among 7- to 17-Year-Old Schoolchildren in Urban Arusha, Tanzania

BACKGROUND

Childhood obesity is currently increasing at an alarming rate worldwide. Childhood obesity research has not been reported in urban Arusha before. This is therefore the first study to investigate the prevalence and predictors of childhood obesity in urban Arusha.

METHODS

A cross-sectional study was conducted involving 451 schoolchildren. Overweight was defined to range from 85th to 94th BMI percentile for age and sex while obesity was defined as above 94th BMI percentile for age and sex. Chi-square test was used for comparison between child sex and sociobehaviors, and multiple logistic regression was used to determine the significant predictor factors at P values = 0.05.

RESULTS

The overall prevalence of overweight and obesity was 17.7% (80/451) with 12.6% (57/451) being obese and 5.1% (23/451) being overweight. Results from univariate logistic regression showed child sex, random sleeping time, and random eating habit were the significant predictor factors. However, when all the predictor factors were used in the final multiple logistic regression model, only random sleeping time and random eating habit of different food items irrespective of their nature were significant at P=0.000, AOR = 4.47, and 95% CI = 2.00-10.01, and P=0.012, AOR = 2.54, and 95% CI = 1.23-5.33, respectively.

CONCLUSIONS

The prevalence of obesity was as higher as twice the prevalence observed in other previous studies in Tanzania. Being a girl, random sleeping time and random eating habit were independent predictors. In addition to larger sample sizes, longitudinal studies are needed in order to track individuals and population level trends in BMI over time.

Application of the Marginal Beta-Binomial Model in Estimation the Overall Odds of Obesity Among Iranian Adults: Meta-Analysis Method

CONTEXT

To obtain accurate and reliable estimation of overall obesity odds ratio (OR) a statistical method is needed to be designed to account for heterogeneity among studies. The marginal beta-binomial model is a new method with attractive features that make it robust for meta-analysis.

OBJECTIVES

The aim of this study is the estimation of overall obesity OR among Iranian adults with particularly attention to age, sex, place of residence, and smoking status.

DATA SOURCES

We systematically reviewed all studies regarding obesity in Iranian adults in national and international journals that are published between 1990 and 2017, including PubMed, Scopus, SID, Google Scholar, Magiran, and IranMedex. The R software was used for data analysis and obtaining overall obesity OR using the marginal beta-binomial model.

RESULTS

A total of 18 studies, with a sample size of 258283, were included in our analysis. Results showed that increasing age, female sex, and residence in urban areas increases the odds of obesity. Using the age group 20 - 30 years as the reference, the overall obesity ORs for 30 - 40, 40 - 50, 50 - 60, and 60+ years were 2.13, 3.33, 3.15, and 2.33, respectively. The overall obesity OR for women was 2.35, compared with men. The estimated odds of obesity were 53% higher for urban adults. Smoking has a negative effect on obesity; the OR of obesity for smokers was 0.48 compared with non-smokers.

CONCLUSION

Consistent results in our research can be used as a basis to reinforce health programs for prevention and treatment of obesity in Iran.

The Investigation of Insulin Resistance in Two Groups of Epileptic Patients Treated with Sodium Valproate and Carbamazepine

BACKGROUND

Valproic acid (VPA) is a widely used broad-spectrum antiepileptic drug for therapy of generalized and focal epilepsies. Cross-sectional studies have suggested that valproate treatment may be associated with hyperinsulinemia. We decided to investigate hyperinsulinemia as a health-threatening side effect of VPA in Iranian epileptic patients.

MATERIALS AND METHODS

Body mass index (BMI), lipid profile, fasting serum insulin, fasting blood glucose (FBS), and homeostatic model assessment-insulin resistance (HOMA-IR) were measured in 30 VPA-treated epileptic patients and 30 controls (CBZ-treated). The Chi-square test, t-test, and Pearson correlation test were used.

RESULTS

BMI was higher in VPA group than in control group (25.7 ± 3.5 > 21.7 ± 4.1) (0.000 < 0.05). Prevalence of obesity was 16.6% in VPA group that was almost the same and even lower than general Iranian population. Serum triglyceride (TG) (150 ± 77.2) was higher than CBZ group (114 ± 35.2) (P = 0.023 < 0.05). However, serum high-density lipoprotein level was lower in VPA group than controls (45.2 ± 11.7 < 54.4 ± 13.9) (P = 0.008 < 0.05). Serum insulin, FBS, HOMA-IR, cholesterol, and low-density lipoprotein did not demonstrate statistically significant differences between the two groups (P > 0.05).

CONCLUSION

Despite the majority of previous studies that are against VPA and according to our study, VPA could be prescribed safely and it may not cause IR and its complications.

Urban-rural and geographic differences in overweight and obesity in four sub-Saharan African adult populations: a multi-country cross-sectional study

BACKGROUND

Overweight and obesity are on the rise in developing countries including sub-Saharan Africa. We undertook a four-country survey to show the collective burden of these health conditions as they occur currently in sub-Saharan Africa and to determine the differences between urban and rural populations and other socio-economic factors.

METHODS

Participants were nurses in two hospitals in Nigeria (200), school teachers in South Africa (489) and Tanzania (229), and village residents in one peri-urban (297) and one rural location in Uganda (200) who completed a standardised questionnaire. Their height and weight were measured and body mass index calculated. Factor analysis procedure (Principal component) was used to generate a wealth index. Univariate and multivariate analyses with binary logistic regression models were conducted to examine the associations between potential correlates and the prevalence of overweight and obesity with 95 % confidence intervals.

RESULTS

The prevalence of overweight and obese (combined) was 46 %, 48 %, 68 %, 75 % and 85 % in rural Uganda, peri-urban Uganda, Nigeria, Tanzania and South Africa (SA), respectively. Rural Uganda, Peri- urban Uganda, Nigeria, Tanzania and SA had obesity prevalence of 10 %, 14 %, 31 %, 40 % and 54 %, respectively (p < 0.001). Overall, prevalence of overweight was 374 (31 %) and obesity, 414 (34 %). Female sex was a predictor of overweight and obesity (combined) in peri-urban Uganda [AOR = 8.01; 95 % CI: 4.02, 15.96) and obesity in rural Uganda [AOR = 11.22; 95%CI: 2.27, 55.40), peri-urban Uganda [AOR = 27.80; 95 % CI: 7.13, 108.41) and SA [AOR = 2.17; 95 % CI: 1.19, 4.00). Increasing age was a predictor of BMI > =25 kg/m2 in Nigeria [Age > =45 - AOR = 9.11; 95 % CI: 1.72, 48.16] and SA [AOR = 6.22; 95 % CI: 2.75, 14.07], while marital status was predictor of BMI > =25 kg/m2 only in peri-urban Uganda. [Married - AOR = 4.49; 95 % CI: 1.74, 11.57]. Those in Nigeria [AOR = 2.56; 95 % CI: 1.45, 4.53], SA [AOR = 4.97; 95 % CI: 3.18, 7.78], and Tanzania [AOR = 2.68; 95 % CI: 1.60, 4.49] were more likely to have BMI > =25 kg/m2 compared with the rural and peri-urban sites.

CONCLUSION

The high prevalence of overweight and obesity in these sub-Saharan African countries and the differentials in prevalence and risk factors further highlights the need for urgent focused intervention to stem this trend, especially among women, professionals and urban dwellers.

Associations between behavioural risk factors and overweight and obesity among adults in population-based samples from 31 countries

OBJECTIVE

Concern about overweight and obesity is growing worldwide, and more research to examine behaviours associated with the risk for increased weight in adult populations is needed. The aim of this study was to estimate associations between behavioural risk factors and overweight and obesity among adults in nationally representative population samples from 20 countries in Europe, 8 countries in Asia, Australia, Chile and USA.

METHODS

This secondary analysis is based on the International Social Survey Program (ISSP), 2011-2013, Health and Health Care Module. In a cross-sectional population-based survey (N=48,741) (mean age 46.6 years, SD=17.4, age range 15-102 years) simple or multi-stage stratified random sampling was used, yielding representative samples of the adult population of respective countries. Body Mass Index was assessed by self-reported height and weight. Correlates were risk behaviours for chronic disease (smoking status, alcohol intake, consumption of fruits and vegetable (=FV), and physical activity).

RESULTS

Overall, for all 31 countries the prevalence of overweight or obesity was 44.1%, 31.7% overweight and 12.4% obese. In adjusted logistic regression models, among men and among women ex-smoking was positively associated with both overweight and obesity, while light or moderate smoking overall and among men were inversely related with obesity. Moderate alcohol use was positively associated with both overweight and obesity, while heavy alcohol use was negatively associated with overweight. The daily consumption of FV was found to be protective from both overweight and obesity, overall and for men but not for women. Physical activity was positively associated with overweight but not obesity.

CONCLUSIONS

Some risk behaviours for chronic disease appear to be associated with overweight and obesity among adults. Interventions targeting these risk behaviours may have the potential to reduce weight.

Age and gender differences in Framingham risk score and metabolic syndrome in psoriasis patients: A cross-sectional study in the Turkish population

Objective:

Psoriasis is associated with an increased frequency of cardiovascular risk factors. Metabolic syndrome (MS) and the Framingham risk score (FRS) are two different algorithms for evaluating cardiovascular risk. They include different features: waist circumference measurement is included in the MS criteria, whereas smoking, age, and gender are questioned in FRS. This study aimed to evaluate the frequency of MS and FRS in psoriasis patients compared with a control group and investigate the differences between MS and FRS.

Methods:

This was a cross-sectional study involving 300 psoriasis patients and 177 controls. MS, FRS, and disease severity were evaluated.

Results:

The frequency of MS was higher in females with psoriasis than in those in the control group (p=0.019). Females in the psoriasis group were more obese than those in the control group (p=0.036). FRS significantly differed between the patients and controls of age >60 years (p=0.006). The risk of hypertension in current and past smokers was higher in the psoriasis patients (OR=2.07 and 2.32–2.48, respectively) than in the control group. There was no statistically significant relationship among MS, FRS, and psoriasis severity (p>0.05).

Conclusion:

The results of this study support the evaluation of cardiovascular risk assessment in female psoriasis patients with MS and in male and elderly psoriasis patients with FRS.

Prevalence of gestational diabetes mellitus and associated risk factors in Turkish women: the Trabzon GDM Study

INTRODUCTION

The aim of this study was to investigate the prevalence of gestational diabetes mellitus (GDM) in Turkish pregnant women in the Trabzon Region and further to identify population-specific risk factors for GDM.

MATERIAL AND METHODS

In this prospective cross-sectional survey, universal screening for GDM was performed in 815 pregnant women. Screening was done with a 50-g oral glucose challenge test (GCT) with a 140 mg/dl cut-off point, then a diagnostic 100 g oral glucose tolerance test (OGTT) was performed according to Carpenter and Coustan (CC) criteria.

RESULTS

The GCT was positive in 182 (22.3%) cases. The OGTT was performed on the 182 screen-positive pregnant women. Thirty-five were diagnosed with GDM on the basis of their results for a prevalence of 4.3% (35/815). Of the pregnancies with negative GCT but having high risk factors for GDM (n = 31), 4 were diagnosed with GDM (0.5%). Prevalence of GDM was found to be 4.8% (n = 39) for all pregnant women. Gestational diabetes mellitus was positively associated with advanced maternal age (p < 0.001), prepregnancy body mass index (p < 0.001), cessation of cigarette smoking (p < 0.001), excessive weight gain during pregnancy (p = 0.003), previous history of GDM (p < 0.001), history of selected medical conditions (p = 0.018), family history of diabetes (FHD) (p < 0.001), and existence of at least one high risk factor for GDM (p < 0.001). In multiple logistic regression analysis, independent predictors for GDM were maternal age, cessation of cigarette smoking, increasing prepregnancy body mass index, weight gain of more than 8 kg during pregnancy, GDM history in previous pregnancies and a history of diabetes in first-degree relatives of pregnant women.

CONCLUSIONS

The prevalence of GDM in Trabzon province was found as moderate. Commonly recognized risk factors including older age, prepregnancy obesity, FHD and past history of GDM, are valid for our urban Turkish population. Also, excessive weight gain in pregnancy and cigarette cessation were observed to be nontradional risk factors of GDM. It was concluded that all pregnant women should be screened for GDM if prevalence was not low.

Prevalence of Obesity and Related Factors among Bouyei and Han Peoples in Guizhou Province, Southwest China

OBJECTIVE

To investigate the prevalence of general and abdominal obesity and associated factors in Bouyei and Han peoples.

DESIGN

A cross-sectional study was carried out in Guizhou province, southwest China in 2012, with multi-stage sampling to enroll 4551 participants aged 20 to 80 years. General and abdominal obesity were defined by World Health Organization (WHO) for Chinese. A design-based analysis was performed to evaluate prevalence of obesity and its related factors.

RESULTS

Bouyei people had a significantly lower prevalence of general obesity (4.8% vs. 10.9%, p < 0.05) and abdominal obesity (13.6% vs. 26.8%, p < 0.05) than that in Han people. Prevalence of obesity increased with age until middle-age period and declined thereafter. Men aged 40-49 years group and women aged 50-59 years group have the highest prevalence of general obesity. Prevalence of abdominal obesity was higher than that of general obesity. Middle-age, Higher income, Han people were significantly associated with an increased risk of General/abdominal obesity.

CONCLUSIONS

Bouyei people had a lower prevalence of general and abdominal obesity than the Han people. Etiological studies should be conducted to determine underlying genetic factors and dietary factors.

The health status of the elderly population of Iran in 2012

BACKGROUND

With advancing age comes dramatic increase in the incidence of chronic diseases, disabilities, and mental problems. This study was conducted to epidemiologically describe the health status of the elderly population of Iran.

MATERIAL AND METHODS

People aged ≥60 were selected. Mini-nutritional assessment, activity of daily living, geriatric depression scale questionnaires were administered. Physical diseases and risk factors were also investigated. For the purpose of this study, 1350 elderly individuals were randomly selected.

RESULTS

The mean age of sample was 69.1±7.3 and 65.9% were illiterate. From total, 727 (53.8%) had vision problems. The most common problem was cataracts with a prevalence of 305 (22.6%) patients who were either suffering from cataracts or had undergone a surgery for it. From 634 individuals who used dentures, 446 (70.3%) wore the same first denture for over 10 years, without being examined. 524 (38.8%) of our seniors spent their free time alone at home. 13.2% of women and 12.6% of men were dependent on others for at least one daily activity. In terms of nutrition, 70 (5.5%) of the elderly (46 women and 24 men) were severely malnourished with 554 (41.3%) (243 men and 311 women) at risk of malnutrition.

CONCLUSION

The health status of the elderly in Iran was similar to other countries in the world. However there continues to be room for improvement. Taking into account the rapidly aging population of Iran, health providers, and policy makers are required to take steps at a national level and direct more resources into supporting the elderly population.

Prevalence of Cardiovascular Disease and Associated Risk Factors among Adult Population in the Gulf Region: A Systematic Review

Background. CVD is a principal cause of mortality and disability globally.Objective. To analyse the epidemiological data on CHD, strokes, and the associated risk factors among adult population in the Gulf countries.Methods. A systematic review of published articles between 1990 and 2014 was conducted.Results. The analysis included 62 relevant studies. The prevalence of CHD was reported to be 5.5% in Saudi Arabia. The annual incidence of strokes ranged from 27.6 to 57 per 100 000 in the Gulf countries with ischaemic stroke being the most common subtype and hypertension and diabetes being the most common risk factors among stroke and ACS patients. The prevalence of overweight and obesity ranged from 31.2% to 43.3% and 22% to 34.1% in males and from 28% to 34.3% and 26.1% to 44% in females, respectively. In males, the prevalence of hypertension and diabetes ranged from 26.0% to 50.7% and 9.3% to 46.8%, respectively; in females these ranged from 20.9% to 57.2% and 6% to 53.2%, respectively. The prevalence of inactivity was from 24.3% to 93.9% and 56.7% to 98.1% in males and females, respectively. Relatively more males (13.4% to 37.4%) than females (0.5% to 20.7%) were current smokers. Available data indicate poor dietary habits with high consumption of snacks, fatty foods, sugar, and fast food.Conclusion. Effective preventative strategies and education programs are crucial in the Gulf region to reduce the risk of CVD mortality and morbidity in the coming years.

Metabolic syndrome in patients undergoing coronary angiography

INTRODUCTION

Metabolic Syndrome (MetS) is basically a cluster of cardiovascular risks that involve changes in metabolic and hemodynamic indicators; various organizations have defined it with small differences. Metabolic syndrome is a lethal endocrinopathy starting with insulin resistance and inviting a chain of systemic disorders such as abdominal obesity, glucose intolerance or diabetes mellitus (DM), dyslipidemia, hypertension (HT) and coronary artery disease (CAD).

MATERIAL AND METHODS

This prospective and descriptive study was conducted at the Cardiology Clinic of a Private Hospital in Osmaniye between January 2014 and May 2014. The study population included all patients who were administered a CA procedure at the Cardiology Clinic of Private New Life Hospital in Osmaniye in 2014.

RESULTS

The majority of the patients were male (63.3%), the mean age was 59.09±10.98, vast majority of them had social security (98.5%), 32.8% of them smoked, 7.2% had peripheral arterial disease (PAD), 52.5% were diagnosed with DM, 24.8% with HT, percutaneous transluminal coronary angioplasty (PTCA) or stent was administered to 40.3% of the patients who underwent CA and coronary artery bypass grafting (CABG) was decided for 15.5% of them. 41.8% of the patients met the MetS diagnosis criteria. The mean BMI was found to be 28.61±4.68, the mean FBS to be 143.20±74.83, the mean triglyceride value to be 168.73±96.94 and the mean HDL value to be 37.04±9.20. Although male gender came first among the patients who underwent CA, the prevalence of MetS did not show a statistically significant correlation with gender, mean age or smoking. The prevalence of HT, PAD and DM was significantly higher in the patients who met the MetS criteria. The mean values of FBS, HDL, CK-MB, triglyceride and cholesterol were also significantly higher in the patients who met the MetS criteria. As BMI increased, the rate at which MetS criteria are met also increased.

CONCLUSION

The objective is to prevent diabetes and cardiovascular diseases. Weight loss achieved with proper nutrition and an exercise program will have a reversing effect on all the disorders seen in metabolic syndrome.

Association of marital status and marital transition with metabolic syndrome: tehran lipid and glucose study

BACKGROUND

Most existing reports indicate that body weight gradually increases following marital status and thereby enhances health status and decreases mortality; however, the association between marital status and the metabolic syndrome (MetS) has not been thoroughly investigated in a longitudinal study.

OBJECTIVES

The aim of this study was to investigate the potential effects of marital status and marital transition on MetS during a 9.6-year follow-up in Tehran Lipid and Glucose Study.

PATIENTS AND METHODS

For this study, 5221 participants (2060 males and 3161 females), aged 15 to 90 years at baseline, were followed for a median of 9.6 years. Marital status was categorized as consistent marital status and marital transition. We measured MetS risk z score and its components and calculated their changes. Then the effects of marital status and marital transition on MetS risk z score and its components were assessed using multivariable linear regression.

RESULTS

In comparison to participants who were married, no significant changes in MetS risk z score was found in single participants. Employed females in the transition to married group had significant increase in MetS risk z score than single employed females. No significant changes in MetS risk z score were observed between widowed/divorced subjects and compared to consistently married subjects.

CONCLUSIONS

Marital status may affect MetS risk z score differently in both genders.

Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults

OBJECTIVE

To determine the best anthropometric measurement among waist: height ratio (WHtR), BMI, waist:hip ratio (WHR) and waist circumference (WC) associated with high CHD risk in adults and to define the optimal cut-off point for WHtR.

DESIGN

Population-based cross-sectional study.

SETTING

Balcova, Izmir, Turkey.

SUBJECTS

Individuals (n 10 878) who participated in the baseline survey of the Heart of Balcova Project. For each participant, 10-year coronary event risk (Framingham risk score) was calculated using data on age, sex, smoking status, blood pressure, serum lipids and diabetes status. Participants who had risk higher than 10 % were defined as 'medium or high risk'.

RESULTS

Among the participants, 67·7% were female, 38·2% were obese, 24·5% had high blood pressure, 9·2% had diabetes, 1·5% had undiagnosed diabetes (≥126 mg/dl), 22·0% had high total cholesterol and 45·9% had low HDL-cholesterol. According to Framingham risk score, 32·7% of them had a risk score higher than 10 %. Those who had medium or high risk had significantly higher mean BMI, WHtR, WHR and WC compared with those at low risk. According to receiver-operating characteristic curves, WHtR was the best and BMI was the worst indicator of CHD risk for both sexes. For both men and women, 0·55 was the optimal cut-off point for WHtR for CHD risk.

CONCLUSIONS

BMI should not be used alone for evaluating obesity when estimating cardiometabolic risks. WHtR was found to be a successful measurement for determining cardiovascular risks. A cut-off point of '0·5' can be used for categorizing WHtR in order to target people at high CHD risk for preventive actions.

Alarming predictions for obesity and non-communicable diseases in the Middle East

OBJECTIVE

The present study aimed to model obesity trends and future obesity-related disease for nine countries in the Middle East; in addition, to explore how hypothetical reductions in population obesity levels could ameliorate anticipated disease burdens.

DESIGN

A regression analysis of cross-sectional data v. BMI showed age- and sex-specific BMI trends, which fed into a micro simulation with a million Monte Carlo trials for each country. We also examined two alternative scenarios where population BMI was reduced by 1 % and 5 %.

SETTING

Statistical modelling of obesity trends was carried out in nine Middle East countries (Bahrain, Egypt, Iran, Jordan, Kuwait, Lebanon, Oman, Saudi Arabia and Turkey).

SUBJECTS

BMI data along with disease incidence, mortality and survival data from national and sub-national data sets were used for the modelling process.

RESULTS

High rates of overweight and obesity increased in both men and women in most countries. The burden of incident type 2 diabetes, CHD and stroke would be moderated with even small reductions in obesity levels.

CONCLUSIONS

Obesity is a growing problem in the Middle East which requires government action on the primary prevention of obesity. The present results are important for policy makers to know the effectiveness of obesity interventions on future disease burden.

Prevalence of dyslipidemia and associated risk factors in Turkish adults

BACKGROUND AND OBJECTIVES

Dyslipidemia is a modifiable major risk factor for coronary heart disease. The objective of this study was to determine the prevalence of dyslipidemia among Turkish adults and its associations with other cardiovascular risk factors.

METHODS

This study included 4309 people ages 20 to 83 years old from 7 provinces of Turkey. People from the city centers, districts, and villages were selected by a stratified sampling method. Weight, height, and waist and hip circumferences were measured. Blood samples were obtained to determine glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG); these parameters were measured with an autoanalyzer. Dyslipidemia was defined according to National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria.

RESULTS

Of 4309 subjects, 43% had high TC, 41.5% had low HDL-C, 36.2% had high LDL-C, and 35.7% had high TG. Of these measures, at least 1 lipid abnormality was diagnosed in 78.7% of men and 80.4% of women. The prevalence of high TC, LDL-C, and TG increased with age, with the highest prevalence in the 46-to-65-year-old age group. The mean values (mg/dL) of TC, LDL-C, HDL-C, and TG were 194.2 ± 47.7, 117.7 ± 41.1, 50.3 ± 16.3, and 145.4 ± 96.3, respectively. Dyslipidemia was positively associated with age, body mass index, waist circumference, fasting blood glucose, and blood pressure, and negatively associated with altitude.

CONCLUSIONS

The high prevalence of dyslipidemia in Turkey is an important public health problem. Enhanced public health preventive measures should be implemented to better diagnose and comprehensively treat dyslipidemia in Turkey.

Obesity prevalence, waist-to-height ratio and associated factors in adult Turkish males

SUMMARY

This study was performed to determine the obesity prevalence and associated risk factors in aged 20 and over years old males living in 11 towns in Kayseri, Turkey between July and August 2007. 1530 men were recruited, of which 6 were excluded because of incomplete information. Data were collected by a questionnaire. Body weight, height, waist and hip circumferences were measured. Body mass index (BMI) of 25.0-29.9 kg/m(2) was accepted as overweight and above 30 kg/m(2) as obesity, waist-to-hip ratio (WHpR) > 1.0 and waist-to-height ratio (WHtR) ≥ 0.5 were accepted as abdominal obesity. Chi-square and logistic regression tests were performed. According to BMI, overweight and obesity prevalences were 39.6% and 16.9%, respectively. Obesity prevalence was 29.9% (50-59 years) according to WHpR, 50.4% (60-69 years) according to waist circumference (WC) and 24.8% (40-49 years) according to WHtR. The logistic regression analysis revealed age of 60-69 years, being a graduate from university, being widowed and having positive familial history of obesity as risk factors of having BMI ≥ 25 kg/m(2). In conclusion, obesity is a serious issue for the males residing in Kayseri and among the anthropometric measurements WHtR is a simple and effective index to identify health related risks even in male of younger ages.:

Educational attainment and obesity: a systematic review

Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese and Spanish were included. This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables and/or attempted to assess causality through the use of quasi-experimental designs. Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention.

Overweight and obesity and related factors in urban Iranian population aged between 20 to 84 years

BACKGROUND

Obesity is one of the most common health problems in the world and is assuming epidemic proportions in both developed and developing countries.

AIM

The present study aimed to provide population-based data on the prevalence of obesity and estimation the risk of some of demographic factors associated with obesity.

SUBJECTS AND METHODS

From May 2007 through December 2008, we conducted a community-based cross-sectional survey on 3,000 males and females (age ≥ 20 years) in Tehran province. Respondents were asked to give their height and weight in the questionnaire. Body mass index (BMI) is recognized as the measure of overall obesity and calculated as body weight divided by the square body height in meters (kg/m(2)).

RESULTS

The overall prevalence of overweight and obesity was 34.1% (924/2708) and 15.4% (417/2708). The combined prevalence of both overweight and obesity was 51.2% (1387/2708) in males and 57.5% (1557/2708) in females. The mean (SD) BMI for the total population studied was 26.14 (4.71) and it was higher in women than in men (P < 0.001). The overall prevalence of overweight and obesity was 39.5% (376/952) and 11.7% (111/952) in men and 36.9% (548/1458) and 20.6% (306/1458) in women. The multivariate-adjusted odds ratios of obesity showed that higher ages, females, married and low educated subjects had more chance to being obese.

CONCLUSION

This population-based cross-sectional survey indicates that the prevalence of overweight and obesity are moderately high in the general Iranian population and must be considered as a significant public health problem at national level especially among women.

Metabolic syndrome prevalence according to ATP III and IDF criteria and related factors in Turkish adults

INTRODUCTION

The aim of this study is to investigate the prevalence of metabolic syndrome (MS) and its components according to Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) criteria and the risk factors affecting MS. Metabolic syndrome prevalence was evaluated according to certain quintet age groups, altitude, location and demographic features.

MATERIAL AND METHODS

This study was a cross-sectional survey conducted in 24 provinces from the 7 regions of Turkey. A total of 4309 adults from 7 regions participated in the study (1947 males, 45.2%).

RESULTS

The mean age of participants was 47 ±14 years. Metabolic syndrome prevalence was found as 36.6% according to ATP III and 44.0% according to IDF. The MS rate was found to be higher in females compared to males in both groups (p < 0.01). According to both criteria, MS prevalence was found to be higher in subjects who lived in coastal regions when evaluated according to altitude and in subjects who lived in district centers when evaluated according to location. The MS risk is 1.62-fold higher in females compared to males. Metabolic syndrome risk increases as age increases and is highest in the 61-65 age group. Metabolic syndrome risk increases 2.75-fold in the overweight compared to normal weighing subjects and 7.80-fold in the obese.

CONCLUSIONS

Metabolic syndrome prevalence was found to be high in Turkey according to both criteria. Metabolic syndrome prevalence increases as age and body mass index (BMI) increase. Age, female gender and obesity are independent risk factors for MS development.

Epidemiology of general obesity, abdominal obesity and related risk factors in urban adults from 33 communities of Northeast China: the CHPSNE study

BACKGROUND

Obesity increases the risk of many diseases. However, there has been little literature about the epidemiology of obesity classified by body mass index (BMI) or waist (abdominal obesity) among urban Chinese adults. This study is to fill the gap by assessing the prevalence of obesity and associated risk factors among urban Chinese adults.

METHODS

A representative sample of 25,196 urban adults aged 18 to 74 years in Northeast China was selected and measurements of height, weight and waist circumference (WC) were taken from 2009-2010. Definitions of overweight and obesity by the World Health Organization (WHO) were used.

RESULTS

The overall prevalence rates of general obesity and overweight classified by BMI were 15.0% (15.7% for men and 14.3% for women, p<0.01) and 19.2% (20.8% for men and 17.7% for women, p<0.01), respectively, and the overall prevalence rate of abdominal obesity was 37.6% (31.1% for men and women 43.9% for women, p<0.01). Multivariable logistic regression showed that the elderly and those who had a history of parental obesity, alcohol drinking, or former cigarette smoking were at high risk of obesity classified by BMI or WC, whereas those with a higher level of education, higher family income, or a healthy and balanced diet were at low risk of obesity. Analysis stratified by gender showed that men with a higher level education level, a white-collar job, a cadre job, or higher family income were the high risk group, and women with a higher level of education or higher family income were the low risk group.

CONCLUSIONS

Obesity and overweight have become epidemic in urban populations in China; associations of risk factors with obesity differ between men and women.

CVD and obesity in transitional Syria: a perspective from the Middle East

Purpose

Syria is caught in the middle of a disruptive nutritional transition. Its healthcare system is distracted by challenges and successes in other areas while neglecting to address the onslaught of Syria’s cardiovascular disease (CVD) epidemic. Despite the official viewpoint touting improvement in health indicators, current trends jeopardize population health, and several surveys in the Syrian population signal the epidemic spreading far and wide. The goal is to counteract the indifference towards obesity as a threat to Syrian’s health, as the country is slowly becoming a leader in CVD mortality globally.

Methods

PubMed, World Health Organization, and official government websites were searched for primary surveys in Syria related to CVD morbidity, mortality, and risk factors. Inclusion criteria ensured that results maximized relevance while producing comparable studies. Statistical analysis was applied to detect the most common risk factor and significant differences in risk factor prevalence and CVD rates.

Results

Obesity remained the prevailing CVD risk factor except in older Syrian men, where smoking and hypertension were more common. CVD mortality was more common in males due to coronary disease, while stroke dominated female mortality. The young workforce is especially impacted, with 50% of CVD mortality occurring before age 65 years and an 81% prevalence of obesity in women over 45 years.

Conclusion

Syria can overcome its slow response to the CVD epidemic and curb further deterioration by reducing obesity and, thus, inheritance and clustering of risk factors. This can be achieved via multilayered awareness and intensive parental and familial involvement. Extinguishing the CVD epidemic is readily achievable as demonstrated in other countries.

Cut off values of waist circumference and associated cardiovascular risk in Egyptians

BACKGROUND

Recent guidelines stressed the need to adopt different values of waist circumference (WC) measurements to define abdominal obesity in different ethnic groups. The aim of this study is to identify WC cutoff points in normotensive and hypertensive subjects which are diagnostic of abdominal obesity in a Middle Eastern population and the prevalence of abdominal obesity in a nationwide sample.

METHODS

Data were collected during phase-2 of the Egyptians National Hypertension Project survey. Blood pressure, anthropometric measurements and laboratory studies were performed according to a standardized protocol by trained personnel. To derive the cutoff points for WC, we applied the factor analysis on CV risk factors: diabetes mellitus, decrease in HDL-C and increase in LDL-C, triglycerides and left ventricular mass index by echocardiography.

RESULTS

The sample included 2313 individuals above the age of 25 years. WC values (mean ± SD) were 88 ± 14 cm and 95 ± 14 cm for normotensive (NT) and hypertensive (HT) men respectively, and 89.6 ± 14.7 cm and 95.7 ± 15.9 cm for NT and HT women respectively. Applying factor analysis, the weighted average cutoff points were 93.5 cm for both NT and HT men and 91.5 and 92.5 cm for NT and HT women respectively. Based on these thresholds, the prevalence of abdominal obesity was 48% in men and 51.5% in women.

CONCLUSION

This is the first report of specific abdominal obesity cutoff points in a Middle Eastern country. The cutoff points were different from the Europid standards. There is a high prevalence rate of abdominal obesity among Egyptians which is associated with increased prevalence of cardiometabolic risk factors.

Prevalence of obesity and associated risk factors among adults in Kinondoni municipal district, Dar es Salaam Tanzania

BACKGROUND

Obesity is on the rise worldwide, not sparing developing countries. Both demographic and socio-economic factors play parts in obesity causation. Few surveys have been conducted in Tanzania to determine the magnitude of obesity and its association with these risk factors. This study aimed at determining the prevalence of obesity and its associated risk factors among adults aged 18 - 65 years in Kinondoni municipality, Dar es Salaam, Tanzania from April 2007 to April 2008.

METHODS

Random sampling of households was performed. Interviews and anthropometric measurement were carried out to eligible and consenting members of the selected households. Obesity was defined using Body Mass Index (BMI).

RESULTS

Out of 1249 subjects recruited, 814 (65.2%) were females. The overall prevalence of obesity was 19.2% (240/1249). However, obesity was significantly more prevalent in women (24.7%) than men (9%), p < 0.001, among respondents with high socio-economic status (29.2%) as compared to those with medium (14.3%) and low socio-economic status (11.3%), p value for trend < 0.001, and among respondents with light intensity activities (26.0%), p value for trend < 0.001.

CONCLUSION

This study revealed a higher prevalence of obesity among Kinondoni residents than previously reported in other parts of the country. Independent predictors of obesity in the population studied were increasing age, marriage and cohabitation, high SES, female sex and less vigorous physical activities.