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Chakrabarty M, Let S. Spatial clustering of overweight/obesity among women in India: Insights from the latest National Family Health Survey. PLoS One 2024; 19:e0305205. [PMID: 39046947 PMCID: PMC11268665 DOI: 10.1371/journal.pone.0305205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/26/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Overweight/obesity has become global health concern with increasing prevalence. This study examined district-level disparities and spatial clustering of overweight/obesity among women of reproductive age (WRA) in India using the latest National Family Health Survey-5 (2019-2021) data. METHOD Information of 623,656 women aged 15 to 49 from the NFHS-5 (2019-2021) were analysed in this study. The outcome variable was BMI as classified by the world health organisation (WHO). Utilising Global Moran's I, Anselin's Local Moran's I, and spatial regression models spatial clustering and associated factors were analysed. RESULT The study found that 24% (95% CI: 23.8-24.3) of WRA in India were overweight/obese in 2019-21. The prevalence was greatest in Punjab (41%) and lowest in Meghalaya (11%). Additionally, the Global Moran's I value for the outcome variable was 0.73, indicating a positive spatial autocorrelation in the overweight/obesity. Districts of Tamil Nadu, Andhra Pradesh, Karnataka, Kerala, Telangana, Punjab, Himachal Pradesh, Jammu & Kashmir, Haryana, and Delhi were hotspots of overweight/obesity. Several factors of overweight/obesity among WRA were identified, including place of residence (β: 0.034, p: 0.011), parity (β: 0.322, p: 0.002), social group (β: -0.031, p: 0.016), religion (β: -0.044, p: <0.001), household wealth status (β: 0.184, p: <0.001), mass-media exposure (β: 0.056, p: 0.031), and diabetes (β: 0.680, p: <0.001). CONCLUSION The study emphasizes the importance of targeted interventions and region-specific strategies, while also stressing the need to address associated factors to develop effective public health initiatives aimed at reducing overweight/obesity prevalence among WRA in India.
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Affiliation(s)
| | - Subhojit Let
- Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Were JM, Kyeremeh E, Annor BOH, Campbell MK, Stranges S. Rural-Urban Divide in the Prevalence and Correlates of Overweight and Obesity Among Women of Reproductive Age in Nigeria: A Multilevel Analysis of Repeated Cross-Sectional Data. Ecol Food Nutr 2024:1-30. [PMID: 38944041 DOI: 10.1080/03670244.2024.2373227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
We examined rural and urban prevalence and correlates of overweight/obesity among women of reproductive age using survey data from Nigeria. Overweight and obesity prevalence increased from 16.1% and 6.1% in 2008 to 18.2% and 10.0% in 2018, while underweight prevalence consistently averaged at 12%. Regardless of the residential setting, age, marital status, education, occupation, wealth, and year were associated with higher risk of overweight/obesity, whereas breastfeeding showed a protective effect. Unique risk factors for overweight/obesity in urban areas were higher parity and female-headed households, while ethnicity, media exposure, and state of residence were unique risk factors in rural areas.
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Affiliation(s)
- Jason Mulimba Were
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Emmanuel Kyeremeh
- Department of Geography and Environmental studies, Toronto Metropolitan University, Ontario, Canada
| | | | - M Karen Campbell
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Department of Pediatrics, Western University, London, Ontario, Canada
- Department of Obstetrics and Gynecology, Western University, London, Ontario, Canada
- Division of Children's Health and Therapeutics, Children's Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Departments of Family Medicine and Medicine, Western University, London, Ontario, Canada
- The Africa Institute, Western University, London, Ontario, Canada
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Saijo Y, Yoshioka E, Sato Y, Kunori Y, Kanaya T, Nakanishi K, Kato Y, Nagaya K, Takahashi S, Ito Y, Iwata H, Yamaguchi T, Miyashita C, Itoh S, Kishi R. Maternal pre-pregnancy body mass index and related factors: A cross-sectional analysis from the Japan Environment and Children's Study. PLoS One 2024; 19:e0304844. [PMID: 38833493 PMCID: PMC11149848 DOI: 10.1371/journal.pone.0304844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/21/2024] [Indexed: 06/06/2024] Open
Abstract
Socioeconomic status and smoking are reportedly associated with underweight and obesity; however, their associations among pregnant women are unknown. This study aimed to investigate whether socioeconomic factors, namely educational attainment, household income, marital status, and employment status, were associated with pre-pregnancy body mass index (BMI) categories, including severe-moderate underweight (BMI ≤ 16.9 kg/m2), mild underweight (BMI, 17.0-18.4 kg/m2), overweight (BMI, 25.0-29.9 kg/m2), and obese (BMI ≥ 30.0 kg/m2) among Japanese pregnant women using data from the Japan Environment and Children's Study (JECS). In total, pregnant women were included 96,751. Age- and parity-adjusted multivariable multinomial logistic regression analyses assessed socioeconomic factors and smoking associations with falling within abnormal BMI categories (normal BMI as the reference group). Lower education and lower household were associated with overweight and obesity, and, especially, lowest education and household income had relatively higher point estimate relative ratios (RRs) of 3.97 and 2.84, respectively. Regarding the risks for underweight, however, only junior high school education had a significantly higher RR for severely to moderately underweight. Regarding occupational status, homemakers or the unemployed had a higher RR for severe-moderate underweight, overweight, and obesity. Unmarried, divorced, or bereaved women had significantly higher RRs for mildly underweight status. Quitting smoking early in pregnancy/still smoking had higher RRs for all four not having normal BMI outcomes; however, quitting smoking before pregnancy had a higher RR only for obese individuals. Lower educational attainment and smoking are essential intervention targets for obesity and severe-moderate underweight prevention in younger women. Lower household income is also a necessary target for obesity.
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Affiliation(s)
- Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Eiji Yoshioka
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Yukihiro Sato
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Yuki Kunori
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Tomoko Kanaya
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Kentaro Nakanishi
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yasuhito Kato
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Ken Nagaya
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan
| | - Satoru Takahashi
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yoshiya Ito
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Hokkaido, Japan
| | - Hiroyoshi Iwata
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
| | - Takeshi Yamaguchi
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
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Gupta RD, Frank HA, Akonde M, Mazumder A, Siddika N, Apu EH, Chakraborty PA. Rural-Urban Differences in Prevalence and Associated Factors of Underweight and Overweight/Obesity among Bangladeshi Adults: Evidence from Bangladesh Demographic and Health Survey 2017-2018. EPIDEMIOLOGIA 2023; 4:505-520. [PMID: 38131674 PMCID: PMC10742748 DOI: 10.3390/epidemiologia4040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this study was to identify the differences in prevalence and associated factors of underweight and overweight/obesity among Bangladeshi adults (≥18 years) by analyzing the cross-sectional Bangladesh Demographic and Health Survey 2017-2018 data. Multilevel multivariable logistic regression was applied to identify the factors associated with underweight and overweight/obesity in urban and rural areas. The prevalence of underweight was 12.24% and 19.34% in urban and rural areas, respectively. The prevalence of overweight/obesity was 50.23% and 35.96%, respectively, in urban and rural areas. In the final multivariable analysis in both urban and rural areas, 30-49 years of age, female sex, being educated up to college or higher level, living in the wealthiest household, and being currently married or being separated/divorced/widowed had higher odds of being overweight/obese compared to other categories. Residence in the Mymensingh and Sylhet region was associated with decreased odds of overweight/obesity in urban and rural areas. On the other hand, being educated up to college or higher level, living in the wealthiest household, and being married were associated with reduced odds of being underweight in both areas. These high-risk groups should be brought under targeted health promotion programs to curb malnutrition.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Hanna A. Frank
- School of Population and Public Health, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Ananna Mazumder
- Jahurul Islam Medical College (JIMC), Bajitpur, Kishoreganj 2336, Bangladesh
| | - Nazeeba Siddika
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
| | - Ehsanul Hoque Apu
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
- Department of Biomedical Engineering, Institute of Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI 48824, USA
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI 48105, USA
- Department of Biomedical Science, College of Dental Medicine, Lincoln Memorial University, Knoxville, TN 37923, USA
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
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Singh A, Let S, Tiwari S, Chakrabarty M. Spatiotemporal variations and determinants of overweight/obesity among women of reproductive age in urban India during 2005-2021. BMC Public Health 2023; 23:1933. [PMID: 37798718 PMCID: PMC10557305 DOI: 10.1186/s12889-023-16842-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND India has witnessed rapid urbanization in recent decades, leading to a worrisome surge in non-communicable diseases, particularly overweight/obesity, which now present a critical public health concern. Therefore, this study seeks to examine spatiotemporal variations and determinants of overweight/obesity among women of reproductive age (WRA) in urban India and its states during 2005-2021. METHODS The study used 44,882, 171,443, and 135,272 WRA aged 15-49 from National Family Health Survey (NFHS)-3 (2005-06), NFHS-4 (2015-16), and NFHS-5 (2019-21), respectively. The outcome variable was overweight/obesity, defined as a Body Mass Index (BMI) of ≥ 25 kg/m2. Chi-squared test and multivariable logistic regression were used to identify the determinants of overweight/obesity. RESULTS Overweight/obesity prevalence among WRA in urban India has risen significantly, from 23% in 2005-06 to 33% in 2019-21. This increase is particularly pronounced among SC/ST women and women with lower educational levels. During the study period, overweight/obesity rates in different states exhibited varying increases, ranging from 3 percentage points (pp) in Rajasthan to 22 pp in Odisha. Certain southern (e.g., Tamil Nadu and Andhra Pradesh) and northeastern states saw a significant 15 pp or more increase. In contrast, several northern, central, and eastern states (e.g., Punjab, Haryana, Rajasthan, Madhya Pradesh, Chhattisgarh, Jharkhand, West Bengal) experienced relatively smaller increases ranging from 5 to 8 pp. As of 2019-21, two regions exhibited high prevalence rates of overweight/obesity, exceeding 35%: the southern region (Tamil Nadu, Andhra Pradesh, Kerala, and Karnataka) and the northern region (Punjab, Himachal Pradesh, Uttarakhand, and Haryana). In contrast, the Empowered Action Group states had relatively lower rates (25% or less) of overweight/obesity. Regression results showed that older women [AOR: 5.98, 95% CI: 5.71-6.27], those from the richest quintile [AOR: 4.23, 95% CI: 3.95-4.54], those living in south India [AOR: 1.77, 95% CI: 1.72-1.82], and those having diabetes [AOR: 1.92, 95% CI: 1.83-2.02] were more likely to be overweight/obese. CONCLUSION Considering the significant increase in overweight/obesity among urban WRA in India, along with substantial disparities across states and socioeconomic groups, it is imperative for the government to formulate state-specific strategies and policies based on determinants to effectively combat overweight/obesity.
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Affiliation(s)
- Aditya Singh
- Department of Geography, Banaras Hindu University, Varanasi, Uttar Pradesh, India
- Girl Innovation, Research, and Learning (GIRL) Center, Population Council, New York, USA
| | - Subhojit Let
- Department of Geography, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Seema Tiwari
- Geography Section, Mahila Maha Vidyalaya, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
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Alem AZ, Yeshaw Y, Liyew AM, Tessema ZT, Worku MG, Tesema GA, Alamneh TS, Teshale AB, Chilot D, Ayalew HG. Double burden of malnutrition and its associated factors among women in low and middle income countries: findings from 52 nationally representative data. BMC Public Health 2023; 23:1479. [PMID: 37537530 PMCID: PMC10398981 DOI: 10.1186/s12889-023-16045-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 06/02/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Double burden of malnutrition (DBM) is an emerging global public health problem. The United Nations member states adopted eradicating all forms of malnutrition as an integral component of the global agenda. However, there is evidence of a high burden of undernutrition among women and rising rates of overweight and obesity, especially in low and middle income countries (LMICs). Therefore, this study aimed to investigate the prevalence and associated factors of underweight, overweight, and obesity among women of reproductive age in LMICs. METHODS Data for the study were drawn from a recent 52 Demographic and Health Surveys (DHS) conducted in LMICS. We included a sample of 1,099,187 women of reproductive age. A multilevel multinomial logistic regression model was used to identify factors associated with DBM. Adjusted relative risk ratio (RRR) with a 95% Confidence Interval (CI) was reported to show an association. RESULTS The prevalence of underweight, overweight, and obesity in LMICs among women of reproductive age was 15.2% (95% CI: 15.1-15.3), 19.0% (95% CI: 18.9- 19.1), and 9.1% (95% CI: 9.0-9.2), respectively. This study found that women aged 24-34 years, aged ≥ 35 years, with primary, secondary, and above educational level, from wealthy households, using modern contraceptives, exposed to media (radio and television), and with high parity (more than one birth) were more likely to have overweight and obesity and less likely to have underweight. Moreover, the risk of having obesity (RRR = 0.59; 95% CI = 0.58-0.60 and overweight (RRR = 0.78; 95% CI = 0.77-0.79) were lower among rural women, while the risk of being underweight was (RRR = 1.13; 95% CI = 1.11-1.15) higher among rural women compared to urban women. CONCLUSION The prevalence of underweight, overweight, and obesity was high among women of reproductive age in LMICs. Underweight, overweight, and obesity are influenced by sociodemographic, socioeconomic, and behavioral-related factors. This study shows that, in order to achieve Sustainable Development Goal 2, a multifaceted intervention approach should be considered to prevent both forms of malnutrition in women of reproductive age. This can be achieved by raising awareness and promoting healthy behaviors such as healthy eating and physical activity, especially among educated women, women from wealthy households, and women exposed to the media.
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Affiliation(s)
- Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Hiwotie Getaneh Ayalew
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Ikoona EN, Toure MA, Njenga A, Namulemo L, Kaluya R, Kamara K, Oyat FWD, Aloyo J, Kitara DL. Prevalence and factors associated with underweight among 15-49-year-old women in Sierra Leone: a secondary data analysis of Sierra Leone demographic health survey of 2019. BMC Womens Health 2023; 23:192. [PMID: 37085835 PMCID: PMC10122406 DOI: 10.1186/s12905-023-02358-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Women are at higher risks of being underweight than men due to biological, socio-economic, and cultural factors. Underweight women have high risks of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with being underweight among women of reproductive age (15-49 years) in Sierra Leone. METHODS We used Sierra Leone Demographic and Health Survey (2019-SLDHS) data of 7,514 women aged 15 to 49 years, excluding pregnant, post-natal, lactating, and post-menopausal women. A multistage stratified sampling approach was used to select study participants, and data was collected using validated questionnaires. A multivariable logistic regression analysis was used to determine factors associated with underweight among 15-49-year-old women in Sierra Leone. Ethical approval for the study was obtained. RESULTS The prevalence of underweight was 6.7% (502/7,514). Underweight was likely among age-group of 15-24 years, AOR = 2.50,95%CI:2.39-2.60;p < 0.001 compared to 25-34 year age-group and likely among women with parity of one to four, AOR = 1.48,95%CI:1.08-2.03;p = 0.015 compared to women who never gave birth. Underweight was unlikely among women who did not listen to radios AOR = 0.67,95%CI:0.55-0.83;p < 0.001 compared to those who did; women from the north AOR = 0.73,95%CI:0.56-0.96;p = 0.026 compared to the east, and not married women AOR = 0.59,95%CI:0.47-0.76;p < 0.001 compared to married. All household wealth indices were not significantly associated with underweight. CONCLUSION The prevalence of underweight among women in the reproductive age (15-49 years) in Sierra Leone was 6.7% and it is lower compared to global and most sub-Saharan African data. Factors associated with underweight were 15-24-year age-group, and parity of one to four. Being underweight was unlikely among women who did not listen to radios, women from the north and not married. All household wealth indices were not significantly associated with underweight. Even though household wealth indices were not significantly associated with being underweight, most underweight women 68.7% (345/502) were in the poorest, poorer, and middle household wealth indices. The need to address socio-economic determinants of underweight among women (aged 15-49 years) due to household poverty is a priority in Sierra Leone.
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Affiliation(s)
| | | | - Amon Njenga
- ICAP at Columbia University, Freetown, Sierra Leone
| | - Lucy Namulemo
- Foothills Community Based Interventions, Monticello, KY, USA
- Lindsey Wilson College, School of Professional Counseling, Kentucky, USA
- Uganda Counseling and Support Services, Kampala, Uganda
| | - Ronald Kaluya
- Uganda Counseling and Support Services, Kampala, Uganda
| | - Kassim Kamara
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Free Town, Sierra Leone
| | | | - Judith Aloyo
- Uganda Medical Association (UMA), UMA-Acholi Branch, Gulu City, Uganda
- Rhites-N, Acholi, Gulu City, Uganda
| | - David Lagoro Kitara
- Uganda Medical Association (UMA), UMA-Acholi Branch, Gulu City, Uganda.
- Department of Surgery, Harvard University and Faculty at Gulu University, Faculty of Medicine, P.0. Box 166, Gulu City, Uganda.
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Azanaw MM, Zewde EA, Gebremariam AD, Dagnaw FT, Asnakew DT, Chanie ES, Feleke DG, Tiruneh SA. Spatiotemporal distribution and determinants of overweight or obesity among urban women in Ethiopia: a multivariate decomposition analysis. BMC Womens Health 2022; 22:494. [PMID: 36471341 PMCID: PMC9724442 DOI: 10.1186/s12905-022-02102-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Overweight /obesity is a global public health concern. It is higher among women than men in most continents of the world. This study aimed to determine the spatiotemporal distribution and determinants of changes in overweight/obesity over time among urban women in Ethiopia. METHODS We used data from three consecutive Demographic and Health Surveys in Ethiopia (2005, 2011, and 2016). The total weighted sample of 1112 in 2005, 3569 in 2011, and 3071 in 2016 urban women were included in the analysis. The primary outcome measure of this study was the spatiotemporal distribution and trends over time in overweight/obesity. Factors contributing to change in overweight/obesity were examined using a logit-based multivariate decomposition analysis. RESULTS Overweight/obesity increased from 14.2% in 2005 to 21% in 2016. Approximately 61.3% of the overall increase in overweight/obesity among urban women was due to the difference in coefficient (difference in the effect of characteristics) across the surveys. Changes in the composition of women aged 25-49 years (β = 0.012, 95% CI 0.008, 0.015), married women (β = 0.010, 95% CI 0.006, 0.014), women with formal education (primary: β = 0.007, 95% CI 0.003, 0.011, higher education: β = 0.014, 95% CI 0.006, 0.022), women with formal employment (β = 0.006, 95% CI 0.001, 0.011), and women with informal employment (β = - 0.002, 95% CI - 0.003, - 0.0004) were factors contributing to the change in overweight/obesity from 2005 to 2016. The risk difference (RD) in women's overweight/obesity significantly varied across regions in urban Ethiopia. Furthermore, a high proportion of overweight/obesity was found mainly in Tigray, Oromia, Amhara, and Addis Ababa. CONCLUSIONS The rate of overweight/obesity among women in urban Ethiopia has shown a significant increase over the last 11 years. This rate change was due to changes in the composition of women's age, educational status, marital status, and employment status. Therefore, program interventions should be targeted at older (> 25 years), educated, married, Addis Ababa residents, and formally employed women.
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Affiliation(s)
- Melkalem Mamuye Azanaw
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Edgeit Abebe Zewde
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Fentaw Teshome Dagnaw
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dessalegn Tesfa Asnakew
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ermias Sisay Chanie
- grid.510430.3Department of Pediatrics Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dejen Getaneh Feleke
- grid.510430.3Department of Pediatrics Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sofonyas Abebaw Tiruneh
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Cazzaniga E, Orlando A, Terenzio A, Suardi C, Mognetti C, Gennaro F, Antolini L, Palestini P. Health Status and Nutritional Habits in Maldives Pediatric Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15728. [PMID: 36497802 PMCID: PMC9740220 DOI: 10.3390/ijerph192315728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Chronic noncommunicable diseases (NCDs) have become the major cause of morbidity and mortality in the Maldives, triggered by the nutrition transition to a "Western diet" that dramatically increases the prevalence of excess weight and hypertension. Our study aimed to evaluate dietary habits, blood pressure (BP) and body mass index in Maghoodoo Public School's students. A sample of 145 students (72 males and 73 females, age 9.37 ± 2.97 years) was enrolled. Factors causing excess weight were investigated through descriptive statistics. The relationship between blood pressure percentiles and possible influencing factors was investigated by a linear regression model.. Excess weight was present in 15.07% and 12.5% females and males, respectively. 15.18% of the subjects had elevated BP, with a significant difference according to gender detected only in the PAS z-score. Eating habits were investigated through a parent-filled questionnaire; 70.15% of the students consumed less than two portions of fruit per day, with a significant difference between gender (84.06% and 55.38% for boys and girls, respectively, p < 0.0001) and 71.64% ate less than two servings of vegetables per day. An alarming finding emerged for sweet snacks (30.6% of the students consumed 2-3 servings per day) and sugary drinks (2-3 servings per day for 32.84% of students) consumption. Our findings suggest that excess weight and hypertension in this population could be due to energy-rich, packaged-foods consumption. A nutrition education approach might thus help to reduce cardiovascular risk.
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Affiliation(s)
- Emanuela Cazzaniga
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
- Bicocca Center of Science and Technology for Food, University of Milano-Bicocca, Piazza della Scienza, 2, 20126 Milano, Italy
| | - Antonina Orlando
- Cardiologic Unit, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy
| | - Annalisa Terenzio
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
| | - Carlotta Suardi
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
| | - Chiara Mognetti
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
| | - Francesca Gennaro
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
- Department of Experimental Oncology, Istituto Europeo di Oncologia (IEO), European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20133 Milano, Italy
| | - Laura Antolini
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
| | - Paola Palestini
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
- Bicocca Center of Science and Technology for Food, University of Milano-Bicocca, Piazza della Scienza, 2, 20126 Milano, Italy
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Singh R, Nyamasege CK, Hawks SR, Wagatsuma Y. Health-Related Lifestyles in Relation to Body Mass Index Among Young and Middle-Aged Women in Japan. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:887-894. [PMID: 36479374 PMCID: PMC9712048 DOI: 10.1089/whr.2022.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Being underweight, overweight, or obese can lead to adverse health effects. Hence, it is important to understand the specific factors that change the burden of underweight and overweight to target appropriate disease control strategies. This study was designed to examine the prevalence and factors associated with underweight and overweight among young and middle-aged women in Japan. MATERIALS AND METHODS A cross-sectional study was conducted among women aged 20-59 years who participated in health checkups at a regional health care center in 2018 and 2019 (N = 1722). The assessments included anthropometric, blood pressure measurements, and a standardized self-administered questionnaire. Multivariable logistic regression analysis assessed lifestyle factors associated with body mass index for underweight <18.5 kg/m2) and overweight/obesity (25.0 kg/m2 and above). RESULTS The prevalence of underweight and overweight/obesity were 12.3%, and 22.5%, respectively. No lifestyle factors were found to be significantly associated with being underweight. Having dinner within 2 hours before bed was positively associated with being overweight/obese [adjusted odds ratio (AOR): 1.448, 95% confidence interval (CI): 1.014-2.068]. Women who gained 10 kg since their 20s were more likely to fall into overweight/obesity category (AOR: 9.674, 95% CI: 1.014-2.068). Women who were using a lipid-lowering medication (AOR: 3.150, CI: 1.892-5.246) were associated with three times higher risk of being overweight/obese. Hypertension and dyslipidemia were significantly associated with overweight/obesity (AOR: 3.094, 95% CI: 2.201-4.351 and AOR: 2.498, 95% CI: 1.831-3.409, respectively). CONCLUSION One in five middle-aged women was overweight or obese, whereas one in eight was underweight. In relation to the prevention of overweight/obesity, specific health promotion messages regarding eating timing should be developed.
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Affiliation(s)
- Rupa Singh
- Department of Clinical Trials and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.,Address correspondence to: Rupa Singh, MPH, Department of Clinical Trials and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Medical Building, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Carolyn K. Nyamasege
- Department of Clinical Trials and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Steven R. Hawks
- Kinesiology and Health Science, Utah State University, Logan, Utah, USA
| | - Yukiko Wagatsuma
- Department of Clinical Trials and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Rezapour M, Ferraro FR, Alsubaiei S. Behavioral and emotional adaptations of obese and underweight students in response to the COVID-19 pandemic. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2022; 9:326. [PMID: 36164459 PMCID: PMC9491673 DOI: 10.1057/s41599-022-01334-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 09/02/2022] [Indexed: 06/06/2023]
Abstract
Previous studies have investigated the effects of COVID-19 on the general population of college students. However, research evaluating the complex behavioral and psychological impact of the pandemic on both obese and underweight students is currently limited. We used data from a survey conducted from March to April 2020 across 2534 students enrolled in seven US universities. We examined whether the associations between taking various behaviors and being obese and underweight students are unidimensional, or varies based on various negative emotions, and their sociodemographic characteristics. Also, we checked whether emotions of obese and underweight groups are impaired, which consequently might impact taking various cautionary behaviors. The results highlight complex relationships between being obese and underweight students and other considered variables. For instance, despite the associated risk, it was found that obese students are associated with less fear, guilt and irritability due to the pandemic. However, those associations vary based on factors such as level of educations. In addition, while obese students are less likely to avoid a large group of people, the impact changes based on gender. Lack of precautions and emotions is despite the increased risk of hospitalization and death associated with obese and underweight groups. Finally, it was found that there are negative and stable associations between higher social class, income, and the lower likelihood of being obese or underweight. Significant differences and similarities were also found across factors to obese and underweight students.
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Affiliation(s)
| | - F. Richard Ferraro
- Department of Psychology, University of North Dakota, Grand Forks, ND 58201 USA
| | - Sabrina Alsubaiei
- Department of Psychology, University of North Dakota, Grand Forks, ND 58201 USA
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Gupta A, Kollimarla M, Reddy B V, Noorani Shaik Y, Kakkar R, Aravindakshan R. Exploring Unknown Predictors of Maternal Anemia Among Tribal Lactating Mothers, Andhra Pradesh, India: A Prospective Cohort Study. Int J Womens Health 2022; 14:1219-1236. [PMID: 36092126 PMCID: PMC9451507 DOI: 10.2147/ijwh.s380159] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/25/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Anemia is a serious public health issue in India, especially among women, adolescent girls, and young children. Tribal people reside mostly in remote underserved regions with little or no basic civic amenities which makes them a highly vulnerable group of Indians. The study aimed to identify unknown risk factors for anemia among tribal lactating mothers. Methodology It was a mixed method prospective cohort study for 10 months carried out among 340 scheduled tribes (ST) mothers in 10 clusters in Guntur district, Andhra Pradesh, India. Data collection using a questionnaire, 24 hours dietary recall, anthropometric measurement, and hemoglobin estimation was done. Weekly local recipe talk in the mother’s kitchen, informal group discussions, was conducted for 12 weeks after baseline data collection. The audio and video tapes of the weekly local recipe talk in the mothers kitchen were transcribed verbatim and then translated into English. The individual responses were grouped as barriers related to acceptability, availability, accessibility, use and utilization, appropriateness, and nutrition environment. Results A total of 340 mothers were enrolled initially of which 315 mothers were studied in an end-line survey with an attrition rate of 7.3%. Over 80% mothers belonged to Yerukula, Yenadis, Lambadi/Sugali tribes, respectively. A total of 345 weekly local mother kitchen recipe talks were conducted in 10 clusters. In the present study, only few mothers mentioned food accessibility and availability issues. Surprisingly, lack of skill to cook the commonly consumed local food item among Indian mothers were recorded. Lack of time for cooking, lack of knowledge of nutritious benefits of food, and use of ready to eat food were other important key findings. Conclusion The study documents initiation of transition of the tribal lactating mothers towards urbanization. The lack of knowledge of cooking, coupled with lifestyles of urban areas exposes the early aged, poor, low literate mothers to the trap of anemia.
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Affiliation(s)
- Arti Gupta
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
- Correspondence: Arti Gupta, Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India, Tel +91-9013902976, Email
| | - Mounika Kollimarla
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - Venkatashiva Reddy B
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | | | - Rakesh Kakkar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Rajeev Aravindakshan
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
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Gupta RD, Haider SS, Eusufzai SZ, Hoque Apu E, Siddika N. Differences in Prevalence and Associated Factors of Underweight and Overweight/Obesity among Bangladeshi Adults by Gender: Analysis of a Nationally Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710698. [PMID: 36078414 PMCID: PMC9517755 DOI: 10.3390/ijerph191710698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 05/23/2023]
Abstract
The objective of this study was to find the differences in prevalence and associated factors of underweight and overweight/obesity among Bangladeshi adults by gender, using the nationally representative Bangladesh Demographic and Health Survey 2017-2018 data. To identify the factors associated with underweight and overweight/obesity in both genders, multilevel multivariable logistic regression was conducted. The prevalence of underweight was 19.79% and 15.49% among males and females, respectively. The prevalence of overweight/obesity was 32.67% and 45.60% among males and females, respectively. Among both genders, participants with the highest likelihood of overweight/obesity were aged 30-49 years and 50-69 years, had the highest educational attainment up to primary and secondary level, resided in a household that belonged to the middle, richer, or richest wealth quintiles, and were currently married. On the other hand, among both genders, increased educational attainment and wealth index were inversely associated with being underweight. Health promotion programs in Bangladesh should focus on these high-risk groups to address the burden of underweight and overweight/obesity.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Shams Shabab Haider
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Sumaiya Zabin Eusufzai
- Department of Biostatistics, School of Dental Sciences, University Sains Malaysia, Kota Bharu 16150, Malaysia
| | - Ehsanul Hoque Apu
- Department of Biomedical Engineering, Institute of Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI 48824, USA
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Nazeeba Siddika
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
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Schubert J, Timmesfeld N, Noever K, Behnam S, Vinturache A, Arabin B. Risk Factors for Maternal Body Mass Index and Gestational Weight Gain in Twin Pregnancies. Geburtshilfe Frauenheilkd 2022; 82:859-867. [PMID: 35967740 PMCID: PMC9365473 DOI: 10.1055/a-1839-5643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/27/2022] [Indexed: 11/01/2022] Open
Abstract
Abstract
Objective This retrospective cohort study analyzes risk factors for abnormal pre-pregnancy body mass index and abnormal gestational weight gain in twin pregnancies.
Methods Data from 10 603/13 682 twin pregnancies were analyzed using uni- and multivariable logistic regression models to determine risk factors for abnormal body mass index and
weight gain in pregnancy.
Results Multiparity was associated with pre-existing obesity in twin pregnancies (aOR: 3.78, 95% CI: 2.71 – 5.27). Working in academic or leadership positions (aOR: 0.57, 95% CI:
0.45 – 0.72) and advanced maternal age (aOR: 0.96, 95% CI: 0.95 – 0.98) were negatively associated with maternal obesity. Advanced maternal age was associated with a lower risk for maternal
underweight (aOR: 0.95, 95% CI: 0.92 – 0.99). Unexpectedly, advanced maternal age (aOR: 0.98, 95% CI: 0.96 – 0.99) and multiparity (aOR: 0.6, 95% CI: 0.41 – 0.88) were also associated with
lower risks for high gestational weight gain. Pre-existing maternal underweight (aOR: 1.55, 95% CI: 1.07 – 2.24), overweight (aOR: 1.61, 95% CI: 1.39 – 1.86), obesity (aOR: 3.09, 95% CI:
2.62 – 3.65) and multiparity (aOR: 1.64, 95% CI: 1.23 – 2.18) were all associated with low weight gain. Women working as employees (aOR: 0.85, 95% CI: 0.73 – 0.98) or in academic or
leadership positions were less likely to have a low gestational weight gain (aOR: 0.77, 95% CI: 0.64 – 0.93).
Conclusion Risk factors for abnormal body mass index and gestational weight gain specified for twin pregnancies are relevant to identify pregnancies with increased risks for poor
maternal or neonatal outcome and to improve their counselling. Only then, targeted interventional studies in twin pregnancies which are desperately needed can be performed.
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Affiliation(s)
- Julia Schubert
- Clara Angela Foundation, Witten and Berlin, Germany
- Phillips-University Marburg, Marburg, Germany
| | - Nina Timmesfeld
- Dep. of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Bochum, Germany
| | | | | | - Angela Vinturache
- Clara Angela Foundation, Witten and Berlin, Germany
- Department of Obstetrics & Gynecology, University of Alberta, Department of Neuroscience, University of Lethbridge, Alberta, Canada
| | - Birgit Arabin
- Clara Angela Foundation, Witten and Berlin, Germany
- Dep. of Obstetrics, Charité University Medicine, Berlin, Germany
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Regional education and wealth-related inequalities in malnutrition among women in Bangladesh. Public Health Nutr 2022; 25:1639-1657. [PMID: 34482847 PMCID: PMC9991694 DOI: 10.1017/s1368980021003840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES This paper examines the associations of socio-economic and demographic correlates with malnutrition among women and investigates education and wealth-related inequalities in malnutrition among women by region. DESIGN We utilise a two-level mixed-effects logistic regression model to evaluate the associations and employ the concentration, Wagstaff and Erreygers's correction indices to measure socio-economic inequalities in malnutrition among women. SETTING Bangladesh Demographic and Health Survey data. PARTICIPANTS Non-pregnant women aged 15-49 years. RESULTS We find evidence of a significant cluster effect in the data. Women's age, marital status, total children ever born, education level, husband's/partner's education level, residence and wealth index appear to be significantly associated with women underweight and overweight/obesity status. Underweight status is higher among less-educated women and women from poor households, whereas overweight/obesity is more concentrated among higher educated women and women from wealthy households. The southwestern region of the country demonstrates lower education and wealth-related inequalities in malnutrition among women. In contrast, the central and the northeastern areas apparently experience the highest education and wealth-related inequalities in malnutrition among women. The regional differences in predicted probabilities of being underweight shrink at higher education level and the richest quintile, whereas the differences in overweight/obese diminish at the primary education level and lower quintile households. CONCLUSIONS Our findings strengthen the evidence base for effective regional policy interventions to mitigate education and wealth-related inequalities in malnutrition among women. There is a need for developing regional awareness programmes and establishing regional monitoring cells to ensure proper health and nutrition facilities in underprivileged regions.
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Ferdausi F, Al-Zubayer MA, Keramat SA, Ahammed B. Prevalence and associated factors of underweight and overweight/obesity among reproductive-aged women: A pooled analysis of data from South Asian countries (Bangladesh, Maldives, Nepal and Pakistan). Diabetes Metab Syndr 2022; 16:102428. [PMID: 35219260 DOI: 10.1016/j.dsx.2022.102428] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIMS Underweight and overweight/obesity is a critical public health problem among women in South Asian countries. This study aimed to find the prevalence of underweight and overweight/obesity and discover its associated factors among women of reproductive age in four South Asian countries. METHODS Population-representative cross-sectional latest Demographic and Health Survey data from four South Asian countries, considering Bangladesh (2017-18), Maldives (2016-17), Nepal (2016), and Pakistan (2017-18), were pooled for this study. To investigate the factors related with underweight and overweight/obesity in women, a multivariate multinomial logistic regression model was deployed. RESULTS The overall prevalence of underweight and overweight/obesity among reproductive-age women in four South Asian countries was 11.8% and 36.3%, respectively. According to adjusted multivariate multinomial logistic regression analysis, women who lived in Pakistan, were older, had a better education, were from the wealthiest home, were currently in union and had media exposure had a considerably decreased probability of being underweight. In contrast, families with a large number of members had a considerably increased risk of becoming underweight. Additionally, women from the Maldives, older age, secondary education, a higher number of children, women from the richest household, currently in the union, the family had media exposure, and pregnant women have been found significantly positively associated with overweight/obesity. However, Nepalese women, large family members, rural residence, and work involvement were significantly negatively associated with overweight/obesity. CONCLUSION The problem of being underweight and overweight/obesity still exists in South Asian countries. Focusing on women's age, education, wealth index, and media exposure, different public health intervention approaches are imperative to reduce unhealthy weight conditions.
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Affiliation(s)
- Farzana Ferdausi
- Ministry of Health and Family Welfare, Government of the People's Republic of Bangladesh, Bangladesh
| | - Md Akib Al-Zubayer
- Statistics Discipline, Science, Engineering and Technology (SET) School, Khulna University, Khulna, 9208, Bangladesh
| | - Syed Afroz Keramat
- Economics Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Benojir Ahammed
- Statistics Discipline, Science, Engineering and Technology (SET) School, Khulna University, Khulna, 9208, Bangladesh.
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Chakraborty PA, Talukder A, Haider SS, Gupta RD. Prevalence and factors associated with underweight, overweight and obesity among 15-49-year-old men and women in Timor-Leste. PLoS One 2022; 17:e0262999. [PMID: 35143506 PMCID: PMC8830684 DOI: 10.1371/journal.pone.0262999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 01/10/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Underweight and overweight both have a long-lasting significant effect on human health at the individual and population levels. However, in the context of Timor-Leste, a country that achieved independence around two decades ago, there is a severe scarcity of evidence regarding the underweight and obesity burden. We conducted this study to find out the prevalence of underweight, overweight and obesity and their associated factors. METHODS This study used the nationally representative data of Timor-Leste Demographic Health Survey 2016 data. We conducted descriptive analysis followed by multivariable logistic regression analysis to find out the prevalence and investigate the associated factors. Both crude and adjusted odds ratio of covariates were reported with 95% confidence interval (CI). RESULTS This study analyzed the data from a weighted sample of 16,488 Timorese aged 15-49 years. The prevalence of normal weight, underweight, and overweight or obesity were found to be 55.2% (95% CI: 54.2%-56.2%), 25.5% (95% CI: 24.4%-26.7%), and 19.3% (95% CI: 18.3%-20.3%), respectively. For underweight, age, sex, type of settlement (urban/rural), township, and wealth, marital, and educational status were found to have a statistically significant relationship (p < 0.05) with Body Mass Index(BMI). After adjustment for the covariates in the logistic regression model age, sex, township, and wealth and marital status were found to be statistically significant correlates (p < .05) of underweight. For overweight and obesity, all the background characteristics included in this study (i.e, age, sex, type of settlement, township, and wealth, marital, and educational status) were found to be statistically significant correlates, after adjustment for the covariates. CONCLUSION This study concludes that Timor-Leste has a significant underweight and overweight burden which needs to be addressed through appropriate interventions. Further studies are also warranted to delve deeper into the complex interplay of factors associated with underweight and overweight.
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Affiliation(s)
- Promit Ananyo Chakraborty
- Department of Public Health, North South University (NSU), Dhaka, Bangladesh
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Animesh Talukder
- Center for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Mohakhali, Dhaka, Bangladesh
| | - Shams Shabab Haider
- Center for Science of Implementation & Scale Up, BRAC James P Grant School of Public Health, BRAC University, Mohakhali, Dhaka, Bangladesh
| | - Rajat Das Gupta
- Center for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Mohakhali, Dhaka, Bangladesh
- Center for Science of Implementation & Scale Up, BRAC James P Grant School of Public Health, BRAC University, Mohakhali, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
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Akokuwebe ME, Idemudia ES. Multilevel Analysis of Urban-Rural Variations of Body Weights and Individual-Level Factors among Women of Childbearing Age in Nigeria and South Africa: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:125. [PMID: 35010382 PMCID: PMC8750190 DOI: 10.3390/ijerph19010125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/13/2022]
Abstract
Background: An unhealthy body weight is an adverse effect of malnutrition associated with morbidity among women of childbearing age. While there is increasing attention being paid to the body weights of children and adolescents in Nigeria and South Africa, a major surge of unhealthy body weight in women has received less attention in both countries despite its predominance. The purpose of this study was to explore the prevalence of body weights (underweight, normal, overweight, and obese) and individual-level factors among women of childbearing age by urban-rural variations in Nigeria and South Africa. Methods: This study used the 2018 Nigeria Demographic Health Survey data (n = 41,821) and 2016 South Africa Demographic Health Survey (n = 8514). Bivariate, multilevel, and intracluster correlation coefficient analyses were used to determine individual-level factors associated with body weights across urban-rural variations. Results: The prevalence of being overweight or obese among women was 28.2% and 44.9%, respectively, in South Africa and 20.2% and 11.4% in Nigeria. A majority, 6.8%, of underweight women were rural residents in Nigeria compared to 0.8% in South Africa. The odds of being underweight were higher among women in Nigeria who were unemployed, with regional differences and according to breastfeeding status, while higher odds of being underweight were found among women from poorer households, with differences between provinces and according to cigarette smoking status in South Africa. On the other hand, significant odds of being overweight or obese among women in both Nigeria and South Africa were associated with increasing age, higher education, higher wealth index, weight above average, and traditional/modern contraceptive use. Unhealthy body weights were higher among women in clustering areas in Nigeria who were underweight (intracluster correlation coefficient (ICC = 0.0127), overweight (ICC = 0.0289), and obese (ICC = 0.1040). Similarly, women of childbearing age in clustering areas in South Africa had a lower risk of experiencing underweight (ICC = 0.0102), overweight (ICC = 0.0127), and obesity (ICC = 0.0819). Conclusions: These findings offer a deeper understanding of the close connection between body weights variations and individual factors. Addressing unhealthy body weights among women of childbearing age in Nigeria and South Africa is important in preventing disease burdens associated with body weights in promoting Sustainable Development Goal 3. Strategies for developing preventive sensitization interventions are imperative to extend the perspectives of the clustering effect of body weights on a country level when establishing social and behavioral modifications for body weight concerns in both countries.
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Kamruzzaman M, Rahman SA, Akter S, Shushmita H, Ali MY, Billah MA, Kamal MS, Elahi MT, Paul DK. The anthropometric assessment of body composition and nutritional status in children aged 2-15 years: A cross-sectional study from three districts in Bangladesh. PLoS One 2021; 16:e0257055. [PMID: 34499671 PMCID: PMC8428712 DOI: 10.1371/journal.pone.0257055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background Early life nutrition plays a critical role in the development of better health and nutrition in adulthood. However, assessing the nutritional status of Bangladeshi children and adolescents through measurement of body composition using skinfold thickness is barely studied. The current study aims to determine children’s body composition and nutritional status, and contributing factors among children aged 2 to 15 years in the northern part of Bangladesh. Methods This is a descriptive cross-sectional study done in Bangladesh. Anthropometric methods, including multiple skinfold thickness and basic anthropometric and socio-demographic characteristics, were used. Body composition was calculated from multiple skinfold thicknesses using the standard regression equation. Nutritional status was measured using Z score according to WHO 2007 reference standard. A total of 330 children from Naogaon, Bogra and Kurigram districts in Bangladesh were examined from April 2019 to September 2019. Results The Nutritional status of 2–15 years old child is exceedingly poor in the northern part of Bangladesh. Fat mass and fat-free mass were higher among children from Kurigram district than from Bogra and Naogaon district. Body fat percentages and arm fat area were greater among female children than males. The overall prevalence of stunting, underweight and wasting was around 25%, 32% and 29%, respectively, and the rate was higher among girls and children aged 2–5 years. The average SD score for weight-for-age, height-for-age, and BMI-for-age was -1.295, -0.937 and -1.009. The median weight-for-age and height-for-age Z scores of boys and girls were below the WHO reference percentile rank. Girls were twice (OR:1.951, CI:1.150–3.331) as likely to suffer from being underweight than boys. Children who don’t practice handwashing are three times (OR:3.531, CI:1.657–7.525) more likely to be underweight. Children become underweight and stunted when their family income is not sufficient to maintain their nutritional requirements. Conclusions The children of the three northern districts had a poor nutritional status, and family income was the potential contributing factor. Therefore, interventions like the promotion of income-generating activities and integrated approaches to ensuring food diversification could be an option to address the nutritional problem of children of the three northern districts of Bangladesh.
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Affiliation(s)
- Md. Kamruzzaman
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
- * E-mail: ,
| | - Shah Arafat Rahman
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
| | - Sharmin Akter
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
| | - Humaria Shushmita
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
| | - Md. Yunus Ali
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
| | - Md Adnan Billah
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
| | - Md. Sadat Kamal
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
| | - M. Toufiq Elahi
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
| | - Dipak Kumar Paul
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
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Kamal SMM. Individual- and community-level factors associated with underweight and overweight among women of reproductive age in Bangladesh: a multilevel analysis. J Biosoc Sci 2021; 54:1-22. [PMID: 33998419 DOI: 10.1017/s0021932021000195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The co-existence of under- and overweight at population level around the globe is well documented. However, this has yet to be explored using suitable statistical techniques in the context of Bangladesh. This study aimed to examine the prevalence and risk factors for being underweight and overweight or obese compared with normal weight in ever-married non-pregnant women aged 15-49 years in Bangladesh using data from the most recent Bangladesh Demographic and Health Survey conducted in 2014. Multilevel multinomial logistic regression (MLMLR) and quantile regression models were fitted to examine the associations of socioeconomic and individual-, household- and community-level factors on the nutritional status of women as measured by BMI. Overall, the prevalences of underweight, normal weight, overweight and obese women were 19%, 58%, 19% and 4%, respectively, in 2014. The MLMLR analysis revealed that women of young age, widowed/divorced/separated, having a larger family size and children aged ≤5 years in the household, currently amenorrhoeic and members of non-government organizations were at significantly increased risk of being underweight; those of older age, having higher parity, more educated, frequently watched TV and non-poor were more likely to be overweight or obese relative to normal BMI. Women from more affluent communities and urban areas were more likely to be overweight or obese relative to normal BMI than their counterparts from less-affluent and rural communities. Women's nutritional status was found to be heterogeneous across the regions of the country. The findings indicate that, along with individual-level factors, community-level characteristics are also important in explaining women's BMI in Bangladesh. The issue of under- and overweight or obesity among women in Bangladesh requires the immediate adoption of a public health policy for its mitigation. When developing intervention programmes, important determinants and uniform development of regions should be taken into consideration to combat the dual burden of under- and overweight among women in Bangladesh.
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