Abstract P086: Urbanization and Geographic Variation of Overweight/Obesity in India: the 2005-06 India Demographic Health Survey

Abstract

Background: Obesity and overweight are considered to be the fifth leading risk factor for deaths worldwide. In India, the prevalence of overweight and obesity is growing, along with an ongoing nutritional transition as more people adopt urban lifestyles or migrate to urban areas for economic opportunities. Objective: This study examined the geographic variation of overweight/obesity in India, as well as a wide range of potential risk factors and correlates of overweight-obesity, including socio-demographics and level of urbanization. Methods: We conducted cross-sectional analyses of the 2005-06 India Demographic Health Survey (DHS), using anthropometric data from 161,050 individuals to determine prevalence of obesity and overweight, and demographics with regards to urban or rural settings. We then used a multivariate logistic regression model to determine the odds of combined overweight and obesity in urban settings as adjusted for age, sex, education level, standard of living, religion and zone for 111,730 individuals (after excluding underweight subjects [BMI < 18.5] and missing cases) for India overall, and then for each zone separately. Results: The overall prevalence of combined overweight/obesity (BMI ≥ 25) was 15.5%. The odds of overweight/obesity in urban settings after adjusting for confounders as age, sex, education level, standard of living, religion and zone were nearly twice that of rural settings (OR 1.95, 95% CI: 1.88-2.02). We also found significant associations between overweight/obesity and higher education (OR 2.11 95% CI: 2.62-2.87), and higher standard of living (OR 6.71 95% CI: 6.25-7.21). Individuals from the southern zone were most likely to be overweight/obese when compared to the northern zone in multivariate analyses (OR 1.44, 95% CI: 1.36-1.52). While urban settings were consistently and significantly associated with higher risks of overweight/obesity across all zones, the risk was highest for individuals from the eastern zone (OR 2.57, 95% CI: 2.30-2.87). Conclusions: The results demonstrate significant associations between overweight/obesity and urbanization in India, with high risk estimates for overweight/obesity in urban settings even for the least urban zones. Socioeconomic prowess and the resulting nutritional transition in India make a compelling case for administrative policy on nutrition and healthy lifestyles to avert future burden of non-communicable diseases associated with overweight/obesity.