Abstract
BackgroundOverweight, obesity, and related chronic diseases are becoming serious public health concerns in rural areas of India. Compounded with the existing issue of underweight, such concerns expose the double burden of disease and may put stress on rural healthcare. The purpose of this article was to present the prevalence and factors associated with underweight, overweight, and obesity in an area of rural south India.MethodsDuring 2013 and 2014, a random sample of adults aged 20–80 years were selected for participation in a cross-sectional study that collected information on diet (using a food frequency questionnaire), physical activity (using the Global Physical Activity Questionnaire), socioeconomic position (using a wealth index), rurality (using the MSU rurality index), education, and a variety of descriptive factors. BMI was measured using standard techniques. Using a multivariate linear regression analysis and multivariate logistic regression analyses, we examined associations between BMI, overweight, obesity, and underweight, and all potential risk factors included in the survey.ResultsAge and sex-adjusted prevalence of overweight, obesity class I, and obesity class II were 14.9, 16.1, and 3.3 % respectively. Prevalence of underweight was 22.7 %. The following variables were associated with higher BMI and/or increased odds of overweight, obesity class I, and/or obesity class II: Low physical activity, high wealth index, no livestock, low animal fat consumption, high n-6 polyunsaturated fat consumption, television ownership, time spent watching television, low rurality index, and high caste. The following variables were associated with increased odds of underweight: low wealth index, high rurality index, and low intake of n-6 PUFAs.ConclusionUnderweight, overweight, and obesity are prevalent in rural regions of southern India, indicating a village-level dual burden. A variety of variables are associated with these conditions, including physical activity, socioeconomic position, rurality, television use, and diet. To address the both underweight and obesity, policymakers must simultaneously focus on encouraging positive behaviour through education and addressing society-level risk factors that inhibit individuals from achieving optimal health.
Highlights
Overweight, obesity, and related chronic diseases are becoming serious public health concerns in rural areas of India
Since there were no significant associations between sex and outcome variables, we present the results for men and women combined
Of the 812 individuals recruited for the study, 753 (92.7 %) participated (341 men and 412 women), of whom 752 (92.6 %) completed an food frequency questionnaire (FFQ) and 745 (91.7 %) consented to anthropometric measurements
Summary
Overweight, obesity, and related chronic diseases are becoming serious public health concerns in rural areas of India. Overweight and obesity are associated with increased risk of non-communicable diseases such as metabolic syndrome, high cholesterol, type 2 diabetes mellitus, high blood pressure, and cardiovascular disease; conditions that are already serious public health concerns in rural and urban India alike [5, 7]. Razak et al [8] found that average fasting glucose levels, LDL cholesterol concentrations, and blood pressure found in Europeans at a BMI of 30 kg/m2 could be found in Asian Indians at a much lower BMI Such studies indicate that Asian Indians are more susceptible to the negative health consequences of overweight and obesity. While a number of studies have examined associations between dietary and lifestyle factors and prevalence of underweight, overweight, and obesity in the US [10, 11] and EU [12, 13], little research has examined similar associations in India, and even fewer in rural India [5]
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