Longitudinal multilevel analysis of correlative factors of abdominal obesity among Chinese reproductive women

Abstract

To longitudinally analyze the associations between physical activity, sedentary time and dietary intake levels with waist circumference and abdominal obesity among Chinese reproductive women. In the five rounds of "China health and nutrition survey" in 2004, 2006, 2009, 2011 and 2015, 2951 women aged 15-49 years old who participated in at least two rounds of surveys were selected as research objects. Physical activity and sedentary time data were collected by questionnaire survey, and food consumption data were collected by 24-hour retrospective method for 3 consecutive days. Analysis of variance was used to analyze the time difference of continuous variables. Chi-square test was used to analyze the differences in time distribution of classified variables. Linear multilevel model was used to analyze the relationships between waist circumference and different levels of physical activity, sedentary time and dietary intake. Logistic multilevel model was used to analyze the risk of abdominal obesity with different levels of physical activity, sedentary time and dietary intake. By incorporating physical activity, sedentary time and dietary intake levels into the multilevel model respectively, compared with the low level of leisure-time physical activity, the waist circumference of the medium level group increased by 0. 47 cm(P=0. 025); compared with low level of TV time, waist circumference of the medium and high level increased by 0. 49 cm(P=0. 033) and 0. 58 cm(P=0. 013), respectively, and the relative risk of abdominal obesity was 1. 13(P=0. 049) and 1. 17(P=0. 010), respectively; compared with the group with insufficient intake of dark vegetables, the waist circumference of the group with adequate intake decreased by 0. 82 cm(P<0. 001), and the relative risk of abdominal obesity was 0. 87(P=0. 028); compared with the group with low level of pastry intake, the waist circumference of the high level group increased by 1. 16 cm(P<0. 001) and the relative risk of abdominal obesity was 1. 33(P<0. 001). By incorporating physical activity, sedentary time and dietary intake levels into the multilevel model simultaneously, there were still statistically significant differences between TV time and dietary intake levels with waist circumference and abdominal obesity and the statistical value did not change much. Compared with low level of TV time, the waist circumference of the medium and high level groups increased by 0. 54 cm(P=0. 028) and 0. 58 cm(P=0. 025), respectively, and the relative risk of abdominal obesity was 1. 15(P=0. 034) and 1. 18(P=0. 011), respectively. Compared with the group with insufficient intake of dark vegetables, the waist circumference of the group with adequate intake decreased by 0. 80 cm(P<0. 001), and the relative risk of abdominal obesity was 0. 87(P=0. 027). Compared with the group with low level of pastry intake, the waist circumference of the high level increased by 1. 13 cm(P<0. 001) and the relative risk of abdominal obesity was 1. 32(P<0. 001). There was no statistical significance in physical activity level with waist circumference and abdominal obesity. Television time and dietary factors(insufficient intake of dark color vegetables and high consumption of pastry) are independent risk factors for abdominal obesity among Chinese reproductive women. Besides strengthening physical activity, the prevention of abdominal obesity in reproductive women should also strengthen the intervention measures to reduce TV time and promote appropriate dietary behaviors(increasing dark color vegetable intake and reducing pastry intake).