Prevalence Of General Obesity Research Articles

#1088 Interaction of general obesity and abdominal obesity with frailty in patients with chronic kidney disease: a nationally representative analysis

Abstract Background and Aims General and abdominal obesity are prevalent, with established associations to frailty in the elderly. However, few studies investigated these associations in patients with chronic kidney disease (CKD), yielding inconsistent results. We explored the relationship between general and abdominal obesity and frailty in CKD patients. Method This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES 2003-2018). Frailty was evaluated by the 36-item frailty index. General obesity was defined as body mass index (BMI) above 30 kg/m2, and abdominal obesity was identified if waist circumference (WC) reached 102 cm in men and 88 cm in women. The association of general and abdominal obesity with frailty were analyzed using weighted multivariate logistic regression and restricted cubic splines. The interaction of general and abdominal obesity with frailty was examined. Results 5604 adult patients (median age 71 years, 42% men) with CKD were included in this analysis, with a median estimated glomerular filtration rate of 57.3 mL/min/1.73 m2. The prevalence of frailty was 40.7%. The prevalence of general obesity and abdominal obesity was 43.3% and 71.5%, respectively. Neither general nor abdominal obesity alone was associated with frailty. There was interaction between general and abdominal obesity with frailty (Table 1). Compared to individuals with normal BMI and WC, those with both general and abdominal obesity, rather than either alone, exhibited significantly increased odds of frailty [odds ratio (OR): 1.53, 95% confidence interval (CI): 1.20-1.95]. General obesity was associated with being frail when CKD patients had abdominal obesity (OR: 1.59, 95% CI: 1.08-2.36) (Fig. 1). Conclusion There may be an interaction between general and abdominal obesity with frailty in patients with CKD. Interventions aimed at preventing frailty should consider both aspects.

Exploring the relationship between dietary patterns and obesity among Nigerian adults: a cross-sectional study

Background/ObjectiveNo previous study has investigated the association between dietary pattern and both general and abdominal obesity risk among adults in Nigeria. This study aimed to evaluate the associations between dietary patterns and the risk of obesity among adult age 18 and above in Ekiti State, Southwestern Nigeria.Methods and study designsA total of 1003 adults were included in this cross-sectional study (males = 558; females = 445). Body mass index (BMI) and waist-to-hip (WHR) were used to assess general and abdominal obesity respectively and they were categorized using WHO recommendation. Partial correlation analyses were performed to assess the associations of dietary patterns with BMI and WHR. Prevalence ratio between dietary pattern and both general and abdominal obesity were calculated using Robust Poisson Regression.ResultsThe prevalence of general obesity among adults was 15.9%, (11.6% among men and 20.2% among women); abdominal obesity was 32.3% (28.9% among males and 44.5% among females). Four dietary patterns were identified; diversified traditional pattern; typical traditional pattern; milk and bread pattern and egg and fish pattern. Diversified traditional pattern was negatively associated with BMI (PR = 0.571, 95%CI: 0.360 ~ 0.905, p = 0.017), and typical traditional pattern was positively associated with BMI (PR = 1.561, 95% CI: 1.043 ~ 2.339, p = 0.031) and WHR in females (PR = 1.849, 95% CI: 1.256 ~ 2.721, p = 0.005). In comparison to those in the lowest quartile, adults with the highest quartile of the typical traditional pattern had a higher risk for abdominal obesity (PR = 1.849, 95%CI = 1.256 ~ 2.721, p = 0.020).ConclusionThis study reports an alarming increase in Obesity prevalence among Nigeria adults which is greatly influence by their lifestyle and eating pattern. We found out that a typical traditional food pattern was associated with a higher risk of both general and abdominal obesity, but a diverse traditional food pattern was associated to a reduced risk of general obesity.

Secular trends of population-attributable fractions of obesity for hypertension among US population by sex and race/ethnicity: Analysis from NHANES 1999–2018

Obesity is a major risk factor of hypertension, therefore quantifying the contribution of obesity to hypertension is necessary. The current study aimed to investigate the changes in population-attributable fractions (PAFs) of hypertension associated with general obesity and abdominal obesity over the recent 2 decades among the US population, as well as important sub-populations. This report was performed based on national-level cross-sectional data for 46,535 adults aged 18 years and older and 20,745 children aged 8–17 from the US National Health and Nutrition Examination Survey 1999–2018. The PAFs of hypertension due to general obesity and abdominal obesity were calculated by sex, race/ethnicity, and survey year. The linear regression analysis was used to evaluate the secular trends of PAFs over the years. The prevalence of general obesity and abdominal obesity presented significantly increasing trends during the past 2 decades in the US. The PAFs of hypertension due to general obesity increased steadily from 11.9 % to 15.1 % in women with a slope of 0.38 % (95 % CI: 0.31 – 0.45 %) and from 8.4 % to 13.4 % in men with a slope of 0.46 % (95 % CI: 0.36 – 0.56 %). Similar increasing trends were also observed for the PAFs due to abdominal obesity in both women and men. Additionally, there were significantly different trends of PAFs in various races/ethnicities. Over the past 2 decades, the contributions of obesity to hypertension were gradually rising among US population, which emphasizes the importance of controlling weight to further reduce the burden of hypertension.

General and central obesity prevalence in young adult: a study based on the Rafsanjan youth cohort study

Growing prevalence of obesity among youth would have adverse consequences and increased risk of developing chronic diseases at older ages. This study explored the prevalence of obesity and its association with relevant risk factors in the Rafsanjan youth cohort population. This cross-sectional study was done on 3006 individuals from the 15–35-year-old population included in the Rafsanjan youth cohort study. The data were extracted from the youth cohort databases, which had been collected through in-person interview and standard questionnaires. Definition of general obesity was considered as body mass index ≤ 30 and that of central obesity as waist to hip ratio (WHR) ≥ 0.9 for men and ≥ 0.85 for women. Multivariate stepwise proportional odds model and multivariable stepwise logistic regression models were done to explore the factors associated with general obesity and central obesity. The mean age was 25.78 ± 6.06 years with 56% (n = 1683) female. The prevalence of general obesity was 15.80% (95% CI 14.50–17.11) and central obesity was 28.41% (95% CI 26.80–30.02). The risk of general obesity increased with increasing age (OR = 1.053, P < 0.0001), being married (OR = 1.658, P < 0.0001), history of diabetes (OR = 1.609, P = 0.0185), history of hypertension (OR = 1.609, P < 0.0001), elevated triglyceride (OR = 1.007, P < 0.0001) and LDL (OR = 1.015, P < 0.0001), while decreasing with being employed (OR = 0.748, P = 0.0002) and elevated HDL (OR = 0.975, P < 0.0001). Prevalence of obesity was high in study population. Marital status, increasing age, and history of chronic diseases were associated with obesity. Preventing programs should be developed against obesity and for promoting healthy habits in young adult especially during education at schools.

The prevalence of general obesity, overweight and abdominal obesity in Iranian university students: A meta-analysis

The prevalence of general obesity, overweight and abdominal obesity in Iranian university students: A meta-analysis

Sociodemographic and behavioral factors related to obesity among adults in the Republic of Palau based on the WHO STEPwise approach to NCD risk factor surveillance 2011-2013: A cross-sectional study.

Pacific islanders face drastic increase of obesity-related noncommunicable disease (NCD) due to lifestyle shifts of unhealthy diets and physical inactivity. To date, however, obesity related factors have not been well elucidated in Republic of Palau. This study aimed to investigate sociodemographic and behavioral factors related to obesity using the national level data in Palau. This is a cross-sectional, population-based study analyzing random sampling data of 2133 adults aged 25-64 years (of 20 thousand national population) from the WHO STEPwise approach to NCD risk factor surveillance (STEPS) implemented between 2011 and 2013. Sociodemographic and behavioral factors were obtained by the STEPS standardized questionnaire for NCD risk factors plus the question on betel nut chewing because of its common behavior in Micronesian countries. Logistic regression analysis was performed to estimate multivariable odds ratio (OR) of general obesity (body mass index ≥30.0 kg/m2) and central obesity (waist circumference ≥90 cm in men and ≥80 cm in women). Means of body mass index, prevalence of general obesity and central obesity were higher in women (29.9 kg/m2, 45.5% and 85.4%) than in men (29.3 kg/m2, 40.4% and 67.6%). After adjusted by other potential factors, native Palauan (OR 4.4, 95% CI, 2.7-7.0 for men and 3.6, 2.3-5.6 for women), betel nut chewing (1.5, 1.1-2.1 for men and 1.6, 1.2-2.3 for women), men who work at government office (1.6, 1.2-2.1), women with higher household income (1.4, 1.0-1.8) were positively associated with general obesity, while frequent vegetable intake were inversely associated with it among women (0.71, 0.54-0.93). Similar associations were observed between the aforementioned factors and central obesity. Native Palauan, people with betel nut chewing behavior, government employment and higher income appeared to be associated with obesity, while frequent vegetable consumption were inversely associated with obesity. Further interventions for prevention and control of obesity are necessary through the enhancing public relation activities to understand harmful health effects on betel nuts chewing and recommending domestic production of vegetables.

Association between obesity and the prevalence of type 2 diabetes mellitus among Chinese adults aged 18-65 years in 15 provinces in 2018

Objective: To analyze the association between different types of obesity, BMI, and waist circumference (WC) and the risk of type 2 diabetes mellitus (T2DM) in Chinese adults. Methods: Based on the China Health and Nutrition Survey data in 2018, different types of obesity were defined across different BMI and WC combinations based on Criteria of weight for adults (WS/T 428-2013), including non-obesity, simple general obesity, simple central obesity, and complex obesity. The associations of different types of obesity, BMI, and WC with T2DM risk were explored using two-level mixed-effects logistic regression and restricted cubic spline models. Results: A total of 7 030 subjects aged 18-65 were included in this study. The prevalence of general obesity and central obesity were 16.29% (502/3 082), 42.28% (1 303/3 082) in males, and 14.41% (569/3 948), 37.87% (1 495/3 948) in females. The prevalence of complex obesity was 14.70% and 12.97% in males and females, respectively. The prevalence of T2DM was 11.28% in participants, and the prevalence in complex obesity (18.98%, 22.07%) was higher than in simple central obesity (16.24%, 15.26%) and non-obesity (9.65%, 5.18%) in males and females, respectively. Multilevel regressions showed that males with simple central obesity and complex obesity had 1.61 (95%CI: 1.24-2.08) and 2.11 (95%CI: 1.56-2.86) times the odds of T2DM, respectively, as compared with the non-obesity; and the odds of T2DM in females were 2.70 (95%CI: 1.16-6.28) times for simple general obesity, 2.62 (95%CI: 2.01-3.40) times for simple central obesity, and 4.47 (95%CI: 3.35-5.98) times for complex obesity. A nearly linear positive association was observed between BMI and T2DM risk. WC was also positively associated with T2DM risk and a non-linearly increased risk in females (P for non-linear=0.024). The risk of T2DM increased when BMI ≥22.5 kg/m2 and 23.0 kg/m2, WC ≥85.0 cm and 80.0 cm in males and females, respectively. Conclusions: Complex obesity adults are more likely to suffer from T2DM. The risk of T2DM increases significantly when BMI is at the normal high values and waist circumference at the stage of pre-central obesity.

The prevalence of general obesity, abdominal obesity, and hypertension and its related risk factors among young adult students in Bangladesh.

Hypertension is a major cause of cardiovascular disease and related mortality worldwide. The presence of general and abdominal obesity in hypertensive individuals increases the risk of cardiovascular mortality. However, evidence on the burden of obesity and hypertension and associated factors are lacking or limited among young adult students in Bangladesh. This study measured the prevalence and factors associated with general and abdominal obesity and hypertension among university students in Bangladesh. In this study, a total of 1011 students (647 males and 364 females) were enrolled on nine public universities in eight divisional regions of Bangladesh. Data were collected on socio‐demographic, anthropometric, and lifestyle in a questionnaire form. Unadjusted and adjusted logistic regression analyses were performed to evaluate the association of general obesity, abdominal obesity and hypertension with different factors. The prevalence of general obesity, abdominal obesity and hypertension was 8.3%, 20.7%, and 10.2%, respectively. The females had a higher prevalence of general obesity (8.8%) and abdominal obesity (26.3%) compared to the males (8.0% and 17.7%, respectively). However, a higher prevalence of hypertension was observed in males (12.2%) than in the female (6.1%) patients. In regression analysis, age showed a significant association with general obesity, whereas, age and female sex were significantly associated with abdominal obesity. The analysis also identified the male sex and high BMI as the increased risk factors for hypertension. Our study suggests a comprehensive screening program and campaigns to increase awareness about obesity and hypertension and its risk factors among young adults in Bangladesh.

Tracking and risk of abdominal and general obesity in children between 4 and 9\xa0years of age. The Longitudinal Childhood Obesity Study (ELOIN)

BackgroundStudies have shown that overweight and obesity conditions tend to be stable from childhood and adolescence to adulthood. Unfortunately, little is known about the evolution of abdominal obesity during childhood. The aim of this study was to evaluate the temporal variations and risk of general and abdominal obesity between 4, 6, and 9 years of age.MethodsMeasurements of children in the ELOIN study taken at the three follow-ups of 4, 6, and 9 years of age were included (N = 1,902). Body mass index and waist circumference were recorded via physical examination. General obesity was determined according to the criteria of the World Health Organization (WHO) and abdominal obesity according to the cut-off points proposed by the International Diabetes Federation (IDF). Prevalence ratios (PRs) were estimated by sex and family affluence using generalized estimating equation models and relative risks (RRs) of obesity were obtained via Poisson regression.ResultsThe prevalence of general obesity was 5.1%, 9.1%, and 15.6% at 4, 6, and 9 years, respectively, yielding a PR of 3.05 (95%CI: 2.55–3.60) (9 years old relative to 4 years). The prevalence of abdominal obesity was 6.8%, 8.4%, 14.5% at 4, 6, and 9 years, respectively, and the PR was 2.14 (95%CI: 1.82–2.51) (9 years old relative to 4 years). An inverse correlation was observed between both general and abdominal obesity and socioeconomic status. Among participants with general or abdominal obesity at 4 years of age, 77.3% and 63.6% remained in their obesity classification at 9 years, respectively, and 3.4% and 3.5% presented general or abdominal obesity also at 6 and 9 years of age, respectively. The RRs of general and abdominal obesity at 9 years were 4.61 (95%CI: 2.76–7.72) and 4.14 (95%CI: 2.65–6.48) for children classified with obesity at 4 years of age, increased to 9.36 (95%CI: 7.72–11.35) and 9.56 (95%CI: 7.79–11.74) for children who had obesity at 6 years, and up to 10.27 (95%CI: 8.52–12.37) and 9.88 (95%CI: 8.07–12.11) for children with obesity at both 4 and 6 years, respectively.ConclusionsGeneral and abdominal obesity begin at an early age and increase over time, showing an inverse correlation with socioeconomic status. In addition, general and abdominal obesity at 9 years are strongly associated with being classified with obesity at 4 and 6 years, so preventive interventions should be established at very early ages.

Correlation of obesity profile and blood pressure among ethnic and immigrant young adult students in Gangtok, Sikkim

Background: Several studies support the influence of ethnicity on the relationship between body mass index (BMI) and risk factors for cardiovascular disease. Aim and Objectives: This study aims to investigate the difference in correlation between obesity profile and blood pressure (BP) between Sikkimese and immigrant students in Gangtok. Materials and Methods: A cross-sectional study was conducted in the Department of Physiology, Sikkim Manipal Institute of Medical Sciences, Sikkim, Gangtok. A total of 274 students aged 18–25 years were included in the study. The anthropometric parameters (Height, weight, BMI, and Waist Circumference [WC]), systolic and diastolic BP (DBP) of the ethnic and immigrant group, were recorded. Two-tail Students’ test was performed to compare two groups and Pearson product-moment correlation coefficient was used to measure the linear correlation. Results: Mean value of all variables-BMI, WC, Systolic BP (SBP), and DBP was higher in the immigrant group as compared to the ethnic group, but the differences were not statistically significant. Lower prevalence of general obesity, abdominal obesity, elevated BP., and hypertension was found among Sikkimese compared to non-Sikkimese young adults. A stronger positive correlation was found between BP and WC and between BP and BMI in immigrants compared to the ethnic group. Conclusion: Higher incidence of different cardiovascular risk factors in young immigrant adults as compared to the ethnic Sikkimese group in this study points toward ethnicity-dependent differences in the relationship between obesity profile and BP.

Nutritional status of sub-Saharans residing in the city of El Jadida - Morocco: weight in relation to socio-economic status.

Onset of overweight and obesity has been previously reported as a result of population migration to western countries. To determine the nutritional status, weight status and their association with socioeconomic status in sub-Saharan settled in El Jadida city in a Mediterranean country Morocco. A descriptive study was carried out in 2018 on 256 sub-Saharans migrants living in the city of El Jadida in Morocco. Information on socio-economic and socio-demographic characteristics as well as anthropometric measurements was collected. The body mass index (BMI) and abdominal obesity by measuring waist circumference (WC) and waist circumference to hip ratio (WHR) and the distribution of body fat by calculating the sum of skin folds are determined. Analysis results indicate that height, waist circumference, hip circumference, sum of trunk skinfolds, total sum of skinfolds, and BMI increase with age. The prevalence of underweight decreases with age, overweight was 38.7% in the youngest age group (18-25 years) and reached higher values after 35 years (44.10%). In addition, the prevalence of general obesity (based on BMI) increased with age and abdominal obesity (based on WHR and WC) was more marked in sub-Saharan people aged 26 to 35 years. These results also reveal the coexistence of underweight, overweight and obesity in all age groups. The analysis revealed a significant association between several variables and obesity. Significant associations were found between age and BMI (P=0.04), between level of education (university) and WHR (p=0.02), between sex and WHR, and between sex and WC (p=0.049). The study revealed also that the majority of the study sample gained weight after their settling in the host country. The study data show that obesity including overweight and abdominal obesity were prevalent among sub-Saharan migrants residing in the city of El Jadida. This prevalence is associated with socio-demographic and socioeconomic factors.

Adolescent obesity: An emerging public health crisis in an urban city in South-South Nigeria

In Nigeria, a prevalence of obesity of 4.2% has been reported among adolescents in a study in South-West Nigeria. Studies on the prevalence of obesity among adolescents have yielded different prevalence rates in different parts of the country. The present study was planned to determine the prevalence of obesity amongst apparently healthy adolescents aged 10-18 years in secondary schools in Uyo, as well as determine associated predisposing factors to obesity. This was a cross sectional school-based study of 1,701 adolescents selected by multi-stage sampling technique, carried out between December 2016 to February 2018. It involved measurement of weight, height and waist circumference of the study subjects, as well as administration of pretested questionnaires. Body Mass Index (BMI), Waist Circumference (WC) percentile and waist to height ratio of the subjects were determined. Data was analysed using SPSS version 20. Prevalence of obesity was determined and Chi Square was used to determine the relationship between qualitative variables. General obesity was defined as a BMI ≥95th percentile, while central obesity was defined as WtHR ≥0.5 or waist circumference ≥90th percentile for age and sex. Prevalence of general obesity was 5.6% while the prevalence of central obesity was 11.2% using WC percentile and 9% using WHtR. This study also revealed higher prevalence of obesity in females, adolescents from monogamous homes, as well as those whose parents are from the upper socio-class. It is recommended that routine measurement of the indices of adiposity and public health enlightenment measures aimed at reducing the burden of obesity amongst adolescents in Uyo be encouraged by public health authorities. The physicians should be encouraged to measure the indices of adiposity during consultations.

Dietary intake of branched-chain amino acids in relation to general and abdominal obesity.

Despite the huge evidence on the link between dietary protein intake and obesity, limited studies have examined the role of individual amino acids in this regard. This study aimed to investigate the association between dietary total and individual BCAAs intake and odds of general and abdominal obesity in a large group of adults. This cross-sectional study was conducted among 8691 adults aged 18-55years in Isfahan, Iran. Dietary BCAAs were assessed using a validated dish-based 106-item semi-quantitative food frequency questionnaire (DS-FFQ). Information about weight and waist circumference was collected through a self-reported validated questionnaire. General obesity was defined as body mass index (BMI) ≥ 30kg/m2, and abdominal obesity was defined as waist circumference (WC) ≥ 88cm for women and ≥ 102cm for men. Mean age of study participants was 36.8 ± 8.1years. Prevalence of general obesity was 9.2% in men and 9.7% in women and that of abdominal obesity was 13.3% and 36.2% in men and women, respectively. We found that participants in the top tertile of total BCAAs intake had higher odds of general obesity compared with those in the bottom tertile (OR: 1.42; 95% CI: 1.09-1.84). Such significant association was seen in men (OR: 1.57; 95% CI: 1.05-2.34), but not in women (OR: 1.33; 95% CI: 0.94-1.89) in our stratified analysis. We found no significant association between total BCAAs intake and odds of abdominal obesity. Stratified by sex, no significant association was observed between total BCAAs intake and odds of abdominal obesity [for men: (OR: 1.10; 95% CI: 0.74-1.65) and for women: (OR: 1.08; 95% CI: 0.84-1.38)]. Assessing the association with individual BCAAs, a significant positive association was observed between dietary intake of valine (OR: 1.42; 95% CI: 1.10-1.84), leucine (OR: 1.43; 95% CI: 1.10-1.86), and isoleucine (OR: 1.42; 95% CI: 1.09-1.84) with general obesity. We observed no significant association between dietary intake of individual BCAAs intake and odds of abdominal obesity. Dietary BCAAs intake was associated with an increased odds of general obesity, in particular among men. No significant association was observed between dietary BCAAs and abdominal obesity. Level V, descriptive cross-sectional study.

Waist circumference, waist-to-height ratio and BMI percentiles in children aged 5 to 19years in India: Apopulation-based study.

ObjectiveNationally representative percentiles for waist circumference (WC), waist‐to‐height‐ratio (WHtR), and body mass index (BMI) are not available for children and adolescents in India.MethodsUsing LMS method, age‐ and gender‐specific reference growth charts were constructed for WC (n = 68,261), WHtR (n = 68,261), and BMI (n = 67,741) from children/adolescents aged 5–19 years who participated in a nationally representative survey. General obesity, indicating overall obesity, was defined as age–sex‐specific BMI z‐scores ≥ 95th percentile. Central obesity was defined in three ways: WC ≥ 90th percentile, WHtR ≥ 0.5, and both WC ≥ 90th percentile and WHtR ≥ 0.5.FindingsWC and BMI percentiles for boys and girls are lower than those previously reported from India and several other countries. The BMI percentiles are lower than the WHO 2007 reference population. The prevalence of general obesity using India specific BMI centiles was 2.9% (95% CI: 2.6–3.2). The prevalence of central obesity was 6.1% (95% CI: 5.7–6.6) using WC ≥ 90th percentile, 5.3% (95% CI: 5.0–5.7) using WHtR ≥ 0.5, and 3.6% using both criteria. Three‐fourth of children with general obesity also had central obesity based on WC ≥ 90th.ConclusionsIndian children are thinner than Caucasian and other Asian children, and the global WHO reference population. Using India specific reference, the prevalence of central obesity is higher than general obesity with a significant overlap between the two.

Feeding habits, Overweight, Obesity and Hypertension and Associated Factors among Polytechnic Students in Ekiti State, Southwest Nigeria

Overweight and obesity is a risk factor to chronic non-communicable diseases. This study assessed level of overweight/obesity and blood pressure among students of a higher institution in Southwest Nigeria. This cross-section study involved 300 students of a public higher institution in Ado- Ekiti, Southwest, Nigeria. A validated self-administered questionnaire was used to collect data on personal characteristics, feeding pattern and lifestyle of the students. Body Mass Index (BMI) was categorized into normal weight (BMI&lt;25) and overweight/obesity (BMI ≥ 25). Waist circumference and waist-hip-ratio (WHR) were classified as normal and at risk. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and diastolic blood pressure (DBP) ≥ 90 mmHg. Chi square test was used to establish relationship between variables at 5% level of significance. The mean age of the students was 22.25 years and 62.8% were above 20years. Monthly allowance less than ₦30000.00 was received by 64.4% of the students, 47.3% skipped breakfast meal, 96% consumed carbonated soft drinks and 37.1% did not engaged in physical exercise. Prevalence of general obesity was 17.1% (BMI≥25); 7% and 15.5% were at risk of abdominal and central obesity respectively. Students in systolic pre-hypertension and stage I hypertension were 33.3% and 3% respectively whereas 15.5% and 2.4% were in diastolic pre-hypertension and stage I hypertension respectively. Female gender, monthly allowance less than ₦30000.00 and adolescent stage were associated with obesity. Older age, male gender and monthly allowance less than ₦30000.00 were associated with BP. Nutrition education is recommended for this population group.

Waist Circumference, Waist-to-Height Ratio and BMI percentiles in children aged 5 to 19 years in India: A population based study

Objective: Nationally representative percentiles for Waist Circumference (WC), Waist-to-Height-Ratio (WtHR) and Body Mass Index (BMI) are not available for children and adolescents in India. Methods: Using LMS method, age- and gender-specific reference growth charts were constructed for WC (n=68,261), WtHR (n=68,261) and BMI (n=67,741) from subjects aged 5-19 years who participated in a nationally representative survey. General obesity was defined as age-sex-specific BMI z-scores ≥95th percentile. Central obesity was defined in three ways: WC≥90th percentile, WtHR≥0·5 and both WC≥90th percentile and WtHR≥0·5 Findings: WC and BMI percentiles for boys and girls are lower than those previously reported from India and several other countries. The BMI percentiles are lower than the WHO 2007 reference population. The prevalence of general obesity using India specific BMI centiles was 2·9% (95%CI: 2·6,3·2). The prevalence of central obesity was 6·1% (95%CI: 5·7,6·6) using WC≥90thpercentile, 5·3% (95%CI: 5·0,5·7) using WtHR≥0·5 and 3·6% using both criteria. Three-fourth of children with general obesity also had central obesity based on WC≥90th. Conclusions: Indian children are thinner than Caucasian and other Asian children, and the global WHO reference population. Using India specific reference, the prevalence of central obesity is higher than general obesity, with a significant overlap between the two.

1556-P: Trend and Prevalence of Underweight, Overweight, Obesity in Chinese Patients with Type 2 Diabetes, Aged 20-89 Years

Background: Both underweight and obesity are associated with highly elevated risks of adverse health outcomes. Gender, and age differences of overweight and obesity prevalence had been identified in overall population. However, less data was specialized evaluate the body mass index (BMI) characteristics, gender and age differences in patients with type 2 diabetes (T2D). Methods: We analyzed six hospital-based studies that had recorded height and weight in adults with T2D aged between 20 and 89 years. We calculated the trends of mean BMI and the prevalence of BMI categories defined by World Health Organization (WHO) and Working Group on Obesity in China (WGOC) criteria stratified by sex, age and provinces. Results: According to WGOC standard, the crude prevalence of general obesity (BMI ≥28 kg/m2) and overweight (24 kg/m2 ≤ BMI &amp;lt; 28 kg/m2) ranged from 10.3% to 16.4%, and 42.0% to 45.2%, respectively. According to WHO standard, the prevalence of general obesity (BMI ≥ 30 kg/m2) and overweight (25 kg/m2 ≤ BMI &amp;lt;30 kg/m2) ranged from 3.9% to 7.0%, and 34.3% to 37.8%, respectively. The crude prevalence of underweight (BMI &amp;lt;18.5 kg/m2) ranged from 1.7% to 2.4%. Age-stratified analysis revealed BMI and prevalence of obesity peaked in men aged 20 to 29 years, thereafter gradually declined. However, in women, BMI and trends of obesity were not consistent. The prevalence of underweight was higher in younger and older patients in both men and women. Geographic heterogeneity of obesity, overweight and underweight were observed across different provinces in mainland China. Conclusion: Gender, age and regional differences of BMI and prevalence of underweight, overweight, obesity were observed in Chinese patients with T2D, aged 20-89 years. Further studies are warranted to investigate the better BMI cutoff value in T2DM of different gender and age to plan health services and promote scientific decision-making in T2D. Disclosure F. Lv: None. X. Cai: None. L. Ji: None. Funding National Natural Science Foundation of China (81970698, 81900805), National Key Research and Development Program of China (2016YFC1304901)

Optimal Cut-Offs of Body Mass Index and Waist Circumference to Identify Obesity in Chinese Type 2 Diabetic Patients.

PurposeThe prevalence of general obesity (commonly defined by body mass index (BMI) in kg/m2) and abdominal obesity (commonly assessed by waist circumference (WC)) has increased rapidly in China. The aim of this study was to investigate the diagnostic accuracy of traditional cut-offs for BMI or WC to identify general or abdominal obesity in Chinese type 2 diabetic patients and propose optimal cut-offs.Patients and MethodsBMI and WC were obtained from 1539 type 2 diabetic patients. Body fat percentage and visceral fat area measured by dual-energy x-ray absorptiometry were set as the gold standard to identify general and abdominal obesity. We assessed the diagnostic power of traditional cut-offs for BMI and WC to define obesity, and analyzed receive operating characteristic (ROC) curves to obtain the optimal cut-offs to identify obesity in Chinese type 2 diabetic patients.ResultsIn Chinese type 2 diabetic patients, the optimal BMI was 25 kg/m2 with the best trade-off between sensitivity and specificity (men: 74.6% (95% CI: 70.7–78.2%) and 65.1% (95% CI: 59.7–70.3%), AUC 0.78 (95% CI: 0.75–0.81), p<0.05; women: 65.8% (95% CI: 60.3–71.0%) and 80.3% (95% CI: 75.7–84.3%), AUC 0.80 (95% CI: 0.77–0.83), p<0.05) in both genders. The optimal WC was 93 cm in men and 90 cm in women with the best trade-off between sensitivity and specificity (men: 87.2% (95% CI: 84.3–89.8%) and 80.2% (95% CI: 74.9–84.8%), AUC 0.91 (95% CI: 0.88–0.92), p<0.05; women: 81.0% (95% CI: 76.9–84.6%) and 88.7% (95% CI: 83.9–92.4%), AUC 0.92 (95% CI: 0.90–0.94), p<0.05).ConclusionFor the Chinese patients with type 2 diabetes, the optimal cut-offs for BMI or WC to identify general or abdominal obesity need to be reconsidered.

Prevalence and associated risk factors of general and abdominal obesity in rural and urban women in Bangladesh.

Obesity is a major public health concern worldwide including Bangladesh. This study aimed to assess the prevalence and associated risk factors of general and abdominal obesity in rural and urban women in Bangladesh. A total of 450 adult women aged ≥ 18 years were recruited from rural (n = 210) and urban (n = 240) areas of four administrative regions (Chattagram, Dhaka and Rajshahi and Sylhet) of Bangladesh. Both socio-demographic and anthropometric data were recorded in this study. WHO proposed cut-off values were used for the Asian population for defining general and abdominal obesity. Multinomial logistic regression analysis was applied to evaluate the risk factors of general and abdominal obesity for Bangladeshi women. Overall, the prevalence of general and abdominal obesity was 28% and 49%, respectively. Urban women had a significantly higher prevalence of both general and abdominal obesity (30.9% and 58.6%, respectively) than in the rural women (26.6% and 38.1%, respectively) (p<0.05 and p<0.01, respectively). As region comparison, the prevalence of general obesity was higher in the Dhaka region (39.3%) compared to the Chattragram (23.3%), Rajshahi (23.9%) and Sylhet (3.5%) regions. On the other hand, abdominal obesity was more frequent among participants in Sylhet (72.4%) and Dhaka regions (61.5%), compared to the Chattagram (27.4%) and Rajshahi (37.3%) regions. A wide variation has been observed on the prevalence of general and abdominal obesity in the different age groups of the four regions. In regression analysis, a high socioeconomic status (ref: low socioeconomic level), low education level (ref: higher education), low physical activity (ref: adequate physical activity) and middle age (ref: ≥ 30 years of age) were significant risk factors for general and abdominal obesity. The prevalence of general and abdominal obesity was higher among participants living in urban areas. Physical inactivity, middle age, high socioeconomic status and low education level were associated with the increased prevalence of general and abdominal obesity. Such a high prevalence of general and abdominal obesity is a health concern for Bangladeshi women; therefore, public awareness and effective health intervention strategies are needed to address these conditions.

Prevalence of Obesity and Correlated Hypertension and Hyperglycaemia Status among Participants of a Health Screening Programme in Inanam Sub-District, Kota Kinabalu, Sabah, Malaysia

Obesity is a known risk factor for non-communicable diseases, including hypertension and diabetes mellitus, with Malaysia having the highest prevalence of obesity among Southeast Asian countries. Additionally, the delivery of medical services to the rural communities remains challenging despite efforts to increase accessibilities to the healthcare facilities. Therefore, regular health screening programmes specifically aiming at these communities are necessary for early diagnosis and intervention to prevent complications while improving the patients’ quality of life. A health screening programme was conducted in a sub-district of Kota Kinabalu, Sabah, Malaysia, where 50 participants were examined for general obesity based on body mass index (BMI) together with central obesity according to waist circumference (WC) and waist-to-hip ratio (WHR). Bioelectrical impedance analysis was performed to estimate body fat percentage (fat%) and body fat mass, along with the measurement of systolic blood pressure (SBP), diastolic blood pressure (DBP), and capillary blood glucose. The median age of the participants was 39.50 years. The prevalence of general obesity, central obesity based on WC and WHR, hypertension, and hyperglycaemia was 28%, 78%, 74%, 24%, and 20%, respectively. Both fat% and fat mass had positive correlations to the BMI (fat%: r = 0.656, p = 0.001; fat mass: r = 0.868, p = 0.001) and WC (fat%: r = 0.505, p = 0.001; fat mass: r = 0.761, p = 0.001). DBP had positive correlations with the BMI (r = 0.390, p = 0.005), WC (r = 0.467, p = 0.001), and WHR (r = 0.331, p = 0.019), while SBP had a positive correlation only with WC (r = 0.341, p = 0.015). Conversely, capillary blood glucose had no significant correlation with either BMI, WC, or WHR. The higher prevalence of central obesity among participants of the health screening program compared to the national level should raise concern among the healthcare providers regarding the future risk for hypertension and hyperglycaemia in this community.