Distribution and social determinants of overweight and obesity: a cross-sectional study of non-pregnant adult women from the Malawi Demographic and Health Survey (2015-2016)
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
OBJECTIVES: Hitherto regarded as a public health issue of well-heeled nations, overweight and obesity have emerged as a problem of concern in developing nations. Although social and demographic factors are equally important as proximal lifestyle factors affecting health, their role is neither well researched nor well understood. We conducted a novel study to determine the distribution, prevalence, and social and demographic determinants of overweight/obesity in Malawi. METHODS: A population-based, quantitative cross-sectional study using data from the Malawi Demographic and Health Survey (2015-2016) was conducted among non-pregnant women aged 18-49 years. A total of 6,443 women were included in the analysis. Overweight/obesity, defined as a body mass index (BMI) ≥25.0 kg/m2, was the main outcome variable. The analysis was done in SPSS version 20.0; after calculating descriptive statistics, bivariate and multivariate logistic regression was conducted to evaluate associations and determine odds. RESULTS: In total, 16.8% and 6.3% of women were overweight and obese, respectively (p<0.001). Overweight and obesity were more prevalent in urban than in rural areas. The BMI distribution among women varied across different background characteristics. Women from the Ngoni ethnicity were more likely to be overweight/obese than others (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.14 to 2.08). Socioeconomic status (SES) and the age of the respondent were highly significant determinants that were strongly associated with being overweight/obese. The richest women were 3 times more likely to be overweight/obese than the poorest (aOR, 3.30; 95% CI, 2.46 to 4.43). CONCLUSIONS: Overweight and obesity were highly prevalent and significantly associated with increasing SES, age, and being from the Ngoni ethnicity. Holistic interventions should also focus on improving social determinants in order to entirely curb the epidemic.
Abstract
OBJECTIVES: Hitherto regarded as a public health issue of well-heeled nations, overweight and obesity have emerged as a problem of concern in developing nations. Although social and demographic factors are equally important as proximal lifestyle factors affecting health, their role is neither well researched nor well understood. We conducted a novel study to determine the distribution, prevalence, and social and demographic determinants of overweight/obesity in Malawi. METHODS: A population-based, quantitative cross-sectional study using data from the Malawi Demographic and Health Survey (2015-2016) was conducted among non-pregnant women aged 18-49 years. A total of 6,443 women were included in the analysis. Overweight/obesity, defined as a body mass index (BMI) ≥25.0 kg/m2, was the main outcome variable. The analysis was done in SPSS version 20.0; after calculating descriptive statistics, bivariate and multivariate logistic regression was conducted to evaluate associations and determine odds. RESULTS: In total, 16.8% and 6.3% of women were overweight and obese, respectively (p<0.001). Overweight and obesity were more prevalent in urban than in rural areas. The BMI distribution among women varied across different background characteristics. Women from the Ngoni ethnicity were more likely to be overweight/obese than others (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.14 to 2.08). Socioeconomic status (SES) and the age of the respondent were highly significant determinants that were strongly associated with being overweight/obese. The richest women were 3 times more likely to be overweight/obese than the poorest (aOR, 3.30; 95% CI, 2.46 to 4.43). CONCLUSIONS: Overweight and obesity were highly prevalent and significantly associated with increasing SES, age, and being from the Ngoni ethnicity. Holistic interventions should also focus on improving social determinants in order to entirely curb the epidemic.
참고문헌 (34)
- "Overweight and obesity" (2018)[URL]
- Barakat-Haddad C, "A longitudinal cohort study examining determinants of overweight and obesity in adulthood", Can J Public Health, 108, pp.e27~e35 (2017)
- Omran AR, "The epidemiologic transition. A theory of the epidemiology of population change", Milbank Mem Fund Q, 49, pp.509~538 (1971)
- Popkin BM, "Global nutrition transition and the pandemic of obesity in developing countries", Nutr Rev, 70, pp.3~21 (2012)
- "Global status report on non-communicable diseases 2014" (2015)[URL]
- Dee A, "The direct and indirect costs of both overweight and obesity : a systematic review", BMC Res Notes, 7, pp.242~ (2014)
- Agyemang C, "Metabolic syndrome", pp.1~13 (2016), Springer International Publishing
- Steyn NP, "Dietary, social, and environmental determinants of obesity in Kenyan women", Scand J Public Health, 39, pp.88~97 (2011)
- Micklesfield LK, "Socio-cultural, environmental and behavioural determinants of obesity in black South African women", Cardiovasc J Afr, 24, pp.369~375 (2013)
- "A conceptual framework for action on the social determinants of health: debates, policy & practice, case studies" (2010)[URL]
- Meehan S, "Maternal obesity and infant mortality : a meta-analysis", Pediatrics, 133, pp.863~871 (2014)
- "National health and nutrition examination survey (NHANES)" (2007)[URL]
- "Obesity: preventing and managing the global epidemic" (2000)[URL]
- "International standard classification of occupations: structure, group definitions and correspondence tables" (2016)[URL]
- Nakagawa S, "A farewell to Bonferroni : the problems of low statistical power and publication bias", Behav Ecol, 15, pp.1044~1045 (2004)
- Adebayo RA, "Prevalence and pattern of overweight and obesity in three rural communities in southwest Nigeria", Diabetes Metab Syndr Obes, 7, pp.153~158 (2014)
- Maher D, "Distribution of hyperglycaemia and related cardiovascular disease risk factors in low-income countries : a cross-sectional population-based survey in rural Uganda", Int J Epidemiol, 40, pp.160~171 (2011)
- Al Kibria GM, "Prevalence and factors affecting underweight, overweight and obesity using Asian and World Health Organization cutoffs among adults in Nepal : analysis of the Demographic and Health Survey 2016", Obes Res Clin Pract, 13, pp.129~136 (2019)
- Subramanian SV, "Weight of nations : a socioeconomic analysis of women in low-to middle-income countries", Am J Clin Nutr, 93, pp.413~421 (2011)
- Atek M, "Obesity and association with area of residence, gender and socio-economic factors in Algerian and Tunisian adults", PLoS One, 8, pp.e75640~ (2013)
- Letamo G, "The prevalence of, and factors associated with, overweight and obesity in Botswana", J Biosoc Sci, 43, pp.75~84 (2011)
- Sola AO, "Underweight, overweight and obesity in adults Nigerians living in rural and urban communities of Benue State", Ann Afr Med, 10, pp.139~143 (2011)
- Amegah AK, "Prevalence and determinants of overweight and obesity in adult residents of Cape Coast, Ghana : a hospital-based study", Afr J Food Agric Nutr Dev, 11, pp.4828~4846 (2011)
- Mogre V, "Impact of physical activity levels and diet on central obesity among civil servants in Tamale metropolis", J Med Biomed Sci, 1, pp.1~9 (2012)
- Pobee RA, "The prevalence of obesity among female teachers of child-bearing age in Ghana", Afr J Food Agric Nutr Dev, 13, pp.7820~7839 (2013)
- "Overcoming obesity: an initial economic analysis" (2014)[URL]
- Mbochi RW, "Predictors of overweight and obesity in adult women in Nairobi Province, Kenya", BMC Public Health, 12, pp.823~ (2012)
- French SA, "Household income difference in food sources and food items purchased", Int J Behav Nutr Phys Act, 7, pp.77~ (2010)
- Rolls BJ, "The relationship between dietary energy density and energy intake", Physiol Behav, 97, pp.609~615 (2009)
- El-Hazmi M, "Relationship between age and the prevalence of obesity and overweight in Saudi population", Bahrain Med Bull, 24, pp.1~7 (2002)
- Dake FA, "Sociodemographic correlates of obesity among Ghanaian women", Public Health Nutr, 14, pp.1285~1291 (2011)
- Duda RB, "Prevalence of obesity in women of Accra, Ghana", Afr J Health Sci, 14, pp.154~159 (2007)
- Yaya S, "Subjective happiness, health and quality of life and their sociocultural correlates among younger population in Malawi", Soc Sci, 8, pp.55~ (2019)
- "Food decisions and cultural perceptions of overweight and obesity: the case of Zulu women in Durban, South Africa" (2014)[URL]