Biosocial covariates of adult male body mass index in Central India

Body mass index (BMI) is the 'measuring rod' of nutritional status. This study investigates the type and extent of correlation between adult male BMI and socioeconomic, cultural and bio-demographical variables using data from 11,496 individuals from 38 districts of Central India. For each individual, stature, body weight and sitting height data were collected, their Cormic index and BMI computed, and averages for each district calculated. Mean BMI was found to be lowest for the population of Tikamgarh (17.90+/-1.91 kg m(-2)) and highest for that of Durg district (19.33+/-2.16 kg m(-2)), whereas the mean BMI for the total population of Central India was 18.67+/-2.18 kg m(-2), which is lower than that of well-to-do individuals in India as a whole. The F ratio indicates that there is inter-district variation in anthropometric characteristics of populations. District-wise biosocial indicators were obtained, namely population density per square kilometre, percentage urban population, percentage of population that is of scheduled caste/tribe, sex ratio, average rural population per PHC/CHC (primary or community health centre), literacy rate, life expectancy, total fertility rate, infant mortality rate, gender development index and human development index. Most of these variables were found to be significantly correlated with each other, but BMI was only significantly correlated with three of them, viz. gender development index (R2=0.211), life expectancy (R2=0.130) and infant mortality rate (R2=0.128). Gender development index and life expectancy were positively correlated with BMI, whereas infant mortality rate was negatively correlated. It is concluded that if BMI increases then life expectancy will also increase. Thus better nutritional status may be a helpful tool for reducing infant mortality rate, which is an indicator of socioeconomic status, health condition, health care and ultimately overall development of a region or population.     

Chronic energy deficiency in some low socio-economic populations from South India: Relationships between body mass index, waist–hip ratio and conicity index

This paper reports the prevalence of chronic energy deficiency (CED) based on body mass index (BMI) and its relation to other adiposity measures namely, waist-hip ratio (WHR) and conicity index (CI) in some low socio-economic groups from South India. Two ethnic groups from each area type, namely, tribal, rural and urban areas, are included and samples of 646 men and 670 women belonging to six groups are selected on a multistage basis. Based on the measurements, BMI, WHR and CI are calculated. A considerable proportion of populations studied here experience CED. A higher proportion of women than men show CED. The BMI and WHR are slightly higher among men and WHR exhibits significant intersex difference. The CI is in expected ranges and all ethnic groups differ from each other in all measurements and indices. Age is strongly correlated with WHR and CI, but not with BMI. Both WHR and CI are influenced by BMI. BMI and sex are found to be significant contributors to the variation in WHR, and ethnicity also added to the variation in CI. The present study also concludes that adult malnutrition (as indicated by BMI) is spread to a considerable extent in these populations of low socio-economic status. It appears that the ethnic differences occurring in several measurements/indices reflect the economic and social conditions.     

Body mass index and chronic energy deficiency of adult males of Central Indian populations

Data on body weight, height, and sitting height from 11,496 adult males, age 18-62 years, belonging to 38 different populations of five major social groups (scheduled tribes, scheduled castes, "other backward castes," general castes, and Muslims) of Central India were taken for our analysis to assess the nutritional status of these groups. Cormic index and body mass index (BMI) were computed, and an analysis of variance (ANOVA) was carried out among different populations as well as among social groups separately on Cormic index and BMI. Shape, size, and generalized distances among the different social groups were computed and dendrograms were drawn. The level of malnutrition is the lowest among the general castes. The opposite is the case with the scheduled castes and scheduled tribes. Comparison of the coefficient of variation shows that there is variation in weight and BMI but that there is no marked variation in the other anthropometric variables. The ANOVA on Cormic index and BMI suggests that the people within a population are more homogeneous than the people between populations. There is a positive but statistically insignificant correlation between Cormic index and BMI. The five social groups differ more in size distance than in shape distance. According to the dendrogram of generalized distance values, the Muslims and the general castes can be grouped into one cluster and the scheduled castes, scheduled tribes, and other backward castes can be grouped into another cluster.     

Prevalence and causes of chronic energy deficiency and obesity in Indian women

We investigate the nutritional status of women in India and its relation to the prevalence of chronic energy deficiency (CED) and obesity. To do this, we have used the data from the Indian National Family Health Survey, 1998-1999, on body mass index (BMI) of ever-married women, ages 15-49 years, along with several socioeconomic factors, such as level of education, religion or caste, occupational status, and standard of living index. The study was based on 81,712 women from 26 states and 6 zones, which were grouped according to geographic proximity of the states of India. A multiple linear regression analysis was done to see the relation between nutritional status of women and different socioeconomic factors. The data reveal that the prevalences of CED, overweight, and obesity in India are 31.2%, 9.4%, and 2.6%, respectively. The incidences of CED and obesity are negatively related. The prevalence of CED is the lowest in Arunachal Pradesh and highest in Orissa. Punjab has the highest prevalence of obesity, and Bihar has the lowest. For the zonewise distribution the Northeast zone has the lowest degree of prevalence of CED and the East zone is at the bottom of the list with the highest degree of malnutrition. We also found that the nutritional status of women goes together with the enhancement of their educational status, standard of living, and so on. There are also significant differences between rural and urban sectors and among castes, religions, and occupations. Furthermore, regression analysis shows that all the socioeconomic variables considered here significantly affect BMI in Indian women.     

Inter-relationships of income, chronic energy deficiency, morbidity and hospitalization among adult male slum dwellers of Midnapore, West Bengal, India

A cross-sectional study of 212 adult (>18 years) male slum dwellers (mean age=34.6+/-14.4 years) of Midnapore town, West Bengal, India, was undertaken to study the inter-relationships of chronic energy deficiency (CED), monthly family income (MFI), self-reported morbidity and hospitalization due to severe illness. The mean height, weight and body mass index (BMI) of the subjects were 160.0 cm, 50.8 kg and 19.9 kg/m2, respectively. The overall frequencies of CED (BMI<18.5 kg/m2), morbidity and hospitalization were 38.2%, 34.4% and 13.7%, respectively. Based on the WHO classification, the prevalence of CED among this population was high (20-39%), indicating a serious situation. Overall, MFI was significantly (p<0.01) positively correlated with BMI (r=0.21). Linear regression analyses showed that MFI had a significant impact (t=3.08; p<0.002) on BMI. Overall, MFI explained 3.9% variation in BMI. Subjects belonging to the lowest family income group (FIG I) had the lowest mean BMI (19.1 kg/m2) and the highest rate of CED (46.3%) and morbidity (36.6%). Those in the highest family income group (FIG III) had the largest mean BMI (20.8 kg/m2) and lowest rate of CED (30.2%) and morbidity (30.2%). The highest rate (18.9%) of hospitalization was found in this group. There were significant family income group differences in mean BMI (F=3.134, p<0.05). The frequency of morbidity (24.6%) and hospitalization (11.9%) was lowest among normal BMI individuals. Morbidity was significantly higher (chi2=11.92, p=0.0026) among CED (48.2%) subjects compared with normal BMI individuals (OR=2.85; CI=1.49-5.46). Similarly, compared with normal BMI subjects, morbidity was higher (38.5%; OR=1.92; 95% CI=0.50-7.18) among overweight subjects. Hospitalization was more common among CED subjects (16.1%; OR=1.42; CI=0.58-3.45) compared with normal BMI subjects. Similarly, the frequency of hospitalization was more among overweight individuals (15.4%; OR=1.35; 95% CI=0.0-7.59). In conclusion, this study provides evidence that the frequency of CED among this population is high, indicating a serious situation. Moreover there exists strong inter-relationships between BMI, CED, MFI and morbidity.     

Body form and nutritional status among adult males of different social groups in Orissa and Bihar States in India

This paper aims to carry out a biological investigation of the body form and nutritional status of the major social groups of Orissa and Bihar States in India. For this, Cormic Index (CI) and Body Mass Index (BMI) have been computed using data on height, sitting height and weight, taken from adult males of age 18-62 years of various ethnic groups in these two states. The subjects have been classified on the basis of chronic energy deficiency (CED). It is found that a substantial proportion of the people with CED are in the grade II and grade III categories. ANOVA, t-tests, correlation and regression were carried out separately. The results reveal that in Orissa, Scheduled Tribes are shorter, lighter and have lowest mean values of BMI and Cormic Index compared to other groups, but in Bihar, though the Scheduled Tribes are shorter, Scheduled Castes are lower in weight and have the lowest mean values of BMI. There are significant differences in BMI as well as in CI between Scheduled Tribes of Orissa and Bihar. Scheduled Castes and Tribes of Bihar have the highest percentage of CED with 64.71% and 57.45%, respectively. Muslims of Bihar are also affected (52.95%), but overall prevalence of CED is lower in Orissa (49.11%) than in Bihar (54.62%). BMI and CI are highly correlated for each of the social groups in Bihar and Orissa.     

Association between Farming and Chronic Energy Deficiency in Rural South India

Objective

To examine factors associated with chronic energy deficiency (CED) and anaemia in disadvantaged Indian adults who are mostly involved in subsistence farming.

Design

A cross-sectional study in which we collected information on socio-demographic factors, physical activity, anthropometry, blood haemoglobin concentration, and daily household food intake. These data were used to calculate body mass index (BMI), basal metabolic rate (BMR), daily energy expenditure, and energy and nutrient intake. Multivariable backward stepwise logistic regression was used to assess socioeconomic and lifestyle factors associated with CED (defined as BMI<18 kg/m²) and anaemia.

Setting

The study was conducted in 12 villages, in the Rishi Valley, Andhra Pradesh, India.

Subjects

Individuals aged 18 years and above, residing in the 12 villages, were eligible to participate.

Results

Data were available for 1178 individuals (45% male, median age 36 years (inter quartile range (IQR 27–50)). The prevalence of CED (38%) and anaemia (25%) was high. Farming was associated with CED in women (2.20, 95% CI: 1.39–3.49) and men (1.71, 95% CI: (1.06–2.74). Low income was also significantly associated with CED, while not completing high school was positively associated with anaemia. Median iron intake was high: 35.7 mg/day (IQR 26–46) in women and 43.4 mg/day (IQR 34–55) in men.

Conclusions

Farming is an important risk factor associated with CED in this rural Indian population and low dietary iron is not the main cause of anaemia. Better farming practice may help to reduce CED in this population.     

Traditional occupations and nutritional adaptation among Central Indian caste populations

The socioeconomic milieu has benefits and drawbacks for determining level of nutrition. The Indian population provides an excellent example of nutrition-driven adaptation. The present paper deals with the relationship between BMI (body mass index) and traditional occupation and process of adaptation among adult males of Central India. Anthropometric data collected by the Anthropological Survey of India on stature, sitting height and weight of 6663 adult males belonging to 22 castes were used for computation of BMI and Cormic index. The caste groups earning their living as labourers are found to be shortest (157.4+/-6.5 cm), and the caste group practising priesthood are tallest (168.6+/-6.6 cm). The prevalence of chronic energy deficiency is found to be highest (72%) among castes earning their living as daily wage labourers. The ANOVA on Cormic index and BMI suggests that people within the same occupational group are more homogeneous than those from different occupational groups. The t test also supports the homogeneity of the same occupational group.     

Age-sex and diurnal variation of blood pressure in different nutritional states among the adult Telegas of Kharagpur in West Bengal, India

An anthropological investigation among the endogamous Telega population (106 adult individuals including 51 males and 55 females) in the district of Paschim Medinipur of West Bengal, India shows wide range of age-sex as well as diurnal variation of mean blood pressure (MBP) with reference to different nutritional status. Distribution of MBP shows distinct bias for sexes separately on different occasions and in association with age and other physiological conditions like menopause in females. Records of increase of blood pressure from morning to evening also indicate clear diurnal change in both male as well as in the female samples with some variations when compared between the two sexes. Results also help us to understand and to record the variation of blood pressure as a physiometric trait in the population under study. Data indicate that nearly 30% of males and more than 30% of females are living at the level of undernutrition. Nutritional status is measured by anthropometric measurements, e.g. height, weight, mid arm circumference (MUAC) and further calculation of body mass index (BMI). Distribution of MBP at different BMI and MUAC levels and Pearson correlation and regression analysis--all suggest that age, BMI and MUAC have significant impacts on BMI with some sex-related variations.     

Body mass index and diabetes in Asia: a cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium

Background

The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia.

Methods and Findings

A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m) and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR) of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5–24.9 Kg/m² as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76) for BMI lower than 15.0 kg/m² to 2.23 (95% CI 1.86, 2.67) for BMI higher than 34.9 kg/m². The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001), in cohorts from India and Bangladesh (p<0.001), in individuals with low education (p-value 0.02), and in smokers (p-value 0.03); no differences were observed by gender, urban residence, or alcohol drinking.

Conclusions

This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk factors for diabetes.     

Body Mass Index and Cardiovascular Disease Risk Factors in Seven Asian and Five Latin American Centers: Data from the International Clinical Epidemiology Network (INCLEN)

We have tested the hypothesis that the relationship between body mass index (BMI) and other cardiovascular disease (CVD) risk factors as well as socioeconomic status is different in five Latin American populations (where BMI is high) and seven Asian populations (where BMI is low). Random samples of approximately 200 males aged between 35 and 65 years were selected from 12 general or industrial populations in Latin America and Asia. Standardized measures of height, weight, blood pressure, blood cholesterol, cigarette smoking, highest level of completed education, occupation and income were made. The mean BMI (kg/m₂) was 253 (SD 3.74) in the five Latin American populations (which were all urban), 22.2 (SD 3.24) in the four Asian urban populations and 21.4 (SD 3.33) in the three Asian rural populations. Despite the differences in mean BMI levels, statistically significant positive relationships of a similar magnitude were seen between BMI and blood pressure levels in Latin America and Asia. Similarly, there was a statistically significant positive relationship found between BMI and total cholesterol in both Latin American and Asian urban samples, but of a higher magnitude in Asian rural samples. Current cigarette smokers had significantly lower BMI than ex-smokers or never smokers in Latin America and Asia. In Asia, there were statistically significant positive associations between BMI and levels of education and income as well as with occupation — these relationships were stronger for education and occupation in rural than in urban samples. There were no statistically significant associations between BMI and these measures of socioeconomic status in Latin America. The similarities of the associations between BMI and blood pressure and cholesterol levels in the two groups suggest that efforts to reduce BMI in all populations is likely to be important in reducing risk of CVD. Preventing the future rise of BMI in populations tions where BMI is still relatively low is a high priority. The difference in association between BMI and socioeconomic status in the different population groups requires study of the way sociocultural factors influence behavior that determines BMI levels.     

Obesity prevalence and nutritional habits among Indian women: a comparison between Punjabi women living in India and Punjabi migrants in Vienna, Austria

The current study aimed to determine the prevalence of obesity and overweight among Indian women living in Punjab, India and in Vienna, Austria. A series of 115 women ageing between 17 and 80 years (x = 38.7 yrs; +/- 14.5) was enrolled in the present study. 65 women lived in the district of Jalandhar in Punjab, 50 Punjabi women lived in as migrants in Vienna Austria. Data collection comprised an anthropometric analysis including stature height, body weight and the body mass index (BMI). For classification of the weight status the Indian BMI cutoffs defined by the WHO for Asian Indians were used. Data concerning dietary patterns and lifestyle parameters were collected by structured interviews using a standardized questionnaire. Among both subgroups overweight and obesity were highly prevalent. Underweight (18.5%) was significantly more prevalent in Punjab than in Vienna (6.0 %), while overweight and obesity were more frequently found among Punjabi women in Vienna (26.0%; 54.0%) than among Punjabi women in India (9.2%; 24.6 %). Analysing lifestyle and dietary patterns it turned out that energy dense meals were preferred and fat and sugar were used frequently among both subsamples. A statistically significant relationship between dietary habits and weight status could not be proved.     

Body Mass Index and Chronic Energy Deficiency Among Urban Bengalee Male Slum Dwellers of Kolkata, India: Relationship with Family Income

A cross-sectional study of 191 adult (>18 years) Bengalee male slum dwellers of Kolkata, India, was undertaken to study the relationships of family income with body mass index (BMI) and chronic energy deficiency (CED). Results revealed that the mean height, weight, and BMI of the subjects were 162.2 cm, 54.0 kg, and 20.5 kg/m², respectively. The overall frequency of CED (BMI < 18.5 kg/m²) was 33.5%. Based on the World Health Organization classification, the prevalence of CED among this population was high (20–39%) and thus the situation is serious. Overall, monthly family income (MFI) was significantly positively correlated (r = 0.18, p < 0.05) with BMI. Linear regression analyses showed that MFI had significant impact (p < 0.05) on BMI. The percent variation in BMI explained by MFI was 2.6%. Subjects belonging to the lowest family income group (FIG) had the lowest mean BMI (19.5 kg/m²) and the highest rate of CED (46.6%) while those in the highest FIG had the largest mean BMI (21.4 kg/m²) and lowest rate of CED (23.1%). There was a significant FIG difference (F = 2.965, p < 0.05) in mean BMI. Moreover, there existed FIG differences (χ ² = 7.54, p < 0.06) in CED rates. In conclusion, this study provided strong evidence that FIG was significantly associated with BMI and the presence of CED. The rate of CED was high, indicating a serious situation. These findings may have severe public health implications. It is recommended that immediate nutritional intervention programs be initiated among this population along with serious efforts to increase their family income.     

Age and sex variation of body mass index and waist circumference among the Santal children of Jharkhand, India

Central body fat (CBF) as measured by waist circumference (WC) etc. has now been considered as risk factor for chronic disease, disability, and death. It has been assumed that one's characteristic level of body fat, as measured by body mass index (BMI), and CBF unfolds during the normal course of growth and development. However, studies of the development of CBF show relatively weak consistency in comparison to body fat. But to the best of our knowledge, no study in this aspect has been undertaken on any Indian population to study the effect of age and sex on body fat and CBF during development. In view of the above consideration, the present work has been undertaken among 179 Santal (a tribal population) children (Boys = 107, Girls = 72) of the Galudih area in East Singbhum, Jharkhand, India. Anthropometric measurements of height, weight, and circumference of waist were taken from each subject using standard procedure. The mean ages of boys and girls were 10.94 years and 9.48 years, respectively. The mean BMI for boys and girls were 14.48 kg/m2 and 13.78 kg/m2 Percent of variance explained by age was much greater for BMI (> 50%) as compared to WC (7-10%) in both sexes. Two way ANOVA showed that BMI had a significant (p < 0.05) effect of age and not of sex, whereas age-sex interaction had a significant impact on WC. The results of the present cross-sectional study indicated that during growth and development unfolding of CBF and BMI is independent of one another. Different set(s) of gene(s), onset of growth hormones during the normal development or their interaction could have been considered for this differentiation.     

An anthropometric and hematological comparison of sickle cell disease children from rural and urban areas

BACKGROUND:

Sickle cell disease (SCD) is a prevalent genetic disorder in India and the rural and urban areas experience distinctly different healthcare facilities. In view of this, a comparative study of SCD-SS pattern children of age 8–15 years from rural and urban areas of Wardha district of Central India was carried out using anthropometric and hematological parameters.

MATERIALS AND METHODS:

The data were collected using standard methods and the results showed a significant (P < 0.05) difference in the mean values for body weight, body mass index (BMI), hemoglobin, hematocrit, and white blood corpuscles (WBC). Statistical analysis of the data was done using SPSS 18.0 software. Individuals were screened by solubility test method. Sickle cell patterns (AS and SS) were determined by using electrophoresis technique.

RESULT:

The SCD-SS children from rural were significantly underweight than those from the urban area of Wardha district. BMI is a good indicator of nutritional status and BMI values of SCD children have less than desired.

CONCLUSION:

The study highlights an urgent need to conduct integrated investigations for SCD population of rural areas covering clinical, nutritional, and social aspects.     

Enhanced frequency of micronuclei in individuals exposed to arsenic through drinking water in West Bengal, India

In West Bengal, India arsenic in ground water has been found to be above the maximum permissible limit in seven districts covering an area of 37,493km2. In the present study, evaluation of the micronuclei (MN) formation in oral mucosa cells, urothelial cells and peripheral blood lymphocytes was carried out in the symptomatic individuals exposed to arsenic through drinking water. Forty five individuals with cutaneous signs of arsenicism from four affected districts (368.11 microg/l of As in drinking water) were considered as the exposed group and 21 healthy individuals with no symptoms of arsenic poisoning and residing in two unaffected districts (5.49 microg/l of As) were considered as controls. The exposed and control groups had similar age distribution and socioeconomic status. Standardised questionnaires were utilised and medical examination was conducted to ascertain exposure history, sociodemographic characteristics, diet, health, medication, addiction and chief symptoms in the study participants. Arsenic exposure was confirmed by measuring the arsenic content in the drinking water, nails, hair and urine samples from the volunteers. Arsenic contents in the urine, nail and hair in the exposed group were 24.45 microg/l, 12.58 and 6.97 microg/g, respectively which were significantly high in comparison to corresponding control group values of 4.88 microg/l, 0.51 and 0.34 microg/g, respectively. Exposed individuals showed a statistically significant increase in the frequency of MN in oral mucosa, urothelial cells and lymphocytes (5.15, 5.74 and 6.39/1000 cells, respectively) when compared with the controls (0.77, 0.56 and 0.53/1000 cells, respectively). Thus, the above results indicate that the symptomatic individuals exposed to arsenic through drinking water in this region have significant cytogenetic damage.     

MORPHOLOGICAL AND ALLOZYMIC VARIATION IN POPULATIONS OF MYTILUS GALLOPROVINCIALISFROM THE AEGEAN SEA

Eight populations of Mytilus galloprovincialis from differentcoasts of the Northern and Central Aegean Sea have been investigatedat the morphological and allozymic level. A significant degreeof variation was found within and among the populations. Theaverage degree of heterozygosity ranges from 0.085 to 0.14 andit is lower than those reported for other populations of thesame species. No correlation was found between the degree ofheterozygosity and the morphological variability among the populationsexamined. (Received 14 May 1992; accepted 1 October 1992)     

Receiver operating characteristic curve analysis of BMI in assessing obesity among adult Bengalee males in India

The present study attempted to understand the appropriateness of different body mass index (BMI) cut-off points in assessing obesity. Four hundred thirty adult Bengalee males with mean age 36.48 +/- 12.23 years (mean +/- SD) from West Bengal, India were studied. Height, weight and percent body fat were measured and BMI was derived following standard equation. Receiver operating characteristic (ROC) curve analysis demonstrated low sensitivity and high specificity of international (> or = 30 kg/m2) and proposed (> or = 25 kg/m2) BMI cut-off points in identifying individuals with obesity. Furthermore, these international and proposed BMI cut-off points also found to be in substantial misclassification to assess obesity as much as 32.09% and 17.44% respectively. However, based on ROC curve analysis, a BMI cut-off point of > or = 24 kg/m2 revealed optimal sensitivity (83.66%) and specificity (90.61%) and as well as less misclassification (11.86%) in assessing obesity among the adult Bengalee males. The present study accentuated that the international and proposed BMI cut-off points so far might not be appropriate in assessing obesity and on the other hand, lower BMI cut-off point (> or = 24 kg/m2) has relatively high sensitivity and specificity in assessing obesity as well. Therefore, the present study envisages the requirement of further lowering down of BMI cut-off point in assessing excess body fat in adult Bengalee males.     

Tuberculosis and Poverty: Why Are the Poor at Greater Risk in India?

Background

Although poverty is widely recognized as an important risk factor for tuberculosis (TB) disease, the specific proximal risk factors that mediate this association are less clear. The objective of our study was to investigate the mechanisms by which poverty increases the risk of TB.

Methods

Using individual level data from 198,754 people from the 2006 Demographic Health Survey (DHS) for India, we assessed self-reported TB status, TB determinants and household socioeconomic status. We used these data to calculate the population attributable fractions (PAF) for each key TB risk factor based on the prevalence of determinants and estimates of the effect of these risk factors derived from published sources. We conducted a mediation analysis using principal components analysis (PCA) and regression to demonstrate how the association between poverty and TB prevalence is mediated.

Results

The prevalence of self-reported TB in the 2006 DHS for India was 545 per 100,000 and ranged from 201 in the highest quintile to 1100 in the lowest quintile. Among those in the poorest population, the PAFs for low body mass index (BMI) and indoor air pollution were 34.2% and 28.5% respectively. The PCA analysis also showed that low BMI had the strongest mediating effect on the association between poverty and prevalent TB (12%, p = 0.019).

Conclusion

TB control strategies should be targeted to the poorest populations that are most at risk, and should address the most important determinants of disease—specifically low BMI and indoor air pollution.     

Presence of high rates of overweight and obesity among adult Marwaris of Howrah, West Bengal, India

A cross-sectional study of 220 (110 men and 110 women) adult (> 20 years) Marwaris of Howrah, West Bengal, India, was undertaken to investigate the frequency of overweight and obesity, using different criteria. Results revealed that men had significantly greater mean height, weight, waist circumference (WC), waist-hip ratio (WHR), conicity index (CI) and fat free mass (FFM), compared with women. Women had significantly higher mean body mass index (BMI), biceps (BSF) and triceps (TSF) skinfolds, mid-upper arm (MUAC) and hip (HC) circumferences, percent body fat (PBF), fat mass index (FMI), mid-arm fat area (MAFA) and PBF/BMI ratio compared with men. The frequency of overweight (BMI > or = 25.0) was significantly higher among women (71.8%) compared with men (44.5%). Similarly, significantly more women (41.8%) had high WHR than men (22.7%). Significantly more women also had high PBF (97.3%) compared with men (90.9%). In conclusion, these results demonstrated that the level of overall and central adiposity, as well as body fat, was found to be high among Marwaris, as compared with other ethnic populations of India. Moreover, there existed significant sexual dimorphism in these measures among this ethnic group. This high level of overall and central adiposity and body fat could have severe adverse health implications in this ethnic group.