Prevalence and risk factors of overweight and obesity in China

Objective: To examine the prevalence and risk factors of overweight and obesity in China. Research Methods and Procedures: A cross‐sectional survey was conducted in a nationally representative sample of 15,540 Chinese adults in 2000–2001. Body weight, height, and waist circumference were measured by trained observers. Overweight and obesity were defined according to the World Health Organization classification. Central obesity was defined according to guidelines of the International Diabetes Federation. Results: Mean BMI and waist circumference were 23.1 kg/m² and 79.6 cm, respectively, for men and 23.5 kg/m² and 77.2 cm, respectively, for women. The prevalences of overweight and obesity were 24.1% and 2.8% in men and 26.1% and 5.0% in women, respectively. The prevalence of central obesity was 16.1% in men and 37.6% in women. The prevalences of overweight, obesity, and central obesity were higher among residents in northern China compared with their counterparts in southern China and among those in urban areas compared with those in rural areas. Lifestyle factors were the most important risk factors to explain the differences in overweight and central obesity between northern and southern residents. Among women, lifestyle and diet were the most important risk factors to explain the differences between urban and rural residents, whereas socioeconomic status, lifestyle, and diet were all important among men. Discussion: Our study indicates that overweight and obesity have become important public health problems in China. Environmental risk factors may be the main reason for regional differences in the prevalence of overweight and obesity in China.     

Prevalence and associated factors of dyslipidemia in the adult Chinese population

To determine the prevalence, associated factors, awareness and control of dyslipidemia in Chinese living in Greater Beijing, we measured the serum cholesterol concentration in 3251 Chinese adults (age: 45 to 89 years) as participants of the population-based Beijing Eye Study 2006. Additional information on treatment of dyslipidemia was obtained using a standard questionnaire. The mean concentrations of total, HDL cholesterol, LDL cholesterol and triglycerides were 4.92±1.01 mmol/L, 1.61±0.36 mmol/L, 2.88±0.85 mmol/L, and 1.76±1.29 mmol/L, respectively. Prevalence of dyslipidemia was 56.1±0.9%%. Presence of dyslipidemia was significantly associated with increasing age (odds ratio (OR):1.02; 95% confidence interval (CI): 1.01, 1.03), female gender (OR:1.51; 95%CI: 1.25, 1.83), urban region (OR:1.82; 95%CI: 1.30, 2.55), body mass index (OR:1.13; 95%CI: 1.10, 1.15), income (OR:1.11; 95%CI:1.02, 1.21), blood glucose concentration (OR:1.10; 95%CI:1.05, 1.16), diastolic blood pressure (OR:1.02; 95%CI: 1.01, 1.03), and smoking (OR:1.23; 1.01, 1.51). Among those who had dyslipidemia, the proportion of subjects who were aware, treated and controlled was 50.9%, 23.8%, and 39.91%, respectively. The awareness rate was associated with urban region (P = 0.001; OR: 6.50), body mass index (P = 0.001; OR:1.06), and income (P = 0.02; OR:1.14). The data suggest that dyslipidemia may be present in about 56% of the population aged 45+ years in Greater Beijing. Factors likely associated with dyslipidemia were higher age, female gender, urban region, higher body mass index, higher income, higher blood concentration of glucose, higher diastolic blood pressure, and smoking. In the examined study population, treatment rate was 24% with about 60% of the treated subjects still having uncontrolled dyslipidemia.     

Prevalence of overweight and obesity among urban and rural adult females of Punjab

The prevalence of overweight and obesity was assessed during a community based epidemiological survey on a randomized sample of 1700 (900 urban and 800 rural) adult Punjabi females in the age group from 20-45 years. For the assessment of overweight and obesity, height and weight measurements were taken on each subject. The prevalence rate of malnutrition was calculated according to the critical limits of body mass index (BMI). The observations show that the combined overall prevalence rate of overweight/obesity in the present study is 43.88% and 22.26%, respectively, for urban and rural females. The frequency of overweight and obesity is more among urban females than in their rural female counterparts.     

Trends and dietary determinants of overweight and obesity in a multiethnic population

Objectives : To describe trends in BMI among different ethnic groups in Hawaii and to explore the relation of nutrient and food intake with excess weight. Research Methods and Procedures : We pooled demographic, anthropometric, and nutritional data derived from a detailed diet history for 159, 683 participants of 18 population‐based epidemiological studies conducted in Hawaii over a 25‐year period. The age‐adjusted prevalence of excess weight (BMI ≥ 25 kg/m²) was estimated for 5‐year intervals. To explore dietary determinants of excess weight, we computed odds ratios using logistic regression. Results : During the study period, the prevalence of excess weight increased considerably among all ethnic groups. Native Hawaiians had the highest and Asian Americans had the lowest prevalence of excess weight at all times. Although the percentage of calories consumed from carbohydrates increased, the percentage of calories from fat decreased over time. On an individual level, fat and protein consumption predicted a higher BMI, and dietary fiber intake predicted a lower BMI. Similarly, a higher consumption of meat, poultry, and fish was related to excess weight, whereas fruit and vegetable intake were inversely associated with excess weight. After stratification by ethnicity, the associations were not materially altered among women, but carbohydrates seemed to have a stronger association with excess weight among Native Hawaiian and Japanese men than among white men. Discussion : In this large ethnically diverse population, plant‐based foods and dietary fiber emerged as a potential protective factor against excess weight regardless of ethnicity.     

Prevalence of metabolic syndrome and its relation to body composition in a Chinese rural population

Objective: To investigate the prevalence of metabolic syndrome (MetS) with three different working definitions in a rural Chinese population and to examine its relation to body composition. Research Methods and Procedures: A total of 18,630 adults 25 to 64 years old (mean age, 45.8 years; 51.2% men) from 5686 families were enrolled from Anhui province of China during 2004 to 2005. Anthropometric measurement, body composition, blood pressure, plasma lipids, and fasting glucose and insulin and a questionnaire‐based interview were obtained from each participant. Three different working definitions for MetS, including the U.S. National Cholesterol Education Program's Adult Treatment Panel III, a modified Adult Treatment Panel III that adopts the World Health Organization's criterion for central obesity in Asian populations, and one recently proposed by the International Diabetes Federation, were used in the study. Results: According to the three definitions, the age‐adjusted prevalence of MetS for adults 25 to 64 years old was 3.2%, 4.9%, and 3.9% in men and 7.2%, 11.5%, and 10.9% in women, respectively. MetS prevalence increases significantly with age in women, but not in men. Body fat percentage and BMI and waist circumference were significantly associated with each component of MetS, especially with triglyceride level, insulin resistance index, and number of MetS components (r = 0.28 to 0.49). Discussion: The age‐adjusted prevalence of MetS in our study population is lower than that reported in other urban Chinese populations. Significant gender differences in MetS prevalence were observed. The waist circumference is a good surrogate for abdominal fat percentage.     

Dietary behaviors as associated factors for overweight and obesity in a sample of adolescents from Aquitaine, France

This study aimed to identify dietary behaviors that might be considered as associated factors for overweight or obesity among French adolescents. Forty-nine of the 536 middle and high schools in Aquitaine (southwest of France) were invited to take part in the study. For each school, participating adolescents were selected using stratification by grade. A self-report questionnaire, including information about sex, age, dietary behaviors, physical and sedentary activities, and parental socioeconomic status (SES), was filled in by adolescents during class. Overweight and obesity were defined according to the age- and sex-specific body mass index cutoff points of the International Obesity Task Force. Multivariate analysis (logistic regression) was used to identify independent dietary factors associated with overweight including obesity and obesity alone (adjustment on sex, age, parental SES, and weight status and adolescents' sedentary activity). In addition to parental SES and weight status and adolescents' sedentary activity, some dietary behaviors are also independently and significantly associated with a higher prevalence of overweight including obesity: absence (OR 1.43, 0.91–2.23) or rare (OR 1.57, 1.23–2.01) breakfast intake (p?<?0.01) and absence (OR 5.03, 3.19–7.92) or rare (OR 1.90, 1.46–2.47) light afternoon meal intake (p?<?0.001). All variables were also significantly and independently associated with obesity alone. This study shows that socioeconomic factors and individual behaviors are associated with overweight or obesity. These results confirm the importance to carry out multifaceted educational actions among adolescents, by promoting physical activity and healthy food choices in order to prevent overweight and promote healthy lifestyle behaviors.     

Prevalence of obesity and correlations with lifestyle and dietary factors in Chinese men

Objective: To estimate the age‐adjusted prevalence of general and centralized obesity among Chinese men living in urban Shanghai. Methods and Procedures: A cross‐sectional study was conducted in 61,582 Chinese men aged 40–75. BMI (kg/m²) was used to measure overweight (23 ≤ BMI < 27.4) and obesity (BMI ≥ 27.5) based on the World Health Organization (WHO) recommended criteria for Asians. Waist‐to‐hip ratio (WHR) was used to measure moderate (75th ≤ WHR < 90th percentile) and severe (WHR ≥ 90th percentile) centralized obesity. Results: The average BMI and WHR were 23.7 kg/m² and 0.90, respectively. The prevalence of overweight was 48.6% and obesity was 10.5%. The prevalence of general and centralized obesity was higher in men with high income or who were retired, tea drinkers, or nonusers of ginseng than their counterparts. Men with high education had a higher prevalence of overweight and centralized obesity, but had a lower prevalence of obesity and severe centralized obesity compared to those with less education. Current smokers or alcohol drinkers had a lower prevalence of general obesity but higher prevalence of centralized obesity than nonsmokers or nondrinkers of alcohol. Ex‐smokers and ex‐alcohol drinkers had a higher prevalence of general and centralized obesity compared to nonsmokers and nondrinkers of alcohol. Prevalence of obesity was associated with high energy intake and less daily physical activity. Discussion: The prevalence of obesity among Chinese men in urban Shanghai was lower than that observed in Western countries but higher than that in other Asian countries, and the prevalence of general and centralized obesity differed by demographic, lifestyle, and dietary factors.     

Prevalence of exclusive breastfeeding and associated factors among mothers in rural Bangladesh: a cross-sectional study

Background

Exclusive breastfeeding (EBF) means that the infant receives only breast milk for the first six months of life after birth. In Bangladesh, the prevalence of EBF remained largely unchanged for nearly two decades and was 43% in 2007. However, in 2011, a prevalence of 64% was reported, an increase by 21 percentage points. The reasons for this large change remain speculative at this point. Thus to investigate the issue further, this study was conducted. The objective was to assess the prevalence of EBF and associated factors among mothers having children aged 0–6 months in rural Bangladesh.

Methods

A cross-sectional study was conducted in Mirzapur Upazilla (sub district) among 121 mothers of infants aged 0–6 months. Eligible mothers were identified and randomly selected using the demographic surveillance system’s computerized database that is updated weekly. A semi-structured questionnaire was used for interviews that inquired information on socio-demographic characteristics, obstetric, health service, breastfeeding related factors (initiation of breastfeeding, prelacteal feeding and colostrum feeding) and economic factors. EBF prevalence was calculated using 24 hour recall method. In multivariate analysis, a logistic regression model was developed using stepwise modeling to analyze the factors associated with EBF.

Results

The prevalence of EBF in the last 24 hours preceding the survey was 36%. Bivariate and multivariate analysis revealed no significant association between EBF and its possible predictors at 0.05 level of alpha. However, there was some evidence of an association between EBF and having a caesarean delivery (OR?=?0.47, 95% CI: 0.21, 1.06). In multivariate analysis, type of delivery: caesarean (AOR?=?0.45, 95% CI: 0.19, 1.03) and wealth quintile: richer (AOR?=?2.40, 95% CI: 0.94, 6.16) also showed some evidence of an association with EBF.

Conclusion

The prevalence of EBF in Mirzapur (36%) is lower than the national figure (64%). Prelacteal feeding was not uncommon. These findings suggest that there is a need for breastfeeding support provided by health services. Hence, promotion of EBF during the first six months of life needs to be addressed and future breastfeeding promotion programmes should give special attention to those women who are not practicing EBF.

     

Prevalence of overweight and obesity in 2- to 6-year-old Italian children

Objective: To assess the prevalence of overweight and obesity in 2‐ to 6‐year‐old Italian children and to compare the prevalence between the north and the south of the country. Research Methods and Procedures: This was a cross‐sectional study of 2150 subjects (M/F: 1137/1013), 5.36 ± 0.83 years of age. The sampling areas were Verona (north Italy) and Messina (south Italy). We used definitions of overweight and obesity using BMI values, with cut‐off values proposed by the International Obesity Task Force. Results: The prevalence of overweight was 16.6% (males: 13.9%, females: 19.6%), and it was higher in the south (males: 17.8%, females: 22.4%) than in the north (males: 11.3%, females: 17.9%). The prevalence of obesity was 8.0% (males: 8.3%, females: 7.7%), and it was higher in the south (males: 12.3%, females: 10.7%) than in the north (males: 5.7%, females: 5.8%). Using the Centers for Disease Control reference charts, the prevalence of overweight and obesity of Italian children was close to that reported in children living in the United States (32% vs. 32.7%, respectively). Discussion: The prevalence of overweight and obesity in young Italian children is very high, and it is rapidly growing. In the south of the country, the prevalence is higher than in the north.     

Prevalence and associated factors of elder mistreatment in a rural community in People's Republic of China: a cross-sectional study

Background

Current knowledge about elder mistreatment is mainly derived from studies done in Western countries, which indicate that this problem is related to risk factors such as a shared living situation, social isolation, disease burden, and caregiver strain. We know little about prevalence and risk factors for elder mistreatment and mistreatment subtypes in rural China where the elder population is the most vulnerable.

Methods

In 2010, we conducted a cross-sectional survey among older adults aged 60 or older in three rural communities in Macheng, a city in Hubei province, China. Of 2245 people initially identified, 2039 were available for interview and this was completed in 2000. A structured questionnaire was used to collect data regarding mistreatment and covariates. Logistic regression analysis was used to identify factors related to elder mistreatment and subtypes of mistreatment.

Results

Elder mistreatment was reported by 36.2% (95% CI: 34.1%–38.3%) of the participants. Prevalence rates of psychological mistreatment, caregiver neglect, physical mistreatment, and financial mistreatment were 27.3% (95% CI: 25.3%–29.2%), 15.8% (95% CI: 14.2%–17.4%), 4.9% (95% CI: 3.9%–5.8%) and 2.0% (95% CI: 1.3%–2.6%), respectively. The multivariate logistic regression analysis revealed that depression, being widowed/divorced/single/separated, having a physical disability, having a labor intensive job, depending solely on self-made income, and living alone were risk factors for elder mistreatment. Different types of elder mistreatment were associated with different risk factors, and depression was the consistent risk factor for the three most common mistreatment subtypes.

Conclusion

Older adults in rural China self-report a higher rate of mistreatment than their counterparts in Western countries. Depression is a main risk factor associated with most subtypes of mistreatment. Our findings suggest that prevention and management of elder mistreatment is a challenge facing a rapidly aging Chinese population.     

Prevalence and pattern of dyslipidemia in hyperglycemic patients and its associated factors among Pakistani population

In diabetes mellitus dyslipidemia is one of the major risk factors for cardiovascular disease. In type 2 diabetes mellitus early detection and treatment of dyslipidemia can avoid risk for cardiovascular disorder. The present study was carried to determine the prevalence and pattern of hyperlipidemia in patients with hyperglycemia. The cross sectional study was done in different laboratories of Pakistan, the laboratories served patients referred from different government and private hospitals between July 2014 and June 2015. All known cases of diabetes mellitus were evaluated for their lipid profile. Totally 200 diabetic patients were included in the study in which 120 (60%) were males and 80 (40%) were females. Prevalence of dyslipidemia among diabetic males was 97.18% while for females 87.15%. Among dyslipidemic male the proportion with mixed dyslipidemic patients was 17.5%, combined two parameters dyslipidemia was 47.5% and isolated single parameter dyslipidemia was 35%. In females these proportions in mixed, combined two parameters and isolated single parameter were 16.25%, 51.25% and 32.5%, respectively. Majority of hyperglycemic patients were dyslipidemic. The most prevalent pattern among male was combined dyslipidemia with high triglycerides (TG) and low High Density Lipoprotein (HDL) and in female it was high Low Density Lipoprotein (LDL) and low HDL. The most prevalent lipid abnormality in our study was low HDL followed by high TG.     

Secular trends of obesity and cardiovascular risk factors in a Mediterranean population

Objective: To evaluate time trends of obesity, abdominal obesity, and cardiovascular risk factors (CRFs) according to BMI and waist circumference (WC) categories in a Mediterranean population. Research Methods and Procedures: Subjects were Spanish men (n = 2383) and women (n = 2525) 25 to 74 years old, examined in 1994 to 1995 and 1999 to 2000 in two independent population‐based cross‐sectional surveys in the northeast of Spain. Lifestyle measures, CRFs, and anthropometric variables were analyzed. Results: Over the 5 years of the study, mean age‐standardized BMI increased by 1.0 units in men and by 0.8 units in women. At the same time the prevalence of obesity increased from 15.4% to 21.9% in men and from 15.4% to 21.4% in women. An upward trend was observed for WC and abdominal obesity (WC > 102 cm in men and WC > 88 cm in women) only in men. The proportion of men and women with hypercholesterolemia, diabetes, and low high‐density lipoprotein‐cholesterol plasma concentration remained stable within BMI and WC categories. The proportion of hypertension and smoking in obese men significantly increased from 1995 to 2000. Discussion: The 5‐year increase in BMI and WC is of considerable magnitude in the present population, although several CRFs remained stable within BMI and WC categories.     

Prevalence of overweight and obesity among the affluent adolescent school children of Amritsar, Punjab

In the present study, an attempt has been made to assess the prevalence of overweight and obesity in adolescent children (between 10-15 years of age) of the affluent families of Amritsar district of Punjab, a state in rapid economic and epidemiological transition. A total of 640 children (323 boys and 317girls) were measured for height and weight. Overweight and obesity were assessed using age and sex-specific body mass index (BMI) cut-off points. 9.91% boys and 11.99% girls were overweight, and 4.95% boys and 6.31% girls were obese. The prevalence of overweight and obesity among the affluent children in Amritsar was as high or higher as in some industrialized countries.     

Relationship between overweight, obesity and socioeconomic factors of adolescents in Vojvodina, Serbia

Obesity is a very important issue in developed societies and depends on many factors. The aim of this paper was to determine a possible relationship between overweight, obesity and socioeconomic factors among adolescents in Vojvodina. A cross-sectional anthropometric study was carried out from 2001 to 2004 in towns of Vojvodina, northern Serbia. The research included height and body weight measurements as well as body mass index (BMI) of 1236 schoolboys and 1414 schoolgirls aged 15–18 years. The socioeconomic factors (SES) included parents’ level of education and monthly income per family member. The overweight prevalence of about 10% (85 < P < 95) and the prevalence of obesity of 5% (P > 95) were recorded in both male and female adolescents. A significant correlation (p < 0.01) between all socioeconomic factors was observed in male subjects, although there were no significant differences in the prevalence of overweight and obesity when different categories of subjects set by SES were compared. In females lower rates of the prevalence of overweight and obesity were detected in the subjects whose parents had a university education, but the difference was not significant. Regarding the prevalence of obesity, a significant difference was recorded between females with high and low incomes, those with a high income showing significantly greater prevalence of obesity than females coming from low income families. The results of the research indicate that in Vojvodina the family income is the only factor that significantly correlates with female obesity.     

Prevalence of gallstones and risk factors in Caucasian women in a rural Canadian community.

The prevalence of gallstones and gallbladder disease was studied in a rural Caucasian population. All the women aged 15 to 50 years were asked to complete a questionnaire, undergo cholecystography and keep a food record for 4 consecutive days. The gallbladder status was assessed in 73%. The prevalence of gallstones in this population, 167/1000, was considerably higher than that reported in the Framingham study (59/1000) but was not significantly different from that recently found in Micmac Indian women living nearby in Canada (211/1000). In contrast to all the other studies in Caucasian women, this study showed the prevalence of gallstones to peak between the ages of 30 and 39 years. The risk factors, controlled for age, were found to be obesity, a narrow range of daily energy intake, a low daily calcium intake and limited activity. Discriminant analysis showed that skinfold thickness and range of daily energy intake or all measures of obesity together correctly separated the persons with gallstones from those without.