Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR - INDIAB Study (Phase-I) [ICMR - INDIAB-3]

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Abstract

Background & objectives:

Overweight and obesity are rapidly increasing in countries like India. This study was aimed at determining the prevalence of generalized, abdominal and combined obesity in urban and rural India.

Methods:

Phase I of the ICMR-INDIAB study was conducted in a representative population of three States [Tamil Nadu (TN), Maharashtra (MH) and Jharkhand (JH)] and one Union Territory (UT)[Chandigarh (CH)] of India. A stratified multi-stage sampling design was adopted and individuals ≥20 yr of age were included. WHO Asia Pacific guidelines were used to define overweight [body mass index (BMI) ≥23 kg/m ² but <25 kg/m ²), generalized obesity (GO, BMI≥25kg/m ²), abdominal obesity (AO, waist circumference ≥90 cm for men and ≥80cm for women) and combined obesity (CO, GO plus AO). Of the 14,277 participants, 13,800 subjects (response rate, 96.7%) were included for the analysis (urban: n=4,063; rural: n=9737).

Results:

The prevalence of GO was 24.6, 16.6, 11.8 and 31.3 per cent among residents of TN, MH, JH and CH, while the prevalence of AO was 26.6, 18.7, 16.9 and 36.1 per cent, respectively. CO was present in 19.3, 13.0, 9.8 and 26.6 per cent of the TN, MH, JH and CH population. The prevalence of GO, AO and CO were significantly higher among urban residents compared to rural residents in all the four regions studied. The prevalence of overweight was 15.2, 11.3, 7.8 and 15.9 per cent among residents of TN, MH, JH and CH, respectively. Multiple logistic regression analysis showed that female gender, hypertension, diabetes, higher socio-economic status, physical inactivity and urban residence were significantly associated with GO, AO and CO in all the four regions studied. Age was significantly associated with AO and CO, but not with GO.

Interpretation & conclusions:

Prevalence of AO as well as of GO were high in India. Extrapolated to the whole country, 135, 153 and 107 million individuals will have GO, AO and CO, respectively. However, these figures have been estimated from three States and one UT of India and the results may be viewed in this light.

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Most cited references 33

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Obesity and the metabolic syndrome in developing countries.

Anoop Misra, Lokesh Khurana (2008)

Prevalence of obesity and the metabolic syndrome is rapidly increasing in developing countries, leading to increased morbidity and mortality due to type 2 diabetes mellitus (T2DM) and cardiovascular disease. Literature search was carried out using the terms obesity, insulin resistance, the metabolic syndrome, diabetes, dyslipidemia, nutrition, physical activity, and developing countries, from PubMed from 1966 to June 2008 and from web sites and published documents of the World Health Organization and Food and Agricultural Organization. With improvement in economic situation in developing countries, increasing prevalence of obesity and the metabolic syndrome is seen in adults and particularly in children. The main causes are increasing urbanization, nutrition transition, and reduced physical activity. Furthermore, aggressive community nutrition intervention programs for undernourished children may increase obesity. Some evidence suggests that widely prevalent perinatal undernutrition and childhood catch-up obesity may play a role in adult-onset metabolic syndrome and T2DM. The economic cost of obesity and related diseases in developing countries, having meager health budgets is enormous. To prevent increasing morbidity and mortality due to obesity-related T2DM and cardiovascular disease in developing countries, there is an urgent need to initiate large-scale community intervention programs focusing on increased physical activity and healthier food options, particularly for children. International health agencies and respective government should intensively focus on primordial and primary prevention programs for obesity and the metabolic syndrome in developing countries.

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Prevalence of obesity among adults from rural and urban areas of the United States: findings from NHANES (2005-2008).

Christie Befort, Niaman Nazir, Michael Perri (2012)

Rural residents have higher rates of chronic diseases compared to their urban counterparts, and obesity may be a major contributor to this disparity. This study is the first analysis of obesity prevalence in rural and urban adults using body mass index classification with measured height and weight. In addition, demographic, diet, and physical activity correlates of obesity across rural and urban residence are examined. Analysis of body mass index (BMI), diet, and physical activity from 7,325 urban and 1,490 rural adults in the 2005-2008 National Health and Nutrition Examination Survey (NHANES). The obesity prevalence was 39.6% (SE = 1.5) among rural adults compared to 33.4% (SE = 1.1) among urban adults (P = .006). Prevalence of obesity remained significantly higher among rural compared to urban adults controlling for demographic, diet, and physical activity variables (odds ratio = 1.18, P = .03). Race/ethnicity and percent kcal from fat were significant correlates of obesity among both rural and urban adults. Being married was associated with obesity only among rural residents, whereas older age, less education, and being inactive was associated with obesity only among urban residents. Obesity is markedly higher among adults from rural versus urban areas of the United States, with estimates that are much higher than the rates suggested by studies with self-reported data. Obesity deserves greater attention in rural America. © 2012 National Rural Health Association.

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High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India.

N Khanna, N. Raj Vikram, R. Pandey … (2001)

In this study, a prevalence survey of various atherosclerosis risk factors was carried out on hitherto poorly studied rural-urban migrants settled in urban slums in a large metropolitan city in northern India, with the aim of studying anthropometric and metabolic characteristics of this population in socio-economic transition. A cross-sectional epidemiological descriptive study. A total of 532 subjects (170 males and 362 females) were included in the study (response rate approximately 40%). In this study, diabetes mellitus was recorded in 11.2% (95% CI 6.8-16.9) of males and 9.9% (95% CI 7.0-13.5) of females, the overall prevalence being 10.3% (95% CI 7.8-13.2). Based on body mass index (BMI), obesity was more prevalent in females (15.6%; 95% CI 10.7-22.3) than in males (13.3%; 95% CI 8.5-19.5). On the other hand, classifying obesity based on percentage body fat (%BF), 10.6% (95% CI 6.4-16.2) of males and 40.2% (95% CI 34.9-45.3) of females were obese. High waist-hip ratio (WHR) was observed in 9.4% (95% CI 5.4-14.8) of males and 51.1% (95% CI 45.8-56.3) of the females. All individual skinfolds and sum of skinfolds were significantly higher in females (P 30%). Furthermore, total cholesterol and low-density lipoprotein cholesterol were high in both males and females. Stepwise multiple linear regression analysis showed that for both males and females BMI, WHR and %BF were positive predictors of biochemical parameters, except for HDL-c, for which these parameters were negatively associated. Appreciable prevalence of obesity, dyslipidaemia, diabetes mellitus, substantial increase in body fat, generalised and regional obesity in middle age, particularly in females, need immediate attention in terms of prevention and health education in such economically deprived populations.

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Author and article information

Journal

Journal ID (nlm-ta): Indian J Med Res

Journal ID (iso-abbrev): Indian J. Med. Res

Journal ID (publisher-id): IJMR

Title: The Indian Journal of Medical Research

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 0971-5916

ISSN (Electronic): 0975-9174

Publication date (Print): August 2015

Volume: 142

Issue: 2

Pages: 139-150

Affiliations

[1 ] Department of Epidemiology & Diabetology, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, Chennai, India

[2 ] Department of Endocrinology, Lilavati Hospital, Mumbai, India

[3 ] Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India

[4 ] Department of Medicine, Indira Gandhi Government Medical College, Nagpur, India

[5 ] Department of Diabetology, Diabetes Care Center, Ranchi, India

[6 ] Department of Medicine, University College of Medical Sciences & GTB Hospital, Delhi, India

[7 ] Department of Endocrinology & Metabolism, Nizam's Institute of Medical Sciences, Hyderabad, India

[8 ] Division of Non Communicable Diseases, Indian Council of Medical Research, New Delhi, India

[9 ] Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India

Author notes

Reprint requests: Dr V. Mohan, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases, Prevention & Control & IDF Centre for Education, 4, Conran Smith Road, Gopalapuram, Chennai 600 086, Tamil Nadu, India e-mail: drmohans@ 123456diabetes.ind.in

Article

Publisher ID: IJMR-142-139

DOI: 10.4103/0971-5916.164234

PMC ID: 4613435

PubMed ID: 26354211

SO-VID: 3e947617-fed4-436a-831a-12ac90204651

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Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR - INDIAB Study (Phase-I) [ICMR - INDIAB-3]

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Abstract

Background & objectives:

Methods:

Results:

Interpretation & conclusions:

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Journal of Medical Education Research

Most cited references 33

Obesity and the metabolic syndrome in developing countries.

Prevalence of obesity among adults from rural and urban areas of the United States: findings from NHANES (2005-2008).

High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India.

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