A cross sectional survey on social, cultural and economic determinants of obesity in a low middle income setting

Abstract

IntroductionObesity is an increasing problem in South Asian countries and Sri Lanka is no exception. The socioeconomic determinants of obesity in Sri Lanka, and in neighbouring countries are inadequately described. Aim was to describe social, cultural and economic determinants of obesity in a representative sample from Kalutara District in Sri Lanka.MethodsThis was a cross sectional descriptive study conducted among adults aged 35–64 years. A representative sample was selected using stratified random cluster sampling method from urban, rural and plantation sectors of Kalutara District. Data were collected using a pre-tested questionnaire. A body mass index of 23.01 kg/m2-27.50 kg/m2 was considered as overweight and ≥27.51 kg/m2 as obese. Waist circumference (WC) of ≥ 90 cm and ≥80 cm was regarded as high for men and women respectively. Significance of prevalence of obesity categories across different socio-economic strata was determined by chi square test for trend.ResultsOf 1234 adults who were screened, age and sex adjusted prevalence of overweight, obesity and abdominal obesity (high WC) were 33.2% (male 27.3%/female 38.7%), 14.3% (male 9.2%/female 19.2%) and 33.6% (male 17.7%/female 49.0%) respectively. The Muslims had the highest prevalence of all three obesity categories. Sector, education, social status quintiles and area level deprivation categories show a non linear social gradient while income shows a linear social gradient in all obesity categories, mean BMI and mean WC. The differences observed for mean BMI and mean WC between the lowest and highest socioeconomic groups were statistically significant.ConclusionThere is a social gradient in all three obesity categories with higher prevalence observed in the more educated, urban, high income and high social status segments of society. The higher socioeconomic groups are still at a higher risk of all types of obesity despite other public health indicators such as maternal and infant mortality displaying an established social gradient.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-015-0140-8) contains supplementary material, which is available to authorized users.

Assessment of Nutritional Status and Dietary Pattern of a Rural Adult Population in Dry Zone, Sri Lanka

“…Rathnayake et al [49] reported a higher average BMI for adult women than in our present study; conversely, the average BMI for women reported by Katulanda et al [8] (22.7 [4.5] kg/m 2 ) was lower than the current study. However, an average BMI for women similar to the present study has also been reported [45,47,48]. The mean BMI of women was higher than that of the men which is similar to previous studies [44,45,47].…”

“…However, an average BMI for women similar to the present study has also been reported [45,47,48]. The mean BMI of women was higher than that of the men which is similar to previous studies [44,45,47]. The mean WC of women (85.96 [9.53] cm) was higher than the Asian cut-off and previously reported values by Katulanda et al (76.8 [12.2] [49].…”

“…The mean (SD) BMI of the total study population was 23.06 (4.2) kg/m 2 , which is similar to the average BMI reported by Ranasinghe et al (23.8 [4.2] kg/m 2 ) [28], but higher than the mean BMI observed in a national survey (21.8 [4.2] kg/m 2 ) [44] and in the Kaluthara district (22.9 [0.28] kg/m 2 ) for adults [45]. The mean BMI for men in the present study is similar to the average BMI for men reported using national (21.1 [3.7] kg/m 2 ) [8], provincial (Central Province, 22.7 [4.2] kg/m 2 [46]; four provinces, 21.5 [3.7] kg/m 2 [47]) and district (Colombo district, 22.8 [4.3] kg/m 2 [48]; Kaluthara district, 21.9 [0.46] kg/m 2 [45]) populations. Rathnayake et al [49] reported a higher average BMI for adult women than in our present study; conversely, the average BMI for women reported by Katulanda et al [8] (22.7 [4.5] kg/m 2 ) was lower than the current study.…”

A Study on Abdominal Obesity at Basra University Staffs

“…while Indian study found that of abdominal obesity was 46.6% (women: 56.2%> men: 35.1%,) [14] study done Sri lank found that prevalence of overweight, obesity and abdominal obesity (high WC) were 33.2% (male 27.3%/female 38.7%), 14.3% (male 9.2%/female 19.2%) and 33.6% (male 17.7%/female 49.0%) respectively. [15] which is similar to our finding to some extent. our study differ from a study done Spain where all the values of obesity and abdominal obesity is less (16.6% in males and 15.2% in females ) [16] also Iran study had less prevalence of obesity (34.8%)and less abdominal obesity (28.3) but it is similar to our study in that female had higher prevalence of abdominal obesity than males [17] Netherlands study showed very low prevalence of obesity in compared to our study, it was 4 and 6% in men and women, respectively [18] …”

A comparison study on the prevalence of obesity and its associated factors among city, township and rural area adults in China

“…13 This was also consistent with the previous report that a higher prevalence of obesity was observed in the more educated, urban, high income and high social status segments of society. [14][15][16][17] Recently, in Drewnowski A's study, census tract level home values and college education were more strongly associated with obesity than household incomes. For each additional $100 000 in median home values, the census tract obesity prevalence was 2.3% lower.…”