The spatial distribution of overweight and obesity among a birth cohort of young adult Filipinos (Cebu Philippines, 2005): an application of the Kulldorff spatial scan statistic

Abstract

Objectives:The objectives of the study were to test for spatial clustering of obesity in a cohort of young adults in the Philippines, to estimate the locations of any clusters, and to relate these to neighborhood-level urbanicity and individual-level socioeconomic status (SES).Subjects:Data are from a birth cohort of young adult (mean age 22 years) Filipino males (n=988) and females (n=820) enrolled in the Cebu Longitudinal Health and Nutrition Survey.Methods:We used the Kulldorff spatial scan statistic to detect clusters associated with unusually low or high prevalences of overweight or obesity (defined using body mass index, waist circumference and body fat percentage). Cluster locations were compared to neighborhood-level urbanicity, which was measured with a previously validated scale. Individual-level SES was adjusted for using a principal components analysis of household assets.Results:High-prevalence clusters were typically centered in urban areas, but often extended into peri-urban and even rural areas. There were also differences in clustering by both sex and the measure of obesity used. Evidence of clustering in males, but not females, was much weaker after adjustment for SES.

Duration of US Residence Is Associated With Overweight Risk in Filipino Immigrants Living in New York Metro Area

“…Also, among Filipinos who migrated to US between the ages of 30–49 years, those who originated from the Visayas region in the Philippines, compared to other regions, were more likely to be overweight, a finding that could be potentially explained by regional variation in urbanicity. 6,7,44 In addition, the geography of the Philippine islands and its complex colonial history– with Spanish, Islamic and US influences – has created considerable cultural diversity among the island regions 46 , and consequently behaviors that relate to diet and/or activity patterns that predispose to obesity.…”

“…Also because of potential variation in degree of urbanization, culture, diet and activity patterns by region in the Philippines, we included island group of origin (Luzon, Visayas, Mindanao). 6,44 …”

“…4 These transitions are occurring throughout the developing world where the pace of urbanization has been especially rapid with evidence of higher obesity rates in more urbanized areas. 6,7,44 Because the Philippines is already experiencing rapid growth in obesity, substantial increases in obesity might have occurred prior to migration to US. 45 Second, having migrated to the US from the Philippines, a country with over 4 decades of US colonial rule 46 , many Filipinos arrive with high levels of English proficiency 18 and begin their US acculturation process prior to migration.…”

Experimental manipulation of visual attention affects body size adaptation but not body dissatisfaction

“…Conversely, a significant proportion of overweight or obese individuals (WHO, ) perceive themselves to be lighter than they really are (Cornelissen et al, ; Gunnare, Silliman, & Morris, ), and this underestimation is associated with underestimation of cardiovascular and personal health risks (Powell et al, ). Since obesity tends to be geographically clustered (Dahly, Gordon‐Larsen, Emch, Borja, & Adair, ; Joost et al, ; Tamura et al, ), individuals living in high obesity areas are both more likely to be obese, and more likely to be exposed to more obese bodies in their visual environment.…”

Fatores clínico-comportamentais associados ao excesso ponderal em adultos jovens estudantes [Clinical-behavioral factors associated with overweight in young adults students] [Factores clínico-conductuales asociados al exceso ponderal en adultos jóvenes estudiantes]

“…Extrapolando essas fronteiras, verificou-se que as Filipinas apresentaram um número de adultos jovens com EP cerca de 4 vezes menor (8,7%) que o encontrado em Fortaleza. Nesse país, diversidades regionais também ficaram evidentes, onde se identificou que os grupos de alta prevalência de EP foram centradas no núcleo urbano da Região Metropolitana 10 . Tal fato remete para uma diferença de hábitos, costumes e questões sociais nas diferentes regiões.…”