Trajectories of body mass index and waist circumference in four Peruvian settings at different level of urbanisation: the CRONICAS Cohort Study

Abstract

BackgroundStudies have reported the incidence/risk of becoming obese, but few have described the trajectories of body mass index (BMI) and waist circumference (WC) over time, especially in low/middle-income countries. We assessed the trajectories of BMI and WC according to sex in four sites in Peru.MethodsData from the population-based CRONICAS Cohort Study were analysed. We fitted a population-averaged model by using generalised estimating equations. The outcomes of interest, with three data points over time, were BMI and WC. The exposure variable was the factorial interaction between time and study site.ResultsAt baseline mean age was 55.7 years (SD: 12.7) and 51.6% were women. Mean follow-up time was 2.5 years (SD: 0.4). Over time and across sites, BMI and WC increased linearly. The less urbanised sites showed a faster increase than more urbanised sites, and this was also observed after sex stratification. Overall, the fastest increase was found for WC compared with BMI. Compared with Lima, the fastest increase in WC was in rural Puno (coefficient=0.73, P<0.001), followed by urban Puno (coefficient=0.59, P=0.001) and Tumbes (coefficient=0.22, P=0.088).ConclusionsThere was a linear increase in BMI and WC across study sites, with the greatest increase in less urbanised areas. The ongoing urbanisation process, common to Peru and other low/middle-income countries, is accompanied by different trajectories of increasing obesity-related markers.

Urbanization in Peru is inversely associated with double burden of malnutrition: Pooled analysis of 92,841 mother–child pairs

“…All aforementioned behavioral changes and obesogenic environments ( 7 , 29 ) explain faster BMI increases among adult women in rural areas ( 30 , 31 , 32 ). In this line, although adult female overweight/obesity seems to be the main driver of DBM ( 33 ), child undernutrition rates remain persistent and higher in rural areas ( 34 ), and thus, rural households will experience DBM.…”

Measured and Perceived Body Weight Status of Women in the Peruvian Amazon

“…In Latin America, almost one quarter of the population is obese [3], with a predicted prevalence of 43.6% by 2030 [4]. Similar trends are observed in Peru, with overweight and obesity prevalence at 43.6% and 26.9%, respectively [5]. Significantly, a greater proportion of excess weight appears among the adult female population, with an estimated 24.2% obese vs. 15.2% of men [6].…”

“…Waist circumference (WC) was measured according to the World Health Organisation protocol [24] at the midpoint between the last palpable rib and the top of the iliac crest. The cut-off point of ≥ 80 cm for women defined central obesity, according to the International Diabetes Federation waist circumference cut-off points for Ethnic Central and South American populations [5,25].…”

Altitude and its inverse association with abdominal obesity in an Andean country: a cross-sectional study

“…Please be careful and consistent with words used.Some longitudinal studies have been published showing the association of interest and they have not been considered here (e.g. PMID: 29472520 1 ).What is the novelty in this paper? Is it altitude?…”

“…Some longitudinal studies have been published showing the association of interest and they have not been considered here (e.g. PMID: 29472520 1 ).…”