What Drives Abdominal Obesity in Peru? A Multilevel Analysis Approach Using a Nationally Representative Survey

Abstract

Abdominal obesity (AO) is a serious public health threat due to its increasing prevalence and effect on the development of various non-communicable diseases. A multilevel analysis of the 2019 Demographic and Family Health Survey (ENDES in Spanish) using the Latin American Diabetes Association (ALAD in Spanish) cut-off points was carried out to evaluate the individual and contextual factors associated with AO in Peru. A total of 30,585 individuals 18 years and older were included in the analysis. The prevalence of AO among Peruvians in 2019 was 56.5%. Individuals of older age (aOR 4.64; 95% CI: 3.95–5.45), women (aOR 2.74; 95% CI: 2.33–3.23), individuals with a higher wealth index (aOR 2.81; 95% CI: 2.40–3.30) and having only secondary education (aOR 1.45; 95% CI: 1.21–1.75) showed increased odds of presenting AO compared to their peers. At a contextual level, only the Human Development Index (aOR 1.59; 95% CI: 1.17–2.16) was associated with the development of AO. A high Human Development Index is the contextual factor most associated with AO. It is necessary to formulate and implement new public health policies focused on these associated factors in order to reduce the prevalence of OA and prevent the excessive burden of associated noncommunicable diseases.

Factors Associated with Normal-Weight Abdominal Obesity Phenotype in a Representative Sample of the Peruvian Population: A 4-Year Pooled Cross-Sectional Study

“…A pattern of abdominal obesity [2] has been shown to increase the health care burden, as previously reported by others [15,16], highlighting the need for encouraging WC measurement even in normal BMI individuals. Fourth, while socioeconomic inequalities among abdominal obesity in the general population have been documented [67], our study suggests that central obesity is currently affecting both extremes of income distribution at an almost similar magnitude among individuals with a normal BMI. Therefore, interventions aimed at reducing the cardiometabolic burden should be tailored to the needs of each income group rather than adopting a "one size fits all" approach.…”

“…Our findings showed that both low and high-wealth indexes displayed a risk for abdominal fat accretion. Previous studies have shown that the wealth index is related to central obesity [10,57,[67][68][69]. However, the associated pattern may differ between countries' income levels.…”

“…On the contrary, in 2020, GDP per capita showed the lowest level in the past 5 years. This, along with the epidemic COVID-19 and the associated confinement, may have increased sedentary behavior and decreased compliance with healthy dietary habits (i.e., a decrease in fruit and vegetable intake and an increase in sweets and dessert consumption, among others) [67,73], which in turn may have increased abdominal obesity prevalence. Furthermore, the release of sanitary restrictions imposed during the COVID-19 pandemic displayed in Peru in the year 2021 may explain the decreased prevalence ratio for the normal-weight abdominal obesity phenotype when compared to 2020.…”

Niveles de adiposidad corporal en el fenotipo delgado metabólicamente obeso: Análisis transversal de pobladores peruanos

“…Sin embargo, es de destacar que estos estudios se realizaron en poblaciones de Canadá y China, que difieren étnicamente de la población de nuestro estudio. En respaldo de lo hallado en esta investigación, se ha reportado en población peruana que las mujeres sufren de manera más severa la adiposidad abdominal y las alteraciones metabólicas en comparación con los hombres 14,34 . Más aun, la distribución de grasa corporal varía entre países de Latinoamérica, donde las mujeres peruanas muestran una mayor asociación entre la genómica ancestral nativo americana y la relación cintura-cadera (β=0,014 p<0,001), respecto de sus pares colombianas y chilenas (β=0,005; p=0,003 y β=0,008; p=0,001, respectivamente) 28 .…”

Diagnostic Performance of the Measurement of Skinfold Thickness for Abdominal and Overall Obesity in the Peruvian Population: A 5-Year Cohort Analysis

“…In Peru, the prevalence of obesity among individuals over 15 years old was reported to be 25.8% in 2021 [9]. Abdominal obesity affects over 50% of the adult population in the country [10].…”