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Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population.

Abstract

BACKGROUND

The associations of body mass index (BMI) and chronic disease may differ between Indo-Asian and Western populations. We used Indo-Asian-specific definitions of overweight and obesity to determine the prevalence of these problems in Pakistan and studied the sensitivity and specificity of BMI cutoff values for an association with hypertension and diabetes mellitus.

METHODS

We analyzed data for 8972 people aged 15 years or more from the National Health Survey of Pakistan (1990-1994). People considered overweight or obese were those with a BMI of 23 kg/m2 or greater, and those considered obese as having a BMI of 27 kg/m2 or greater. We built multivariable models and performed logistic regression analysis.

RESULTS

The prevalence of overweight and obesity, weighted to the general Pakistani population, was 25.0% (95% confidence interval [CI] 21.8%-28.2%). The prevalence of obesity was 10.3% (95% CI 7.0%-13.2%). The factors independently and significantly associated with overweight and obesity included greater age, being female, urban residence, being literate, and having a high (v. low) economic status and a high (v. low) intake of meat. With receiver operating characteristic curves, we found that the use of even lower BMI cutoff values (21.2 and 22.1 kg/m2 for men and 21.2 and 22.9 kg/m2 for women) than those recommended for an Indo-Asian population yielded the optimal areas under the curve for an association with hypertension and diabetes, respectively.

INTERPRETATION

A quarter of the population of Pakistan would be classified as overweight or obese with the use of Indo-Asian-specific BMI cutoff values. Optimal identification of those at risk of hypertension and diabetes and healthy targets may require the use of even lower BMI cutoff values than those already proposed for an Indo-Asian population.

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  • Authors+Show Affiliations

    ,

    Clinical Epidemiology Unit, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan. tazeen.jafar@aku.edu

    ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Asia
    Body Mass Index
    Cross-Sectional Studies
    Diabetes Mellitus
    Female
    Humans
    Hypertension
    India
    Male
    Middle Aged
    Obesity
    Overweight
    Pakistan
    Prevalence
    Regression Analysis
    Sensitivity and Specificity

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    17060656

    Citation

    Jafar, Tazeen H., et al. "Prevalence of Overweight and Obesity and Their Association With Hypertension and Diabetes Mellitus in an Indo-Asian Population." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 175, no. 9, 2006, pp. 1071-7.
    Jafar TH, Chaturvedi N, Pappas G. Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population. CMAJ. 2006;175(9):1071-7.
    Jafar, T. H., Chaturvedi, N., & Pappas, G. (2006). Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 175(9), pp. 1071-7.
    Jafar TH, Chaturvedi N, Pappas G. Prevalence of Overweight and Obesity and Their Association With Hypertension and Diabetes Mellitus in an Indo-Asian Population. CMAJ. 2006 Oct 24;175(9):1071-7. PubMed PMID: 17060656.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population. AU - Jafar,Tazeen H, AU - Chaturvedi,Nish, AU - Pappas,Gregory, PY - 2006/10/25/pubmed PY - 2006/11/9/medline PY - 2006/10/25/entrez SP - 1071 EP - 7 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 175 IS - 9 N2 - BACKGROUND: The associations of body mass index (BMI) and chronic disease may differ between Indo-Asian and Western populations. We used Indo-Asian-specific definitions of overweight and obesity to determine the prevalence of these problems in Pakistan and studied the sensitivity and specificity of BMI cutoff values for an association with hypertension and diabetes mellitus. METHODS: We analyzed data for 8972 people aged 15 years or more from the National Health Survey of Pakistan (1990-1994). People considered overweight or obese were those with a BMI of 23 kg/m2 or greater, and those considered obese as having a BMI of 27 kg/m2 or greater. We built multivariable models and performed logistic regression analysis. RESULTS: The prevalence of overweight and obesity, weighted to the general Pakistani population, was 25.0% (95% confidence interval [CI] 21.8%-28.2%). The prevalence of obesity was 10.3% (95% CI 7.0%-13.2%). The factors independently and significantly associated with overweight and obesity included greater age, being female, urban residence, being literate, and having a high (v. low) economic status and a high (v. low) intake of meat. With receiver operating characteristic curves, we found that the use of even lower BMI cutoff values (21.2 and 22.1 kg/m2 for men and 21.2 and 22.9 kg/m2 for women) than those recommended for an Indo-Asian population yielded the optimal areas under the curve for an association with hypertension and diabetes, respectively. INTERPRETATION: A quarter of the population of Pakistan would be classified as overweight or obese with the use of Indo-Asian-specific BMI cutoff values. Optimal identification of those at risk of hypertension and diabetes and healthy targets may require the use of even lower BMI cutoff values than those already proposed for an Indo-Asian population. SN - 1488-2329 UR - https://www.unboundmedicine.com/medline/citation/17060656/Prevalence_of_overweight_and_obesity_and_their_association_with_hypertension_and_diabetes_mellitus_in_an_Indo_Asian_population_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=17060656 DB - PRIME DP - Unbound Medicine ER -