TY - JOUR
T1 - Trends and social determinants of the obesity epidemic among reproductive-age women in ten Asian countries
AU - Thapa, Subash
AU - Ahmed, Kedir Y.
AU - Bizuayehu, Habtamu Mellie
AU - Huda, M. Mamun
AU - Chalise, Binaya
AU - Bore, Meless G.
AU - Belachew, Sewunet Admasu
AU - Hassen, Tahir A.
AU - Amsalu, Erkihun
AU - Shifti, Desalegn Markos
AU - Seid, Abdulbasit
AU - Mesfin, Yonatan M.
AU - Tegegne, Teketo Kassaw
AU - Dadi, Abel F.
AU - Odo, Daniel Bogale
AU - Kibret, Getiye Dejenu
AU - Ketema, Daniel Bekele
AU - Kassa, Zemenu Yohannes
AU - Anyasodor, Anayochukwu E.
AU - Mahmood, Shakeel
AU - Astawesegn, Feleke Hailemichael
AU - Ross, Allen G.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/9/29
Y1 - 2024/9/29
N2 - The rapid epidemiological transition in Asian countries, resulting from the rising trend of urbanisation and lifestyle changes, is associated with an increasing risk of obesity in women of reproductive age. This is the first study to investigate the trends and population-attributable fraction (PAF) of obesity, and the interaction effects of education and wealth on obesity among reproductive-age women aged 15–49 years in ten Asian countries. This cross-sectional study examined the most recent (2000 to 2022) Demographic and Health Surveys (DHS) data from ten Central and Southeast Asian countries. Multilevel multinomial logistic regression models were used to compute odds ratios (ORs). PAFs adjusted for communality were calculated using adjusted ORs and prevalence estimates for each risk factor. This study included a weighted sample of 743,494 reproductive-age women. All the countries showed an increasing trend for obesity and a decreasing trend for underweight, except for the Maldives. The highest PAFs of obesity were associated with women who were married (PAF = 22.2%; 95% CI 22.1, 22.4), aged 35–49 years (PAF = 16.4%; 95% CI 15.5, 17.1), resided in wealthy households (PAF = 14.5%; 95% CI 14.4, 14.5), watched television regularly (PAF = 12.5%; 95% CI 12.1, 12.8), and lived in urban areas (PAF = 7.8%; 95% CI 7.7, 8.0). The combined PAF showed that these five risk factors were associated with 73.3% (95% CI 71.8, 74.9) of obesity among reproductive-age women. Interaction analysis between women’s education and household wealth revealed that having a secondary or higher level of education and residing in a wealthier household was associated with a lower risk of obesity (OR = 0.71, 95% CI 0.66, 0.76). The findings of this study suggest that, in order to address the rising rate of obesity among women in Asian countries, education and lifestyle modifications in urban areas should be a priority. Pakistan and the Maldives need to be a priority given the rapidly increasing trends in obesity and underweight subpopulations in their respective countries.
AB - The rapid epidemiological transition in Asian countries, resulting from the rising trend of urbanisation and lifestyle changes, is associated with an increasing risk of obesity in women of reproductive age. This is the first study to investigate the trends and population-attributable fraction (PAF) of obesity, and the interaction effects of education and wealth on obesity among reproductive-age women aged 15–49 years in ten Asian countries. This cross-sectional study examined the most recent (2000 to 2022) Demographic and Health Surveys (DHS) data from ten Central and Southeast Asian countries. Multilevel multinomial logistic regression models were used to compute odds ratios (ORs). PAFs adjusted for communality were calculated using adjusted ORs and prevalence estimates for each risk factor. This study included a weighted sample of 743,494 reproductive-age women. All the countries showed an increasing trend for obesity and a decreasing trend for underweight, except for the Maldives. The highest PAFs of obesity were associated with women who were married (PAF = 22.2%; 95% CI 22.1, 22.4), aged 35–49 years (PAF = 16.4%; 95% CI 15.5, 17.1), resided in wealthy households (PAF = 14.5%; 95% CI 14.4, 14.5), watched television regularly (PAF = 12.5%; 95% CI 12.1, 12.8), and lived in urban areas (PAF = 7.8%; 95% CI 7.7, 8.0). The combined PAF showed that these five risk factors were associated with 73.3% (95% CI 71.8, 74.9) of obesity among reproductive-age women. Interaction analysis between women’s education and household wealth revealed that having a secondary or higher level of education and residing in a wealthier household was associated with a lower risk of obesity (OR = 0.71, 95% CI 0.66, 0.76). The findings of this study suggest that, in order to address the rising rate of obesity among women in Asian countries, education and lifestyle modifications in urban areas should be a priority. Pakistan and the Maldives need to be a priority given the rapidly increasing trends in obesity and underweight subpopulations in their respective countries.
KW - Obesity prevention
KW - Population attributable fraction
KW - Reproductive-age women
KW - Secondary education
KW - Social determinants of health
KW - Urbanization
UR - http://www.scopus.com/inward/record.url?scp=85205248152&partnerID=8YFLogxK
U2 - 10.1038/s41598-024-73522-5
DO - 10.1038/s41598-024-73522-5
M3 - Article
C2 - 39343972
AN - SCOPUS:85205248152
SN - 2045-2322
VL - 14
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 22545
ER -
