Obesity and the Metabolic Syndrome in Developing Countries

Department of Diabetes and Metabolic Diseases, Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, New Delhi 110070, India.
Journal of Clinical Endocrinology &amp Metabolism (Impact Factor: 6.31). 11/2008; 93(11 Suppl 1):S9-30. DOI: 10.1210/jc.2008-1595
Source: PubMed

ABSTRACT Prevalence of obesity and the metabolic syndrome is rapidly increasing in developing countries, leading to increased morbidity and mortality due to type 2 diabetes mellitus (T2DM) and cardiovascular disease.
Literature search was carried out using the terms obesity, insulin resistance, the metabolic syndrome, diabetes, dyslipidemia, nutrition, physical activity, and developing countries, from PubMed from 1966 to June 2008 and from web sites and published documents of the World Health Organization and Food and Agricultural Organization.
With improvement in economic situation in developing countries, increasing prevalence of obesity and the metabolic syndrome is seen in adults and particularly in children. The main causes are increasing urbanization, nutrition transition, and reduced physical activity. Furthermore, aggressive community nutrition intervention programs for undernourished children may increase obesity. Some evidence suggests that widely prevalent perinatal undernutrition and childhood catch-up obesity may play a role in adult-onset metabolic syndrome and T2DM. The economic cost of obesity and related diseases in developing countries, having meager health budgets is enormous.
To prevent increasing morbidity and mortality due to obesity-related T2DM and cardiovascular disease in developing countries, there is an urgent need to initiate large-scale community intervention programs focusing on increased physical activity and healthier food options, particularly for children. International health agencies and respective government should intensively focus on primordial and primary prevention programs for obesity and the metabolic syndrome in developing countries.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Assessment of correlation and agreement among three different field methods of determining Percent Body Fat (PBF) in obese University females. Methods: Convenience and snowball sampling technique were used to recruit 30 obese females for the study. PBF were obtained from each participant using three field methods of bioelectric impedance analysis (BIA), skinfold calliper (SC) and body adiposity index (BAI) respectively. Data were analysed using Pearson correlation, independent t-test and Bland-Altman plot. Alpha level was set at 0.05. Results: There was no significant relationship (r=0.376; p=0.30) between methods of assessing percentage body fat using SC and BIA. There was significant relationship (r=0.196; p=0.041) between BAI and BIA methods of assessing percentage body fat. There was no significant relationship in the results obtained between each of the other methods and skinfold calliper. Conclusions: There was a poor level of agreement amongst the methods despite the evidence or lack of relationships.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Obesity and the lifestyle characteristic of Indian society lead young people to conditions of potential cardiovascular risk. The purpose of this study was to assess the prevalence of overweight/obesity and central obesity and its associated factors in a sample of Indian university students. Methods In a cross-sectional survey assessed anthropometric measurements and a self-administered questionnaire among a sample of randomly selected university students. The sample included 800 university students from non health (mainly sciences) courses Gitam University in India. The students were 541 (67.6%) males and 259 (32.4%) females in the age range of 17–20 years (M age 18.2 years, SD = 1.0). Results 37.5% were overweight or obese, 26.8% overweight (≥23–27.4 BMI) and 10.7% obese (≥27.5 kg/m2), 11.7% underweight (<18.5 kg/m2) and 16.4% central obesity (WC ≥90 cm for men and ≥80 cm for women). In multivariate analysis among men lack of non-organised religious activity (odds ratio = OR 0.85, confidence interval = CI 0.77–0.95), lower dietary risk knowledge (OR = 0.64, CI = 0.41–0.99), tobacco use (OR = 2.23, CI = 1.14–4.38), and suffering from depression (OR = 1.59, CI = 1.00–2.47) were associated with overweight/obesity, and younger age (OR = 0.32, CI = 0.12–0.90), lives away from parents or guardians (OR = 1.79, CI = 1.04–3.07), healthy dietary practices (OR = 1.95, CI = 1.02–3.72) and 9 or more hours sleep duration (OR = 0.28, CI = 0.09–0.96) were associated with central obesity. In bivariate analysis among women, lack of social support, lower dietary risk knowledge, tobacco use, and 9 or more hours sleep duration were associated with overweight/obesity and lives away from parents or guardians and abstinence from alcohol associated with central obesity. Conclusions The study found a high prevalence of overweight/obesity and central obesity. Several gender specific health risk practices were identified including lack of dietary risk knowledge, shorter sleep duration, living away from parents or guardians, tobacco use and lack of social support and religiousness that can be utilised in health promotion programmes.
    Obesity Research & Clinical Practice 11/2014; DOI:10.1016/j.orcp.2013.12.003 · 0.70 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study investigated the determinants of overweight/obesity in adolescents. A cross-sectional survey was carried out on 1157 adolescents. Weight and height were measured. Information on socio-economic status (SES), dietary intakes, physical activity, and sedentary behaviours were collected by a self-administered questionnaire. Binary and multivariate binary logistic regressions were used to obtain the relationships and odds-ratios, respectively. The prevalence of overweight and obesity was higher among adolescents in low- or high-income families, adolescents whose mothers worked out of home, adolescents whose parents were both overweight, adolescents who watched a lot of TV or had excessive energy intake, adolescents with lower physical activity or lower intake of dietary fibre, those who skipped breakfast ≥4 times per week, and those with low and high fat intake. However, multiple logistic regression analysis showed that only energy intake was associated with increased odds and vegetables and fibre intake were associated with a reduction in the odds of being overweight (all p< 0.05). Adolescents from middle SES showed a lower risk of overweight/obesity than low and high SES due to better dietary intakes and less sedentary behaviours. Therefore, in overweight/obesity prevention programs, adolescents with determined risk factors from families with low and high SES should receive attention.
    Appetite 07/2014; 82. DOI:10.1016/j.appet.2014.07.026 · 2.52 Impact Factor