An Epidemiological Study of Overweight and Obesity Among Women in an Urban Area of North India

Abstract

Background:
Obesity is a complex, multi-factorial chronic disease. Overweight and obesity are the fifth leading risk for global deaths.

Objectives:
To find the prevalence and risk factors for obesity in women aged 20-60 years in Ludhiana city.

Methods:
The present study is a community based cross sectional study carried out in an urban area of Ludhiana among women aged 20-60 years. Among the study population of 324 women, a pre-designed and pre-tested questionnaire was used to record the socio-demographic and anthropometric profile of women. Chi square test and logistic regression was used to find the association of obesity and hypertension with socio-demographic variables.

Results:
The prevalence of overweight and obesity was 12.7% and 29.6% respectively. Obesity was found to be more common among middle-aged Punjabi housewives belonging to upper socio-economic strata. There was strong association between overweight/obesity and hypertension.

Full text

Indian Journal of
Community Medicine
Official Publication of Indian Association of Preventive and Social Medicine
www.ijcm.org.in
Apr-Jun 2016 / Vol 41 / Issue 2
ISSN 0970-0218
Indian Journal of Community Medicine • Volume 41 • Issue 2 • April-June 2016 • Pages 85-***

Indian Journal of Community Medicine/Vol 41/Issue 2/April 2016 154
Introduction
Obesity is a complex condition, one with serious
social and psychological dimensions, that affects
virtually all age and socio-economic groups and
threatens to overwhelm both developed and developing
countries.(1) As in developed societies, the risk for obesity
in developing countries is also strongly inuenced by
diet and lifestyle, which are changing dramatically
as a result of the economic and nutrition transition.
Obesity is a key risk factor in the natural history of non-
communicable diseases like hypertension.
According to WHO global estimates, about 13% of
the world’s adult population (11% of men and 15% of
women) were obese in 2014.(2) Prevalence of obesity
varies according to age, sex and region. In India the
percentage of ever married women aged 15-49 years who
are overweight or obese increased from 11% in National
Family Health Survey (NFHS)-2 to 15% in NFHS-3.(3)
The percentage of women who are overweight or obese
is highest in Punjab (29.9%), followed by Kerala (28.1%)
and Delhi (26.4%).(4) Therefore in the present study, an
attempt has been made to nd the prevalence and risk
factors for overweight and obesity in women aged 20-60
years in Ludhiana city.
Materials and Methods
The present study is a cross sectional, community
based study carried out in an urban area of Ludhiana
among women aged 20-60 years during 2013. The
sample size of 324 was calculated on the basis of 30%
prevalence rate of obesity among women in Punjab
according to NFHS-3 data, using formula in innite
population:(5)
Sample size (n) = z2 p (1-p)/d2
An Epidemiological Study of Overweight and
Obesity Among Women in an Urban Area of
North India
Sangeeta Girdhar, Sarit Sharma, Anurag Chaudhary, Priya Bansal, Mahesh Satija
Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
ABSTRACT
Background: Obesity is a complex, multi-factorial chronic disease. Overweight and obesity are the fifth leading risk for global deaths.
Objectives: To find the prevalence and risk factors for obesity in women aged 20-60 years in Ludhiana city. Methods: The present
study is a community based cross sectional study carried out in an urban area of Ludhiana among women aged 20-60 years. Among
the study population of 324 women, a pre-designed and pre-tested questionnaire was used to record the socio-demographic and
anthropometric profile of women. Chi square test and logistic regression was used to find the association of obesity and hypertension
with socio-demographic variables. Results: The prevalence of overweight and obesity was 12.7% and 29.6% respectively. Obesity
was found to be more common among middle-aged Punjabi housewives belonging to upper socio-economic strata. There was strong
association between overweight/obesity and hypertension.
Key Words: Obesity, overweight, BMI, marital status, hypertension
Address for correspondence:
Dr. Sarit Sharma, Department of Community Medicine, Dayanand Medical College and Hospital, Civil Lines, Ludhiana - 141 001, Punjab, India.
E-mail: sarit_sharma@yahoo.com
Received: 13-05-14, Accepted: 22-09-14
Access this article online
Quick Response Code:
Website:
www.ijcm.org.in
DOI:
10.4103/0970-0218.173492
Short Communication

Girdhar, et al.: Epidemilogy of obesity among women
155 Indian Journal of Community Medicine/Vol 41/Issue 2/April 2016
A list of all 3194 females between 20-60 yrs of age
residing in the urban eld practice area was made and
the study subjects were selected by random sampling
method. Antenatal women were excluded from the
study.
A pre-designed, pre-tested questionnaire was used to
record the socio-demographic prole of women after
obtaining informed consent. Socio-economic status was
determined by using Modied Kuppuswami scale.(6)
Anthropometric data regarding height and weight was
also taken. The body mass index (BMI) was calculated
using Quetelet index. Asian classication of obesity(7)
was used [Table 1]. The BP was recorded as per AHA
guidelines.(8) Analysis was done in Microsoft excel and
SPSS version 20.0. Chi square test was used to nd the
association between socio-demographic variables and
obesity. Logistic regression analysis for dependent
variables obesity and hypertension was done. The
independent variables considered for this analysis
were age, occupation, marital status, ethnicity and
socio-economic status for dependent variable obesity,
and age, education, socio economic status and obesity
for dependent variable hypertension. P < 0.05 was taken
as signicant.
Results
In the study population, the prevalence of overweight
(BMI = 23-24.9) and obesity (BMI > 25) was 12.7% and
29.6% respectively. Most of the overweight/obese
women belonged to the age group of 40-60 years and
prevalence increased with increase in age (P < 0.001).
On univariate analysis, obesity was found to be
signicantly more in married Punjabi housewives of
upper socio-economic strata [Table 2]. The effect of
selected variables of obesity and hypertension was
analysed by performing logistic regression analysis.
Increasing age, native Punjabi origin and upper
socio-economic strata were found to be independent
risk factors for obesity [Table 3]. In conducting binary
logistic regression for hypertension, age and obesity
were highly signicant predictors for development of
hypertension [Table 4].
Discussion
The study was carried out in an urban area of Ludhiana
to nd out the prevalence of overweight and obesity
among women aged 20-60 years which was found to
be 12.7% and 29.6% respectively. This is comparable
with the findings of NFHS-3 where prevalence of
overweight/obesity in females was found to be 29.9%.(4)
In a study conducted by Anuradha et al. in women
aged 20 yrs and above in Chennai,(9) the prevalence
of overweight and obesity was 27.7% and 19.8%
respectively whereas in another study conducted in
upper middle class urban women aged 20 yrs and
above in Punjab, the prevalence was 20% and 25.3%
respectively.(10)
The prevalence of overweight/obesity was highest in
the age group of 50-60 years followed by 40-49 years
and the trend was found to be statistically highly
signicant. Misra et al.(11) also found a signicantly
increasing trend with advancing.
In the present study, prevalence of obesity was highest in
housewives belonging to higher socio-economic status.
Similar trend was reported by Gopalan(12) in 1998 and
Table 1: WHO Asian-BMI classication
Nutritional status BMI (kg/m2)
Underweight <18.5
Normal range 18.5-22.9
Overweight 23-24.9
Obese I 25-29.9
Obese II >30
Table 2: Association of BMI with various socio-demographic
variables of study subjects
Variable BMI (kg/m2) N (%) χ2 (P value)
<23 ≥23
Age group (yrs.)
23.750 (0.000)
20-29 74 (76.3) 23 (23.7)
30-39 53 (57.6) 39 (42.4)
40-49 34 (46.6) 39 (53.4)
50-60 26 (41.9) 36 (58.1)
Educational status
2.807 (0.422)
No education 47 (61.8) 29 (38.2)
Primary school 26 (61.9) 16 (38.1)
Middle school 78 (52.7) 70(47.3)
Matric and above 36 (62.1) 22 (37.9)
Occupation
9.907 (0.019)
Housewife 167 (55.5) 134 (44.5)
Working 10 (76.9) 3 (23.1)
Student 10 (100) 0 (0)
Socio-economic status
25.149 (0.000)
Low 16 (100) 0 (0)
Low middle 80 (66.7) 40 (33.3)
High middle 84 (50.6) 82 (49.4)
High 7 (31.8) 15 (68.2)
Marital status
17.805 (0.000)
Married 156 (54.0) 133 (46.0)
Unmarried 20 (100) 0 (0)
Widow 11 (73.3) 4 (26.7)
Religion
3.098 (0.212)
Hindu 128 (60.7) 83 (39.3)
Sikh 58 (51.8) 54 (48.2)
Any other 1 (100) 0 (0)
Ethnicity
16.250 (0.000)
Migrant 68 (75.6) 22 (24.4)
Punjabi 119 (50.9) 115 (49.1)

Girdhar, et al.: Epidemilogy of obesity among women
Indian Journal of Community Medicine/Vol 41/Issue 2/April 2016 156
Anuradha et al.(9) in 2009. Obesity was also found to be
signicantly higher in married and Punjabi women in
the present study. The higher prevalence among Punjabi
housewives in the age group of 40-60 years could be due
to menopausal changes, decreasing physical activity and
high fat diet.
Obesity was seen more frequently in literate women
(43.5%) as compared to illiterate (38.2%) but the
difference was not signicant. Similar ndings were seen
in the study conducted by Anuradha et al.(9) On logistic
regression, obesity was signicantly more in middle
aged, Punjabi housewives belonging to upper socio-
economic class. Highly signicant number of middle
aged obese women were found to be hypertensive as
compared to non obese females. In a study conducted
in Africa,(13) BMI was positively associated with systolic,
diastolic and mean arterial pressure. Gothankar(14)
also found a signicant association between BMI and
hypertension in her study conducted in Pune.
Conclusion and Recommendation
In the present study, obesity was highest in middle
aged housewives belonging to middle and high
socio-economic status. Hypertension was more common
in obese women therefore specic programs targeting
high risk and vulnerable group of the society need to be
designed to address this upcoming epidemic.
References
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Table 3: Logistic regression analysis with dependent
variable obesity
Variable (P-value) Exp (B) 95% C.I.
Age in years (0.003)
20-29®
30-39 1.683 0.868-3.263
40-49 2.674 1.331-5.375
50-60 3.801 1.782-8.109
Occupation (0.274)
Working/Student®
Housewife 2.212 0.534-9.166
Marital Status (0.009)
Unmarried/Widow®
Married 5.079 1.504-17.152
Ethnicity (0.020)
Migrant®
Punjabi 2.044 1.132-3.691
Socio-economic status (0.003)
Low/Low-middle®
High-middle 1.986 1.179-3.344
High 4.642 1.626-13.249
®Reference category
Table 4: Logistic regression analysis with dependent
variable hypertension
Variable (P-value) Exp (B) 95% C.I.
Age in years (0.000)
20-29®
30-39 0.226 0.026-1.981
40-49 0.042 0.005-0.342
50-60 0.018 0.002-0.141
Education (0.837)
No-education®
Primary school 0.787 0.256-2.423
Middle school 1.253 0.493-3.184
Matric and above 1.287 0.308-5.382
Socio-economic status (0.367)
Low/Low-middle®
High-middle 0.549 0.239-1.262
High 0.675 0.152-3.009
Obesity (0.000)
Non-obese®
Obese 5.707 2.587-12.590
®Reference category

Girdhar, et al.: Epidemilogy of obesity among women
157 Indian Journal of Community Medicine/Vol 41/Issue 2/April 2016
relationship with obesity: Results from a national blood pressure
survey in Eritrea. J Hum Hypertens 2006;20:59-65.
14. Gothankar JS. Prevalence of obesity and its associated comorbidities
amongst adults. Natl J Community Med 2011;2:221-4
How to cite this article: Girdhar S, Sharma S, Chaudhary A, Bansal P, Satija
M. An epidemiological study of overweight and obesity among women in an
Urban area of North India. Indian J Community Med 2016;41:154-7.
Source of Support: Nil, Conicts of Interest: None declared.