Rathnayake Kumari M, Roopasingam Tharrmini, Dibley Michael J
Department of Applied Nutrition, Faculty of Livestock, Fisheries and Nutrition, Wayamba University of Sri Lanka, Makandura 60170, Sri Lanka.
BMC Res Notes. 2014 Aug 23;7:564. doi: 10.1186/1756-0500-7-564.
Prevalence of obesity and overweight is rising in developing countries, including Sri Lanka at a rapid pace due to dietary and lifestyle changes. This study aimed to assess the association between high carbohydrate diet, physical inactivity and central obesity among premenopausal housewives in Sri Lanka.
This study was conducted as a cross-sectional study. A sample of 100 premenopausal women with home duties aged between 20 to 45 years were selected randomly from two divisional secretariats (DS), representing urban and rural sectors in Sri Lanka. Data on basic characteristics, anthropometric measurements, dietary assessment and physical activity were collected. We defined central obesity as a waist circumference ≥80 cm, which is the WHO recommended cut-off. Independent sample t test was used to compare the mean values. Linear and binary logistic regression analyses were performed to find out the relationship and the magnitude of association between central obesity and percentage of energy contributed from carbohydrate and physical activity level, respectively.
The women reported an average of 18 starch portions per day, which was well above the national recommendations. Seventy percent of energy in the diet came from carbohydrate. The mean BMI and waist circumference of total sample was 25.4 kgm-2 and 78.5 cm, respectively. Prevalence of overweight, obesity and centrally obesity among total sample was 38%, 34% and 45%, respectively. A significant positive correlation observed between high carbohydrate diet and waist circumference (r = 0.628, p < 0.0001). There was a significant negative correlation between energy expenditure from physical activity and waist circumference (r = -0.742, p < 0.0001). High carbohydrate diet and physical inactivity were significantly associated with central obesity (OR = 6.26, p = 0.001, 95% CI-2.11-18.57, OR = 3.32, p = 0.028, 95% CI-1.14-9.68).
High carbohydrate diet and physical inactivity are possible explanations for the high prevalence of central obesity. There is an urgent need to implement effective specific public health interventions at household level to reverse this trend among the housewives in Sri Lanka.
由于饮食和生活方式的改变，包括斯里兰卡在内的发展中国家肥胖和超重的患病率正在迅速上升。本研究旨在评估高碳水化合物饮食、身体活动不足与斯里兰卡绝经前家庭主妇中心性肥胖之间的关联。
本研究为横断面研究。从代表斯里兰卡城乡地区的两个分区秘书处随机抽取100名年龄在20至45岁之间有家务的绝经前女性作为样本。收集了基本特征、人体测量、饮食评估和身体活动的数据。我们将中心性肥胖定义为腰围≥80厘米，这是世界卫生组织推荐的临界值。使用独立样本t检验比较均值。分别进行线性和二元逻辑回归分析，以找出中心性肥胖与碳水化合物提供的能量百分比和身体活动水平之间的关系及关联强度。
这些女性报告平均每天摄入18份淀粉类食物，远高于国家建议水平。饮食中70%的能量来自碳水化合物。总样本的平均体重指数和腰围分别为25.4千克/平方米和78.5厘米。总样本中超重、肥胖和中心性肥胖的患病率分别为38%、34%和45%。高碳水化合物饮食与腰围之间存在显著正相关（r = 0.628，p < 0.0001）。身体活动的能量消耗与腰围之间存在显著负相关（r = -0.742，p < 0.0001）。高碳水化合物饮食和身体活动不足与中心性肥胖显著相关（比值比 = 6.26，p = 0.001，95%置信区间 - 2.11 - 18.57，比值比 = 3.32，p = 0.028，95%置信区间 - 1.14 - 9.68）。
高碳水化合物饮食和身体活动不足可能是中心性肥胖患病率高的原因。迫切需要在家庭层面实施有效的具体公共卫生干预措施，以扭转斯里兰卡家庭主妇中的这一趋势。
