Centre of Social Medicine and Community Health, Jawaharlal Nehru University, Delhi, India.
School of Health System Studies, Tata Institute of Social Sciences, Mumbai, India.
PLoS One. 2023 Aug 17;18(8):e0290020. doi: 10.1371/journal.pone.0290020. eCollection 2023.
Globally by 2030, 38% of the world's population would be overweight, and another 20% would be obese. This has led to rising concerns regarding how swiftly and substantially the world is moving towards this epidemic of "globesity". India too is facing an increased burden of overweight and obese population. The changing dietary patterns are significantly associated with the increasing prevalence of overweight/obesity and related complications, especially among women. Hence, the present study aims to observe the spatial patterns of overweight or obesity among women in reproductive age group in India and factors associated with it.
The study analyzed data from a cross-sectional nationwide household survey, i.e. National Family Health Survey (NFHS-4), 2015-16. The primary outcome variable of this study was overweight/obesity among reproductive-age women, which was measured through the body mass index (BMI) of the women. Bivariate and multivariate logistic regression analysis was used to analyze the data. Additionally, for spatial analysis in terms of overweight/obesity among women in India, univariate and bivariate Moran's I index measurements were used along with the usage of spatial regression models.
The value of spatial-autocorrelation for overweight or obese was 0.64, which depicts the moderately high prevalence of the overweight/obesity coverage over districts of India. The overall prevalence overweight/obesity among women in India is around 25% and higher proportion of women from urban areas (37.8%), and non-poor (33.4%) economic group reported to be overweight or obese. From spatial lag model, the lag coefficient was found to be 0.28, implying that a change in the prevalence of overweight/obesity among women in a certain district may statistically lag the prevalence of overweight/obesity by 28% in the neighbouring districts. There were significantly high clustering of overweight/obese women and non-poor wealth quintiles in 132 districts, mainly from states of Punjab, Haryana, Gujarat, Maharashtra, Kerala, Tamil Nadu, Karnataka and Andhra Pradesh. Additionally, there was high-high clustering of overweight/obese women and those who ever had caesarean in 82 districts, mostly from Kerala, Tamil Nadu, Andhra Pradesh and Karnataka.
The spatial patterns on the prevalence of overweight and obesity in India show that the women belonging to the southern states' districts are more overweight or obese in comparison to other states. The determinants like older age, higher education, urban residence, higher economic status are the key factors contributing to the prevalence of overweight or obesity among women in the reproductive age group. The study concludes and recommends an urgent need of interventions catering to urban women belonging to higher socio-economic status, to reduce the risks of health consequences due to overweight and obesity.
到 2030 年，预计全球将有 38%的人口超重，另有 20%的人口肥胖。这导致人们对世界肥胖流行的速度和程度日益担忧。印度也面临着超重和肥胖人口增加的负担。饮食模式的变化与超重/肥胖的流行及其相关并发症显著相关，尤其是在女性中。因此，本研究旨在观察印度生育年龄组妇女超重或肥胖的空间模式及其相关因素。
本研究分析了 2015-2016 年全国家庭调查（NFHS-4）的横断面全国性家庭调查数据。本研究的主要结局变量是生育年龄妇女的超重/肥胖，通过妇女的体重指数（BMI）来衡量。采用双变量和多变量逻辑回归分析来分析数据。此外，为了对印度妇女超重/肥胖的空间模式进行分析，使用了单变量和双变量 Moran's I 指数测量值，以及空间回归模型。
超重或肥胖的空间自相关值为 0.64，表明印度各地区超重/肥胖的高流行率。印度妇女超重/肥胖的总体流行率约为 25%，其中来自城市地区（37.8%）和非贫困人口（33.4%）的妇女报告超重或肥胖的比例较高。从空间滞后模型来看，滞后系数为 0.28，这意味着一个地区妇女超重/肥胖的流行率变化可能会导致邻近地区的超重/肥胖流行率滞后 28%。在 132 个地区，超重/肥胖妇女和非贫困人口的财富五分位数存在显著的高度聚集，主要来自旁遮普邦、哈里亚纳邦、古吉拉特邦、马哈拉施特拉邦、喀拉拉邦、泰米尔纳德邦、卡纳塔克邦和安得拉邦。此外，在 82 个地区，超重/肥胖妇女和曾经剖腹产的妇女存在高度聚集，主要来自喀拉拉邦、泰米尔纳德邦、安得拉邦和卡纳塔克邦。
印度超重和肥胖流行的空间模式表明，与其他州相比，来自南部各州地区的妇女更容易超重或肥胖。年龄较大、教育程度较高、居住在城市、经济地位较高等决定因素是导致生育年龄组妇女超重或肥胖流行的关键因素。研究得出结论并建议迫切需要针对城市中较高社会经济地位的妇女进行干预，以降低超重和肥胖导致的健康后果的风险。
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