Singh Prashant Kumar, Singh Lucky, Saroj Shashi Kala, Kumar Chandan, Kashyap Shekhar, Singh Shalini
Division of Preventive Oncology and Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India.
Faculty of Medical Research, The Academy of Scientific and Innovative Research (AcSIR), New Delhi, India.
Curr Dev Nutr. 2025 Jun 21;9(7):107489. doi: 10.1016/j.cdnut.2025.107489. eCollection 2025 Jul.
This study examines the level and determinants of spousal concordance in overweight/obesity among married couples in India.
The rising prevalence of overweight/obesity is a growing public health concern globally. While spousal concordance in obesity is recognized in developed countries, less is known about this phenomenon in low- and middle-income countries. Understanding the shared risk factors within couples is crucial for effective intervention.
We analyzed data from 52,737 married couples using the nationally representative National Family Health Survey (NFHS)-5 (2019-2021). This study used the Asian body mass index (BMI) (in kg/m) cutoff for overweight/obesity (≥23.0) concordance. Descriptive statistics were used to assess sociodemographic characteristics. The log-binomial regression model was used to estimate the adjusted risk ratio (ARR) of spousal concordance in overweight/obesity.
Overall, 27.4% of couples exhibited concordance for overweight or obesity. Concordance was more prevalent among couples belonging to the richest wealth quintile (47.6%), residing in urban areas (38.4%), living in nuclear families (28.9%), sharing similar age (28.8%) or higher (28.9%), or having similar education levels (31.4%). Higher concordance was also associated with couples not engaged in paid work (33.9%) and those who frequently used media (newspapers: 39.6%, television: 32.8%) or consumed nonvegetarian foods weekly-eggs (30.7%), chicken (29.9%). Geographically, the highest concordance was observed in the southern (37.2%) and northern (33.5%) regions, with Kerala, Jammu and Kashmir, Manipur, Delhi, Goa, Tamil Nadu, and Punjab reporting the highest state-level prevalence (≥42%). Multivariable analysis showed significantly increased risk of spousal overweight/obesity concordance among couples in the richest wealth quintile (ARR = 4.311; 95% CI: 3.757, 4.947), urban areas (ARR = 1.085; 95% CI: 1.016, 1.159), other religious groups (ARR = 1.185; 95% CI: 1.089, 1.291). Regular consumption of eggs (14%), fish (25%), chicken (9%), fried foods (6%), and alcohol (98%) were also linked to higher concordance.
Spousal concordance in overweight/obesity is strongly influenced by shared socioeconomic status, lifestyle behaviors, and dietary patterns. Couples in urban, affluent, media-exposed, and nonvegetarian households are particularly at risk. Public health strategies should prioritize couple-based interventions, especially among high-risk subgroups, to curb the dual burden of overweight/obesity and associated chronic diseases.
本研究调查了印度已婚夫妇中配偶超重/肥胖的一致性水平及其决定因素。
超重/肥胖患病率的上升是全球日益严重的公共卫生问题。虽然肥胖的配偶一致性在发达国家已得到认可，但在低收入和中等收入国家，对这一现象的了解较少。了解夫妻间共同的风险因素对于有效干预至关重要。
我们使用具有全国代表性的第五轮全国家庭健康调查（NFHS-5，2019 - 2021年）对52,737对已婚夫妇的数据进行了分析。本研究采用亚洲体重指数（BMI，单位：kg/m）超重/肥胖（≥23.0）一致性标准。描述性统计用于评估社会人口学特征。对数二项回归模型用于估计配偶超重/肥胖一致性的调整风险比（ARR）。
总体而言，27.4%的夫妇在超重或肥胖方面表现出一致性。一致性在属于最富有财富五分位数的夫妇中更为普遍（47.6%），居住在城市地区的夫妇（38.4%），生活在核心家庭的夫妇（28.9%），年龄相近（28.8%）或年龄较大（28.9%），或教育水平相似（31.4%）的夫妇中更为常见。较高的一致性还与未从事有偿工作的夫妇（33.9%）以及经常使用媒体（报纸：39.6%，电视：32.8%）或每周食用非素食食品（鸡蛋：30.7%，鸡肉：29.9%）的夫妇有关。在地理上，南部（37.2%）和北部（33.5%）地区的一致性最高，喀拉拉邦、查谟和克什米尔、曼尼普尔邦、德里、果阿、泰米尔纳德邦和旁遮普邦报告的州级患病率最高（≥42%）。多变量分析显示最富有财富五分位数的夫妇（ARR = 4.311；95%置信区间：3.757，4.947）、城市地区的夫妇（ARR = 1.085；95%置信区间：1.016，1.159）以及其他宗教群体的夫妇（ARR = 1.185；95%置信区间：1.089，1.291）配偶超重/肥胖一致性风险显著增加。经常食用鸡蛋（14%）、鱼类（25%）、鸡肉（9%）、油炸食品（6%）和酒精（98%）也与较高的一致性有关。
配偶超重/肥胖的一致性受到共同的社会经济地位、生活方式行为和饮食模式的强烈影响。城市、富裕、接触媒体和非素食家庭的夫妇尤其面临风险。公共卫生策略应优先考虑基于夫妻的干预措施，特别是在高风险亚组中，以遏制超重/肥胖及相关慢性病的双重负担。
