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Unequal obesity distributions among adult populations have been reported in low- and middle-income countries, but mainly based on data of women of reproductive age. Moreover, incorporation of ever-changing skewed BMI distributions in analyses has been a challenge. Our study aimed to assess magnitude and rates of change in BMI distributions by age and sex.
Shapes of BMI distributions were estimated for 2005 and 2010, and their changes were assessed, using the generalized additive model for location, scale and shape (GAMLSS) and assuming BMI follows a Box–Cox power exponential (BCPE) distribution.
Nationally representative, repeated cross-sectional health surveys conducted between 2005 and 2013 in Mexico, Colombia and Peru.
Adult men and non-pregnant women aged 20–69 years.
Whereas women had more right-shifted and wider BMI distributions than men in almost all age groups across the countries in 2010, men in their 30s–40s experienced more rapid increases in BMI between 2005 and 2010, notably in Peru. The highest increase in overweight and obesity prevalence was observed among Peruvian men of 35–39 years, with a 5-year increase of 21 percentage points.
The BCPE–GAMLSS method is an alternative to analyse measurements with time-varying distributions visually, in addition to conventional indicators such as means and prevalences. Consideration of differences in BMI distributions and their changes by sex and age would provide vital information in tailoring relevant policies and programmes to reach target populations effectively. Increases in BMI portend increases of obesity-associated diseases, for which preventive and preparative actions are urgent.
To investigate the association between maternal employment and childhood overweight in low- and middle-income countries (LMIC).
We utilized cross-sectional data from forty-five Demographic and Health Surveys from 2010 to 2016 (n 268 763). Mothers were categorized as formally employed, informally employed or non-employed. We used country-specific logistic regression models to investigate the association between maternal employment and childhood overweight (BMI Z-score>2) and assessed heterogeneity in the association by maternal education with the inclusion of an interaction term. We used meta-analysis to pool the associations across countries. Sensitivity analyses included modelling BMI Z-score and normal weight (weight-for-age Z-score≥−2 to <2) as outcomes.
Participants included children 0–5 years old and their mothers (aged 18–49 years).
In most countries, neither formal nor informal employment was associated with childhood overweight. However, children of employed mothers, compared with children of non-employed mothers, had higher BMI Z-score and higher odds of normal weight. In countries where the association varied by education, children of formally employed women with high education, compared with children of non-employed women with high education, had higher odds of overweight (pooled OR=1·2; 95 % CI 1·0, 1·4).
We find no clear association between employment and child overweight. However, maternal employment is associated with a modestly higher BMI Z-score and normal weight, suggesting that employment is currently associated with beneficial effects on children’s weight status in most LMIC.
To assess the ability of anthropometric measurements to identify young women at risk of developing diabetes, hypertension and heart disease in the future and to compare cut-off points for common anthropometric measures established with receiver-operating characteristic (ROC) curves with those reported in the literature.
Eight hundred and two young Mexican women living in semi-urban poverty.
The ability of anthropometric measures of fatness and fat distribution (body mass index (BMI), summed skinfold thickness (SST), waist circumference (WC), waist-to-hip ratio (WHR), conicity index (CI), abdominal volume index (AVI)) to predict risk of future disease (pre-diabetes: fasting blood glucose 100–126 mg dl−1; pre-hypertension: systolic blood pressure 120–139 mmHg and/or diastolic blood pressure 80–89 mmHg; hypertriglyceridaemia: triglycerides ≥150 mg dl−1; or a combination of risk factors) was assessed using ROC curve analysis.
Twenty-three of the 802 women who were interviewed had incomplete data and 50 (6.4%) were eliminated from the analysis due to hypertension and/or diabetes. Mean age of the remaining 729 women was 29.6 ± 5.4 years and mean BMI was 27.7 ± 4.5 kg m−2. There were no significant differences in the area under the ROC curve for BMI, WC, AVI or SST for any of the four outcomes. However, these indices performed significantly better than WHR and CI (P < 0.05). The BMI cut-off points that maximised sensitivity and specificity for the four outcomes were in the range of 27.7–28.4 kg m−2, and for WC were 89.3–91.2 cm. To detect 90% of the cases of any metabolic alteration, the necessary BMI cut-off was 26.1 kg m−2. Younger women (<25 years) were at greater risk than older women for a given BMI increment (P < 0.05).
We found that BMI and WC cut-off points commonly used for the identification of risk of existing disease were also appropriate in this population for the identification of risk in the future among women without diabetes or hypertension. The early identification of at-risk individuals, prior to the onset of disease, is fundamental particularly in the context of a country with scarce resources that is rapidly undergoing nutrition transition.
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