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Nationally representative surveys show gradual shifting of overweight and obesity towards poor and less-educated women of reproductive age in Nepal

Published online by Cambridge University Press:  27 March 2020

Ipsita Sutradhar Open the ORCID record for Ipsita Sutradhar [Opens in a new window] ,
Tahmina Akter ,
Mehedi Hasan ,
Rajat Das Gupta Open the ORCID record for Rajat Das Gupta [Opens in a new window] ,
Hemraj Joshi ,
Mohammad Rifat Haider Open the ORCID record for Mohammad Rifat Haider [Opens in a new window]  and
Malabika Sarker
Ipsita Sutradhar*
Affiliation:
Centre for Non-Communicable Diseases and Nutrition (CNCDN), BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh Centre of Excellence for Science of Implementation & Scale Up (CoE-SISU), BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Tahmina Akter
Affiliation:
Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
Mehedi Hasan
Affiliation:
Centre for Non-Communicable Diseases and Nutrition (CNCDN), BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh Centre of Excellence for Science of Implementation & Scale Up (CoE-SISU), BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Rajat Das Gupta
Affiliation:
Centre for Non-Communicable Diseases and Nutrition (CNCDN), BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh Centre of Excellence for Science of Implementation & Scale Up (CoE-SISU), BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
Hemraj Joshi
Affiliation:
Child Health Program Office, Lifeline Nepal, Kathmandu, Nepal
Mohammad Rifat Haider
Affiliation:
Department of Social and Public Health, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
Malabika Sarker
Affiliation:
Centre for Non-Communicable Diseases and Nutrition (CNCDN), BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh Centre of Excellence for Science of Implementation & Scale Up (CoE-SISU), BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh Institute of Public Health, University of Heidelberg, Heidelberg, Germany
*
*Corresponding author. Email: ipsitaeva69@gmail.com
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Abstract

Overweight and obesity are considered major public health concerns all over the world. They have the potential to increase the risk of developing non-communicable diseases in reproductive age women, increasing their risk of pregnancy related complications and adverse birth outcome. This study was carried out to identify the trend of prevalence of overweight and obesity, along with their determinants, among reproductive age women (15–49 years) in Nepal. Data were taken from the nationally representative 2006, 2011 and 2016 Nepal Demographic and Health Surveys (NDHSs). Women were considered to be overweight or obese when their BMI was 23.0–27.5 kg/m2 or ≥27.5 kg/m2, respectively. Univariate, bivariate and multivariate analyses were performed, with significance taken at p<0.05. The prevalences of overweight and obesity both showed rising trends in women of reproductive age in Nepal from 2006 to 2016, particularly among those with no education, only primary education and poor women. The presence of overweight and obesity was found to be significantly associated with the sample women’s age, educational status, wealth index, place of residence, ecological zone, developmental region, number of household members, marital status and ethnicity. In 2016 one in every three women of reproductive age in Nepal was either overweight or obese. As overweight and obesity have detrimental effects on women’s health, the Government of Nepal, in collaboration with other government and non-government organizations, should take action to halt the rising trends in overweight and obesity in the country.

Keywords

Overweight and obesityWomenNepal
Type
Research Article
Information
Journal of Biosocial Science , Volume 53 , Issue 2 , March 2021 , pp. 214 - 232
Copyright
© The Author(s) 2020. Published by Cambridge University Press

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References

Abarca-Gómez, L, Abdeen, ZA, Hamid, ZA, Abu-Rmeileh, NM, Acosta-Cazares, B and Acuin, C et al. (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. The Lancet 390(10113), 2627–2642.CrossRefGoogle Scholar
Adair, LS (2004) Dramatic rise in overweight and obesity in adult Filipino women and risk of hypertension. Obesity Research 12, 1335–1341.CrossRefGoogle ScholarPubMed
Amugsi, DA, Dimbuene, ZT, Mberu, B, Muthuri, S and Ezeh, AC (2017) Prevalence and time trends in overweight and obesity among urban women: an analysis of demographic and health surveys data from 24 African countries, 1991–2014. BMJ Open 7(10), e017344.CrossRefGoogle ScholarPubMed
Arnold, M, Pandeya, N, Byrnes, G, Renehan, AG, Stevens, GA and Ezzati, M et al. (2015) Global burden of cancer attributable to high body-mass index in 2012: a population-based study. The Lancet Oncology 16(1), 36–46.CrossRefGoogle ScholarPubMed
Aryal, KK, Mehata, S, Neupane, S, Vaidya, A, Dhimal, M and Dhakal, P et al. (2015) The burden and determinants of non communicable diseases risk factors in Nepal: findings from a nationwide STEPS survey. PloS One 10(8), e0134834.Google ScholarPubMed
Athukorala, C, Rumbold, AR, Willson, KJ and Crowther, CA (2010) The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy and Childbirth 10(1), 56.CrossRefGoogle ScholarPubMed
Balarajan, Y and Villamor, E (2009) Nationally representative surveys show recent increases in the prevalence of overweight and obesity among women of reproductive age in Bangladesh, Nepal, and India. Journal of Nutrition 139(11), 2139–2144.Google ScholarPubMed
Barba, C, Cavalli-Sforza, T, Cutter, J and Darnton-Hill, I (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet 363(9403), 157.Google Scholar
Bennett, L, Dahal, DR and Govindasamy, P (2008) Caste, Ethnic and Regional Identity in Nepal: Further Analysis of the 2006 Nepal Demographic and Health Survey. Macro International Inc., Calverton, MD. URL: https://dhsprogram.com/pubs/pdf/FA58/FA58.pdf (accessed 5th June 2019).Google Scholar
Bhandari, P (2018) Regional variation in food security in Nepal. Dhaulagiri Journal of Sociology and Anthropology 12, 1–10.Google Scholar
Boney, CM, Verma, A, Tucker, R and Vohr, BR (2005) Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 115(3), e290–e296.CrossRefGoogle ScholarPubMed
Chen, Y, Copeland, WK, Vedanthan, R, Grant, E, Lee, JE and Gu, D et al. (2013) Association between body mass index and cardiovascular disease mortality in east Asians and south Asians: pooled analysis of prospective data from the Asia Cohort Consortium. British Medical Journal 347, f5446.CrossRefGoogle ScholarPubMed
Chong, AP, Rafael, RW and Forte, CC (1986) Influence of weight in the induction of ovulation with human menopausal gonadotropin and human chorionic gonadotropin. Fertility and Sterility 46(4), 599–603.CrossRefGoogle ScholarPubMed
Christakis, NA and Fowler, JH (2007) The spread of obesity in a large social network over 32 years. New England Journal of Medicine 357(4), 370–379.CrossRefGoogle Scholar
Deutsch, MI, Mueller, WH and Malina, RM (1985) Androgyny in fat patterning is associated with obesity in adolescents and young adults. Annals of Human Biology 12(3), 275–286.CrossRefGoogle ScholarPubMed
Dhitali, SM and Arjun, K (2013) Dealing with the burden of hypertension in Nepal: current status, challenges and health system issues. Regional Health Forum 17(1), 44–52.Google Scholar
Ford, ND, Patel, SA and Narayan, KV (2017) Obesity in low-and middle-income countries: burden, drivers, and emerging challenges. Annual Review of Public Health 38, 145–164.CrossRefGoogle ScholarPubMed
GBD 2015 Obesity Collaborators (2017) Health effects of overweight and obesity in 195 countries over 25 years. New England Journal of Medicine 377, 13–27.CrossRefGoogle Scholar
Guragain, AM, Paudel, BK, Lim, A and Choonpradub, C (2017) Adolescent marriage in Nepal: a subregional level analysis. Marriage & Family Review 53(4), 307–319.CrossRefGoogle Scholar
Hamilton-Fairley, D, Kiddy, D and Watson, H (1992) Association of moderate obesity with a poor pregnancy outcome in women with polycystic ovary syndrome treated with low dose gonadotrophin. British Journal of Obstetrics & Gynaecology 99, 128–131.CrossRefGoogle ScholarPubMed
Hanson, RL, Imperatore, G, Bennett, PH and Knowler, WC (2002) Components of the “metabolic syndrome” and incidence of type 2 diabetes. Diabetes 51(10), 3120–3127.CrossRefGoogle ScholarPubMed
Hasan, M, Sutradhar, I, Shahabuddin, A and Sarker, M (2017) Double burden of malnutrition among Bangladeshi women: a literature review. Cureus 9, e1986.Google ScholarPubMed
Hodge, A, Byrne, A, Morgan, A and Jimenez-Soto, E (2015) Utilisation of health services and geography: deconstructing regional differences in barriers to facility-based delivery in Nepal. Maternal and Child Health Journal 19(3), 566–577.CrossRefGoogle ScholarPubMed
IIPS and ICF (2017) National Family Health Survey (NFHS-4), 2015–16. International Institute for Population Sciences, Mumbai. URL: http://rchiips.org/nfhs/NFHS-4Reports/India.pdf (accessed 30th April 2018).Google Scholar
Kain, J, Vio, F and Albala, C (2003) Obesity trends and determinant factors in Latin America. Cadernos de Saúde Pública 19, S77–S86.Google ScholarPubMed
Kelly, T, Yang, W, Chen, CS, Reynolds, K and He, J (2008) Global burden of obesity in 2005 and projections to 2030. International Journal of Obesity (London) 32, 1431–1437.Google ScholarPubMed
Kinnunen, TI and Neupane, S (2014) Prevalence of overweight among women of childbearing age in Nepal: trends from 2001 to 2011 and associations with socio-demographic factors. Maternal and Child Health Journal 18(8), 1846–1853.CrossRefGoogle ScholarPubMed
Klein, BE, Klein, R and Lee, KE (2002) Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in Beaver Dam. Diabetes Care 25(10), 1790–1794.CrossRefGoogle ScholarPubMed
Koirala, M, Khatri, RB, Khanal, V and Amatya, A (2015) Prevalence and factors associated with childhood overweight/obesity of private school children in Nepal. Obesity Research & Clinical Practice 9(3), 220–227.CrossRefGoogle ScholarPubMed
Lamon-Fava, S, Wilson, PW and Schaefer, EJ (1996) Impact of body mass index on coronary heart disease risk factors in men and women: the Framingham Offspring Study. Arteriosclerosis, Thrombosis, and Vascular Biology 16(12), 1509–1515.CrossRefGoogle ScholarPubMed
Lancki, N, Siddique, J, Schneider, JA, Kanaya, AM, Fujimoto, K and Dave, SS et al. (2018) Social network body size is associated with body size norms of South Asian adults. Obesity Medicine 11, 25–30.CrossRefGoogle ScholarPubMed
Leddy, MA, Power, ML and Schulkin, J (2008) The impact of maternal obesity on maternal and fetal health. Reviews in Obstetrics and Gynecology 1, 170–178.Google ScholarPubMed
Manson, JE, Willett, WC, Stampfer, MJ, Colditz, GA, Hunter, DJ and Hankinson, SE et al. (1995) Body weight and mortality among women. New England Journal of Medicine 333, 677–685.CrossRefGoogle ScholarPubMed
Marchi, J, Berg, M, Dencker, A, Olander, EK and Begley, C (2015) Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obesity Review 16, 621–638.CrossRefGoogle ScholarPubMed
Mendez, MA, Monteiro, CA and Popkin, BM (2005) Overweight exceeds underweight among women in most developing countries. American Journal of Clinical Nutrition 81, 714–721.CrossRefGoogle ScholarPubMed
Misra, A, Tandon, N, Ebrahim, S, Sattar, N, Alam, D and Shrivastava, U et al. (2017) Diabetes, cardiovascular disease, and chronic kidney disease in South Asia: current status and future directions. British Medical Journal 357, j1420.CrossRefGoogle ScholarPubMed
Mistry, SK and Puthussery, S (2015) Risk factors of overweight and obesity in childhood and adolescence in South Asian countries: a systematic review of the evidence. Public Health 129(3), 200–209.Google Scholar
MOHP, New ERA and ICF International (2017) Nepal Demographic and Health Survey (2016). Ministry of Health and Population [Nepal], Kathmandu, Nepal, New ERA, and ICF International, Calverton, MD. URL: https://www.dhsprogram.com/pubs/pdf/fr336/fr336.pdf (accessed 28th April 2018).Google Scholar
MOHP, New ERA and ICF International (2012) Nepal Demographic and Health Survey 2011. Ministry of Health and Population [Nepal], Kathmandu, Nepal, New ERA, and ICF International, Calverton, MD. URL: https://dhsprogram.com/pubs/pdf/FR257/FR257[13April2012].pdf (accessed 26th April 2018).Google Scholar
MOHP, New ERA and Macro International (2007) Nepal Demographic and Health Survey 2006. Ministry of Health and Population [Nepal], Kathmandu, Nepal, New ERA, and ICF International, Calverton, MD. URL: https://dhsprogram.com/pubs/pdf/FR191/FR191.pdf (accessed 30th April 2018).Google Scholar
MOHP, NHRC and WHO (2014) Non-Communicable Diseases Risk Factors: STEPS Survey. Nepal Health Research Council, Kathmandu Nepal. URL: http://www.searo.who.int/nepal/mediacentre/non_communicable_diseases_risk_factors_steps_survey_nepal_2013.pdf (accessed 20th April 2018).Google Scholar
Mokdad, AH, Ford, ES, Bowman, BA, Dietz, WH, Vinicor, F and Bales, VS et al. (2003) Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Journal of the American Medical Association 289(1), 76–79.CrossRefGoogle ScholarPubMed
Morea, M, Miu, N, Morea, VF and Cornean, R (2013) Maternal obesity – a risk factor for metabolic syndrome in children. Clujul Medical 86(3), 259.Google ScholarPubMed
Ng, M, Fleming, T, Robinson, M, Thomson, B, Graetz, N and Margono, C et al. (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 384(9945), 766–781.CrossRefGoogle ScholarPubMed
Pandey, JP, Dhakal, MR, Karki, S, Poudel, P and Pradhan, MS (2013) Maternal and Child Health in Nepal: The Effects of Caste, Ethnicity, and Regional Identity. Further Analysis of the 2011 Nepal Demographic and Health Survey. Calverton, MD, Nepal Ministry of Health and Population, New ERA and ICF International. URL: https://www.dhsprogram.com/pubs/pdf/FA73/FA73.pdf (accessed 7th June 2019).Google Scholar
Popkin, BM (2001) The nutrition transition and obesity in the developing world. Journal of Nutrition 131, 871S–873S.Google ScholarPubMed
Popkin, BM and Slining, MM (2013) New dynamics in global obesity facing low- and middle-income countries. Obesity Reviews 14, 11–20.CrossRefGoogle ScholarPubMed
Sebire, NJ, Jolly, M, Harris, JP, Wadsworth, J, Joffe, M and Beard, RW et al. (2001) Maternal obesity and pregnancy outcome: a study of 287 213 pregnancies in London. International Journal of Obesity 25(8), 1175.CrossRefGoogle Scholar
Simkhada, P, Poobalan, A, Simkhada, PP, Amalraj, R and Aucott, L (2011) Knowledge, attitude, and prevalence of overweight and obesity among civil servants in Nepal. Asia Pacific Journal of Public Health 23(4), 507–517.CrossRefGoogle ScholarPubMed
Stewart, CP, Christian, P, Wu, LS, LeClerq, SC, Khatry, SK and West, KP Jr et al. (2013) Prevalence and risk factors of elevated blood pressure, overweight, and dyslipidemia in adolescent and young adults in rural Nepal. Metabolic Syndrome and Related Disorders 11(5), 319–328.CrossRefGoogle Scholar
Stunkard, AJ (2000) Factors in obesity: current views. In Bacallao, J (ed.) Obesity and Poverty: A New Public Health Challenge. Pan American Health Organization, Washington, DC, pp. 23–29.Google Scholar
Subedi, M (2016) Caste/ethnic dimensions of change and inequality: implications for inclusive and affirmative agendas in Nepal. Nepali Journal of Contemporary Studies 16(1), 1–16.Google Scholar
Subedi, YP, Marais, D and Newlands, D (2015) Where is Nepal in the nutrition transition? Asia Pacific Journal of Clinical Nutrition 26, 358–367.Google Scholar
Vaidya, A, Shakya, S and Krettek, A (2010) Obesity prevalence in Nepal: public health challenges in a low-income nation during an alarming worldwide trend. International Journal of Environmental Research and Public Health 7(6), 2726–2744.CrossRefGoogle Scholar
Woo, J, Leung, SSF, Ho, SC, Sham, A, Lam, TH and Janus, ED et al. (1999) Influence of educational level and marital status on dietary intake, obesity and other cardiovascular risk factors in a Hong Kong Chinese population. European Journal of Clinical Nutrition 53, 461.CrossRefGoogle Scholar
Zaadstra, BM, Seidell, JC, Van Noord, P, te Velde, ER, Habbema, JD and Vrieswijk, B et al. (1993) Fat and female fecundity: prospective study of effect of body fat distribution on conception rates. British Medical Journal 306(6876), 484–487.CrossRefGoogle ScholarPubMed