High carbohydrate diet and physical inactivity associated with central obesity among premenopausal housewives in Sri Lanka

BMC Research Notes, Aug 2014

Background 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. Methods 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. Results 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). Conclusion 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.

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High carbohydrate diet and physical inactivity associated with central obesity among premenopausal housewives in Sri Lanka

BMC Research Notes High carbohydrate diet and physical inactivity associated with central obesity among premenopausal housewives in Sri Lanka Kumari M Rathnayake 0 Tharrmini Roopasingam 0 Michael J Dibley 1 0 Department of Applied Nutrition, Faculty of Livestock, Fisheries and Nutrition, Wayamba University of Sri Lanka , Makandura 60170 , Sri Lanka 1 Sydney School of Public Health, Sydney Medical School, The University of Sydney , Sydney , Australia Background: 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. Methods: 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. Results: 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). Conclusion: 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. Central obesity; Premenopausal; Housewives; High carbohydrate diet Background Sri Lanka is a developing country undergoing rapid epidemiological and nutritional transition in which both overand undernutrition are serious public health concerns. The prevalence of overweight and obesity is increasing rapidly in Sri Lanka. The prevalence of overweight, obesity and central obesity among adults in Sri Lanka was 25%, 9% and 26%, respectively according to the WHO Asian cut-offs [ 1 ]. The age-adjusted prevalence of metabolic syndrome among Sri Lankan adults was 24.3% [ 2 ]. Moreover, the prevalence of hypertension, diabetes and dysglycaemia in Sri Lanka was 20%, 11% and 20%, respectively [ 3,4 ]. Obesity is a complex mulitfactorial chronic disease [ 5 ]. Although obesity increases the risk of chronic noncommunicable diseases, studies have shown that the distribution of body fat is more important than general obesity [ 6 ]. Moreover, abdominal obesity is an independent predictor of cardiovascular disease risk factors, morbidity and mortality in many populations [ 7 ]. In most studies, being a woman is a risk factor for obesity [ 8 ]. According to a recent study from Sri Lanka, the prevalence of obesity followed by central obesity was higher in women compared with men [ 1 ]. In Sri Lanka, the prevalence of obesity and central obesity based on the WHO cut off values for Asians was 7.2% and 16.5% for men, and 11.5% and 36.3% for women, respectively. The nutritional etiology of obesity remains unclear and controversial especially with regard to the role of dietary and behavioral factors. It is widely accepted that the obesity epidemic in Sri Lanka is partly due to unhealthy dietary habits. The Sri Lankan population mainly depends on cereal-based diets that lack dietary diversity. Based on recent research findings, the average daily serving size of starch consumption among Sri Lankan women exceeded the recommended level of 6–11 servings [ 9 ]. Physical inactivity is a well-established risk factor for the development and maintenance of obesity [ 10 ]. An association between dietary patterns and behavioral factors and central adiposity has been reported for high-income countries, but data available low and middle-income countries are scanty. Therefore, evaluating the (...truncated)


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Kumari M Rathnayake, Tharrmini Roopasingam, Michael J Dibley. High carbohydrate diet and physical inactivity associated with central obesity among premenopausal housewives in Sri Lanka, BMC Research Notes, 2014, pp. 564, Volume 7, Issue 1, DOI: 10.1186/1756-0500-7-564