Research Article

Study of Sex Wise Prevalence of Obesity in Urban and Rural Population

Nikita Vadsaria*, Apoorva Pandya, Devshree Oza, Tapan Patel and Mehandi Vadsaria

Department of Zoology, School of Sciences, Gujarat University, India

Submission: January 27, 2023; Published: March 01, 2023

*Corresponding author: Nikita Vadsaria, Department of Zoology, School of Sciences, Gujarat University, India

How to cite this article: Nikita Vadsaria*, Apoorva Pandya, Devshree Oza, Tapan Patel and Mehandi Vadsaria. Study of Sex Wise Prevalence of Obesity in Urban and Rural Population. Nutri Food Sci Int J. 2023. 11(5): 555823.. DOI: 10.19080/NFSIJ.2023.11.555823.

Abstract

Aim: Rural residents have higher rates of chronic diseases compared to their urban counterparts; however, its reasons are unknown. We hypothesize that obesity may be one of the main contributors of increased illness, to this disparity one of the reasons can be change in lifestyle. This study analyses obesity prevalence in rural and urban adults using body mass index classification with measured height and weight that correlates amount of obesity across rural and urban residence are examined. This was so done to analyse and study the emergence and prevalence of Obesity in different age groups.

Method: The present study was to investigate the Obesity level among population of Ahmadabad and Villages. Name of Zone in Ahmadabad city: Vejalpur, Navrangpura and that of Villages: Hasanpura, Gangad, Zanzaraka. The data obtained randomly from 300 individual from Urban and Rural area to get a clear data of common people who don’t have routine check-up. Analysis was done using Omron HBF-375 body composition monitor.

Result: BMI, BMR, TSF, body age, body fat % was observed significantly high in urban population whereas muscle mass was seen more in rural population.

Conclusion: The rise in obesity and its complications threatens to bankrupt the healthcare system. Early treatment and prevention offer multiple long term health benefits, and they are the only way towards a sustainable health service.

Keywords: Obesity, Urban, Rural, Male, Female, BMI, BMR, TSF, Body Age, Body Fat, Lifestyle, Surrounding Environment

Abbreviation: BMI: Body Mass Index, BMR: Basal Metabolic Rate, TSF: Triceps Skin Fold, NCD: Non-Communicable Diseases, CURES: Chennai Urban Rural Epidemiology Study

Introduction

Obesity is considered as ‘global epidemic’ and one of the most important and neglected public health problems [1,2]. Obesity is a multi-factorial and challenging problem that is increasing at an alarming rate across the globe without any biases in age group [3]. Obesity can be seen as the first wave of a defined cluster of most non transmittable diseases called New World Syndrome creating great socioeconomic and public health burden in underdeveloped and developing countries [1]. Obesity is simply defined as accumulation excess of body fat that leads to adverse health effects. This excessive fat builds up results from an imbalance between calories consumed on one hand and calories expended on the other hand [4]. Overweight and obesity are key risk factors for many chronic diseases, including diabetes, cardiovascular diseases, and cancer. Obesity is attributed to around 44% diabetes, 23% of the ischemic heart diseases, 7%- 41% of few cancers and other diseases like type 2 diabetes mellitus, osteoarthritis [5-7]. Studies say that India will become the global diabetes capital by 2050 if the abdominal and lower limb obesity and metabolic syndrome are not arrested. Obesity and overweight are linked with deaths worldwide. Around 3.4 million adults die each year due to overweight. There is a vast difference in the quality of life in urban population resulting in substantial increase in obesity in the urban population [8]. Obesity is also on the rise with excessive consumption of processed foods, high fat diets and acquiring sedentary lifestyle [9]. Malnutrition and Underweight is high in rural, urban slums and tribal areas of India and it is growing issue [1].

Method

The present study was to investigate the Obesity level among the population of Ahmadabad and Villages. Name of Zone in Ahmadabad city: Vejalpur, Navrangpura and that of Villages: Hasanpura, Gangad, Zanzaraka. The study protocol was approved by Gujarat University Institutional Ethical Clearance [GUJIEC- 09-2015]. The data obtained randomly from 300 patients from each Urban and Rural area to get a clear data of common people who don’t have routein check-up. also categorized in six groups (18-20, 21-30, 31-40, 41-50, 51-60, >60). Analysis was done using Omron HBF-375 body composition monitor.

Exclusion Criter

Pregnant women were not taken as a part of study. People such as body builders were not taken as a part of study. Infants and children's were not taken in to an account. Aged people above 80 were also excluded.

Inclusion Criteria

Adults of age above 18 years and below 80 years of age were considered.

Statistical Analysis

The differences between rural residents and urban residents were evaluated by Graph Pad Prism 7 with column analyses by t-test.

Result

The result shows that the basal metabolic rate (BMR), was significantly high in urban (1550 ±16.20) as compared to village population and was more prevalent in males. Urban male (1626±20.24), rural male (1425±20.2) then in females (urban female=1441 ±23.33), rural female (1185±24.22). Body age: body age was observed significantly high in urban (52.58±0.86) then in rural area (37.68±1.24) and was observed slightly more in urban females and rural females (urban-55.32±1.316, rural-33.99±1.927) then in urban males and rural males (urban males-51.19±12.7, rural-36.57±1.625). Body fat %: it was observed high in urban area (32.71±0.44) then in rural area (30.73±1.29). Body fat % was observed slightly more in age group above 60 and was observed more in females (urban females-37.1±0.53, rural females-33.87±0.82 then in males (urban males-29.55±0.53, rural males-28.02±2.27). Muscle mass: Muscles mass was observed significantly high in rural (29.58±1.17) then in urban area (26.09±0.37). Triceps skin fold: TSF is observed more in urban (32.29±0.47) then in rural (20.79±0.58). Moreover, TSF is observed more in females (urban-29.12±0.62, rural 24.30±0.68) then in females (20.21±0.49 and rural male 17.47±0.79). Visceral fat was observed high in urban area (12.28±0.40) and that in rural area was observed 8.28±0.46. BMI was observed more in urban (28.00±0.34) and that in rural (24.19±0.43). Moreover, BMI was observed more in females (urban 28.84±0.57 and rural females 26.42±0.41) Then that in males (urban27.37±0.42 and in rural 23.60±0.58) (Table 1-4).

Discussion

There was a great change in the health status in the world impelled by technological and socio-economic changes which greatly brought changes in life expectancy and ways of living. Unrestrained behaviour, lifestyle changes, and Dietary deficits that has accompanied with industrialization, and urbanization along with economic development which has made a significant contribution to the most globally persistent change of the rising burden of obesity and non-communicable diseases (NCDs). Obesity was labelled as a disease thirty six years ago when the WHO listed obesity as a disease state in its International Classification of Diseases in 1979. Prevalence of mortality trends is large relation to NCDs in developing countries (e.g., China, India, and Brazil) [10]. The Chennai Urban Rural Epidemiology Study (CURES) conducted in Chennai city in Tamil Nadu reported occurrence of obesity to be 45.9% [11]. Similar study conducted in urban north India [New Delhi], the overall prevalence of obesity was 50.1% [Bhardwaj et al, 2006]. Obesity in our study was found to be higher in females (urban females 36.6% and that of rural is 19.7%) rather than in males (urban males 24.6% and that in rural males is 13.54). Several studies in India have reported predominance of obesity among women [12-16]. The prevalence of obesity among Indian women has increased from 10.6% (NFHS2 in 1998-1999) to 12.6% (NFHS3 in 2005-2006) i.e., an increase by 24.52 per cent in a 7-year period [17]. In our study Obesity in females was observed more, significantly in urban females. It was observed more in age group of 18-20 [66.66%] whereas in rural females’ obesity was observed high in age group of above 60 (71.42). BMI was observed more in urban (28.00±0.34) and that in rural (24.19±0.43). Moreover, BMI was observed more in females (urban 28.84±0.57 and rural females 26.42±0.41) Then that in males (urban 27.37±0.42 and in rural 23.60±0.58). Studies indicate that central obesity, characterized by increased waist circumference is associated with an increased risk for a few diseases including cardiovascular diseases, noninsulin dependent diabetes mellitus, high blood pressure, gall bladder disease, stroke, and certain cancers in patients with a BMI in the range between 25 and 34.9 and is associated with overall mortality, independent of BMI [18] (Table 5-8).

A study conducted in Delhi and rural Ballabgarh (Haryana State), revealed that overweight was widely prevalent in the urban population (men: 35.1%, women: 47.6%) compared to the rural population (men: 7.7%, women: 11.3%) [19]. Similar result was observed in our study where overweight was observed high in urban area than in rural area. Contradicting results were found to that of Reddy et al when the data was analysed in genders of different age group and on the other hand underweight was observed significantly high. In rural area and (in all age group) underweight was observed more in age group of 18-20 in urban area. This depicts the scenario of difference in quality of life in rural and urban region.

Asian Indians have a greater predisposition to abdominal obesity and accumulation of visceral fat, and this has been termed as “Asian Indian phenotype [12,20]. The increased waist circumference is unlikely to be due to visceral adipose tissue alone; it probably reflects both visceral and subcutaneous fat and hence total fatness. In contrast the body mass index measures the sum of fat mass and fat free mass, and it is impossible to know the relative contributions of each [21]. Our result depicts, visceral fat was observed high in urban area (12.28±0.40) and that in rural area was observed (8.28±0.46) even TSF is observed more in urban (32.29±0.47) then in rural (20.79±0.58). This revels the unhealthy dietary habit and sedentary lifestyle which in urban area which has resulted high BMI, VF and TSF value in urban than that in rural area. On the other hand, muscles mass was observed significantly high in rural (29.58±1.17) then in urban area (26.09±0.37) and underweight also observed more in rural population that depicts that, yet the amount of calorie burnt due work done is more still under nourished and underweight is observed more one of the reasons may be due to prevalence of poverty and laborious work done by them. This scenario shows the ill management in health care. In countries like India, the rise in obesity prevalence could be attributed to the increasing urbanization, increasing availability of processed and fast foods, use of mechanized transport, adoption of less physically active lifestyles, increased television viewing, and consumption of more “energy dense, nutrient poor” diets [4,18,22]. Socioeconomic status is another factor which has been linked to problem of overweight and obesity in many other studies [23,24]. Traditional diet has been replaced by the ‘Western diet’ and major declines in all phases of activity and increased sedentary activity as the main reasons explaining the rapid increase in overweight and obesity, bring major economic and health costs. [25-28].

Conclusion

Today India is confronted with a great nutritional puzzle because on one hand India’s rich and urban population is facing an epidemic of obesity which acts as a host to welcome other problems such as cardio vascular diseases, hypertension, metabolic syndrome, and is being projected to be the diabetic capital of the world resulting in increased morbidity and mortality from life style and non-communicable diseases and on the other hand India is home to largest number of malnourished population in the world especially the rural confronting malnutrition, sanitation related, communicable, water born and poverty diseases. In India there is a tremendous ‘Urban (Rich)/Rural (Poor)’ biasness and is further increasing in present era of globalisation and is contributing higher prevalence of obesity in the urban rich than in rural areas and poor communities. India is on its way ahead in increasing epidemic of lifestyle disorders associated with adult as well as childhood obesity. Few of the key reason of the epidemic in India can be unhealthy eating patterns, reduced physical activity, increased sedentary pursuits and possibly `constitutional predispositions’/`early origins. Prevention must begin early in the form of a public health campaign directed towards lifestyle changes of the family/society. The campaign requires strong social and political will. Health professionals must think `prevention of obesity’ at all visits, monitor BMI and ensure that `nutrition messages are not conflicting and confusing. Standard treatment approaches for overweight and obesity must be tailored to the needs of various patients or patient groups.

Large individual variation exists within any social or cultural group; furthermore, substantial overlap occurs among subcultures within the larger society. Obesity affects almost every phase of life. The rise in obesity and its complications threatens to bankrupt the healthcare system. Early treatment and prevention offer multiple long term health benefits, and they are the only way towards a sustainable health service. A good system of specialties can contribute to manage the great Indian nutritional puzzle of epidemic of obesity on one hand and grave danger from under nutrition on the other.

References

1. World Health Organization (2000) Obesity: Preventing and Managing the Global Epidemic - Report of a WHO Consultation. WHO Tech Rep Ser No 894. Geneva. World Health Organization.
2. Wong JPS, Ho SY, Lai MK, Leung GM, Stewart SM, et al. (2005) Overweight, obesity, weight-related concerns and behaviours in Hong Kong Chinese Children and adolescents. Acta Pediatric 94: 595-601.
3. Elizabeth KE (2007) Nutrition and Child Development, 3^rd Revised Edition, Hyderabad Paras Medical Publisher.
4. World Health Organization (WHO) (2003) Diet, nutrition, and the prevention of chronic diseases. Report of a joint WHO/FAO expert consultation. World Health Organ Tech Rep Series 916: i-viii.
5. World Health Organization Fact Sheet N°311 (2015) Obesity and overweight.
6. Bakari AG, Onyemelukwe GC, Sani BG, Aliyu IS, Hassan SS, et al. (2007) Obesity, Overweight and underweight in suburban northern Nigeria. Int J Diabetes and Metabolism 15: 68-69.
7. Centres for Disease Control and Prevention (CDC) (2007) Obesity among adults in the United States. No statistically change since 2003-2004 p: 1-8.
8. Swaminathan M (2005) Principles of Nutrition and Dietetics. 2^nd Edition, Bapco Publishing, Bangalore, India pp: 528.
9. Little Flower Augustine, Rashmi H Poojara (2003) Prevalence of Obesity, Weight Perceptions and Weight Control Practices among Urban College Going Girls. Indian Journal of Community Medicine 28(4): 187-190
10. Murray CJL, Lopez AD (1994) Global Comparative Assessments in the Health Sector. Geneva: World Health Organization.
11. Deepa M, Farooq S, Deepa R, Manjula D, Mohan V (2009) Prevalence and significance of generalized and central body obesity in an urban Asian Indian population in Chennai, India (CURES: 47). Eur J Clin Nutr 63: 259-267.
12. Deepa R, Sandeep S, Mohan V (2006) Abdominal obesity, visceral fat, and type 2 diabetes Asian Indian phenotype. In: Mohan V, Rao GHR, editors. Type 2 diabetes in South Asians: epidemiology, risk factors and prevention. New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd pp: 138-152.
13. Misra A, Pandey RM, Devi JR, Sharma R, Vikram NK, et al. (2001) High prevalence of diabetes, obesity, and dyslipidaemia in urban slum population in northern India. Int J Obes Relat Metab Disord 25: 1722-1729.
14. Zargar AH, Masoodi SR, Laway BA, Khan AK, Wani AI, Bashir MI, et al. (2000) Prevalence of obesity in adults: an epidemiological study from Kashmir valley of Indian subcontinent. J Assoc Physicians India 48: 1170-1174.
15. Singh RB, Pella D, Mechirova V, Kartikey K, Demeester F, et al. (2007) Five City Study Group. Prevalence of obesity, physical inactivity and undernutrition, a triple burden of diseases during transition in a developing economy. Acta Cardiol 62: 119-127.
16. Shukla HC, Gupta PC, Mehta HC, Hebert JR (2002) Descriptive epidemiology of body mass index of an urban adult population in western India. J Epidemiol Community Health 56: 876-880.
17. Garg C, Khan SA, Ansari SH, Garg M (2010) Prevalence of obesity in Indian women. Obes Rev 11(2): 105-108.
18. Bell AC, Ge K, Popkin BM (2002) The road to obesity or the path to prevention: motorized transportation and obesity in China. Obes Res 10(4): 277-283.
19. Reddy KS, Prabhakaran D, Shah P, Shah B (2002) Differences in body mass index and waist: hip ratios in North Indian rural and urban populations. Obes Rev 3(3): 197-202.
20. Joshi SR (2003) Metabolic syndrome emerging clusters of the Indian phenotype. J Assoc Physicians India 51: 445–446.
21. Maynard LM, Wisemandle W, Roche AF, Chumlea WC, Guo SS, et al. (2001) Childhood body composition in relation to body mass index. Pediatrics 107(2): 344–350.
22. Misra A, Singhal N, Khurana L (2010) Obesity, the metabolic syndrome, and type 2 diabetes in developing countries: role of dietary fats and oils. J Am Coll Nutr 29: 289S-301S.
23. Gupta R, Goyle A, Kashyap S, Agarwal M, Consul R, et al. (1998) Prevalence of atherosclerosis risk factors in adolescent school children. Indian Heart J 50: 511-515.
24. Kaur S, Sachdev HP, Dwivedi SN, Lakshmy R, Kapil U (2008) Prevalence of overweight and obesity amongst school children in Delhi, India. Asia Pac J Clin Nutr 17(4): 592-596.
25. Popkin BM, Du S, Zhai F, Zhang B (2010) Cohort Profile: The China Health and Nutrition Survey--monitoring and understanding socio-economic and health change in China, 1989—2011. Int J Epidemiol 39: 1435–1440.
26. Du H, Bennett D, Li L (2013) Physical activity and sedentary leisure time and their associations with BMI, waist circumference, and percentage body fat in 0.5 million adults: the China Kadoorie Biobank study. Am J Clin Nutr 97(3): 487-496.
27. Pandey RM, Gupta R, Misra A, Misra P, Singh V, et al. (2013). Determinants of urban rural differences in cardiovascular risk factors in middleaged women in India: a cross-sectional study. Int J Cardiol 163(2): 157-162.
28. Bhardwaj S, Misra A, Misra R, Goel K, Bhatt SP, et al. (2011) High prevalence of abdominal, intraabdominal, and subcutaneous adiposity and clustering of risk factors among urban Asian Indians in North India. PLoS One 6: e24362.