Trends and social determinants of the obesity epidemic among reproductive-age women in ten Asian countries

Subash Thapa; Kedir Y Ahmed; Habtamu Mellie Bizuayehu; M Mamun Huda; Binaya Chalise; Meless G Bore; Sewunet Admasu Belachew; Tahir A Hassen; Erkihun Amsalu; Desalegn Markos Shifti; Abdulbasit Seid; Yonatan M Mesfin; Teketo Kassaw Tegegne; Abel F Dadi; Daniel Bogale Odo; Getiye Dejenu Kibret; Daniel Bekele Ketema; Zemenu Yohannes Kassa; Anayochukwu E Anyasodor; Shakeel Mahmood; Feleke Hailemichael Astawesegn; Allen G Ross

doi:10.1038/s41598-024-73522-5

Trends and social determinants of the obesity epidemic among reproductive-age women in ten Asian countries

Sci Rep. 2024 Sep 29;14(1):22545. doi: 10.1038/s41598-024-73522-5.

Authors

Subash Thapa^{1

2}, Kedir Y Ahmed³, Habtamu Mellie Bizuayehu⁴, M Mamun Huda³, Binaya Chalise⁵, Meless G Bore^{6

7}, Sewunet Admasu Belachew⁴, Tahir A Hassen⁸, Erkihun Amsalu^{9

10}, Desalegn Markos Shifti¹¹, Abdulbasit Seid¹², Yonatan M Mesfin¹³, Teketo Kassaw Tegegne¹⁴, Abel F Dadi^{15

16}, Daniel Bogale Odo¹⁷, Getiye Dejenu Kibret^{18

19}, Daniel Bekele Ketema^{20

21}, Zemenu Yohannes Kassa²², Anayochukwu E Anyasodor³, Shakeel Mahmood³, Feleke Hailemichael Astawesegn³, Allen G Ross³

Affiliations

¹ Rural Health Research Institute, Charles Sturt University, Orange, NSW, 2800, Australia. [email protected].
² Health and Development Society Nepal, Lalitpur, Nepal. [email protected].
³ Rural Health Research Institute, Charles Sturt University, Orange, NSW, 2800, Australia.
⁴ The First Nations Cancer and Wellbeing Research (FNCWR) Program, School of Public Health, The University of Queensland, Queensland, Australia.
⁵ Health and Development Society Nepal, Lalitpur, Nepal.
⁶ School of Nursing and Midwifery, University of Technology Sydney, Sydney, Australia.
⁷ School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia.
⁸ Center for Women's Health Research, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia.
⁹ Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
¹⁰ St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.
¹¹ Child Health Research Centre, The University of Queensland, Queensland, Australia.
¹² School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.
¹³ Infection, Immunity, & Global Health, Asia-Pacific Health, Murdoch Children's Research Institute (MCRI), Parkville, VIC, Australia.
¹⁴ Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia.
¹⁵ Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.
¹⁶ Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
¹⁷ National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
¹⁸ School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
¹⁹ Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
²⁰ The George Institute for Global Health, University of New South Wales (UNSW), Sydney, Australia.
²¹ School of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia.
²² College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.

Abstract

The rapid epidemiological transition in Asian countries, resulting from the rising trend of urbanisation and lifestyle changes, is associated with an increasing risk of obesity in women of reproductive age. This is the first study to investigate the trends and population-attributable fraction (PAF) of obesity, and the interaction effects of education and wealth on obesity among reproductive-age women aged 15-49 years in ten Asian countries. This cross-sectional study examined the most recent (2000 to 2022) Demographic and Health Surveys (DHS) data from ten Central and Southeast Asian countries. Multilevel multinomial logistic regression models were used to compute odds ratios (ORs). PAFs adjusted for communality were calculated using adjusted ORs and prevalence estimates for each risk factor. This study included a weighted sample of 743,494 reproductive-age women. All the countries showed an increasing trend for obesity and a decreasing trend for underweight, except for the Maldives. The highest PAFs of obesity were associated with women who were married (PAF = 22.2%; 95% CI 22.1, 22.4), aged 35-49 years (PAF = 16.4%; 95% CI 15.5, 17.1), resided in wealthy households (PAF = 14.5%; 95% CI 14.4, 14.5), watched television regularly (PAF = 12.5%; 95% CI 12.1, 12.8), and lived in urban areas (PAF = 7.8%; 95% CI 7.7, 8.0). The combined PAF showed that these five risk factors were associated with 73.3% (95% CI 71.8, 74.9) of obesity among reproductive-age women. Interaction analysis between women's education and household wealth revealed that having a secondary or higher level of education and residing in a wealthier household was associated with a lower risk of obesity (OR = 0.71, 95% CI 0.66, 0.76). The findings of this study suggest that, in order to address the rising rate of obesity among women in Asian countries, education and lifestyle modifications in urban areas should be a priority. Pakistan and the Maldives need to be a priority given the rapidly increasing trends in obesity and underweight subpopulations in their respective countries.

Keywords: Obesity prevention; Population attributable fraction; Reproductive-age women; Secondary education; Social determinants of health; Urbanization.

MeSH terms

Adolescent
Adult
Asia / epidemiology
Cross-Sectional Studies
Epidemics
Female
Health Surveys
Humans
Middle Aged
Obesity* / epidemiology
Prevalence
Risk Factors
Social Determinants of Health
Socioeconomic Factors
Young Adult