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Prajakta Parab-Waingankar ¹, Shobha Rao ¹

Affiliations
1 Biometry & Nutrition Unit, Agharkar Research Institute, Pune- 411 004, IN

Abstract

Although hypertension is highly prevalent among urban Indian population, there exists insufficient investigation on its relation with obesity and abdominal obesity indicators for early risk prediction. Data on Body Mass Index (BMI), Body Fat (BF%), Waist Circumference (WC), Abdominal Circumference (AC), Waist to Hip Ratio (WHR), Waist to Height ratio (WHT), Sub-scapular (SSF) and Supra-iliac Skin Folds (SUF) and Blood Pressure were recorded through a cross-sectional study on 302 urban affluent men (aged 30-60 years) in Pune, India. Younger adults had the highest prevalence of both overweight (25.2%) and obesity (52.0%) and age related trend was significant (p<0.05) for prevalence of abdominal obesity. Obesity prevalence based on BF (%) was alarmingly high compared to that based on BMI. Indicators of abdominal obesity (WC, AC, SSF and SUF) increased with increase in BMI. Mean values of SBP and DBP and prevalence of hypertension increased significantly (p<0.05) with increase in BMI, AC, WC and its ratios but not with increase in either BF (%) or skinfolds indicating that it is the distribution of fat and not the total body fat that matters. The risk of hypertension was 2 to 3 times higher for BMI > 27.6 kg/m², for WC > 91.3 cm, for AC > 97.0 cm and for WHT > 0.55. Optimal cut-off for risk of hypertension obtained by ROC was much lower than conventional cut-off in case of WC (86.3 vs 90 cm) than that for BMI (25.3 vs 25 kg/m²) indicating the need for further studies to validate the potential of simple measurements such as WC and its ratios for risk assessment of hypertension among Indian population.

Keywords

Obesity, Abdominal Obesity, BMI, Waist Circumference, Hypertension.

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Prajakta Parab-Waingankar ¹, Shobha Rao ¹

Affiliations
1 Biometry and Nutrition Group, Agharkar Research Institute, Pune - 411 004, IN

Abstract

Indian diets have not been thoroughly investigated despite the fact that 'Nutrition Transition' parallels a rapidly escalating epidemic of obesity and Non-Communicable Diseases. Data on socio-economic background, dietary intake, BMI, Body Fat, Waist Circumference (WC), Abdominal Circumference (AC) and fasting blood estimations were recorded on 302 affluent men (30-60 years) in a cross-sectional study in Pune, India. Average daily calorie intake was lower (1714.7 ± 442 kcal) than the Recommended Dietary Allowance (ICMR, 2010) while mean fat (45.8 ± 19.1 g), carbohydrate (279.2 ± 68.3 g) and protein intakes (46.5 ± 15.1 g) were comparable. Increase in mean WC and AC (3.9 cm), in prevalence of overall obesity (49.4% to 65.4%) and in prevalence of abdominal obesity (24.7% to 40.7%) was significant (p<0.05 for all) across tertiles of total calories. But with increase in fat intake, it was only the prevalence of abdominal obesity that increased significantly (23.2% to 39.5%; p<0.05). Subjects having higher calorie intake (>1816 kcal/d) had two times higher risk for overall and abdominal adiposity while subjects having higher fat intake (>50g/d) had two times higher risk for abdominal obesity alone. Fat density but not carbohydrate, was sensitive as the prevalence of high Fasting Blood Glucose (FBG), significantly (p<0.05) increased (20.2% to 42.9%) with its increase. Additionally, the risk of high FBG was about 3 times higher (p<0.01) for high fat density (>30%). Thus, high fat density but not carbohydrate density may be an important causative factor for high rates of abdominal obesity and disturbed glucose metabolism in India.

Keywords

Overall Obesity, Abdominal Obesity, Fat Density, Fasting Blood Glucose.

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Prajakta Parab-Waingankar ¹, Shobha Rao ¹

Affiliations
1 Biometry and Nutrition Group, Agharkar Research Institute, Pune-411004, IN

Abstract

The pertinent role of diet in the development of obesity and metabolic syndrome (MS) is evident among studies from developed countries, however scarce data is available from India that has a culturally unique diet pattern. Data on socio-economic background, dietary patterns, BMI, body fat, circumferences, skin folds and blood pressure were recorded on 302 affluent men (30-60 years) in a cross-sectional study in Pune, India. Fasting blood estimations were performed for glucose, insulin and lipids. The subjects were predominantly (70%) vegetarians with daily butter consumption at 50%, high consumption (>4 times/week) of milk at 60.5% and >2 times/week for milk products (36%), home-made fried snacks (35%), outside snacks (25.5%) and outside meals (32.2%). High consumption of home-made fried and sweet snacks, outside snacks and milk products showed significantly higher (p<0.05) means, prevalence and odds ratio for overall and abdominal obesity. High consumption of fried foods increased abdominal obesity by 2-4 times. Significant associations were also observed between consumption patterns, dyslipidemia and MS. Prevalence of dyslipidemia significantly (p<0.05) increased from 42% to 48% to 55% across tertiles of outside snack consumption, with a significant risk observed in the middle tertile (OR: 1.94, p<0.05). Food groups that had displayed risk for abdominal obesity continued to demonstrate a positive association with MS viz. milk products (OR:2.23, p<0.05), home-made fried snacks (OR: 4.45, p<0.01) and outside snacks (OR:3.45, p<0.05). Odds ratio for fried and outside snacks continued to be significant even after adjusting for BMI. In contrast, the risk for MS was lowest (OR: 0.15, p=0.068) among subjects consuming fish (>once/week) as compared to consumption of once or less per month, even after adjusting for BMI. It was thus evident that consuming foods high in unhealthy fats and sugar (>2 times/week) increased the risk for both abdominal obesity and metabolic syndrome.

Keywords

Obesity, Abdominal Obesity, BMI, Waist Circumference, Metabolic Syndrome, Dyslipidemia, Diet, Fried Foods, Outside Snacks.

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