Obesity found to be new, growing health threat among Indian women

October 02, 2001

CHAPEL HILL - Past nutrition research in India has focused chiefly on malnutrition associated with food shortages, poverty and high infection rates, but a new study offers a surprise and cause for concern, scientists say. A significant, growing percentage of Indian women are now overweight or obese, their research shows.

Conducted by investigators at the University of North Carolina at Chapel Hill's schools of public health and medicine and Carolina Population Center, the study concentrated on 4,032 women in both urban and rural parts of the southern state of Andhra Pradesh, which has a population of nearly 80 million.

"Recent data from the Indian National Family Health Survey of 1998-1999 show the major nutrition problem facing women continues to be under-nutrition, but 12 percent of the women could be classified as overweight, and 2 percent were obese," said postdoctoral fellow Dr. Paula Griffiths. "In the large cities of Andhra Pradesh, where 4 percent of the sample live, we found 37 percent of women were overweight or obese."

Griffiths and Dr. Margaret E. Bentley, associate professor and associate chair of nutrition at UNC, co-wrote a report on their findings, which appear in the October issue of the Journal of Nutrition. Overall, 37 percent of women in the region have a body mass index of less than 18.5 and are considered thin, and 8 percent are severely malnourished, the researchers found. Body mass index is a mathematical combination of height and weight that is an indicator of nutritional status. A BMI between 18.5 and 24.9 is considered to be in the normal range.

"In rural areas where 74 percent of the study population reside, 43 percent of women have a low body mass index," they wrote. "Women from lower socioeconomic groups are also significantly more likely to have a low BMI."

Subjects' economic status was a better predictor of both overweight and underweight than where the women lived, although urban living was an important factor too. Those who were more affluent tended to weigh more than others, which usually is true in poor nations but not necessarily in wealthy ones like the United States.

Religion was a significant factor, they found, with Muslim women more likely to be overweight or obese than women from other religious groups, primarily Hindu. Those who watched more television than others also tended to weigh more.

The new study is important because as obesity rises, India is beginning to feel the burden of associated chronic diseases, the researchers said. Among these are heart disease, hypertension and adult-onset diabetes. The World Health Organization estimates the latter will triple there from 19.4 million cases in 1995 to 57.2 million in 2025.

In 1993, the World Development Report showed an increase in consumption of fat, saturated fat, sugar, salt and the clarified butter product known as ghee in India. Surveys by the National Nutritional Monitoring Bureau revealed that 5 percent of the Indian population were consuming 40 percent of the available fat. "By nearly any measure, India remains one of the poorest countries in the world, with a population of over one billion and a fertility rate well above replacement level," Griffiths and Bentley wrote. "Nevertheless, infant mortality rates dropped from 115 per thousand live births in 1980 to 70 in 1998, and the total fertility rate dropped from 5 to 3.2 children during the same period."

Improvements in the nutritional status of the population have been less impressive, they said. More than half of the world's undernourished population lives in India, and more than half of Indian children are undernourished. More than 50 percent of women are anemic.

"Educated people in high socioeconomic groups are the first to respond to nutrition education messages and reduce their risk of obesity," the authors wrote. "Hence, providing health education messages and interventions for overweight women in the higher socioeconomic groups on healthy diets and healthy lifestyles might be effective in reducing the incidence of overweight and obesity in this group." Public health and nutrition education challenges are far greater among the poor, they said, but information and programs for rural residents are also needed.

The U.S. Agency for International Development chiefly funded the second Indian Family Health Survey of 1998-99 with additional contributions coming from the United Nations Children's Fund (UNICEF). The National Family Health Survey 1998-99 data were collected by the International Institute for Population Sciences in Mumbai, India.

Women in the survey ranged in age from 15 to 49. All were either married or formerly married.
Note: Griffiths can be reached at 919-843-4445 or plg3@unc.edu Bentley at 966-9575, 843-9962 or pbentley@unc.edu. News Services Contact: David Williamson, 962-8596. School of Public Health Contact: Lisa Katz, 966-7467

University of North Carolina at Chapel Hill

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