Contribution of economic and nutritional context to overweight/obesity dynamics in Indian women from 1998 to 2016: a multilevel analysis of national survey data

Background Overweight/obesity increased dramatically among Indian women since 2000. We evaluated the independent contributions of economic and nutrition context to the changing distribution of overweight/obesity among women from 1998 to 2016 across India.Methods Individual-level data from 473 912 ev...

Full description

Saved in:
Bibliographic Details
Main Authors: K M Venkat Narayan, Tinku Thomas, Anura V Kurpad, Shivani Patel, Jeswin Baby, Jithin Sam Varghese, Shruthi Cyriac
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/12/e050598.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846129741887700992
author K M Venkat Narayan
Tinku Thomas
Anura V Kurpad
Shivani Patel
Jeswin Baby
Jithin Sam Varghese
Shruthi Cyriac
author_facet K M Venkat Narayan
Tinku Thomas
Anura V Kurpad
Shivani Patel
Jeswin Baby
Jithin Sam Varghese
Shruthi Cyriac
author_sort K M Venkat Narayan
collection DOAJ
description Background Overweight/obesity increased dramatically among Indian women since 2000. We evaluated the independent contributions of economic and nutrition context to the changing distribution of overweight/obesity among women from 1998 to 2016 across India.Methods Individual-level data from 473 912 ever married Indian women aged 18–49 in the National Family Health Surveys (1998–1999, 2005–2006, 2015–2016) were merged with year-matched state-level economic and nutrition context indicators. Cross-classified generalised linear mixed models were estimated to quantify associations of contextual characteristics with overweight/obesity (body mass index ≥25 kg/m2) across survey rounds.Results Between 1998 and 2016, age-standardised prevalence of overweight/obesity increased from 13.9% to 27.5% nationally at an annual growth rate of 0.8%. After accounting for a woman’s age, parity and social class, the adjusted OR (aOR) for overweight/obesity was 2.02 times higher for every unit of state log per capita gross domestic product (GDP) (95% credible interval (CrI) 2.00 to 2.03). Yet, the association of state GDP with overweight/obesity generally decreased over survey round. Women in states with higher per capita daily oil (aOR 1.02 per gram; 95% CrI 1.01 to 1.03) and sugar (aOR 1.05 per gram; 95% CrI 1.04 to 1.05) consumption were more likely to be overweight/obese, while women in states with higher cereal consumption were less likely to be overweight/obese (aOR 0.93 per 10 gram; 95% CrI 0.93 to 0.93).Conclusions Indicators of state economic development and nutrition transition were independently associated with a woman’s likelihood of being overweight/obese. The impact of state wealth waned over survey round, suggesting that risks for overweight/obesity may be increasingly shaped by individual factors as economic development expands in India.
format Article
id doaj-art-4469db2ef8a047e59da92eb944acd253
institution Kabale University
issn 2044-6055
language English
publishDate 2021-12-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-4469db2ef8a047e59da92eb944acd2532024-12-09T20:25:10ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-050598Contribution of economic and nutritional context to overweight/obesity dynamics in Indian women from 1998 to 2016: a multilevel analysis of national survey dataK M Venkat Narayan0Tinku Thomas1Anura V Kurpad2Shivani Patel3Jeswin Baby4Jithin Sam Varghese5Shruthi Cyriac6Rollins School of Public Health, Atlanta, Georgia, USADivision of Biostatistics, St John`s Research Institute, Bangalore, Karnataka, IndiaSt John`s Medical College, Bangalore, Karnataka, IndiaDepartment of Global Health and Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USADivision of Epidemiology and Biostatistics, St John’s Research Institute, Bangalore, Karnataka, IndiaNutrition and Health Sciences Doctoral Program, Laney School of Graduate Studies, Emory University, Atlanta, Georgia, USANutrition and Health Sciences Doctoral Program, Laney School of Graduate Studies, Emory University, Atlanta, Georgia, USABackground Overweight/obesity increased dramatically among Indian women since 2000. We evaluated the independent contributions of economic and nutrition context to the changing distribution of overweight/obesity among women from 1998 to 2016 across India.Methods Individual-level data from 473 912 ever married Indian women aged 18–49 in the National Family Health Surveys (1998–1999, 2005–2006, 2015–2016) were merged with year-matched state-level economic and nutrition context indicators. Cross-classified generalised linear mixed models were estimated to quantify associations of contextual characteristics with overweight/obesity (body mass index ≥25 kg/m2) across survey rounds.Results Between 1998 and 2016, age-standardised prevalence of overweight/obesity increased from 13.9% to 27.5% nationally at an annual growth rate of 0.8%. After accounting for a woman’s age, parity and social class, the adjusted OR (aOR) for overweight/obesity was 2.02 times higher for every unit of state log per capita gross domestic product (GDP) (95% credible interval (CrI) 2.00 to 2.03). Yet, the association of state GDP with overweight/obesity generally decreased over survey round. Women in states with higher per capita daily oil (aOR 1.02 per gram; 95% CrI 1.01 to 1.03) and sugar (aOR 1.05 per gram; 95% CrI 1.04 to 1.05) consumption were more likely to be overweight/obese, while women in states with higher cereal consumption were less likely to be overweight/obese (aOR 0.93 per 10 gram; 95% CrI 0.93 to 0.93).Conclusions Indicators of state economic development and nutrition transition were independently associated with a woman’s likelihood of being overweight/obese. The impact of state wealth waned over survey round, suggesting that risks for overweight/obesity may be increasingly shaped by individual factors as economic development expands in India.https://bmjopen.bmj.com/content/11/12/e050598.full
spellingShingle K M Venkat Narayan
Tinku Thomas
Anura V Kurpad
Shivani Patel
Jeswin Baby
Jithin Sam Varghese
Shruthi Cyriac
Contribution of economic and nutritional context to overweight/obesity dynamics in Indian women from 1998 to 2016: a multilevel analysis of national survey data
BMJ Open
title Contribution of economic and nutritional context to overweight/obesity dynamics in Indian women from 1998 to 2016: a multilevel analysis of national survey data
title_full Contribution of economic and nutritional context to overweight/obesity dynamics in Indian women from 1998 to 2016: a multilevel analysis of national survey data
title_fullStr Contribution of economic and nutritional context to overweight/obesity dynamics in Indian women from 1998 to 2016: a multilevel analysis of national survey data
title_full_unstemmed Contribution of economic and nutritional context to overweight/obesity dynamics in Indian women from 1998 to 2016: a multilevel analysis of national survey data
title_short Contribution of economic and nutritional context to overweight/obesity dynamics in Indian women from 1998 to 2016: a multilevel analysis of national survey data
title_sort contribution of economic and nutritional context to overweight obesity dynamics in indian women from 1998 to 2016 a multilevel analysis of national survey data
url https://bmjopen.bmj.com/content/11/12/e050598.full
work_keys_str_mv AT kmvenkatnarayan contributionofeconomicandnutritionalcontexttooverweightobesitydynamicsinindianwomenfrom1998to2016amultilevelanalysisofnationalsurveydata
AT tinkuthomas contributionofeconomicandnutritionalcontexttooverweightobesitydynamicsinindianwomenfrom1998to2016amultilevelanalysisofnationalsurveydata
AT anuravkurpad contributionofeconomicandnutritionalcontexttooverweightobesitydynamicsinindianwomenfrom1998to2016amultilevelanalysisofnationalsurveydata
AT shivanipatel contributionofeconomicandnutritionalcontexttooverweightobesitydynamicsinindianwomenfrom1998to2016amultilevelanalysisofnationalsurveydata
AT jeswinbaby contributionofeconomicandnutritionalcontexttooverweightobesitydynamicsinindianwomenfrom1998to2016amultilevelanalysisofnationalsurveydata
AT jithinsamvarghese contributionofeconomicandnutritionalcontexttooverweightobesitydynamicsinindianwomenfrom1998to2016amultilevelanalysisofnationalsurveydata
AT shruthicyriac contributionofeconomicandnutritionalcontexttooverweightobesitydynamicsinindianwomenfrom1998to2016amultilevelanalysisofnationalsurveydata