Obesity odds more than twice as high for women than men in low- and middle-income nations
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Key takeaways:
- Women from low and middle-income countries have a 2.72 times greater likelihood for developing obesity than men.
- Women living in the Middle East and North Africa have the highest prevalence of obesity.
Women living in low- and middle-income countries have a higher prevalence of obesity and other cardiometabolic disorders than men, according to findings published in The Journal of Clinical Endocrinology & Metabolism.
Researchers conducted a systematic review and meta-analysis of studies analyzing the prevalence of obesity and cardiometabolic diseases in 63 low- and middle-income countries. The meta-analysis revealed women had a 2.72 times higher likelihood for obesity than men, and 23.1% of all women included in the study had obesity.
“For the first time, we are able to assess the extent of poor metabolic health faced by women than men in low- and middle-income countries,” Thaís Rocha, MD, PhD, clinical research coordinator in the Institute of Metabolism and Systems Research at the University of Birmingham in the U.K., and Shakila Thangaratinam, MD, PhD, the Dame Hilda Lloyd Professor of Maternal and Perinatal Health at University of Birmingham, told Healio. “Our research shows that obesity does not manifest evenly across women and men, with women being two to three times more likely to be affected than men in low- and middle-income countries.”
Rocha, Thangaratinam and colleagues searched the Embase, MEDLINE and Cochrane databases for studies assessing the prevalence of obesity as measured by BMI for nonpregnant women in countries classified as low-, lower-middle- or upper-middle-income nations by the World Bank regions in the year the study was conducted. Associations between men and women and the odds for obesity, hypertension and type 2 diabetes were assessed. The overall prevalence for obesity, hypertension, type 2 diabetes, impaired glucose tolerance, dyslipidemia, metabolic dysfunction-associated steatotic liver disease (the new nomenclature replacing nonalcoholic fatty liver disease), coronary heart disease, myocardial infarction and stroke for women in low- and middle-income countries were summarized.
There were 345 studies with 3,916,276 adults included in the meta-analysis. Of the included studies, 55.7% were conducted in sub-Saharan Africa, 11.6% in South Asia, 11% in Latin America and the Caribbean, 10.4% in East Asia and the Pacific, 9.9% in the Middle East and North Africa and 1.4% in Europe and Central Asia. Of the nations included in the meta-analysis, 41.2% were considered low-middle income, 34.8% were upper-middle income and 24.1% were low income.
Across all included studies, women were more likely to have obesity than men (OR = 2.72; 95% CI, 2.55-2.91). The findings varied by region, with the largest difference in obesity odds between women and men occurring in sub-Saharan Africa (OR = 3.91; 95% CI, 3.49-4.39) and the smallest difference occurring in South Asia (OR = 1.43; 95% CI, 1.29-1.59) and East Asia and the Pacific (OR = 1.43; 95% CI, 1.19-1.71).
Women were less likely to have hypertension (OR = 0.95; 95% CI, 0.91-0.99) but more likely to have type 2 diabetes (OR = 1.07; 95% CI, 1-1.14) than men.
The prevalence of obesity for women in low- and middle-income countries was 23.1%, the prevalence of hypertension was 26.5%, and 7.1% of women had type 2 diabetes. Prevalence varied across regions for all three conditions. The Middle East and North Africa had the highest prevalence for all three conditions, with 37% of women having obesity, 38% having hypertension and 17% having type 2 diabetes. Prevalence for all three diseases also varied by country income status, with the highest prevalence found in upper-middle-income countries. The odds for developing obesity (OR = 1.04), hypertension (OR = 1.07) and type 2 diabetes (OR = 1.07) increased for women with each 1 year of older age.
Women with obesity in lower- and middle-income countries were more likely to develop hypertension (OR = 2.41; 95% CI, 1.89-3.08), type 2 diabetes (OR = 2.65; 95% CI, 1.76-3.98) and IGT (OR = 3.06; 95% CI, 1.84-5.11) than women without obesity.
“Funders and policymakers must implement woman-centered measures addressing the underlying social, cultural and behavioral factors to improve their long-term metabolic health,” Rocha and Thangaratinam said.
More studies are needed to examine how cultural aspects shape body weight perceptions for women and how to use those findings to create community-level interventions, they said.
For more information:
Thaís Rocha, MD, PhD, can be reached at t.rocha@bham.ac.uk.
Shakila Thangaratinam, MD, PhD, can be reached at s.thangaratinam.1@bham.ac.uk.
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