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Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan

BACKGROUND: Similar to other developing countries, Pakistan is going through a rapid nutrition transition where shift from underweight to overweight and obesity is occurring. In this paper, we report on the relationship of household socioeconomic position (SEP), community SEP and urbanicity with und...

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Autores principales: Janjua, Naveed Zafar, Mahmood, Bushra, Bhatti, Junaid A., Khan, M. Imran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383475/
https://www.ncbi.nlm.nih.gov/pubmed/25835540
http://dx.doi.org/10.1371/journal.pone.0122314
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author Janjua, Naveed Zafar
Mahmood, Bushra
Bhatti, Junaid A.
Khan, M. Imran
author_facet Janjua, Naveed Zafar
Mahmood, Bushra
Bhatti, Junaid A.
Khan, M. Imran
author_sort Janjua, Naveed Zafar
collection PubMed
description BACKGROUND: Similar to other developing countries, Pakistan is going through a rapid nutrition transition where shift from underweight to overweight and obesity is occurring. In this paper, we report on the relationship of household socioeconomic position (SEP), community SEP and urbanicity with under- and over-weight categories of BMI among Pakistani women. METHODS: We analyzed data on 4,767 women ages 15-49 years enrolled in a nationally representative Pakistan Demographic Health Survey (PDHS) conducted in 2012-13 that employed a multistage, stratified cluster sampling design. We assessed the association of urbanicity, household and community SEP derived from household assets and utilities, with categories of body mass index (BMI) using multinomial regression analysis where normal weight (BMI 18.6-22.5) was the reference category. RESULTS: Thirteen percent of women were underweight (BMI <18.5), 15% pre-overweight (BMI: 22.6-24.9), 25% overweight (BMI: 25.0–29.9) and 14% were obese (BMI≥30). Pre-overweight, overweight and obesity among women increased across household wealth quintiles (HWQs) in a graded fashion whereas there was no significant difference in underweight by household wealth. Women in urban areas were more likely to be obese. There was a pronounced increase in adjusted odds ratios (aORs) for overweight/obesity across HWQs within urban areas compared to rural areas. There was a steeper gradient in aORs for obesity from 1st to 5th HWQs in high income communities compared to the middle- and low income communities. In community-level analyses, communities in urban areas were more likely to have higher levels of obesity while in rural areas, especially in Sindh, more communities were more likely to have a higher level of underweight. CONCLUSION: A shift to higher overweight and obesity than underweight in Pakistan is associated with high household and community wealth as well as living in urban areas. Clustering of obesity and underweight in distinct communities afford opportunity for tailored intervention programs.
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spelling pubmed-43834752015-04-09 Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan Janjua, Naveed Zafar Mahmood, Bushra Bhatti, Junaid A. Khan, M. Imran PLoS One Research Article BACKGROUND: Similar to other developing countries, Pakistan is going through a rapid nutrition transition where shift from underweight to overweight and obesity is occurring. In this paper, we report on the relationship of household socioeconomic position (SEP), community SEP and urbanicity with under- and over-weight categories of BMI among Pakistani women. METHODS: We analyzed data on 4,767 women ages 15-49 years enrolled in a nationally representative Pakistan Demographic Health Survey (PDHS) conducted in 2012-13 that employed a multistage, stratified cluster sampling design. We assessed the association of urbanicity, household and community SEP derived from household assets and utilities, with categories of body mass index (BMI) using multinomial regression analysis where normal weight (BMI 18.6-22.5) was the reference category. RESULTS: Thirteen percent of women were underweight (BMI <18.5), 15% pre-overweight (BMI: 22.6-24.9), 25% overweight (BMI: 25.0–29.9) and 14% were obese (BMI≥30). Pre-overweight, overweight and obesity among women increased across household wealth quintiles (HWQs) in a graded fashion whereas there was no significant difference in underweight by household wealth. Women in urban areas were more likely to be obese. There was a pronounced increase in adjusted odds ratios (aORs) for overweight/obesity across HWQs within urban areas compared to rural areas. There was a steeper gradient in aORs for obesity from 1st to 5th HWQs in high income communities compared to the middle- and low income communities. In community-level analyses, communities in urban areas were more likely to have higher levels of obesity while in rural areas, especially in Sindh, more communities were more likely to have a higher level of underweight. CONCLUSION: A shift to higher overweight and obesity than underweight in Pakistan is associated with high household and community wealth as well as living in urban areas. Clustering of obesity and underweight in distinct communities afford opportunity for tailored intervention programs. Public Library of Science 2015-04-02 /pmc/articles/PMC4383475/ /pubmed/25835540 http://dx.doi.org/10.1371/journal.pone.0122314 Text en © 2015 Janjua et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Janjua, Naveed Zafar
Mahmood, Bushra
Bhatti, Junaid A.
Khan, M. Imran
Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan
title Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan
title_full Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan
title_fullStr Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan
title_full_unstemmed Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan
title_short Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan
title_sort association of household and community socioeconomic position and urbanicity with underweight and overweight among women in pakistan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383475/
https://www.ncbi.nlm.nih.gov/pubmed/25835540
http://dx.doi.org/10.1371/journal.pone.0122314
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