20-Year Trends in Filipino Women's Weight Reflect Substantial Secular and Age Effects

Abstract

Increasing obesity in low- and middle-income countries is well documented in cross-sectional studies. However, few longitudinal studies identify factors that influence individual weight gain patterns over time in relation to the major social and economic changes that now characterize these settings. This study uses data from adult Filipino women participating in the Cebu Longitudinal Health and Nutrition Survey from 1983 to 2005. A sample of 3005 women contributed 1-8 observations each. Longitudinal mixed effects models identified how age and secular weight trends related to underlying effects of urbanization and changing household socioeconomic status (SES) and to proximate individual effects of reproductive history, diet, and occupational physical activity. The 23-y secular trend in weight amounted to nearly 10 kg. Younger women gained more weight than older women (12.4 kg in those < 20 y old in 1983 vs. 4.9 kg in those > 35 y). Periods of more rapid weight gain corresponded to periods of rapid increase in SES and urbanization. Weight was positively related to energy intake, percentage of calories from protein, and more sedentary occupations, but negatively related to months pregnant and lactating and postmenopausal status. These effects all varied with age and over time. The trends contributed to a 6-fold increase in prevalence of overweight and an increasing number of women who have or are likely to develop obesity-related metabolic diseases. The trends are highly relevant for health policy and preventive health measures in the Philippines and other countries now facing the dual burden of over- and undernutrition.

25‐year weight gain in a racially balanced sample of U.S. adults: The CARDIA study

“…In contrast, other studies have shown that individuals who initially had excess weight gained less weight over time than participants who were leaner at baseline . In CARDIA, aging‐related weight gain was greatest in the early to mid‐20s for most groups, which is consistent with other epidemiological studies in the U.S. and other countries that have demonstrated the greatest adult weight gains in early adulthood .…”

“…However, most of this previous research has examined weight gain over time periods ranging from 5 to 10 years , although two studies, including one in the U.S. and one in the Philippines , followed the same participants for 20 years. In the U.S. study, weight gain was most pronounced in early adulthood (aged 25–35 years), and this was consistent for men and women as well as Blacks and Whites .…”

Comparative insights into the regulation of inflammation: Levels and predictors of interleukin 6 and interleukin 10 in young adults in the Philippines

“…It is a lower-middle income nation undergoing significant economic, dietary and lifestyle changes. Although rates of overweight/obesity, CVD, and metabolic syndrome are relatively low, they are on the rise (Adair et al 2011; Pedro et al 2007; Tanchoco et al 2003). At the same time, infectious disease accounts for more than 30% of all mortality in Southeast Asia, with pneumonia, diarrhea, and tuberculosis serving as major contributors (WHO 2004).…”

The spatial distribution of overweight and obesity among a birth cohort of young adult Filipinos (Cebu Philippines, 2005): an application of the Kulldorff spatial scan statistic

“…Motivated by the increasing prevalence of obesity in the Philippines, 41, 42 and other lower-income countries, 7 particularly in urban areas, we aimed to identify spatial clusters of obesity in Metropolitan Cebu. By identifying spatial clusters and relating them to the urbanicity of the study area, we hoped to facilitate further etiological research aimed at identifying environmental determinants of obesity in this study area.…”

“…However, the mothers of this birth cohort underwent a remarkable sixfold increase in OW and obesity prevalence between 1983 and 2005. 42 Space-time clustering of obesity in the cohort mothers will provide additional insights and help overcome these limitations.…”