Alarming weight gain in women of a post-transitional country

Abstract

Objective: In post-transitional countries, obesity disproportionally affects women. Longitudinal studies can detect high-risk groups in whom to target actions. We investigated the magnitude and velocity of BMI changes in Chilean women of reproductive age and evaluated whether these trends vary in specific groups. Design: Longitudinal study. We measured weight and height in 2007 (baseline) and again in 2010 (follow-up); we estimated change in BMI (weight/height 2 ) within the 3-year period and assessed its relationship with age, years of education and parity, collected at baseline and follow-up using a questionnaire. Setting: Population-based cohort of low-to middle-income Chilean women. Subjects: Seven hundred and sixty-one women of reproductive age (mean 32?0 (SD 7?0) years), mothers of children who participate in the Growth and Obesity Cohort Study (GOCS). , P , 0?001). An increase in parity was positively associated with BMI change, independently of age, nutritional status and education (P , 0?05). Age and education were not associated with BMI change after controlling for other factors (P . 0?05). Conclusions: In Chile, a post-transitional country, we observed an alarming increase in obesity among women of reproductive age. Our results indicate that in this population actions need to be targeted at all women irrespective of their nutritional status. A key component of these policies should be avoiding excessive weight gain during pregnancy. Keywords Obesity Weight gain Women Latin AmericaOver the last two decades, the prevalence of obesity in women has increased dramatically, especially in middleincome countries (1) in which women are disproportionally affected by obesity. A variety of conditions are associated with obesity in women (including type 2 diabetes mellitus, CVD and breast cancer, among others) (2) that not only decrease their survival, but also compromise their current quality of life and reproductive health (3) . Moreover, maternal obesity is an important risk factor for childhood obesity (4) ; thus, obesity in women has a multiplicative detrimental effect.Chile, a post-transitional upper-middle-income Latin American country, has experienced a rapid epidemiological and nutritional transition (5) . The 2003 and 2010 National Health Surveys informed an obesity prevalence in women aged 25-44 years of 26?1 % and 28?3 %, respectively (6,7) . Although these data showed an increase in obesity, they were obtained from independent crosssectional surveys; therefore, they do not reflect life-course BMI trajectories and do not provide information of the velocity of BMI changes. This information is relevant to identify critical periods of life in which to intervene, as well as to detect high-risk groups in which to target preventive interventions.Presently, in Chile, as in several other countries, the public health-care system considers only secondary obesity preventive actions. Programmes are targeted to obese pregnant and elderly women and consider counselling and reductions in fat and sodium of th...

Does Chile’s nutritional situation constitute a double burden?

“…This implies changing the goals, strategies, and focus of interventions; redefining target groups; and establishing partnerships for joint actions implemented by the state, civil society, and community groups. Such partnerships should include consumer groups and the substantial academic community studying this issue (29). The results presented with regard to children also indicate that actions to prevent overweight should start from a very early age.…”

Obesidad en mujeres chilenas en edad fértil

“…En la década 2000-09, además de las dos ENS que se resumirán más adelante, se encontraron 9 estudios. Cinco de estos estudios se realizaron en población general, dos son de cohorte y tres transversales, alcanzando prevalencias de obesidad más altas a las décadas precedentes, desde 18% a 35% [36][37][38][39][40] . Cuatro estudios se realizaron en universitarias, con prevalencias de obesidad entre 0% y 6% [41][42][43][44] (Tabla 1) .…”

“…En relación a los estudios publicados, fue difícil la comparación entre los mismos debido a la heterogeneidad de poblaciones de estudio, diseños, tamaños muestrales, tipos de muestreo y los puntos de corte utilizados para el diagnóstico de obesidad, como en el caso de Berríos que utilizó como punto de corte para obesidad un IMC ≥ 27 32 . Pocos de los estudios encontrados se focalizaron específicamente en este grupo etáreo y muestran prevalencias variables, las prevalencias más altas se encontraron en San Carlos en la década 2000-09 y en general en los estudios de base poblacional [36][37][38][39][40] más que en la población universitaria [41][42][43][44] , probablemente asociado a una mayor edad y a un menor nivel educacional.…”

Mujeres chilenas en edad fértil: su estado nutricional y la asociación con actividad física y hábitos alimentarios

“…Su situación de salud se ha ido deteriorando según las últimas encuestas nacionales de salud 2003-2009 5 , lo que implica un contexto epigenéticamente desfavorable para las futuras generaciones. Este estudio muestra una elevada prevalencia de malnutrición por exceso (64,1%), similar a otros estudios nacionales y comparables con otras encuestas nacionales latinoamericanas, cifras reportadas entre 52 y 75% [19][20][21][22][23][24] . En relación a los hábitos alimentarios, el consumo de cereales integrales fue un efecto protector de la prevalencia de malnutrición por exceso, sin embargo, sólo 13,8% de las mujeres encuestadas refieren consumir cereales integrales al menos una vez al día.…”