Occupation Is More Important than Rural or Urban Residence in Explaining the Prevalence of Metabolic and Cardiovascular Disease Risk in Guatemalan Adults1

Abstract

Diet and activity pattern changes consequent to urbanization are contributing to the global epidemic of cardiovascular disease; less research has focused on activity within rural populations. We studied 527 women and 360 men (25-42 y), all rural-born and currently residing in rural or urban areas of Guatemala. We further classified rural male occupations as agricultural or nonagricultural. Overweight status (BMI > or = 25 kg/m(2)) differed by residence/occupation among men (agricultural-rural, 27%; nonagricultural-rural, 44%; and urban, 55%; P< 0.01) and women (rural, 58%; and urban, 68%; P= 0.04). A moderate-to-vigorous lifestyle was reported by 76, 37, and 20% of men (agricultural-rural, nonagricultural-rural, and urban, respectively; P< 0.01); most women were sedentary, with no difference by residence. Prevalence of the metabolic syndrome was 17, 24, and 28% in agricultural-rural, nonagricultural-rural, and urban men, respectively (P= 0.2), and 44 and 45% in rural and urban women (P= 0.4). Dietary variables were largely unassociated with adiposity or cardio-metabolic risk factors; physical activity was inversely associated with the percentage of body fat in men. Percent body fat was inversely associated with HDL-cholesterol, and positively associated with triglycerides, blood pressure, and the metabolic syndrome in both men and women, and with LDL-cholesterol and fasting glucose in women. Differences in physical activity level, mainly attributable to occupation, appear more important than residence, per se, in influencing the risk for cardiovascular disease among men; differences among these sedentary women are likely related to other factors associated with an urban environment.

Clustering and combining pattern of metabolic syndrome components in a rural Brazilian adult population

“…Men still perform the field activities that require high energy expenditure, while women are devoted to housework. 5 Another investigation developed using the same population as in this study showed that men were more active than women in relation to leisure, commuting and work, while women were more active than men in the household domain. 21 We observed in this study that there were occurrences of three or more metabolic syndrome components at rates greater than would be predicted by chance.…”

“…Similar findings have also been shown in studies developed in rural areas in Brazil 4 and other countries. 5,20 There seems to be a pattern of metabolic syndrome occurrence in rural areas that is characterized by higher prevalence among women. This phenomenon might be determined by people's occupations in this region, which differ greatly according to sex.…”

“…1 This syndrome is recognized as an important public health problem worldwide, due to prevalence greater than 20.0% in adult populations living both in urban and in rural areas, [2][3][4][5][6][7] and also to its strong association with cardiovascular diseases and type 2 diabetes, which are both major causes of death worldwide. 1,[8][9] Despite this epidemiological context, the management of metabolic syndrome in clinical practice remains controversial, 10,11 primarily because of the random clustering of its components.…”

“…14 In Brazil, these issues have been poorly investigated, particularly in rural areas, given that studies have usually focused on the prevalence of metabolic syndrome and associated factors in urban populations. Furthermore, there may be a need for different approaches towards evaluating metabolic syndrome in rural populations, which are also highly affected by this pathological condition 4,5,7 and thus would benefit from interventions such as establishing preventive strategies and adequate treatment.…”

Síndrome metabólico según tipo de trabajo en empleados del Jurado Nacional de Elecciones. Lima, 2013

“…La prevalencia del síndrome metabólico fluctúa ampliamente dependiendo de la población estudiada, teniendo esto en cuenta, en el estudio de Gregory C, et al, encuentran en la población americana una prevalencia de 24% en adultos guatemaltecos que varía desde 7 al 28%, de acuerdo a que se tratasen de agricultores, de la población rural y urbana (11) .…”