|BRIEF RESEARCH ARTICLE
|Year : 2015 | Volume
| Issue : 1 | Page : 49-53
Desirable factors for maintaining normal BMI of urban affluent women of Delhi
Anu Taneja Gupta1, Anupa Siddhu2
1 Assistant Professor, Department of Home Science, Lakshmibai College, University of Delhi, Delhi, India
2 Director, Lady Irwin College, University of Delhi, Delhi, India
|Date of Web Publication||9-Mar-2015|
Anu Taneja Gupta
Assistant Professor, Department of Home Science, Lakshmibai College, University of Delhi, A-62, Third Floor, South Extension, Part-2, New Delhi - 110 049
Source of Support: None, Conflict of Interest: None
| Abstract|| |
The study aimed to identify desirable social, familial, reproductive, dietary, and lifestyle factors for maintaining normal body mass index (BMI) of urban affluent women (25-45 years) in Delhi, India. A total of 387 urban affluent women with at least one living child participated in this cross-sectional study conducted from March 2008 to April 2010. Women were classified into four BMI categories on the basis of World Health Organization (WHO; 2004) classification for Asians. Significant factors for maintaining normal BMI were: Younger age, less parity, nuclear family, normal weight status of parents, postpartum weight gain between 2 and 3 kg, regularity in taking meals, fixed meal size, self-perceived normal weight, and shorter sitting time and television viewing time. Multivariate regression analysis identified five determining factors for maintaining BMI, which are normal weight of father, self-perceived normal weight, fixed meal size, sitting time less than 6 h/day, and television viewing time less than 1 h/day. By small lifestyle modifications, normal BMI can be maintained.
Keywords: Diet, Factors, Lifestyle, Normal, Normal weight, Obese, Overweight, Urban affluent women
|How to cite this article:|
Gupta AT, Siddhu A. Desirable factors for maintaining normal BMI of urban affluent women of Delhi. Indian J Public Health 2015;59:49-53
|How to cite this URL:|
Gupta AT, Siddhu A. Desirable factors for maintaining normal BMI of urban affluent women of Delhi. Indian J Public Health [serial online] 2015 [cited 2020 Oct 27];59:49-53. Available from: https://www.ijph.in/text.asp?2015/59/1/49/152864
India, which is typically known for high prevalence of undernutrition, has a significant proportion of overweight and obese people. The major causative factors are related to the lifestyle changes occurring due to rapid socioeconomic transition. In India, obesity is concentrated in urban affluent women as compared to rural women due to high purchasing power, more accessibility to energy-dense and fat-rich foods and inactive lifestyle. This has resulted in calorie imbalance leading to weight gain.  Also, Asians are born with adverse body composition features like high upper body adiposity and high body fat percentage at low body mass index (BMI) values.  The concern for unhealthy excess weight is higher in women because apart from obesity-related co-morbidities, they are exposed to greater health risks like menstrual irregularities, pregnancy-related complications, giving birth to overweight babies, ovarian cancer, etc.  Thus, it becomes imperative to identify various socio-demographic, familial, reproductive, and lifestyle factors that help in maintaining normal BMI of urban affluent women.
This cross-sectional observational study was carried out from March 2008 to April 2010 in selected residential colonies of Delhi, capital of India. The study was conducted on women (25-45 years) belonging to high socioeconomic strata, i.e. household income ≥Rs. 960,000/- per annum.  The sample size was ascertained by keeping the level of significance (α) = 0.05, precision (d) = 5%, and prevalence value of obesity (P ) = 0.6 with 95% confidence on Epistat statistical package and calculated. The P value was based on the research data that there is 60% prevalence of overweight and obesity among urban healthy women in Delhi in the age group of 30-49 years.  The calculated value of the sample size was 369. The subjects for the study were identified by holding a body composition camp in the selected residential areas. The purposive sample was selected based on the study inclusion/exclusion criteria which are as follows: The woman should have at least one living child, have a BMI of ≥18.5 kg/m  , and should not have attained menopause or have had undergone hysterectomy or any major surgery, and was not taking drugs containing steroids. Random sampling was not possible because confounding factors of overweight and obesity had to be ruled out.
A pre-tested questionnaire was used to obtain information on the socio-demographic data, weight status of parents, postpartum weight status of self, dietary pattern, and activity pattern of the women subjects. Anthropometric measures like weight and height were taken using digital weighing scale with a sensitivity of 0.1 kg and anthropometrical rod which read up to a minimum of 0.1 cm, respectively.
The sample was categorized into four BMI categories as follows: Normal (N), i.e., BMI value between 18.5 and 22.9 kg/m  ; at risk of overweight/pre-overweight (PO), i.e., BMI value between 23.0 and 24.9 kg/m  ; overweight (OW), i.e., BMI value between 25.0 and 29.9 kg/m  ; and obese (Ob), i.e., BMI value ≥30 kg/m  , based on World Health Organization (WHO; 2004)  classification for Asians. The various factors affecting the weight status were studied with respect to these four BMI categories. The Statistical Package for Social Sciences (SPSS) version 15.0 was used to analyze data. Chi-square test and analysis of variance (ANOVA) were used to identify significant factors, and final determining factors for maintaining weight were identified using binary logistic regression analysis. The level of significance used was P < 0.05.
Approval for the study was obtained from Institutional Ethics Committee, Lady Irwin College, University of Delhi.
The final study sample consisted of 387 women. It was observed that the prevalence of Ob in the sample was 20.7% (n = 80), OW was 40.3% (n = 156), PO was 15.8% (n = 61), and N was 23.3% (n = 90). The mean age of women in N (34.6 years) BMI category was significantly lower (P = 0.001) as compared to that in other three BMI categories [Table 1]. Significantly higher (P = 0.001) number of women belonging to OW (43.2%) and Ob (23.0%) had two children, as compared to that in N (17.5%) and PO (16.4%) categories. Significantly higher (P = 0.002) number of women in OW (59.6%) and Ob (53.7%) categories were living in joint family, as compared to that in N (52.2%) and PO (31.1%) categories [Table 1]. Normal weight status of parents was reported by significantly higher (P < 0.001) number of women in N. Mean weight gain after parity [Table 1] was highest for women belonging to Ob (10-11 kg), followed by OW (6-7 kg) and PO (5-8 kg), whereas it was just 3-4 kg for women in N. Significantly higher (P < 0.001) number of women in N (90.0%) perceived themselves as normal weight as compared to 2.5% of women in Ob [Table 1]. Significantly higher percentage of women in N [Table 1] were regularly taking the three main meals, i.e., breakfast, lunch, and dinner, and also had a fixed meal size (65.6%) as compared to women in PO (13.1%), OW (6.4%), and Ob (3.7%) groups. Significantly higher mean (P < 0.001) time was spent in television viewing [Table 1] by the women in PO (70 min), OW (90 min), and Ob (95 min) categories, as compared to 55 min by women in N. Time spent in television viewing was found to be positively and significantly (r = +0.284; P < 0.001) correlated with BMI. Mean sitting time [Table 1] was significantly lower (P < 0.001) for N (5.9 h) as compared to PO (7.6 h), OW (8.7 h), and Ob (8.4 h). Time spent in sitting which included occupational sitting as well as sitting for leisure was positively and significantly (r = +0.184; P < 0.001) correlated with BMI. On the other hand, the mean standing time was significantly higher (P < 0.001) for N (6.9 h) as compared to PO (6.4 h), OW (5.5 h) and Ob (6.0 h). However, the four categories did not differ significantly (P = 0.280) with respect to mean walking time.
|Table 1: Signifi cant factors for maintaining normal BMI of urban affl uent women (25-45 yrs); (n = 387); n (%)|
Click here to view
Significant factors as mentioned in [Table 1] were further analyzed using binary logistic regression analysis and five factors were identified as the determining factors of normal weight status. Normal weight status of father, self-perceived normal weight status, having fixed meal size, sitting time less than 6 h/day, and television viewing time less than 1 h/day were found to be the determining factors for maintaining normal BMI of urban affluent women [Table 2].
|Table 2: Factors determining maintaining normal BMI of urban affl uent women (25– 45 years) found by multivariate regression analysis|
Click here to view
The socio-demographic factors like younger age and living in a nuclear family favored normal BMI. Women tend to gain weight with age as has been widely reported by various researchers. Probability of gaining weight is higher in joint family system as chances of elaborate meals and socializing are more, which normally leads to increased intake. Familial factors like normal weight status of parents help in maintaining normal BMI. Various researchers have also reported a positive association between parental and offspring adiposity, which persists into adulthood.  In the present study, apart from parental weight status, father's normal weight [P = 0.006; odds ratio (OR) = 3.33] status was identified as one of the determining factors for maintaining normal BMI of urban affluent women. This finding is different because most research studies have reported maternal weight status to be a greater predictor of the child's weight status. Impact of father's normal weight status on daughter's weight status can be attributed to the role of genes;  however, it needs to be studied further. Reproductive factors like less number of parity and postpartum weight gain in the range of 3-4 kg favored normal BMI. Parity has always played an important role in determining women's weight status. Research studies in the past have pointed to cumulative cycles of postpartum weight retention as the mechanism by which parity leads to overweight.  Eating behavior practices like regularity in taking three main meals and having a fixed meal size help in maintaining normal BMI. Significantly higher (P = 0.001) number of women in OW, Ob, and PO groups were skipping one or more of their three main meals, as compared to almost none in N. Similar observation was made by a research study on the prevalence and possible causes of obesity in Eastern Mediterranean region. It was observed that obese adults were skipping meals and were snacking frequently.  It is a well-known practice to reduce food intake in order to lose weight, but it is normally accompanied by reduced physical activity, which prevents weight loss. Lifestyle factors like sitting time less than 6 h/day and television viewing time less than 1 h/day help in maintaining normal BMI and were also identified as the determining factors for maintaining normal weight. Dunton et al. reported that a group of adults watching television for less than 60 min/day had a lower BMI as compared to the group watching television for more than 60 min/day.  The findings of the present study are important in today's obesogenic environment because they quantitatively support the sedentary behavior guidelines for adults formulated by health agencies of various nations. It is recommended that adults should minimize the amount of time spent in prolonged sitting and should break up long periods of sitting as often as possible. 
Out of the five factors, just one factor, i.e., normal weight status of the father, is non-modifiable. The remaining four factors i.e., self-perceived normal weight status, intake of fixed meals, shorter sitting time, and shorter television viewing time, are all related to behavior and are very much modifiable.
The present study is able to identify the factors which help in maintaining normal BMI of urban affluent women in the age group of 25-45 years. The study clearly points out that normal weight status can be maintained by having regulated and fixed meals, sitting for less than 6 h/day, and watching television for less than 60 min/day. Thus, normal body weight status can be maintained by modifying one's eating behavior and lifestyle.
| Acknowledgments|| |
The authors acknowledge the support of Department of Food and Nutrition, Lady Irwin College, University of Delhi, Delhi and Dr. Tulsi Adhikari, National Institute of Medical Statistics, ICMR, New Delhi.
| References|| |
Subramanian SV, Smith GD. Patterns, distribution, and determinants of under- and overnutrition: A population-based study of women in India. Am J Clin Nutr 2006;84:633-40.
Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-63.
Garg C, Khan SA, Ansari SH, Garg M. Prevalence of obesity in Indian women. Obes Rev 2010;11:105-8.
National Council of Applied Economic Research (NCAER), 2006-2007. National Council of Applied Economic Research. Available from: http:. [Last accessed on 2008 Jan 09].
Wasuja M, Siddhu A. Age related alterations in energy cost, energy requirement and energy status of affluent women (30-38 years) - A cross-sectional study. Department of Home Science, Lady Irwin College, University of Delhi, Delhi: 2002.
Cooper R, E, Berry D, Power C. Associations between parental and offspring adiposity up to midlife: The contribution of adult lifestyle factors in the 1958 British Birth Cohort Study. Am J Clin Nutr 2010;92:946-53.
Kral TV, Faith MS. Parental obesity status predicts child overweight status: The familial association. J Pediatr Psychol 2009;34:596-605.
Winkvist A, Rasmussen KM, Lissner L. Associations between reproduction and maternal body weight: Examining the component parts of a full reproductive cycle. Eur J Clin Nutr 2003;57:114-27.
Musaiger AO. Overweight and obesity in eastern mediterranean region: Prevalence and possible causes. J Obes 2011;2011:407237.
Dunton GF, Berrigan D, Ballard-Barbash R, Graubard B, Atienza AA. Joint associations of physical activity and sedentary behaviors with body mass index: Results from a time use survey of US adults. Int J Obes (Lond) 2009;33:1427-36.
Bali K, Brown W, Craword D. Who does not gain weight? Prevalence and predictors of weight maintenance in young women. Int J Obes 2011;26:1570-8.
[Table 1], [Table 2]