Date of Award

12-2024

Degree Type

Thesis

Degree Name

MS in Public Health

First Advisor

Dr. Syed Asad Ali

Second Advisor

Dr. Romaina Iqbal

Third Advisor

Dr. Tahir Yusuf Zai

Department

Community Health Sciences

Abstract

Introduction: Overweight and obesity are the accumulation of high body adiposity, which can have detrimental health effects and contribute to the development of numerous preventable non-communicable diseases. These outcomes include type 2 diabetes, cardiovascular disease, cancer, shorter life expectancies, and mortality. Overweight and obesity are the fifth leading cause for global deaths and an estimated 2.8 million adult deaths are attributed to obesity or being overweight each year. Many studies conducted worldwide have revealed that women are more likely to be overweight or obese than men. The aim of this study is to examine the determinants including socioeconomic status, dietary intake, physical activity, food insecurity and sleep quality contributing to the rise in overweight and obesity among women of reproductive age from rural Pakistan.
Methods: This study was conducted in the rural communities of Matiari, Sindh. A total of 161 participants were enrolled, out of which 81 were cases and 80 were controls. The women of reproductive age (18-49 years) having BMI >23kg/m2 from households were identified as overweight and obese and were included in cases and women of reproductive age having BMI 18-23kg/m2 of normal weight were enrolled as controls. Comprehensive questionnaires were used to collect data on sociodemographic and lifestyle factors from women in person. Anthropometric assessment was done by measuring height, weight and circumference. The association between the exposure variables which were socioeconomic status, dietary intake, physical activity, food insecurity, sleep quality and outcome variable i.e. overweight and obesity were assessed with simple logistic regression. Adjusted odds ratio was reported with significance level at p value < 0.05. Stata version 16.0 was used for all the analyses.
Results: Individuals with overweight and obesity were slightly of higher age with mean age of 34.80 ± 7.97 as compared to 29.62 ± 9.06 for individuals with normal weight. The mean waist circumference for overweight and obese women were found to be 88.17 ± 9.62 and for normal weight women it was 70.56 ± 6.96. The BMI of participants by their wealth quintiles exhibited that higher proportion of women with normal weight i.e. 23.8% belonged to poorest wealth quintile, however vii for women with overweight and obesity the higher proportion i.e. 23.5% belonged to rich wealth quintile as determined by the wealth index calculated based on household assets and amenities. Moreover, the categorization of exposure variables in pre-defined groups showed that the food insecurity experience level for the participants at household level exhibited that around 35.4% women with normal weight experienced more household level severe food insecurity as compared to 25.9% in women with overweight and obesity. The scoring of physical activity level, dietary diversity and sleep quality did not demonstrate any significant difference for both cases and controls. Additionally, the unadjusted logistic regression analysis (p=0.20) revealed that older age groups (above 30 years) with a p-value of 0.001, being married with p-value of 0.08 and severe food insecurity with p-value of 0.051 showed significant correlation with the risk of being overweight and obesity in this model. However, the adjusted logistic regression analysis (p=0.05) did not reveal any statistically significant associations between any exposure variables and the likelihood of being overweight and obese in the model.
Conclusion: According to the results of the adjusted logistic regression analysis, none of our variables, including socioeconomic status, dietary intake, physical activity, food insecurity, and sleep quality, showed any significant correlations with the outcome of overweight and obesity in the adjusted model. Even though these variables did not achieve statistical significance in this analysis, their possible contribution to disease risk is still significant and demands future investigation in larger studies using more extensive datasets. It will be undoubtedly easier to comprehend the intricate architecture of obesity onset and progression if future research focuses on heredity, gene–lifestyle interactions, epigenetics, and obesogenic environment factors, especially for rural settings. Continued research efforts and targeted interventions based on these findings have the potential to make significant strides in improving population health and reducing the burden of the studied condition.

First Page

11

Last Page

82

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