Poster Topical Area: Energy and Macronutrient Metabolism
Location: Hall D
Poster Board Number: 402
Objectives: The nutrition transition, marked by changes in dietary patterns and physical activity, is associated with increases in obesity, hypertension, and diabetes in many low and middle income countries, but recent secular and age trends in co-occurrence of these conditions have not well studied in in these settings. We examine predictors of prevalence, and patterns of co-occurrence of overweight and obesity (OW=BMI>25 kg/m2) high waist circumference (WC>80 cm), diabetes, and hypertension from 1998-2016 among Filipino women participating in the Cebu Longitudinal Health and Nutrition Survey (CLHNS).
Methods. The CLHNS is a community-based study that recruited >3000 pregnant women in 1983-84, and has followed them in multiple survey rounds across > 30 years. Data from the 5 most recent survey rounds (1998-2016) included blood pressure measured by trained interviewers, and diabetes status (self-reported in 1998 and 2002, fasting glucose in 2005, and HbA1c in 2012 and 2016). Hypertension and diabetes were defined according to International Diabetes Federation guidelines. Women, who ranged in age from 29 to 62 in 1998, were grouped in each year according to the presence/absence of OW, high WC, Hypertension and diabetes, and we used multinomial logistic regression to identify factors associated with membership in each group.
Results. Comparing 1998 to 2016: The occurrence of having none of these conditions declined from 50% to 20%; being "metabolically healthy" (OW or high WC but no hypertension or diabetes) declined from 26% to 17 %, hypertension increased from 21% to 59%, and diabetes increased from 2% to 14%. On average across all years, only about half of women with hypertension were OW or had high WC. In general, women in groups that included OW or high WC were older, taller, from more urbanized communities, and households with higher assets. The lowest prevalence of these adverse conditions was in rural, more disadvantaged women. Further analyses will explore the role of diet and other lifestyle factors.
Conclusions: Urbanization and increasing socioeconomic status are strongly related to rising prevalence and co-occurrence of cardio-metabolic diseases as women move from middle to older adulthood.
University of North Carolina at Chapel Hill
Durham, North Carolina