General and abdominal obesity in adults living in a rural area in Southern Brazil

Martins-Silva, Thais; Mola, Christian Loret de; Vaz, Juliana dos Santos; Tovo-Rodrigues, Luciana

doi:10.11606/S1518-8787.2018052000264

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Brasil

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Sumário

Rural Health Supplement, Original Articles • Rev. Saúde Pública 52 (suppl 1) • 2018 • https://doi.org/10.11606/S1518-8787.2018052000264 copy

General and abdominal obesity in adults living in a rural area in Southern Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To evaluate the prevalence of general and abdominal obesity and the concomitant presence of both outcomes and their determinants among adults living in a rural area.

METHODS

This cross-sectional, population-based study was carried out in a medium-sized city in the southern region of Brazil. We evaluated three outcomes: general obesity (body mass index ≥ 30 kg/m ² ), abdominal obesity (waist circumference ≥ 102 cm and ≥ 88 cm in men and women, respectively), and concomitant obesities, classified as: no risk, only one risk factor, and aggregate factors. We performed crude and adjusted Poisson regression analyses for each obesity outcome and multinomial logistic regression for metabolic risk. We considered demographic and socioeconomic characteristics as independent variables.

RESULTS

A total of 1,433 individuals were included in the study. Of them, 29.5% presented general obesity and 37.8% presented abdominal obesity. We observed the presence of a risk factor in 15.8% of the sample, while 25.8% presented aggregate factors. The risk of general and abdominal obesity and concomitant outcomes increased significantly with age in both sexes. Richer men were at increased risk for general obesity (PR = 1.7; 95%CI 1.0–2.9), abdominal obesity (PR = 1.8; 95%CI 1.1–2.9), and aggregate factors (OR = 1.9; 95%CI 1.4–5.8). An education level of twelve years or more was a protective factor for women in relation to abdominal obesity (PR = 0.4; 95%CI 0.2–0.8) and aggregate factors (OR = 0.2; 95%CI 0.05–0.7). Rural activity reduced the risk of general obesity (PR = 0.6; 95%CI 0.5–0.8) and aggregate factors (OR = 0.5; 95%CI 0.3–0.8) in women, and the risk of abdominal obesity (PR = 0.6; 95%CI 0.5–0.8) and presence of a risk factor (OR = 0.5; 95%CI 0.3–0.7) in men. Skin color and time lived in rural areas were not statistically associated with the outcomes studied.

CONCLUSIONS

We observed high prevalences of general and abdominal obesity in this population, which is consistent with the values found in urban populations. However, rural activities were a protective factor for obesity outcomes.

Adult; Obesity; Obesity, Abdominal, Epidemiology; Body Mass Index; Waist Circumference; Risk Factors; Rural Population

Variable	Total (n = 1,439)		Men (n = 702)	Women (n = 737)

	%		%	%
Age (years)			p = 0.759 ^a
18–29	18.5		19.5	17.5
30–44	24.7		24.4	25.0
45–54	21.1		21.1	21.1
55–64	16.4		16.5	16.4
65 or over	19.1		18.4	19.8
Skin color			p = 0.764 ^a
White	85.8		85.3	85.8
Non-white	14.3		14.6	14.1
Education level (years)			p < 0.001 ^a
0–4	38.3		37.6	38.9
5–8	37.4		40.6	34.5
9–11	19.8		19.2	20.4
12 or more	4.3		12.5	6.0
Quintiles of goods			p = 0.347 ^a
1 (poor)	19.6		18.4	20.7
2	19.5		19.7	19.3
3	20.2		20.9	19.6
4	20.2		20.1	20.3
5 (rich)	20.2		20.6	19.8
Living with a partner			p = 0.373 ^a
No	28.0		29.0	27.1
Yes	71.9		70.9	72.8
Percentage of life living in the rural area ^b			p = 0.228 ^a
< 50%	19.0		19.1	18.9
50%–99%	14.0		12.5	15.4
100%	66.9		68.3	65.6
Rural activity ^c			p < 0.001 ^a
No	65.1		55.9	73.9
Yes	34.8		44.0	26.0
General obesity ^d			p < 0.001 ^a
No	70.4		74.9	66.1
Yes	29.5		25.0	33.9
Abdominal obesity ^e			p < 0.001 ^a
No	62.1		75.2	49.5
Yes	37.8		24.7	50.4

Concomitant outcomes			p < 0.001 ^a
No risk		58.3	68.8	48.3
One risk factor		15.8	12.4	19.0
Aggregate factors		25.8	18.6	32.6

Variable	Men		Women

	_Crude PR (95%CI)	_Adjusted PR (95%CI)	_Crude PR (95%CI)	_Adjusted PR (95%CI)
1st level

Age (years)	p = 0.024 ^a	p = 0.027 ^a	p < 0.001 ^a	p < 0.001 ^a
18–29	1	1	1	1
30–44	1.46 (0.86–2.45)	1.38 (0.80–2.38)	2.26 (1.63–3.13)	2.25 (1.68–3.00)
45–54	1.72 (1.13–2.60)	1.71 (1.09–2.68)	2.35 (1.75–3.16)	2.35 (1.75–3.16)
55–64	1.78 (1.08–2.94)	1.72 (0.97–3.06)	2.83 (2.10–3.82)	2.74 (2.03–3.72)
65 or over	2.10 (1.31–3.35)	2.16 (1.33–3.49)	2.56 (2.08–3.15)	2.51 (1.94–3.24)
Skin color	p = 0.950 ^a	p = 0.601 ^a	p = 0.489 ^a	p = 0.198 ^a
White	1	1	1	1
Non-white	1.01 (0.64–1.58)	1.12 (0.70–1.79)	1.09 (0.84–1.41)	1.19 (0.90–1.58)
Years of study	p = 0.237 ^a	p = 0.233 ^a	p < 0.001 ^a	p = 0.168 ^a
0–4	1	1	1	1
5–8	1.14 (0.89–1.45)	1.23 (0.96–1.58)	0.83 (0.66–1.04)	0.94 (0.74–1.19)
9–11	0.75 (0.47–1.18)	0.91 (0.58–1.42)	0.69 (0.50–0.95)	0.95 (0.66–1.36)
12 or more	1.34 (0.63–2.85)	1.41 (0.59–3.35)	0.35 (0.14–0.85)	0.44 (0.19–1.05)
Quintiles of goods	p = 0.373 ^a	p = 0.262 ^a	p = 0.022 ^a	p = 0.280 ^a
1 (poor)	1	1	1	1
2	1.65 (0.86–3.17)	1.69 (0.90–3.17)	0.86 (0.56–1.32)	0.91 (0.59–1.41)
3	1.81 (0.99–3.32)	1.83 (1.02–3.28)	1.15 (0.83–1.60)	1.23 (0.87–1.73)
4	1.78 (1.01–3.16)	1.87 (1.09–3.18)	0.89 (0.63–1.25)	1.02 (0.72–1.45)
5 (rich)	1.69 (0.97–2.94)	1.73 (1.01–2.96)	0.75 (0.54–1.03)	0.91 (0.64–1.30)

2nd level

Living with a partner	p = 0.009 ^a	p = 0.453 ^a	p = 0.351 ^a	p = 0.532 ^a
No	1	1	1	1
Yes	1.47 (1.10–1.96)	1.12 (0.81–1.57)	1.07 (0.91–1.27)	1.06 (0.87–1.28)

3rd level

Percentage of life living in the rural area	p = 0.793 ^a	p = 0.724 ^a	p = 0.406 ^a	p = 0.453 ^a
< 50%	1	1	1	1
50%–99%	1.16 (0.67–2.00)	1.14 (0.68–1.91)	1.24 (0.89–1.73)	1.20 (0.87–1.65)
100%	1.14 (0.76–1.69)	1.16 (0.79–1.71)	1.12 (0.84–1.50)	1.17 (0.84–1.62)
Occupation related to rural activity	p = 0.083 ^a	p = 0.105 ^a	p = 0.009 ^a	p = 0.002 ^a
No	1	1	1	1
Yes	0.80 (0.63–1.03)	0.79 (0.60–1.05)	0.74 (0.59–0.92)	0.68 (0.54–0.86)

Variable	Men		Women

	_Crude PR (95%CI)	_Adjusted PR (95%CI)	_Crude PR (95%CI)	_Adjusted PR (95%CI)
1st level

Age (years)	p < 0.001 ^a	p < 0.001 ^a	p < 0.001 ^a	p < 0.001 ^a
18–29	1	1	1	1
30–44	1.80 (0.86–3.75)	1.68 (0.77–3.64)	2.25 (1.59–3.20)	2.19 (1.57–3.06)
45–54	2.51 (1.42–4.42)	2.39 (1.32–4.32)	2.85 (1.92–4.22)	2.77 (1.91–4.01)
55–64	3.54 (1.90–6.59)	3.30 (1.69–6.47)	3.08 (2.14–4.43)	2.90 (2.08–4.05)
65 or over	4.53 (2.55–8.04)	4.44 (2.44–8.10)	3.65 (2.47–5.38)	3.32 (2.33–4.72)
Skin color	p = 0.546 ^a	p = 0.988 ^a	p = 0.507 ^a	p = 0.085 ^a
White	1	1	1	1
Non-white	0.82 (0.43–1.57)	1.00 (0.52–1.92)	1.05 (0.89–1.24)	1.15 (0.97–1.36)
Years of study	p = 0.011 ^a	p = 0.019 ^a	p < 0.001 ^a	p = 0.028 ^a
0–4	1	1	1	1
5–8	1.01 (0.79–1.30)	1.21 (0.96–1.58)	0.70 (0.56–0.88)	0.85 (0.70–1.04)
9–11	0.58 (0.36–0.91)	0.86 (0.58–1.42)	0.56 (0.41–0.75)	0.79 (0.62–1.01)
12 or more	0.77 (0.33–1.79)	0.78 (0.59–3.35)	0.34 (0.17–0.67)	0.42 (0.21–0.85)
Quintiles of goods	p = 0.258 ^a	p = 0.161 ^a	p = 0.531 ^a	p = 0.720 ^a
1 (poor)	1	1	1	1
2	1.12 (0.67–1.85)	1.19 (0.76–1.88)	0.85 (0.66–1.10)	0.90 (0.70–1.16)
3	1.33 (0.77–2.32)	1.42 (0.91–2.21)	0.94 (0.77–1.14)	1.07 (0.90–1.27)
4	1.53 (0.90–2.58)	1.67 (1.06–2.62)	0.82 (0.64–1.04)	1.00 (0.81–1.24)
5 (rich)	1.61 (0.95–2.74)	1.80 (1.11–2.92)	0.79 (0.58–1.10)	1.05 (0.79–1.41)

2nd level

Living with a partner	p = 0.013 ^a	p = 0.525 ^a	p = 0.771 ^a	p = 0.346 ^a
No	1	1	1	1
Yes	1.66 (1.12–2.45)	1.14 (0.74–1.74)	1.02 (0.87–1.18)	1.07 (0.92–1.24)

3rd level

Percentage of life living in the rural area	p = 0.317 ^a	p = 0.369 ^a	p = 0.013 ^a	p = 0.226 ^a
< 50%	1	1	1	1
50%–99%	1.39 (0.76–2.54)	1.30 (0.80–2.11)	1.21 (0.96–1.53)	1.07 (0.83–1.38)
100%	1.32 (0.91–1.92)	1.28 (0.88–1.86)	0.94 (0.76–1.15)	0.91 (0.73–1.14)
Rural activity	p = 0.012 ^a	p = 0.007 ^a	p = 0.011 ^a	p = 0.053 ^a
No	1	1	1	1
Yes	0.69 (0.53–0.91)	0.68 (0.52–0.89)	0.81 (0.69–0.94)	0.82 (0.67–1.00)

Variable	Men				Women

	One risk factor		Aggregate factors		One risk factor		Aggregate factors

	_Crude OR (95%CI)	_Adjusted OR (95%CI)	_Crude OR (95%CI)	_Adjusted OR (95%CI)	_Crude OR (95%CI)	_Adju_sted OR (95%CI)	_Crude OR (95%CI)	_Adjusted OR (95%CI)
1st level

Age (years)	p = 0.004 ^a	p = 0.004 ^a	p = 0.004 ^a	p = 0.004 ^a	p < 0.001 ^a	p < 0.001 ^a	p < 0.001 ^a	p < 0.001 ^a
18–29	1	1	1	1	1	1	1	1
30–44	1.52 (0.74–3.12)	1.59 (0.74–3.42)	1.89 (0.79–4.47)	1.71 (0.67–4.33)	2.55 (1.23–5.28)	2.37 (1.15–4.85)	3.50 (2.23–5.49)	3.38 (2.26–5.06)
45–54	2.54 (1.12–5.75)	3.06 (1.22–7.67)	2.50 (1.23–5.10)	2.36 (1.11–5.01)	5.88 (2.40–14.39)	5.56 (2.19–14.15)	4.57 (2.83–7.36)	4.46 (2.76–7.19)
55–64	2.35 (0.84–6.53)	2.69 (0.86–8.34)	3.65 (1.65–8.07)	3.35 (1.32–8.49)	6.18 (2.86–13.35)	5.52 (2.83–10.76)	6.08 (3.86–9.57)	5.52 (3.43–8.89)
65 or over	3.49 (1.72–7.11)	4.72 (2.11–10.55)	5.12 (2.53–10.38)	5.16 (2.52–10.53)	12.63 (4.98–32.0)	9.91 (4.19–23.42)	7.79 (5.13–11.83)	6.91 (4.47–10.69)
Skin color	p = 0.934 ^a	p = 0.936 ^a	p = 0.934 ^a	p = 0.936 ^a	p = 0.727 ^a	p = 0.257 ^a	p = 0.727 ^a	p = 0.257 ^a
White	1	1	1	1	1	1	1	1
Non-white	0.93 (0.46–1.87)	1.12 (0.58–2.17)	0.86 (0.37–2.01)	1.07 (0.42–2.73)	1.12 (0.66–1.90)	1.42 (0.78–2.56)	1.15 (0.77–1.72)	1.44 (0.88–2.34)
Years of study	p = 0.158 ^a	p = 0.021 ^a	p = 0.158 ^a	p = 0.021 ^a	p < 0.001 ^a	p = 0.203 ^a	p < 0.001 ^a	p = 0.203 ^a
0–4	1	1	1	1	1	1	1	1
5–8	1.30 (0.82–2.08)	1.78 (1.14–2.79)	1.09 (0.77–1.54)	1.32 (0.87–1.99)	0.40 (0.22–0.71)	0.63 (0.35–1.14)	0.53 (0.32–0.86)	0.75 (0.44–1.26)
9–11	0.81 (0.38–1.75)	1.52 (0.59–3.91)	0.52 (0.27–0.98)	0.75 (0.39–1.43)	0.23 (0.09–0.57)	0.45 (0.18–1.09)	0.37 (0.22–0.64)	0.71 (0.39–1.28)
12 or more	2.31 (0.69–7.72)	3.55 (0.87–14.46)	0.85 (0.23–3.21)	0.83 (0.20–3.49)	0.22 (0.06–0.76)	0.29 (0.07–1.16)	0.13 (0.04–0.44)	0.20 (0.05–0.71)
Quintiles of goods	p = 0.375 ^a	p = 0.043 ^a	p = 0.375 ^a	p = 0.043 ^a	p = 0.184 ^a	p = 0.194 ^a	p = 0.184 ^a	p = 0.194 ^a
1	1	1	1	1	1	1	1	1
2	1.02 (0.41–2.50)	1.03 (0.43–2.44)	1.73 (0.74–4.04)	1.90 (0.81–4.46)	0.68 (0.41–1.12)	0.73 (0.38–1.39)	0.72 (0.37–1.40)	0.80 (0.38–1.64)
3	1.30 (0.53–3.18)	1.38 (0.58–3.29)	2.06 (0.92–4.49)	2.25 (1.10–4.61)	0.55 (0.29–1.04)	0.78 (0.42–1.47)	1.05 (0.61–1.80)	1.30 (0.73–2.32)
4	0.98 (0.43–2.24)	0.99 (0.43–2.29)	2.42 (1.08–5.41)	2.84 (1.33–6.09)	0.70 (0.35–1.39)	1.18 (0.61–2.28)	0.68 (0.37–1.23)	0.99 (0.53–1.90)
5	1.17 (0.40–3.46)	1.01 (0.32–3.20)	2.37 (1.13–4.96)	1.90 (1.43–5.85)	0.65 (0.29–1.48)	1.25 (0.51–3.07)	0.58 (0.31–1.08)	0.96 (0.46–1.97)

2nd level

Living with a partner	p = 0.025 ^a	p = 0.734 ^a	p = 0.025 ^a	p = 0.734 ^a	p = 0.562 ^a	p = 0.561 ^a	p = 0.562 ^a	p = 0.561 ^a
No	1	1	1	1	1	1	1	1
Yes	1.62 (0.91–2.86)	1.22 (0.64–2.33)	1.94 (1.20–3.14)	1.21 (0.69–2.11)	0.87 (0.55–1.36)	0.99 (0.58–1.69)	1.11 (0.83–1.48)	1.16 (0.82–1.64)

3rd level

Percentage of life living in the rural area	p = 0.440 ^a	p = 0.572 ^a	p = 0.440 ^a	p = 0.572 ^a	p = 0.020 ^a	p = 0.181 ^a	p = 0.020 ^a	p = 0.181 ^a
< 50%	1	1	1	1	1	1	1	1
50%–99%	1.75 (0.76–4.02)	1.95 (0.82–4.62)	1.33 (0.50–3.51)	1.25 (0.51–3.03)	1.52 (0.74–3.14)	1.08 (0.45–2.54)	1.62 (0.94–2.81)	1.42 (0.73–2.72)
100%	1.01 (0.57–1.77)	1.32 (0.75–2.32)	1.42 (0.82–2.44)	1.34 (0.77–2.33)	0.71 (0.43–1.17)	0.61 (0.34–1.11)	1.04 (0.64–1.69)	1.05 (0.58–1.89)
Rural activity	p = 0.014 ^a	p = 0.011 ^a	p = 0.014 ^a	p = 0.011 ^a	p = 0.021 ^a	p = 0.021 ^a	p = 0.021 ^a	p = 0.021 ^a
No	1	1	1	1	1	1	1	1
Yes	0.53 (0.34–0.81)	0.50 (0.31–0.79)	0.70 (0.48–1.02)	0.65 (0.42–1.02)	0.70 (0.50–0.97)	0.78 (0.47–1.29)	0.61 (0.43–0.85)	0.54 (0.35–0.84)

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[1] Correspondence: Thais Martins da Silva Rua Marechal Deodoro, 1160 3° andar 96020-220 Pelotas, RS, Brasil E-mail: thaismartins88@hotmail.com