Normal weight obesity among young adults in Trinidad and Tobago: prevalence and associated factors
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Cherrita Ramsaran
Abstract
Background:
Patients with normal weight obesity (NWO) have a normal body mass index (BMI) but elevated body fat percentage (BF%), thereby increasing their risk of cardiovascular and metabolic disorders. The purpose of this research was to determine the prevalence of NWO and its associated factors in a sample of young adults in Trinidad and Tobago (T&T).
Methods:
A cross sectional study involving a convenience non-voluntary sample of participants with a normal BMI of 18.5–24.9 kg/m2 was conducted. The following information was collected: history, basic anthropometric measurements, including BF% via the Tanita Ironman Body Composition Analyzer (BC554), physical examination and basic blood investigations. Participants were divided into two groups; normal BF% (<23.1% males, <33.3% females) and elevated BF% (≥23.1% males, ≥33.3% females).
Results:
Two hundred and thirty-six students participated, F:M (2.1:1), aged 18–28 years [Mean 21.33 (SD 2.5)], mean BMI 21.66 (SD 1.9). A response rate of 80.3%. The prevalence of NWO for this population was 19.9% [95% confidence interval (CI) 15.1–25.7]. Males 14.4% (95% CI 10.3–19.7) and females 5.5% (95% CI 3.1–9.5). Variables with a statistically significant association with NWO included gender, waist circumference, waist-to-hip ratio (WHR), systolic blood pressure (BP), the ratio of total cholesterol (TC) to high density lipoprotein and in females, the presence of polycystic ovarian syndrome (PCOS) (p<0.05). Binary logistic regression revealed that predictors of NWO were male gender and waist circumference.
Conclusions:
One in five of this young adult population was found to have NWO. Long-term studies are recommended to study the full implications of these findings.
Acknowledgments
This work was conducted as the Doctor of Medicine (Family Medicine) research report of the first author and supervised by the second author. Funding for this work was provided by a Campus Research and Publication grant # CRP.3.MAR12.13 from The University of the West Indies, St. Augustine, T&T. The authors would like to thank Nurse Florence Arthur, research assistant; Mrs. Yasmin Baksh-Comeau, colleague; the medical, nursing and clerical staff at the Health Services Unit; Rhonda Maraj and Nadira Maraj, laboratory technicians at the San Fernando General Hospital; Dr. George Legall, statistician; Mr. Mark Lutchman; and the students of the St Augustine Campus, University of the West Indies.
Implications and contribution: This is the first study of Normal Weigh Obesity (NWO) in a Caribbean, non-Caucasian, young adult population at high risk for developing non-communicable diseases. The results suggest a high prevalence of NWO in males, who traditionally carry the burden of early cardiovascular mortality in this population. Further study is recommended.
Conflict of interest: The authors report no conflict of interest. Bryden pi (Trinidad) and Roche Diagnostics provided test kits at a discount for the biochemical studies reported in this work.
References
1. Pan American Health Organization/ Caribbean Community Secretariat (CARICOM). Report of the Caribbean Commission on Health and Development. Kingston, Jamaica: Ian Randle Publishers, 2006. Accessed on April 16, 2015. URL: www.who.int/macrohealth/action/paho_report.pdf.Search in Google Scholar
2. Samuels TA, Fraser H. Caribbean wellness day: mobilizing a region for chronic noncommunicable disease prevention and control. Rev Panam Salud Publica 2010;28:472–9.10.1590/S1020-49892010001200009Search in Google Scholar
3. Batson Y, Teelucksingh S, Maharaj RG, Cockburn B. A cross-sectional study to determine the prevalence of obesity and other risk factors for Type2 diabetes among school children in Trinidad, West Indies. Paediatr Int Child Health 2014;34:178–83.10.1179/2046905514Y.0000000116Search in Google Scholar PubMed
4. IDF Diabetes Atlas. Sixth edition. Country Summary Table: estimates for 2014. Accessed on 7th April 2015. URL: http://www.idf.org/diabetesatlas/update-2014.Search in Google Scholar
5. World Health Organisation. Report of a WHO Expert Consultation. Waist Circumference and Waist-Hip ratio. Geneva, 8–11th December 2008. Geneva, WHO: 2011. Accessed on July 23, 2015. URL: whqlibdoc.who.int/publications/2011/9789241501491_eng.pdf.Search in Google Scholar
6. Okorodudu DO, Jumean MF, Montori VM, Romero-Corral A, Somers VK, et al. Diagnostic performance of body mass index to identify obesity as defined by adiposity: a systematic review and meta-analysis. Int J Obes 2010;34:791–9.10.1038/ijo.2010.5Search in Google Scholar PubMed
7. Romero-Corral A, Somers VK, Sierra-Johnson J, Korenfeld Y, Boarin S, et al. Normal weight obesity: a risk factor for cardio-metabolic dysregulation and cardiovascular mortality. Eur Heart J 2010;31:737–46.10.1093/eurheartj/ehp487Search in Google Scholar PubMed PubMed Central
8. Ruderman N, Chrisholm D, Pi-Sunyer X, Schneider S. Perspectives in diabetes: the metabolically obese, normal weight individual revisited. Diabetes 1998;47:699–713.10.2337/diabetes.47.5.699Search in Google Scholar PubMed
9. U.S. Department Of Health And Human Services. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH Publication No. 04-5230 August 2004. Accessed on 7th April 2015. URL: http://www.nhlbi.nih.gov/files/docs/guidelines/jnc7full.pdf.Search in Google Scholar
10. National Health and Nutrition Examination Survey (NHANES). Anthropometry Procedures Manual. CDC, 2011. Accessed on 7th April 2015. URL: http://www.cdc.gov/nchs/data/nhanes/nhanes_11_12/Anthropometry_Procedures_Manual.pdf.Search in Google Scholar
11. Jebb SA, Cole TJ, Doman D, Murgatroyd PR, Prentice AM. Evaluation of the novel Tanita body-fat analyser to measure body composition by comparison with a four-compartment model. Br J Nutr 2000;83:115–22.10.1017/S0007114500000155Search in Google Scholar PubMed
12. Thomas LE, Kane MP, Bakst G, Busch RS, Hamilton RA, et al. A glucose meter accuracy and precision comparison: the FreeStyle Flash versus the Accu-Chek Advantage, Accu-Chek Compact Plus, Ascensia Contour, and the BD Logic. Diabetes Technol Ther 2008;10:102–10.10.1089/dia.2007.0244Search in Google Scholar PubMed
13. Roche Diagnostics. Cobas 6000 analyzer series brochure. Accessed on April 2nd, 2015. URL: http://www.cobas.com/content/dam/cobas_com/pdf/product/cobas-6000/cobas%206000%20brochuere.pdf.Search in Google Scholar
14. National Institutes of Health. Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) NECP.NIH Publication. 2001; No. 01-3670.10.1001/jama.285.19.2486Search in Google Scholar PubMed
15. Millán J, Pinto X, Munoz A, Zúñiga M, Rubiés-Prat J, et al. Lipoprotein ratios: physiological significance and clinical usefulness in cardiovascular prevention. Vasc Health Risk Manag 2009;5:757–65.Search in Google Scholar
16. Gillett MJ. Guidelines review. the international expert committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care 2009;32:1327–34.10.2337/dc09-9033Search in Google Scholar PubMed PubMed Central
17. Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2010;122:e584–36.10.1161/CIR.0b013e3182051b4cSearch in Google Scholar PubMed
18. Marques-Vidal P, Chiolero A, Paccaud F. Large differences in the prevalence of normal weight obesity using various cut-offs for excess body fat. E Spen Eur E J Clin Nutr Metab 2008;3:e159–62.10.1016/j.eclnm.2008.05.003Search in Google Scholar
19. Shea JL, King MT, Yi Y, Gulliver W, Sun G. Body fat percentage is associated with cardiometabolic dysregulation in BMI-defined normal weight subjects. Nutr Metab Cardiovasc Dis 2012;22:741–7.10.1016/j.numecd.2010.11.009Search in Google Scholar PubMed
20. Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev 2012;30:981–1030.10.1210/er.2011-1034Search in Google Scholar PubMed PubMed Central
21. De Lorenzo A, Del Gobbo V, Premrov MG, Bigioni M, Galvano F, et al.. Normal weight obese syndrome: early inflammation? Am J Clin Nutr 2007;85:40–5.10.1093/ajcn/85.1.40Search in Google Scholar PubMed
22. Dvorak RV, DeNino WF, Ades PA, Poelhman ET. Phenotypic characteristics associated with insulin resistance in metabolically obese but normal-weight young women. Diabetes 1999;48:2210–4.10.2337/diabetes.48.11.2210Search in Google Scholar PubMed
23. Karelis AD, St-Pierre DH, Conus F, Rabasa Lhoret R, Poehlman ET. Metabolic and body composition factors in a subgroup of obesity. What do we know? J Clin Endocr Metab 2004;89:2569–75.10.1210/jc.2004-0165Search in Google Scholar PubMed
24. Caribbean Health Research Council and Pan American Health Organization. Managing Diabetes in Primary Care in the Caribbean. Accessed on April 10, 2015. Accessed on July 23, 2015. URL: http://www.chrc-caribbean.org/Publications.aspx.Search in Google Scholar
25. Conus F, Allison DB, Rabasa-Lhoret R, St-Onge M, St-Pierre DH, et al. Metabolic and behavioral characteristics of metabolically obese but normal-weight women. J Clin Endocr Metab 2004;89:5013–20.10.1210/jc.2004-0265Search in Google Scholar PubMed
26. Succurro E, Marini M, Frontoni S, Hribal ML, Andreozzi F, et al. Insulin secretion in metabolically obese, but normal weight, and metabolically healthy but obese individuals. Obesity 2008;16:1881–6.10.1038/oby.2008.308Search in Google Scholar PubMed
27. Kennedy AP, Shea JL, Sun G. Comparison of the classification of obesity by BMI vs. dual energy X ray absorptiometry in the newfoundland population. Obesity 2009;7:2094–9.10.1038/oby.2009.101Search in Google Scholar PubMed
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- Postnatal testosterone may be an important mediator of the association between prematurity and male neurodevelopmental disorders: a hypothesis
- Dietary habits and sedentary behaviors among health science university students in Bahrain
- Diet quality and physical activity in relation to childhood obesity
- Determinants of cigarette smoking among school adolescents on the island of Java, Indonesia
- Oral health impact, dental caries experience, and associated factors in 12–15-year-old school children in India
- The effects of educating mothers and girls on the girls’ attitudes toward puberty health: a randomized controlled trial
- Challenges and results of a school-based intervention to manage excess weight among school children in Tunisia 2012–2014
- The effectiveness of an adolescent reproductive health education intervention in Uganda
- Comparison of parental socio-demographic factors in children and adolescents presenting with internalizing and externalizing disorders
- Health seeking behaviour and health awareness among rural and urban adolescents in Dehradun District, Uttarakhand, India
- Knowledge and perception of young adults in Nigeria on effectiveness of condom use in prevention of sexually transmitted infections
- Media exposure, interactive health literacy, and adolescents’ susceptibility to future smoking
- Disordered eating and body image issues and their associated factors among adolescents in urban secondary schools in Sarawak, Malaysia
- Normal weight obesity among young adults in Trinidad and Tobago: prevalence and associated factors
- Prevalence and correlates of suicidal ideation and attempts among children and adolescents
- Neurogenic speech sequelae following suicide attempt by hanging: a case report
- Tubo-ovarian abscess in non sexually active adolescents
- Implicit emotion regulation: linking childhood oppositional defiant disorder with adult depression and bipolar disorder?
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