Weight of nations:
a socioeconomic analysis of women in low- to middle-income countries
From the Department of Society, Human Development and Health (SVS), and the Department of Global Health and Population (EC), Harvard School of Public Health; the Department of Health Policy, Harvard University (JMP); and the Department of Social Medicine, Bristol University, Bristol, United Kingdom (GDS).
Am J Clin Nutr 2011;93:413–21. - 2011 American Society for Nutrition
“…..Weights of individuals in developing countries have shown an upward shift with corresponding increases in prevalence of overweight and obesity in developing countries (1–5). These overall assessments, however, mask the substantial variation within and between developing countries, especially along socioeconomic dimensions (2). In several developing countries (6–11), weight status is positively associated with socioeconomic status (SES), which is in stark contrast to the patterns observed in developed countries (12–16).
It has been hypothesized that the association between SES and weight within countries is contingent on the country's overall level of economic development, with the prevalence of overweight shifting from high to low socioeconomic groups in countries at higher levels of economic development (17–19). A review of 333 studies showed a gradual reversal of the social gradient in weight, in which the proportion of positive associations between SES and weight increased (and the proportion of negative associations decreased) when moving from countries ranked high to medium to low in development (20).
However, the review also showed that for women in low- and middle-income countries, a positive association between SES and weight was the most common pattern. Furthermore, in a sample of 41 countries, obesity was observed to be most prevalent in the richest quintile, although this was based on self-reported height and weight data (21).
Despite the increasing prevalence of overweight in developing countries (22), and the policy relevance of ascertaining who is more likely to be burdened with the problem of overweight, there is limited systematic evidence on the association between SES and weight in developing countries….”
“…The distributive aspects of BMI and overweight by socioeconomic groups need to be central to the deliberations and development of appropriate policy responses to improving nutritional status of populations in developing countries. …” [au]….”
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