Nutr Hosp. 2016; 33(5):1149-1158 ISSN 0212-1611 - CODEN NUHOEQ S.V.R.

318

Nutrición
Hospitalaria

Trabajo Original Epidemiología y dietética

Prevalence of overweight, obesity, abdominal-obesity and short stature of adult

population of Rosario, Argentina
Prevalencia de sobrepeso, obesidad, obesidad abdominal y baja estatura de la población adulta
de Rosario, Argentina
María Elisa Zapata1, María del Mar Bibiloni2 and Josep A. Tur2
1
Facultad de Química. Universidad del Centro Educativo Latinoamericano. Rosario, Santa Fé. Argentina. 2Research Group on Community Nutrition and Oxidative Stress.
Universidad de las Islas Baleares & CIBEROBN (Fisiopatología de la Obesidad y la Nutrición). Palma de Mallorca, Spain

Abstract
Introduction: The aim of this work was to assess the prevalence of overweight, obesity, abdominal-obesity and short stature among Rosario
(Argentina) adult population.
Materials and methods: A cross-sectional nutritional survey was carried out in Rosario (2012-2013). A random sample (n = 1194) of adult
population (18-70 years old) was interviewed. Anthropometric measurements and a general questionnaire incorporating questions related to
socio-demographic and lifestyle characteristics, education level and physical activity were used.
Results: The current study detected a high prevalence of overweight and obesity among adult population in Rosario. The prevalence of overweight
was 32.7% (43.9% in men and 27.6% in women, p < 0.001), of obesity was 23.5% (21.6% in men and 24.3% in women), and of abdominal
obesity was 57.5% (63.5% in men vs. 54.8% in women, p < 0.005). Multivariate analysis showed that the prevalence of overweight/obesity
Key words: and abdominal obesity increased according the age and abdominal obesity decreased with high physical activity in men. In women prevalence
Overweight. Obesity. of overweight/obesity, and abdominal obesity increased with age, marital status (married or coupled), presence of at least one child at home
Short stature. Adult. and low educational level.
Rosario. Conclusion: The prevalence of short stature was higher in women (16.4% vs. 8.4%, p < 0.001) and was related with age, overweight and
abdominal obesity.

Resumen
Introducción: el objetivo de este trabajo fue evaluar la prevalencia de sobrepeso, obesidad, obesidad abdominal y baja estatura entre la población
adulta de Rosario (Argentina).
Material y métodos: se llevó a cabo un estudio nutricional transversal en Rosario (2012-2013), entrevistando una muestra aleatoria (n = 1.194)
de la población adulta (18-70 años). Se realizaron mediciones antropométricas y un cuestionario general de características sociodemográficas,
estilo de vida, nivel de educación y actividad física.
Resultados: este estudio encontró una alta prevalencia de sobrepeso y obesidad entre la población adulta en Rosario. La prevalencia de
sobrepeso fue del 32,7% (43,9% en hombres y 27,6% en las mujeres, p < 0,001), de obesidad fue 23,5% (21,6% en hombres y 24,3% en las
mujeres) y de obesidad abdominal fue de 57,5% (63,5% en los hombres y 54,8% en las mujeres, p < 0,005). El análisis multivariado mostró
que la prevalencia de sobrepeso/obesidad y obesidad abdominal aumentó según la edad y la obesidad abdominal se redujo en hombres con
Palabras clave: elevada práctica de actividad física. En las mujeres, la prevalencia de sobrepeso/obesidad y obesidad abdominal aumentó con la edad, el estado
civil (casado o en pareja), la presencia de al menos un niño en casa y bajo nivel educativo.
Sobrepeso. Obesidad.
Baja estatura. Adulto. Conclusión: la prevalencia de talla baja fue mayor en las mujeres (16,4% vs. 8,4%, p < 0,001) y estaba relacionada con la edad, el sobrepeso
Rosario. y la obesidad abdominal.

Received: 01/12/2015
Accepted: 07/03/2016 Correspondence:
Josep A. Tur. Research Group on Community Nutrition
Zapata ME, Bibiloni MM, Tur JA. Prevalence of overweight, obesity, abdominal-obesity and short stature of and Oxidative Stress. Universitat de les Illes Balears &
adult population of Rosario, Argentina. Nutr Hosp 2016;33:1149-1158 CIBEROBN. Guillem Colom Bldg, Campus.
E-07122 Palma de Mallorca, Spain
DOI: http://dx.doi.org/10.20960/nh.580 e-mail: [email protected]
1150 M. E. Zapata et al.

INTRODUCTION sion of 5% (type I error = 0.05; type error II = 0.10) and 95%
of confidence. The sampling technique included stratification
During the last century, industrialization, urbanization, economic according to age and sex of inhabitants, and random selection
development and the globalization have led to changes in the diet within subgroups in each Rosario Municipal District Centers
and lifestyle of people, with deep consequences on the health and (MCD) located in the six areas of the city (center, north, south,
nutritional status of the population. The economic transition that east, southwest, northwest) being the primary sampling units,
followed the industrialization came associated with demograph- and individuals within these district comprising the final sample
ic, epidemiological and nutritional transitions that have impact- units. Participants were recruited by opportunistic sampling at
ed producing important nutritional changes in urban and rural all Municipal District Centers (MCD) of Rosario. The final sample
households, due to a multiplicity of factors that have influenced size was 1194 individuals, 373 men and 827 women. Pregnant
the lifestyle and food consumption patterns (1,2). and lactating women were excluded.
The World Health Organization (WHO) recognizes high blood
pressure, tobacco use, high blood glucose, physical inactivity,
and overweight and obesity as the leading global risk for mortal- ETHICS
ity in the world. Overweight and obesity are responsible for 5%
of deaths globally. A high body mass index (BMI) is a risk factor The project was approved by the Committee of Ethics in
which account for cardiovascular and ischemic heart disease, Research of the Public Health Secretary of Rosario Municipality
the leading cause of death worldwide (3). WHO has defined (Resolution no. 1816/2010) on September 5, 2012, and author-
obesity as the epidemic of the 21st century, which has high ized by the Sub Secretariat General of the Rosario Municipality.
impact on morbidity and mortality, health and quality of life. The All the aspects involved in the development of this project be
worldwide prevalence of obesity has almost doubled between undertaken by adhering to national and international regulations
1980 and 2008 (4). Latin America has changed from a condition and the criteria referred to in the principles contained in the Dec-
of high prevalence of low weight and deficit of growth towards a laration of Helsinki and of the law on secret statistical no. 17622
scenario marked by an increase in obesity and chronic diseases which guarantees the anonymity of the participants and the con-
such as cardiovascular diseases, diabetes and cancer (5-8). fidentiality of the information during the processing of the data.
Levels of overweight and obesity across low- and middle-in- Each participant signed an informed consent prior to the survey.
come countries have approached levels found in higher-income
countries (9).
The aim of this work was to assess the prevalence of over- ANTHROPOMETRIC MEASUREMENTS
weight, obesity, abdominal-obesity and short stature among Ros-
ario (Argentina) adult population. Body weight was determined using a digital scale (OMROM®
HBF - 500INT, Kyoto, Japan) to the nearest 100 g. The subjects
were weighed in bare feet and minimum clothes wear, which was
MATERIALS AND METHODS accounted for by subtracting the weight of the clothing that had
not been removed, taking standard reference values. Height was
STUDY DESIGN determined using a portable anthropometer (CAM®, Buenos Aires,
Argentina) to the nearest millimeter, with the subject standing,
The present study is a population based cross-sectional nutri- back to stadiometer, in bare feet, with the subject’s head in the
tional survey carried out in the Rosario city (Argentina) between Frankfurt plane (the line from the auditory meatus to the lower
October 2012 and June 2013. border of the eye orbit). Waist circumference was determined
using an inextensible and flexible measuring tape (Sanny med-
ical®, SN- 40, Jaipur, India) to the nearest millimeter, and was
SAMPLE measured with the subject of foot, on the horizontal plane equi-
distant between the bottom edge of the last rib and iliac crest,
The target population consisted of all inhabitants living in after an inspiration and deep exhalation, both were measured
Rosario aged 18-70 years. The theoretical sample size was without clothes. Anthropometric measurements were performed
calculated take into account the prevalence of overweight by well-trained students of the last year of nutrition carrier in
and obesity (53.0%), inadequate energy intake (57.0%), low order to avoid the inter-observer coefficients of variation. Accord-
physical activity (51%) of Argentinian National Nutritional Sur- ing to the WHO classification the prevalence of overweight (BMI
vey (10) and the prevalence of overweight and obesity (53.4%), 25 to 29.9 kg/m2) and obesity (BMI ≥ 30 kg/m2) was calculated.
smoking habit (27.1%) and daily consumption of fruits (35.7%) Waist-to-height ratio (WHtR) was also calculated, and a cut-off of
and vegetables (37.6%) of Argentinian National Risk Factors 0.5 was used to define abdominal obesity for men and women
Survey (11) and then was adjusted according to the Rosario (13). Short stature in adulthood was defined as height < 153 cm
census (12). The sample was set at a minimum of 365 men among females and < 164 cm among males, according to the
and 374 women in order to provide a specific relative preci- percentile 10 of national references (14).

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GENERAL QUESTIONNAIRE p < 0.001) while obesity was similar in both (21.6% vs. 24.3%).
The prevalence of abdominal obesity (WtHR > 0.5) was 57.5%,
A questionnaire incorporating the following questions was used: higher in men than women (63.5% vs. 54.8%, p < 0.005).
age, marital status (single; married/coupled; unmarried/divorced/ Weight, height and waist circumference showed significant dif-
widowed), living with at least one children (yes; no), education ferences between men and women of all age groups; weight and
level (grouped according to complete years of formal education: waist circumference increased with age, while height decreased.
low, ≤ 7 years; medium, 8-11 years; high ≥ 12 years), profession- The mean BMI was lower than 25 kg/m2 only in 18-30 y.o. sub-
al profile (grouped into student; unemployed; employed), smoking jects, with no differences between sexes. The prevalence of over-
habits (yes; no), alcohol intake (yes; no) were utilized. weight was higher in men at all studied ages, while the prevalence
Physical activity level was evaluated according to the guide- of obesity didn’t show differences between sexes. Abdominal
lines for data processing and analysis of the International Physical obesity increased according to age and was higher among men
Activity Questionnaire (IPAQ) (15) in the short form (SF) to Argen- (Table II).
tina. The IPAQ-SF assesses four domains of physical activity over Overweight/obesity and abdominal obesity in men showed
the previous week, including vigorous activity (i.e. activities that positive relation only with age (Table III). The risk of overweight/
make breathing much harder than normal), moderate activity obesity tripled between age groups; the risk of abdominal obesity
(i.e. activities that make breathing somewhat harder than nor- was 2.85 times higher at age 31-50 years and 9.08 times at age
mal), walking and time spent sitting. Data from the IPAQ-SF were 51-70 years in comparison to the youngest group (18-30 years).
scored as per the IPAQ-SF scoring protocol and classifieds into Both showed significant differences after adjustment by all
three categories (low; moderate; high) (16) according to the total explanatory variables. Abdominal obesity had negative association
time and METs (Estimated Metabolic Equivalents) by week. with physical activity level. There were not significant differences
in the prevalence of overweight/obesity and abdominal obesity
according to the socio-demographic and lifestyle characteristics
STATISTICAL METHODS (Table III).
In women overweight/obesity and abdominal obesity were relat-
Analyses were performed using SPSS version 21.0 (SPSS Inc., ed with age, marital status, presence of children at home and
Chicago, IL, USA) and STATA version 12.1 (StataCorp, College educational level. The age was the variable that showed a great-
Station, Texas, USA). Differences between group means were er relationship with overweight/obesity and abdominal obesity.
tested by an unpaired Students’ t-test. Logistic regression mod- From a group to the following one, the prevalence increased
els with the calculations of corresponding odds ratio (OR) and 2-3 fold, being significant after adjusting for all covariates; the
95% confidence interval (CI) were used to examine the possible same scenario was observed among men. Married or coupled
association between socio-demographic and lifestyle character- women showed higher risk. Although the risk of abdominal obesity
istics (independent variables) and overweight/obesity, abdomin- remained after adjustment for all covariates, the risk of over-
al-obesity and short stature (dependent variables). Multivariate weight/obesity disappeared after adjustment by all explanatory
analysis with adjustment for age was first carried out for all the variables. The risk of overweight/obesity and abdominal obesity,
socio-demographic and lifestyle variables that could be associ- after adjustment by age, was double in women with at least one
ated with the frequency of overweight/obesity, abdominal obesity child at home. The prevalence of overweight/obesity and abdom-
and short stature. Multivariate analyses with adjustment for all inal obesity decreased according to the increase of educational
variables were also used to examine the effect of the sociodemo- level. The risk of overweight/obesity, adjusted by all covariates,
graphic and lifestyle variables on the prevalence of overweight/ was lower 65% in women with medium level and 81% among
obesity, abdominal obesity and short stature. Level of significance those with high education level, whereas the risk of abdominal
for acceptance was p < 0.05. obesity was lower four times in women with medium education
level and nine times in women with high level; this association
was different after adjustment for all the explanatory variables.
RESULTS Abdominal obesity was higher in non-smokers women and in
those that not consume alcohol. Women with medium physical
Table I shows the characteristics of participants. Married or activity level showed the highest risk of abdominal obesity, being
coupled was the most representative marital status in both sexes. significant after adjustment by all explanatory variables (Table IV).
More than half of participants lived with children. There were more The prevalence of short stature was 16.4% in women and
men employed and more students among women. Smoking habit 8.4% in men (p < 0.001). Men with less education (p = 0.031)
didn’t show differences between sexes while alcohol consumption and unemployed (p = 0.016) showed higher prevalence of height
was higher in men. Women were less active than men. below p10, while in women the prevalence of short stature
The overall prevalence of overweight and obesity estimated increased according to age (p = 0.001), decreased according
for the adult population of Rosario was 32.7% (CI 95% 30.1- to the educational level (p = 0.005), was lower in single women
35.4) and 23.5% (CI 95% 21.1-25.9%) respectively (Table II). (p = 0.009), higher in women who did not consume alcohol
Overweight was higher in men than women (43.9 vs. 27.6%, (p = 0.007) and decreased according to the increase of physical

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1152 M. E. Zapata et al.

Table I. Socio-demographic characteristics of study participants

Total (n = 1,194) Men (n = 371) Women (n = 823) p*
% 31.1 68.9
Age (years)† 39.5 ± 15.0 39.7 ± 14.7 39.4 ± 15.1 0.710
  18 - 30 39.3 37.7 40.0
  31 - 50 34.3 35.8 33.7
  51 - 70 26.4 26.4 26.4
Educational level (%)‡ 0.140
 Low 24.8 21.6 26.2
 Medium 60.8 62.0 60.3
 High 14.4 16.4 13.5
Marital status (%)‡ 0.024
 Single 37.6 41.0 36.1
  Married or coupled 52.7 52.6 52.7
  Separated, divorced, widowed 9.7 6.5 11.2
Living with children (%)‡ < 0.001
 None 43.2 33.4 47.6
  At least one child at home 56.8 66.6 52.4
Professional profile (%)‡ < 0.001
 Student 10.1 7.0 11.6
 Unemployed 22.0 12.7 26.3
 Employed 67.8 80.3 62.2
Smoking habits (%)‡ 0.251
 No 78.0 76.0 78.9
 Yes 22.0 24.0 21.1
Alcohol consumption (%)‡ < 0.001
 No 32.3 20.2 37.8
 Yes 67.7 79.8 62.2
PA level (%)‡ < 0.001
 Low 51.9 46.4 54.4
 Medium 31.9 30.5 32.6
 High 16.2 23.2 13.0
Data were expressed as †mean ± standard deviation, and ‡%; *Gender differences were tested by means of χ2.

activity practice (p = 0.027). Women with overweight and abdom- ario, Argentina. Levels of overweight and obesity across low- and
inal obesity showed higher prevalence of short stature. The risk of middle-income countries showed similar levels to those found in
short stature in women, adjusted by age, was higher according to ­higher-income countries, particularly in the Middle East, North
the age, to the lower education level, to the alcohol consumption, Africa, Latin America and the Caribbean[9]. The observed preva-
and to overweight and abdominal obesity. After adjustment for all lence of overweight and obesity (32.7% and 23.5% respectively) is
explanatory variables, age, abdominal obesity and medium physic- closely related with the observed at the Argentinian national level
al activity level showed association with short stature (Table V). in successive years that was conducted by the National Survey of
Risk Factors for No Communicable Diseases (NSRF) (11,17,18).
The prevalence of overweight and obesity in 2005 was 34.4% and
DISCUSSION 14.6% (11); in 2009 35.4% and 18.0% (17); in 2013 37.1%
and 20.8% (18), respectively. The higher prevalence of overweight
The present results reveal the magnitude of overweight/ observed in men (43.9 vs. 27.6%, p < 0.0001) also matches
obesity and abdominal obesity among adult population of Ros- to the NSRF at Argentinian national level (43.2% in men and

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Table II. Anthropometric characteristics, overweight, obesity and abdominal-obesity

prevalence among adult population1,2
Men Women
n mean ± SD, % n mean ± SD, % p2
Weight (kg)† 371 81.6 ± 14.7 823 67.9 ± 15.5 < 0.001
  18-30 years-old 140 75.1 ± 12.6 329 62.3 ± 13.1 < 0.001
  31-50 years-old 133 85.0 ± 14.5 277 70.9 ± 16.5 < 0.001
  51-70 years-old 98 86.5 ± 14.7 217 72.6 ± 14.9 < 0.001
Height (cm)† 371 173.6 ± 7.1 823 160.0 ± 6.5 < 0.001
  18-30 years-old 140 174.3 ± 7.2 329 161.5 ± 6.0 < 0.001
  31-50 years-old 133 174.3 ± 6.9 277 159.8 ± 6.7 < 0.001
  51-70 years-old 98 171.7 ± 6.9 217 158.2 ± 6.4 < 0.001
BMI (kg/m )†
2
371 27.1 ± 4.6 823 26.6 ± 6.3 0.136
  18-30 years-old 140 24.6 ± 3.5 329 23.9 ± 5.0 0.073
  31-50 years-old 133 28.0 ± 4.6 277 27.8 ± 6.7 0.788
  51-70 years-old 98 29.3 ± 4.6 217 29.1 ± 6.0 0.687
Prevalence of overweight (%)‡ 371 43.9 823 27.6 < 0.001
  18-30 years-old 140 35.7 329 19.5 < 0.001
  31-50 years-old 133 48.9 277 30.3 < 0.001
  51-70 years-old 98 49.0 217 36.4 0.035
Prevalence of obesity (%)‡ 371 21.6 823 24.3 0.301
  18-30 years-old 140 7.1 329 10.9 0.206
  31-50 years-old 133 25.6 277 30.0 0.356
  51-70 years-old 98 36.7 217 37.3 0.920
Waist circumference (cm)† 370 93.3 ± 13.7 818 84.5 ± 15.6 < 0.001
  18-30 years-old 140 84.7 ± 9.8 329 76.9 ± 12.8 < 0.001
  31-50 years-old 133 95.2 ± 11.7 274 87.1 ± 15.7 < 0.001
  51-70 years-old 97 103.1 ± 13.5 215 92.8 ± 13.9 < 0.001
WHtR† 370 0.54 ± 0.08 818 0.53 ± 0.10 0.112
  18-30 years-old 140 0.49 ± 0.05 329 0.48 ± 0.08 0.165
  31-50 years-old 133 0.55 ± 0.07 274 0.55 ± 0.10 0.945
  51-70 years-old 97 0.60 ± 0.08 215 0.59 ± 0.09 0.209
Prevalence of abdominal-obesity (%)‡ 370 63.5 818 54.8 0.005
  18-30 years-old 140 37.1 329 30.1 0.135
  31-50 years-old 133 71.4 274 62.8 0.085
  51-70 years-old 97 90.7 215 82.3 0.055
BMI: body mass index; WHtR: waist-to-height ratio. 1Data were expressed as †mean ± standard deviation, and ‡%. 2Gender differences were tested by an †unpaired
Students’ t-test, and by ‡χ2.

28.4% in women) and in Santa Fe province (45.8% in men and The association between sociodemographic and lifestyle factors
27.0% in women) (17). Obesity prevalence was no different and overweight/obesity and abdominal obesity in Rosario adult
between sexes, being slightly higher in women (21.6% in men population showed that age is one of the strength factors associ-
and 24.3% in women), although the NRFS showed a higher preva- ated with the prevalence, whereas in women the educational level
lence in men at Argentinian national level (19.1% vs. 17.1%) and was strongly associated with overweight/obesity and abdominal
in Santa Fe province (20.5% vs. 19.7%) (17). obesity. NSRF showed that the prevalence of overweight and

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1154 M. E. Zapata et al.

Table III. Socio-demographic and lifestyle characteristics among men classified as

overweight/obesity (BMI ≥ 25 kg/m2) and abdominal-obese (WHtR ≥ 0.5)1,2
Overweight/obesity Abdominal-obesity
Additionally- Additionally-
BMI BMI Age-adjusted OR 1
WHtR WHtR Age-adjusted OR1
adjusted OR2 adjusted OR2
< 25 kg/m2 ≥ 25 kg/m2 (95% CI) < 0.5 ≥ 0.5 (95% CI)
(95% CI) (95% CI)
Age group
  18-30 years-old 57.1 42.9 1.00 (ref.) 1.00 (ref.) 62.9 37.1 1.00 (ref.) 1.00 (ref.)
  31-50 years-old 25.6 74.4 3.88 (2.32-6.49)*** 2.97 (1.57-5.63)** 28.6 71.4 4.23 (2.54-7.04)*** 2.85 (1.50-5.41)**
  51-70 years-old 14.3 85.7 8.00 (4.15-15.44)*** 6.72 (2.92-15.44)*** 9.3 90.7 16.55 (7.69-35.62)*** 9.08 (3.69-22.33)***
Marital status
 Single 50.0 50.0 1.00 (ref.) 1.00 (ref.) 57.2 42.8 1.00 (ref.) 1.00 (ref.)
 Married/coupled 24.1 75.9 1.26 (0.71-2.23) 1.02 (0.51-2.04) 22.7 77.3 1.32 (0.73-2.38) 1.41 (0.69-2.88)
 Unmarried/
divorced/ 20.8 79.2 1.06 (0.33-3.40) 1.07 (0.33-3.49) 16.7 83.3 1.12 (0.31-4.07) 1.76 (0.49-6.27)
widowed
Living with children
 None 41.7 58.3 1.00 (ref.) 1.00 (ref.) 44.5 55.5 1.00 (ref.) 1.00 (ref.)
 At least one child
20.2 79.8 1.56 (0.88-2.75) 1.38 (0.69-2.74) 20.3 79.7 1.25 (0.68-2.30) 1.36 (0.66-2.82)
at home
Educational level
 Low 23.8 76.3 1.00 (ref.) 1.00 (ref.) 25.0 75.0 1.00 (ref.) 1.00 (ref.)
 Medium 38.7 61.3 0.64 (0.34-1.20) 0.63 (0.34-1.20) 41.5 58.5 0.63 (0.32-1.23) 0.62 (0.32-1.20)
 High 32.8 67.2 0.57 (0.25-1.26) 0.49 (0.21-1.12) 32.8 67.2 0.53 (0.23-1.25) 0.60 (0.25-1.43)
Professional profile
 Student 61.5 38.5 1.00 (ref.) 1.00 (ref.) 65.4 34.6 1.00 (ref.) 1.00 (ref.)
 Unemployed 36.2 63.8 1.00 (0.19-1.88) 0.78 (0.25-2.40) 28.3 71.7 0.79 (0.23-2.67) 1.10 (0.33-3.66)
 Employed 31.9 68.1 1.32 (0.55-3.16) 1.47 (0.59-3.62) 35.2 64.8 0.90 (0.36-2.24) 0.60 (0.25-1.43)
Smoking habit
 No 32.1 67.9 1.00 (ref.) 1.00 (ref.) 36.0 64.0 1.00 (ref.) 1.00 (ref.)
 Yes 40.6 59.4 0.84 (0.51-1.38) 0.77 (0.45-1.30) 37.7 62.3 1.29 (0.76-2.21) 1.19 (0.68-2.06)
Alcohol consumption
 No 33.3 66.7 1.00 (ref.) 1.00 (ref.) 34.7 65.3 1.00 (ref.) 1.00 (ref.)
 Yes 34.8 65.2 0.97 (0.55-1.74) 1.04 (0.57-1.90) 36.9 63.1 0.96 (0.52-1.77) 1.06 (0.56-2.00)
PA level
 Low 29.7 70.3 1.00 (ref.) 1.00 (ref.) 28.7 71.3 1.00 (ref.) 1.00 (ref.)
 Medium 34.5 65.5 0.86 (0.50-1.50) 0.86 (0.49-1.51) 30.1 69.9 1.09 (0.60-1.98) 1.08 (0.60-1.96)
 High 44.2 55.8 0.85 (0.48-1.53) 0.76 (0.42-1.38) 60.5 39.5 0.42 (0.22-0.77)** 0.37 (0.20-0.68)**
BMI: body mass index; WHtR: waist-to-height ratio; OR: odds ratio; CI: confidence interval; PA: physical activity.
1
Univariate analysis (logistic regression analysis considering the effect of one explanatory variable).*p < 0.05, **p < 0.01, ***P < 0.001.
2
Multivariate analyses (multiple logistic regressions considering the simultaneous effect of all the explanatory variables).*p < 0.05, **p < 0.01, ***p < 0.001.

obesity at Argentinian national level was rising according the age obesity were the most prevalent in women with low educational
(17.9% and 3.9% at 18 to 24y to 41.7% and 22.8% at 60 to 64y, level. Between 2005 and 2009, the prevalence of obesity in women
overweight and obesity respectively) (11). with low education increased 7.5 points (23.6% in 2005 to 31.1%
In Argentina, previous studies have seen that among women, in 2009) while in high education just increased 1.7 points (10.1%
higher education was associated with better risk factor profiles to 11.8%). However, in men the increase of obesity was around
for non-communicable diseases in all areas and more strongly in 4 points in all educational levels (20). In Latin America women with
more urban than in less urban areas (19). Rosario is an urban city, higher levels of education showed the lowest levels of obesity (21-
according with the last census in Rosario live 1193605 inhabitants, 24). Maternal overweight and obesity are associated with maternal
and 739025 are 20 to 69 year old adults (12), becoming the third morbidity, preterm birth, and increased infant mortality (25). Preva-
city with most population in Argentina. The NSRF (17) showed that lence of overweight (BMI ≥ 25 kg/m²) and obesity (BMI ≥ 30 kg/m²)

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Table IV. Socio-demographic and lifestyle characteristics among women classified as

overweight/obesity (BMI ≥ 25 kg/m2) and abdominal-obese (WHtR ≥ 0.5)1,2
Overweight/obesity Abdominal-obesity
Age-adjusted Additionally- Age-adjusted Additionally-
BMI BMI WHtR WHtR
OR1 adjusted OR2 OR1 adjusted OR2
< 25 kg/m2 ≥ 25 kg/m2 < 0.5 ≥ 0.5
(95% CI) (95% CI) (95% CI) (95% CI)
Age group
  18-30 years-old 69.6 30.4 1.00 (ref.) 1.00 (ref.) 69.9 30.1 1.00 (ref.) 1.00 (ref.)
  31-50 years-old 39.7 60.3 3.48 (2.48-4.87)*** 2.29 (1.49-3.52)*** 37.2 62.8 3.92 (2.79-5.50)*** 2.40 (1.53-3.76)***
  51-70 years-old 26.3 73.7 6.43 (4.38-9.43)*** 4.34 (2.67-7.06)*** 17.7 82.3 10.82 (7.09-16.51)*** 7.00 (4.10-11.97)***
Marital status
 Single 67.0 33.0 1.00 (ref.) 1.00 (ref.) 68.6 31.4 1.00 (ref.) 1.00 (ref.)
 Married/coupled 38.5 61.5 1.75 (1.23-2.50)** 1.49 (0.99-2.24) 33.0 67.0 2.14 (1.49-3.09)*** 2.02 (1.32-3.09)**
Unmarried/divorced/ widowed 32.6 67.4 1.25 (0.68-2.27) 1.32 (0.71-2.45) 27.2 72.8 1.30 (0.69-2.46) 1.49 (0.77-2.89)
Living with children
 None 60.8 39.2 1.00 (ref.) 1.00 (ref.) 59.3 40.7 1.00 (ref.) 1.00 (ref.)
  At least one child at home 34.2 65.8 1.98 (1.45-2.71)*** 1.32 (0.90-1.92) 29.6 70.4 2.08 (1.50-2.88)*** 1.21 (0.81-1.82)
Educational level
 Low 25.0 75.0 1.00 (ref.) 1.00 (ref.) 18.7 81.3 1.00 (ref.) 1.00 (ref.)
 Medium 54.4 45.6 0.31 (0.21-0.45)*** 0.35 (0.24-0.53)*** 52.1 47.9 0.22 (0.14-0.33)*** 0.26 (0.17-0.42)***
 High 64.9 35.1 0.17 (0.10-0.29)*** 0.19 (0.11-0.33)*** 65.8 34.2 0.10 (0.05-0.17)*** 0.11 (0.06-0.20)***
Professional profile
 Student 69.5 30.5 1.00 (ref.) 1.00 (ref.) 70.5 29.5 1.00 (ref.) 1.00 (ref.)
 Unemployed 33.8 66.2 1.53 (0.85-2.73) 1.12 (0.60-2.07) 26.2 73.8 1.94 (1.07-3.53)* 1.34 (0.70-2.58)
 Employed 50.3 49.7 1.06 (0.64-1.76) 1.17 (0.68-2.04) 48.6 51.4 0.98 (0.58-1.65) 1.32 (0.74-2.36)
Smoking habit
 No 47.0 53.0 1.00 (ref.) 1.00 (ref.) 43.3 56.7 1.00 (ref.) 1.00 (ref.)
 Yes 51.4 48.6 0.93 (0.67-1.31) 0.79 (0.55-1.12) 51.0 49.0 0.80 (0.57-1.14) 0.63 (0.43-0.92)*
Alcohol consumption
 No 33.3 66.7 1.00 (ref.) 1.00 (ref.) 37.5 62.5 1.00 (ref.) 1.00 (ref.)
 Yes 34.8 65.2 0.74 (0.54-1.00) 0.94 (0.68-1.30) 49.9 50.1 0.64 (0.46-0.88)** 0.92 (0.65-1.30)
PA level
 Low 48.2 51.8 1.00 (ref.) 1.00 (ref.) 46.5 53.5 1.00 (ref.) 1.00 (ref.)
 Medium 46.3 53.7 1.07 (0.77-1.49) 1.07 (0.76-1.50) 38.3 61.7 1.48 (1.05-2.09)* 1.51 (1.05-2.18)*
 High 52.3 47.7 1.06 (0.68-1.66) 1.28 (0.79-2.06) 57.0 43.0 0.82 (0.52-1.31) 1.01 (0.61-1.67)
BMI: body mass index; WHtR: waist-to-height ratio; OR: odds ratio; CI: confidence interval; PA: physical activity.
1
Univariate analysis (logistic regression analysis considering the effect of one explanatory variable). *p < 0.05, **p < 0.01, ***p < 0.001.

has been rising in all regions, together reaching more than 70% health risks (42-44) and it could be more closely associated with
in the Americas and the Caribbean and more than 40% in Africa central obesity than BMI (45) and even better than waist circum-
by 2008 (26,27), but Americas showed the highest proportion of ference by the adjustment to different statures (46,47). The risk
overweight and obese women (25). level in the current study was rated to WHtR ≥ 0.50, according this
It is well recognized that WHtR is a good predictor for morbidity cut off point the prevalence of abdominal obesity was 57.5%. The
and mortality (28). Even though BMI is commonly used as a meas- risk level across gender was also increased, with WHtR of 63.5%
ure of overall adiposity and classify risk level to various chron- and 54.8% among men and women, respectively, with men to
ic illnesses (29,32), growing evidence suggests that a central have more central obesity than women (p < 0.005). In Argentina,
(abdominal) fat distribution pattern, evidenced by a higher waist population-based studies which used WHtR to estimate central
circumference or WHtR, might be a better measure of risk (33-41). obesity were not found. In Bahia (Brazil) the observed prevalence
Growing and strong evidence supports the use of the WHtR as was 65,3% among women and 44,5% in men (48), while in
a more sensitive measurement than BMI as an early warning of Florianópolis (Brasil) was 38,9% and 50,5%, respectively (49).

[Nutr Hosp 2016;33(5):1149-1158]

1156 M. E. Zapata et al.

Table V. Socio-demographic and lifestyle characteristics among adult population classified

as short stature (< p10)1,2
Men Women
Age-adjusted Additionally- Age-adjusted Additionally-
Height Height Height Height
OR1 adjusted OR2 OR1 adjusted OR2
< p10 ≥ p10 < p10 ≥ p10
(95% CI) (95% CI) (95% CI) (95% CI)
Age group
  18-30 years-old 7.1 92.9 1.00 (ref.) 1.00 (ref.) 9.7 90.3 1.00 (ref.) 1.00 (ref.)
  31-50 years-old 6.8 93.2 0.94 (0.37-2.40) 1.09 (0.33-3.64) 17.3 82.7 1.95 (1.21-3.14)** 1.56 (0.85-2.87)
  51-70 years-old 12.2 87.8 1.81 (0.75-4.38) 1.36 (0.37-4.99) 25.3 74.7 3.15 (1.96-5.07)*** 2.01 (1.06-3.81)*
Marital status
 Single 8.6 91.4 1.00 (ref.) 1.00 (ref.) 12.1 87.9 1.00 (ref.) 1.00 (ref.)
 Married/coupled 7.7 92.3 0.52 (0.20-1.38) 0.38 (0.11-1.31) 17.5 82.5 1.00 (0.62-1.62) 0.91 (0.53-1.56)
 Unmarried/divorced/widowed 12.5 87.5 0.78 (0.17-3.56) 0.72 (0.13-3.94) 25.0 75.0 1.12 (0.56-2.26) 1.22 (0.59-2.51)
Living with children
 None 8.9 91.1 1.00 (ref.) 1.00 (ref.) 18.6 81.4 1.00 (ref.) 1.00 (ref.)
  At least one child at home 8.1 91.9 0.93 (0.42-2.06) 1.84 (0.63-5.35) 14.4 85.6 1.04 (0.71-1.54) 0.76 (0.48-1.20)
Educational level
 Low 15.0 85.0 1.00 (ref.) 1.00 (ref.) 23.1 76.9 1.00 (ref.) 1.00 (ref.)
 Medium 7.4 92.6 0.50 (0.22-1.12) 0.47 (0.20-1.11) 14.7 85.3 0.66 (0.44-0.99)* 0.73 (0.46-1.15)
 High 3.3 96.7 0.20 (0.04-0.91)* 0.26 (0.05-1.28) 10.8 89.2 0.44 (0.22-0.87)* 0.57 (0.27-1.21)
Professional profile
 Student 7.7 92.3 1.00 (ref.) 1.00 (ref.) 9.5 90.5 1.00 (ref.) 1.00 (ref.)
 Unemployed 19.1 80.9 2.14 (0.36-12.70) 2.66 (0.43-16.45) 19.0 81.0 1.04 (0.44-2.45) 0.94 (0.38-2.29)
 Employed 6.7 93.3 0.72 (0.15-3.52) 1.10 (0.20-5.98) 16.6 83.4 1.16 (0.54-2.50) 1.30 (0.57-2.97)
Smoking habit
 No 8.7 91.3 1.00 (ref.) 1.00 (ref.) 8.7 91.3 1.00 (ref.) 1.00 (ref.)
 Yes 7.5 92.5 0.93 (0.40-2.18) 1.03 (0.42-2.55) 7.5 92.5 1.02 (0.66-1.58) 1.08 (0.69-1.70)
Alcohol consumption
 No 12.0 88.0 1.00 (ref.) 1.00 (ref.) 20.9 79.1 1.00 (ref.) 1.00 (ref.)
 Yes 7.4 92.6 0.59 (0.26-1.35) 0.66 (0.27-1.56) 13.7 86.3 0.64 (0.44-0.93)* 0.70 (0.47-1.04)
PA level
 Low 8.7 91.3 1.00 (ref.) 1.00 (ref.) 19.4 80.6 1.00 (ref.) 1.00 (ref.)
 Medium 11.5 88.5 1.38 (0.63-3.03) 1.12 (0.48-2.62) 13.8 86.2 0.65 (0.43-0.99)* 0.60 (0.38-0.92)*
 High 3.5 96.5 0.43 (0.12-1.56) 0.39 (0.10-1.48) 10.3 89.7 0.54 (0.28-1.06) 0.57 (0.29-1.14)
BMI (kg/m2)
  < 25 7.0 93.0 1.00 (ref.) 1.00 (ref.) 10.9 89.1 1.00 (ref.) 1.00 (ref.)
  ≥ 25 9.1 90.9 1.08 (0.46-2.56) 0.98 (0.28-3.43) 21.5 78.5 1.74 (1.14-2.64)* 0.85 (0.47-1.53)
WHtR
  < 0.5 5.9 94.1 1.00 (ref.) 1.00 (ref.) 8.4 91.6 1.00 (ref.) 1.00 (ref.)
  ≥ 0.5 9.8 90.2 1.40 (0.55-3.60) 1.35 (0.36-5.04) 22.8 77.2 2.53 (1.59-4.03)*** 2.83 (1.47-5.46)**
BMI: body mass index; WHtR: waist-to-height ratio; PA: physical activity.
1
Multivariate analysis (multiple logistic regression analysis considering the effect of one explanatory variable adjusted for age (continuous)). *p < 0.05, **p < 0.01, *** p <0.001.
2
Multivariate analyses (multiple logistic regressions considering the simultaneous effect of all the explanatory variables).*p < 0.05, **p < 0.01, ***p < 0.001.

In Chile the prevalence of WHtR among people of rural area was Women showed higher prevalence of short stature, although
57.6% in women and 51% in men (50), while in other Chilean the prevalence decreases according to age increase, which could
study considering WHtR > 0.55, 55.6% of adult population were be related to better living conditions that those underwent by
abdominally obese (51). the Argentinian population in the past decades. In last five dec-

[Nutr Hosp 2016;33(5):1149-1158]

PREVALENCE OF OVERWEIGHT, OBESITY, ABDOMINAL-OBESITY AND SHORT STATURE OF ADULT POPULATION OF 1157
ROSARIO, ARGENTINA

ades the life expectancy increased 11 years (65 years in 1960 ACKNOWLEDGMENTS
and 76 years in 2012 in whole population, and from 68.2 years
to 79.8 years in female (52)), and the mortality under 5 years We are grateful to the participants of the study and also to
dropped from 73.3 per 1000 in 1969 to 13.3 per 1000 in 2013 the students who collaborated in data collection: Antonela Fé,
(52). The improvement of health care and health conditions has Antonela Fiori, Juliana Francione, Guillermina Giorello, María
contributed to reduce the prevalence of short stature in women, Mercedes Giusti, Mercedes Gordillo Franco, Sofía Macarena
which is in conjunction with the decrease of iron deficiency Hernández, Virginia Marzioni, María Celeste Piva, Caren Sánchez,
anaemia and hence the risk of death of the mother at delivery. Ivana Traglia, Luciana Quattrocchi. Funding: Bank of Santander
Maternal short stature is a risk factor for caesarean delivery, and (PhD Programme Santander-Iberoamérica grant 314 to Maria
largely related to cephalopelvic disproportion (53). It is well known Elisa Zapata). Spanish Ministry of Health and Consumption Affairs
that maternal height influences offspring linear growth over the (Projects 14/00636, Red Predimed-RETIC RD06/0045/1004, and
growing period, which includes genetic and non-genetic factors, CIBEROBN CB12/03/30038), Grant of support to research groups
including nutrition-related intergenerational influences on growth no. 35/2011 (Balearic Islands Gov.), EU FEDER funds.
that prevent the attainment of genetic height potential in low- and
middle-income countries (54-57).
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