Autor(es): Santos, Maria ; Sousa-Uva, Mafalda ; Namorado, Sónia ; Gonçalves, Teresa ; Matias Dias, Carlos ; Gaio, Vânia
Data: 2023
Identificador Persistente: http://hdl.handle.net/10400.18/8833
Origem: Repositório Científico do Instituto Nacional de Saúde
Assunto(s): Obesity; Obesidade; INSEF 2015; Determinantes da Saúde e da Doença; Estados de Saúde e de Doença; Portugal
Introduction: Overweight and obesity cause 1.2 million deaths annually and contribute to 7% of Years Lived with Disability in the World Health Organization (WHO) European Region, increasing the risk of cardiovascular diseases, diabetes, and various cancers. This study aimed to estimate and characterize the prevalence of abdominal obesity (AO) in the Portuguese population aged 25-74 years in 2015, using different anthropometric measures as a proxy of AO: waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and a body shape index (ABSI). Materials and methods: Data from the 1st National Health Examination Survey (INSEF) in 2015 were used. The subsample consisted of 4812 individuals who met the inclusion criteria: age 25-74 years, absence of pregnancy and available data on anthropometric measurements (weight, height, WC, hip circumference). Individuals undergoing cancer treatment were excluded from the analysis. The prevalence of abdominal obesity was stratified by sex, age group, marital status, education level, occupational activity, degree of urbanization, health region, and income quintile. Results: In Portugal, in 2015, the prevalence of abdominal obesity according to each considered anthropometric measure was 40.3% (95% CI: 38.0 - 42.5), 43.6% (95% CI: 40.1 - 47.0), 65.2% (95% CI: 62.8 - 67.5) and 75.5% (95% CI: 74.1 - 76.9) when considering WC, ABSI, WHR and WHtR, respectively. The prevalence was higher in women for WC and ABSI, while it was higher in men for WHR and WHtR. The most affected individuals had 60-74 years old. Regarding education, the highest prevalence was observed among individuals with no formal education or only primary education. In terms of occupation, the prevalence was higher among individuals engaged in low-skilled occupations (e.g., farmers, industrial workers, and construction workers). These findings remain consistent, regardless of the index under consideration. Discussion: In 2015, INSEF reported 38.9% of Portuguese adults had overweight, and 28.7% were obese. According to the WHO European Regional Obesity Report 2022, Portugal had a 57.5% prevalence of overweight and 20.8% of obesity in 2016. Within the WHO European Region, 58.7% of adults were overweight, and 23.3% were obese. The high prevalence of abdominal obesity in Portugal is a significant public health concern and is in line with European Region obesity trends. To determine the most accurate anthropometric index for assessing abdominal obesity, further research using imaging methods like computed tomography and nuclear magnetic resonance would be essential among the INSEF 2015 participants, as no gold standard index currently exists. Conclusion: The prevalence of abdominal obesity ranged from 40.3% for WC to 75.5% for WHtR. Nonetheless, irrespective of the index employed, the prevalence remains significantly elevated. The prevalence of abdominal obesity was higher in older age groups, individuals with lower education levels, and those engaged in less skilled occupations. Early identification of abdominal obesity in Primary Healthcare is essential for the most susceptible groups, as well as providing nutritional support, mainly for individuals in socioeconomic vulnerability.
