Prevalence of excess weight and abdominal obesity in the general population of a Peruvian Andean city at 3 600 meter above sea level: A cross-sectional study
Introduction
More than 50% of the world's population presented excess weight by 2016, tripling its prevalence in the last 40 years (World Health Organization, 2021). In the past 20 years, many low and middle-income countries have experienced economic growth and urbanization. Promoting the development of obesogenic environments with changes in unhealthy diet and decreased physical activity (Malik et al., 2020). Specific changes in the diet were the increase in refined flours and sugar, especially in sugar-sweetened beverages, due to better availability of low-cost products with high caloric and low nutritional quality (Malik and Hu, 2022). The increase in weight has been linked to the development of diabetes mellitus in half of the patients (Carbone et al., 2019). Likewise, obesity causes two-thirds of cases of cardiovascular disease (Powell-Wiley et al., 2021) and 20% of all types of cancer (De Pergola and Silvestris, 2013).
The Peruvian national trend for 20 years shows a transition in which undernutrition decreased and obesity increased (Tarqui-Mamani et al., 2017). Our country's national prevalence of excess weight in people over 15 years old is 62% (overweight 37.6% and obesity 24.6%) (Pajuelo-Ramírez, 2017). A poor trend in dietary intake is demonstrated in Peruvian national surveys. Consumption of fruits and vegetables declined from 2004 to 2009 from two to one serving per week. Geographical, economic, nutritional, and cultural access to food will influence diet and weight in the general population (Diez-Canseco and Saavedra-Garcia, 2017).
An inverse relationship between obesity and altitude has been shown in all countries (Merrill, 2020) and, there is evidence of less resistance to insulin and other metabolic conditions at higher altitudes (Castillo Sayán, 2015). According to this, the prevalence of overweight-obesity in the Peruvian Andes is 8.9%. This prevalence is lower compared to areas near sea level such as the jungle with 11.7% and the coast with 13.5%. (Sayán and Woolcott, 2017). Likewise, the national prevalence of abdominal obesity at 3000 masl was 24.2%, and below 1000 masl, it was 36% (Pajuelo Ramírez et al., 2020).
National health surveys do not individualize metabolic conditions in the recently urbanized cities. Economic development has promoted changes in healthy lifestyles in the region's capitals. Promoting greater migration and increased population density predisposes to an obesogenic environment. (Wang et al., 2019). Considering that 20% of the Peruvian population lives above 3000 masl, surveys are required in urbanized Andean cities to verify this new trend. (Tremblay and Ainslie, 2021). Therefore, the present study aims to estimate the prevalence of excess weight and abdominal obesity, and evaluate the characteristics associated in the general population of Huancavelica city, capital of the Huancavelica region, located at 3600 masl.
Section snippets
Design study and scenario
A cross-sectional study was conducted from April to June 2015 in the general population of the city of Huancavelica at 3673 m above sea level (masl).
The city of Huancavelica is one of the oldest in Peru. It was founded in 1571 and is located in the center and south of the country (Fig. 1). This region is the poorest in Peru. However, the city belongs to the quintile with the lowest monetary poverty (Instituto Nacional de Estadística e Informática, 2020). A large percentage of the population has
Results
A total of 402 dwellings were visited, and 381 subjects were contacted. We excluded four subjects for presenting medical conditions that predispose to edema, five subjects with difficulty in performing anthropometric measurements, and ten who refused to participate. Finally, a total of 362 subjects were included in the analysis. The complete selection process can be seen in Fig. S1 of Supplementary Material.
The female population was 55.8% and more than 50% of the sample was under 40 years of
Discussion
This general population-based survey shows a high prevalence of excess weight and abdominal obesity in Huancavelica, a Peruvian Andean city. Both pathologies were more frequent in adulthood, female sex, residence in urban areas, and comorbidities such as hypertension or previous hyperglycemia.
We found an excess weight prevalence of 56.1% (38.7% overweight and 17.4% obesity). Likewise, there was an abdominal obesity prevalence of 41%. Both outcomes exceeded the average of the Huancavelica region
Conclusions
We concluded that 56% of residents of the city of Huancavelica have excess weight and that 47% of the same people have abdominal obesity. Age under 60 years, female sex and living in an urban area are factors that increase its prevalence. Further research is necessary to know other non-communicable diseases of cardiovascular importance, as well as to evaluate the effectiveness of the healthy food strategies implemented in Peru a few years ago. Local authorities should consider establishing
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
CRediT authorship contribution statement
Marlon Yovera-Aldana: Conceptualization, Methodology, Formal analysis, Writing – review & editing. Paola Sifuentes-Hermenegildo: Visualization, Writing – original draft. Martha Sofia Cervera-Ocaña: Visualization, Writing – original draft. Javier Tasayco-Ancevalle: Conceptualization, Resources, Validation, Investigation, Supervision.
Declaration of competing interest
None to declare.
Acknowledgments
We would like to thank the staff of the Department of Medicine of the Regional Hospital of Huancavelica for their support in preparing the field interviewers.
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