|ISSN No. 1606-7754 Vol.17 No.1 April 2009|
Obesity profile in Turkey
N Bagriacik1, H Onat2, B Ilhan3, T Tarakci4, Z Oşar5, M Ozyazar5, HH Hatemi5, G Yildiz6
Turkish Association for the Study of Obesity and Turkish Diabetes Association1;Turkish Diabetic Association, Kirklareli Branch2; Turkish Diabetic Association and Turkish Association for the Study of Obesity3; Konya Local Health Authority4; Cerrahpasa School of Medicine, Istanbul University5; Turkish Diabetic Association, Denizli Branch6
Background: Obesity is becoming a severe health problem worldwide. We evaluated the prevalence of obesity in different regions of Turkey, to study the association between BMI and regional nutritional habits and to compare the results with previous epidemiological studies. Method: 13,878 individuals (6,799 males and 7,079 females) were screened in six different regions of Turkey between 2000-2005 (Istanbul and Kastamonu from Northern part of the country, Gaziantep from South, Denizli and Kırklareli from the West and Konya from the middle part of the country). The sample was randomly selected and all participants were older than 20 years of age. Weight (kg), height (cm) and waist circumference (cm) were measured and body mass index (BMI) was calculated according to World Health Organization (WHO) methods and criteria. Results: The mean BMI was 27.52 kg/m2, 26.80 kg/m2 in men and 28.24 kg/m2 in women. The mean waist circumference was 98.5 cm in men and 79.8 cm in women. 30.9% of the subjects have normal weight, 39.6 % were overweight, and 29.5% were obese according to the WHO classification. The highest prevalence (39.9%) of obesity was observed between the ages of 50-59 years. The prevalence of obesity was highest in Gaziantep (41.6%), which is an industrialized city in the southeastern part of the country. The prevalence of overweight in men aged from 60-69 years was 49.7% and was 37.2% in women between the ages of 30-39 years. The highest frequency of obesity for men was 27.9 % in the 50-59 years age group whereas the highest frequency of obesity for women was 51.4 %) in the 50-59 years age group. A heterogenous set of results were obtained with respect to lifestyles and nutritional habits for every city when the prevalence of overweight and obesity in the age groups were evaluated according to regions. Conclusion: Obesity is a major health problem in Turkey and the increased prevalence of obesity in the young age group raises concern.
Key Words: Obesity prevalence, body mass index, waist circumference
The increasing prevalence of overweight and obesity is a major health problem not only in industrialized but also in developing countries. The prevalence of obesity has tripled in developing countries because they have been adopting a western mode of nutrition and lifestyle.1 Today, more than 1.1 billion adults are overweight and 300 million are obese. More than 50 % of the US population is obese. Overweight and obesity are serious public health problems, especially during childhood and adolescence.2,3,4
Sedentary lifestyles that lack regular physical exercise and based on fast food are being adopted by an increasing number of people all over the world including Turkey. It is known that adopting a vegetarian diet or vegetable-rich diet decreases the risk of obesity5, however, it has been found that preparation of foods and cultural orientations affect this risk.6
More than two-thirds of people with type 2 diabetes are either overweight or obese. Weight reduction can decrease medication cost and improve metabolic control. The benefits of intentional weight loss on mortality rate are well established in overweight subjects with diabetes.7,8
Various definitions of obesity have made it difficult to compare data from different studies.9 Previous studies in Europe have often used the definition of the Broca Index, whereas in 1985, a National Institutes of Health (NIH) consensus approved the use of body mass index (BMI).10 In 1995, an expert committee convened by the WHO recommended a classification for obesity using BMI cut-off points of 25, 30, and 40 as grade 1, 2, and 3, respectively.11,12 It has been demonstrated that BMI increases with age and its rate of increase is greater in men than in women.
Obesity and its complications are a growing epidemic across the world. Every year at least 300,000 deaths in the US can be linked to obesity.13,14 Obesity also is one of the biggest obstacles in the management of type 2 diabetes. There is evidence for a causal link between obesity and type 2 diabetes in obese children.15,16