Overweight and obesity among urban women with iron deficiency anaemia in Bangladesh

Prevalence and determinants of mother and newborn skin-to-skin contact: an assessment from the 2017-18 BDHS data

BACKGROUND

Evidence shows that skin-to-skin contact (SSC) enhances children's well-being. More information is needed on the prevalence and determinants of SSC in Bangladesh. This study aimed to estimate the prevalence and associated factors of mothers and their newborns' skin-to-skin contact in Bangladesh.

METHODS

Data extracted from a cross-sectional survey, (Bangladesh Demographic and Health Survey (BDHS) 2017-18), where 5304 (unweighted) women who gave birth in the last 3 years preceding the survey were included in the final analysis. Multivariable logistic regression analysis was used to identify the determinants of SSC practice. Adjusted odds ratios (aORs) with their corresponding 95% confidence intervals (CIs) were reported.

RESULTS

The prevalence of SSC practice in Bangladesh was 15.6% (95% CI [14.3, 17.0]). The adjusted regression model showed that the SSC practice was significantly associated with the geographic region, place of delivery, mode of delivery, and number of antenatal care visits. The SSC practice was 50% lower (aOR = 0.5, 95% CI [0.3, 0.8]) in the Rajshahi Division compared to the Dhaka Division. Women who had an institutional delivery had 2 times higher odds (aOR = 2.0, 95% CI [1.6, 2.5]) of SSC practice than women who had experienced a non-institutional delivery. Compared to women who delivered by cesarean section, the odds of SSC practice were 2.1 times higher (aOR = 2.1, 95% CI [1.6, 2.6]) for women who had a normal delivery. Women who completed at least four antenatal visits had 20% higher odds (aOR = 1.2, 95% CI [1.0, 1.4]) of SSC practice than women who completed fewer than four antenatal visits.

CONCLUSION

Given that only approximately one-sixth of the surveyed women are engaged in SSC practice, informal instructional and awareness programs are necessary in Bangladesh to promote the importance and extent of SSC practice.

Prevalence and Factors Associated With Intra-Individual Double Burden of Malnutrition Among Filipino Women of Reproductive Age

In the Philippines, the co-occurrence of two or more types of malnutrition in an individual, also known as intra-individual double burden of malnutrition (DBM), has rarely been investigated. This study aimed to determine the prevalence and the factors associated with DBM at the individual level among Filipino women of reproductive age (WRA) using the data collected from the 2018 Philippine Expanded National Nutrition Survey. For this study, intra-individual DBM was defined as the co-existence of overweight or obesity and anemia in an individual. Analysis showed that a significantly high prevalence of intra-individual DBM was found among WRA aged 40 to 49 years old, widowed, and those with a waist circumference of ≥80 cm. Furthermore, a waist circumference of ≥80 cm was highly associated with the likelihood of having intra-individual DBM among this age group. On the contrary, being single had a significantly lower risk of having this condition.

Prevalence and predictors of overweight and obesity among women of childbearing age in the province of Essaouira, Morocco

Low- and middle-income countries are facing a rapid increase in nutritional problems, particularly in Africa, where undernutrition, overweight and micronutrient deficiencies coexist, creating a double burden of malnutrition and a challenge to public health policies. In this context, Morocco stands out for its early nutritional transition, characterized by a moderate prevalence of overweight and undernutrition and elevated levels of micronutrient deficiencies. The aim of this study was to assess the weight status of women of childbearing age and identify its determinants to suggest ways to improve it. The study was conducted in the province of Essaouira in Morocco, which is characterized by a predominance of rural areas and multidimensional poverty. We conducted a quantitative cross-sectional survey of 1,466 married women of childbearing age via stratified random sampling. Data were collected via questionnaires and anthropometric measurements; we applied the WHO curves to classify BMI. Data entry and statistical processing were performed via SPSS® v. 26. The results show that women's weight status is worrisome, with an average BMI of 26.4 kg/m². The prevalence of overweight was 61.6% (BMI ≥ 25 kg/m2), with 17.9% of women being obese. Bivariate analysis revealed that age, education level, socioprofessional activity, family structure, household income and parity were significantly associated with overweight. Binary logistic regression confirmed that women's age and level of education are major determinants of overweight/obesity. There is a need to strengthen public health policies aimed at reducing overweight and obesity among women of childbearing age in Morocco, with an emphasis on nutrition education and monitoring their weight status throughout their reproductive lives.

Bayesian analysis of non-communicable diseases risk factors: a focus on the lower-educated population in Bangladesh

BACKGROUND

This study investigates non-communicable disease (NCD) risk factors, specifically hypertension and diabetes, among Bangladeshi adults with lower educational attainment. With an increasing global burden of NCDs, understanding the dynamics in lower-educated populations becomes crucial for targeted interventions and achieving Sustainable Development Goal 3.4-curtailing premature mortality from non-communicable diseases by one-third by 2030 through prevention and treatment.

METHODS

Utilizing data from the Bangladesh Demographic and Health Survey (2017-2018), a two-stage stratified sampling design identified 7287 lower-educated individuals. Bayesian logistic regression was applied for risk factor analysis.

RESULTS

The prevalence of hypertension and diabetes among lower-educated people was 31% and 9.3%, respectively. NCD prevalence (37.3%) underscored a significant health burden. Factors such as gender, age, wealth status, working status, residence and region showed significant associations with NCDs. Bayesian analysis revealed that females were 1.30 times more likely to develop NCDs, while older age groups demonstrated 4.30 times greater likelihood. Employed individuals exhibited a 43% lower risk. Wealthier households showed higher NCD likelihood and residence in the central region was associated with an 11% lower risk.

CONCLUSIONS

This study highlights the high risk of developing NCDs among lower-educated females, particularly those ≥35 y of age in Bangladesh. Therefore, targeted interventions for this group are critical to reducing NCD risks, supporting national health objectives and advancing progress toward the Sustainable Development Goals.

Correlation of Anemia Due to Poor Iron Status With Obesity at King Fahad Medical City, Riyadh, Saudi Arabia

Background Saudi Arabia has a high prevalence of chronic diseases such as obesity. Moreover, iron deficiency anemia (IDA) in developing countries is the most prevalent type of anemia. This study aims to assess the correlation between anemia related to poor iron status and obesity. Methods A cross-sectional observational study was conducted at the obesity center in King Fahad Medical City, Saudi Arabia, from April to September 2020. Two hundred and forty participants were needed to be included in the study. The data was gathered by utilizing a designed data collection form. Socio-demographic data, weight and height, questions related to the history of anemia, and gynecological data (for females) were collected. The data was analyzed using SPSS (Statistical Package for Social Science) version 28.0. Descriptive statistics were used to present numerical and categorical data and a Chi-square test was conducted to assess the correlation between categorical variables. Informed written consent was obtained from all participants and ethical approval was obtained from the Ethical Board Committee in King Fahad Medical City. Results The study included 240 participants. Two-thirds of the study population are females (64.6%), 66.7% are married, and 65.8% have obesity. Almost one-half of the study population (46%, N=128) was diagnosed with IDA with malnourishment being the most common reason for IDA (88.2%). The results indicated a correlation between obesity and the prevalence of IDA. The prevalence of IDA among participants with obesity (60.4%) was significantly higher compared to non-obese participants (39.5%), p=0.002. The study found that females and underweight individuals have a higher prevalence of IDA (p<0.001). Conclusion Results of the present study suggest that obesity could be associated with a risk of IDA. In addition, Saudi women could be more prone to IDA than men. Further prospective controlled studies among diverse populations in Saudi Arabia including laboratory assessment of inflammatory markers and iron status are required to better understand the correlation between obesity and IDA.

The association of body mass index and weight waist adjustment index with serum ferritin in a national study of US adults

BACKGROUND

Abnormal serum ferritin levels are associated with a variety of diseases. Meanwhile, abnormal serum ferritin is influenced by a variety of risk factors, but its correlation with obesity remains poorly described.

OBJECTIVE

This study aimed to investigate the association of body mass index (BMI) and weight waist adjustment index (WWI) with serum ferritin in US adults.

METHODS

Participants in this study took part in the National Health and Nutrition Examination Survey (NHANES) prior to the pandemic from 2017 to March 2020. Serum ferritin was used as the sole response variable and BMI and WWI were used as independent variables. Multiple linear regression was used to assess the relationship between serum ferritin and the independent variables, and smoothed curve fitting and threshold effects analysis were performed to assess the presence of non-linear relationships. To validate the sensitive individuals for the correlation between the independent and the dependent variables, a subgroup analysis was performed.

RESULTS

A final total of 7552 participants were included in this study. Both independent variables had a positive relationship with serum ferritin, with effect values of (β = 0.68, 95% CI: 0.17-1.19) when BMI was the independent variable and (β = 8.62, 95% CI: 3.53-13.72) when WWI was the independent variable in the fully adjusted model. This positive association between the two obesity-related indexes and serum ferritin became more significant as BMI and WWI increased (P for trend < 0.001). In subgroup analyses, the positive association between the independent variables and serum ferritin was more pronounced in participants who were male, 40-59 years old, white, and had diabetes and hypertension. In addition, smoothed curve fitting and threshold effects analysis demonstrated a linear positive association of BMI and WWI with serum ferritin.

CONCLUSIONS

In the US adult population, while there was a linear positive association of WWI and BMI with serum ferritin, the effect values between WWI and serum ferritin were more significant. Male, 40-59 years old, white, participants with diabetes and hypertension should be cautious that higher WWI might entail a risk of higher serum ferritin levels.

Causal relationship between obesity and iron deficiency anemia: a two-sample Mendelian randomization study

Background

Observational studies have suggested an association between obesity and iron deficiency anemia, but such studies are susceptible to reverse causation and residual confounding. Here we used Mendelian randomization to assess whether the association might be causal.

Methods

Data on single-nucleotide polymorphisms that might be associated with various anthropometric indicators of obesity were extracted as instrumental variables from genome-wide association studies in the UK Biobank. Data on genetic variants in iron deficiency anemia were extracted from a genome-wide association study dataset within the Biobank. Heterogeneity in the data was assessed using inverse variance-weighted regression, Mendelian randomization Egger regression, and Cochran's Q statistic. Potential causality was assessed using inverse variance-weighted, Mendelian randomization Egger, weighted median, maximum likelihood and penalized weighted median methods. Outlier SNPs were identified using Mendelian randomization PRESSO analysis and "leave-one-out" analysis.

Results

Inverse variance-weighted regression associated iron deficiency anemia with body mass index, waist circumference, trunk fat mass, body fat mass, trunk fat percentage, and body fat percentage (all odds ratios 1.003-1.004, P ≤ 0.001). Heterogeneity was minimal and no evidence of horizontal pleiotropy was found.

Conclusion

Our Mendelian randomization analysis suggests that obesity can cause iron deficiency anemia.

Iron status and obesity-related traits: A two-sample bidirectional Mendelian randomization study

BACKGROUND

The association between iron status and obesity-related traits is well established by observational studies, but the causality is uncertain. In this study, we performed a two-sample bidirectional Mendelian randomization analysis to investigate the causal link between iron status and obesity-related traits.

METHODS

The genetic instruments strongly associated with body mass index (BMI), waist-hip ratio (WHR), serum ferritin, serum iron, transferrin saturation (TSAT), and total iron-binding capacity (TIBC) were obtained through a series of screening processes from summary data of genome-wide association studies (GWAS) of European individuals. We used numerous MR analytical methods, such as inverse-variance weighting (IVW), MR-Egger, weighted median, and maximum likelihood to make the conclusions more robust and credible, and alternate methods, including the MR-Egger intercept test, Cochran's Q test, and leave-one-out analysis to evaluate the horizontal pleiotropy and heterogeneities. In addition, the MR-PRESSO and RadialMR methods were utilized to identify and remove outliers, eventually achieving reduced heterogeneity and horizontal pleiotropy.

RESULTS

The results of IVW analysis indicated that genetically predicted BMI was associated with increased levels of serum ferritin (β: 0.077, 95% CI: 0.038, 0.116, P=1.18E-04) and decreased levels of serum iron (β: -0.066, 95% CI: -0.106, -0.026, P=0.001) and TSAT (β: -0.080, 95% CI: -0.124, -0.037, P=3.08E-04), but not associated with the levels of TIBC. However, the genetically predicted WHR was not associated with iron status. Genetically predicted iron status were not associated with BMI and WHR.

CONCLUSIONS

In European individuals, BMI may be the causative factor of serum ferritin, serum iron, and TSAT, but the iron status does not cause changes in BMI or WHR.

Overweight and obesity among urban women with iron deficiency anaemia in Bangladesh

In this study, we aimed to determine the prevalence and factors associated with overweight and obesity among nonpregnant and nonlactating (NPNL) women of reproductive age with iron deficiency anaemia (IDA) in urban Bangladesh. We obtained data from the baseline assessment of a randomized control trial conducted among 525 women of reproductive age (18–49 years) with IDA (Hb < 12 gdl⁻¹ and serum ferritin <30 μg L⁻¹). The study was carried out in Mirpur, Dhaka, Bangladesh, between December 2017 and January 2019. We collected information on women's socio‐demographic characteristics and anthropometry. Body mass index (BMI) was calculated using the following formula: weight in kilograms per height in square metres. BMI ≥ 25–29.9 kg m⁻² was considered as overweight, whereas BMI ≥ 30 kg m⁻² as obese. A multivariable logistic regression model was used to ascertain the risk factors of overweight and obesity. The prevalence of overweight and obesity was 29.9% (95% CI: 26.0–34.0) and 13.1% (95% CI: 10.4–16.3), respectively. The combined prevalence of overweight and obesity was 43.0% (95% CI: 38.7–47.4). The multivariable analysis showed married women (aOR: 4.4; CI: 1.8–11.1), women aged 30–49 years (aOR: 7.6; CI: 2.4–24.1), unemployed women (aOR 1.5; CI: 1.0–2.4) and women from the wealthier households (aOR 3.9; CI: 2.3–6.8) had the highest risk of being overweight and obese compared with their counterparts. Both age and household wealth statuses showed dose–response relationships. Combination of overweight and obesity with IDA poses a particular challenge for public health interventions. The policymakers should consider what new interventions and policy initiatives are needed to address this combination of overweight and obesity with IDA.