Regular articlePrevalence of overweight and obesity and its associated factors: findings from National Nutrition and Health Survey in Taiwan, 1993–1996
Introduction
The increasing prevalence of obesity has become a worldwide-public health problem [1], [2], [3], [4]. Evidence from several national health surveys in Asia indicates that the prevalence of overweight/obesity is increasing but varies by country [5], [6], [7], [8], [9]. Ethnic or regional differences within the same country have also been observed [5], [8]. Issues related to the possibly high prevalence of obesity in minority populations have been raised [10].
As the economy and technology have rapidly developed and advanced over the past few decades, the lifestyles and dietary habits of the people in Taiwan have evolved toward affluence. Taiwanese are eating a diet high in fat, protein, and vitamins A and C, but low in carbohydrate, fiber, vitamin E, and calcium [11]. Mortality, incidence, and prevalence rates of several obesity-related chronic conditions, particularly diabetes and breast cancer, have risen rapidly [12]. Nevertheless, statistics on the nationwide epidemic of overweight/obesity have not been reported according to internationally accepted criteria. Whether obesity is more prevalent in certain regionsor minority groups in Taiwan is also a topic of interest. It has been reported that the life expectancy of the aborigines is 10 years less than that of the average of other Taiwanese, and in general, their standardized mortality ratios of certain cancers and cerebrovascular disease and the prevalence of hyperuricemia are significantly higher [13], [14]. In the current study, we report the prevalence of overweight and obesity in Taiwan as a whole and the regional differences. The correlates contributing to the state of obesity were examined, including predisposing factors (age, gender, participants' residing stratum, education level, and nutrition/health-related knowledge score), enabling factors (nutrition information sources and tendency to store snack foods at home), and behavioral factors (dietary habits, caloric intake from alcoholic drinks, physical activity, smoking status, and labor intensiveness of one's job) (Fig. 1).
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Design
The data used in the current analysis were collected through the Nutrition and Health Survey in Taiwan 1993–96 (NAHSIT 1993–96). Two major groups of Taiwanese are the Fukiens and the Hakkas. They are distinguished from each other in dialects, certain dietary behaviors, and in cultural traditions. The aborigines account for about 1.7% of the total population and are thought to resemble the Malayo-Polynesians in their genetic make-up, and most of them live in the mountainous areas. The mountains
Overall prevalence of obesity
Table 1 shows the age- and gender-specific BMI distribution. Using the current WHO definition, 22.3% of the males and 19.9% of the females in Taiwanese adults were overweight, and the prevalence rate of obesity was 2.4% in males and 5.6% in females. There were fewer overweight women than men between the ages of 20 and 45 years, but a reversed men–women trend was observed for age group of 45–64 years and for the 65 years and above group. There were more obese women than men in every age group.
Discussion
According to the WHO definition, the prevalence rate of overweight in Taiwanese adults aged 20–64 years (22.3% in males, 18.3% in females) was similar to that of Malaysia metropolitans (23.9% in males, 17.5% in females) and middle-aged Japanese (24.3% in males, 20.2% in females) (Table 4). The people in Taiwan and the Chinese in Hong Kong were comparable in the prevalence of obesity (2.3% and 2.2% in males, 5.0% and 4.8% in females), which was slightly higher than that in Japan (1.9% in males,
Acknowledgements
The authors thank Dr. Hsing-Yi Chang, Division of Health Policy Research, National Health Research Institutes, Taipei, Taiwan, for her advice on statistical analyses. Appreciation also goes to all the field workers and those who helped organize and coordinate the field work in every survey site. The survey was sponsored by Department of Health in Taiwan (DOH FN8202, DOH-84-FS-11, DOH-85-FS-11, DOH-86-FS-11).
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