@article{fdi:010064014,
  title = {{A}bdominal vs. overall obesity among women in a nutrition transition context : geographic and socio-economic patterns of abdominal-only obesity in {T}unisia},
  author = {{T}raissac, {P}ierre and {P}radeilles, {R}. and {E}l {A}ti, {J}. and {A}ounallah-{S}khiri, {H}. and {E}ymard-{D}uvernay, {S}abrina and {G}artner, {A}gn{\`e}s and {B}eji, {C}. and {B}ougatef, {S}. and {M}artin-{P}r{\'e}vel, {Y}ves and {K}olsteren, {P}. and {D}elpeuch, {F}rancis and {B}en {R}omdhane, {H}. and {M}aire, {B}ernard},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {M}ost assessments of the burden of obesity in nutrition transition contexts rely on body mass index ({BMI}) only, even though abdominal adiposity might be specifically predictive of adverse health outcomes. {I}n {T}unisia, a typical country of the {M}iddle {E}ast and {N}orth {A}frica ({MENA}) region, where the burden of obesity is especially high among women, we compared female abdominal vs. overall obesity and its geographic and socio-economic cofactors, both at population and within-subject levels. {M}ethods: {T}he cross-sectional study used a stratified, three-level, clustered sample of 35-to 70-year-old women (n = 2,964). {O}verall obesity was {BMI} = weight/height(2) >= 30 kg/m(2) and abdominal obesity waist circumference = 88 cm. {W}e quantified the burden of obesity for overall and abdominal obesity separately and their association with place of residence (urban/rural, the seven regions that compose {T}unisia), plus physiological and socio-economic cofactors by logistic regression. {W}e studied the within-subject concordance of the two obesities and estimated the prevalence of subject-level "abdominal-only" obesity ({AO}) and "overall-only" obesity ({OO}) and assessed relationships with the cofactors by multinomial logistic regression. {R}esults: {A}bdominal obesity was much more prevalent (60.4% [57.7-63.0]) than overall obesity (37.0% [34.5-39.6]), due to a high proportion of {AO} status (25.0% [22.8-27.1]), while the proportion of {OO} was small (1.6% [1.1-2.2]). {W}e found mostly similar associations between abdominal and overall obesity and all the cofactors except that the regional variability of abdominal obesity was much larger than that of overall obesity. {T}here were no adjusted associations of {AO} status with urban/rural area of residence ({P} = 0.21), education ({P} = 0.97) or household welfare level ({P} = 0.94) and only non-menopausal women ({P} = 0.093), lower parity women ({P} = 0.061) or worker/employees ({P} = 0.038) were somewhat less likely to be {AO}. {H}owever, there was a large residual adjusted regional variability of {AO} status (from 16.6% to 34.1%, adjusted {P} < 0.0001), possibly of genetic, epigenetic, or developmental origins. {C}onclusion: {M}easures of abdominal adiposity need to be included in population-level appraisals of the burden of obesity, especially among women in the {MENA} region. {T}he causes of the highly prevalent abdominal-only obesity status among women require further investigation.},
  keywords = {{W}omen ; {B}ody mass index ; {W}aist circumference ; {O}besity ; {A}bdominal obesity ; {N}utrition transition ; {G}eographic disparities ; {S}ocio-economic factors ; {T}unisia ; {TUNISIE}},
  booktitle = {},
  journal = {{P}opulation {H}ealth {M}etrics},
  volume = {13},
  numero = {},
  pages = {art. 1 [11 p.]},
  ISSN = {1478-7954},
  year = {2015},
  DOI = {10.1186/s12963-015-0035-3},
  URL = {https://www.documentation.ird.fr/hor/fdi:010064014},
}