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Body weight patterns in a country in transition: a population-based survey in Tirana City, Albania

Published online by Cambridge University Press:  22 December 2006

Laidon Shapo ,
Joceline Pomerleau ,
Martin McKee ,
Richard Coker  and
Agron Ylli
Laidon Shapo*
Affiliation:
European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Joceline Pomerleau
Affiliation:
European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Martin McKee
Affiliation:
European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Richard Coker
Affiliation:
European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Agron Ylli
Affiliation:
Endocrinology Department, University Hospital Centre ‘Mother Theresa’, Dibra Street, 370 Tirana, Albania
*
*Corresponding author: Email: Laidon.Shapo@lshtm.ac.uk
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Abstract

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Objective:

This paper reports the distribution and determinants of body mass index (BMI) and obesity in Tirana City (Albania).

Design:

Cross-sectional survey conducted in mid-2001.

Setting:

Tirana City.

Subjects:

One thousand one hundred and twenty adults aged 25 years and over (response rate 72.7%), selected using multi-stage cluster sampling.

Results:

Over three-quarters of male and female respondents had an excess body weight. The overall population prevalence of obesity in Tirana was estimated to be 22.0% in men and 30.9% in women. Obesity affected both genders (age-standardised prevalence in males 22.0%, females 30.9%; age-adjusted odds ratio (OR) 1.89; 99% confidence interval (CI) 1.33–2.67) and all age groups, but most particularly middle-aged women. The age-standardised overall prevalence of central obesity was 21.6% in men and 29.4% in women (age-adjusted OR 1.58; 99% CI 1.11–2.25), increasing with age (P <0.01). In women, the likelihood of being obese was inversely related to educational achievement (trend P = 0.001) and alcohol consumption (trend P = 0.009). Income, smoking and leisure-time physical activity were not associated with obesity.

Conclusions:

Excess weight and obesity are major public health problems in the adult population of Tirana, but most particularly in middle-aged women. The high obesity prevalence observed along with the recent decrease in physical activity, dietary changes and increase in smoking prevalence make it probable that there will be substantial increases in many non-communicable diseases in Albania in the coming decades. Health promotion strategies are needed that prevent excess weight gain in the Albanian population.

Keywords

Tirana CityBody mass indexOverweightCentral obesityDiet
Type
Research Article
Information
Public Health Nutrition , Volume 6 , Issue 5 , August 2003 , pp. 471 - 477
Copyright
Copyright © The Authors 2003

References

1World Health Organization (WHO). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity. Geneva: WHO, 1998.Google Scholar
2World Health Organization (WHO). The World Health Report 1998. Life in the 21st Century – A Vision for All. Geneva: WHO, 1998.Google Scholar
3National Institutes of Health, National Heart, Lung, and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Washington, DC: Department of Health and Human Services, Public Health Service, 1998; 23.Google Scholar
4Seidell, JC, Vershuren, WM, van Leer, EM, Kromhout, D. Overweight, underweight, and mortality. A prospective study of 48,287 men and women. Archives of Internal Medicine 1996; 156: 958–69.Google Scholar
5Manson, JE, Willett, WC, Stampfer, MJ. Body weight and mortality among women. New England Journal of Medicine 1995; 333: 677–85.CrossRefGoogle ScholarPubMed
6Rissanen, A, Heliovaara, M, Knekt, P, Reunanen, A, Aromaa, A, Maatela, J. Risk of disability and mortality due to overweight in a Finish population. British Medical Journal 1990; 301: 835–7.CrossRefGoogle Scholar
7van Itallie, TB. Health implications of overweight and obesity in the United States. Annals of Internal Medicine 1985; 103: 983–8.Google Scholar
8Hubert, HB, Feinleib, M, McNamara, PM, Castelli, WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart study. Circulation 1983; 67: 968–77.CrossRefGoogle ScholarPubMed
9Jousilahti, P, Tuomilehto, J, Vartiainen, E, Pekkanen, J, Puska, P. Body weight, cardiovascular risk factors, and coronary mortality: 15 year follow up of middle-aged men and women in eastern Finland. Circulation 1996; 93: 1372–9.Google Scholar
10Abbott, RD, Behrens, GR, Sharp, DS, Rodriguez, BL, Burchfiel, CM, Ross, GW, et al. Body mass index and thromboembolic stroke in nonsmoking men in older middle age. The Honolulu Heart Program. Stroke 1994; 25: 2370–6.CrossRefGoogle ScholarPubMed
11Schapira, DV, Clark, RA, Wolff, PA, Jarrett, AR, Kumar, NB, Aziz, NM. Visceral obesity and breast cancer risk. Cancer 1994; 74: 632–9.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
12le Marchand, L, Wilkens, LR, Mi, MP. Obesity in youth and middle age and risk of colorectal cancer in men. Cancer Causes & Control 1992; 3: 349–54.Google Scholar
13Schaten, BJ, Smith, GD, Kuller, LH, Neaton, JD. Risk factors for the development of type 2 diabetes among men enrolled in the usual care group in the Multiple Risk Factor Intervention Trial. Diabetes Care 1994; 17: 288–96.Google Scholar
14Chan, JM, Rimm, EB, Colditz, GA, Stampfer, MJ, Willett, WC. Obesity, fat distribution and weight gain as risk factors for clinical diabetes in men. Diabetes Care 1994; 17: 961–9.CrossRefGoogle ScholarPubMed
15Walker, ARP, Adam, F, Walker, BF. World pandemic of obesity: the situation in Southern African populations. Public Health 2001; 115: 368–72.Google ScholarPubMed
16Shapo, L, McKee, M, Cooker, R, Ylli, A. Type 2 diabetes in Albania: a rapid increase in a country in transition. Diabetic Medicine submitted for publication.Google Scholar
17Henderson, RH, Sundaresan, T. Cluster sampling to assess immunization coverage: a review of experience with a simplified sampling method. Bulletin of the World Health Organization 1982; 60: 253–60.Google ScholarPubMed
18World Health Organization (WHO). WHO Expert Committee on Diabetes Mellitus Second Report. Technical Report Series No. 626. Geneva: WHO, 1980.Google Scholar
19World Health Organization (WHO). Obesity. Preventing and Managing the Global Epidemic. Geneva: WHO, 1997.Google Scholar
20British Heart Foundation, Health Promotion Research Group. Coronary heart diseases statistics. British Heart Foundation Statistics Database 2000. Annual Compendium: 2000 Edition. London: British Heart Foundation, 2000.Google Scholar
21Joint Health Survey Unit. Health Survey for England 1998. London: The Stationery Office, 1999.Google Scholar
22Pudule, I, Grinberga, D, Kadziauskiene, K, Abaravicius, A, Vaask, S, Robertson, A, et al. Patterns of smoking in the Baltic Republics. Journal of Epidemiology and Community Health 1999; 53: 277–83.CrossRefGoogle ScholarPubMed
23McKee, M, Pomerleau, J, Robertson, A, Pudule, I, Grinberga, D, Kadziauskiene, K, et al. Alcohol consumption in the Baltic Republics. Journal of Epidemiology and Community Health 2000; 54: 361–6.CrossRefGoogle ScholarPubMed
24Pomerleau, J, McKee, M, Robertson, A, Vaask, S, Kadziauskiene, K, Abaravicius, A, et al. Physical inactivity in the Baltic countries. Preventive Medicine 2000; 31: 665–72.Google Scholar
25 Forum 2000. National reports on the statistical implications of the Summit for Social Development – Albania. Presented at Seminar on Statistics for Social Progress, Geneva, 27 June 2000.Google Scholar
26Rao, JNK, Scott, AJ. A simple method for the analysis of clustered binary data. Biometrics 1992; 48: 577–85.CrossRefGoogle ScholarPubMed
27Pagano, R, La Vecchia, C. Overweight and obesity in Italy, 1990–91. International Journal of Obesity and Related Metabolic Disorders 1995; 18: 665–9.Google Scholar
28Moreno, LA, Sarría, A, Popkin, BM. The nutrition transition in Spain: a European Mediterranean country. European Journal of Clinical Nutrition 2002; 56: 992–1003.Google Scholar
29British Heart Foundation Health Promotion Research Group. European Cardiovascular Disease Statistics, 2000 edition [online]. Available at: http://www.dphpc.ox.ac.uk/bhfhprg/stats/2000/europe/homepage.htmlGoogle Scholar
30Caballero, B. Symposium: Obesity in developing countries: biological and ecological factors. Introduction. Journal of Nutrition 2001; 103: 866S–70S.Google Scholar
31Maire, B, Lioret, S, Gartner, A, Delpeuch, F. Nutritional transition and non-communicable diet-related chronic diseases in developing countries. Santé 2002; 12: 45–55.Google ScholarPubMed
32Raleigh, VS. World population and health in transition. British Medical Journal 1999; 319: 981–4.Google Scholar
33Government of Albania. Interim Poverty Reduction Strategy Paper, May 2000.Google Scholar
34Gjonca, A, Bobak, M. Albanian paradox, another example of protective effect of Mediterranean lifestyle?. Lancet 1997; 350: 1815–7.Google Scholar
35Gjonça, A. Communism, Health and Lifestyle. The Paradox of Mortality Transition in Albania 1950–1990. Westwood CT: Greenwood Press, 2001.Google Scholar
36Daly, PA, Solomon, CG, Manson, J. Risk modification in the obese patient. In: Manson, J, Ridker, P, Gaziano, JM, Hennekens, C, eds. Prevention of Myocardial Infarction. New York: Oxford University Press, 1996; 231–63.Google Scholar
37Lapidus, L, Bengtsson, C, Larsson, B, Pennert, K, Rybo, E, Sjostrom, L. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow-up of participants in the population study of women in Gothenberg, Sweden. British Medical Journal (Clinical Research Edition) 1984; 289: 1257–61.CrossRefGoogle Scholar
38de Pablos-Velasco, PL, Martinez-Martin, FJ, Rodriguez-Perez, F. Prevalence of obesity in a Canarian community. Association with type 2 diabetes mellitus: the Guia Study. European Journal of Clinical Nutrition 2002; 56: 557–60.Google Scholar
39Ramos de Marins, VM, Varnier Almeida, RMR, Pereira, RA, Barros, MBA. Factors associated with overweight and central body fat in the city of Rio de Janeiro: results of a two-stage random sampling survey. Public Health 2001; 115: 236–42.CrossRefGoogle Scholar
40Taylor, RW, Keil, D, Gold, EJ, Williams, SM, Goulding, A. Body mass index, waist girth, and waist to hip ratio as indexes of total regional adiposity in women: evaluation using receiver operating characteristic curves. American Journal of Clinical Nutrition 1998; 67: 44–9.Google Scholar
41Abdul-Rahim, HF, Abu-Rmeileh, NM, Husseini, A, Holmboe-Ottesen, G, Jervell, J, Bjertness, E. Obesity and selected co-morbidities in an urban Palestinian population. International Journal of Obesity and Related Metabolic Disorders 2001; 25: 1736–40.Google Scholar
42Aranceta, J, Perez, RC, Serra, ML, Ribas, L, Quiles, IJ, Vioque, J, et al. Prevalence of obesity in Spain: the SEEDO'97 study. Spanish Collaborative Group for the Study of Obesity. Medicina Clínica (Barcelona) 1998; 111: 441–5.Google Scholar
43Pomerleau, J, Pudule, I, Grinberga, D, Kadziauskiene, K, Abaravicius, A, Bartkeviciute, R, et al. Patterns of body weight in the Baltic Republics. Public Health Nutrition 1999; 3: 3–10.CrossRefGoogle Scholar
44Gilmore, A, McKee, M, Rose, R. Determinants of and inequalities in self-perceived health in Ukraine. Social Science & Medicine 2002; 55: 2177–88.Google Scholar
45Seidell, JC. Obesity in Europe: scaling and epidemic. International Journal of Obesity 1995; 19(Suppl. 3): S1–4.Google Scholar
46Klesges, RC, Klesges, LM. The relationship between body mass and cigarette smoking using a biochemical index of smoking exposure. International Journal of Obesity 1993; 17: 585–91.Google ScholarPubMed
47Bennett, N, Dodd, T, Flatley, J, Freeth, S, Bolling, K. Health Survey for England 1993. London: HMSO, 1995.Google Scholar
48Sharp, I, White, J, Rogers, L. Physical Activity: An Agenda for Action. London: National Forum for Coronary Heart Disease Prevention, 1995.Google Scholar