title: High carbohydrate diet and physical inactivity associated with central obesity among premenopausal housewives in Sri Lanka.
abstract: BACKGROUND
  Prevalence of obesity and overweight is rising in developing countries, including Sri Lanka at a rapid pace due to dietary and lifestyle changes. This study aimed to assess the association between high carbohydrate diet, physical inactivity and central obesity among premenopausal housewives in Sri Lanka.
  
  
  METHODS
  This study was conducted as a cross-sectional study. A sample of 100 premenopausal women with home duties aged between 20 to 45 years were selected randomly from two divisional secretariats (DS), representing urban and rural sectors in Sri Lanka. Data on basic characteristics, anthropometric measurements, dietary assessment and physical activity were collected. We defined central obesity as a waist circumference ≥80 cm, which is the WHO recommended cut-off. Independent sample t test was used to compare the mean values. Linear and binary logistic regression analyses were performed to find out the relationship and the magnitude of association between central obesity and percentage of energy contributed from carbohydrate and physical activity level, respectively.
  
  
  RESULTS
  The women reported an average of 18 starch portions per day, which was well above the national recommendations. Seventy percent of energy in the diet came from carbohydrate. The mean BMI and waist circumference of total sample was 25.4 kgm-2 and 78.5 cm, respectively. Prevalence of overweight, obesity and centrally obesity among total sample was 38%, 34% and 45%, respectively. A significant positive correlation observed between high carbohydrate diet and waist circumference (r = 0.628, p < 0.0001). There was a significant negative correlation between energy expenditure from physical activity and waist circumference (r = -0.742, p < 0.0001). High carbohydrate diet and physical inactivity were significantly associated with central obesity (OR = 6.26, p = 0.001, 95% CI-2.11-18.57, OR = 3.32, p = 0.028, 95% CI-1.14-9.68).
  
  
  CONCLUSIONS
  High carbohydrate diet and physical inactivity are possible explanations for the high prevalence of central obesity. There is an urgent need to implement effective specific public health interventions at household level to reverse this trend among the housewives in Sri Lanka.
authors.affiliation: Department of Applied Nutrition, Faculty of Livestock, Fisheries and Nutrition, Wayamba University of Sri Lanka, Makandura 60170, Sri Lanka. rldk_rathnayake@yahoo.com.
authors.forename: Kumari M
authors.initials: KM
authors.lastname: Rathnayake
authors.forename: Tharrmini
authors.initials: T
authors.lastname: Roopasingam
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dibley
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D056128:Obesity, Abdominal / Q000453:epidemiology*; D017697:Premenopause; D057185:Sedentary Behavior; D013188:Sri Lanka / Q000453:epidemiology
chemical_list: D004040:Dietary Carbohydrates