title: Social epidemiology of excess weight and central adiposity in older Indians: analysis of Study on global AGEing and adult health (SAGE).
abstract: OBJECTIVE
  We aimed to estimate the prevalence of overweight and obesity, represented by extra body weight and abdominal circumference, among older Indians; and to characterise the social pattern of obesity and measure the magnitude of hypertension attributable to it.
  
  
  METHODS
  A nationally representative sample of older Indians was selected from 6 Indian states, including Rajasthan, Uttar Pradesh, West Bengal, Assam, Maharashtra and Karnataka, as a part of the multicountry Study on global AGEing and adult health (SAGE).
  
  
  METHODS
  Indians aged 50 years or more (n=7273) were included in the first wave of the SAGE (2010), which we used in our study.
  
  
  METHODS
  The primary outcome measures included excess weight (EW), defined by body mass index (BMI) >25 kg/m(2), and central adiposity (CA), defined by waist circumference >90 cm for men and >80 cm for women. The secondary outcome included hypertension, defined by systolic blood pressure >139 or diastolic blood pressure >79 mm Hg, or by those receiving antihypertensive medications.
  
  
  RESULTS
  14% of older Indians possessed EW, whereas 35% possessed CA; 50.9% of the wealthier third and 27.7% of the poorer two-thirds have CA; the proportions being 69.1% and 46.2%, respectively, in older women. Mostly wealth (adjusted OR for CA: 4.36 (3.23 to 5.95) and EW: 4.39 (3.49 to 5.53)), but also urban residence, privileged caste, higher education, white-collared occupation and female gender, were important determinants. One of 17 older Indians overall and 1 of 18 in the poorer 70% suffered from CA-driven hypertension, independent of BMI.
  
  
  CONCLUSIONS
  The problem of CA and its allied diseases is already substantial and expected to rise across all socioeconomic strata of older Indians, though currently, CA affects the privileged more than the underprivileged, in later life. Population-based promotion of appropriate lifestyles, with special emphasis on women, is required to counteract prosperity-driven obesity before it becomes too entrenched and expensive to uproot.
authors.affiliation: Centre for Disease Epidemiology and Surveillance, Asian Institute of Public Health, Bhubaneswar, Odisha, India.
authors.forename: Sudipta
authors.initials: S
authors.lastname: Samal
authors.affiliation: Center for Global Health and Development, University of Nebraska Medical Center, Omaha, Nebraska, USA.
authors.forename: Pinaki
authors.initials: P
authors.lastname: Panigrahi
authors.affiliation: Centre for Disease Epidemiology and Surveillance, Asian Institute of Public Health, Bhubaneswar, Odisha, India.
authors.forename: Ambarish
authors.initials: A
authors.lastname: Dutta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors; D012923:Social Class; D055105:Waist Circumference; D015430:Weight Gain
keywords: EPIDEMIOLOGY; PUBLIC HEALTH