Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Longitudinal study of the socio-demographic determinants of changes in body weight and waist circumference in a multi-ethnic Asian population

International Journal of Obesity volume 33, pages 1299–1308 (2009)Cite this article

Abstract

Objective:

To examine the changes in weight and waist circumference of adult Singaporeans between 1998 and 2005–2007, and the associations of these changes with demographic and socio-economic factors.

Methodology:

A prospective study, which followed up participants aged 18–69 years from the 1998 National Health Survey. Analysis was performed on data from 2483 individuals (53% of original sample) who returned for follow-up in 2005–2007. Body weight and waist circumference were measured both at baseline and follow-up. Logistic regression was used to examine factors associated with being overweight and obese at baseline. Linear regression was used to examine changes in weight and waist circumference over time. The variables examined were age, gender, ethnicity, marital status, educational level, housing and employment status, smoking, alcohol consumption and sports activities.

Results:

Mean weight for the population increased over the follow-up period by 1.48 kg (s.d.=4.95) and mean waist circumference increased by 3.32 cm (s.d.=7.92). Cross-sectionally, those who were overweight or obese were more likely to be Malays or Indians, married, homemakers and have lower educational level. Prospectively, individuals who gained the most weight were younger, more likely to be ethnic minority groups and have the lowest body mass index (BMI) at baseline. They also appeared to be of higher socio-economic status (SES) based on housing type. These associations were statistically significant even after adjusting for other variables.

Conclusion:

Obesity prevention should start early in the younger age. Preventive programs need to reach out to Malay and Indian ethnic groups and those with higher SES. These findings should be used in designing messaging of preventive strategies.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. World Health Organization Global InfoBase team. The Surf Report 2. Surveillance of Chronic Disease Risk Factors: Country-Level Data and Comparable Estimates. World Health Organization: Geneva, 2005.

  2. World Health Organization. Obesity and Overweight Fact Sheet September 2006. Available at http://www.who.int/mediacentre/factsheets/fs311/en/index.html, accessed on July 11 2008.

  3. Wang Y, Lobstein T . Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006; 1: 11–25.

    Article  Google Scholar 

  4. World Health Organization. Risk Factor Projects. Overweight and Obesity, 2005. Available at: http://www.who.int/chp/chronic_disease_report/part2_ch1/en/index16.html, accessed on July 11, 2007.

  5. Epidemiology and Disease Control Division, Ministry of Health, Singapore. National Health Survey 2004 Singapore. Available at http://www.moh.gov.sg/mohcorp/publicationsreports.aspx?id=2984, accessed on July 11 2008.

  6. Butland B, Jebb S, Kopelman P, McPherson K, Thomas S, Mardell J et al. Foresight. Tackling obesities: future choices - project report. 2nd edn. Government Office for Science: London, 2007.

  7. Prospective Studies Collaboration. Body-Mass Index and Cause-Specific Mortality in 900 000 adults: Collaborative Analyses of 57 Prospective Studies. Lancet 2009; e-pub ahead of print 18 March 2009.

  8. Gu D, He J, Duan X, Reynolds K, Wu X, Chen J et al. Body weight and mortality among men and women in China. JAMA 2006; 295: 776–783.

    Article  CAS  Google Scholar 

  9. Jee SH, Sull JW, Park J, Lee SY, Ohrr H, Guallar E et al. Body-mass index and mortality in Korean men and women. N Engl J Med 2006; 355: 779–787.

    Article  CAS  Google Scholar 

  10. James WPT, Jackson-Leach R, Mhurchu CN, Kalamara E, Shayeghi M, Rigby NJ et al. Overweight and obesity (high body mass index). In: Ezzati M, Lopez AD, Rodgers A, Murray CJL (eds). Comparative Quantification of Health Risk. Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. Vol 1. World Health Organization: Geneva, 2004. pp 497–596.

    Google Scholar 

  11. Gregg EW, Cheng YJ, Cadwell BL, Imperatore G, Williams DE, Flegal KM et al. Secular trends in cardiovascular disease risk factors according to body mass index in US adults. JAMA 2005; 293: 1868–1874.

    Article  CAS  Google Scholar 

  12. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ . Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348: 1625–1638.

    Article  Google Scholar 

  13. Flegal KM, Graubard B, Williamson DF, Gail MH . Excess deaths associated with underweight, overweight, and obesity. JAMA 2005; 293: 1861–1867.

    Article  CAS  Google Scholar 

  14. Koh-Banerjee P, Chu NF, Spiegelman D, Rosner B, Colditz G, Willett W et al. Prospective study of the association of changes in dietary intake, physical activity, alcohol consumption, and smoking with 9-y gain in waist circumference among 16 587 US men. Am J Clin Nutr 2003; 78: 719–727.

    Article  CAS  Google Scholar 

  15. Purslow LR, Young EH, Wareham NJ, Forouhi N, Brunner EJ, Luben RN et al. Socioeconomic position and risk of short-term weight gain: prospective study of 14,619 middle-aged men and women. BMC Public Health 2008; 8: 112.

    Article  Google Scholar 

  16. Lewis CE, Smith DE, Wallace DD, Williams OD, Bild DE, Jacobs Jr DR . Seven-year trends in body weight and associations with lifestyle and behavioral characteristics in black and white young adults: the CARDIA study. Am J Public Health 1997; 87: 635–642.

    Article  CAS  Google Scholar 

  17. Sherwood NE, Jeffery RW, French SA, Hannan PJ, Murray DM . Predictors of weight gain in the pound of prevention study. Int J Obes 2000; 24: 395–403.

    Article  CAS  Google Scholar 

  18. de Koning L, Merchant AT, Pogue J, Anand SS . Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J 2007; 28: 850–856.

    Article  Google Scholar 

  19. Koster A, Leitzmann MF, Schatzkin A, Mouw T, Adams KF, van Eijk JT et al. Waist circumference and mortality. Am J Epidemiol 2008; 167: 1465–1475.

    Article  Google Scholar 

  20. Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB . Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Circulation 2008; 117: 1658–1667.

    Article  Google Scholar 

  21. Ministry of Health Epidemiology and Disease Control Department. The National Health Survey 1998 Singapore. Available at http://www.moh.gov.sg/mohcorp/publicationsreports.aspx?pubfid=210, accessed on 23 December 2008.

  22. Wu Y, Tai ES, Heng D, Tan CE, Low LP, Lee J . Risk factors associated with hypertension awareness, treatment, and control in a multi-ethnic Asian population. J Hypertens 2009; 27: 190–197.

    Article  CAS  Google Scholar 

  23. Khaing NEE, Khoo CM, Tai ES, Lim SC, Tavintharan S, Wong TY et al. Is there a clear threshold for fasting plasma glucose that differentiates between those with and without neuropathy and chronic kidney disease? The Singapore Prospective Study Program. Am J Epidemiol 2009; 169: 1454–1462.

    Article  Google Scholar 

  24. Housing Mobility 1995 and 2005. Singapore Department of Statistics Mar 2006. Available at http://www.singstat.gov.sg/pubn/papers/people/op-s10.pdf, accessed on 20 April 2009.

  25. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report on a WHO Consultation on Obesity. World Health Organization: Geneva, 2007. WHO/NUT/NCD/98.1.

  26. American College of Sports Medicine. Position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 1998; 30: 975–991.

  27. World Health Organization. Guidelines for Controlling and Monitoring the Tobacco Epidemic. World Health Organization: Geneva, 1998.

  28. Beydoun MA, Wang Y . Gender-ethnic disparity in BMI and waist circumference distribution shifts in US adults. Obesity 2009; 17: 169–176.

    Article  Google Scholar 

  29. Williamson DF . Descriptive epidemiology of body weight and weight change in U. S. adults. Ann Intern Med 1993; 119 (7 Pt 2): 646–649.

    Article  CAS  Google Scholar 

  30. Wardle J, Boniface D . Changes in the distributions of body mass index and waist circumference in English adults, 1993/1994 to 2002/2003. Int J Obes (Lond) 2008; 32: 527–532.

    Article  CAS  Google Scholar 

  31. Rissanen A, Heliovarra M, Aromaa A . Overweight and anthropometric changes in adulthood: a prospective study of 17,000 finns. Int J Obes 1988; 12: 391–401.

    CAS  PubMed  Google Scholar 

  32. Chei CL, Iso H, Yamagishi K, Inoue M, Tsugane S . Body mass index and weight change since 20 years of age and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based Study. Int J Obes (Lond) 2008; 32: 144–151.

    Article  CAS  Google Scholar 

  33. Williams PT . Changes in body weight and waist circumference affect incident hypercholesterolemia during 7 years of follow-up. Obesity 2008; 16: 2163–2168.

    Article  Google Scholar 

  34. Williams PT . Increases in weight and body size increase the odds for hypertension during 7 years of follow-up. Obesity 2008; 16: 2541–2548.

    Article  Google Scholar 

  35. Strandberg TE, Strandberg A, Salomaa VV, Pitkäl K, Miettinen TA . Impact of midlife weight change on mortality and quality of life in old age. Prospective cohort study. Int J Obes Relat Metab Disord 2003; 27: 950–954.

    Article  CAS  Google Scholar 

  36. Kumanyika SK, Obarzanek E, Stettler N, Bell R, Field AE, Fortmann SP et al. Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention. Circulation 2008; 118: 428–464.

    Article  Google Scholar 

  37. Chor D, Faerstein E, Kaplan GA, Lynch JW, Lopes CS . Association of weight change with ethnicity and life course socioeconomic position among Brazilian civil servants. Int J Epidemiol 2004; 33: 100–106.

    Article  Google Scholar 

  38. Lewis CE, Jacobs Jr DR, McCreath H, Kiefe CI, Schreiner PJ, Smith DE et al. Weight gain continues in the 1990s: 10-year trends in weight and overweight from the CARDIA study. Coronary artery risk development in young adults. Am J Epidemiol 2000; 151: 1172–1181.

    Article  CAS  Google Scholar 

  39. Baltrus PT, Lynch JW, Everson-Rose S, Raghunathan TE, Kaplan GA . Race/ethnicity, life-course socioeconomic position, and body weight trajectories over 34 years: the Alameda County Study. Am J Public Health 2005; 95: 1595–1601.

    Article  Google Scholar 

  40. Monteiro CA, Moura EC, Conde WL, Popkin BM . Socioeconomic status and obesity in adult populations of developing countries: a review. Bull World Health Organ 2004; 82: 940–946.

    PubMed  Google Scholar 

  41. Sobal J, Hanson KL, Frongillo EA . Gender, Ethnicity, Marital Status, and Body Weight in the United States. Obesity 2009, e-pub ahead of print 19 March 2009.

  42. Averett SL, Sikora A, Argys LM . For better or worse: relationship status and body mass index. Econ Hum Biol 2008; 6: 330–349.

    Article  Google Scholar 

  43. Giskes K, van Lenthe FJ, Turrell G, Kamphuis CB, Brug J, Mackenbach JP . Socioeconomic position at different stages of the life course and its influence on body weight and weight gain in adulthood: a longitudinal study with 13-year follow-up. Obesity 2008; 16: 1377–1381.

    Article  Google Scholar 

  44. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH . Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997; 337: 869–873.

    Article  CAS  Google Scholar 

  45. Guo SS, Huang C, Maynard LM, Demerath E, Towne B, Chumlea WC et al. Body mass index during childhood, adolescence and young adulthood in relation to adult overweight and adiposity: the Fels Longitudinal Study. Int J Obes Relat Metab Disord 2000; 24: 1628–1635.

    Article  CAS  Google Scholar 

  46. Gunderson EP, Murtaugh MA, Lewis CE, Quesenberry CP, West DS, Sidney S . Excess gains in weight and waist circumference associated with childbearing: the Coronary Artery Risk Development in Young Adults Study (CARDIA). Int J Obes Relat Metab Disord 2004; 28: 525–535.

    Article  CAS  Google Scholar 

  47. Wolfe WS, Sobal J, Olson CM, Frongillo Jr EA, Williamson DF . Parity-associated weight gain and its modification by sociodemographic and behavioral factors: a prospective analysis in US women. Int J Obes Relat Metab Disord 1997; 21: 802–810.

    Article  CAS  Google Scholar 

  48. Sternfeld B, Wang H, Quesenberry Jr CP, Abrams B, Everson-Rose SA, Greendale GA et al. Physical activity and changes in weight and waist circumference in midlife women: findings from the study of women's health across the nation. Am J Epidemiol 2004; 160: 912–922.

    Article  Google Scholar 

  49. Scott KM, Bruffaerts R, Simon GE, Alonso J, Angermeyer M, de Girolamo G et al. Obesity and mental disorders in the general population: results from the world mental health surveys. Int J Obes (Lond) 2008; 32: 192–200.

    Article  CAS  Google Scholar 

  50. Lidstone JS, Ells LJ, Finn P, Whittaker VJ, Wilkinson JR, Summerbell CD . Independent associations between weight status and disability in adults: results from the Health Survey for England. Public Health 2006; 120: 412–417.

    Article  CAS  Google Scholar 

  51. Liou TH, Pi-Sunyer FX, Laferrère B . Physical disability and obesity. Nutr Rev 2005; 63: 321–331.

    Article  Google Scholar 

Download references

Acknowledgements

This study was funded by the Biomedical Research Council of Singapore grant number 03/1/27/18/216. This study was approved by the Singapore General Hospital Institutional Review Board.

Author information

Authors and Affiliations

  1. Epidemiology and Disease Control Division, Ministry of Health, Singapore, Singapore

    S K Ong, C W Fong, S Ma, D Heng & W-Y Lim

  2. Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    J Lee

  3. Health Services Research and Evaluation Division, Ministry of Health Singapore, Singapore, Singapore

    M Deurenberg-Yap

  4. Duke-Graduate Medical School, National University of Singapore, Singapore

    M Deurenberg-Yap

  5. Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Sciences (SICS), Singapore, Singapore

    Y-L Low

  6. Department of Endocrinology, Singapore Health Services, Singapore, Singapore

    M Tan & E S Tai

Authors
  1. S K Ong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C W Fong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D Heng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M Deurenberg-Yap
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Y-L Low
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. W-Y Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. E S Tai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E S Tai.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ong, S., Fong, C., Ma, S. et al. Longitudinal study of the socio-demographic determinants of changes in body weight and waist circumference in a multi-ethnic Asian population. Int J Obes 33, 1299–1308 (2009). https://doi.org/10.1038/ijo.2009.173

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2009.173

Keywords

This article is cited by

Search

Advanced search

Quick links