Original Article DOI: 10.14235/bas.galenos.2019.3302 Bezmialem Science 2020;8(4):371-378 A Study of Obesity Prevalence in the Rural Population in Turkey: Güzelyurt (Aksaray) Example Türkiye’de Kırsal Nüfusta Obezite Sıklığı Üzerine Bir Araştırma: Güzelyurt (Aksaray) Örneği Derya IŞIKLAR ÖZBERK1, Ömer ÖZBERK2 1Aksaray Provincial Health Directorate, Family Medicine, Aksaray, Turkey 2Aksaray University Training and Research Hospital, Clinic of Radyology, Aksaray, Turkey ABSTRACT ÖZ Objective: Obesity is a common health problem in almost all Amaç: Obezite, hemen hemen tüm toplumlarda yaygın görülen bir societies. The aim of this study was to investigate obesity in rural sağlık sorunudur. Bu çalışmanın amacı kırsal kesimdeki obeziteyi areas. araştırmaktır. Methods: Descriptive, cross-sectional study included patients who Yöntemler: Tanımlayıcı, kesitsel tipteki bu araştırmaya Eylül 2018- applied to Güzelyurt District Hospital in September-November Kasım 2018 tarihleri arasında Güzelyurt İlçe Devlet Hastanesi aile hekimliği polikliniğine 18 yaş ve üzeri herhangi bir nedenle 2018 for any reason over 18 years of age. Body weight, height, body müracaat eden hastalar dahil edildi. Tüm katılımcıların vücut mass index (BMI), waist/hip circumference ratio (WHR), waist- ağırlığı, boy, beden kitle indeksi (BKİ), bel/kalça çevresi oranı to-height ratio (WHtR), and blood pressure measurements were (BKO), bel-boy oranı, boyun çevresi (ByÇ) ve kan basıncı ölçümleri evaluated. In addition, age, gender, marital status, education level, değerlendirildi. Ayrıca yaş, cinsiyet, medeni durum, eğitim düzeyi, occupation, smoking habits, the disease was diagnosed, whether the meslek, sigara kullanım alışkanlığı, tanı aldığı hastalık ve kullandığı drug was recorded. ilaç olup olmadığı kaydedildi. Results: The mean age of the 191 participants was 46.8±15.6 years, Bulgular: Çalışmaya kabul edilen 191 katılımcının yaş ortalaması 79.1% were female, 36.6% were primary school graduates, 72.8% 46,8±15,6 yıl (19-85) %79,1’i kadın, %36,6’sı ilkokul mezunu, were housewives, 85.9% living in town or village. The frequency %72,8’i ev hanımı, %85,9’u kasaba veya köyde yaşamakta idi. of obesity 46.6%, 51.7% in females, 27.5% in males. Abdominal BKİ’ne göre obezite sıklığı genelde %46,6, kadınlarda %51,7, obesity; according to WC, 25.0% males, 68.2% females, according erkeklerde %27,5 olarak saptandı. Abdominal obezite sıklığı; BÇ’ye göre erkeklerde %25,0, kadınlarda %68,2, BKO’ya göre erkeklerde to WHR, 70.0% males, 57.6% females, and according to WHtR, %70,0, kadınlarda %57,6 ve bel/boy oranına göre erkeklerde 77.5% males and 90.7% females. There was a moderate positive %77,5, kadınlarda %90,7 olarak bulundu. Katılımcıların yaşı correlation between the age and BMI. BMI was strong positively ile BKİ arasındaki korelasyon incelendiğinde pozitif yönde orta significantly correlated with WHtR, WC and HC, a weaker derecede bir korelasyon saptandı BKİ ile bel-boy oranı, BÇ ve correlation between BMI to NC and WHR. KÇ arasında pozitif yönde çok kuvvetli derecede bir korelasyon Conclusion: The prevalence of obesity was 46.6%. It is possible saptanmasına rağmen, BKİ ile BynÇ ve BKO arasında pozitif yönde to say that such a high rate in living conditions does not allow daha zayıf bir korelasyon mevcuttu. Address for Correspondence: Derya IŞIKLAR ÖZBERK, Aksaray Provincial Health Directorate, Family Received: 15.05.2019 Medicine, Aksaray, Turkey Accepted: 17.12.2019 E-mail: [email protected] ORCID ID: orcid.org/0000-0003-0984-8860 Cite this article as: Işıklar Özberk D, Özberk Ö. A Study of Obesity Prevalence in the Rural Population in Turkey: Güzelyurt (Aksaray) Example. Bezmialem Science 2020;8(4):371-378. ©Copyright 2020 by the Bezmiâlem Vakıf University Bezmiâlem Science published by Galenos Publishing House. 371 Işıklar Özberk and Özberk. Obesity Prevalence in the Rural Population sedentary life and families with low socioeconomic status have such Sonuç: Bu çalışmada obezite prevalansı %46.6 olarak tespit edildi. a high rate. Obesity is health problem of our age in rural areas. Yaşam koşulları sedanter yaşama elvermeyen, sosyoekonomik düzeyi düşük ailelerin çoğunlukta olduğu bir ilçede bu kadar yüksek bir Keywords: Obesity prevalence, rural, body mass index, waist-to- oran saptamamız obezitenin kırsalda da çağımızın en önemli sağlık height ratio, waist/hip circumference ratio, neck circumference sorunu olduğunu söylemek mümkündür. Anahtar Sözcükler: Obezite prevalansı, kırsal, beden kitle indeksi, bel-boy oranı, bel/kalça çevresi oranı, boyun çevresi Introduction 2018 for any reason were included. Before starting the study, the study was approved by The Aksaray University Ethics Committee Obesity is defined by the World Health Organization (WHO) with the number 152 on 10.07.2018. Afterwards, administrative as the accumulation of excess fat in the body to the extent that it permission was obtained from the Provincial Health Directorate. disrupts human health. It is a common public health problem all over the world. The WHO reported in 2016 that the the country Data Collection with the highest prevalence of obesity in Europe was Turkey with Sociodemographic characteristics, smoking and chronic illnesses the rate of 29.5% (1). According to the studies of TURDEP-I (1998) and TURDEP-II (2010) conducted with an interval of status, drug use, height, weight, WC, hip circumference (HC), twelve years in the adult population in our country and in the neck circumference (NC), and blood pressure (BP) values were same centers, the prevalence of obesity increased from 22.3% recorded in the questionnaire form previously prepared by (32.9% in women, 13.2% in men) to 31.2% (44.2% in women, the researcher. Before starting the study, the participants were 27.3% in men) (2). informed about the study and their verbal consent was obtained. Individuals whose standing height and weight could not be Although obesity is mostly a problem of developed countries, it measured, those under the age of 18 and those who did not want is estimated that the prevalence of obesity is increasing rapidly to participate in the study voluntarily were excluded from the in developing countries. Knowing the body fat distribution study. is important in predicting the health problems that may be related and determining the risk factors. Performing some The prevalence of obesity in our country has been found to be anthropometric measurements contributes to the determination 35% in studies based on the general population (1). of these risk factors (3). Increased waist circumference (WC) Anthropometric Measurements or waist/hip ratio (WHR) is defined as abdominal (central or visceral) obesity. Abdominal obesity is an important risk factor By the same researcher, the heights of the patients were measured for cardiovascular problems. It has been reported that waist after removing the shoes, and the weights of the patients were circumference in particular reflects the current risk better as an measured after removing the jacket and excess clothes with an indicator of abdominal obesity (4). adult digital scales with height measurement (weight sensitivity range 100 g). While the patients were standing, WC was Overweight is defined as body mass index (BMI) of 25 kg/m2 measured from the midpoint between the lowest rib and lateral or above, and obesity as 30 kg/m2 or above. Abdominal obesity iliac spurs, and HC was measured at the level of the greater is a waist circumference of 88 cm or above for women and 102 cm or above for men (5). The frequency of abdominal obesity trochanters. The NC was measured at the superior edge of was found to be 64.3% in women and 34.6% in men in the the cricothyroid membrane while the patients were awake and TURDEP-II study (6). standing. All measurements were made by the same person and the results were rounded to the nearest 0.5 cm value to reduce the The aim of this study was to determine the prevalence of obesity person’s margin of error. with anthropometric measurements in adults whose living conditions did not allow for sedentary life, in a rural district BMI was determined with the formula of weight (kg)/height 2 where families with low socioeconomic levels were in the majority (m) . and to determine the sociodemographic status of obese people. • BMI ≤18.5 kg/m2 underweight In the literature review, no clear data showing the prevalence of obesity in Aksaray province and its districts was found, and our • BMI between 18.5-24.99 kg/m2 normal weight study was intended to be a guide on this issue. • BMI between 25.00-29.99 kg/m2 overweight Method • BMI ≥30 kg/m2 obese In this descriptive, cross-sectional study, patients aged 18 or • BMI between 30.00-34.99 kg/m2 mild obese over who were admitted to the District State Hospital General Outpatient Clinic between September 2018 and November • BMI between 35.00-39.99 kg/m2 moderate obese 372 Bezmialem Science 2020;8(4):371-378 • BMI between 40.00-49.99 kg/m2 morbid obese group compared to the normal-underweight group (p<0.001 and p=0.001, respectively). In addition, systolic BP value • BMI ≥50 kg/m2 super obese was significantly higher in the obese group compared to the Abdominal obesity criteria; waist circumference ≥100 cm for men, overweight group (p=0.002) (Figure 2). ≥90 cm for women, waist circumference to hip circumference The comparison of various sociodemographic characteristics of ratio >0.85 and waist-height ratio ≥0.5 (1). obese and non-obese participants is given in Table 3. According Statistical Analysis Table 1. Sociodemographic characteristics of the Statistical analyzes were performed using SPSS version 20 participants software. The normal distribution of the variables was examined n % by visual (histogram and probability graphics) and analytical Gender methods (Kolmogorov-Smirnov/Shapiro-Wilk tests). Descriptive Female 151 79.1 analyzes were given for variables without normal distribution, using median and minimum-maximum values (and​​ frequency Male 40 20.9 tables for ordinal variables).