Wealth, Weight Linked in Women in Poor Countries

Wealthy women in developing countries are more likely to be overweight than their socioeconomically disadvantaged counterparts, according to a recent study by the Harvard School of Public Health.

The study, which considered data from 54 countries labeled as low to middle income by the World Bank, found a direct correlation between socioeconomic status and high body mass index in all but Moldova and Kazakhstan.

The nutritional trends in developing countries have not followed the same path as those in developed countries, where primarily the poor are overweight, said S. V. Subramanian, the lead author of the paper and an assistant professor at HSPH.

Subramanian said the trend in developed nations can be attributed to inexpensive food that helps low-income people maintain an appropriate daily calorie intake. He said that food prices in developing countries are often still expensive, especially relative to spending power.

While the strength of the association varied among the developing countries, an average increase by one quartile in the wealth index was associated with a 33 percent increase in the number of overweight people.

Subramanian said that he was motivated to conduct this study because of the lack of data-driven research on this subject in developing nations.

“We have a lot of studies from developed countries, but we don’t really know what is happening in developing countries,” said Emre S. Özaltin, an HSPH student and a co-author of the study. “This really is the most comprehensive look that gives us a picture of where we are, and getting the epidemiological picture correct was quite important.”

The researchers took data from 1994 through 2008 on height and weight of women of reproductive age—between the ages of 15 and 49—and calculated BMI. Although the study focuses on overweight trends in higher socioeconomic tiers in developing nations, Subramnian said it reveals a need for a comprehensive nutritional policy across socioeconomic lines.

Most of the developing countries analyzed in the study are also facing underweight health-related concerns, largely among the poor, but Subramanian said these problems are more likely to go unaddressed in the press and in politics because they affect a less influential segment of society.

According to Subramanian, a focus on obesity among the wealthy should be complemented by a policy aimed at targeting under-nutrition among the poor.

“It’s a much better scenario than that we encounter in western countries, where hunger and obesity are concentrated in the same group,” he said.

The results of the study were published online last month in the American Journal of Clinical Nutrition.

—Staff writer Radhika Jain can be reached at radhikajain@college.harvard.edu.