Incidence, increasing prevalence, and predictors of change in obesity and fat distribution over 5 years in the rapidly developing population of Mauritius.

OBJECTIVE To investigate the incidence and trends in prevalence of obesity and adverse fat distribution in Mauritius over 5 years. DESIGN Prevalence studies were conducted in 1987 and 1992, incidence was estimated in a sub-sample of subjects attending on both occasions. SUBJECTS 5021 Indian, Creole and Chinese Mauritian adults aged 25-74 were examined in 1987, in 1992 5111 subjects were examined, of whom 3667 had data from 1987. MEASUREMENTS Body mass index (BMI), waist-hip ratio (WHR) and 75g oral glucose tolerance test. Questionnaire data were collected on parity, physical activity, smoking, education and income. RESULTS The prevalence of 'overweight or obesity' (BMI > 25 kg/m2) increased from 26.1% to 35.7% in men and from 37.9% to 47.7% in women. The prevalence of abdominal obesity (WHR > 85 percentile in 1987 for each sex) also increased. The cumulative incidence of overweight or obesity in men ranged from 10.8% in Chinese to 18.2% in Creoles, and in women from 16.1% to 27.5% in Chinese and Creoles, respectively. The incidence of abdominal obesity exceeded 20% in Indian men and Indian and Creole women. Increases in BMI were predicted by younger age, leanness, non-diabetic glucose tolerance, smoking cessation (men) and multiparity and lower baseline income (women). Increases in WHR were predicted by ethnicity and BMI in men, and by glucose tolerance and BMI in women. CONCLUSION The increases in obesity observed in this study occurred despite concurrent national programs promoting a healthy diet and increased physical activity. This highlights the difficulty of reversing the adverse effects of lifestyle change in rapidly modernising populations.