ArticleJournal of epidemiology and global health2026
Age Cohort Patterns of Socioeconomic Inequalities in High-Risk Body Mass Index (BMI) and Waist to Hip Ratio (WHR) Composite: Findings from Nationally Representative Survey.
Article in Journal of epidemiology and global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundObesity is a growing global health challenge, with central adiposity posing particularly high cardiometabolic risk. In low- and middle-income countries (LMICs) like India, the coexistence of undernutrition and obesity reflects a double burden of malnutrition. However, limited research has examined how socioeconomic inequalities in high-risk adiposity vary across age cohorts using combined anthropometric measures.
aimTo assess age-cohort patterns of socioeconomic inequalities in high-risk adiposity defined using a composite of body mass index (BMI) and waist-to-hip ratio (WHR) in a nationally representative Indian population.
methodsWe analysed data from Wave-1 (2017-2018) of the Longitudinal Ageing Study in India (LASI), including 65,150 adults with complete anthropometric and socioeconomic data. High-risk BMI-WHR composite (BWC) was defined as overweight BMI with high-risk WHR, or obese BMI with any WHR. Descriptive analyses, regression models, and inequality measures (CI, ECI, and Wagstaff decomposition) were used to examine disparities across age cohorts, accounting for survey weights, clustering, and stratification.
resultsThe 18-44 cohort had the highest prevalence of overweight (28.4%) and obesity (10.9%), while WHR increased sharply with age (p < 0.001). Nearly all overweight (93%) and obese (91.6%) individuals were WHR high-risk. High-risk BWC was more common among women, urban residents, and individuals with higher education and wealth (p < 0.001). Inequality analysis showed a pro-rich concentration in all cohorts, peaking at ages 45-59 (ECI: 0.214), with education as the largest contributor (24-30%).
conclusionHigh-risk adiposity in India is patterned by age and SES. WHR captures substantial central obesity risk, highlighting the need for equity-focused, life-course obesity prevention strategies.
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