Association between Obesity and Selected Morbidities: A Study of BRICS Countries

Citation: Shukla A, Kumar K, Singh A (2014) Association between Obesity and Selected Morbidities: A Study of BRICS Countries. PLoS ONE 9(4): e94433. doi:10.1371/journal.pone.0094433
Published: April 9, 2014

Objective: Over the past few decades, obesity has reached epidemic proportions, and is a major contributor to the global burden of chronic diseases and disability. There is little evidence on obesity related co-morbidities in BRICS countries. The first objective is to examine the factors associated with overweight and obesity in four of the five BRICS countries (China, India, Russia and South Africa). The second is to examine the linkage of obesity with selected morbidities.
Methods: We used data from the Study on Global Ageing and Adult Health (SAGE) survey conducted by the World Health Organization (WHO) in China, India, Russia and South Africa during 2007–10. The morbidities included in the analysis are Hypertension, Diabetes, Angina, Stroke, Arthritis and Depression.
Findings: The prevalence of obesity was highest in South Africa (35%) followed by Russia (22%), China (5%) and India (3%). The prevalence of obesity was significantly higher in females as compared to males in all the countries. While the wealth quintile was associated with overweight in India and China, engaging in work requiring physical activity was associated with obesity in China and South Africa. Overweight/obesity was positively associated with Hypertension and Diabetes in all the four countries. Obesity was also positively associated with Arthritis and Angina in China, Russia and South Africa. In comparison, overweight/obesity was not associated with Stroke and Depression in any of the four countries.
Conclusion: Obesity was statistically associated with Hypertension, Angina, Diabetes and Arthritis in China, Russia and South Africa. In India, obesity was associated only with Hypertension and Diabetes.


Over the past few decades obesity has emerged as a global health challenge, with every sixth person being obese [1], [2]. In 2008, more than 1.4 billion adults aged 20 or more years were overweight [3]. Of these, 500 million adult men and women were obese. Statistics suggest significant variations in the prevalence of obesity across the globe. The prevalence of obesity ranges from below 5% in China, Japan and African countries to over 75% in urban Samoa [4], [5].

Obesity is known to affect the overall health of a population. According to the World Health Organization (WHO), overweight and obesity are the fifth leading risk for global deaths [3]. Obesity is also found to be associated with a number of non-communicable diseases (NCDs) such as cardiovascular diseases, diabetes, musculoskeletal disorders and some forms of cancers [3]. Statistics indicate that 44% of the diabetes burden, 23% of the heart disease burden and between 7% and 41% of certain cancer burdens can be attributed to overweight and obesity [3].

BRICS is an international association of emerging national economies: Brazil, Russia, India, China, and South Africa. The member countries represent a mix of economies with developing countries like Brazil, India, China and South Africa and a developed country like Russia. The share of China, India, Russia and South Africa together in the total world population is approximately 40%. In terms of population aged 18 years or older, these comprise 41% of the world’s population [6]. These countries are at different stages of demographic and epidemiological transition. Like in many developed countries, obesity is emerging as an important public health problem in BRICS. Economic burden of obesity related NCDs in BRICS is...

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