Obesity in the Qatari Population: An Epidemiological Perspective
Authors: Cheema Sohaila , Mamtani Ravinder , Lowenfels Albert , Alrouh Hekmat , Al-Samraye Sura , Ismail Awatef , Abdulmalik Maryam , Aigha Idil I. , Aseel Mona Taher , El Emadi Nada , Al Mujalli Azza , Abdelkerim Ahmed , Youssif Siddik , Al-Thani Al-Anood , Al-Thani Mohammed , Sheikh Javaid , Chouchane Lotfi 
Published: July 2019

BackgroundObesity is strongly associated with several non-communicable conditions including diabetes, heart disease, hypertension, stroke, and hypercholesterolemia.1 The global frequency of obesity and the metabolic syndrome has increased over the most recent decades and has been linked to an increase in the global burden of disease2. According to the 2012 STEPS survey, 70% of the adult Qatari population is overweight whereas 41% are obese3. Obesity and diseases linked to obesity have reached especially high levels in Qatar4.AimThe aim of our study was to establish a comprehensive database with a focus on obesity to capture epidemiologic features of a sample of the Qatari population. This database would be used to determine the prevalence of obesity and features of the metabolic syndrome in the Qatari population and to detect risk factors associated with obesity in this population.MethodologyTrained research coordinators conducted an interview based survey across a cross sectional population of adult Qataris mainly from the Primary Health Care Centers. Additionally, some subjects were recruited from the Blood Donation Center at Hamad General Hospital. The survey consisted of questions on demographics, nutrition, smoking, hospitalization and risk factors for metabolic syndrome. Furthermore, anthropometric measurements for each participant including weight, height, and waist circumference were recorded as well as the systolic and diastolic blood pressure. The final data set consisted of 1072 individuals. Overweight or obese individuals (n = 746) comprised 70% of the entire sample. Individuals with normal BMI comprised 30% of the sample population (n = 326). The individuals with normal BMI served as the control group. Statistical analysis using SAS software version 9.2 (Cary, NC) was performed on data. Before performing the analysis validity checks were performed for all the variables and any obvious data inconsistencies were clarified by consulting with the original data forms. stratified patients according to Body Mass Index (BMI) status based on WHO criteria.5 For determination of hypertension based on blood pressure measurements we adopted guidelines published in 2007.6 To study the characteristics of the participants we prepared contingency tables based on frequency and relative percentages. For continuous variables, we used mean, standard deviation, median, minimum and maximum values. Differences in the frequency of characteristics of obese (cases) and non-obese (controls) were compared with Fisher's exact test for categorical variables and with the Mantel-Haenszel test for trend for ordinal variables. For continuous variables, mean differences were compared using the two-sample Student's T-test. Association between characteristics identified in the contingency tables and obesity status was further studied with univariate and multivariate logistic regression models adjusted for age, sex, and education. The Joint Institutional Review Board of Hamad Medical Corporation and Weill Cornell Medicine - Qatar, approved the protocol for data collection.ResultsWe will discuss the epidemiologic risk factors associated with obesity in Qataris. Descriptive variables of BMI, interview site, age, gender, marital status, level of education and marriage to first cousin will be presented. Additionally, risk estimates for main factors (e.g. elevated blood pressure, systolic and diastolic blood pressure, elevated blood sugar, family history of diabetes, heart disease or blood pressure) significantly associated with the metabolic syndrome stratified by obesity status in overweight/obese subjects with normal weight individuals, as the comparison group will also be presented. Results of multivariate analysis of main factors significantly associated with the metabolic syndrome in study sample participants and first degree relatives for both genders will be explored.Furthermore, data on self-reported prevalence rates for hospitalization for any cause in overweight/obese persons compared to persons of normal weight will be shared.ImplicationsOur study findings have implications for preventive strategies, which may effect the national population. Additionally, the study results can be disseminated among health care professionals so they can have a better understanding about the causes, risk factors and prevention of obesity-related chronic disease in the Qatari population. Our study findings can be beneficial to patients who can take an overall active role in managing their health and also to physicians by providing the highest quality of care to the patients.This work has been supported by Weill Cornell Medicine – Qatar's Biomedical Research Program funded by Qatar Foundation, and by a grant from the Qatar National Research Fund (NPRP 4-294-3-092).References(1) Patel AV, Hildebrand JS, Gapstur SM. Body mass index and all-cause mortality in a large prospective cohort of white and black U.S. Adults. PLoS One 2014; 9(10):e109153.(2) Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012 Dec 15; 380(9859):2224–60.(3) http://www.who.int/chp/steps/Qatar_FactSheet_2012.pdf. Accessed Oct 23, 2015.(4) Alhyas L, McKay A, Balasanthiran A, Majeed A. Prevalences of overweight, obesity, hyperglycaemia, hypertension and dyslipidaemia in the Gulf: systematic review. JRSM Short Rep 2011 Jul; 2(7):55.(5) https://www. who int/bmi/index jsp?introPage = intro_3 html Accessed Nov 12, 2015.(6) Mancia G, De BG, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension. J Hypertens 2007 Sep; 25(9):1751–62.