Sedentary work and expanding waistlines: a cross-sectional study on occupational roles and abdominal obesity in India

Low- and middle-income countries are undergoing epidemiological and demographic transitions alongside economic growth, contributing to a rise in abdominal obesity. In India, the increase in sedentary occupations and insufficient physical activity are key drivers of this growing health concern. This study investigates the relationship between occupational types and abdominal obesity markers in well-characterised adults, accounting for a wide range of confounders.

Using a nationally representative sample of 99,653 women and 91,990 men, occupations were categorised into sedentary work (SW), non-sedentary work (NSW), and not working (NW). Two outcomes were assessed: abdominal obesity, measured via waist-to-hip ratio (WHR) using WHO cutoffs, and a higher-risk threshold of WHR ≥ 1. Bivariate analyses and multivariable logistic regression, adjusted for socioeconomic and demographic factors, were conducted to evaluate the risk of abdominal obesity by occupation type.

Among women, abdominal obesity prevalence based on WHO criteria was 56% (95% CI: 55.60-56.46), highest in NW (57.3%; 95% CI: 56.80-57.83), followed by SW (57.1%; 95% CI: 55.39-58.78) and NSW (51.5%; 95% CI: 50.63-52.43). Among men, prevalence was 48.9% (95% CI: 48.31-49.46), highest in SW (57.8%; 95% CI: 56.51-59.14), followed by NSW (49.9%; 95% CI: 49.15-50.63) and NW (37.3%; 95% CI: 36.14-38.43). Adjusted odds of abdominal obesity were significantly higher for SW compared to NSW (women: aOR 1.08, 95% CI: 1.02-1.14; men: aOR 1.20, 95% CI: 1.16-1.25).

High prevalence of abdominal obesity among both men and women implies an emerging health risk in India. The findings that contributed to associations between sedentary occupation and abdominal obesity may inform occupation-related health risks and development of interventions to limit daily sitting at work place which may reduce metabolic disease risk.