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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2252
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8806
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.
6
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1
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M
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201
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c
o
n
t
i
n
ue
s
t
o
gr
o
w
[
8]
.
A
n
o
t
h
e
r
s
t
ud
y
wa
s
c
a
r
r
i
e
d
o
ut
i
n
2015
a
m
o
n
g
t
h
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L
e
b
a
n
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s
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po
pu
l
a
t
i
o
n
,
r
e
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a
l
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t
h
a
t
26.
1%
o
f
t
h
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L
e
b
a
n
e
s
e
pe
o
p
l
e
a
r
e
o
b
e
s
e
[
9]
.
On
e
po
s
s
i
bl
e
e
x
p
lan
a
t
i
o
n
i
s
t
h
a
t
t
h
e
de
c
l
i
ne
i
n
t
h
e
p
hy
s
i
c
a
l
a
c
t
i
vi
t
y
a
n
d
t
h
e
t
r
a
n
s
i
t
i
o
n
i
n
t
he
t
y
pe
o
f
l
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i
s
ur
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t
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vi
t
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e
s
s
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m
s
a
pr
i
m
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us
pe
c
t
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n
t
h
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gr
o
wt
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o
f
o
b
e
s
i
t
y
i
n
L
e
ba
n
o
n
.
T
hi
s
s
ur
v
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im
e
d
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o
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he
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a
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t
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du
l
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o
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a
t
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n
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v
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c
l
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ng
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ge
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ge
n
de
r
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n
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o
c
c
upa
t
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n
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e
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l
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i
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g
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t
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if
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e
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c
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nc
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e
a
s
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d
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M
I
a
n
d
W
C
,
a
n
d
de
t
e
r
m
i
n
i
ng
t
h
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c
ut
o
f
f
po
i
n
t
s
f
o
r
t
h
e
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C
f
o
r
b
o
t
h
Ge
n
de
r
s
b
a
s
e
d
o
n
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M
I
l
e
v
e
l
s
.
2.
RE
S
E
AR
CH
M
E
T
HO
D
2.
1.
S
am
p
l
in
g
f
r
a
m
e
300
h
e
a
l
t
hy
L
e
b
a
ne
s
e
a
du
l
t
s
a
ge
d
b
e
t
we
e
n
18
a
nd
74
we
r
e
r
a
n
do
m
ly
r
e
c
r
u
i
t
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d
f
r
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m
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e
i
r
ut
r
e
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o
n
.
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a
m
p
li
ng
wa
s
do
n
e
a
t
t
h
r
e
e
pr
i
m
a
r
y
h
e
a
l
t
h
c
a
r
e
c
e
n
t
e
r
s
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K
a
r
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g
h
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a
n
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t
e
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f
o
r
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d
c
a
r
e
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o
t
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r
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hil
d
we
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f
a
r
e
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a
n
d
Al
Ho
r
j
a
l
M
a
ka
s
s
e
d
c
e
n
t
e
r
)
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h
e
s
i
t
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s
we
r
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c
h
o
s
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o
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c
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t
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ge
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o
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uni
t
y
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h
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y
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ng
t
o
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a
l
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t
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go
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i
e
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a
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pul
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o
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ge
n
de
r
s
w
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t
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d
if
f
e
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n
t
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duc
a
t
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o
n
a
l
l
e
v
e
l
s
.
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du
l
t
s
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r
e
f
a
c
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o
f
a
c
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n
t
e
r
vi
e
we
d
a
n
d
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nvi
t
e
d
t
o
pa
r
t
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c
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pa
t
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i
n
a
s
e
l
f
-
r
e
po
r
t
e
d
que
s
t
i
o
nn
a
i
r
e
.
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f
i
nc
l
us
i
o
n
c
r
i
t
e
r
i
a
we
r
e
m
e
t
,
t
h
e
que
s
t
i
o
nna
i
r
e
w
a
s
h
a
n
de
d
t
o
t
h
e
m
t
o
b
e
c
o
m
p
l
e
t
e
d.
I
n
d
i
vi
dua
l
s
i
nc
l
ude
d
in
t
hi
s
s
t
ud
y
we
r
e
h
e
a
l
t
hy
,
a
ge
d
b
e
t
we
e
n
18
a
n
d
74
ye
a
r
s
o
l
d,
a
n
d
o
nl
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f
r
o
m
t
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a
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e
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a
t
i
o
n
a
li
t
y
.
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ubj
e
c
t
s
c
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ul
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b
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n
c
l
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e
d
i
n
t
hi
s
s
t
ud
y
if
t
h
e
y
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e
t
a
k
i
n
g
m
e
d
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c
a
t
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o
ns
a
f
f
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c
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g
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ppe
t
i
t
e
,
t
h
o
s
e
wh
o
h
a
ve
c
h
r
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d
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s
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a
l
s
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c
t
s
w
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r
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n
a
l
,
li
ve
r
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pa
n
c
r
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t
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c
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f
f
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c
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s
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o
r
a
ny
c
h
r
o
ni
c
i
n
f
l
a
mm
a
t
o
r
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o
r
i
n
f
e
c
t
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o
us
d
i
s
e
a
s
e
,
hy
pe
r
t
e
n
s
i
o
n
,
c
a
r
d
i
o
v
a
s
c
u
l
a
r
d
i
s
e
a
s
e
,
d
i
a
be
t
i
c
,
de
m
e
n
t
e
d
i
n
d
i
v
i
dua
l
s
,
pr
e
gn
a
n
t
a
n
d
l
a
c
t
a
t
i
n
g
wo
m
e
n
we
r
e
a
ll
e
x
c
l
ude
d.
S
u
bj
e
c
t
s
w
h
o
h
a
v
e
a
c
t
i
v
e
t
hy
r
o
i
d
d
i
s
e
a
s
e
,
o
r
wh
o
we
r
e
r
e
c
e
i
vi
n
g
t
hy
r
o
i
d
h
o
r
m
o
n
e
s
u
b
s
t
i
t
ut
i
o
n
we
r
e
a
l
s
o
e
x
c
l
ude
d.
2.
2.
S
t
u
d
y
De
s
ign
T
hi
s
c
r
o
s
s
-
s
e
c
t
i
o
n
a
l
s
t
ud
y
wa
s
c
o
n
duc
t
e
d
a
t
v
a
r
i
o
us
h
o
ur
s
o
f
t
h
e
we
e
k
da
y
s
be
t
we
e
n
M
a
r
c
h
a
nd
M
a
y
,
2016.
2.
3.
DA
T
A
Coll
e
c
t
ion
As
t
h
e
que
s
t
i
o
nn
a
i
r
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c
o
n
t
a
i
n
e
d
pe
r
s
o
n
a
l
i
n
f
o
r
m
a
t
i
o
n
s
uc
h
a
s
a
ge
gr
o
ups
,
ge
n
de
r
;
An
t
h
r
o
p
o
m
e
t
r
i
c
da
t
a
s
uc
h
a
s
t
h
e
w
e
i
g
h
t
,
h
e
i
g
h
t
,
a
n
d
wa
i
s
t
c
i
r
c
u
m
f
e
r
e
n
c
e
;
c
o
nf
i
d
e
n
t
i
a
l
i
t
y
a
n
d
c
o
m
p
l
e
t
e
a
n
o
nymi
t
y
we
r
e
hi
g
hly
gua
r
a
n
t
e
e
d.
E
a
c
h
p
a
r
t
i
c
i
pa
n
t
c
o
m
p
l
e
t
e
d
a
s
e
l
f
-
r
e
po
r
t
e
d
que
s
t
i
o
nn
a
i
r
e
;
a
g
e
wa
s
c
l
a
s
s
i
f
i
e
d
i
n
t
o
t
w
o
c
a
t
e
g
o
r
i
e
s
:
a
du
l
t
s
(
18
-
64
y
e
a
r
s
)
,
a
n
d
e
l
d
e
r
l
y
(
65
-
7
4
y
e
a
r
s
)
.
An
t
h
r
o
po
m
e
t
r
i
c
m
e
a
s
ur
e
m
e
n
t
s
we
r
e
t
a
ke
n
u
s
i
ng
s
t
a
n
da
r
d
i
z
e
d
t
e
c
hni
que
s
a
n
d
c
a
li
br
a
t
e
d
e
qu
i
p
m
e
n
t
's
.
T
h
e
h
e
i
g
h
t
wa
s
m
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a
s
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e
d
w
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t
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ut
s
h
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e
s
a
n
d
r
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c
o
r
de
d
to
t
h
e
n
e
a
r
e
s
t
0.
5
c
m
us
i
ng
a
s
t
a
d
i
o
m
e
t
e
r
.
T
h
e
we
i
g
h
t
wa
s
m
e
a
s
ur
e
d
by
a
po
r
t
a
bl
e
c
a
l
i
br
a
t
e
d
s
c
a
l
e
w
i
t
h
b
a
r
e
f
e
e
t
.
T
h
e
wa
i
s
t
c
i
r
c
u
mf
e
r
e
n
c
e
wa
s
m
e
a
s
ur
e
d
us
i
n
g
a
m
e
a
s
ur
e
m
e
n
t
t
a
pe
.
T
h
e
Ge
n
e
r
a
l
pr
a
c
t
i
c
e
p
hy
s
i
c
a
l
a
c
t
i
vi
t
y
qu
e
s
t
i
o
nn
a
i
r
e
(
GPP
A
Q)
wa
s
de
ve
l
o
pe
d
to
p
r
o
vi
de
a
s
im
p
l
e
,
4
-
l
e
v
e
l
P
hy
s
i
c
a
l
Ac
t
i
vi
t
y
I
n
de
x
(
P
A
I
)
r
e
f
l
e
c
t
i
n
g
a
n
i
nd
i
v
i
dua
l
’
s
c
ur
r
e
n
t
phy
s
i
c
a
l
a
c
t
i
vi
t
y
,
f
o
r
us
e
i
n
ge
n
e
r
a
l
pr
a
c
t
i
c
e
to
de
c
i
de
w
h
e
n
i
n
t
e
r
v
e
n
t
i
o
ns
t
o
i
n
c
r
e
a
s
e
p
hy
s
i
c
a
l
a
c
t
i
vi
t
y
mi
g
h
t
b
e
a
ppr
o
pr
i
a
t
e
.
Que
s
t
i
o
n
s
c
o
n
c
e
r
ni
ng
wa
l
k
i
ng,
h
o
us
e
wo
r
k/chi
l
dc
a
r
e
a
n
d
g
a
r
de
ni
ng/DI
Y
ha
v
e
b
e
e
n
i
nc
l
ude
d,
h
o
we
v
e
r
t
h
e
y
h
a
v
e
n
o
t
b
e
e
n
s
h
o
wn
t
o
y
i
e
l
d
da
t
a
o
f
a
s
u
f
f
i
c
i
e
n
t
r
e
l
i
a
bil
i
t
y
to
c
o
n
t
r
i
b
ut
e
to
a
n
o
bj
e
c
t
i
v
e
a
s
s
e
s
s
m
e
n
t
o
f
o
v
e
r
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l
l
phy
s
i
c
a
l
a
c
t
i
vi
t
y
l
e
v
e
l
s
a
n
d
a
r
e
n
o
t
i
n
c
l
ude
d
i
n
t
h
e
c
a
l
c
u
l
a
t
i
o
n
o
f
t
h
e
P
A
I
.
P
a
t
i
e
n
t
s
a
r
e
c
l
a
s
s
if
i
e
d
i
n
t
o
f
o
ur
c
a
t
e
g
o
r
i
e
s
(
A
c
t
i
v
e
,
M
o
de
r
a
t
e
l
y
a
c
t
i
ve
,
m
o
de
r
a
t
e
l
y
i
na
c
t
i
v
e
a
n
d
I
na
c
t
i
v
e
)
b
a
s
e
d
o
n
t
h
e
o
r
i
g
i
na
l
E
P
I
C
i
n
d
e
x
f
r
o
m
w
hi
c
h
t
h
e
GPP
A
Q
wa
s
de
v
e
l
o
pe
d
[
10]
.
T
hi
s
que
s
t
i
o
nna
i
r
e
i
s
a
v
a
l
i
d
a
t
e
d
s
c
r
e
e
ni
ng
t
oo
l
f
o
r
us
e
i
n
pr
im
a
r
y
c
a
r
e
(
GPP
A
Q
2008)
[
10]
t
h
a
t
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I
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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N
:
2252
-
8806
I
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
P
HS
I
S
S
N:
2252
-
8806
P
hy
s
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A
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15%
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r
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g
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(
21%
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A
c
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wo
m
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w
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d
gr
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i
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f
Am
e
r
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c
a
’
s
(
W
HO
)
[
11]
.
Al
s
o
,
o
ur
r
e
s
u
l
t
i
s
pa
r
a
l
l
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b
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du
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s
we
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i
n
a
c
t
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ve
[
12]
.
T
hi
s
i
ns
u
f
f
i
c
i
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nc
y
i
n
p
hy
s
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c
a
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y
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s
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f
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n
c
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s
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a
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pr
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vi
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,
m
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nly
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t
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s
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us
,
o
b
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s
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y
,
s
m
o
k
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ng,
h
e
a
l
t
h
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n
d
m
o
bil
i
t
y
i
s
s
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e
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pe
r
s
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n
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l
m
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v
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s
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c
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l
e
nvi
r
o
nm
e
n
t
s
in
w
hi
c
h
pe
o
pl
e
li
ve
[
13]
.
I
n
a
c
t
i
vi
t
y
a
m
o
n
g
wo
m
e
n
wa
s
s
ho
wn
to
b
e
hi
g
h
e
s
t
t
h
a
n
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n
m
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t
h
a
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s
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ke
ly
t
o
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oot
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d
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m
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r
r
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s
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di
t
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A
r
a
b
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c
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s
,
wh
e
r
e
wo
m
e
n
a
r
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e
n
m
a
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n
ly
a
s
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hil
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o
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to
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nc
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por
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vi
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s
[
14]
.
T
h
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r
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l
a
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ns
hi
p
be
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we
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t
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l
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s
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h
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t
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high
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s
t
W
C
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B
M
I
we
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f
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c
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m
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ha
n
d
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d
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p
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c
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vi
t
y
[
2]
,
[
15]
-
[
18]
.
T
hi
s
m
a
y
b
e
due
t
o
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o
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c
upa
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na
l
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m
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y
ha
v
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ga
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pa
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d
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v
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dua
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b
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ha
vi
o
r
[
19]
-
[
21]
l
e
a
d
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ng
t
o
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n
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nc
r
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s
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b
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ly
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n
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a
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o
t
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s
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de
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r
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M
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w
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nc
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s
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in
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y
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wo
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k
[
22]
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On
t
h
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h
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d,
Gut
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f
o
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m
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o
b
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s
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t
y
c
o
nf
o
un
d
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ng
f
a
c
t
or
s
[
23
]
.
M
a
ny
a
n
t
h
r
o
p
o
m
e
t
r
i
c
m
e
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s
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ve
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y
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nc
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ng
B
M
I
a
n
d
W
C
.
T
h
e
W
HO
de
f
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ne
s
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v
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i
g
h
t
a
s
B
M
I
≥
25kg/
m
2
,
o
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t
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s
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M
I
≥
30
kg/
m
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W
C
≥
10
2
c
m
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m
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a
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d
W
C
≥
88
c
m
[
24]
.
Ho
we
v
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r
,
s
uc
h
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m
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pul
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,
w
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c
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c
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nn
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d
to
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r
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f
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s
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n
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pr
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C
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B
M
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v
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f
30
kg/
m
2
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n
b
ot
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ge
n
d
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r
we
r
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r
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por
t
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to
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hi
g
h
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r
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100
c
m
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m
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d
105
c
m
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)
t
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s
c
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5
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25
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r
wo
m
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n
)
[
25]
,
a
n
d
ot
h
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s
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c
m
f
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r
m
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n
a
nd
90
c
m
f
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r
wo
m
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n
)
[
26]
.
I
n
a
ddi
t
i
o
n
,
t
h
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wa
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s
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c
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r
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m
f
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c
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c
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-
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f
f
f
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r
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M
I
≥
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kg/m
2
o
f
t
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t
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p
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g
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)
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27]
a
n
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po
pu
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(
90
c
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80
c
m
f
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r
wo
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)
(
Al
pe
r
S
e
t
a
l
2013)
[
26]
.
T
h
e
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d
i
f
f
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4.
1.
S
t
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gt
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T
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.
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.
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ct
i
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i
t
y
a
n
d
H
ea
l
t
h
,
v
o
l
.
6
,
p
p
.
315
-
3
2
0
,
2
0
0
9
.
[1
3
]
P
.
T
.
K
at
zm
arz
y
k
,
“
Ph
y
s
i
c
al
A
c
t
i
v
i
t
y
,
S
e
d
en
t
ar
y
B
eh
a
v
i
o
r,
a
n
d
H
e
a
l
t
h
:
Parad
i
g
m
Paral
y
s
i
s
o
r
Parad
i
g
m
S
h
i
ft
?”
ADA
,
2010
.
[1
4
]
D
en
n
i
s
V.
,
e
t
a
l
.
,
“O
b
e
s
i
t
y
i
n
o
l
d
e
r
ad
u
l
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s
:
t
ech
n
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c
al
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v
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ew
a
n
d
p
o
s
i
t
i
o
n
s
t
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t
o
f
t
h
e
A
me
ri
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n
So
ci
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t
y
fo
r
N
u
t
ri
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d
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A
A
SO
,
T
h
e
O
b
e
s
i
t
y
S
o
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i
e
t
y
,
”
A
m
J
Cl
i
n
Nu
t
r
,
vol
/
i
s
s
u
e:
82
(
5
),
p
p
.
9
2
3
-
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4
,
2
0
0
5
.
[1
5
]
L
i
v
i
n
g
s
t
o
n
e
M
.
B.
,
et
a
l
.
,
“
Ph
y
s
i
c
al
a
c
t
i
v
i
t
y
p
at
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e
rn
s
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n
a
n
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o
n
al
l
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re
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t
at
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s
a
m
p
l
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f
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d
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l
t
s
i
n
I
r
e
l
a
n
d
,
”
P
u
b
l
i
c
H
ea
l
t
h
Nu
t
r
,
v
o
l
/
i
s
s
u
e:
4
(5
A
)
,
p
p
.
1107
-
16
,
2
0
0
1
.
[1
6
]
Su
l
em
an
a
H
.
,
et
a
l
.
,
“
Re
l
at
i
o
n
s
h
i
p
b
e
t
w
ee
n
p
h
y
s
i
c
a
l
ac
t
i
v
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y
an
d
b
o
d
y
m
as
s
i
n
d
e
x
i
n
ad
o
l
e
s
ce
n
t
s
,
”
M
ed
S
ci
S
p
o
r
t
s
E
xer
c
.
,
2006
.
[1
7
]
H
.
T
i
l
ak
i
an
d
H
ei
d
ar
i
B
.,
“
Pre
v
al
en
ce
o
f
o
b
e
s
i
t
y
,
ce
n
t
ral
o
b
e
s
i
t
y
an
d
t
h
e
as
s
o
c
i
at
e
d
fa
c
t
o
rs
i
n
u
rb
an
p
o
p
u
l
at
i
o
n
ag
e
d
20
-
7
0
y
e
ars
,
i
n
t
h
e
n
o
rt
h
o
f
I
ra
n
:
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p
o
p
u
l
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o
n
-
b
as
e
d
s
t
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d
y
a
n
d
r
eg
r
e
s
s
i
o
n
ap
p
ro
ach
,
”
O
b
es
R
e
v.
,
2007
.
[1
8
]
A
.
J
ääs
k
e
l
äi
n
e
n
,
et
a
l
.
,
“
A
s
s
o
c
i
at
i
o
n
b
e
t
w
ee
n
o
ccu
p
at
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o
n
al
p
s
y
ch
o
s
o
ci
al
fac
t
o
rs
a
n
d
w
a
i
s
t
c
i
r
cu
m
f
e
r
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n
ce
i
s
mo
d
i
fi
e
d
b
y
d
i
e
t
a
m
o
n
g
men
,
”
E
u
r
o
p
e
a
n
Jo
u
r
n
a
l
o
f
Cl
i
n
i
c
a
l
Nu
t
r
i
t
i
o
n
,
2
0
1
5
.
[1
9
]
San
d
ri
n
e
D
.
,
et
a
l
.
,
“
W
o
rk
-
r
e
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at
e
d
a
n
d
D
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e
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ar
y
Fa
ct
o
rs
A
s
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d
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W
e
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g
h
t
G
ai
n
o
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P
e
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d
o
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E
m
p
l
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men
t
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n
Para
me
d
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c
s
,
”
O
ccu
p
a
t
i
o
n
a
l
M
ed
i
c
i
n
e
&
H
ea
l
t
h
A
f
f
a
i
r
,
2
0
1
4
.
[2
0
]
Pau
l
A
.
,
et
a
l
.
,
“
W
o
rk
,
O
b
e
s
i
t
y
,
a
n
d
O
ccu
p
at
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n
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l
Saf
e
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y
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d
H
e
al
t
h
,
”
A
m
J
P
u
b
l
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c
H
ea
l
t
h
,
2
0
0
7
.
[2
1
]
K
o
u
v
o
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e
n
A
.
,
et
a
l
.
,
“
Re
l
at
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p
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d
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4
5
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m
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d
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e
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p
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s
,
”
P
s
ych
o
s
o
m
M
ed
,
2
0
0
5
.
[2
2
]
Barb
e
ri
o
A
.
a
n
d
M
cL
ar
e
n
L
.
,
“
O
cc
u
p
at
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o
n
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p
h
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s
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l
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ct
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v
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d
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(BM
I
)
a
m
o
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g
Ca
n
ad
i
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s
:
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o
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s
p
h
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s
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l
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el
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t
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l
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i
c
p
at
t
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rn
i
n
g
o
f
b
o
d
y
w
ei
g
h
t
?”
Ca
n
J
P
u
b
l
i
c
H
ea
l
t
h
,
v
o
l
/
i
s
s
u
e:
1
0
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(3
)
,
p
p
.
1
6
9
-
73
,
2
0
1
1
.
[2
3
]
G
u
t
i
e´
rr
e
z
,
et
a
l
.
,
“
W
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rk
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rel
at
ed
p
h
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as
s
i
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d
e
x
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d
o
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s
i
t
y
,
”
O
b
es
R
es
,
2
0
0
2
.
[2
4
]
W
ai
s
t
ci
r
c
u
m
f
e
r
en
ce
an
d
w
a
i
s
t
–
h
i
p
rat
i
o
:
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e
p
o
rt
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f
a
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O
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x
p
e
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s
u
l
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e
n
ev
a,
8
–
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1
D
ecem
b
e
r
2
0
0
8
.
[2
5
]
Ram
i
n
H
.
,
et
a
l
,
“
T
h
e
A
p
p
ro
p
ri
at
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W
ai
s
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Ci
r
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t
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ra
n
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P
o
p
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l
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n
,
”
A
ct
a
M
ed
In
d
o
n
es
-
In
d
o
n
e
s
J
In
t
e
r
n
M
ed
,
v
o
l
/
i
s
s
u
e
:
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2
(4
)
,
p
p
.
2
0
9
-
15
,
2
0
1
0
.
[2
6
]
A
.
So
n
me
z
,
et
a
l
.,
“
W
ai
s
t
Ci
rc
u
m
f
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en
ce
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t
o
ff
Po
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n
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o
Pred
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O
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e
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y
,
M
e
t
ab
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l
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c
S
y
n
d
r
o
me
,
”
Ca
r
d
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o
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s
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l
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r
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k
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n
Tu
r
k
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h
A
d
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l
t
s
,
2
0
1
3
.
[2
7
]
Bo
u
g
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e
rra
R
.
,
et
a
l
.,
“
W
ai
s
t
c
i
r
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m
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ce
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t
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o
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t
s
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r
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t
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fi
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d
o
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n
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e
s
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y
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n
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l
t
p
o
p
u
l
at
i
o
n
,
”
D
i
a
b
et
e
s
O
b
es
M
et
a
b
.
,
2
0
0
7
.
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