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Kirunda BE, Fadnes LT, Wamani H, Van den Broeck J, Tylleskär T. Population-based survey of overweight and obesity and the associated factors in peri-urban and rural Eastern Uganda. BMC Public Health 2015; 15:1168. [PMID: 26602893 PMCID: PMC4659217 DOI: 10.1186/s12889-015-2506-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 11/17/2015] [Indexed: 12/11/2022] Open
Abstract
Background In sub-Saharan Africa (SSA), the rising prevalence of overweight, obesity and non-communicable diseases co-exists with the high burden of under-nutrition. The paucity of data on adulthood overweight and obesity, disaggregated by socio-demographic characteristics and in rural settings in SSA calls for research. We determined the prevalence of underweight, overweight/obesity and associated factors among adults in peri-urban and rural Uganda. Methods A cross-sectional study of 1210 randomly selected adults aged ≥ 18 years was conducted in Iganga-Mayuge Health and Demographic Surveillance Site in eastern Uganda in 2013. Height, weight and socio-demographic variables were assessed. Overweight was defined as BMI = 25.0-29.99 kg/m2, obesity ≥ 30 kg/m2 and overweight/obesity ≥ 25 kg/m2. Logistic regression was used to identify factors associated with overweight/obesity. Results Of the participants, 7 % were underweight (8.1 % of men; 5.9 % of women, p = 0.99); 17.8 % were overweight (12.4 % of men; 23.1 % of women, p < 0.001); and 7 % were obese (2.0 % of men; 12.7 % of women, p < 0.001). Overweight prevalence was 15.8 % and 23.8 % among rural and peri-urban adults, respectively (p < 0.001). Obesity prevalence was 3.9 % and 17.8 % among rural and peri-urban adults, respectively (p < 0.001). Factors associated with overweight/obesity were: being female, adjusted odds ratio (AOR) 4.3 (95 % confidence interval (PloS one 8:e75640, 20013) 3.2–5.9); peri-urban residence AOR 2.6 (1.9–3.6); being in age group 35–44, AOR 3.1 (1.8–5.3); 45–54 AOR 4.1 (2.3–7.3); 55–64 AOR 2.6 (1.4–5.0); ≥ 65 years AOR 3.1 (1.6–6.0); and having socio-economic status (SES) in the third AOR 2.8 (1.7–4.6), fourth 2.5 (1.5–4.2) and fifth 2.7 (1.6–4.4) quintile. Conclusions Overweight/obesity was prevalent among adults. Overweight/obese was associated with being female, being aged 35 years and older, residing in a peri-urban area and having a higher SES. The time has come to develop interventions to prevent and control overweight/obesity. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2506-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Barbara Eva Kirunda
- Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, School of Public Health, P.O. Box 7072, Kampala, Uganda. .,Centre for International Health, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway.
| | - Lars Thore Fadnes
- Centre for International Health, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway. .,Department of Clinical Dentistry, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway.
| | - Henry Wamani
- Department of Community Health and Behavioural Sciences, Makerere University College of Health Sciences, School of Public Health, P.O. Box 7072, Kampala, Uganda.
| | - Jan Van den Broeck
- Centre for International Health, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway
| | - Thorkild Tylleskär
- Centre for International Health, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway.
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Kanamori MJ, Carter-Pokras OD, Madhavan S, Lee S, He X, Feldman RH. Associations Between Orphan and Vulnerable Child Caregiving, Household Wealth Disparities, and Women's Overweight Status in Three Southern African Countries Participating in Demographic Health Surveys. Matern Child Health J 2015; 19:1662-71. [PMID: 25630405 DOI: 10.1007/s10995-015-1680-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study examines whether orphan and vulnerable children (OVC) primary caregivers are facing absolute household wealth (AWI) disparities, the association between AWI and women's overweight status, and the modifying role of OVC primary caregiving status on this relationship. Demographic Health Surveys data (2006-2007) from 20 to 49 year old women in Namibia (n = 6,305), Swaziland (n = 2,786), and Zambia (n = 4,389) were analyzed using weighted marginal means and logistic regressions. OVC primary caregivers in Namibia and Swaziland had a lower mean AWI than other women in the same country. In Zambia, OVC primary caregivers had a lower mean AWI score than non-primary caregivers living with an OVC but a higher mean AWI score than non-OVC primary caregivers. In Swaziland and Zambia, even small increases in household wealth were associated with higher odds for being overweight regardless of women's caregiving status. Only in Namibia, OVC primary caregiving modified the effect of the previous association. Among Namibian OVC primary caregivers, women who had at least medium household wealth (4 or more AWI items) were more likely to be overweight than their poorest counterparts (0 or 1 AWI items). OVC primary caregivers are facing household wealth disparities as compared to other women from their communities. Future studies/interventions should consider using population-based approaches to reach women from every household wealth level to curb overweight in Swaziland and Zambia and to focus on specific household wealth characteristics that are associated with OVC primary caregivers' overweight status in Namibia.
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Affiliation(s)
- Mariano J Kanamori
- Center for Research on U.S. Latinos HIV/AIDS and Drug Use, Florida International University, 11200 SW 8th ST PCA 353A, Miami, FL, 33199, USA,
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Reddy NL, Tan BK, Barber TM, Randeva HS. Brown adipose tissue: endocrine determinants of function and therapeutic manipulation as a novel treatment strategy for obesity. BMC OBESITY 2014; 1:13. [PMID: 26937283 PMCID: PMC4765227 DOI: 10.1186/s40608-014-0013-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 07/18/2014] [Indexed: 11/10/2022]
Abstract
Introduction Recent observation of brown adipose tissue (BAT) being functional in adult humans provides a rationale for its stimulation to increase energy expenditure through ‘adaptive thermogenesis’ for an anti-obesity strategy. Many endocrine dysfunctions are associated with changes in metabolic rate that over time may result in changes in body weight. It is likely that human BAT plays a role in such processes. Review In this brief review article, we explore the endocrine determinants of BAT activity, and discuss how these insights may provide a basis for future developments of novel therapeutic strategies for obesity management. A review of electronic and print data comprising original and review articles retrieved from PubMed search up to December 2013 was conducted (Search terms: brown adipose tissue, brown fat, obesity, hormone). In addition, relevant references from the articles were screened for papers containing original data. Conclusion There is promising data to suggest that targeting endocrine hormones for BAT modulation can yield a cellular bioenergetics answer for successful prevention and management of human obesity. Further understanding of the physiological link between various endocrine hormones and BAT is necessary for the development of new therapeutic options. Electronic supplementary material The online version of this article (doi:10.1186/s40608-014-0013-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Narendra L Reddy
- Clinical Sciences Research Laboratories, Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX UK ; Warwickshire Institute for Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX UK
| | - Bee K Tan
- Obstetrics and Gynaecology, Birmingham Heartlands and Solihull Hospitals, Heart of England NHS Foundation Trust, Birmingham, B9 5SS UK
| | - Thomas M Barber
- Clinical Sciences Research Laboratories, Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX UK ; Warwickshire Institute for Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX UK
| | - Harpal S Randeva
- Clinical Sciences Research Laboratories, Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX UK ; Warwickshire Institute for Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX UK
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Consequences of Abdominal Adiposity within the Metabolic Syndrome Paradigm in Black People of African Ancestry. J Clin Med 2014; 3:897-912. [PMID: 26237484 PMCID: PMC4449646 DOI: 10.3390/jcm3030897] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/28/2014] [Accepted: 05/29/2014] [Indexed: 01/13/2023] Open
Abstract
The metabolic syndrome (MetS) is a constellation of risk factors that are associated with increased risks for coronary heart disease and type 2 diabetes. Although the cause is unknown, abdominal adiposity is considered the underpinning of these metabolic alterations. Hence, increased abdominal adiposity contributes to dyslipidemia, hyperglycemia, beta cell dysfunction, insulin resistance, hypertension and inflammation. The role of abdominal adiposity in the causation of metabolic alterations that lead to the clinical expression of the MetS has become a focus of active research. In addition, there are ethnic/racial differences in the manifestation of the MetS. Therefore, the focus of this current review is to: (1) explore the consequences of abdominal obesity within the MetS paradigm; and (2) discuss the impact of ethnicity/race on MetS in Black People of African Ancestry (PAA).
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Letamo G, Navaneetham K. Prevalence and determinants of adult under-nutrition in Botswana. PLoS One 2014; 9:e102675. [PMID: 25054546 PMCID: PMC4108334 DOI: 10.1371/journal.pone.0102675] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 06/22/2014] [Indexed: 01/22/2023] Open
Abstract
Background To estimate the prevalence and determinants of adult under-nutrition in Botswana. Methods A cross-sectional survey was conducted where a nationally representative sample of people aged 20 to 49 years was used for the analysis. The outcome measure of under-nutrition was measured as BMI<18.5 kg/m2. Results Of the total sample, 19.5% of males and 10.1% of females were underweight (BMI<18.5 kg/m2). The wealth index showed that 30.9% of the adult population with low a BMI belongs to the poorest 20% of the households while only 9.6% comprised of the richest 20% of the households. Results from logistic regression analysis indicated that both adult men and women who had no education and belonged to the low socioeconomic group had a statistically significant association with low BMI. Among the female adult population, being young and not having watched TV at least once a week were significantly associated with low BMI. For the male adult population, being unmarried was significantly associated with low BMI. Conclusions Programme interventions aimed at improving the nutritional status of adults can use these findings to make appropriate policy, to establish baselines and study nutritional changes over time and its covariates.
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Affiliation(s)
- Gobopamang Letamo
- Department of Population Studies, University of Botswana, Gaborone, Botswana
- * E-mail:
| | - Kannan Navaneetham
- Department of Population Studies, University of Botswana, Gaborone, Botswana
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Pichayapinyo P, Lagampan S, Rueangsiriwat N. Effects of a dietary modification on 2 h postprandial blood glucose in Thai population at risk of type 2 diabetes: An application of the Stages of Change Model. Int J Nurs Pract 2014; 21:278-85. [PMID: 24621355 DOI: 10.1111/ijn.12253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to investigate the effect of a dietary modification intervention programme by applying the Stages of Change Model in 2 h postprandial capillary glucose reduction among Thai population. A randomized control trial was conducted for people at risk of type 2 diabetes for a period of 8 weeks. The intervention programme consisted of evaluating an individual's stage of change after being provided dietary information regarding kind of food and portions, discussion with a role model, and keeping a food diary record. By the end of the intervention programme, most participants in the experimental group were in the action stage (n = 36), whereas those in the control group were in the preparation stage (n = 32). Body mass index, blood pressure, food consumption behaviour and the 2 h postprandial blood glucose (PPG) in the experimental group had improved (P < 0.05). When performing regression analysis, intervention participation and the 2 h PPG at the baseline accounted for approximately 54% of total variance in predicting the 2 h PPG. This study yielded evidence for the benefits of using the Stages of Change Model as a framework in a dietary modification programme among people at risk of type 2 diabetes.
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Affiliation(s)
- Panan Pichayapinyo
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Rajathewi, Bangkok, Thailand
| | - Sunee Lagampan
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Rajathewi, Bangkok, Thailand
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Abstract
The Africa Region (AFR), where diabetes was once rare, has witnessed a surge in the condition. Estimates for type 1 diabetes suggest that about 39,000 people suffer from the disease in 2013 with 6.4 new cases occurring per year per 100,000 people in children <14 years old. Type 2 diabetes prevalence among 20-79-year-olds is 4.9% with the majority of people with diabetes <60 years old; the highest proportion (43.2%) is in those aged 40-59 years. Figures are projected to increase with the numbers rising from 19.8 million in 2013 to 41.5 million in 2035, representing a 110% absolute increase. There is an apparent increase in diabetes prevalence with economic development in AFR with rates of 4.4% in low-income, 5.0% in lower-middle income and 7.0% in upper-middle income countries. In addition to development and increases in life-expectancy, the likely progression of people at high risk for the development of type 2 diabetes will drive the expected rise of the disease. This includes those with impaired glucose tolerance, the prevalence of which is 7.3% among 20-79-year-olds in 2013. Mortality attributable to diabetes in 2013 in AFR is expected to be over half a million with three-quarter of these deaths occurring in those <60 years old. The prevalence of undiagnosed diabetes remains unacceptably high at 50.7% and is much higher in low income (75.1%) compared to lower- and upper-middle income AFR countries (46.0%). This highlights the inadequate response of local health systems which need to provide accessible, affordable and optimal care for diabetes.
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Affiliation(s)
- Nasheeta Peer
- Chronic Diseases of Lifestyle Research Unit, South African Medical Research Council, Durban, South Africa
| | - Andre-Pascal Kengne
- Chronic Diseases of Lifestyle Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Ayesha A Motala
- Department of Diabetes and Endocrinology, Nelson R Mandela School of Medicine, University of KwaZulu - Natal, South Africa
| | - Jean Claude Mbanya
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon.
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de Leeuw E. Health promotion research: war on health, battle of bulge or conflict of confidence? Health Promot Int 2013; 28:1-3. [DOI: 10.1093/heapro/dat004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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