Overnutrition and associated factors among adults aged 20 years and above in fishing communities in the urban Cape Coast Metropolis, Ghana

Updating the association between socioeconomic status and obesity in low-income and lower-middle-income sub-Saharan African countries: A literature review

Globally, the literature tends to emphasize negative associations between socioeconomic status (SES) and bodyweight in countries improving their economic development. However, little is known about the social distribution of obesity in sub-Saharan Africa (SSA) where economic growth has been highly heterogeneous the last decades. This paper reviews an exhaustive set of recent empirical studies examining its association in low-income and lower-middle-income countries in SSA. Although there is evidence of a positive association between SES and obesity in low-income countries, we found mixed associations in lower-middle-income countries, potentially providing evidence of a social reversal of the obesity burden.

Predicting type 2 diabetes mellitus among fishermen in Cape Coast: a comparison between the FINDRISC score and the metabolic syndrome

Background

Studies over the past decades have observed a sharp rise in the prevalence and incidence of type 2 diabetes mellitus (T2DM). A highly sensitive and specific predictive tool for risky populations is essential. This study assessed two significant diabetes mellitus predictive tools for effectiveness and accuracy among people living in fishing communities in Cape Coast, Ghana.

Method

In April 2019, we recruited one hundred and thirty-five (135) fishermen from three fishing communities in Cape Coast in the Central Region of Ghana. Each participant underwent a standard metabolic procedure including clinical examination as well as taking of anthropometric variables such as weight, height, waist and hip circumference were also measured. The FINDRISC questionnaire was used to gather data from the respective participants. Serum glucose and lipids were estimated with enzymatic techniques, and metabolic syndrome (MetS) screened with the international diabetes federation (IDF) criteria.

Results

Of the 135 participants, 71 (52.6%) were women. The average age of study participants was 52 ± 16 years with females averagely older (56.6 ± 15.0) than the males (47.3 ± 15.0). This study recorded 31.1% and 8.9% prediabetic and diabetic fishermen respectively. Frequency of both prediabetes and diabetes was significantly predominant among females (71.4% vs 83.3%) than males (26.2% vs 25.0%) (p < 0.001) respectively. Prevalence of MetS according to the IDF criteria was 18.5%, significantly higher among females (92.0%) than recorded among the males (18.5%). The discriminatory accuracy of FINDRISC [aROC = 0.76 (95% CI 0.68 to 0.83); sensitivity = 58.3% and specificity = 86.9%; p = 0.003; optimal cut-off point = 13.50] and the MetS [aROC = 0.74 (95% CI 0.66 to 0.81); sensitivity = 75.0% and specificity = 71.5%; p = 0.002] despite demonstrating a significantly good capacity to detect T2DM were statistically comparable [aROC = 0.018 (95% CI -0.152 to 0.189); p = 0.834] in our study.

Conclusion

Our findings indicate that both FINDRISC (with a suitable cut-off value of 13.5) and MetS screening tools possess a good predictive capacity for the detection of T2DM. Additionally, FINDRISC can be employed to detect MetS in a high-risk population.

The prevalence and correlates of the double burden of malnutrition among women in Ghana

Anaemia and underweight or overweight/obesity are major public health problems driving maternal and child mortality in low- and middle-income countries. While the burden of these conditions is recognised, the evidence for the co-occurrence of these conditions is fragmented and mixed, especially at the individual level. Further, many studies have focused on families and communities. The different pathways for the occurrence of anaemia and BMI challenges indicate that an individual can potentially live with both conditions and suffer the complications. This study examined the prevalence and factors associated with the co-occurrence of anaemia and BMI challenges among a cohort of women in Ghana. Data from the 2014 Ghana Demographic and Health Survey were used. The sample size was 4 337 women aged 15-49 years who were not pregnant during the survey. Women who suffered simultaneously from underweight or overweight/obesity and anaemia were considered as having the double burden of malnutrition. The data were analysed using descriptive statistics, Chi-square test and logistic regression in STATA. One-fifth of the participants were overweight (21%), 4% were underweight and about one-tenth were obese (12%). The prevalence of anaemia was 41%. Only one in three women had normal weight and was not anaemic (34%). About 14% of the women experienced the double burden of malnutrition. Being overweight and anaemic (57%) was the most common form of this double burden. Age, marital status, parity, and wealth were t key risk factors associated with the double burden of malnutrition. The findings from this study show that women experience multiple nutritional challenges concurrently and that only a few women had healthy nutritional status. This information is particularly important and can be introduced into health education programmes to help address misconceptions about body weight and health.

Dietary fat quantity and quality in relation to general and abdominal obesity in women: a cross-sectional study from Ghana

BACKGROUND

Although relationships between obesity and total fat and fat types have been widely examined, the associations between the relative proportions of fatty acids calculated in the form of indices and obesity/overweight are lacking. The objective of this study was to assess associations between dietary fat quality indices and odds of obesity/overweight in women from Ghana.

METHODS

In this cross-sectional study, dietary information was obtained using 24-h dietary recall. The odds of obesity were evaluated across quintiles of specific DFQ indices [atherogenicity index (AI), thrombogenic index (TI), hypo- and hypercholesterolemic fatty acids ratio (h/H), omega-3 to omega-6 polyunsaturated fatty acids ratio (∑ω-3/∑ω-6), polyunsaturated fatty acids/saturated fatty acids ratio (PSR), dietary lipophilic index (LI) and percentage of energy from total fat (TF)].

RESULTS

After adjustment for covariates, general obesity and overweight were inversely associated with ∑ω-3/∑ω-6 ratio (OR: 0.63; 95% CI: 0.24-1.63; P for trend (P) = 0.005) and positively with TI (4.14; 95% CI: 1.78-9.66; P = 0.01) and LI (2.49; 95% CI: 1.14-5.43; P = 0.01). The odds of abdominal obesity based on waist circumference (WC) were significantly higher among participants in the fifth quintile (Q) compared with those in the first Q of AI (1.24; 95% CI: 0.56-2.74; P = 0.01), TI (4.14; 95% CI: 1.78-9.66; P = 0.009), LI (2.11; 95% CI: 0.98-4.55; P = 0.02) and TF (1.59; 95% CI: (0.73-3.46; P = 0.003). Similarly, waist to height ratio (WHtR) was positively associated with AI (2.89; 95% CI: 1.32-6.31; P = 0.04), TI (2.65; 95% CI: 1.22-5.76; P = 0.03), LI (3.32; 95% CI: 1.52-7.28; P = 0.007) and TF (1.83; 95% CI: 0.85-3.93; P = 0.009).

CONCLUSION

There was an inverse association between ∑ω-3/∑ω-6 ratio and general obesity and WC. We also found positive associations between abdominal obesity and AI and TF. Furthermore, TI and LI showed positive relationships with both general and abdominal obesity. Therefore, intake of dietary fatty acids in favor of higher ratios of ∑ω-3/∑ω-6 may be important in obesity prevention.

Dietary behaviours in the context of nutrition transition: a systematic review and meta-analyses in two African countries

OBJECTIVE

To synthesise evidence of urban dietary behaviours (macronutrients, types of foods, dietary diversity and dietary practices) in two African countries in relation to postulated changes in the context of nutrition transition.

DESIGN

Systematic review and meta-analyses, including six online databases and grey literature, 1971-2018 (Protocol CRD42017067718).

SETTING

Urban Ghana and Kenya.

PARTICIPANTS

Population-based studies of healthy adolescents and adults.

RESULTS

The forty-seven included studies encompassed 20 726 individuals plus 6526 households. Macronutrients were within WHO-recommended ranges: mean energy intake was 1867 kcal/d (95 % CI 1764, 1969) and the proportions of macronutrients were carbohydrate 61·2 % (58·4, 64·0), fat 25·3 % (22·8, 28·0) and protein 13·7 % (12·3, 15·1). The proportion of population consuming fruit and vegetables was 51·6 %; unhealthy foods, 29·4 %; and sugar-sweetened beverages (SSBs), 39·9 %. Two-thirds (68·8 %) consumed animal-source proteins. Dietary diversity scores were within the mid-range. Meal patterns were structured (typically three meals per day), with evidence lacking on snacking or eating out.

CONCLUSIONS

Population-level diets fell within WHO macronutrient recommendations, were relatively diverse with structured meal patterns, but some indications of nutrition transition were apparent. The proportion of population consuming fruit and vegetables was low compared to healthy-eating recommendations, and consumption of SSBs was widespread. A paucity of evidence from 1971 to 2010 precluded a longitudinal analysis of nutrition transition. Evidence from these two countries indicates which aspects of dietary behaviours may be contributing to increasing overweight/obesity, namely a low proportion of population consuming fruit and vegetables and widespread consumption of SSBs. These are potential targets for promoting healthier diets.

Transitions to adulthood and the changing body mass index of adolescent girls in Zambia

Adolescent girls in low‐ and middle‐income countries often experience several important life transitions, including school‐leaving, marriage, and childbearing. Understanding how these transitions are associated with changes in the nutritional status of adolescent girls and young women (AGYW) is crucial for programs that aim to improve nutritional outcomes among youth and promote healthy transitions to adulthood. We investigated the associations between adolescent transitions and body mass index (BMI) among a cohort of 4887 adolescent girls in Zambia aged 10–19 years when first interviewed in 2013. Estimating fixed‐effects models controlling for constant and time‐varying confounders, we found that school‐leaving, marital status, and childbearing are associated with the nutritional status of AGYW in diverse ways. School‐leaving was associated with higher BMI and increased odds of overweight/obesity. Marriage was not only associated with increased odds of undernutrition, particularly in rural areas, but also with increased odds of overweight/obesity among older girls. Motherhood was associated with lower BMI and lower odds of overweight/obesity, particularly among breastfeeding mothers. Our results provide evidence of characteristics of AGYW that would be useful for targeted nutritional interventions and behavior change programming, including girls leaving school, recently married, and young women undergoing a marital separation, as well as young mothers and their children.

Prevalence and factors associated with overweight and obesity among rural and urban women in Burkina Faso

Introduction

Low- and middle-income countries, including Burkina Faso, are facing increasing urbanization with health challenges related to nutrition transition that impact body weight change. This study reported the prevalence and factors associated with overweight/obesity among women living in rural and urban Burkina Faso.

Methods

We conducted a secondary analysis using data from the Burkina Faso 2013 WHO STEPwise survey. Data included socio-demographic, clinical (anthropometric, systolic/diastolic blood pressure (SBP/DBP), oral/dental symptoms), biological (total and high-density lipoprotein cholesterol and fasting blood sugar), and alcohol and tobacco consumption data. A total of 2191 participants with complete data were considered in the analysis. We categorized the 13 Burkinabe regions by urbanization rate quartiles. We then performed Student's t, chi-squared, and Fisher's exact tests and backward stepwise regressions.

Results

The overall prevalence of overweight/obesity was 19.6% (13.1% and 44% in rural and urban women respectively, p=0.0001). Common factors positively associated with overweight/obesity in both rural and urban women were being a resident of a region in the highest urbanization rate quartile, having a high level of total cholesterol (alone or via an interaction with age) and having a high DBP. In urban women only, overweight/obesity was also associated with a high SBP.

Conclusion

The prevalence of overweight/obesity in urban women in Burkina was among the highest levels in urban sub-Saharan Africa and roughly mimicked the urbanization profile of the country. In overweight/obesity conditions, cardiovascular concerns, such as increase in total cholesterol and blood pressure, were objective, and the blood pressure increase was more severe in urban women than in rural women.

Overweight and obesity epidemic in Ghana-a systematic review and meta-analysis

Background

In many low and middle income countries (LMICs), the distribution of adulthood nutritional imbalance is shifting from a predominance of undernutrition to overnutrition. This complex problem poses a huge challenge to governments, non-state actors, and individuals desirous of addressing the problem of malnutrition in LMICs. The objective of this study was to systematically review the literature towards providing an estimate of the prevalence of overweight and obesity among adult Ghanaians.

Methods

This study followed the recommendations outlined in the PRISMA statement. Searches were performed in PubMed, Science Direct, google scholar, Africa Journals Online (AJOL) and the WHO African Index Medicus database. This retrieved studies (published up to 31st March 2016) that reported overweight and obesity prevalence among Ghanaians. All online searches were supplemented by reference screening of retrieved papers to identify additional studies.

Results

Forty-three (43) studies involving a total population of 48,966 sampled across all the ten (10) regions of Ghana were selected for the review. Our analysis indicates that nearly 43% of Ghanaian adults are either overweight or obese. The national prevalence of overweight and obesity were estimated as 25.4% (95% CI 22.2–28.7%) and 17.1% (95% CI = 14.7–19.5%), respectively. Higher prevalence of overweight (27.2% vs 16.7%) and obesity (20.6% vs 8.0%) were estimated for urban than rural dwellers. Prevalence of overweight (27.8% vs 21.8%) and obesity (21.9% vs 6.0%) were also significantly higher in women than men. About 45.6% of adult diabetes patients in Ghana are either overweight or obese. At the regional level, about 43.4%, 36.9%, 32.4% and 55.2% of residents in Ashanti, Central, Northern and Greater Accra region, respectively are overweight or obese. These patterns generally mimic the levels of urbanization. Per studies’ publication years, consistent increases in overweight and obesity prevalence were observed in Ghana in the period 1998–2016.

Conclusions

There is a high and rising prevalence of overweight and obesity among Ghanaian adults. The possible implications on current and future population health, burden of chronic diseases, health care spending and broader economy could be enormous for a country still battling many infectious and parasitic diseases. Public health preventive measures that are appropriate for the Ghanaian context, culturally sensitive, cost-effective and sustainable are urgently needed to tackle this epidemic.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3901-4) contains supplementary material, which is available to authorized users.

Examining the Risk Factors Associated With Hypertension Among the Elderly in Ghana

OBJECTIVE

This study sought to examine the risk factors associated with hypertension among the elderly in Ghana. We focused on the association between chronic diseases, socioeconomic factors, and being hypertensive.

METHOD

Data for the study were drawn from Wave 1 of the 2007/2008 Ghana Study on Global Ageing and Adult Health (SAGE). A binary logit model was used to estimate the effect of other noncommunicable diseases, psychosocial factors, lifestyle factors, and sociocultural and biosocial factors on the elderly being hypertensive.

RESULTS

Elderly Ghanaians who had been diagnosed with arthritis, angina, diabetes, and asthma were significantly more likely to be hypertensive. Additionally, those depressed were found to be 1.22 times more likely to be hypertensive.

DISCUSSION

Prevention and control of hypertension are complex and demand multistakeholder collaboration including governments, educational institutions, media, food and beverage industry, and a conscious focus on personal lifestyle factors.