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Hormenu T, Salifu I, Paku JE, Awlime-Ableh E, Antiri EO, Gabla AMH, Arthur RA, Nyane B, Amoah S, Banson C, Prah JK. Unmasking the Risk Factors Associated with Undiagnosed Diabetes and Prediabetes in Ghana: Insights from Cardiometabolic Risk (CarMeR) Study-APTI Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:836. [PMID: 39063413 PMCID: PMC11276330 DOI: 10.3390/ijerph21070836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/28/2024] [Accepted: 04/29/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION Undiagnosed diabetes poses significant public health challenges in Ghana. Numerous factors may influence the prevalence of undiagnosed diabetes among adults, and therefore, using a model that takes into account the intricate network of these relationships should be considered. Our goal was to evaluate fasting plasma levels, a critical indicator of diabetes, and the associated direct and indirect associated or protective factors. METHODS This research employed a cross-sectional survey to sample 1200 adults aged 25-70 years who perceived themselves as healthy and had not been previously diagnosed with diabetes from 13 indigenous communities within the Cape Coast Metropolis, Ghana. Diabetes was diagnosed based on the American Diabetes Association (ADA) criteria for fasting plasma glucose, and lipid profiles were determined using Mindray equipment (August 2022, China). A stepwise WHO questionnaire was used to collect data on sociodemographic and lifestyle variables. We analyzed the associations among the exogenous, mediating, and endogenous variables using a generalized structural equation model (GSEM). RESULTS Overall, the prevalence of prediabetes and diabetes in the Cape Coast Metropolis was found to be 14.2% and 3.84%, respectively. In the sex domain, females had a higher prevalence of prediabetes (15.33%) and diabetes (5.15%) than males (12.62% and 1.24%, respectively). Rural areas had the highest prevalence, followed by peri-urban areas, whereas urban areas had the lowest prevalence. In the GSEM results, we found that body mass index (BMI), triglycerides (TG), systolic blood pressure (SBP), gamma-glutamyl transferase (GGT), and female sex were direct predictive factors for prediabetes and diabetes, based on fasting plasma glucose (FPG) levels. Indirect factors influencing diabetes and prediabetes through waist circumference (WC) included childhood overweight status, family history, age 35-55 and 56-70, and moderate and high socioeconomic status. High density lipoprotein (HDL) cholesterol, childhood overweight, low physical activity, female sex, moderate and high socioeconomic status, and market trading were also associated with high BMI, indirectly influencing prediabetes and diabetes. Total cholesterol, increased TG levels, WC, age, low physical activity, and rural dwellers were identified as indirectly associated factors with prediabetes and diabetes through SBP. Religion, male sex, and alcohol consumption were identified as predictive factors for GGT, indirectly influencing prediabetes and diabetes. CONCLUSIONS Diabetes in indigenous communities is directly influenced by blood lipid, BMI, SBP, and alcohol levels. Childhood obesity, physical inactivity, sex, socioeconomic status, and family history could indirectly influence diabetes development. These findings offer valuable insights for policymakers and health-sector stakeholders, enabling them to understand the factors associated with diabetes development and implement necessary public health interventions and personalized care strategies for prevention and management in Ghana.
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Affiliation(s)
- Thomas Hormenu
- Department of Health, Physical Education and Recreation, Faculty of Science Technology Education, College of Education Studies, University of Cape Coast, Cape Coast 00233, Ghana; (J.E.P.); (E.A.-A.); (E.O.A.); (A.M.-H.G.)
- Cardiometabolic Epidemiology Research Laboratory, Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast 00233, Ghana; (I.S.); (R.A.A.); (B.N.)
| | - Iddrisu Salifu
- Cardiometabolic Epidemiology Research Laboratory, Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast 00233, Ghana; (I.S.); (R.A.A.); (B.N.)
| | - Juliet Elikem Paku
- Department of Health, Physical Education and Recreation, Faculty of Science Technology Education, College of Education Studies, University of Cape Coast, Cape Coast 00233, Ghana; (J.E.P.); (E.A.-A.); (E.O.A.); (A.M.-H.G.)
- Cardiometabolic Epidemiology Research Laboratory, Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast 00233, Ghana; (I.S.); (R.A.A.); (B.N.)
| | - Eric Awlime-Ableh
- Department of Health, Physical Education and Recreation, Faculty of Science Technology Education, College of Education Studies, University of Cape Coast, Cape Coast 00233, Ghana; (J.E.P.); (E.A.-A.); (E.O.A.); (A.M.-H.G.)
- Cardiometabolic Epidemiology Research Laboratory, Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast 00233, Ghana; (I.S.); (R.A.A.); (B.N.)
| | - Ebenezer Oduro Antiri
- Department of Health, Physical Education and Recreation, Faculty of Science Technology Education, College of Education Studies, University of Cape Coast, Cape Coast 00233, Ghana; (J.E.P.); (E.A.-A.); (E.O.A.); (A.M.-H.G.)
- Cardiometabolic Epidemiology Research Laboratory, Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast 00233, Ghana; (I.S.); (R.A.A.); (B.N.)
| | - Augustine Mac-Hubert Gabla
- Department of Health, Physical Education and Recreation, Faculty of Science Technology Education, College of Education Studies, University of Cape Coast, Cape Coast 00233, Ghana; (J.E.P.); (E.A.-A.); (E.O.A.); (A.M.-H.G.)
- Cardiometabolic Epidemiology Research Laboratory, Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast 00233, Ghana; (I.S.); (R.A.A.); (B.N.)
| | - Rudolf Aaron Arthur
- Cardiometabolic Epidemiology Research Laboratory, Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast 00233, Ghana; (I.S.); (R.A.A.); (B.N.)
- Directorate of University Health Services, University of Cape Coast, Cape Coast 00233, Ghana; (S.A.); (C.B.); (J.K.P.)
| | - Benjamin Nyane
- Cardiometabolic Epidemiology Research Laboratory, Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast 00233, Ghana; (I.S.); (R.A.A.); (B.N.)
- Directorate of University Health Services, University of Cape Coast, Cape Coast 00233, Ghana; (S.A.); (C.B.); (J.K.P.)
| | - Samuel Amoah
- Directorate of University Health Services, University of Cape Coast, Cape Coast 00233, Ghana; (S.A.); (C.B.); (J.K.P.)
| | - Cecil Banson
- Directorate of University Health Services, University of Cape Coast, Cape Coast 00233, Ghana; (S.A.); (C.B.); (J.K.P.)
| | - James Kojo Prah
- Directorate of University Health Services, University of Cape Coast, Cape Coast 00233, Ghana; (S.A.); (C.B.); (J.K.P.)
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Afriyie-Adjimi H, Nkyi AK. Impact of body image and perceived stigmatization on the psychological wellbeing of obese women in Kumasi metropolis, Ghana. PLoS One 2024; 19:e0296061. [PMID: 38574001 PMCID: PMC10994485 DOI: 10.1371/journal.pone.0296061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/05/2023] [Indexed: 04/06/2024] Open
Abstract
Obesity is found to have a significant impact on body image perception and overall well-being. This study examines the impact of body image and perceived stigmatization on the psychological wellbeing of obese women in Kumasi metropolis, Ghana. A sample of 231 obese women was selected from health shops and some fitness centers using snowballing technique (purposive, snowballing technique and convenience). The study employed the descriptive survey design and made use of both descriptive and inferential data analysis approaches. The body shape questionnaire BSQ-34, the inventory of the Stigmatization Situation (SSI) and finally, the psychological well-being tools were used. Also, frequency distributions mean, and standard deviation, Pearson correlation coefficient and simple linear regression analysis were employed using SPSS version 23. Our findings indicated that obese women in the Kumasi metropolis were significantly satisfied with their body image. This is a true reflection of their higher self-esteem and standard of living. The body image and perceived stigmatization on the psychological wellbeing of the obese do have some counselling implications. Counselors, nutritionists, and clinical psychologists address specific schemes such as binge eating, dieting, and exercising to build the self-esteem of obese women.
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Affiliation(s)
| | - Anthony Kwabena Nkyi
- Department of Guidance and Counselling, Faculty of Educational Foundations, College of Education Studies, University of Cape Coast, Cape Coast, Ghana
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Vander-Pallen R, Domfeh EA, Hayford FEA, Asante M, Amoah AGB, Asare GA, Wiredu EK. Nutritional status and effect of highly active anti-retroviral therapy (HAART) on selected trace elements in people living with HIV in Ghana. SCIENTIFIC AFRICAN 2023. [DOI: 10.1016/j.sciaf.2023.e01586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
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Mensah Bonsu I, Myezwa H, Brandt C, Ajidahun AT, Moses MO, Asamoah B. An exploratory study on excess weight gain: Experiences of Postmenopausal Women in Ghana. PLoS One 2023; 18:e0278935. [PMID: 36638076 PMCID: PMC9838829 DOI: 10.1371/journal.pone.0278935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/23/2022] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Excess weight gain is a problem with a significant impact on health and quality of life as well as the consequent economic burden on human populations. While society advocates preference for excess weight gain, limited evidence exists concerning postmenopausal women's experiences in Ghana. AIM The current study explored the experiences regarding excess weight (overweight and obesity) gain among Ghanaian postmenopausal women in Bono East (Techiman) region. METHODS This is a qualitative exploratory descriptive study where anthropometric measurements [body mass index (BMI), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR)] were determined and participants who were identified with excess weight (obesity and overweight) were recruited to participate in a focus group discussion (FGD). Four focus group discussions were held and 24 postmenopausal women (>45 years) in Techiman took part. Discussions were audio-recorded and transcribed for thematic analysis. RESULTS From the qualitative analysis of the FGD, three major themes emerged from the study namely, (i) perception of body weight, (ii) measures to reduce body weight, and (iii) support to adhere to the weight management program. Sub-themes revealed that weight gained was viewed as the presence of diseases and admired by society as a culturally accepted body image. Diet-related changes, a combination of diet modification and physical activity, and weight management supplements emerged as measures to reduce excess weight. Support to adhere to the weight program included health education, access, affordable exercise facilities, and social support. CONCLUSIONS Sociocultural norms influence the image perception and acceptance of weight gain among postmenopausal women in Ghana, but there is an acknowledgment of the perceived negative health implications of such excess weight. Measures for weight reduction and support to adhere to the weight reduction programme require attention in Ghana.
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Affiliation(s)
- Isaac Mensah Bonsu
- Department of Physiotherapy, School of Therapeutic Sciences, University of The Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | - Hellen Myezwa
- Department of Physiotherapy, School of Therapeutic Sciences, University of The Witwatersrand, Johannesburg, South Africa
| | - Corlia Brandt
- Department of Physiotherapy, School of Therapeutic Sciences, University of The Witwatersrand, Johannesburg, South Africa
| | - Adedayo Tunde Ajidahun
- Department of Physiotherapy, School of Therapeutic Sciences, University of The Witwatersrand, Johannesburg, South Africa
| | - Monday Omoniyi Moses
- Faculty of Allied Health Sciences, Department of Physiotherapy and Sports Science, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Benjamin Asamoah
- Faculty of Allied Health Sciences, Department of Physiotherapy and Sports Science, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Mensah Bonsu I, Brandt C, Ajidahun AT, Omoniyi M, Myezwa H. Physical activity, lifestyle, sociocultural factors and prevalence of excess weight gain among postmenopausal women: A cross-sectional study. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231184508. [PMID: 38099449 PMCID: PMC10725110 DOI: 10.1177/17455057231184508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Most women experienced postmenopausal symptoms during the menopause transition, and they are a common reason for seeking medical attention and lifestyle modification during this phase of life. OBJECTIVE This study assessed the physical activity, lifestyle, and sociocultural levels-associated prevalence of excess weight (overweight and obesity) among postmenopausal women (PW) in Bono-East (Techiman) region, Ghana. DESIGN This is cross-sectional study. METHOD This was a cross-sectional study conducted at Bono-East regional capital, Techiman in Ghana over 5 months. Self-administered questionnaires were used to obtain sociodemographic data, physical activity, lifestyle, and sociocultural associated prevalence of excess weight. Anthropometric indices including ((body mass index (BMI), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR)) were assessed. RESULTS A total of 393 postmenopausal women with a mean age of 60.09 ± 6.24 years participated in the study. When reporting prevalence, obesity, and overweight were distinguished. Using the anthropometric parameters (BMI, WHtR, and WHR) as measured for being overweight, the prevalent rates were 35.7%, 21.7%, and 9.0% respectively. Also, when using obesity, the prevalent rate was 37.8%, 70.1%, and 82.0% using BMI, WHtR, and WHR, respectively. Over 55 (55.2%) of the study participants engaged in moderate physical activities, 23.1% were low and 21.7% with high physical activities. Housewives and unemployed participants are shown to have a higher risk of gaining weight (obese) especially when assessed with WHR and WHtR. Most participants responded that cultural beliefs prevent them from losing weight. Most participants had a poor attitude toward their eating habits. CONCLUSION According to the findings, postmenopausal Ghanaian women showed a high level of obesity and a moderate level of being overweight. The cultural perception of beauty influences Ghanaian postmenopausal women's physical activity level and dietary habits.
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Affiliation(s)
- Isaac Mensah Bonsu
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Corlia Brandt
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Adedayo Tunde Ajidahun
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Moses Omoniyi
- Department of Physiotherapy and Sports Science, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Hellen Myezwa
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Clark SN, Bennett JE, Arku RE, Hill AG, Fink G, Adanu RM, Biritwum RB, Darko R, Bawah A, Duda RB, Ezzati M. Small area variations and factors associated with blood pressure and body-mass index in adult women in Accra, Ghana: Bayesian spatial analysis of a representative population survey and census data. PLoS Med 2021; 18:e1003850. [PMID: 34762663 PMCID: PMC8584976 DOI: 10.1371/journal.pmed.1003850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/14/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Body-mass index (BMI) and blood pressure (BP) levels are rising in sub-Saharan African cities, particularly among women. However, there is very limited information on how much they vary within cities, which could inform targeted and equitable health policies. Our study aimed to analyse spatial variations in BMI and BP for adult women at the small area level in the city of Accra, Ghana. METHODS AND FINDINGS We combined a representative survey of adult women's health in Accra, Ghana (2008 to 2009) with a 10% random sample of the national census (2010). We applied a hierarchical model with a spatial term to estimate the associations of BMI and systolic blood pressure (SBP) and diastolic blood pressure (DBP) with demographic, socioeconomic, behavioural, and environmental factors. We then used the model to estimate BMI and BP for all women in the census in Accra and calculated mean BMI, SBP, and DBP for each enumeration area (EA). BMI and/or BP were positively associated with age, ethnicity (Ga), being currently married, and religion (Muslim) as their 95% credible intervals (95% CrIs) did not include zero, while BP was also negatively associated with literacy and physical activity. BMI and BP had opposite associations with socioeconomic status (SES) and alcohol consumption. In 2010, 26% of women aged 18 and older had obesity (BMI ≥ 30 kg/m2), and 21% had uncontrolled hypertension (SBP ≥ 140 and/or DBP ≥ 90 mm Hg). The differences in mean BMI and BP between EAs at the 10th and 90th percentiles were 2.7 kg/m2 (BMI) and in BP 7.9 mm Hg (SBP) and 4.8 mm Hg (DBP). BMI was generally higher in the more affluent eastern parts of Accra, and BP was higher in the western part of the city. A limitation of our study was that the 2010 census dataset used for predicting small area variations is potentially outdated; the results should be updated when the next census data are available, to the contemporary population, and changes over time should be evaluated. CONCLUSIONS We observed that variation of BMI and BP across neighbourhoods within Accra was almost as large as variation across countries among women globally. Localised measures are needed to address this unequal public health challenge in Accra.
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Affiliation(s)
- Sierra N. Clark
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, United Kingdom
| | - James E. Bennett
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, United Kingdom
| | - Raphael E. Arku
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, United States of America
| | - Allan G. Hill
- Department of Social Statistics and Demography, University of Southampton, Southampton, United Kingdom
| | - Günther Fink
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
| | - Richard M. Adanu
- Department of Population, Family, and Reproductive Health, University of Ghana, Accra, Ghana
| | | | - Rudolph Darko
- School of Medicine, University of Ghana, Accra, Ghana
| | - Ayaga Bawah
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - Rosemary B. Duda
- Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, United Kingdom
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
- Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, United Kingdom
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Tagbo SO, Abebe D, Oguoma VM. Overweight and obesity among non-pregnant women of reproductive age in Nigeria: findings from the 2008-2018 Nigerian Demographic and Health Survey. Public Health 2021; 198:348-357. [PMID: 34530237 DOI: 10.1016/j.puhe.2021.07.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/19/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Overweight and obesity are known risk factors for diabetes, heart disease, certain cancers and pregnancy-related problems. This study aimed to determine the prevalence and change in prevalence of overweight and obesity among non-pregnant women of reproductive age and relationship with individual- and community-level factors over a decade. STUDY DESIGN This was a cross-sectional survey with two-stage probability sampling design. METHODS Data sets were pooled from the 2008, 2013 and 2018 Nigerian Demographic and Health Survey - a cross-sectional, nationally representative sample of the entire Nigerian population aged 15-49 years. Body mass index (BMI) was used to classify overweight and obesity. Multilevel logistic regression was used to assess associations between overweight (25.0-29.9 kg/m2), obesity (≥30.0 kg/m2) and individual and community factors. RESULTS There were 76,729 non-pregnant women (38.0% in 2008, 44.5% in 2013 vs 17.5% in 2018) with a mean age of 29.0 years and a BMI of 23.0 kg/m2 across the three survey periods. Overweight and obesity prevalence were 16.0% and 6.2% in 2008, 17.2% and 7.5% in 2013 and 18.1% and 9.9% in 2018, respectively. There was 76% (95% confidence interval: 44% to twofold) increased odds of obesity in 2018 compared with 2008 in adjusted analysis. Older women with at least primary education living in urban areas, ever married and from wealthier households are at a greater odd of being overweight and obese. CONCLUSION Over a decade, overweight and obesity prevalence increased among non-pregnant women of reproductive age in Nigeria. There is an urgent need for public health strategies and interventions to improve on deficient knowledge and low awareness about healthy foods and physical activity at individual and community levels especially in urban areas.
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Affiliation(s)
- S O Tagbo
- Oceania University of Medicine, North Rocks, New South Wales, Australia
| | - D Abebe
- Oceania University of Medicine, North Rocks, New South Wales, Australia
| | - V M Oguoma
- Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia; Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
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Golzarand M, Salari-Moghaddam A, Mirmiran P. Association between alcohol intake and overweight and obesity: a systematic review and dose-response meta-analysis of 127 observational studies. Crit Rev Food Sci Nutr 2021; 62:8078-8098. [PMID: 33998940 DOI: 10.1080/10408398.2021.1925221] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Several studies have assessed the relationship between alcohol intake and overweight/obesity; however, the reported results are inconsistent. Therefore, the present systematic review and dose-response meta-analysis of observational studies was designed to investigate the association between alcohol intake and general and abdominal obesity among the adults. Literature search was conducted in the PubMed/Medline and Web of Science databases up to August 2020. Odds ratio (OR), risk ratio (RR), or hazard ratio (HR) with 95% confidence interval (95% CI) were used to pool effect size. To conduct dose-response meta-analysis, amount of alcohol intake was classified into three categories including light (<14 g/d), moderate (14-28 g/d), and heavy (>28 g/d). In the present study, 127 eligible studies were included. In cohort studies, there was no significant association between alcohol drinking and risk of overweight (OR: 0.93, 95% CI: 0.46 to 1.89), obesity (OR: 0.84, 95% CI: 0.52 to 1.37), overweight/obesity (OR: 1.15, 95% CI: 0.84 to 1.58), and abdominal obesity (OR: 1.13, 95% CI: 0.90 to 1.41). In cross-sectional studies, alcohol intake was associated with the increased odds of overweight (OR: 1.11, 95% CI: 1.05 to 1.18), overweight/obesity (OR: 1.23, 95% CI: 1.11 to 1.37), and abdominal obesity (OR: 1.19, 95% CI: 1.09 to 1.29); but not obesity (OR: 1.03, 95% CI: 0.95 to 1.12). Results of dose-response analysis indicated that heavy alcohol drinking was positively associated with odds of overweight (OR: 1.12, 95% CI: 1.01 to 1.24), overweight/obesity (OR: 1.32, 95% CI: 1.16 to 1.51), and abdominal obesity (OR: 1.25, 95% CI: 1.12 to 1.38) compared to non- or light alcohol drinking. There was no publication bias among studied on outcomes of interest. In conclusion, our results revealed alcohol drinkers, especially heavy alcohol drinkers, had increased odds of overweight, overweight/obesity, and abdominal obesity than non-alcohol drinker or light alcohol drinkers among cross-sectional studies but not cohort studies.
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Affiliation(s)
- Mahdieh Golzarand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asma Salari-Moghaddam
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Osunkwo DA, Nguku PM, Mohammed A, Umeokonkwo CD, Kamateeka M, Ibrahim M, Kefas IB, Abolade OS, Nwokeukwu HI, Zoakah AI. Prevalence of obesity and associated factors in Benue State, Nigeria: A population-based study. Ann Afr Med 2021; 20:9-13. [PMID: 33727505 PMCID: PMC8102896 DOI: 10.4103/aam.aam_36_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: The prevalence of obesity has risen to over 650 million adults in 2016, and accounts for 41 million deaths globally. It is a major contributor to the burden of noncommunicable diseases. We determined the prevalence and associated factors of obesity to inform policy decisions toward developing robust prevention and management strategies. Materials and Methods: We conducted a population-based cross-sectional study in July 2017 among 1265 adults in urban and rural communities in Benue State. We used multistage sampling technique in selecting the participants. The WHO standardized and validated tool were used to collect information on sociodemographic and anthropometric measurements. We calculated age standardized prevalence of obesity and determined factors associated with obesity using logistic regression at 5% level of significance. Results: The age standardized prevalence of obesity was 11.1% (rural 4.2%, urban 14.3%). The odds for obesity was higher among females (adjusted odds ratio [aOR]: 3.4; 95% confidence interval [CI]: 2.27–4.99), those with tertiary education (aOR: 3.3; 95% CI: 1.61–6.95), married (aOR: 2.1; 95% CI: 1.37–3.36), and those residing in urban areas (aOR: 3.0; 95% CI: 1.73–5.05) compared to rural dwellers. Conclusions: The prevalence of obesity was high among adults in Benue State. It is more prevalent among females, married, educated, and urban dwellers. Interventions targeted at healthy lifestyle choices should be directed at these populations for effective control.
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Affiliation(s)
- Damaris Amarachukwu Osunkwo
- Department of Medicine, National Hospital; African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - Patrick M Nguku
- African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - Amina Mohammed
- Department of Family Health, National Bureau of Statistics, Abuja; Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Chukwuma David Umeokonkwo
- African Field Epidemiology Network, Nigeria Country Office, Abuja; Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Moreen Kamateeka
- African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - Mohammed Ibrahim
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | - Oladimeji S Abolade
- Department of Demography and Social Statistics, National Bureau of Statistics, Abuja, Nigeria
| | | | - Ayuba Ibrahim Zoakah
- Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
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Sirikyi IH, Eliason S, Ghartey FN, Ekenam E, Pereko KKA, Okai E, Yiridong F, Hagan OCK, Nsiah P. Anthropometric indices and cardiometabolic risk factors in a Ghanaian adolescent population. J Pediatr Endocrinol Metab 2021; 34:35-44. [PMID: 33581703 DOI: 10.1515/jpem-2020-0273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 08/11/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Adolescent overweight and obesity is a public health concern globally, especially in lower- and middle- income countries where there is an additional burden of undernutrition. The prevalence of adolescent overweight/2obesity has increased markedly over the past three decades. The transition in dietary habits coupled with reduced physical activity has been blamed for the increasing trend. Overweight/obesity in adolescence is complicated by cardiometabolic, respiratory, musculoskeletal and psychosocial disorders. Additionally, adolescent obesity is a predictor of future development of type 2 diabetes, cardiovascular diseases and metabolic disorders. The burden of cardiometabolic risk factors associated with adolescent overweight/obesity in Ghana is lacking, the project, therefore, was undertaken to add to the existing knowledge. METHODS The study was undertaken in adolescent students of a tertiary institution in Ghana. Two hundred and one students consented to participate in the study. Questionnaires on sociodemographic characteristics, dietary and substance abuse habits were self-administered. Blood pressure, height, weight and waist circumference measures were performed and venous blood drawn for the determination of fasting serum total/LDL/HDL cholesterol and triglycerides. Body mass indices were determined as the weight per square of their heights. RESULTS The prevalence of obesity was determined to be 15.81% generally, 27.71% in the females and 7.08% in the males. Diastolic blood pressure was the only cardiometabolic risk factor significantly associated with obesity in our study. CONCLUSION Overweight/obesity is common in Ghanaian adolescents, with the prevalence highest in the female population.
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Affiliation(s)
| | - Sebastian Eliason
- University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Frank N Ghartey
- University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Evans Ekenam
- University of Cape Coast Hospital Cape Coast Ghana, Cape Coast, Ghana
| | | | - Emmanuel Okai
- University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Felix Yiridong
- University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Oheneba C K Hagan
- University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Paul Nsiah
- University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
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Amegbor PM, Rosenberg MW. Health and socioeconomic risk factors for overnight admission among older adults in Ghana. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09294-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Mensah KB, Mensah ABB. Cancer control in Ghana: A narrative review in global context. Heliyon 2020; 6:e04564. [PMID: 32775744 PMCID: PMC7404540 DOI: 10.1016/j.heliyon.2020.e04564] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 09/21/2019] [Accepted: 07/23/2020] [Indexed: 12/12/2022] Open
Abstract
Globally, cancer is likely to be ranked as the leading cause of death among non-communicable diseases in the 21st century. In Ghana, estimates suggest that the disease is expected to increase continuously. The best way to address the increasing burden is through a comprehensive cancer control program. This paper presents an appraisal of the literature, reports and, studies that seek to highlight strategies for cancer control globally and in Ghana. In consideration of literature, a search of relevant databases (PubMed, Google Scholar, Cochrane Database of Systematic Reviews, Google, International organizations web pages, International reports, Ministry of Health of Ghana reports, and textbooks) was performed. A narrative review of the background information on this subject is provided to inform future research on cancer control. This review was conducted as part of a study to involve community pharmacists in cancer detection and prevention in Ghana.
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Affiliation(s)
- Kofi Boamah Mensah
- Department of Pharmacy Practice, Faculty of Pharmacy & Pharmaceutical Science, College of Health Science, Kwame Nkrumah University of Science & Technology, Ghana
- University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, College of Health Sciences, Westville Campus, University Road, Durban, South Africa
| | - Adwoa Bemah Boamah Mensah
- Department of Nursing, College of Health Science, Kwame Nkrumah University of Science & Technology, Ghana
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13
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Mohammed AS, Adem F, Tadiwos Y, Woldekidan NA, Degu A. Level of Adherence to the Dietary Recommendation and Glycemic Control Among Patients with Type 2 Diabetes Mellitus in Eastern Ethiopia: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:2605-2612. [PMID: 32801812 PMCID: PMC7384875 DOI: 10.2147/dmso.s256738] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/08/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Dietary modification is the cornerstone and initial recommendation in the management of diabetes mellitus. Adhering to the recommended dietary practice has a significant role in diabetic control, but not uniformly practised. OBJECTIVE To assess dietary adherence and glycemic control among type 2 diabetic patients on follow-up at Dilchora Referral Hospital (DRH), Dire Dawa, Eastern Ethiopia. METHODS A hospital-based cross-sectional study was conducted from 22 August to 23 October 2019, at DRH. Data were collected through an interviewer-administered questionnaire. The Perceived Dietary Adherence Questionnaire (PDAQ) was used to estimate the level of dietary adherence. Glycemic control was measured using fasting blood glucose. Multivariate logistic regression analyses were employed to identify factors associated with dietary adherence. RESULTS Of the 307 included patients, 62.5% were poorly adherent to the recommended diet. Lack of dietary education (83.38%) and inability to afford a healthy diet (71.33%) were the perceived barriers to practice dietary recommendation. More than half (54.7%) failed to achieve the recommended fasting blood glucose target. In multivariate logistic regression, patients who were adherent to dietary recommendations were 3.56 times more likely to have good glycemic control. Those patients living in urban areas, having monthly income greater than 1000 Ethiopia Birr, family history of the disease, duration of treatment greater than 10 years and who received counseling were more likely to have good dietary adherence. CONCLUSION The level of adherence to the dietary recommendation and glycemic control was low. Healthcare providers should be proactive in tackling the barrier for non-adherence and should promote adherence to dietary recommendations in T2DM patients.
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Affiliation(s)
- Ammas Siraj Mohammed
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fuad Adem
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yohannes Tadiwos
- Department of Pharmacology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Nigist Alemayehu Woldekidan
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amsalu Degu
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy and Health Science, United States International University Africa, Nairobi, Kenya
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Amegah AK, Boachie J, Näyhä S, Jaakkola JJK. Association of biomass fuel use with reduced body weight of adult Ghanaian women. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:670-679. [PMID: 30804452 DOI: 10.1038/s41370-019-0129-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/21/2019] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
The association of biomass fuel use with body weight has never been investigated. We therefore examined the effect of biomass fuel use on body weight of adult Ghanaian women. Data from the 2014 Ghana Demographic and Health Survey, a nationally representative population-based survey was analysed for this study. A total of 4751 women who had anthropometric (height and weight) data qualified for inclusion in this study. In linear regression modelling, charcoal use resulted in 3.08 kg (95% CI: 2.04, 4.12) and 0.81 kg/m2 (95%CI: 0.29, 1.33) reduction in weight and body mass index (BMI), respectively, compared to clean fuel (electricity, liquefied petroleum gas and natural gas) use. Use of wood resulted in much higher reduction in weight and BMI. In modified Poisson regression, charcoal users had 19% (Adjusted Prevalence Ratio [aPR] = 0.81; 95%CI: 0.71, 0.92) and 29% (aPR = 0.71; 95%CI: 0.61, 0.83) decreased risk of overweight and obesity, respectively, compared to clean fuel users. Wood users had much higher decreased risk of overweight and obesity. In conclusion, biomass fuel use was associated with reduced body weight and BMI of Ghanaian women and is the first report on the relationship. However, it is important that our findings are confirmed and the biological mechanisms elucidated through rigorous study designs.
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Affiliation(s)
- A Kofi Amegah
- Public Health Research Group, Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Johnmark Boachie
- Public Health Research Group, Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Simo Näyhä
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
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Lartey NL, Asare-Anane H, Ofori EK, Antwi S, Asiedu-Larbi J, Ayertey F, Okine LKN. Antidiabetic activity of aqueous stem bark extract of Annickia polycarpa in alloxan-induced diabetic mice. J Tradit Complement Med 2020; 11:109-116. [PMID: 33728270 PMCID: PMC7936091 DOI: 10.1016/j.jtcme.2020.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 02/01/2020] [Accepted: 02/03/2020] [Indexed: 11/28/2022] Open
Abstract
Background and aim There is a growing need to develop new drugs for type II diabetes mellitus (DM) from plant sources due to the high cost and adverse side effects of current drug therapies. To this end, the antidiabetic activity of aqueous stem-bark extract of A. polycarpa (APE) in alloxan-induced diabetic ICR mice was investigated. Experimental procedure The effect of APE (20, 100 and 500 mg/kg), glibenclamide and metformin as positive controls, were determined over 4 weeks on fasting blood glucose (FBG). An oral glucose tolerance test (OGTT) was also conducted. The effects of these treatments on the morphology of the pancreas were assessed. In addition, phytochemical constituents and antioxidant properties of APE were determined. Results and conclusion APE, like glibenclamide and metformin, showed significant hypoglycaemic effect. The OGTT supported the hypoglycaemic effect. The destroyed pancreatic beta-cells in diabetic control mice were restored to normal by APE or drug treatment. APE showed antioxidant activity by scavenging DPPH free radicals; this may be due to the presence of phenolic compounds, particularly flavonoids. Thus, APE may act by restoring pancreatic beta-cell integrity through mopping of reactive oxygen species (ROS) associated with the diabetic state, and thereby improving pancreatic function and consequently, the lowering of FBG levels. These findings provide ample evidence to validate the traditional use of A. polycarpa in the management of DM. Aqueous stem bark extract of A. polycarpa (APE) possesses significant antidiabetic activity. APE has the ability to cause the regeneration of beta cells of the pancreas. APE’s possess antioxidant activity and may scavenge ROS, thus help in overcoming advanced complications of DM. Alkaloids and phenolics (flavonoids) detected may be responsible for the hypoglycaemic and antioxidant activity of APE.
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Affiliation(s)
- N L Lartey
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, College of Health Sciences, Accra, Ghana
| | - H Asare-Anane
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, College of Health Sciences, Accra, Ghana
| | - E K Ofori
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, College of Health Sciences, Accra, Ghana
| | - S Antwi
- Pharmacology/Toxicology Department, Centre for Plant Medicine Research, Mampong-Akuapem, Ghana
| | - J Asiedu-Larbi
- Pharmacology/Toxicology Department, Centre for Plant Medicine Research, Mampong-Akuapem, Ghana
| | - F Ayertey
- Pharmacology/Toxicology Department, Centre for Plant Medicine Research, Mampong-Akuapem, Ghana
| | - L K N Okine
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
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Keetile M, Navaneetham K, Letamo G, Bainame K, Rakgoasi SD, Gabaitiri L, Masupe T, Molebatsi R. Socioeconomic and behavioural determinants of overweight/obesity among adults in Botswana: a cross-sectional study. BMJ Open 2019; 9:e029570. [PMID: 31818834 PMCID: PMC6924755 DOI: 10.1136/bmjopen-2019-029570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To undertake a comprehensive assessment of socioeconomic and behavioural determinants of overweight/obesity among adult population in Botswana. DESIGN The study adopted a cross-sectional design by selecting adult respondents in 3 cities and towns, 15 urban villages and 15 rural areas across Botswana using a multistage probability sampling technique. SETTING The study was conducted in selected rural and urban areas of Botswana. PARTICIPANTS The study sample consisted of 1178 adult males and females aged 15 years and above. PRIMARY OUTCOME MEASURES Objectively measured overweight/obesity. RESULTS Prevalence of overweight/obesity in the study population was estimated at 41%. The adjusted OR (AOR) of overweight/obesity were highest among women (AOR=2.74, 95% CI 1.92 to 3.90), in ages 55-64 years (AOR=5.53, 95% CI 2.62 to 11.6), among individuals with secondary (AOR=1.70, 95% CI 1.11 to 2.61) and tertiary education (AOR=1.99, 95% CI 1.16 to 3.38), smokers (AOR=2.16, 95% CI 1.22 to 3.83) and people with poor physically activity (AOR=1.46, 95% CI 1.03 to 3.24). These were statistically significant at 5% level. CONCLUSION Women, older adults, people with high education level, smokers and people who reported poor physical activity were found to have higher odds of being overweight/obesity. These findings suggest the need for broad based strategies encouraging physical activity among different socioeconomic groups.
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Affiliation(s)
- Mpho Keetile
- Department of Population Studies, University of Botswana, Gaborone, Botswana
| | - Kannan Navaneetham
- Department of Population Studies, University of Botswana, Gaborone, Botswana
| | - Gobopamang Letamo
- Department of Population Studies, University of Botswana, Gaborone, Botswana
| | - Kenabetsho Bainame
- Department of Population Studies, University of Botswana, Gaborone, Botswana
| | | | | | - Tiny Masupe
- Department of Family Medicine & Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
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Laar AK, Adler AJ, Kotoh AM, Legido-Quigley H, Lange IL, Perel P, Lamptey P. Health system challenges to hypertension and related non-communicable diseases prevention and treatment: perspectives from Ghanaian stakeholders. BMC Health Serv Res 2019; 19:693. [PMID: 31615529 PMCID: PMC6792211 DOI: 10.1186/s12913-019-4571-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/30/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hypertension, itself a cardiovascular condition, is a significant risk factor for other cardiovascular diseases. Hypertension is recognized as a major public health challenge in Ghana. Beginning in 2014, a collaborative team launched the community-based hypertension improvement program (ComHIP) in one health district in Ghana. The ComHIP project, a public-private partnership, tests a community-based model that engages the private sector and utilizes information and communication technology (ICT) to control hypertension. This paper, focuses on the various challenges associated with managing hypertension in Ghana, as reported by ComHIP stakeholders. METHODS A total of 55 informants - comprising patients, health care professionals, licensed chemical sellers (LCS), national and sub-national policymakers - were purposively selected for interview and focus group discussions (FGDs). Interviews were audio-recorded and transcribed verbatim. Where applicable, transcriptions were translated directly from local language to English. The data were then analysed using two-step thematic analysis. The protocol was approved by the two ethics review committees based in Ghana and the third, based in the United Kingdom. All participants were interviewed after giving informed consent. RESULTS Our data have implications for the on-going implementation of ComHIP, especially the importance of policy maker buy-in, and the benefits, as well as drawbacks, of the program to different stakeholders. While our data show that the ComHIP initiative is acceptable to patients and healthcare providers - increasing providers' knowledge on hypertension and patients' awareness of same- there were implementation challenges identified by both patients and providers. Policy level challenges relate to task-sharing bottlenecks, which precluded nurses from prescribing or dispensing antihypertensives, and LCS from stocking same. Medication adherence and the phenomenon of medical pluralism in Ghana were identified challenges. The perspectives from the national level stakeholders enable elucidation of whole of health system challenges to ComHIP and similarly designed programmes. CONCLUSIONS This paper sheds important light on the patient/individual, and system level challenges to hypertension and related non-communicable disease prevention and treatment in Ghana. The data show that although the ComHIP initiative is acceptable to patients and healthcare providers, policy level task-sharing bottlenecks preclude optimal implementation of ComHIP.
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Affiliation(s)
- Amos K Laar
- Department of Population, Family, & Reproductive Health, School of Public Health, University of Ghana, LG 13, Legon, Accra, Ghana.
| | - Alma J Adler
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.,Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Agnes M Kotoh
- Department of Population, Family, & Reproductive Health, School of Public Health, University of Ghana, LG 13, Legon, Accra, Ghana
| | - Helena Legido-Quigley
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.,Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Pulau Ujong, Singapore
| | - Isabelle L Lange
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Pablo Perel
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Peter Lamptey
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.,Family Health International 360, DC, Washington, WA, USA
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Yaya S, Ghose B. Trend in overweight and obesity among women of reproductive age in Uganda: 1995-2016. Obes Sci Pract 2019; 5:312-323. [PMID: 31452916 PMCID: PMC6700515 DOI: 10.1002/osp4.351] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/28/2022] Open
Abstract
Countries in Sub-Saharan Africa (SSA) are experiencing rising burdens of overweight/obesity and associated non-communicable diseases. As in other developing regions, this epidemiological transition in African countries is believed to be resulting from changes in dietary, sociodemographic structure and lifestyle factors. To date, not much is known about the prevalence and sociodemographic patterns of overweight/obesity in Uganda, especially among women of reproductive age. Therefore, this study aimed to address this research gap by using nationally representative data on women of this age group in Uganda. METHODS This study involved analysis of cross-sectional data on 19,395 women aged between 15 and 49 years from Uganda Demographic and Health Survey for the years 1995-2016. Overweight/obesity was measured using body mass index as per World Health Organization guidelines, and logistic regression methods were used to identify the sociodemographic predictors. RESULTS There has a been significant rise in the prevalence of overweight (9.77% in 1995 vs. 16.21% in 2016) and obesity (1.99% in 1995 vs. 6.21% in 2016) since the first survey in 1995, with the most noticeable increase occurring in the central region that accounted for a combined prevalence of 17.22% in 1995 compared with 37. 21% in 2016. Multivariate analysis showed an increased likelihood of having overweight/obesity among women who live in the urban areas, have primary and above primary education, from non-poor households and users of radio and TV. CONCLUSION During the last two decades, there has been a slow but steady rise in the prevalence of overweight and obesity among women of reproductive age in Uganda. The present findings highlight the need for an enhanced attention on growing overweight/obesity within the broader goal improving maternal and child health in the country.
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Affiliation(s)
- S. Yaya
- Faculté de MédecineUniversité de ParakouParakouBenin
| | - B. Ghose
- Institute of Nutrition and Food ScienceUniversity of DhakaDhakaBangladesh
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Govender RD, Al-Shamsi S, Regmi D. Weight bias and eating behaviours of persons with overweight and obesity attending a general medical practice in Durban, South Africa. S Afr Fam Pract (2004) 2019. [DOI: 10.1080/20786190.2018.1554305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- RD Govender
- Department of Family Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
| | - S Al-Shamsi
- Department of Internal Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
| | - D Regmi
- Department of Family Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
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Evaluation of Metabolic Syndrome and Its Associated Risk Factors in Type 2 Diabetes: A Descriptive Cross-Sectional Study at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4562904. [PMID: 31187045 PMCID: PMC6521427 DOI: 10.1155/2019/4562904] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 04/18/2019] [Indexed: 12/12/2022]
Abstract
Background. Metabolic syndrome (MS) is a collection of cardiovascular risk factors comprising insulin resistance, dyslipidemia, obesity, and hypertension, which may cause further complications in diabetes. Although metabolic syndrome (MS) is increasing in incidence in diabetics and leading to significant cardiovascular diseases and mortality, there is dearth of data in Ghana. This study investigated metabolic syndrome, its prevalence, and its associated risk factors in type 2 diabetes at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Methods. The study involved 405 diabetic patients attending the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH) Kumasi, in the Ashanti Region of Ghana. A well-structured questionnaire was used to obtain demographic background such as their age and gender. Anthropometric measurements were obtained using the Body Composition Monitor (Omron ® 500, Germany) which generated digital results on a screen and also by manual methods. Fasting venous blood was collected for the measurement of biochemical parameters comprising fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), high density lipoprotein cholesterol (HDL-c), and triglyceride (TG). Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Results. Out of the total of 405 participants, 81 were males and 324 were females, and the estimated mean age was 58.5 ± 9.9 years. The female patients exhibited higher mean waist circumference (WC) and mean hip circumference (HC) as well as an approximately higher body mass index than males (28.3 ± 5.1, 26.5 ± 4.2 for the female and male respectively). Overall, the prevalence of metabolic syndrome observed among the study population was 90.6%. Conclusions. The prevalence of metabolic syndrome observed among the study population was 90.6%, with a higher percentage in females than males. High triglyceride levels and high waist circumference were the main risk factors for MS in the diabetic population.
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Ayele AA, Emiru YK, Tiruneh SA, Ayele BA, Gebremariam AD, Tegegn HG. Level of adherence to dietary recommendations and barriers among type 2 diabetic patients: a cross-sectional study in an Ethiopian hospital. Clin Diabetes Endocrinol 2018; 4:21. [PMID: 30519484 PMCID: PMC6267803 DOI: 10.1186/s40842-018-0070-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/06/2018] [Indexed: 12/28/2022] Open
Abstract
Background Limited data are available regarding the level of adherence and barriers to dietary recommendations in individuals with type 2 diabetes in Africa including Ethiopia. Therefore, this study aimed at assessing the level of dietary adherence and its barriers among patients with type 2 diabetes in northwest Ethiopia. Methods A prospective hospital-based cross-sectional study was conducted from August to October 2017 at Debre Tabor General Hospital, Northwest Ethiopia. The Perceived Dietary Adherence Questionnaire (PDAQ) was used for dietary adherence measurement. Multivariate logistic regression was done to identify the barriers influencing dietary adherence. Result A significant percentage (74.3%) of the study participants had poor adherence to dietary recommendations. The highest mean score was obtained for the question regarding consuming foods high in sugar with a mean 5.49 ± 1.20 times a week. On the other hand, our participants had a low consumption of fruits and vegetables and foods high in omega-3 fats with a mean of 1.84 ± 1.96 and 0.1 ± 0.62 times a week respectively. According to the survey of participants, lack of knowledge, lack of diet education, inability to afford the cost of healthy diet and poor awareness about the benefit of dietary recommendations were the most cited reasons for poor dietary adherence. In multivariate logistics regression, low level of educational status, the presence of co-morbidities, lack of previous exposure to dietary education and low monthly income were statistically significant factors associated with non-adherence. Conclusion The rate of non-adherence to dietary recommendation among patients with T2DM was found to be high in northwest Ethiopia. Hence, providing customized health education about the potential benefit of proper dietary recommendations in controlling blood glucose is recommended. Health care providers should be proactive in promoting adherence to dietary recommendations in patients with T2DM.
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Affiliation(s)
- Asnakew Achaw Ayele
- 1Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, BOX 520 Gondar, PO Ethiopia
| | - Yohannes Kelifa Emiru
- 2School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Sofonyas Abebaw Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Belete Achamyelew Ayele
- 4Department of Epidemiology and Biostatics, Institute of Public health College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | | | - Henok Getachew Tegegn
- 1Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, BOX 520 Gondar, PO Ethiopia.,5School of Medicine and Pharmacy, University of New England, Armidale, NSW 2351 Australia
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22
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Physical Environment Correlates of Physical Activity in Developing Countries: A Review. J Phys Act Health 2017; 15:303-314. [PMID: 29278043 DOI: 10.1123/jpah.2017-0184] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Noncommunicable diseases and obesity are considered problems of wealthy, developed countries. These conditions are rising dramatically in developing countries. Most existing research on the role of the physical environment to support physical activity examines developed countries only. OBJECTIVES This review identifies physical environment factors that are associated with physical activity in developing countries. METHODS This review is modeled on a highly cited review by Saelens and Handy in 2008. The current review analyzes findings from 159 empirical studies in the 138 developing countries. RESULTS Results discuss the association of physical environment features and physical activity for all developing countries and identify the patterns within regions. The review supports the association of traffic safety with physical activity for transportation. Rural (vs urban) residence, distance to nonresidential land uses, and "composite" features of the physical environment are associated with general physical activity. Rural (vs urban) residence is associated with physical activity for work. CONCLUSIONS More research is needed on associations between the physical environment and physical activity in developing countries. Research should identify specific physical environment features in urban areas that are associated with higher activity levels.
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Amoakoh-Coleman M, Ogum-Alangea D, Modey-Amoah E, Ntumy MY, Adanu RM, Oppong SA. Blood pressure patterns and body mass index status in pregnancy: An assessment among women reporting for antenatal care at the Korle-Bu Teaching hospital, Ghana. PLoS One 2017; 12:e0188671. [PMID: 29211781 PMCID: PMC5718510 DOI: 10.1371/journal.pone.0188671] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 11/10/2017] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Maternal obesity in pregnancy has been linked with increased risk of pregnancy induced hypertension (PIH). In some tertiary referral hospitals in Ghana, PIH is the leading cause of institutional maternal mortality. OBJECTIVE To evaluate blood pressure changes during pregnancy amongst different body mass index (BMI) groups and how this relates to the risk of developing PIH. METHODS Women who had a dating ultrasound before 20 weeks gestation and registering for antenatal care at the Korle-Bu Teaching Hospital in Accra, between February and December 2013 and met the inclusion criteria were recruited into a cohort study. BMI was assessed at baseline. Blood pressure measurements were taken at (±2) 24, 28 and 36 weeks. Primary outcome measure of interest during follow-up was a diagnosis of PIH at these points. BP changes during follow up at the three points were measured. Descriptive analysis of baseline factors was carried out and compared for the BMI groups. Relative risk (RR) of PIH was estimated at 95% confidence interval. RESULTS Mean (SD) age for the 361 women was 30.9 (4.8) years. Incidence of PIH amongst the cohort was 10.5% (95% CI: 7.45% - 14.45%) and 40.4% and 33.0% of them were overweight and obese respectively at baseline. Pregnant women who were obese at baseline had a three-fold increased risk of PIH compared to those with normal BMI [RR = 3.01 (1.06-8.52), p = 0.04]. CONCLUSION Obese women have a significantly increased risk of PIH. Women should be screened at booking for obesity status. Antenatal protocols should have interventions for prevention or early detection of obesity and management of obesity to improve outcomes.
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Affiliation(s)
- Mary Amoakoh-Coleman
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands
| | - Deda Ogum-Alangea
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana
| | - Emefa Modey-Amoah
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana
| | - Michael Yao Ntumy
- Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Richard M. Adanu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana
| | - Samuel A. Oppong
- Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
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Gato WE, Acquah S, Apenteng BA, Opoku ST, Boakye BK. Diabetes in the Cape Coast metropolis of Ghana: an assessment of risk factors, nutritional practices and lifestyle changes. Int Health 2017; 9:310-316. [PMID: 28911126 DOI: 10.1093/inthealth/ihx028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/27/2017] [Indexed: 11/13/2022] Open
Abstract
Background Despite the significant increase in the incidence of diabetes in Ghana, research in this area has been lagging. The purpose of the study was to assess the risk factors associated with diabetes in the Cape Coast metropolis of Ghana, and to describe nutritional practices and efforts toward lifestyle change. Methods A convenient sample of 482 adults from the Cape Coast metropolis was surveyed using a self-reported questionnaire. The survey collected information on the demographic, socioeconomic characteristics, health status and routine nutritional practices of respondents. The aims of the study were addressed using multivariable regression analyses. Results A total of 8% of respondents reported that they had been diagnosed with diabetes. Older age and body weight were found to be independently associated with diabetes. Individuals living with diabetes were no more likely than those without diabetes to have taken active steps at reducing their weight. Conclusion The percentage of self-reported diabetes in this population was consistent with what has been reported in previous studies in Ghana. The findings from this study highlight the need for more patient education on physical activity and weight management.
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Affiliation(s)
- Worlanyo E Gato
- Department of Chemistry & Biochemistry, Georgia Southern University, Statesboro GA 30458, USA
| | - Samuel Acquah
- Department of Medical Biochemistry, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Bettye A Apenteng
- Department of Health Policy & Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA
| | - Samuel T Opoku
- Department of Health Policy & Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA
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Mohammed H, Ghosh S, Vuvor F, Mensah-Armah S, Steiner-Asiedu M. Dietary intake and the dynamics of stress, hypertension and obesity in a peri-urban community in Accra. Ghana Med J 2017; 50:16-21. [PMID: 27605720 DOI: 10.4314/gmj.v50i1.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study intends to investigate the association between dietary intake, stress and prevalence of chronic diseases. DESIGN AND SETTING The study was a cross-sectional design conducted in two poor peri-urban communities in Accra. PARTICIPANTS AND OUTCOME MEASURES A total of 90 households each with a male and female between the ages of 18 and 45 years were sampled, and their socio-demographic status, anthropometric measurement and fasting blood sugar were assessed. Blood pressure was measured and chronic stress/anxiety was determined using the trait and state inventory (T-stai) questionnaire. Three days repeated 24-hour dietary recall was also done. Analysis of variance and linear regression analysis were used in data analysis. RESULTS About 28% of the subjects were hypertensive and 55.5% had high chronic stress. Hypertension was higher in males (32.2%) than females (24.4%) (p=.023) whiles stress was higher in females (60.9%) than males (50.0%) (p=.017). Hypertensive subjects recorded higher stress (51.02%) and hypertension was more prevalent in subjects with high stress (32.89%) especially in females (57.14%, p=.036). Hypertension increased with mean age whiles stress decreased with mean age. Hypertensive subjects recorded a significantly higher BMI and sodium intake whiles high stress individuals recorded a lower animal protein but a higher cereal protein intake (p<.05). Chronic stress was associated with intake of low animal protein and high cereal protein. Increased dietary diversity score was associated with decreased obesity prevalence (p<.05). CONCLUSION Hypertension, chronic stress, and obesity were linked, and affected by dietary sodium, animal protein, and dietary diversity of subjects respectively.
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Affiliation(s)
- Husein Mohammed
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana; Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA
| | - Shibani Ghosh
- Nevin Scrimshaw International Nutrition Foundation, Boston, USA; Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA
| | - Fred Vuvor
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Seth Mensah-Armah
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana; Department of Food and Nutrition, Iowa State University, Iowa, USA
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Mogre V, Abanga ZO, Tzelepis F, Johnson NA, Paul C. Adherence to and factors associated with self-care behaviours in type 2 diabetes patients in Ghana. BMC Endocr Disord 2017; 17:20. [PMID: 28340613 PMCID: PMC5366118 DOI: 10.1186/s12902-017-0169-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 03/18/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Previous research has failed to examine more than one self-care behaviour in type 2 diabetes patients in Ghana. The purpose of this study is to investigate adult Ghanaian type 2 diabetes patients' adherence to four self-care activities: diet (general and specific), exercise, self-monitoring of blood glucose (SMBG) and foot care. METHODS Consenting type 2 diabetes patients attending diabetes outpatient clinic appointments at three hospitals in the Tamale Metropolis of Ghana completed a cross-sectional survey comprising the Summary of Diabetes Self-Care Activities Measure, and questions about demographic characteristics and diabetes history. Height and weight were also measured. Multiple linear regression analyses were conducted to identify the factors associated with adherence to each of the four self-care behaviours. RESULTS In the last 7 days, participants exercised for a mean (SD) of 4.78 (2.09) days and followed diet, foot care and SMBG for a mean (SD) of 4.40 (1.52), 2.86 (2.16) and 2.15 (0.65) days, respectively. More education was associated with a higher frequency of reported participation in exercise (r = 0.168, p = 0.022), following a healthy diet (r = 0.223, p = 0.002) and foot care (r = 0.153, p = 0.037) in the last 7 days. Males reported performing SMBG (r = 0.198, p = 0.007) more frequently than their female counterparts. CONCLUSION Adherence to diet, SMBG and checking of feet were relatively low. People with low education and women may need additional support to improve adherence to self-care behaviours in this type 2 diabetes population.
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Affiliation(s)
- Victor Mogre
- Department of Health Professions Education, School of Medicine and Health Sciences, University for Development Studies, P. O. Box TL 1883, Tamale, Ghana.
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Zakaria Osman Abanga
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Locked bag 1000, New Lambton, NSW, 2305, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Locked Mail Bag 10, Wallsend, NSW, 2287, Australia
| | - Natalie A Johnson
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Locked bag 1000, New Lambton, NSW, 2305, Australia
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Ofori-Asenso R, Agyeman AA, Laar A, Boateng D. Overweight and obesity epidemic in Ghana-a systematic review and meta-analysis. BMC Public Health 2016; 16:1239. [PMID: 27938360 PMCID: PMC5148846 DOI: 10.1186/s12889-016-3901-4] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 12/02/2016] [Indexed: 01/07/2023] Open
Abstract
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.
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Affiliation(s)
- Richard Ofori-Asenso
- Research Unit, Health Policy Consult, P. O. Box WJ 537, Weija, Greater-Accra, Ghana.
| | - Akosua Adom Agyeman
- Research Unit, Health Policy Consult, P. O. Box WJ 537, Weija, Greater-Accra, Ghana
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Daniel Boateng
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht University, Utrecht, The Netherlands
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Yeboah K, Antwi DA, Gyan B, Govoni V, Mills CE, Cruickshank JK, Amoah AGB. Arterial stiffness in hypertensive and type 2 diabetes patients in Ghana: comparison of the cardio-ankle vascular index and central aortic techniques. BMC Endocr Disord 2016; 16:53. [PMID: 27680212 PMCID: PMC5041289 DOI: 10.1186/s12902-016-0135-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 09/21/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Diabetes and hypertension increase arterial stiffness and cardiovascular events in all societies studied so far; sub-Saharan African studies are sparse. We investigated factors affecting arterial function in Ghanaians with diabetes, hypertension, both or neither. METHOD Testing the hypothesis that arterial stiffness would progressively increase from controls to multiply affected patients, 270 participants were stratified into those with diabetes or hypertension only, with both, or without either. Cardio-ankle vascular index (CAVI), heart-ankle pulse wave velocity (haPWV), aortic PWV (PWVao) by Arteriograph, aortic and brachial blood pressures (BP), were measured. RESULTS In patients with both diabetes and hypertension compared with either alone, values were higher of CAVI (mean ± SD, 8.3 ± 1.2 vs 7.5 ± 1.1 and 7.4 ± 1.1 units; p < 0.05), PWVao (9.1 ± 1.4 vs 8.7 ± 1.9 and 8.1 ± 0.9 m/s; p < 0.05) and haPWV (8.5 ± 1 vs 7.9 ± 1 and 7.2 ± 0.7 m/s; p < 0.05) respectively. In multivariate analysis, age, having diabetes or hypertension and BMI were independently associated with CAVI in all participants (β = 0.49, 0.2, 0.17 and -0.2 units; p < 0.01, respectively). Independent determinants of PWVao were heart rate, systolic BP and age (β = 0.42, 0.27 and 0.22; p < 0.01), and for haPWV were systolic BP, age, BMI, diabetes and hypertension status (β = 0.46, 0.32, -0.2, 0.2 and 0.11; p < 0.01). CONCLUSION In this sub-Saharan setting with lesser atherosclerosis than the western world, arterial stiffness is significantly greater in patients with coexistent diabetes and hypertension but did not differ between those with either diabetes or hypertension only. Simple, reproducibly measured PWV/CAVI may offer effective and efficient targets for intervention.
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Affiliation(s)
- Kwame Yeboah
- Department of Physiology, School of Biomedical & Allied Health Sciences, University of Ghana, P.O. Box KB 143, Accra, Ghana.
| | - Daniel A Antwi
- Department of Physiology, School of Biomedical & Allied Health Sciences, University of Ghana, P.O. Box KB 143, Accra, Ghana
| | - Ben Gyan
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Virginia Govoni
- Cardiovascular Medicine Group, Division of Diabetes and Nutrition, King's College and King's Health Partners, London, UK
| | - Charlotte E Mills
- Cardiovascular Medicine Group, Division of Diabetes and Nutrition, King's College and King's Health Partners, London, UK
| | - J Kennedy Cruickshank
- Cardiovascular Medicine Group, Division of Diabetes and Nutrition, King's College and King's Health Partners, London, UK
| | - Albert G B Amoah
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
- National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
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An Analysis of Anthropometric Indicators and Modifiable Lifestyle Parameters Associated with Hypertensive Nephropathy. Int J Hypertens 2016; 2016:6598921. [PMID: 27774313 PMCID: PMC5059654 DOI: 10.1155/2016/6598921] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/15/2016] [Accepted: 08/18/2016] [Indexed: 12/16/2022] Open
Abstract
The surge in prevalence of chronic noncommunicable diseases like hypertension and chronic kidney disease has been linked with modifiable lifestyle practices and increased body fat. This study sought to compare the association between different modifiable lifestyle practices, adiposity indices, renal function parameters, and hypertension as well as the predictive implications for levels of these parameters in target cardiac organ damage among an urban Ghanaian hypertensive population. Using a hospital-based case-control study design, 241 Ghanaian indigenes from the Kumasi metropolis were recruited for this study. The case group was made up of 180 hypertensives and 61 normotensives served as controls. In addition to sociodemographic data, standard haemodynamic, anthropometric, renal function, and cardiac organ damage assessments were done. The prevalence of chronic kidney disease (CKD) ranged from 13.3% to 16.6% depending on the equation used in estimating the glomerular filtration rate (eGFR). Percentage cluster distribution by chronic kidney disease was observed to be significantly tilted toward the upper quartiles (3rd and 4th) of the haemodynamic parameters measured. Chronic kidney disease was significantly higher among self-reported smokers and alcoholic hypertensives. In this urban population, adiposity was associated with hypertension and renal insufficiency. Chronic kidney disease was associated with hypertension and cardiac abnormalities.
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Malhotra R, Hoyo C, Østbye T, Hughes G, Schwartz D, Tsolekile L, Zulu J, Puoane T. Determinants of obesity in an urban township of South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2008.11734173] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Commodore-Mensah Y, Hill M, Allen J, Cooper LA, Blumenthal R, Agyemang C, Himmelfarb CD. Sex Differences in Cardiovascular Disease Risk of Ghanaian- and Nigerian-Born West African Immigrants in the United States: The Afro-Cardiac Study. J Am Heart Assoc 2016; 5:e002385. [PMID: 26896477 PMCID: PMC4802474 DOI: 10.1161/jaha.115.002385] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 01/06/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The number of African immigrants in the United States grew 40-fold between 1960 and 2007, from 35 355 to 1.4 million, with a large majority from West Africa. This study sought to examine the prevalence of cardiovascular disease (CVD) risk factors and global CVD risk and to identify independent predictors of increased CVD risk among West African immigrants in the United States. METHODS AND RESULTS This cross-sectional study assessed West African (Ghanaian and Nigerian) immigrants aged 35-74 years in the Baltimore-Washington metropolitan area. The mean age of participants was 49.5±9.2 years, and 58% were female. The majority (95%) had ≥1 of the 6 CVD risk factors. Smoking was least prevalent, and overweight or obesity was most prevalent, with 88% having a body mass index (in kg/m(2)) ≥25; 16% had a prior diagnosis of diabetes or had fasting blood glucose levels ≥126 mg/dL. In addition, 44% were physically inactive. Among women, employment and health insurance were associated with odds of 0.09 (95% CI 0.033-0.29) and 0.25 (95% CI 0.09-0.67), respectively, of having a Pooled Cohort Equations estimate ≥7.5% in the multivariable logistic regression analysis. Among men, higher social support was associated with 0.90 (95% CI 0.83-0.98) lower odds of having ≥3 CVD risk factors but not with having a Pooled Cohort Equations estimate ≥7.5%. CONCLUSIONS The prevalence of CVD risk factors among West African immigrants was particularly high. Being employed and having health insurance were associated with lower CVD risk in women, but only higher social support was associated with lower CVD risk in men.
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Affiliation(s)
| | - Martha Hill
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - Jerilyn Allen
- Johns Hopkins University School of Nursing, Baltimore, MD
| | | | | | - Charles Agyemang
- Department of Public Health, Academic Medical Centre/University of Amsterdam, The Netherlands
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Dake FAA, Fuseini K. Recreation, transportation or labour saving? Examining the association between household asset ownership and body mass index among Ghanaian women. BMC OBESITY 2015; 2:45. [PMID: 26594382 PMCID: PMC4642763 DOI: 10.1186/s40608-015-0075-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 11/07/2015] [Indexed: 11/15/2022]
Abstract
Background In most of the developing world, ownership of modern household assets such as television sets, refrigerators, microwave ovens and washing machines is becoming common. Ownership of these household assets, however, promotes sedentary behaviour which has implications for obesity and non-communicable disease conditions such as hypertension, diabetes, stroke and other cardiovascular conditions. Additionally, increased household asset ownership is an indicator of socio-economic status and is also associated with obesity promoting dietary behaviours especially in urban areas. Very few studies have examined the relationship between household asset ownership and obesity in sub-Saharan Africa where asset ownership is becoming a norm. This paper examined the relationship between ownership of different types of household assets and Body Mass Index (BMI) among a nationally representative sample of Ghanaian women. Methods The study analysed secondary data from the 2008 Ghana Demographic and Health Survey (GDHS) involving a total of 4916 women aged 15–49 years. The analytical sample consist of 4010 (weighted sample) non-pregnant females who had valid data on all the variables used in the analyses. The BMI of the women was used as the dependent variable with three categories of normal weight, overweight and obese based on the standard World Health Organization (WHO) classifications. Multinomial logistic regression models were specified to examine the relationship between ownership of household assets and BMI. Results Obesity was more common among women whose household owned a television-15.60 %, DVD/VCD-18.58 %, computer-20.70 %, refrigerator-17.16 % and washing machine-27.43 %, but less common among women whose household owned a motorcycle/scooter-7.74 % and a bicycle-7.92 %. Household ownership of DVD was significantly associated with increased odds of obesity (OR = 1.59, P < 0.01) while ownership of a motor cycle/scooter (OR = 2.05, P <0.001), a refrigerator (OR = 1.33, P < 0.05), and a television set (OR = 1.27, P < 0.10) were associated with higher odds of overweight. Ownership of each additional household asset was also associated with 15 % and 25 % higher odds of overweight and obesity respectively. Conclusion The findings indicate that at least one asset among the various domains of household assets examined is associated with either overweight or obesity among Ghanaian women. Also, increased household asset ownership is associated with increased odds of overweight and obesity. Interventions that aim at reducing sedentary and unhealthy dietary behaviours in the phase of increasing asset ownership maybe helpful in addressing the rising prevalence of obesity among Ghanaian women.
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Affiliation(s)
- Fidelia A A Dake
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Accra Ghana
| | - Kamil Fuseini
- Population Training and Research Unit, North-West University (Mafikeng Campus), Mafikeng, South Africa
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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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Addo PNO, Nyarko KM, Sackey SO, Akweongo P, Sarfo B. Prevalence of obesity and overweight and associated factors among financial institution workers in Accra Metropolis, Ghana: a cross sectional study. BMC Res Notes 2015; 8:599. [PMID: 26499885 PMCID: PMC4619450 DOI: 10.1186/s13104-015-1590-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 10/14/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Certain professions are associated with low physical activity. Workers in such professions spend the most part of their adult working lives less engaged in physical activity if they don't consciously exercise outside of working hours. This increases their risk of obesity and its associated diseases. This study determined the prevalence of obesity and overweight and associated factors among workers of a financial institution in Accra Metropolis, Ghana. METHODS A cross-sectional study was conducted among 180 workers of a financial institution in Accra using the World Health Organization's STEPS (STEPwise approach) instrument for non-communicable disease risk factor surveillance. Relevant sociodemographic information were recorded and BMI was computed for each respondent. RESULTS The overall prevalence of obesity and overweight among the bank workers was 55.6 % (17.8 % obese and 37.8 % overweight). After adjusting for other variables, physical activity (OR = 0.34, 95 % CI = 0.13-0.89, p = 0.03), alcohol consumption (OR = 3.00, 95 % CI = 1.35, 6.68, p = 0.007), marital status (OR = 2.74, 95 % CI = 0.96-7.85, p = 0.04), sex (OR = 2.78, 95 % CI = 1.23-6.33, p = 0.01), and age (OR = 1.10, 95 % CI = 1.01-1.20, p = 0.036) were significantly associated with obesity and overweight. CONCLUSION Being physically inactive, consumption of alcohol, being married and a female, in addition to old age, increase the risk of obesity and overweight significantly. These factors should inform policy makers in developing strategies to reduce the burden of obesity and overweight among this category of workers.
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Affiliation(s)
- Prince N O Addo
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
| | - Kofi M Nyarko
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
- Non Communicable Diseases Control Program, Ghana Health Service, Box KB 493, Korle-Bu, Accra, Ghana.
| | - Samuel O Sackey
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
| | - Patricia Akweongo
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
| | - Bismark Sarfo
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
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Darko SN, Yar DD, Owusu-Dabo E, Awuah AAA, Dapaah W, Addofoh N, Salifu SP, Awua-Boateng NY, Adomako-Boateng F. Variations in levels of IL-6 and TNF-α in type 2 diabetes mellitus between rural and urban Ashanti Region of Ghana. BMC Endocr Disord 2015; 15:50. [PMID: 26391589 PMCID: PMC4578269 DOI: 10.1186/s12902-015-0047-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 09/07/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND A surge in pro-inflammatory markers, Il-6 and TNF-α, has been associated with type 2 diabetes mellitus (T2DM). However, there is no data on the dynamics of these markers in T2DM Ghanaian populations. The aim of this study was to determine variations in the levels of IL-6 and TNF-α in T2DM patients. This study also examined the associations of IL-6 and TNF-α with anthropometric measurement and the effect of co-morbidity with hypertension using rural and urban dwellers in the Ashanti region, Ghana. METHODS A nested case-control design using participants aged 25-70 years consisting of 77 T2DM ± hypertension patients and 112 controls were selected from a larger study on Research on Obesity and Diabetes among African Migrants (RODAM). Anthropometric measurements, blood pressure and body fat percentage were measured. Fasting blood samples were analyzed for glucose, IL-6 and TNF-α levels. RESULTS The median level of IL-6 was significantly higher (p < 0.0001) among rural dwellers compared to urban dwellers. Inversely, urban dwellers had significantly higher (p = 0.0424) median level of TNF-α compared to rural cases. No significant differences were observed in IL-6 (p = 0.3571) and TNF-α (p = 0.2581) among T2DM patients compared with T2DM ± hypertension patients. A weak negative correlation was found between IL-6 and BMI in urban T2DM. DISCUSSION The average level of IL-6 was higher in rural T2DM participants compared with those in urban setting. However, higher levels of TNF-α was observed among the study participants with T2DM in urban settings compared to those of rural. In this study, we observed that co-morbidity of hypertension had no significant effect on the levels of IL-6 and TNF-α. We are of the opinion that higher physical activity levels among rural particpants and high obesity levels in urabn participants explain the observation but needs more numbers to validate. CONCLUSION This study revealed that IL-6 levels were higher among rural dwellers than urban while TNF-α levels were higher in urban dwellers than rural in patients with T2DM. There was no association of body fat percentage and body mass index with IL-6 and TNF-α levels. Co-morbidity of hypertension with T2DM had no effect on IL-6 and TNF-α levels.
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Affiliation(s)
- Samuel N Darko
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
| | - Denis D Yar
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
| | - Ellis Owusu-Dabo
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
- School of Public Health, KNUST, Kumasi, Ghana.
| | - Anthony Afum-Adjei Awuah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
| | - Williams Dapaah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
| | - Nicholas Addofoh
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
| | - Samson P Salifu
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
- Department of Biochemistry and Biotechnology, KNUST, Kumasi, Ghana.
| | - Nana Y Awua-Boateng
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
| | - Fred Adomako-Boateng
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
- Ghana Health Service, Kumasi, Ashanti Region, Ghana.
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Obesity and Cardio-Metabolic Risk Factors in an Urban and Rural Population in the Ashanti Region-Ghana: A Comparative Cross-Sectional Study. PLoS One 2015; 10:e0129494. [PMID: 26046349 PMCID: PMC4457529 DOI: 10.1371/journal.pone.0129494] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 05/08/2015] [Indexed: 12/27/2022] Open
Abstract
There is a surge in chronic diseases in the developing world, driven by a high prevalence of cardio-metabolic risk factors. This study described differences in prevalence of obesity and cardio-metabolic risk factors between urban and rural settlements in the Ashanti Region of Ghana. This comparative cross-sectional study included 672 participants (median age 50 years), of which 312 were from Kumasi (urban) and 360 from Jachie-Pramso (rural). Demographic, anthropometric and other cardio-metabolic risk factors were gathered and venous blood samples were drawn for biochemical assays. Results suggested significant differences in diastolic blood pressure (80.0 mmHg vs 79.5 mmHg; p = 0.0078), and fasting blood sugar (5.0 mmo/l vs 4.5 mmol/l; p < 0.0001) between the two groups. Further differences in anthropometric measures suggested greater adiposity amongst participants in the urban area. Participants in the urban area were more likely than rural participants, to have high total cholesterol and LDL-c (p < 0.0001 respectively). Risk factors including BMI ≥ 25 (p < 0.0001), BMI ≥ 30 (p < 0.0001), high waist circumference (p < 0.0001), high waist-to-height ratio (p < 0.0001) and alcohol consumption (p = 0.0186) were more prevalent amongst participants in the urban area. Markers of adiposity were higher amongst females than males in both areas (p < 0.05). In the urban area, hypertension, diabetes and lifestyle risk factors were more prevalent amongst males than females. Differences in risk factors by urban/rural residence remained significant after adjusting for gender and age. Obesity and cardio-metabolic risk factors are more prevalent amongst urban settlers, highlighting an urgent need to avert the rise of diet and lifestyle-related chronic diseases.
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Maruf FA, Udoji NV. Prevalence and Socio-Demographic Determinants of Overweight and Obesity in a Nigerian Population. J Epidemiol 2015; 25:475-81. [PMID: 26005065 PMCID: PMC4483373 DOI: 10.2188/jea.je20140099] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective This survey explored prevalence of overweight and obesity and their associations with socio-demographic variables in a Nigerian population. Methods This cross-sectional survey involved 1521 adults in Nnewi. Age, sex, educational and occupational status, and BMI were recorded. Results Prevalence of overweight was higher in males (32.3%; 95% CI, 29.5%–35.2%) than in females (29.8%; 95% CI, 26.8%–33.0%); the reverse was the case for prevalence of obesity (19.6%; 95% CI, 17.3%–22.2% in males and 36.0%; 95% CI, 32.8%–39.4% in females). Higher odds ratios (ORs) for overweight and obesity were observed in participants aged 41–60 years (OR 2.03; 95% CI, 1.57–2.61 for overweight and OR 4.29; 95% CI, 3.25–5.67 for obesity) and those >60 years (OR 1.72; 95% CI, 1.21–2.43 for overweight and OR 4.21; 95% CI, 2.86–6.19 for obesity) compared to those aged 18–40 years. Female sex was associated with higher ORs for overweight (OR 1.20; 95% CI, 0.96–1.51) and obesity (OR 2.21; 95% CI, 1.73–2.83). Participants with secondary education had marginally higher ORs for overweight (OR 1.15; 95% CI, 0.88–1.51) and obesity (OR 1.17; 95% CI, 0.86–1.59) than those with tertiary education, and so were those with primary education for obesity (OR 1.19; 95% CI, 0.74–1.89) but higher OR for overweight (OR 1.44; 95% CI, 0.98–2.13). Unskilled participants had about the same OR for overweight and obesity as professionals, and while skilled participants had about the same OR for overweight as professionals, their OR for obesity (OR 1.27; 95% CI, 0.67–2.43) was fairly higher than that for professionals. Conclusions Prevalence of overweight is higher in males than in females, but the reverse is the case for prevalence of obesity. Older age and female sex are associated with increased risk of overweight and obesity, while working at a skilled occupation is associated with obesity, and tertiary educational attainment is associated with overweight.
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Affiliation(s)
- Fatai A Maruf
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University
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Afrifa-Anane E, Agyemang C, Codjoe SNA, Ogedegbe G, de-Graft Aikins A. The association of physical activity, body mass index and the blood pressure levels among urban poor youth in Accra, Ghana. BMC Public Health 2015; 15:269. [PMID: 25881047 PMCID: PMC4376361 DOI: 10.1186/s12889-015-1546-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 02/16/2015] [Indexed: 11/10/2022] Open
Abstract
Background Globally, there is an increasing prevalence of high blood pressure (HBP) among adults and youth. However, the mechanisms of how the risk factors (physical inactivity and obesity) relate with blood pressure (BP) are not well known especially among the urban poor youth in low and middle income countries. Meanwhile childhood and adolescent physical inactivity and obesity, particularly in conditions of poverty, predispose individuals to cardiovascular diseases (CVDs) in later life. The aim of this study was to assess the BP levels and to examine its associations with physical activity (PA) and body mass index (BMI) amongst urban poor youth in Accra, Ghana. Methods We studied 201 youth aged 15–24 years in three urban poor communities in Accra, Ghana. Height, weight and BP were measured in all subjects. PA levels were assessed using the Edulink Urban Health and Poverty project questionnaire. Multiple linear regression analysis was used to determine the factors influencing BP levels. Results The proportion of pre-hypertension and hypertension among the youth was 32.3% and 4%, respectively. The rates of pre-hypertension (42.0 vs. 24.8) and hypertension (6.8 vs. 1.8) were higher in males than in females. More than three-quarters (84.1%) of the youth were not physically active. Females were more physically inactive compared to the males (94.7% vs. 70.5%). The average BMI was 22.8 kg/m2. For overweight (17.7 vs. 6.8) and obesity (13.3 vs. 2.3), females had higher rates than males. BMI was positively related to systolic BP, and significantly associated with systolic BP (β = 1.4, p < 0.000 and β = 0.8, p < 0.000; respectively for male and female youth) compared to diastolic BP. Youth with low PA had raised BP. Conclusion The positive association of BMI and BP in the study communities suggests the need for health measures to tackle their increase and related public health consequences. Further studies on BP and other risk factors among the youth of rural populations and other developing countries will be important to stall the rising prevalence and implications for adult morbidity and mortality.
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Affiliation(s)
- Ernest Afrifa-Anane
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Ghana.
| | - Charles Agyemang
- Department of Public Health Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Samuel Nii Ardey Codjoe
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Ghana.
| | - Gbenga Ogedegbe
- Centre for Healthful Behaviour Change, New York University, School of Medicine, New York, USA.
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Ghana.
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Correlates and Predictors of Increasing Waist Circumference in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:318569. [PMID: 27398399 PMCID: PMC4897519 DOI: 10.1155/2014/318569] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 06/18/2014] [Accepted: 06/26/2014] [Indexed: 11/17/2022]
Abstract
Type 2 diabetes mellitus (type 2 DM) has become a disease of public health concern worldwide. Obesity and elevated blood pressure have been shown to be comorbidities of type 2 DM. In this cross-sectional study in Tamale, Ghana, we determined the prevalence of abdominal obesity among type 2 DM patients. Furthermore, we examined the demographic, clinical, and anthropometric predictors of increasing waist circumference in this population. Three hundred type 2 DM patients attending the outpatient diabetes clinic of the Tamale Teaching Hospital, Ghana, were recruited for the study. Waist circumference (WC) and hip circumferences were measured appropriately. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) and fasting plasma glucose (FPG) were taken from the personal health record files of patients. Demographic data were obtained. Pearson correlation and multiple linear regression models were employed to identify predictors of increasing WC. The prevalence of abdominal obesity was 77.0% and was significantly higher in women than in men. A positive correlation was observed between waist-to-hip ratio (WHR) and WC (r = 0.56, P < 0.001), female gender (r = 0.73, P < 0.001), and age (r = 0.20, P < 0.001). A high prevalence of abdominal obesity was observed. Predictors of increasing WC were gender, age, FPG, and WHR.
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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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Adebayo RA, Balogun MO, Adedoyin RA, Obashoro-John OA, Bisiriyu LA, Abiodun OO. Prevalence and pattern of overweight and obesity in three rural communities in southwest Nigeria. Diabetes Metab Syndr Obes 2014; 7:153-8. [PMID: 24872714 PMCID: PMC4026024 DOI: 10.2147/dmso.s55221] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Limited data exist on the prevalence of overweight and obesity in the Nigerian adult rural population. This study therefore assessed the prevalence and pattern of overweight and obesity in adults in three rural communities of the Ife North Local Government Area, Nigeria. MATERIALS AND METHODS A total of 777 adults between 20 and 90 years of age were recruited into this cross-sectional study, which was performed over a 6-month period using a multistage proportional stratified random sampling technique. Sociodemographic data and anthropometric variables were obtained. RESULTS A total of 385 (49.5%) men and 395 (50.5%) women participated in the study. The mean age and body mass index of the participants were 36.3±14.3 years and 23.53±4.6 kg/m(2), respectively. The overall crude prevalence of overweight and obesity in the total population were 20.8% and 8.4%, respectively. Obesity increased across the age gradient, peaking in the 51- to 60-year age-group in men and women. Among the overweight and obese subjects (n=227), 70.9% of them were overweight and the remaining 29.1% were obese, with class I obesity accounting for 20.7% of these overweight and obese subjects. CONCLUSION The prevalence of overweight and obesity in these communities was 20.8% and 8.4% respectively, indicating a trend towards increased prevalence. Class I obesity is the most common obesity pattern, and obesity increased across the age gradient, peaking in the 51- to 60-year age-group. There is a need for regular community education on healthy lifestyles, and regular health screening to control the rising prevalence of overweight and obesity, as well as to prevent or reduce the risk of obesity comorbidities in these communities.
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Affiliation(s)
- Rasaaq A Adebayo
- Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Michael O Balogun
- Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Rufus A Adedoyin
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Luqman A Bisiriyu
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
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Abstract
There is epidemiological evidence for associations between dietary patterns and type 2 diabetes. However, for sub-Saharan Africa, information on dietary patterns and their contribution to diabetes is lacking. The aim of the present study was to identify dietary patterns and their associations with type 2 diabetes in an urban Ghanaian population. In a hospital-based case-control study on risk factors for type 2 diabetes in Kumasi, a FFQ was administered to 675 controls and 542 cases. Dietary patterns were identified by using factor analysis including thirty-three food items. Logistic regression was used to evaluate the associations of dietary patterns with type 2 diabetes. Overall, two dietary patterns were identified: (1) a 'purchase' dietary pattern which positively correlated with the consumption of sweets, rice, meat, fruits and vegetables and (2) a 'traditional' dietary pattern that correlated with the intake of fruits, plantain, green leafy vegetables, fish, fermented maize products and palm oil. In the highest quintile of the 'purchase' dietary pattern, participants were younger, leaner and of higher socio-economic status than those in the lower quintiles. In contrast, participants in the highest quintile of the 'traditional' dietary pattern were older, heavier and more deprived compared with those in the lower quintiles. In the multivariate model, the 'purchase' dietary pattern was inversely associated with type 2 diabetes (OR per 1 sd 0·41, 95% CI 0·33, 0·50); the 'traditional' dietary pattern increased the odds of diabetes per 1 sd by 54% (95% CI 1·35, 1·81). In conclusion, two diverse dietary patterns were identified and associated with type 2 diabetes in urban Ghana. The determinants of pattern adherence require further investigation.
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Agyemang C, Beune E, Meeks K, Owusu-Dabo E, Agyei-Baffour P, Aikins ADG, Dodoo F, Smeeth L, Addo J, Mockenhaupt FP, Amoah SK, Schulze MB, Danquah I, Spranger J, Nicolaou M, Klipstein-Grobusch K, Burr T, Henneman P, Mannens MM, van Straalen JP, Bahendeka S, Zwinderman AH, Kunst AE, Stronks K. Rationale and cross-sectional study design of the Research on Obesity and type 2 Diabetes among African Migrants: the RODAM study. BMJ Open 2014; 4:e004877. [PMID: 24657884 PMCID: PMC3963103 DOI: 10.1136/bmjopen-2014-004877] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Obesity and type 2 diabetes (T2D) are highly prevalent among African migrants compared with European descent populations. The underlying reasons still remain a puzzle. Gene-environmental interaction is now seen as a potential plausible factor contributing to the high prevalence of obesity and T2D, but has not yet been investigated. The overall aim of the Research on Obesity and Diabetes among African Migrants (RODAM) project is to understand the reasons for the high prevalence of obesity and T2D among sub-Saharan Africans in diaspora by (1) studying the complex interplay between environment (eg, lifestyle), healthcare, biochemical and (epi)genetic factors, and their relative contributions to the high prevalence of obesity and T2D; (2) to identify specific risk factors within these broad categories to guide intervention programmes and (3) to provide a basic knowledge for improving diagnosis and treatment. METHODS AND ANALYSIS RODAM is a multicentre cross-sectional study among homogenous sub-Saharan African participants (ie, Ghanaians) aged >25 years living in rural and urban Ghana, the Netherlands, Germany and the UK (http://rod-am.eu/). Standardised data on the main outcomes, genetic and non-genetic factors are collected in all locations. The aim is to recruit 6250 individuals comprising five subgroups of 1250 individuals from each site. In Ghana, Kumasi and Obuasi (urban stratum) and villages in the Ashanti region (rural stratum) are served as recruitment sites. In Europe, Ghanaian migrants are selected through the municipality or Ghanaian organisations registers. ETHICS AND DISSEMINATION Ethical approval has been obtained in all sites. This paper gives an overview of the rationale, conceptual framework and methods of the study. The differences across locations will allow us to gain insight into genetic and non-genetic factors contributing to the occurrence of obesity and T2D and will inform targeted intervention and prevention programmes, and provide the basis for improving diagnosis and treatment in these populations and beyond.
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Affiliation(s)
- Charles Agyemang
- Department of Public Health, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Erik Beune
- Department of Public Health, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Karlijn Meeks
- Department of Public Health, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Ellis Owusu-Dabo
- Faculty of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Peter Agyei-Baffour
- Faculty of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ama de-Graft Aikins
- The Regional Institute for Population Studies: University of Ghana, Legon, Ghana
| | - Francis Dodoo
- The Regional Institute for Population Studies: University of Ghana, Legon, Ghana
| | - Liam Smeeth
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Juliet Addo
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Frank P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Stephen K Amoah
- Institute of Tropical Medicine and International Health, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition (DIfE), Potsdam-Rehbruecke, Nuthetal, Germany
| | - Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition (DIfE), Potsdam-Rehbruecke, Nuthetal, Germany
| | - Joachim Spranger
- Department of Endocrinology, Diabetes and Nutrition, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Mary Nicolaou
- Department of Public Health, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tom Burr
- Source BioScience, Nottingham, UK
| | - Peter Henneman
- Department of Clinical Genetics, Academic Medical Centre, Amsterdam, The Netherlands
| | - Marcel M Mannens
- Department of Clinical Genetics, Academic Medical Centre, Amsterdam, The Netherlands
| | - Jan P van Straalen
- Department of Clinical Chemistry, Academic Medical Centre, Amsterdam, The Netherlands
| | - Silver Bahendeka
- International Diabetes Federation, Africa Region, Kampala, Uganda
| | - A H Zwinderman
- Department of Clinical Epidemiology, Bioinformatics, and Biostatistics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public Health, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands
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Iloh GUP, Ikwudinma AO, Obiegbu NP. Obesity and Its Cardio-metabolic Co-morbidities Among Adult Nigerians in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria. J Family Med Prim Care 2014; 2:20-6. [PMID: 24479038 PMCID: PMC3894014 DOI: 10.4103/2249-4863.109936] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Obesity once thought the medical problem of affluent countries now exist in Nigeria and has been described as a time bomb for the future explosion in the frequency of cardio-metabolic diseases. The most deleterious health consequences of obesity are on the cardiovascular system and associated disorder of lipid and glucose homeostasis. Aim: This study was designed to determine the magnitude of obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital South-Eastern, Nigeria. Materials and Methods: A cross-sectional study carried out on 2391 adult Nigerians who were assessed for obesity using body mass index (BMI) criterion. 206 patients who had BMI ≥30kg/m2 were screened for cardio-metabolic co-morbidities. The data collected included basic demographic variables, weight, height, blood pressure; fasting plasma glucose and lipid profile. Results: The prevalence of obesity was 8.6%. Grade I obesity (67.5%) was the most common pattern; others included grade II obesity (23.3%) and grade III obesity (9.2%). Hypertension (42.7%) was the most common cardio-metabolic morbidity. Others included low HDL-cholesterol (22.8%), diabetes mellitus (15.1%), high triglyceride (12.6%), high total cholesterol (9.2%), and high LDL-cholesterol (6.8%). Conclusion: Obesity and its cardio-metabolic morbidities exist among the study population. Anthropometric determination of obesity and screening for its associated cardio-metabolic co-morbidities should constitute clinical targets for intervention in primary care clinics.
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Gbary AR, Kpozehouen A, Houehanou YC, Djrolo F, Amoussou MPG, Tchabi Y, Salamon R, Houinato DS. Prevalence and risk factors of overweight and obesity: findings from a cross-sectional community-based survey in Benin. ACTA ACUST UNITED AC 2014. [DOI: 10.7243/2052-5966-2-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Danquah I, Othmer T, Frank LK, Bedu-Addo G, Schulze MB, Mockenhaupt FP. The TCF7L2 rs7903146 (T) allele is associated with type 2 diabetes in urban Ghana: a hospital-based case-control study. BMC MEDICAL GENETICS 2013; 14:96. [PMID: 24059590 PMCID: PMC3848778 DOI: 10.1186/1471-2350-14-96] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 09/10/2013] [Indexed: 02/07/2023]
Abstract
Background Type 2 diabetes mellitus is increasing dramatically in sub-Saharan Africa, and genetic predisposition is likely involved in that. Yet, genetic variants known to confer increased susceptibility among Caucasians are far from being established in African populations. In Ghanaian adults, we examined associations of several of these polymorphisms with type 2 diabetes. Methods A hospital-based case–control study on type 2 diabetes (and hypertension) was conducted in Kumasi, Ghana. TCF7L2 rs7903146, KCNJ11 rs5219, PPARγ rs1801282 and CAPN10 rs3842570, rs3792267, and rs5030952 were typed and associations with type 2 diabetes and phenotypic traits examined. Results 675 patients with type 2 diabetes and 377 controls were compared. The minor allele frequency of the TCF7L2 (T) allele was 0.33. In the multivariate model, this allele increased the risk of type 2 diabetes by 39% (95% confidence interval (CI), 1.07-1.81; p = 0.014). The minor alleles KCNJ11 (G) and PPARγ (G) were practically absent (each, 0.001). Minor allele frequencies of CAPN10 were for -43 (A) 0.11 and for -63 (C) 0.46. These variants showed no significant associations with type 2 diabetes. Two CAPN10 haplotypes tended to protect against type 2 diabetes: 211 (aOR, 0.32; 95% CI, 0.03-1.92; p = 0.31) and 221 (aOR, 0.73; 95% CI, 0.48-1.10; p = 0.13). Conclusions In urban Ghana, the frequency of the TCF7L2 rs7903146 (T) allele is comparable to the one in Caucasians; the association with type 2 diabetes is slightly weaker. The risk allele KCNJ11 (G) and the protective allele PPARγ (G) are virtually absent. The potential influence of comparatively rare CAPN10 haplotypes on type 2 diabetes risk in this population requires further evaluation. Large-scale genetic studies among native Africans aiming at fine-mapping the candidate genes are needed to identify the actual factors involved in their increased susceptibility to type 2 diabetes.
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Affiliation(s)
- Ina Danquah
- Institute of Tropical Medicine and International Health, Charité, Universitätsmedizin Berlin, Spandauer Damm 130, 14050 Berlin, Germany.
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Seck SM, Guéye S, Tamba K, Ba I. Prevalence of chronic cardiovascular and metabolic diseases in Senegalese workers: a cross-sectional study, 2010. Prev Chronic Dis 2013; 10:110339. [PMID: 23286359 PMCID: PMC3545700 DOI: 10.5888/pcd10.110339] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Noncommunicable diseases (NCDs) are a major public health threat, particularly in developing countries. In sub-Saharan Africa, the scarcity of reliable data on NCDs in the general population makes it difficult to develop efficient prevention strategies. The objective of this cross-sectional study was to assess the prevalence of 4 cardiometabolic NCDs among 402 private-sector workers in Dakar, Senegal: high blood pressure (HBP), diabetes, obesity, and chronic kidney disease (CKD). Methods We collected demographic, clinical, and biological data for each worker during routine occupational health visits between September 1 and November 30, 2010. Multivariate analyses were performed to identify risk factors associated with NCDs. Results Among the 402 study participants, 24.1% had HBP, 9.7% had diabetes, 16.7% were obese, and 22.4% had CKD. About half of participants (48.5%) were not aware of their diseases before the screening. Univariate analysis showed that age was significantly associated with blood pressure, fasting blood glucose, and renal function. After adjusting for age and sex, systolic blood pressure was correlated with renal function, and physical inactivity was significantly associated with obesity. Conclusion Despite its small sample size, our study provides a perspective on the extent of cardiometabolic NCDs in Senegalese workers. Our study also suggests that targeted screening activities focusing on socio-professional groups may be helpful in the absence of national integrated prevention programs.
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Affiliation(s)
- Sidy Mohamed Seck
- Internal Medicine and Nephrology Department, Faculty of Health Sciences, University Gaston Berger, Route de Ngalléle, BP 234 Saint-Louis, Sénégal.
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Asekun-Olarinmoye EO, Akinwusi PO, Adebimpe WO, Isawumi MA, Hassan MB, Olowe OA, Makanjuola OB, Alebiosu CO, Adewole TA. Prevalence of hypertension in the rural adult population of Osun State, southwestern Nigeria. Int J Gen Med 2013; 6:317-22. [PMID: 23641157 PMCID: PMC3639715 DOI: 10.2147/ijgm.s42905] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the prevalence of hypertension in two rural communities of Osun State, Nigeria. METHODS A consenting adult population of the Alajue and Obokun rural communities in southwestern Nigeria that presented for the screening exercise participated in this community-based cross-sectional descriptive study. Two hundred and fifty-nine respondents aged older than 18 years completed a standardized, pretested, structured questionnaire as part of activities celebrating World Kidney Day and World Glaucoma Day in 2011. Anthropometric data and blood pressure were recorded, and the data were analyzed using the Statistical Package for Social Sciences version 17. RESULTS The mean age of the respondents was 49.7 ± 1.6 years, 100 (38.6%) were males, 84 (32.4%) were farmers, and 111 (42.9%) were traders. The prevalence of hypertension was 13.16% (present in 34 respondents). Seventeen (6.6%) had isolated systolic hypertension, while 11 (4.2%) had isolated diastolic hypertension. Two hundred and thirty-six (91.1%) undertook daily exercise lasting at least 30 minutes and 48 (18.5%) had ever taken antihypertensive drugs on a regular basis. Four respondents (1.6%) claimed a family history of hypertension. The average body mass index (BMI) among respondents was 23.4 ± 4.9 kg/m(2), 51 (19.6%) had a BMI of 25.0-29.9, and 30 (11.5%) had a BMI ≥ 30. A significant association existed between age older than 40 years and having hypertension (P < 0.05), while no relationship existed between age and BMI or between gender and hypertension (P > 0.05). Rates of older age and high BMI were significantly higher among hypertensives than among normotensives. Respondents with BMI ≥ 25 had at least a three times greater likelihood of developing hypertension than those with BMI < 25 (odds ratio 2.9, 95% confidence interval 0.007-0.056, P = 0.011). CONCLUSION The prevalence of hypertension is high in this study population and we recommend scaling up primary prevention efforts to reduce this in Nigerian communities.
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Affiliation(s)
- EO Asekun-Olarinmoye
- Department of Community Medicine, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
| | - PO Akinwusi
- Department of Medicine, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
| | - WO Adebimpe
- Department of Community Medicine, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
| | - MA Isawumi
- Department of Surgery, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
| | - MB Hassan
- Department of Surgery, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
| | - OA Olowe
- Department of Microbiology, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
| | - OB Makanjuola
- Department of Microbiology, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
| | - CO Alebiosu
- Department of Medicine, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
| | - TA Adewole
- Department of Chemical Pathology, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
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Adeboye B, Bermano G, Rolland C. Obesity and its health impact in Africa: a systematic review. Cardiovasc J Afr 2013; 23:512-21. [PMID: 23108519 PMCID: PMC3721807 DOI: 10.5830/cvja-2012-040] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Accepted: 05/03/2012] [Indexed: 01/17/2023] Open
Abstract
Abstract Obesity and its association with co-morbidities in Africa are on the rise. This systematic review examines evidence of obesity and its association with co-morbidities within the African continent. Comparative studies conducted in Africa on adults 17 years and older with mean body mass index (BMI) ≥ 28 kg/m2 were included. Five electronic databases were searched. Surveys, case–control and cohort studies from January 2000 to July 2010 were evaluated. Of 720 potentially relevant articles, 10 met the inclusion criteria. Prevalence of obesity was higher in urban than rural subjects with significant increases in obesity rates among women. Inflammatory marker levels were significantly elevated among Africans compared with Caucasians. The co-relationship between obesity and chronic diseases was also highlighted. This systematic review demonstrates that while obesity remains an area of significant public health importance to Africans, particularly in urban areas, there is little evidence of proper diagnosis, treatment and/or prevention.
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Affiliation(s)
- Bridget Adeboye
- Centre for Obesity Research and Epidemiology, Faculty of Health and Social Care, Robert Gordon University, Aberdeen, Scotland, UK
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Zeba AN, Delisle HF, Renier G, Savadogo B, Baya B. The double burden of malnutrition and cardiometabolic risk widens the gender and socio-economic health gap: a study among adults in Burkina Faso (West Africa). Public Health Nutr 2012; 15:2210-9. [PMID: 22463806 PMCID: PMC10271501 DOI: 10.1017/s1368980012000729] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 12/21/2011] [Accepted: 02/03/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To document the double burden of malnutrition and cardiometabolic risk factors (CMRF) in adults and its occurrence according to different sociodemographic parameters. DESIGN Population-based cross-sectional observational study. We first randomly selected 330 households stratified by tertile of the income levels proxy as low, middle and high income. SETTING Northern district of Ouagadougou, the capital city of Burkina Faso. SUBJECTS In each income stratum, 110 individuals aged 25-60 years and who had lived permanently in Ouagadougou for at least 6 months were randomly selected, followed with collection of anthropometric, socio-economic and clinical data, and blood samples. RESULTS The overall obesity/overweight prevalence was 24.2 % and it was twice as high in women as in men (34.1 % v. 15.5 %, P < 0.001). Hypertension, hyperglycaemia and low HDL cholesterol prevalence was 21.9 %, 22.3 % and 30.0 %, respectively, without gender difference. The prevalence of the metabolic syndrome was 10.3 %. Iron depletion and vitamin A deficiency affected 15.7 % and 25.7 % of participants, respectively, with higher rates in women. Coexistence of at least one nutritional deficiency and one CMRF was observed in 23.5 % of participants, and this 'double burden' was significantly higher in women than in men (30.4 % v. 16.1 %, P = 0.008) and in the low income group. CONCLUSIONS CMRF are becoming a leading nutritional problem in adults of Ouagadougou, while nutritional deficiencies persist. The double nutritional burden exacerbates health inequities and calls for action addressing both malnutrition and nutrition-related chronic diseases.
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Affiliation(s)
- Augustin N Zeba
- Département de Nutrition, Faculté de Médecine, Université de Montréal, CP 6128 succ. Centre-ville, Montréal, Quebec, Canada, H3C 3J7
- Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest (IRSS/DRO), Bobo-Dioulasso, Burkina Faso
| | - Hélène F Delisle
- Département de Nutrition, Faculté de Médecine, Université de Montréal, CP 6128 succ. Centre-ville, Montréal, Quebec, Canada, H3C 3J7
| | - Genevieve Renier
- Centre Hospitalier Universitaire de Montréal, Département de Médecine, Université de Montréal, Montréal, Quebec, Canada
| | - Boubacar Savadogo
- Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest (IRSS/DRO), Bobo-Dioulasso, Burkina Faso
| | - Banza Baya
- Institut Supérieur des Sciences de la Population (ISSP), Université de Ouagadougou, Ouagadougou, Burkina Faso
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