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Keino BC, Carrel M. Multilevel factors associated with overweight and obesity in East Africa: Comparative analysis in five countries from 2003 to 2016. Health Place 2024; 89:103326. [PMID: 39067171 DOI: 10.1016/j.healthplace.2024.103326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/03/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024]
Abstract
Rising rates of overweight/obesity in sub-Saharan Africa (SSA) are a growing concern. Regional analysis of sociodemographic factors associated with overweight/obesity, as is common, may mask nationally specific associations. We examine the spatiotemporal trends of overweight/obesity in women (15-49 years) using 13 years of data (2003-2016) from Demographic and Health Surveys in five East African countries. Multivariable logistic regression reveals that urbanization and individual education, wealth, employment, marital status, and age are linked to overweight/obesity in the region, but their influence varied between nations. Variations in sociodemographic risk factors across nations underscore the need for tailored surveillance and interventions to address the increasing burden of overweight/obesity in East Africa.
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Affiliation(s)
- Barbara Chebet Keino
- Department of Geographical Sciences and Sustainability, University of Iowa, Iowa City, Iowa, USA.
| | - Margaret Carrel
- Department of Geographical Sciences and Sustainability, University of Iowa, Iowa City, Iowa, USA.
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Daran B, Levasseur P, Clément M. Updating the association between socioeconomic status and obesity in low-income and lower-middle-income sub-Saharan African countries: A literature review. Obes Rev 2023; 24:e13601. [PMID: 37415279 DOI: 10.1111/obr.13601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 07/08/2023]
Abstract
Globally, the literature tends to emphasize negative associations between socioeconomic status (SES) and bodyweight in countries improving their economic development. However, little is known about the social distribution of obesity in sub-Saharan Africa (SSA) where economic growth has been highly heterogeneous the last decades. This paper reviews an exhaustive set of recent empirical studies examining its association in low-income and lower-middle-income countries in SSA. Although there is evidence of a positive association between SES and obesity in low-income countries, we found mixed associations in lower-middle-income countries, potentially providing evidence of a social reversal of the obesity burden.
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Affiliation(s)
- Bertille Daran
- PSAE, INRAE, AgroParisTech, Université Paris-Saclay, Palaiseau, France
| | - Pierre Levasseur
- SADAPT, INRAE, AgroParisTech, Université Paris-Saclay, Palaiseau, France
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Herrmann A, Gonnet A, Millogo RM, d'Arc Kabré WJ, Beremwidougou TR, Coulibaly I, Ouili I, Zoromé S, Weil K, Fuelbert H, Soura A, Danquah I. Sustainable dietary weight loss intervention and its effects on cardiometabolic parameters and greenhouse gas emissions: study protocol of a randomised controlled trial with overweight and obese adults in Ouagadougou, Burkina Faso. BMJ Open 2023; 13:e070524. [PMID: 37015795 PMCID: PMC10083789 DOI: 10.1136/bmjopen-2022-070524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/02/2023] [Indexed: 04/06/2023] Open
Abstract
INTRODUCTION The global obesity epidemic and its adverse health effects have reached sub-Saharan Africa. In some urban settings, like Burkina Faso's capital Ouagadougou, up to 43% of the adult population are overweight or obese. At the same time, modernised food systems are responsible for 26% of global greenhouse gas emissions, 50% of land use and 70% of freshwater use. International guidelines on the treatment of overweight and obesity recommend dietary intervention programmes that promote reduced calorie intake and increased physical activity. So far, weight loss interventions rarely consider sustainable dietary concepts, including healthfulness, affordability, cultural appropriateness and environmental friendliness. Therefore, we present a study protocol of a novel randomised controlled trial that aims to establish the effects of a sustainable weight loss intervention on cardiometabolic and environmental outcomes in urban Burkina Faso. METHODS AND ANALYSIS We conduct a non-blinded randomised controlled trial, comparing a 6-month sustainable diet weight loss intervention programme (n=125) with a standard weight loss information material and 5 min oral counselling at baseline (n=125). Primary outcome is a reduction in fasting plasma glucose of ≥0.1 mmol/L. Outcome measures are assessed at baseline, after 6 months and after 12 months. ETHICS AND DISSEMINATION Ethical approval for the study has been obtained from the Medical Faculty of Heidelberg University (S-376/2019) and from the Ministry of Health and the Ministry of Higher Education, Scientific Research and Innovation in Ouagadougou, Burkina Faso (No 2021-01-001). The results of the study will be disseminated to local stakeholders at a final project meeting and to the wider research community through peer-reviewed publications and conferences. TRIAL REGISTRATION NUMBER DRKS00025991.
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Affiliation(s)
- Alina Herrmann
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital and Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Anais Gonnet
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital and Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Roche Modeste Millogo
- Institut Supérieur des Sciences de la Population (ISSP), University of Ouagadougou, Ouagadougou, Burkina Faso
| | | | - Tenin Rosine Beremwidougou
- Institut Supérieur des Sciences de la Population (ISSP), University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Issa Coulibaly
- Institut Supérieur des Sciences de la Population (ISSP), University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Idrissa Ouili
- Institut Supérieur des Sciences de la Population (ISSP), University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Souleymane Zoromé
- Institut Supérieur des Sciences de la Population (ISSP), University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Konstantin Weil
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital and Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Hannah Fuelbert
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital and Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Abdramane Soura
- Institut Supérieur des Sciences de la Population (ISSP), University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital and Medical Faculty, Heidelberg University, Heidelberg, Germany
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Kamkuemah M, Gausi B, Oni T, Middelkoop K. Multilevel correlates of abdominal obesity in adolescents and youth living with HIV in peri-urban Cape Town, South Africa. PLoS One 2023; 18:e0266637. [PMID: 36693111 PMCID: PMC9873196 DOI: 10.1371/journal.pone.0266637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Chronic non-communicable disease comorbidities are a major problem faced by people living with HIV (PLHIV). Obesity is an important factor contributing to such comorbidities and PLHIV face an elevated risk of obesity. However, there is data paucity on the intersection of obesity and HIV in adolescents and youth living with HIV (AYLHIV) in sub-Saharan Africa. We therefore aimed to investigate the prevalence of abdominal obesity and associated multilevel factors in AYLHIV in peri-urban Cape Town, South Africa. METHODS We conducted a cross-sectional study enrolling AYLHIV aged 15-24 years attending primary healthcare facilities in peri-urban Cape Town in 2019. All measures, except for physical examination measures, were obtained via self-report using a self-administered electronic form. Our outcome of interest was abdominal obesity (waist-to-height ratio ≥ 0.5). We collected individual-level data and data on community, built and food environment factors. Data was summarized using descriptive statistics, stratified by obesity status. Multilevel logistic regression was conducted to investigate factors associated with abdominal obesity, adjusted for sex and age. FINDINGS A total of 87 participants were interviewed, 76% were female and the median age was 20.7 (IQR 18.9-23.0) years. More than two fifths had abdominal obesity (41%; 95% CI: 31.0-51.7%), compared to published rates for young people in the general population (13.7-22.1%). In multilevel models, skipping breakfast (aOR = 5.42; 95% CI: 1.32-22.25) was associated with higher odds of abdominal obesity, while daily wholegrain consumption (aOR = 0.20; 95% CI: 0.05-0.71) and weekly physical activity (aOR = 0.24; 95% CI: 0.06-0.92) were associated with lower odds of abdominal obesity. Higher anticipated stigma was associated with reduced odds of obesity (aOR = 0.58; 95% CI: 0.33-1.00). Land-use mix diversity (aOR = 0.52; 95% CI: 0.27-0.97), access to recreational places (aOR = 0.37; 95% CI: 0.18-0.74), higher perceived pedestrian and traffic safety (aOR = 0.20; 95% CI: 0.05-0.80) and having a non-fast-food restaurant within walking distance (aOR = 0.30; 95% CI: 0.10-0.93) were associated with reduced odds of abdominal obesity. The main limitations of the study were low statistical power and possible reporting bias from self-report measures. CONCLUSIONS Our findings demonstrate a high prevalence of abdominal obesity and highlight multilevel correlates of obesity in AYLHIV in South Africa. An intersectoral approach to obesity prevention, intervening at multiple levels is necessary to intervene at this critical life stage.
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Affiliation(s)
- Monika Kamkuemah
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- * E-mail:
| | - Blessings Gausi
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Tolu Oni
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Keren Middelkoop
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Physical Activity Measured by Pedometer in a Peri-Urban Mozambican Population. J Phys Act Health 2022; 19:777-785. [DOI: 10.1123/jpah.2022-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/06/2022]
Abstract
Aim: This study was performed to describe physical activity behavior and its demographic associations in a peri-urban population from Mozambique, using device-based data. Methods: Physical activity was assessed by pedometers in a sample of 15- to 64-year-old subjects from Maputo, Mozambique. Participants wore a pedometer for 7 consecutive days, and physical inactivity was classified using a variety of approaches: sedentary (<5000 steps/d), physically inactive (<7500 steps/d), and no moderate-to-vigorous physical activity (MVPA < 1 min/d). Results: The percentage of sedentary subjects was 17.8%, and the percentage who were physically inactive was 41.8%. A total of 9.0% of participants participated in no MVPA (<1 min/d). Logistic regression analysis showed that females had a higher odds of being sedentary or inactive and having no MVPA compared with males. Unemployed participants were more sedentary and inactive than those who were employed. Socioeconomic status and body mass index did not show any significant association with physical activity. Conclusions: Findings suggest that physical activity levels of this peri-urban African city population are insufficient relative to the amount of activity recommended to improve health. Moreover, being sedentary and inactive was associated with occupation and gender but not with other sociodemographic characteristics and body mass index.
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Alathari BE, Nyakotey DA, Bawah AM, Lovegrove JA, Annan RA, Ellahi B, Vimaleswaran KS. Interactions between Vitamin D Genetic Risk and Dietary Factors on Metabolic Disease-Related Outcomes in Ghanaian Adults. Nutrients 2022; 14:2763. [PMID: 35807945 PMCID: PMC9269445 DOI: 10.3390/nu14132763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
The Ghanaian population is experiencing an upsurge in obesity and type 2 diabetes (T2D) due to rapid urbanization. Besides dietary factors, vitamin D-related genetic determinants have also been shown to contribute to the development of obesity and T2D. Hence, we aimed to examine the interactions between dietary factors and vitamin D-related genetic variants on obesity and T2D related outcomes in a Ghanaian population. Three hundred and two healthy Ghanaian adults (25-60 years old) from Oforikrom, Municipality in Kumasi, Ghana were randomly recruited and had genetic tests, dietary consumption analysis, and anthropometric and biochemical measurements of glucose, HbA1c, insulin, cholesterol, and triglycerides taken. A significant interaction was identified between vitamin D-GRS and fiber intake (g/day) on BMI (pinteraction = 0.020) where those who were consuming low fiber (≤16.19 g/d) and carrying more than two risk alleles for vitamin D deficiency (p = 0.01) had a significantly higher BMI. In addition, an interaction between vitamin D-GRS and fat intake (g/day) on HbA1c (total fat, pinteraction = 0.029) was found, where participants who had a lower total fat intake (≤36.5 g/d), despite carrying more than two risk alleles, had significantly lower HbA1c (p = 0.049). In summary, our study has identified novel gene-diet interactions of vitamin D-GRS with dietary fiber and fat intakes on metabolic traits in Ghanaian adults.
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Affiliation(s)
- Buthaina E. Alathari
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK; (B.E.A.); (J.A.L.)
- Department of Food Science and Nutrition, Faculty of Health Sciences, The Public Authority for Applied Education and Training, P.O. Box 14281, AlFaiha 72853, Kuwait
| | - David A. Nyakotey
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi GH233, Ghana; (D.A.N.); (A.-M.B.); (R.A.A.)
- Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Abdul-Malik Bawah
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi GH233, Ghana; (D.A.N.); (A.-M.B.); (R.A.A.)
| | - Julie A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK; (B.E.A.); (J.A.L.)
- Institute of Cardiovascular and Metabolic Research, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK
| | - Reginald A. Annan
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi GH233, Ghana; (D.A.N.); (A.-M.B.); (R.A.A.)
| | - Basma Ellahi
- Faculty of Health and Social Care, University of Chester, Riverside Campus, Chester CH1 4BJ, UK;
| | - Karani S. Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK; (B.E.A.); (J.A.L.)
- Institute of Cardiovascular and Metabolic Research, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK
- Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AH, UK
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Mensah D, Ogungbe O, Turkson-Ocran RAN, Onuoha C, Byiringiro S, Nmezi NA, Mannoh I, Wecker E, Madu EN, Commodore-Mensah Y. The Cardiometabolic Health of African Immigrants in High-Income Countries: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7959. [PMID: 35805618 PMCID: PMC9265760 DOI: 10.3390/ijerph19137959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 12/04/2022]
Abstract
In recent decades, the number of African immigrants in high-income countries (HICs) has increased significantly. However, the cardiometabolic health of this population remains poorly examined. Thus, we conducted a systematic review to examine the prevalence of cardiometabolic risk factors among sub-Saharan African immigrants residing in HICs. Studies were identified through searches in electronic databases including PubMed, Embase, CINAHL, Cochrane, Scopus, and Web of Science up to July 2021. Data on the prevalence of cardiometabolic risk factors were extracted and synthesized in a narrative format, and a meta-analysis of pooled proportions was also conducted. Of 8655 unique records, 35 articles that reported data on the specific African countries of origin of African immigrants were included in the review. We observed heterogeneity in the burden of cardiometabolic risk factors by African country of origin and HIC. The most prevalent risk factors were hypertension (27%, range: 6-55%), overweight/obesity (59%, range: 13-91%), and dyslipidemia (29%, range: 11-77.2%). The pooled prevalence of diabetes was 11% (range: 5-17%), and 7% (range: 0.7-14.8%) for smoking. Few studies examined kidney disease, hyperlipidemia, and diagnosed cardiometabolic disease. Policy changes and effective interventions are needed to improve the cardiometabolic health of African immigrants, improve care access and utilization, and advance health equity.
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Affiliation(s)
- Danielle Mensah
- College of Medicine, Drexel University, Philadelphia, PA 19129, USA;
| | - Oluwabunmi Ogungbe
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA; (O.O.); (S.B.)
| | | | - Chioma Onuoha
- School of Medicine, University of California, San Francisco, CA 94143, USA;
| | - Samuel Byiringiro
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA; (O.O.); (S.B.)
| | - Nwakaego A. Nmezi
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD 21201, USA;
| | - Ivy Mannoh
- School of Medicine, Johns Hopkins University, Baltimore, MD 21201, USA; (I.M.); (E.W.)
| | - Elisheva Wecker
- School of Medicine, Johns Hopkins University, Baltimore, MD 21201, USA; (I.M.); (E.W.)
| | - Ednah N. Madu
- College of Nursing and Public Health, Adelphi University, Garden City, NY 11530, USA;
| | - Yvonne Commodore-Mensah
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA; (O.O.); (S.B.)
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Kwansa AL, Akparibo R, Cecil JE, Infield Solar G, Caton SJ. Risk Factors for Overweight and Obesity within the Home Environment of Preschool Children in Sub-Saharan Africa: A Systematic Review. Nutrients 2022; 14:nu14091706. [PMID: 35565675 PMCID: PMC9100775 DOI: 10.3390/nu14091706] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.
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Affiliation(s)
- Albert L. Kwansa
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Robert Akparibo
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Joanne E. Cecil
- School of Medicine, Population and Behavioural Sciences, University of St Andrews, St Andrews KY16 9TF, UK;
| | | | - Samantha J. Caton
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
- Correspondence:
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Mogo ER, Brugulat-Panés A, Micklesfield LK, Ebikeme C, Muzenda T, Foley L, Oni T. A protocol for a systematic review on intersectoral interventions to reduce non-communicable disease risk factors in African cities. PUBLIC HEALTH IN PRACTICE 2022; 3:100251. [PMID: 35770235 PMCID: PMC9207189 DOI: 10.1016/j.puhip.2022.100251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/28/2022] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Ebele R.I. Mogo
- MRC Epidemiology Unit, Global Diet and Activity Research Group and Network, University of Cambridge, United Kingdom
| | - Anna Brugulat-Panés
- MRC Epidemiology Unit, Global Diet and Activity Research Group and Network, University of Cambridge, United Kingdom
| | - Lisa K. Micklesfield
- South African Medical Research Council, University of the Witwatersrand Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Charles Ebikeme
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Trish Muzenda
- Research Initiative for Cities Health and Equity, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa
| | - Louise Foley
- MRC Epidemiology Unit, Global Diet and Activity Research Group and Network, University of Cambridge, United Kingdom
| | - Tolu Oni
- MRC Epidemiology Unit, Global Diet and Activity Research Group and Network, University of Cambridge, United Kingdom
- Research Initiative for Cities Health and Equity, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa
- Corresponding author. Global Diet and Physical Activity Research Group, MRC Epidemiology Unit, Cambridge Biomedical Campus, CB2 0QQ, United Kingdom.
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Israel E, Hassen K, Markos M, Wolde K, Hawulte B. Central Obesity and Associated Factors Among Urban Adults in Dire Dawa Administrative City, Eastern Ethiopia. Diabetes Metab Syndr Obes 2022; 15:601-614. [PMID: 35241919 PMCID: PMC8887614 DOI: 10.2147/dmso.s348098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/16/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Central obesity (CO) is a medical problem in which extra fat is accumulated in the abdomen and stomach extent that it may harm health. Furthermore, previous studies in Ethiopia predominantly relied on body mass index used to measure obesity and do not show distribution of fat. However, there is a paucity of information on the measurement of central obesity using waist circumference and associated factors in Ethiopia particularly in the study area. Hence, the purpose of this study is to assess the prevalence of central obesity and associated factors among urban adults in Dire Dawa, administrative city, Eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among 633 adults in selected kebeles of administrative city from October 15 to November 15, 2020. A multistage and systematic sampling procedure was used to select study participants. Central obesity is defined as a condition with waist circumference ≥83.7 cm for men and ≥78 cm for women with or without general obesity (GO). Odds ratio along with 95% confidence interval was estimated to identify factors associated with central obesity using multiple logistic regression analysis. RESULTS The overall prevalence of central obesity was 76.1%; at 95% CI (73%, 80%). Associated factors of central obesity were age 45 years and above [AOR = 3.75, 95% CI (1.86, 7.55)], being female [AOR = 2.52, 95% CI: (1.62, 3.94)], alcohol consumption [AOR = 2.61, 95% CI: (1.69, 4.05], physical inactivity [AOR = 2.05, 95% CI: (1.23, 3.42)], and two hour and more time spent on watching television [AOR = 3.30, 95% CI: (1.59, 6.82)]. CONCLUSION The study shows central obesity was high in the study area. Age 45 years and above, being females, married, physically inactive, alcohol consumption, and spending a long time watching television was associated with central obesity. Having regular physical activity, limiting alcohol drinking, and limiting time spent watching television were recommended to prevent central obesity and associated risk among adults.
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Affiliation(s)
- Ephrem Israel
- Dire Dawa Regional Health Bureau, Dire Dawa City Administration, Dire Dawa, Ethiopia
| | - Kalkidan Hassen
- Department of Population and Family Health, Institute of Health Science, Jimma University, Jimma, Ethiopia
| | - Melese Markos
- Department of Public Health, College of Health and Medical Science, Wachemo University Durame Campus, Durame, Ethiopia
| | - Kiber Wolde
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Bahailu Hawulte
- School of Public Health, College of Medicine and Health Science, Haramaya University, Harar, Ethiopia
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Bojang KS, Lyrawati D, Sujuti H, Wahono D. Prevalence of Metabolic Syndrome and its Components in Kanifing Municipality, The Gambia. Med Arch 2022; 75:340-346. [PMID: 35169354 PMCID: PMC8740674 DOI: 10.5455/medarh.2021.75.340-346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/15/2021] [Indexed: 11/03/2022] Open
Abstract
Background Metabolic syndrome (MetS) is a complex syndrome with clustering of interrelated risk factors for cardiovascular disease and diabetes. Its rising worldwide prevalence has been largely related to the increasing obesity. In The Gambia, the last and only time a MetS related study was conducted, and then reported, was 21 years. Therefore, there is need for evaluating the prevalence of MetS and its components in the country. Objective This study was aimed to evaluate the prevalence of MetS and its individual components in Kanifing Municipality (KM). Methods It was a cross-sectional study conducted at Kanifing General Hospital, Kanifing Municipality. Data obtained from each participants included anthropometric indices, blood pressure, fasting plasma glucose, triglyceride and high-density lipoprotein levels, and clinical information. Results One hundred and thirty-six participants were included in the analysis. The overall MetS prevalence was 54.4% with significant female predominance (female, 58%; male, 29.4%; P=0.025). The most predominant component among the study population was central obesity (raised WC) (72.8%). Hypertriglyceridemia was found to be the strongest predictor of MetS among our participants (OR: 118.13; 95% CI: 33.79-412.77; P < 0.001). Conclusion Our study discloses a very high prevalence of MetS among the participants, and a significant female predominance, with central obesity the commonest Mets component. The results suggest that hypertriglyceridemia is the strongest predictor of metabolic syndrome in our study participants.
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Affiliation(s)
- Kebba S Bojang
- Doctoral Program, Postgraduate Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia.,School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia.,Department of Internal Medicine, Kanifing General Hospital, Kanifing, The Gambia
| | - Diana Lyrawati
- Doctoral Program, Postgraduate Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia.,Department of Pharmacy, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Hidayat Sujuti
- Doctoral Program, Postgraduate Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia.,Department of Ophthalmology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Djoko Wahono
- Doctoral Program, Postgraduate Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia.,Department of Internal Medicine, Faculty of Medical, Brawijaya University, Malang, Indonesia
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12
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Belay M, Oumer A, Abdureshid N, Ale A. Overnutrition and Associated Factors Among High School Adolescents in Mid COVID-19 Pandemic in Ethiopia: Neglected Public Health Concern. Adolesc Health Med Ther 2022; 13:1-14. [PMID: 35082546 PMCID: PMC8784252 DOI: 10.2147/ahmt.s349189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Adolescent overnutrition is becoming a global public health problem, increasing at an alarming rate in developing countries. Overnutrition increases the risks of serious diet-related chronic diseases, including type 2 diabetes, hypertension, cardiovascular disease, and stroke. However, there is limited evidence on the magnitude and risk factors of overnutrition in the study area. OBJECTIVE To determine the magnitude of overnutrition and associated factors among school adolescents in Dire Dawa, Eastern Ethiopia. METHODS A cross-sectional study was conducted from May to June 2021 among 498 adolescent students selected using a multi-stage sampling procedure. A systematic random sampling technique was employed. Self-administered questionnaires, including food frequency and anthropometric measurement, were used to collect the data. The BMI-for-age Z score was calculated using the WHO Anthro-Plus. A binary logistic regression model was fitted with an odds ratio, and 95% confidence levels. Statistical significance is declared at a p-value below 0.05. RESULTS A total of 498 (98.4%) were included with the overall prevalence of overnutrition of 26.1% (95% CI: 22.3-29.9), where 23.7% and 2.4% had overweight and obesity, respectively. Being female (AOR = 3.32; 95% CI: 1.65-6.63), attending at private school (AOR = 4.97; 95% CI: 1.72-14.35), having sweet food preferences (AOR = 6.26; 95% CI: 3.14-12.5), snacking (AOR = 3.05; 95% CI: 1.11-8.36), sedentary behavior (AOR = 3.20; 95% CI: 1.67-6.09), and eating while watching TV (AOR= 2.95; 95% CI: 1.47-5.95) were significantly associated with overnutrition. CONCLUSION Overnutrition is a major emerging public health problem in eastern Ethiopia. School type, sex, sweet food preferences, habits of snacking, sedentary behaviors, and eating while watching TV were significantly associated with overnutrition. Therefore, public health strategies to curb overweight and obesity among high school adolescents are urgently needed in order to reduce the prevalence and its adverse complications.
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Affiliation(s)
- Michael Belay
- Department of public health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Abdu Oumer
- Department of public health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Neil Abdureshid
- Department of Midwifery and College Quality Improvement Coordinator, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Ahmed Ale
- School of Medicine, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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13
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Towards Sustainable Shifts to Healthy Diets and Food Security in Sub-Saharan Africa with Climate-Resilient Crops in Bread-Type Products: A Food System Analysis. Foods 2022; 11:foods11020135. [PMID: 35053868 PMCID: PMC8774613 DOI: 10.3390/foods11020135] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
Massive urbanization and increasing disposable incomes favor a rapid transition in diets and lifestyle in sub-Saharan Africa (SSA). As a result, the SSA population is becoming increasingly vulnerable to the double burden of malnutrition and obesity. This, combined with the increasing pressure to produce sufficient food and provide employment for this growing population together with the threat of climate change-induced declining crop yields, requires urgent sustainable solutions. Can an increase in the cultivation of climate-resilient crops (CRCs) and their utilization to produce attractive, convenient and nutritious bread products contribute to climate change adaptation and healthy and sustainable diets? A food system analysis of the bread food value chain in SSA indicates that replacement of refined, mostly imported, wheat in attractive bread products could (1) improve food and nutrition security, (2) bring about a shift to more nutritionally balanced diets, (3) increase economic inclusiveness and equitable benefits, and (4) improve sustainability and resilience of the food system. The food system analysis also provided systematic insight into the challenges and hurdles that need to be overcome to increase the availability, affordability and uptake of CRCs. Proposed interventions include improving the agronomic yield of CRCs, food product technology, raising consumer awareness and directing policies. Overall, integrated programs involving all stakeholders in the food system are needed.
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14
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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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15
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Alaofè H, Yeo S, Okechukwu A, Magrath P, Amoussa Hounkpatin W, Ehiri J, Rosales C. Cultural Considerations for the Adaptation of a Diabetes Self-Management Education Program in Cotonou, Benin: Lessons Learned from a Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168376. [PMID: 34444125 PMCID: PMC8393923 DOI: 10.3390/ijerph18168376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 12/02/2022]
Abstract
Background: Type 2 diabetes (T2D) poses a disproportionate burden on Benin, West Africa. However, no diabetes intervention has yet been developed for Benin’s contexts. This study aimed to explore specific cultural beliefs, attitudes, behaviors, and environmental factors to help adapt a diabetes self-management program to patients with T2D from Cotonou, in southern Benin. Methods: Qualitative data were collected through focus group discussions (FDGs) involving 32 patients with T2D, 16 academic partners, and 12 community partners. The FDGs were audio-recorded, transcribed verbatim from French to English, and then analyzed thematically with MAXQDA 2020. Results: Healthy food was challenging to obtain due to costs, seasonality, and distance from markets. Other issues discussed were fruits and vegetables as commodities for the poor, perceptions and stigmas surrounding the disease, and the financial burden of medical equipment and treatment. Information about local food selections and recipes as well as social support, particularly for physical activity, were identified, among other needs. When adapting the curriculum, gender dynamics and spirituality were suggested. Conclusions: The study demonstrates the need for culturally sensitive interventions and a motivation-based approach to health (spiritual and emotional support). It also lays the groundwork for addressing T2D contextually in Benin and similar sub-Saharan African countries.
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Affiliation(s)
- Halimatou Alaofè
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
- Correspondence: ; Tel.: +1-(520)-626-5614
| | - Sarah Yeo
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
| | - Abidemi Okechukwu
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
| | - Priscilla Magrath
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
| | - Waliou Amoussa Hounkpatin
- School of Nutrition and Food Science and Technology, Faculty of Agricultural Sciences, University of Abomey-Calavi (FSA-UAC), Campus d’Abomey-Calavi, Calavi 01 BP 526, Benin;
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
| | - Cecilia Rosales
- Division of Public Health Practice & Translational Research, University of Arizona, Phoenix Plaza Building, 550 E. Van Buren Street, Phoenix, AZ 85006, USA;
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16
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Blum RW, Li M, Choiriyyah I, Barnette Q, Michielson K, Mmari K. Body Satisfaction in Early Adolescence: A Multisite Comparison. J Adolesc Health 2021; 69:S39-S46. [PMID: 34217458 DOI: 10.1016/j.jadohealth.2021.03.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 01/25/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE This study assesses the relationship between unequal gender perceptions, socioecological factors, and body satisfaction among early adolescents in six urban poor settings in four countries. METHODS A cross-sectional study, part of the Global Early Adolescent Study, was conducted in Shanghai, China; Cuenca, Ecuador; Kinshasa, DRC; and three cities in Indonesia: Denpasar, Semarang, and Bandar Lampung. Bivariate and multiple linear regressions were conducted to assess the relationships between body satisfaction, perceptions of gender norms, and socioecological factors. A final sample of 7840 respondents aged between 10 and 14 years were included in the analysis. RESULTS Adolescents who endorsed more traditional sex roles and traits were more likely to be satisfied with their bodies in Kinshasa and Indonesia, while only endorsement of GST was associated with body satisfaction in Shanghai. Individual factors related to body satisfaction varied by site and included perceived health status, perception of body weight, height, and growth rate. Family and neighborhood factors related to increased body satisfaction varied by site and sex and included closeness to parents, parental communication, discussing bodily changes with anyone, parental awareness, and perception of neighborhood. CONCLUSION The results highlight the association between gender norms and social factors at individual, family, and neighborhood levels with body satisfaction. While associations differ significantly by site and sex, namely in perception of body weight and height, there exists commonalities that suggest body satisfaction, gender norms, and social context are intertwined.
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Affiliation(s)
- Robert Wm Blum
- Department of Population, Family and Reproductive Health, Johns Hopkins University, Baltimore, Maryland.
| | - Mengmeng Li
- Department of Population, Family and Reproductive Health, Johns Hopkins University, Baltimore, Maryland
| | - Ifta Choiriyyah
- Department of Population, Family and Reproductive Health, Johns Hopkins University, Baltimore, Maryland; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Quinn Barnette
- Department of Population, Family and Reproductive Health, Johns Hopkins University, Baltimore, Maryland
| | - Kristien Michielson
- International Centre for Reproductive Health, University of Ghent, Ghent, Belgium
| | - Kristin Mmari
- Department of Population, Family and Reproductive Health, Johns Hopkins University, Baltimore, Maryland
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17
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Mukanu MM, Abdool Karim S, Hofman K, Erzse A, Thow AM. Nutrition related non-communicable diseases and sugar sweetened beverage policies: a landscape analysis in Zambia. Glob Health Action 2021; 14:1872172. [PMID: 33876714 PMCID: PMC8079008 DOI: 10.1080/16549716.2021.1872172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Background: Taxation on unhealthy products is recommended as a cost-effective intervention to address the global burden of non-communicable diseases. Taxation of sugar-sweetened beverages dis-incentivize consumption of unhealthy products. Implementation of such policies is difficult in Sub-Saharan African countries, which are targets for global corporate expansion by the sugar-sweetened beverages industry.Objective: To identify opportunities to strengthen policies relating to sugar-sweetened beverage taxation in Zambia, through: (1) understanding the policy landscape and political context in which policies for nutrition-related non-communicable diseases are being developed, particularly sugar-sweetened beverage taxation, and exploring the potential use of revenue arising from sugar-sweetened beverage taxation to support improved nutrition.Methods: We conducted a retrospective qualitative policy analysis with a review of nutrition-related non-communicable diseases policies and key informant interviews (n = 10) with policy actors. Data were coded and analyzed data using pre-constructed matrices based on the Kingdon's Policy Agenda Framework.Results: Government responses to nutrition-related non-communicable diseases were developed in an incoherent policy environment. The health sector's commitment to regulate sugar-sweetened beverages conflicted with the manufacturing sector's priorities for economic growth. Increased regulation of sugar-sweetened beverages was a priority for the health sector. Economic interests sought to grow the manufacturing sector, including the food and beverage industries. Consequently, incoherent policy objectives might have contributed to the adoption of a weakened excise tax. The general public were poorly informed about nutrition-related non-communicable diseases.Conclusions: The tension between the Government's economic and public health priorities is a barrier for strengthening fiscal measures to address nutrition-related non-communicable diseases. However, this did not prevent the introduction of a differential sugar tax on sugar-sweetened beverages. Opportunities exist to strengthen the existing taxation of sugar-sweetened beverages in Zambia. These include a more inclusive consultation process for policy formulation and comprehensive monitoring of risk factors.
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Affiliation(s)
- Mulenga M Mukanu
- Health Policy and Management Unit, University of Zambia School of Public Health, Lusaka, Zambia
| | - Safura Abdool Karim
- SAMRC Centre for Health Economics and Decision Science - Priority Cost Effective Lessons for Systems Strengthening (PRICELESS SA), University of the Witwatersrand, School of Public Health, Johannesburg, South Africa
| | - Karen Hofman
- SAMRC Centre for Health Economics and Decision Science - Priority Cost Effective Lessons for Systems Strengthening (PRICELESS SA), University of the Witwatersrand, School of Public Health, Johannesburg, South Africa
| | - Agnes Erzse
- SAMRC Centre for Health Economics and Decision Science - Priority Cost Effective Lessons for Systems Strengthening (PRICELESS SA), University of the Witwatersrand, School of Public Health, Johannesburg, South Africa
| | - Anne-Marie Thow
- Menzies Centre for Health Policy, School of Public Health, The University of Sydney, Sydney, Australia
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18
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Hill B. Expanding our understanding and use of the ecological systems theory model for the prevention of maternal obesity: A new socioecological framework. Obes Rev 2021; 22:e13147. [PMID: 33000890 DOI: 10.1111/obr.13147] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/20/2020] [Accepted: 09/07/2020] [Indexed: 12/20/2022]
Abstract
The reproductive life phase, most notably the preconception, pregnancy and postpartum periods, is a key driver of weight gain in women and therefore substantially increases the risk of noncommunicable diseases for mothers and their offspring. The ecological systems theory (EST) model for maternal obesity prevention positions the woman and her behaviour as interacting with surrounding layers of influences, including proximal interpersonal relationships embedded within social, environmental, and policy contexts. However, current thinking and use of the EST model for maternal obesity prevention are limited by a focus on women as being responsible for lifestyle change, with the associated blame and weight stigma, and by a lack of understanding of the interactions between EST layers. This paper presents a new socioecological framework for maternal obesity prevention, which aims to address these issues and offer potential strategies to assist researchers to generate new knowledge and understanding of the myriad ways we can approach maternal obesity prevention.
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Affiliation(s)
- Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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19
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Cham B, Scholes S, Groce NE, Badjie O, Mindell JS. High level of co-occurrence of risk factors for non-communicable diseases among Gambian adults: A national population-based health examination survey. Prev Med 2020; 141:106300. [PMID: 33121964 DOI: 10.1016/j.ypmed.2020.106300] [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: 12/12/2019] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 10/23/2022]
Abstract
Non-communicable diseases (NCDs) are the leading causes of morbidity and mortality globally. Co-occurrence of risk factors predisposes an individual to NCDs; the burden increases cumulatively with the number of risk factors. Our study aimed to examine the co-occurrence of NCD risk factors among adults in The Gambia. This study is based on a random nationally representative sample of 4111 adults aged 25-64 years (78% response rate) with data collected between January and March 2010 in The Gambia using the WHO STEPwise survey methods. We restricted our analysis to non-pregnant participants with valid information on five NCD risk factors: high blood pressure, smoking, obesity, low fruit and vegetable consumption, and physical inactivity (n = 3000 adults with complete data on all risk factors). We conducted age-adjusted and fully-adjusted gender stratified multinomial logistic regression analysis to identify factors associated with the number of NCD risk factors. More than 90% of adults had at least one risk factor. Only 7% (95% CI: 5.2-9.8) had no risk factor; 22% (95% CI: 19.1-24.9) had at least three. Older age and ethnicity were significantly associated with having three or more risk factors (versus none) among men in the fully adjusted model. Lower education, older age, and urban residence were significantly associated with three or more risk factors (versus none) among women. The burden of NCDs is expected to increase in The Gambia if preventive and control measures are not taken. There should be an integrated approach targeting all risk factors, including wider treatment and control of hypertension.
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Affiliation(s)
- Bai Cham
- Research Department of Epidemiology and Public Health, UCL (University College London), London WC1E 6BT, United Kingdom; Department of Public Health, University of The Gambia, Brikama Campus, P.O.Box, 3530, Serrekunda, The Gambia; Disease Control and Elimination theme, Medical Research Council Unit, The Gambia, at the London School of Hygiene and Tropical Medicine, Atlantic Road, Fajara, P.O.Box 273, Banjul, The Gambia.
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health, UCL (University College London), London WC1E 6BT, United Kingdom
| | - Nora E Groce
- Research Department of Epidemiology and Public Health, UCL (University College London), London WC1E 6BT, United Kingdom
| | - Omar Badjie
- Non-Communicable Diseases Unit, Ministry of Health, Banjul, The Gambia
| | - Jennifer S Mindell
- Research Department of Epidemiology and Public Health, UCL (University College London), London WC1E 6BT, United Kingdom
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Jaca A, Iwu C, Durão S, Onyango AW, Wiysonge CS. Understanding the underlying drivers of obesity in Africa: a scoping review protocol. BMJ Open 2020; 10:e040940. [PMID: 33177144 PMCID: PMC7661354 DOI: 10.1136/bmjopen-2020-040940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The worldwide prevalence of obesity and overweight has doubled since 1980, such that approximately a third of the world's population is reported as obese or overweight. Obesity rates have increased in all ages and both sexes irrespective of geographical area, ethnicity or socioeconomic status. Due to the high prevalence, related health consequences and costs of childhood and adult obesity, there is a need to comprehensively identify and assess the major underlying drivers of obesity and overweight in the African context. METHODS AND ANALYSIS This scoping review will be carried out as per the methodological outline by Arksey and O'Malley. The search strategy will be developed and search performed in the Scopus and PubMed electronic databases. In the first search, we will identify concepts that are used as an equivalent to obesity and overweight. Subsequently, we will search for studies comprising of search terms on the underlying factors that drive the development of obesity and overweight. Lastly, we will check reference lists for additional publications. Abstracts and full-text studies will independently be screened by two authors. ETHICS AND DISSEMINATION The proposed study will generate evidence from published data and hence does not require ethics approval. Evidence generated from this review will be disseminated through journal publications and conference presentations.
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Affiliation(s)
- Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
| | - Chinwe Iwu
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Solange Durão
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
| | - Adelheid W Onyango
- Department of Nutrition for Health and Development, World Health Organization, Brazzaville, Congo
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
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21
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Christian AK, Frempong GA. Correlates of over- or under-estimation of body size among resource-poor urban dwellers in a sub-Saharan African city. Ann Hum Biol 2020; 47:602-609. [PMID: 32988221 DOI: 10.1080/03014460.2020.1830171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Individual perception of body size has implications for lifestyle behaviours including dietary habits and weight management practices. AIM To examine factors related to respondents' estimation of their body sizes compared to their body mass index (BMI). SUBJECTS AND METHODS This cross-sectional survey comprised a sample of 917 adults in urban poor Accra, Ghana. Silhouette figure ratings were used to assess perceived body size and ideal body size at a community level. Logistic regression analysis was used to determine correlates of respondents overestimating or underestimating their body sizes. RESULTS Approximately, 69% of respondents either underestimated or overestimated their body sizes. About a quarter of respondents perceived being overweight as the preferred ideal body size in their communities. The mean BMI of females and males who underestimated their body sizes were within the overweight category and normal weight category, respectively. Gender, educational level, employment status, the community of residence, and ethnicity were associated with how respondents correctly estimated, over- or under-estimated their body sizes. There was evidence of ethnicity mediating the association between the community of residence and body size estimation. CONCLUSION Weight management interventions must be mindful of the socio-demographic and cultural proclivities of the targeted populace for optimum impact.
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Adebayo PB, Mwakabatika RE, Mazoko MC, Taiwo FT, Ali AJ, Zehri AA. Relationship Between Obesity and Severity of Carpal Tunnel Syndrome in Tanzania. Metab Syndr Relat Disord 2020; 18:485-492. [PMID: 32795111 DOI: 10.1089/met.2020.0062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Carpal tunnel syndrome (CTS) is the most common focal mononeuropathy in the general population, and obesity is one of its established independent risk factors The prevalence of obesity in CTS patients and its association with CTS severity are yet to be fully studied among Tanzanians. In this study, we determined the frequency of obesity in patients with CTS and its relationship with the electrophysiological severity of CTS in a Tanzanian private tertiary level hospital. Methods: This is a retrospective observational and analytical study of patients referred for electrodiagnostic (EDX) evaluation of suspected CTS at the clinical neurophysiology laboratory of the Aga Khan Hospital, Dar es Salaam, Tanzania. All EDX studies done for CTS indications between August 1, 2017, and December 31, 2019, were reviewed. The frequency of CTS patients with obesity (body mass index >30 kg/m2) and overweight (25.0-29.9 kg/m2) was determined. Next, we explored the relationship between obesity and the electrophysiologic severity of CTS. Results: One-hundred nine hands were studied. The prevalence of obesity was 50.5% and overweight was 31.2%. Females were significantly more obese than males (P = 0.001). Many of the EDX parameters that defined CTS, including prolonged median nerve sensory and distal motor latencies as well as sensory conduction velocity, were significantly more abnormal in the obese when compared to the nonobese patients. On univariate analysis, severe CTS (stage 5) was commoner among nonobese patients (P = 0.031), while moderate CTS (stage3) was more prevalent among obese patients (P < 0.001). Multivariate regression analysis, however, revealed no effect of obesity on CTS severity (P = 0.490). Conclusion: Obesity and overweight are prevalent among this cohort with CTS, but did not predict severe CTS. The use of other indices of adiposity may show a trend.
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Affiliation(s)
- Philip B Adebayo
- Neurology Section, Department of Internal Medicine, Aga Khan University, Dar es Salaam, Tanzania.,Clinical Neurophysiology Laboratory, Aga Khan Hospital, Dar es Salaam, Tanzania
| | - Rose E Mwakabatika
- Clinical Neurophysiology Laboratory, Aga Khan Hospital, Dar es Salaam, Tanzania
| | - Mugisha C Mazoko
- Neurosurgery Section, Department of Surgery, Aga Khan University, Dar es Salaam, Tanzania
| | - Funmilola T Taiwo
- Neurology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Asmita J Ali
- Clinical Neurophysiology Laboratory, Aga Khan Hospital, Dar es Salaam, Tanzania
| | - Ali A Zehri
- Department of Surgery, Aga Khan University, Dar es Salaam, Tanzania
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Mengesha Kassie A, Beletew Abate B, Wudu Kassaw M, Gebremeskel Aragie T. Prevalence of Underweight and Its Associated Factors among Reproductive Age Group Women in Ethiopia: Analysis of the 2016 Ethiopian Demographic and Health Survey Data. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:9718714. [PMID: 32802085 PMCID: PMC7403906 DOI: 10.1155/2020/9718714] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 01/22/2023]
Abstract
Background Underweight is defined as being below the healthy weight range. Underweight in reproductive age group women not only affects women but also increases the risk of an intergenerational cycle of malnutrition and child mortality. Various factors are linked with underweight among women. However, studies on the prevalence of underweight and its associated factors among women are limited in Ethiopia. Hence, this study aimed to assess the prevalence of underweight and its associated factors among reproductive age group women in Ethiopia. Methods For this study, data were drawn from the 2016 Ethiopian demographic and health survey (EDHS). From the total, 15,683 women participants of the 2016 EDHS; a subsample of 2,848 participants aged 15-49 years who had a complete response to all variables of interest were selected and utilized for analysis. Data were analyzed using SPSS version 20 software program. Pearson's chi-squared test was used to assess the frequency distribution of underweight and is presented with different sociodemographic characteristics. Logistic regression models were applied for analysis. A two-sided p value of less than 0.05 was used to declare a statistically significant association between the independent variables and underweight among women. Results The prevalence of underweight among reproductive age group women in Ethiopia was 17.6%. The majority, 78.3% of underweight women, were rural dwellers. The odds of being underweight was higher among the young aged women, among those residing in rural areas, in those with higher educational status, and in those who have one or more children. On the other hand, the odds of underweight among respondents living in Benishangul, SNNPR, and Addis Ababa were less compared to those living in Dire Dawa. Similarly, the odds of underweight among participants with a higher level of husband or partner educational status and among those who chew Khat were less compared to their counterparts. Conclusion Underweight among reproductive age group women in Ethiopia is still a major public health problem, particularly among rural dwellers. Underweight was significantly associated with different sociodemographic variables. Hence, context-based awareness creation programs need to be designed on the prevention methods of underweight in Ethiopia, giving especial emphasis to those residing in rural areas.
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Affiliation(s)
- Ayelign Mengesha Kassie
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Mesfin Wudu Kassaw
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
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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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Tumwesigye NM, Mutungi G, Bahendeka S, Wesonga R, Katureebe A, Biribawa C, Guwatudde D. Alcohol consumption, hypertension and obesity: Relationship patterns along different age groups in Uganda. Prev Med Rep 2020; 19:101141. [PMID: 32685360 PMCID: PMC7358719 DOI: 10.1016/j.pmedr.2020.101141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 12/29/2022] Open
Abstract
Hypertension prevalence ratios don’t rise with age groups among frequent drinkers. Alcohol consumption pattern partly modifies the age-hypertension relationship. Alcohol consumption pattern does not modify obesity-age relationship.
The prevalence of non-communicable diseases including hypertension and obesity is rising and alcohol consumption is a predisposing factor. This study explored the effect of alcohol consumption patterns on the hypertension-age group and obesity-age group relationships. The data were extracted from the 2014 National NCD Survey of adults aged 18–69 years. Hypertension was defined as a condition of having systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg while obesity was defined as having a body mass index ≥30 kg/m2. Frequent alcohol consumption was measured as alcohol use ≥3 times a week. Multivariable log binomial regression analysis was used to assess independent relationship between the outcomes and alcohol consumption. The prevalences of hypertension, frequent alcohol consumption and obesity increased across age groups but were divergent towards last age group. Hypertension prevalence ratios were higher with higher age groups among moderate and nondrinkers but not among frequent drinkers. Alcohol drinking pattern modified the age hypertension relationship in a model with ungrouped age. The drinking pattern did not modify obesity-age relationship. Alcohol consumption pattern appeared to modify the hypertension-age group relationship. However, more research is needed to explain why prevalence ratios are higher with higher age groups among moderate drinkers and abstainers while they stagnate among the frequent drinkers. There was no evidence to show the effect of alcohol consumption on obesity-age group relationship.
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Affiliation(s)
| | - Gerald Mutungi
- Control of Non-communicable Diseases Desk, Ministry of Health, Kampala, Uganda
| | - Silver Bahendeka
- Department of Internal Medicine St. Francis Hospital Nsambya, Kampala, Uganda
| | - Ronald Wesonga
- School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Agaba Katureebe
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda
| | - Claire Biribawa
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda
| | - David Guwatudde
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda
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Cham B, Scholes S, Ng Fat L, Badjie O, Groce NE, Mindell JS. The silent epidemic of obesity in The Gambia: evidence from a nationwide, population-based, cross-sectional health examination survey. BMJ Open 2020; 10:e033882. [PMID: 32487572 PMCID: PMC7265034 DOI: 10.1136/bmjopen-2019-033882] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Non-communicable diseases account for 70% of global deaths; 80% occur in low-income and middle-income countries. The rapid increase of obesity in sub-Saharan Africa is a concern. We assessed generalised and abdominal obesity and their associated risk factors among adults in The Gambia. DESIGN Nationwide cross-sectional health examination survey using the WHO STEPwise survey methods. SETTING The Gambia. PARTICIPANTS This study uses secondary analysis of a 2010 nationally representative random sample of adults aged 25-64 years (78% response rate). The target sample size was 5280, and 4111 responded. Analysis was restricted to non-pregnant participants with valid weight and height measurements (n=3533). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome variable was generalised obesity, using WHO body mass index (BMI) thresholds. Analyses used non-response weighting and adjusted for the complex survey design. We conducted multinomial logistic regression analysis to identify factors associated with BMI categories. The secondary outcome variable was abdominal obesity, defined as high waist circumference (using the International Diabetes Federation thresholds for Europeans). RESULTS Two-fifths of adults were overweight/obese, with a higher obesity prevalence in women (17%, 95% CI 14.7 to 19.7; men 8%, 95% CI 6.0 to 11.0). 10% of men and 8% of women were underweight. Urban residence (adjusted relative risk ratio 5.8, 95% CI 2.4 to 14.5), higher education (2.3, 1.2 to 4.5), older age, ethnicity, and low fruit and vegetable intake (2.8, 1.1 to 6.8) were strongly associated with obesity among men. Urban residence (4.7, 2.7 to 8.2), higher education (2.6, 1.1 to 6.4), older age and ethnicity were associated with obesity in women. CONCLUSION There is a high burden of overweight/obesity in The Gambia. While obesity rates in rural areas were lower than in urban areas, obesity prevalence was higher among rural residents in this study compared with previous findings. Preventive strategies should be directed at raising awareness, discouraging harmful beliefs on weight, and promoting healthy diets and physical activity.
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Affiliation(s)
- Bai Cham
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
- Department of Public Health, University of The Gambia, Brikama, The Gambia
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Linda Ng Fat
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Omar Badjie
- Non-communicable Diseases Control Unit, Ministry of Health, Banjul, The Gambia
| | - Nora Ellen Groce
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Jennifer S Mindell
- Research Department of Epidemiology and Public Health, University College London, London, UK
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Mařincová L, Šafaříková S, Cahlíková R. Analysis of main risk factors contributing to obesity in the region of East Africa: meta-analysis. Afr Health Sci 2020; 20:248-256. [PMID: 33402913 PMCID: PMC7750060 DOI: 10.4314/ahs.v20i1.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Over a few decades obesity has become a major global health problem. Its prevalence worldwide has more than doubled since 1980. The situation is expected to worsen in the future, especially in the developing countries that experience nutrition transition due to economic growth. It contributes to reduction in malnutrition which supports an increase in obesity prevalence. Objectives The aim of this study was to analyse the predictors of obesity in the region of East Africa. Methods Meta-analysis of existing studies was used in order to find the different risk factors and their significance in obesity development. Data extracted from 16 published academic research articles described the situation in East African countries. The significance of the effect of each variable was tested by means of an asymptotic chi-square test, or Fisher's exact (factorial) test and the risk ratios were calculated. Results Based on the chi-square test and the risk ratios of the aggregated data, three risk factors were found to be significant in the development of obesity – gender, type of residence and socio-economic status. In East African countries, women are significantly more likely to be obese. Living in an urban area and socioeconomic status are also positively associated with obesity. Because of insufficient data three other risk factors did not prove to be of any significance – alcohol consumption, smoking and education level. Conclusion Conclusions of this meta-analysis confirm world trends but we also found results that are not in line with them (e.g. education). This meta-analysis confirms the huge existing research gap concerning obesity predictors in the East African region.
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Okop KJ, Levitt N, Puoane T. Weight underestimation and body size dissatisfaction among black African adults with obesity: Implications for health promotion. Afr J Prim Health Care Fam Med 2019; 11:e1-e8. [PMID: 31714115 PMCID: PMC6852259 DOI: 10.4102/phcfm.v11i1.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 05/22/2019] [Accepted: 05/24/2019] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Body image perception has an impact on modifiable cardiovascular disease (CVD) risk, lifestyle and psychological health in many populations. AIM To assess weight discordance (underestimating own weight) and body size dissatisfaction (perceiving body size as either 'too small' or 'too large') among overweight and obese South Africans, the associated factors and the implications for health promotion. SETTING A rural community and an urban township in two provinces of South Africa. METHODS An ancillary study within a prospective cohort involving 920 adults aged 35-78 years. Information on body image perception, anthropometry, risk factors and weight change were obtained on year 4 follow-up. Obesity was described as having a body mass index (BMI) 25 kg/m2. Descriptive and multivariate analyses were undertaken. RESULTS Most obese and overweight adults, respectively, underestimated their own weight (85% vs. 79%) and considered their body sizes as either 'too large' (59%) or 'too small' (57%). Those who perceived CVD threat, compared with those who did not, were 3.0 times more likely to be dissatisfied with their body sizes (p 0.0001) and 1.6 times more likely to underestimate their own weight (p 0.001). Those who indicated their willingness to lose weight were seven times more likely to be dissatisfied with their body sizes and unlikely to have discordant weight status (p = 0.0002). CONCLUSION Body size dissatisfaction and weight underestimation were influenced by perceived threat of CVD and the willingness to lose weight. Obesity prevention should leverage on perceived CVD threat messaging and self-motivation for attaining a healthy weight.
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Affiliation(s)
- Kufre J Okop
- School of Public Health, University of the Western Cape, Bellville, South Africa; and, Department of Medicine, Chronic Disease Initiative for Africa, Division of Diabetic Medicine and Endocrinology, University of Cape Town, Cape Town.
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Moise IK, Kangmennaang J, Halwiindi H, Grigsby-Toussaint DS, Fuller DO. Increase in Obesity Among Women of Reproductive Age in Zambia, 2002-2014. J Womens Health (Larchmt) 2019; 28:1679-1687. [PMID: 31448978 DOI: 10.1089/jwh.2018.7577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To describe trends in obesity in Zambian women of reproductive age and to identify factors that may have contributed to changes in trends and nutrition outcomes. Materials and Methods: We obtained data on body mass index and individual factors of women from the Zambia Demographic and Health Survey for the period 2002 to 2014. From these data, we calculated descriptive statistics and examined the extent to which factors link to the odds of obesity over time. We also reviewed primary and secondary data sources, such as government documents, theses, and search engines to identify factors that may have contributed to trends and changes in nutrition outcomes. Results: The proportion of obesity doubled from 2002 (12.5%) to 2014 (22.3%). The odds were higher among educated, currently married and wealthy women, and it increased with age. Rural residence and working in agricultural-related jobs were linked to lower odds for obesity. This disparity varies by province. In addition, despite the presence of many nutrition policies and strategies, the increase in obesity occurred within the past two decades when urbanization and other factors (e.g., sedentary work, a proliferation of fast food restaurants, and advertisements) may have affected changes in nutrition outcomes for women. Conclusions: We identified increasing trends in obesity in women of reproductive age over time. The rapid urbanization and other factors that occurred in Zambia during this period are significant risk factors for obesity in Zambian women. The findings will be of interest to countries that are undergoing a nutrition transition.
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Affiliation(s)
- Imelda K Moise
- Department of Geography and Regional Studies/Public Health Sciences, University of Miami, Coral Gables, Florida
| | - Joseph Kangmennaang
- Department of Geography and Earth Sciences, University of North Carolina Charlotte, North Carolina
| | - Hikabasa Halwiindi
- Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
| | | | - Douglas O Fuller
- Department of Geography and Regional Studies/Public Health Sciences, University of Miami, Coral Gables, Florida
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Lartey ST, Magnussen CG, Si L, Boateng GO, de Graaff B, Biritwum RB, Minicuci N, Kowal P, Blizzard L, Palmer AJ. Rapidly increasing prevalence of overweight and obesity in older Ghanaian adults from 2007-2015: Evidence from WHO-SAGE Waves 1 & 2. PLoS One 2019; 14:e0215045. [PMID: 31425568 PMCID: PMC6699701 DOI: 10.1371/journal.pone.0215045] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 07/26/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Studies on changes in the prevalence and determinants of obesity in older adults living in sub-Saharan Africa are scarce. We examined recent changes in obesity prevalence and associated factors for older adults in Ghana between 2007/08 and 2014/15. METHODS Data on adults aged 50 years and older in Ghana were drawn from the WHO SAGE 2007/08 (Wave 1; n = 4158) and 2014/15 (Wave 2; n = 1663). The weighted prevalence of obesity, overweight, normal weight and underweight, and of high central adiposity were compared in 2007/08 and 2014/15. Multinomial and binomial logistic regressions were used to examine whether the determinants of weight status based on objectively measured body mass index and waist circumference changed between the two time periods. RESULTS The prevalence of overweight (2007/08 = 19.6%, 95% CI: 18.0-21.4%; 2014/15 = 24.5%, 95% CI: 21.7-27.5%) and obesity (2007/08 = 10.2%, 95% CI: 8.9-11.7%; 2014/15 = 15.0%, 95% CI: 12.6-17.7%) was higher in 2014/15 than 2007/08 and more than half of the population had high central adiposity (2007/08 = 57.7%, 95% CI: 55.4-60.1%; 2014/15 = 66.9%, 95% CI: 63.7-70.0%) in both study periods. While the prevalence of overweight increased in both sexes, obesity prevalence was 16% lower in males and 55% higher in females comparing 2007/08 to 2014/15. Female sex, urban residence, and high household wealth were associated with higher odds of overweight/obesity and high central adiposity. Those aged 70+ years had lower odds of obesity in both study waves. In 2014/15, females who did not meet the recommended physical activity were more likely to be obese. CONCLUSION Over the 7-year period between the surveys, the prevalence of underweight decreased and overweight increased in both sexes, while obesity decreased in males but increased in females. The difference in obesity prevalence may point to differential impacts of past initiatives to reduce overweight and obesity, potential high-risk groups in Ghana, and the need to increase surveillance.
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Affiliation(s)
- Stella T. Lartey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Lei Si
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- The George Institute for Global Health, University of New South Wales, Kensington, NSW, Australia
| | - Godfred O. Boateng
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - Nadia Minicuci
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Paul Kowal
- World Health Organization (WHO), Geneva, Switzerland
- University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, New South Wales, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Andrew J. Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Ahmed SH, Meyer HE, Kjøllesdal MK, Marjerrison N, Mdala I, Htet AS, Bjertness E, Madar AA. The prevalence of selected risk factors for non-communicable diseases in Hargeisa, Somaliland: a cross-sectional study. BMC Public Health 2019; 19:878. [PMID: 31272414 PMCID: PMC6611144 DOI: 10.1186/s12889-019-7101-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/03/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs), particularly cardiovascular diseases, diabetes, respiratory conditions and cancers, are the most common causes of morbidity and mortality globally. Information on the prevalence estimates of NCD risk factors such as smoking, low fruit & vegetable intake, physical inactivity, raised blood pressure, overweight, obesity and abnormal blood lipid are scarce in Somaliland. The aim of this study was to determine the prevalence of these selected risk factors for NCDs among 20-69 year old women and men in Hargeisa, Somaliland. METHODS A cross-sectional study was conducted in five districts of Hargeisa (Somaliland), using the STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) to collect data on demographic and behavioral characteristics and physical measurements (n = 1100). The STEPS approach is a standardized method for collecting, analysing and disseminating data on NCD risk factor burden. Fasting blood sugar, serum lipids (total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides) were collected in half of the participants. RESULTS The vast majority of participants had ≤1 serving of fruits daily (97.7%) and ≤ 1 serving of vegetables daily (98.2%). The proportion of participants with low physical activity levels was 78.4%. The overall prevalence of high salt intake was 18.5%. The prevalence of smoking and khat chewing among men was 27 and 37% respectively, and negligible among women. In women, the prevalence of hypertension increased from 15% in the age group 20-34 years to 67% in the age group 50-69 years, the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) from 51 to 73%, and the prevalence of diabetes from 3 to 22%. Similar age-trends were seen in men. CONCLUSION Most of the selected risk factors for noncommunicable diseases were high and increased by age in both women and men. Overweight and obesity and low physical activity needs intervention in women, while hypertension and low fruit and vegetable consumption needs intervention in both men and women. Somaliland health authorities should develop and/or strengthen health services that can help in treating persons with hypertension and hyperlipidaemia, and prevent a future burden of NCDs resulting from a high prevalence of NCD risk factors.
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Affiliation(s)
- Soheir H. Ahmed
- College of Medicine & Health Science, University of Hargeisa, Hargeisa, Somaliland
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Haakon E. Meyer
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Marte K. Kjøllesdal
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Niki Marjerrison
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Aung Soe Htet
- International Relations Division, Ministry of Health and Sports, Nay Pyi, Taw, 15011 Myanmar
| | - Espen Bjertness
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ahmed A. Madar
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Ahmed SH, Marjerrison N, Kjøllesdal MKR, Stigum H, Htet AS, Bjertness E, Meyer HE, Madar AA. Comparison of Cardiovascular Risk Factors among Somalis Living in Norway and Somaliland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132353. [PMID: 31277276 PMCID: PMC6650937 DOI: 10.3390/ijerph16132353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 12/04/2022]
Abstract
Objective: We aimed to assess and compare cardiovascular disease (CVD) risk factors and predict the future risk of CVD among Somalis living in Norway and Somaliland. Method: We included participants (20–69 years) from two cross-sectional studies among Somalis living in Oslo (n = 212) and Hargeisa (n = 1098). Demographic data, history of CVD, smoking, alcohol consumption, anthropometric measures, blood pressure, fasting serum glucose, and lipid profiles were collected. The predicted 10-year risk of CVD was calculated using Framingham risk score models. Results: In women, systolic and diastolic blood pressure were significantly higher in Hargeisa compared to Oslo (p < 0.001), whereas no significant differences were seen in men. The ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol was significantly higher in Hargeisa compared to Oslo among both men (4.4 versus 3.9, p = 0.001) and women (4.1 versus 3.3, p < 0.001). Compared to women, men had higher Framingham risk scores, but there were no significant differences in Framingham risk scores between Somalis in Oslo and Hargeisa. Conclusion: In spite of the high body mass index (BMI) in Oslo, most CVD risk factors were higher among Somali women living in Hargeisa compared to those in Oslo, with similar patterns suggested in men. However, the predicted CVD risks based on Framingham models were not different between the locations.
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Affiliation(s)
- Soheir H Ahmed
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway.
- College of Medicine & Health Science, University of Hargeisa, 002563 Hargeisa, Somaliland.
| | - Niki Marjerrison
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
| | - Marte Karoline Råberg Kjøllesdal
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
- Health Services Research, Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Hein Stigum
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
| | - Aung Soe Htet
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
- International Relations Division, Ministry of Health and Sports, Nay Pyi, Taw 15011, Myanmar
| | - Espen Bjertness
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
| | - Haakon E Meyer
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, 0473 Oslo, Norway
| | - Ahmed A Madar
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
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Dietary habits, body image, and health service access related to cardiovascular diseases in rural Zambia: A qualitative study. PLoS One 2019; 14:e0212739. [PMID: 30794667 PMCID: PMC6386486 DOI: 10.1371/journal.pone.0212739] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/10/2019] [Indexed: 12/15/2022] Open
Abstract
Background Cardiovascular diseases are among the leading causes of mortality and morbidity in sub-Saharan Africa, including Zambia, where cardiovascular diseases account for 8% of the mortality rates. Despite an increasing number of cardiovascular disease-related studies in Zambia, qualitative studies exploring how cardiovascular diseases and their risk factors are understood in the socioeconomic and cultural contexts are still few. This study, therefore, aimed to analyze the beliefs, perceptions, and behaviors related to cardiovascular diseases and their risk factors among the local residents of Zambia. Methods This qualitative study was conducted from August to September 2014 among healthy residents aged 40 years and above in a rural community in Mumbwa District. We investigated the beliefs, perceptions, and behaviors related to cardiovascular diseases and their potential risk factors in the sociocultural context of Zambia by conducting in-depth interviews and focus group interviews. Audio-recorded interviews were transcribed and analyzed using thematic analysis with investigator triangulation. Results We conducted 34 in-depth interviews and 6 focus group interviews with 27 males and 40 females. Most participants were aware of the prevalence of cardiovascular diseases around them and correctly identified hypertension, excessive salt, sugar, and cooking oil intakes, poor quality cooking oil, consumption of meat or vegetables contaminated with chemicals, obesity, stress [“thinking too much”], lack of physical exercise, and heredity as potential risk factors of cardiovascular diseases, while smoking and alcohol were mentioned by only a few participants. However, they claimed that many of these risk factors were difficult to avoid due to ingrained taste preferences for high salt and sugar, increasingly busy lives that force them to use cooking oil to reduce preparation time, cultural preference for big body size or fatness, especially for women, stigmatized body image attached to HIV, stressful life or life events related to poverty, and financial barriers to affording quality foods and healthcare services. Limited health screening opportunities and the negative impact of HIV-related stigma on health-seeking behavior also emerged as important risk factors for cardiovascular diseases. Conclusions This study revealed that participants are relatively well aware of cardiovascular diseases and their risk factors. However, they engage in high-risk health behaviors, due to ingrained taste preferences, limited knowledge, and unavoidable socioeconomic and cultural circumstances. Results suggest that prevention interventions addressing cardiovascular diseases in rural Zambia should target gaps in knowledge and socioeconomic and cultural barriers.
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Challenges and opportunities to tackle the rising prevalence of diet-related non-communicable diseases in Africa. Proc Nutr Soc 2019; 78:506-512. [PMID: 30732666 DOI: 10.1017/s0029665118002823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Africa is experiencing a sharp rise in non-communicable diseases (NCD) related to rapid globalisation and urbanisation leading to shifts in dietary and lifestyle patterns characterised by increased energy intake and physical inactivity. However, unlike more resource-endowed regions, Africa has a double burden of disease: NCD co-exist with infectious diseases including lower respiratory tract infections, HIV/AIDS and diarrhoeal diseases. The African economy is also relatively weaker, making it difficult to cope with this burden. It is postulated that NCD will soon overtake infectious diseases as the number one cause of death in the African region. The recognition of NCD as diseases and obesity as a related risk factor is weak in Africa, compounded by stigma associated with wasting in HIV/AIDS and obesity being perceived as a sign of wealth, achievement and care. There is also a dearth of data on overweight and obesity in the region and little knowledge that infant feeding practices, such as breast-feeding, are linked to reduced risk of NCD in both children and mothers. While complex multi-sectoral approaches to address this NCD menace are needed, Africa may benefit from taking simple initial steps to address NCD risk factors including: (1) behaviour change communication to challenge perceptions on NCD; (2) promoting and protecting breast-feeding; (3) formulating policies and regulations limiting wide availability of unhealthy foods; (4) mainstream nutrition education in school curricula and (5) collection of accurate data based on indicators that can reflect the double burden of disease and malnutrition; and fostering multi-sectoral actions against NCD.
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Gebremariam LW, Aoyama A, Kahsay AB, Hirakawa Y, Chiang C, Yatsuya H, Matsuyama A. Perception and practice of 'healthy' diet in relation to noncommunicable diseases among the urban and rural people in northern Ethiopia: a community-based qualitative study. NAGOYA JOURNAL OF MEDICAL SCIENCE 2019; 80:451-464. [PMID: 30587860 PMCID: PMC6295432 DOI: 10.18999/nagjms.80.4.451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dietary habits are related to the risks of noncommunicable diseases (NCDs), such as cardiovascular disease and diabetes, of which burdens are increasing in low-income countries including Ethiopia. Although several epidemiological studies of NCD risk factors were conducted in Ethiopia, qualitative studies on people's dietary habit in relation to NCDs have not been conducted yet. This study aims to describe people's perception and practice of 'healthy' diet, and barriers to practice 'healthy' diet, paying attention to the dynamics between the perception and practice. We conducted 16 key informant interviews and eight focus group discussions in an urban and a rural areas in northern Ethiopia between November 2014 and January 2016. Audio-records in local language were transcribed word-for-word, and translated into English. English text data were analyzed qualitatively, through constant comparative analysis following the principles of the grounded theory. Three themes have emerged: (1) dietary habit perceived as 'good' or 'bad' for health; (2) reasons for continuing current 'unhealthy' dietary habit; and (3) current dietary habit perceived as 'traditional.' People's practice was mostly consistent with their perception, while they sometimes practiced contrary to the perception because of personal preference and physical or financial obstacles. People were often indifferent of health implications of their habitual dietary practice, such as drinking a lot of sweet coffee. We showed dynamics between perception and practice of 'healthy' diet among people in northern Ethiopia. It is needed to increase awareness of NCDs both among the urban and rural people and to improve the social environment for removing the obstacles.
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Affiliation(s)
| | - Atsuko Aoyama
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
| | - Alemayehu Bayray Kahsay
- Department of Public Health, Mekelle University College of Health Sciences, Mekelle, Ethiopia
| | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
| | - Chifa Chiang
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan.,Department of Public Health, Fujita Health University School of Medicine, Toyoake, Japan
| | - Akiko Matsuyama
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
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Lartey ST, Magnussen CG, Si L, de Graaff B, Biritwum RB, Mensah G, Yawson A, Minicuci N, Kowal P, Boateng GO, Palmer AJ. The role of intergenerational educational mobility and household wealth in adult obesity: Evidence from Wave 2 of the World Health Organization's Study on global AGEing and adult health. PLoS One 2019; 14:e0208491. [PMID: 30625141 PMCID: PMC6326547 DOI: 10.1371/journal.pone.0208491] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 11/19/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Obesity has emerged as a major risk factor for non-communicable diseases in low and middle-income countries but may not follow typical socioeconomic status (SES)-related gradients seen in higher income countries. This study examines the associations between current and lifetime markers of SES and BMI categories (underweight, normal weight, overweight, obese) and central adiposity in Ghanaian adults. METHODS Data from 4,464 adults (2,610 women) who participated in the World Health Organization's Study on global AGEing and adult health (SAGE) Wave 2 were examined. Multilevel multinomial and binomial logistic regression models were used to examine associations. SES markers included parental education, individual education, intergenerational educational mobility and household wealth. Intergenerational educational mobility was classified: stable-low (low parental and low individual education), stable-high (high parental and high individual education), upwardly (low parental and high individual education), or downwardly mobile (high parental and low individual education). RESULTS The prevalence of obesity (12.9%) exceeded the prevalence of underweight (7.2%) in the population. High parental and individual education were significantly associated with higher odds of obesity and central adiposity in women. Compared to the stable low pattern, stable high (obesity: OR = 3.15; 95% CI: 1.96, 5.05; central adiposity: OR = 1.75; 95% CI: 1.03, 2.98) and upwardly (obesity: OR = 1.71; 95% CI: 11.13, 2.60; central adiposity: OR = 1.60; 95% CI: 1.08, 2.37) mobile education patterns were associated with higher odds of obesity and central adiposity in women, while stable high pattern was associated with higher odds of overweight (OR = 1.88; 95% CI: 1.11, 3.19) in men. Additionally, high compared to the lowest household wealth was associated with high odds of obesity and central adiposity in both sexes. CONCLUSION Stable high and upwardly mobile education patterns are associated with higher odds of obesity and central adiposity in women while the stable high pattern was associated with higher odds of overweight in men.
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Affiliation(s)
- Stella T. Lartey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Lei Si
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- The George Institute for Global Health, University of New South Wales, Kensington, NSW, Australia
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - George Mensah
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Alfred Yawson
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Nadia Minicuci
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Paul Kowal
- World Health Organization (WHO), Geneva, Switzerland
- University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, New South Wales, Australia
| | - Godfred O. Boateng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Andrew J. Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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Tateyama Y, Techasrivichien T, Musumari PM, Suguimoto SP, Zulu R, Macwan’gi M, Dube C, Ono-Kihara M, Kihara M. Obesity matters but is not perceived: A cross-sectional study on cardiovascular disease risk factors among a population-based probability sample in rural Zambia. PLoS One 2018; 13:e0208176. [PMID: 30496252 PMCID: PMC6264511 DOI: 10.1371/journal.pone.0208176] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 11/13/2018] [Indexed: 01/12/2023] Open
Abstract
Background Sub-Saharan Africa, including Zambia, has experienced an increase in overweight and obesity due to rapid lifestyle changes associated with recent economic growth. We explored the prevalence and correlates of overweight and obesity in rural Zambia. We also investigated the role of self-perception of body weight in weight control given the local socio-cultural context. Methods In this cross-sectional study, we recruited 690 residents of the Mumbwa district aged 25–64 years through a multistage, clustered, household random sampling. We administered a questionnaire and collected anthropometric and bio-behavioral data from May to July 2016. Factors associated with body mass index (BMI) ≥25 kg/m2 and underestimation of body weight were assessed using multiple logistic regression. Results Of the weighted sample of 689 participants (335 men and 354 women), 185 (26.8%) had BMI ≥25 kg/m2. In multivariate analyses, female gender, age 45–64 years, tertiary education, higher fruit and vegetable intake, high blood pressure, abnormal blood lipid profile, and Hemoglobin A1c ≥5.7% were significantly associated with BMI ≥25 kg/m2. Among participants with BMI ≥25 kg/m2, 14.2% and 58.2% perceived themselves as being underweight and normal weight, respectively. Age 45–64 years was the only factor significantly associated with body weight underestimation. Preference for obesity was reported by 17.5% and 3.6% of respondents with BMI <25 kg/m2 and BMI≥25 kg/m2, respectively; “looks attractive” and “fear of being perceived as HIV-positive” were the main reasons. Conclusion In rural Zambia, overweight and obesity are prevalent and significantly associated with alterations in blood pressure, blood lipid profile, and glucose metabolism. However, most subjects with BMI ≥25 kg/m2 underestimated their body weight; some preferred obesity, in part due to cultural factors and HIV-related stigma. A health promotion program that addresses such perceptions and body weight underestimation should be urgently introduced in Zambia.
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Affiliation(s)
- Yukiko Tateyama
- Department of Global Health and Socio-epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- * E-mail:
| | - Teeranee Techasrivichien
- Department of Global Health and Socio-epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Patou Masika Musumari
- Department of Global Health and Socio-epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - S. Pilar Suguimoto
- Department of Global Health and Socio-epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Medical Education Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Richard Zulu
- Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia
| | - Mubiana Macwan’gi
- Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia
| | | | - Masako Ono-Kihara
- Department of Global Health and Socio-epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahiro Kihara
- Department of Global Health and Socio-epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Babatunde-Sowole OO, Power T, Davidson P, Ballard C, Jackson D. Exploring the diet and lifestyle changes contributing to weight gain among Australian West African women following migration: A qualitative study. Contemp Nurse 2018; 54:150-159. [PMID: 29635959 DOI: 10.1080/10376178.2018.1459760] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
AIMS AND OBJECTIVES This paper reports on women's experiences of weight gain and obesity as they became acculturated to the Australian diet and lifestyle. BACKGROUND Migrants from sub-Saharan Africa have a much higher risk of obesity than the native population when settling in industrialised countries. METHOD Qualitative. RESULTS Women in this study reported weight gain post-migration. This was attributed to increased access to a wide variety of food including takeaway food and more sedentary lifestyles. CONCLUSIONS Obesity has long-term consequences for health and well-being. Further research is needed to support a healthy transition to life in Australia. RELEVANCE TO CLINICAL PRACTICE Gaining insight into the underlying reasons that West African immigrants to Australia become obese could contribute to assisting health professionals design culturally appropriate interventions and health education programmes to support new arrivals.
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Affiliation(s)
| | - Tamara Power
- a Faculty of Health , University of Technology Sydney , Broadway , New South Wales , Australia
| | - Patricia Davidson
- b School of Nursing , Johns Hopkins University , Baltimore , MD , USA
| | - Charlotte Ballard
- c Oxford Institute for Nursing, Midwifery & Allied Health Research (OxINMAHR), Oxford Brookes University , Oxford , UK
| | - Debra Jackson
- a Faculty of Health , University of Technology Sydney , Broadway , New South Wales , Australia.,c Oxford Institute for Nursing, Midwifery & Allied Health Research (OxINMAHR), Oxford Brookes University , Oxford , UK
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Ahmed SH, Meyer HE, Kjøllesdal MK, Madar AA. Prevalence and Predictors of Overweight and Obesity among Somalis in Norway and Somaliland: A Comparative Study. J Obes 2018; 2018:4539171. [PMID: 30250753 PMCID: PMC6140005 DOI: 10.1155/2018/4539171] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/06/2018] [Accepted: 05/23/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND AIM The knowledge about the health status of Somalis in Norway and Somaliland is limited. This paper reports the results of a comparative study on the prevalence and predictors of overweight/obesity among Somalis in Norway and Somaliland. METHOD We conducted two cross-sectional studies using the same tools and procedures, between 2015 and 2016. The study population was adults aged 20-69 years (n=1110 (Somaliland) and n=220 (Norway)). RESULTS The prevalence of obesity (body mass index (BMI) ≥30 kg/m2) was 44% and 31% in women in Norway and Somaliland, respectively. In contrast, the prevalence of obesity was low in men (9% in Norway; 6% in Somaliland). Although the prevalence of high BMI was higher in Somali women in Norway than women in Somaliland, both groups had the same prevalence of central obesity (waist circumference (WC) ≥ 88 cm). In men, the prevalence of central obesity (WC ≥ 102 cm) was lower in Somaliland than in Norway. For women in Somaliland, high BMI was associated with lower educational level and being married. CONCLUSION The prevalence of overweight and obesity is high among Somali immigrants in Norway, but also among women in Somaliland. The high prevalence of overweight and obesity, particularly among women, calls for long-term prevention strategies.
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Affiliation(s)
- Soheir H. Ahmed
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- College of Medicine & Health Science, University of Hargeisa, Hargeisa, Somaliland
| | - Haakon E. Meyer
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Marte K. Kjøllesdal
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ahmed A. Madar
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Macia E, Cohen E, Gueye L, Boetsch G, Duboz P. Prevalence of obesity and body size perceptions in urban and rural Senegal: new insight on the epidemiological transition in West Africa. Cardiovasc J Afr 2017; 28:324-330. [PMID: 29083431 PMCID: PMC5730727 DOI: 10.5830/cvja-2017-034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 07/13/2017] [Indexed: 11/12/2022] Open
Abstract
Background: The objectives of this study were to assess the prevalence of obesity in Dakar and in Tessekere, a rural municipality in northern Senegal, and to compare ideal body size between these populations. Methods: A cross-sectional survey was carried out in 2015 on a representative sample of 1 000 adults, aged 20 years and older in Dakar, and 500 adults of the same age in Tessekere. Results: The prevalence of obesity and overweight was higher in Dakar than in Tessekere. However, overweight and obesity rates of young women living in this rural area were close to those of young women in Dakar. At a body mass index of 27.5 kg/m², less than 40% of the men in Dakar and Tessekere found themselves too fat, compared to 50% of urban women and 30% of rural women. Conclusion: This study explains how and why obesity is becoming a rural health problem in Senegal.
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Affiliation(s)
- Enguerran Macia
- Faculty of Medicine, Pharmacology and Odontology, University of Cheikh Anta Diop, Dakar, Senegal; National Centre for Scientific Research, University of Bamako, Mali; and National Centre for Scientific and Technological Research, Burkina Faso.
| | - Emmanuel Cohen
- Faculty of Medicine, Pharmacology and Odontology, University of Cheikh Anta Diop, Dakar, Senegal; National Centre for Scientific Research, University of Bamako, Mali; and National Centre for Scientific and Technological Research, Burkina Faso; Department of Eco-Anthropology and Ethnobiology, National Museum of Natural Science, University of Paris, France
| | - Lamine Gueye
- Faculty of Medicine, Pharmacology and Odontology, University of Cheikh Anta Diop, Dakar, Senegal; National Centre for Scientific Research, University of Bamako, Mali; and National Centre for Scientific and Technological Research, Burkina Faso
| | - Gilles Boetsch
- Faculty of Medicine, Pharmacology and Odontology, University of Cheikh Anta Diop, Dakar, Senegal; National Centre for Scientific Research, University of Bamako, Mali; and National Centre for Scientific and Technological Research, Burkina Faso
| | - Priscilla Duboz
- Department of Anthropology, Ethics and Health, Santé, Aix-Marseille University, Marseille, France
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Wanyama R, Obai G, Odongo P, Kagawa M, Baingana R. Effect of maternal Helicobacter Pylori infection on gestational weight gain in an urban community of Uganda. Pan Afr Med J 2017. [PMID: 29541293 PMCID: PMC5847056 DOI: 10.11604/pamj.2017.28.145.9989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Introduction Maternal Helicobacter pylori (H. pylori) infection has been associated with undesirable effects during pregnancy such as; hyperemesis gravidarum, anemia, intrauterine fetal growth restriction and miscarriage. Our aim was to document the effect of H. pylori infection on gestational weight gain (GWG) in a low-income urban setting in Uganda. Methods This was a prospective cohort study conducted in Kampala between May 2012 and May 2013. The participants were HIV negative, H. pylori positive and H. pylori negative primigravidae and secundigravidae. Recruitment was at gestation age of eighteen or less weeks and follow up assessments were carried out at 26 and 36 weeks gestation age. H. pylori infection was determined using H. pylori stool antigen test. Maternal weight and height were measured, and body mass index (BMI) and rates of GWG were calculated. Results The participants’ mean±standard deviation (sd) age was 20.9±2.7 years. Primigravidae were 68.8% (n = 132) and 57.3% (n = 110) of the participants were positive for H. pylori infection. Low pre-women pregnancy BMI (< 18.5 kg/m2) was recorded in 14.6% (n = 28). The mean±sd rate of GWG during second and third trimesters was 300.5±79.7 grams/week. The mean±sd weight gained by 36 weeks of gestation was 9.6±2.2 kg while gestation age at delivery was 39.4±1.0 weeks. Factors independently associated with the rates of GWG during the second and third trimesters were parity (P=0.023), H. pylori infection (P = 0.006), pre-pregnancy BMI (P = 0.037), height (P = 0.022) and household income (P = 0.003). Conclusion H. pylori infection is associated with low rates of GWG among primigravidae and secundigravidae.
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Affiliation(s)
- Ronald Wanyama
- Department of Biochemistry, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Gerald Obai
- Department of Physiology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Pancras Odongo
- Department of Internal Medicine, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Michael Kagawa
- Department of Obstetrics & Gynecology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rhona Baingana
- Department of Biochemistry and Sports Science, School of Biolsciences, Makerere University, Kampala, Uganda
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Atun R, Davies JI, Gale EAM, Bärnighausen T, Beran D, Kengne AP, Levitt NS, Mangugu FW, Nyirenda MJ, Ogle GD, Ramaiya K, Sewankambo NK, Sobngwi E, Tesfaye S, Yudkin JS, Basu S, Bommer C, Heesemann E, Manne-Goehler J, Postolovska I, Sagalova V, Vollmer S, Abbas ZG, Ammon B, Angamo MT, Annamreddi A, Awasthi A, Besançon S, Bhadriraju S, Binagwaho A, Burgess PI, Burton MJ, Chai J, Chilunga FP, Chipendo P, Conn A, Joel DR, Eagan AW, Gishoma C, Ho J, Jong S, Kakarmath SS, Khan Y, Kharel R, Kyle MA, Lee SC, Lichtman A, Malm CP, Mbaye MN, Muhimpundu MA, Mwagomba BM, Mwangi KJ, Nair M, Niyonsenga SP, Njuguna B, Okafor OLO, Okunade O, Park PH, Pastakia SD, Pekny C, Reja A, Rotimi CN, Rwunganira S, Sando D, Sarriera G, Sharma A, Sidibe A, Siraj ES, Syed AS, Van Acker K, Werfalli M. Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol 2017; 5:622-667. [PMID: 28688818 DOI: 10.1016/s2213-8587(17)30181-x] [Citation(s) in RCA: 280] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 04/10/2017] [Accepted: 05/02/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Rifat Atun
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA; Harvard Medical School, Harvard University, Boston, MA, USA.
| | - Justine I Davies
- Centre for Global Health, King's College London, Weston Education Centre, London, UK; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Education Campus, University of Witwatersrand, Parktown, South Africa
| | | | - Till Bärnighausen
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA; Institute of Public Health, Faculty of Medicine, Heidelberg University, Heidelberg, Germany; Africa Health Research Institute, KwaZulu, South Africa
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Naomi S Levitt
- Division of Diabetic Medicine & Endocrinology, University of Cape Town, Cape Town, South Africa; Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Moffat J Nyirenda
- Department of NCD Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; NCD Theme, MRC/UVRI Uganda Research Unit, Entebbe, Uganda
| | - Graham D Ogle
- International Diabetes Federation Life for a Child Program, Glebe, NSW, Australia; Diabetes NSW & ACT, Glebe, NSW, Australia
| | | | - Nelson K Sewankambo
- Department of Medicine, and Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda
| | - Eugene Sobngwi
- University of Newcastle at Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Solomon Tesfaye
- Sheffield Teaching Hospitals and University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK
| | - John S Yudkin
- Institute of Cardiovascular Science, Division of Medicine, University College London, London, UK
| | - Sanjay Basu
- Center for Population Health Sciences and Center for Primary Care and Outcomes Research, Department of Medicine and Department of Health Research and Policy, Stanford University, Palo Alto, CA, USA
| | - Christian Bommer
- University of Goettingen, Centre for Modern Indian Studies & Department of Economics, Goettingen, Germany
| | - Esther Heesemann
- University of Goettingen, Centre for Modern Indian Studies & Department of Economics, Goettingen, Germany
| | - Jennifer Manne-Goehler
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA; Harvard Medical School, Harvard University, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Iryna Postolovska
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Vera Sagalova
- University of Goettingen, Centre for Modern Indian Studies & Department of Economics, Goettingen, Germany
| | - Sebastian Vollmer
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA; University of Goettingen, Centre for Modern Indian Studies & Department of Economics, Goettingen, Germany
| | - Zulfiqarali G Abbas
- Muhimbili University of Health and Allied Sciences, and Abbas Medical Centre, Dar es Salaam, Tanzania
| | - Benjamin Ammon
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Akhila Annamreddi
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ananya Awasthi
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | | | - Agnes Binagwaho
- Harvard Medical School, Harvard University, Boston, MA, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA; University of Global Health Equity, Kigali, Rwanda
| | | | - Matthew J Burton
- International Centre for Eye Health, Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Jeanne Chai
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Felix P Chilunga
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | | | - Anna Conn
- The Fletcher School of Law and Diplomacy, Tufts University, Medford, MA, USA
| | - Dipesalema R Joel
- Department of Paediatrics and Adolescent Health, Faculty of Medicine, University of Botswana and Princess Marina Hospital, Gaborone, Botswana
| | - Arielle W Eagan
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| | | | - Julius Ho
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Simcha Jong
- Leiden University, Science Based Business, Leiden, Netherlands
| | - Sujay S Kakarmath
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Ramu Kharel
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA; University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michael A Kyle
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Seitetz C Lee
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Amos Lichtman
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Maïmouna N Mbaye
- Clinique Médicale II, Centre de diabétologie Marc Sankale, Hôpital Abass Ndao, Dakar, Senegal
| | - Marie A Muhimpundu
- The Institute of HIV/AIDS, Disease Prevention & Control, Rwanda Biomedical Center, Kigali, Rwanda
| | | | | | - Mohit Nair
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Simon P Niyonsenga
- The Institute of HIV/AIDS, Disease Prevention & Control, Rwanda Biomedical Center, Kigali, Rwanda
| | | | - Obiageli L O Okafor
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Oluwakemi Okunade
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Paul H Park
- Partners In Health, Rwinkwavu, South Kayonza, Rwanda
| | - Sonak D Pastakia
- Purdue University College of Pharmacy (Purdue Kenya Partnership), Indiana Institute for Global Health, Uasin Gishu, Kenya
| | | | - Ahmed Reja
- Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Institutes of Health, Bethesda, MD, USA
| | - Samuel Rwunganira
- The Institute of HIV/AIDS, Disease Prevention & Control, Rwanda Biomedical Center, Kigali, Rwanda
| | - David Sando
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Anshuman Sharma
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | | | - Azhra S Syed
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kristien Van Acker
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Mahmoud Werfalli
- Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Haregu TN, Oti S, Egondi T, Kyobutungi C. Measurement of overweight and obesity an urban slum setting in sub-Saharan Africa: a comparison of four anthropometric indices. BMC OBESITY 2016; 3:46. [PMID: 27833755 PMCID: PMC5100227 DOI: 10.1186/s40608-016-0126-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 10/29/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND As a result of both genetic and environmental factors, the body composition and topography of African populations are presumed to be different from western populations. Accordingly, globally accepted anthropometric markers may perform differently in African populations. In the era of rapid emergence of cardio-vascular diseases in sub-Saharan Africa, evidence about the performance of these markers in African settings is essential. The aim of this study was to investigate the inter-relationships among the four main anthropometric indices in measuring overweight and obesity in an urban poor African setting. METHODS Data from a cardiovascular disease risk factor assessment study in urban slums of Nairobi were analyzed. In the major study, data were collected from 5190 study participants. We considered four anthropometric markers of overweight and obesity: Body Mass Index, Waist Circumference, Waist to Hip Ratio, and Waist to Height Ratio. Pairwise correlations and kappa statistics were used to assess the relationship and agreement among these markers, respectively. Discordances between the indices were also analyzed. RESULTS The weighted prevalence of above normal body composition was 21.6 % by body mass index, 28.9 % by waist circumference, 45.5 % by waist to hip ratio, and 38.9 % by waist to height ratio. The overall inter-index correlation was +0.44. Waist to hip ratio generally had lower correlation with the other anthropometric indices. High level of discordance exists between body mass index and waist to hip ratio. Combining the four indices shows that 791 (16.1 %) respondents had above normal body composition in all four indices. Waist circumference better predicted hypertension and hyperglycemia while waist to height ratio better predicted hypercholesterolemia. CONCLUSIONS There exists a moderate level of correlation and a remarkable level of discordance among the four anthropometric indices with regard to the ascertainment of abnormal body composition in an urban slum setting in Africa. Waist circumference is a better predictor of cardio-metabolic risk.
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Affiliation(s)
- Tilahun Nigatu Haregu
- African Population and Health Research Center, P.O. Box 10787 code 00100, Nairobi, Kenya
| | - Samuel Oti
- International Development Research Centre, PO Box 62084-00200, Nairobi, Kenya
| | - Thaddaeus Egondi
- Drugs for Neglected Diseases initiative (DNDi) Africa, P.O. Box 21936-00505, Nairobi, Kenya
| | - Catherine Kyobutungi
- African Population and Health Research Center, P.O. Box 10787 code 00100, Nairobi, Kenya
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Bismarck Eke C, Onyeka Edelu B, Nnaemeka Ikefuna A, Josephine Emodi I, Chidozie Ibe B. Obesity in Preschool-Aged Children with Sickle Cell Anemia: Emerging Nutritional Challenge in a Resource Limited Setting. Pediatr Hematol Oncol 2016; 32:390-8. [PMID: 26154621 DOI: 10.3109/08880018.2015.1030716] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The burden of childhood obesity is increasing in most developing countries particularly in the urban areas owing to globalization; and children with sickle cell anemia (SCA) in such environment do not live in isolation. The study is aimed at determining the prevalence of obesity in younger children with SCA. METHODS A consecutive recruitment of 58 children with SCA aged between 1 year and 5 years 4 months (subjects) and their age and sex matched controls selected using multistage sampling technique were carried out. The weight and height of the children were obtained using standard equipment. The WHO Anthro and Anthro-Plus software were used for analyzing the nutritional status of the children based on standard deviation (z-scores). The data were analyzed using SPSS version 19.0 while the level of significance was set at p < 0.05. RESULTS The mean BMI for the subjects was 15.38 ± 1.93 (range from 11.50-20.80) and 17.10 ± 2.28 (range from 13.4-23.20) in the controls. Overweight (z-score > + 1 ≤ 2) and obesity (z score >+2) were recorded in 10 (17.2%) and 2 (3.4%) of the subjects while in the controls overweight and obesity were observed in 16 (27.6%) and 13 (22.4%), respectively (p = 0.000). CONCLUSIONS Obesity and overweight is becoming prevalent among children with SCA and so awareness and preventive health education about obesity should be created among caregivers of children with sickle cell anemia in our setting to avert its possible complications.
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Affiliation(s)
- Christopher Bismarck Eke
- a Department of Paediatrics, College of Medicine , University of Nigeria/University of Nigeria, Teaching Hospital Ituku-Ozalla , Enugu , Nigeria
| | - Benedict Onyeka Edelu
- a Department of Paediatrics, College of Medicine , University of Nigeria/University of Nigeria, Teaching Hospital Ituku-Ozalla , Enugu , Nigeria
| | - Anthony Nnaemeka Ikefuna
- a Department of Paediatrics, College of Medicine , University of Nigeria/University of Nigeria, Teaching Hospital Ituku-Ozalla , Enugu , Nigeria
| | - Ifeoma Josephine Emodi
- a Department of Paediatrics, College of Medicine , University of Nigeria/University of Nigeria, Teaching Hospital Ituku-Ozalla , Enugu , Nigeria
| | - Bede Chidozie Ibe
- a Department of Paediatrics, College of Medicine , University of Nigeria/University of Nigeria, Teaching Hospital Ituku-Ozalla , Enugu , Nigeria
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Dake FAA, Thompson AL, Ng SW, Agyei-Mensah S, Codjoe SNA. The Local Food Environment and Body Mass Index among the Urban Poor in Accra, Ghana. J Urban Health 2016; 93:438-55. [PMID: 27091736 PMCID: PMC4899328 DOI: 10.1007/s11524-016-0044-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Obesity in the sub-Saharan Africa region has been portrayed as a problem of affluence, partly because obesity has been found to be more common in urban areas and among the rich. Recent findings, however, reveal rising prevalence among the poor particularly the urban poor. A growing body of literature mostly in Western countries shows that obesity among the poor is partly the result of an obesogenic-built environment. Such studies are lacking in the African context. This study examines the characteristics of the local food environment in an urban poor setting in Accra, Ghana and further investigates the associated risk of obesity for residents. Data on the local food environment was collected using geographic positioning system (GPS) technology. The body mass indices (BMI) of females (15-49 years) and males (15-59 years) were calculated from measured weight and height. Data on the socio-demographic characteristics and lifestyle behaviors of respondents was also collected through a household survey. Spatial analysis tools were used to examine the characteristics of the local food environment while the influence of the food environment on BMI was examined using a two-level multilevel model. The measures of the food environment constituted the level 2 factors while individual socio-demographic characteristics and lifestyle behaviors constituted the level 1 factors. The local food environment in the study communities is suggestive of an obesogenic food environment characterized by an abundance of out-of-home cooked foods, convenience stores, and limited fruits and vegetables options. The results of the multilevel analysis reveal a 0.2 kg/m(2) increase in BMI for every additional convenience store and a 0.1 kg/m(2) reduction in BMI for every out-of-home cooked food place available in the study area after controlling for individual socio-demographic characteristics, lifestyle behaviors, and community characteristics. The findings of this study indicate that the local food environment in urban poor Accra is associated with increased risk of obesity through providing access to convenience stores. In order to reduce the risk of obesity in these urban poor communities, there is the need to regulate the availability of and access to convenience stores while also encouraging healthier offerings in convenience stores.
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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.
| | - Amanda L Thompson
- Department of Anthropology and Carolina Population Center, University of North Carolina at Chapel Hill, CB # 8120, 137 East Franklin St., Chapel Hill, NC, 27516, USA
| | - Shu Wen Ng
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill (UNC), CB # 8120, 137 East Franklin St., Chapel Hill, NC, 27516, USA
| | - Samuel Agyei-Mensah
- Department of Geography and Resource Development, University of Ghana, P.O. Box LG 59, Legon, Accra, Ghana
| | - Samuel N A Codjoe
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Accra, Ghana
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46
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Cresswell JA, Campbell OMR, De Silva MJ, Slaymaker E, Filippi V. Maternal obesity and Caesarean delivery in sub-Saharan Africa. Trop Med Int Health 2016; 21:879-85. [PMID: 27118357 DOI: 10.1111/tmi.12713] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To quantify maternal obesity as a risk factor for Caesarean delivery in sub-Saharan Africa. METHODS Multivariable logistic regression analysis using 31 nationally representative cross-sectional data sets from the Demographic and Health Surveys (DHS). RESULTS Maternal obesity was a risk factor for Caesarean delivery in sub-Saharan Africa; a clear dose-response relationship (where the magnitude of the association increased with increasing BMI) was observable. Compared to women of optimal weight, overweight women (BMI 25-29 kg/m(2) ) were significantly more likely to deliver by Caesarean (OR: 1.54; 95% CI: 1.33, 1.78), as were obese women (30-34.9 kg/m(2) (OR: 2.39; 95%CI: 1.96-2.90); 35-39.9 kg/m(2) (OR: 2.47 95%CI: 1.78-3.43)) and morbidly obese women (BMI ≥40 kg/m(2) OR: 3.85; 95% CI: 2.46-6.00). CONCLUSIONS BMI is projected to rise substantially in sub-Saharan Africa over the next few decades and demand for Caesarean sections already exceeds available capacity. Overweight women should be advised to lose weight prior to pregnancy. Furthermore, culturally appropriate prevention strategies to discourage further population-level rises in BMI need to be designed and implemented.
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Affiliation(s)
- Jenny A Cresswell
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Oona M R Campbell
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Mary J De Silva
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Emma Slaymaker
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Veronique Filippi
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Okop KJ, Mukumbang FC, Mathole T, Levitt N, Puoane T. Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study. BMC Public Health 2016; 16:365. [PMID: 27129700 PMCID: PMC4850665 DOI: 10.1186/s12889-016-3028-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 04/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The obesity epidemic is associated with rising rates of cardiovascular disease (CVD) among adults, particularly in countries undergoing rapid urbanisation and nutrition transition. This study explored the perceptions of body size, obesity risk awareness, and the willingness to lose weight among adults in a resource-limited urban community to inform appropriate community-based interventions for the prevention of obesity. METHOD This is a descriptive qualitative study. Semi-structured focus group discussions were conducted with purposively selected black men and women aged 35-70 years living in an urban South African township. Weight and height measurements were taken, and the participants were classified into optimal weight, overweight and obese groups based on their body mass index (Kg/m(2)). Participants were asked to discuss on perceived obesity threat and risk of cardiovascular disease. Information on body image perceptions and the willingness to lose excess body weight were also discussed. Discussions were conducted in the local language (isiXhosa), transcribed and translated into English. Data was analysed using the thematic analysis approach. RESULTS Participants generally believed that obesity could lead to health conditions such as heart attack, stroke, diabetes, and hypertension. However, severity of obesity was perceived differently in the groups. Men in all groups and women in the obese and optimal weight groups perceived obesity to be a serious threat to their health, whereas the overweight women did not. Obese participants who had experienced chronic disease conditions indicated strong perceptions of risk of obesity and cardiovascular disease. Obese participants, particularly men, expressed willingness to lose weight, compared to the men and women who were overweight. The belief that overweight is 'normal' and not a disease, subjective norms, and inaccessibility to physical activity facilities, negatively influenced participants' readiness to lose weight. CONCLUSION Low perception of threat of obesity to health particularly among overweight women in this community indicates a considerable challenge to obesity control. Community health education and promotion programmes that increase awareness about the risk associated with overweight, and improve the motivation for physical activity and maintenance of optimal body weight are needed.
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Affiliation(s)
- Kufre Joseph Okop
- School of Public Health, University of the Western Cape, Bellville, 7535, South Africa.
| | - Ferdinand C Mukumbang
- School of Public Health, University of the Western Cape, Bellville, 7535, South Africa
| | - Thubelihle Mathole
- School of Public Health, University of the Western Cape, Bellville, 7535, South Africa
| | - Naomi Levitt
- Division of Endocrinology and Diabetes, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Thandi Puoane
- School of Public Health, University of the Western Cape, Bellville, 7535, South Africa
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48
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Koopman JJE, van Bodegom D, Ziem JB, Westendorp RGJ. An Emerging Epidemic of Noncommunicable Diseases in Developing Populations Due to a Triple Evolutionary Mismatch. Am J Trop Med Hyg 2016; 94:1189-92. [PMID: 26880777 DOI: 10.4269/ajtmh.15-0715] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/09/2016] [Indexed: 11/07/2022] Open
Abstract
With their transition from adverse to affluent environments, developing populations experience a rapid increase in the number of individuals with noncommunicable diseases. Here, we emphasize that developing populations are more susceptible than western populations to acquire these chronic diseases, because their genetic, cultural, and epigenetic characteristics do not match with the eagerly awaited affluent environments. In regard to this, there is an urgent need for public health organizations to reorganize current environments in developing populations so as to fit their inherited characteristics. Unfortunately, this need is neglected as an essential part of the Sustainable Development Goals that form the core of the United Nations' Post-2015 Development Agenda. Only through global collaborative efforts can the environments in developing populations be reorganized and, thereby, the emerging epidemic of noncommunicable diseases be stalled.
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Affiliation(s)
- Jacob J E Koopman
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands; Leyden Academy on Vitality and Ageing, Leiden, The Netherlands; Department of Clinical Laboratory Sciences, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana; Department of Public Health and Center of Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - David van Bodegom
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands; Leyden Academy on Vitality and Ageing, Leiden, The Netherlands; Department of Clinical Laboratory Sciences, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana; Department of Public Health and Center of Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Juventus B Ziem
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands; Leyden Academy on Vitality and Ageing, Leiden, The Netherlands; Department of Clinical Laboratory Sciences, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana; Department of Public Health and Center of Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Rudi G J Westendorp
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands; Leyden Academy on Vitality and Ageing, Leiden, The Netherlands; Department of Clinical Laboratory Sciences, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana; Department of Public Health and Center of Healthy Aging, University of Copenhagen, Copenhagen, Denmark
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Fruhstorfer BH, Mousoulis C, Uthman OA, Robertson W. Socio-economic status and overweight or obesity among school-age children in sub-Saharan Africa - a systematic review. Clin Obes 2016; 6:19-32. [PMID: 26781602 DOI: 10.1111/cob.12130] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 11/14/2015] [Accepted: 11/24/2015] [Indexed: 12/24/2022]
Abstract
Childhood overweight and obesity have emerged as a public health concern in sub-Saharan Africa. We conducted a systematic review with the aim to examine the association between socio-economic status (SES) and overweight or obesity among school-age children in sub-Saharan Africa. In March 2014 we searched five electronic databases for reports which presented cross-sectional data on prevalence levels of overweight or obesity stratified by SES groups among school-age children in sub-Saharan Africa. We used a random-effect model to pool the relative indexes of inequality of the association from the individual studies. In total, 20 reports satisfied the inclusion criteria providing results of 21 datasets. The risk of overweight or obesity in children from highest SES households was 5.28 times as high as that of children from lowest SES households (95% confidence interval [CI] 2.62 to 10.66). On subgroup analysis, this association was statistically significant for household income and composite SES measures but not for parental educational attainment and occupation type. Similarly, the risk of overweight or obesity in children attending affluent (private) schools was 15.94 times as high as that of children going to either urban or rural public schools (95% CI 5.82 to 43.68). The magnitude of the association tended to be stronger for area or school-type compared with composite measures. In summary, children from higher SES households and those attending private schools tended to be overweight and obese.
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Affiliation(s)
- B H Fruhstorfer
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - C Mousoulis
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - O A Uthman
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - W Robertson
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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50
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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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