The prevalence and associated factors of underweight and overweight/obesity among adults in Kenya: evidence from a national cross-sectional community survey

Multilevel factors associated with overweight and obesity in East Africa: Comparative analysis in five countries from 2003 to 2016

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.

Gender differences in the proportion of Japanese parents meeting 24-h movement guidelines and associations with weight status

OBJECTIVES

Parents' healthy behaviors are important for both their health and role models for their children. The purpose of this study was to evaluate adherence to the three recommendations associated with health in the Canadian 24-h movement or Japanese physical activity (PA) guidelines and their relationship with weight status (underweight or obesity) in Japanese parents.

METHODS

This cross-sectional study included 425 mothers and 237 fathers. Meeting the 24-h movement guidelines was defined as: ≥150 min/week of moderate-to-vigorous PA (MVPA) (Canada) or at least 60 min/day of MVPA (Japan), ≤8 h/day of sedentary time which includes ≤3 h of recreational screen time, and 7 to 9 h/night of sleep. MVPA and sedentary time were accelerometer-determined while screen time and sleep duration were self-reported.

RESULTS

The prevalence of mothers meeting all three recommendations was 30.6% using Canadian PA guidelines and 20.7% using Japanese PA guidelines, while that of fathers was 10.6% and 8.0%, respectively. Mothers not meeting the sedentary behavior recommendation had a lower odds ratio and those not meeting Japanese PA recommendations had a higher odds ratio for underweight compared to mothers meeting the recommendations, adjusted for age and area socioeconomic status.

CONCLUSIONS

The screen time recommendation and Japanese PA recommendation were associated with underweight in mothers. None of the recommendations was associated with weight status in fathers. Further research is needed to understand the relationships among movement behaviors and weight status, particularly among Japanese women, whose routine behaviors, such as household activities, may be misclassified by a questionnaire.

Double burden of malnutrition among women in reproductive Age (15-49 years) in Sierra Leone: a secondary data analysis of the demographic health survey 2019 (SLDHS-2019)

BACKGROUND

The double burden of malnutrition (DBM) is rising globally, particularly in sub-Saharan Africa. In Sierra Leone, the incidence of overweight, obesity (OWOB), and overnutrition among women has sharply increased. This finding accompanies the high incidence of undernutrition, which has been prevalent for decades. This study aimed to determine the prevalence of different malnutrition categories (underweight, overweight, obesity, and overnutrition) and associated factors among women of reproductive age (15-49 years) in Sierra Leone using secondary data analysis of the Sierra Leone Demographic Health Survey of 2019 (SLDHS-2019).

METHODS

We conducted secondary data analysis of the SLDHS-2019 of 7,514 women aged 15-49 years. We excluded pregnant, post-natal, lactating, and post-menopausal women. Data was collected using validated questionnaires, and respondents were selected through a multistage stratified sampling approach. A multivariable logistic regression analysis was used to determine factors associated with malnutrition among 15-49-year-old women in Sierra Leone.

RESULTS

Among 15-49-year-old women in Sierra Leone, the prevalence of underweight was 6.7% (95%CI: 4.5-8.9%); overweight at 19.7% (95%CI: 17.7-21.7%); obesity was 7.4% (95% CI: 5.2-9.6%); and overnutrition, 27.1% (95%CI: 25.2-29.0%). Women aged 25-34 years were more likely to be underweight (adjusted Odds Ratios, aOR = 1.670, 95%CI: 1.254-2.224; p < 0.001) than those aged 15-24 years; women who were not married were less likely to be underweight (aOR = 0.594, 95%CI: 0.467-0.755; p < 0.001) than married women. Women from the North were less likely to be underweight (aOR = 0.734, 95%CI: 0.559-0.963; p = 0.026) than the East, and those who did not listen to the radio were less likely to be underweight (aOR = 0.673; 95%CI: 0.549-0.826; p < 0.001) than those who did. Overweight was less likely among 25-34 years (aOR = 0.609, 95%CI: 0.514-0.722; p < 0.001) and 35-49 years (aOR = 0.480, 95%CI: 0.403-0.571; p < 0.001) age-groups than 15-24 years; more likely among not married women (aOR = 1.470, 95%CI:1.249-1.730; p < 0.001) than married; less likely among working-class (aOR = 0.840, 95%CI: 0.720-0.980; p = 0.026) than not working-class; most likely in women from the North (aOR = 1.325, 95%CI:1.096-1.602; p = 0.004), and less likely among women from the South (aOR = 0.755, 95%CI: 0.631-0.903; p = 0.002) than the East; less likely among women of middle-wealth-index (aOR = 0.656, 95%CI: 0.535-0.804; p < 0.001), richer-wealth-index (aOR = 0.400, 95%CI: 0.309-0.517; p < 0.001), and richest-wealth-index (aOR = 0.317, 95%CI: 0.234-0.431; p < 0.001) than the poorest-wealth-index; and more likely among women who did not listen to radios (aOR = 1.149; 95%CI:1.002-1.317; p = 0.047) than those who did. The predictors of overweight among women 15-49 years are the same as obesity and overnutrition, except overnutrition and obesity were less likely in female-headed households (aOR = 0.717,95%CI: 0.578-0.889; p < 0.001).

CONCLUSION

The prevalence of all categories of malnutrition among women of reproductive age in Sierra Leone is high, affirming a double burden of malnutrition in this study population. Underweight was more likely among the 25-34-year age group than 15-24-year. The predictors of overweight, obesity, and overnutrition were being unmarried/single, residing in the North, and not listening to the radio. There is an urgent need for policymakers in Sierra Leone to design comprehensive educational programs for women of reproductive age on healthy lifestyles and the dangers of being underweight or over-nourished.

Health-Related Lifestyles in Relation to Body Mass Index Among Young and Middle-Aged Women in Japan

BACKGROUND

Being underweight, overweight, or obese can lead to adverse health effects. Hence, it is important to understand the specific factors that change the burden of underweight and overweight to target appropriate disease control strategies. This study was designed to examine the prevalence and factors associated with underweight and overweight among young and middle-aged women in Japan.

MATERIALS AND METHODS

A cross-sectional study was conducted among women aged 20-59 years who participated in health checkups at a regional health care center in 2018 and 2019 (N = 1722). The assessments included anthropometric, blood pressure measurements, and a standardized self-administered questionnaire. Multivariable logistic regression analysis assessed lifestyle factors associated with body mass index for underweight <18.5 kg/m²) and overweight/obesity (25.0 kg/m² and above).

RESULTS

The prevalence of underweight and overweight/obesity were 12.3%, and 22.5%, respectively. No lifestyle factors were found to be significantly associated with being underweight. Having dinner within 2 hours before bed was positively associated with being overweight/obese [adjusted odds ratio (AOR): 1.448, 95% confidence interval (CI): 1.014-2.068]. Women who gained 10 kg since their 20s were more likely to fall into overweight/obesity category (AOR: 9.674, 95% CI: 1.014-2.068). Women who were using a lipid-lowering medication (AOR: 3.150, CI: 1.892-5.246) were associated with three times higher risk of being overweight/obese. Hypertension and dyslipidemia were significantly associated with overweight/obesity (AOR: 3.094, 95% CI: 2.201-4.351 and AOR: 2.498, 95% CI: 1.831-3.409, respectively).

CONCLUSION

One in five middle-aged women was overweight or obese, whereas one in eight was underweight. In relation to the prevention of overweight/obesity, specific health promotion messages regarding eating timing should be developed.

Behavioral and emotional adaptations of obese and underweight students in response to the COVID-19 pandemic

Previous studies have investigated the effects of COVID-19 on the general population of college students. However, research evaluating the complex behavioral and psychological impact of the pandemic on both obese and underweight students is currently limited. We used data from a survey conducted from March to April 2020 across 2534 students enrolled in seven US universities. We examined whether the associations between taking various behaviors and being obese and underweight students are unidimensional, or varies based on various negative emotions, and their sociodemographic characteristics. Also, we checked whether emotions of obese and underweight groups are impaired, which consequently might impact taking various cautionary behaviors. The results highlight complex relationships between being obese and underweight students and other considered variables. For instance, despite the associated risk, it was found that obese students are associated with less fear, guilt and irritability due to the pandemic. However, those associations vary based on factors such as level of educations. In addition, while obese students are less likely to avoid a large group of people, the impact changes based on gender. Lack of precautions and emotions is despite the increased risk of hospitalization and death associated with obese and underweight groups. Finally, it was found that there are negative and stable associations between higher social class, income, and the lower likelihood of being obese or underweight. Significant differences and similarities were also found across factors to obese and underweight students.

Multilevel Analysis of Urban-Rural Variations of Body Weights and Individual-Level Factors among Women of Childbearing Age in Nigeria and South Africa: A Cross-Sectional Survey

Background: An unhealthy body weight is an adverse effect of malnutrition associated with morbidity among women of childbearing age. While there is increasing attention being paid to the body weights of children and adolescents in Nigeria and South Africa, a major surge of unhealthy body weight in women has received less attention in both countries despite its predominance. The purpose of this study was to explore the prevalence of body weights (underweight, normal, overweight, and obese) and individual-level factors among women of childbearing age by urban-rural variations in Nigeria and South Africa. Methods: This study used the 2018 Nigeria Demographic Health Survey data (n = 41,821) and 2016 South Africa Demographic Health Survey (n = 8514). Bivariate, multilevel, and intracluster correlation coefficient analyses were used to determine individual-level factors associated with body weights across urban-rural variations. Results: The prevalence of being overweight or obese among women was 28.2% and 44.9%, respectively, in South Africa and 20.2% and 11.4% in Nigeria. A majority, 6.8%, of underweight women were rural residents in Nigeria compared to 0.8% in South Africa. The odds of being underweight were higher among women in Nigeria who were unemployed, with regional differences and according to breastfeeding status, while higher odds of being underweight were found among women from poorer households, with differences between provinces and according to cigarette smoking status in South Africa. On the other hand, significant odds of being overweight or obese among women in both Nigeria and South Africa were associated with increasing age, higher education, higher wealth index, weight above average, and traditional/modern contraceptive use. Unhealthy body weights were higher among women in clustering areas in Nigeria who were underweight (intracluster correlation coefficient (ICC = 0.0127), overweight (ICC = 0.0289), and obese (ICC = 0.1040). Similarly, women of childbearing age in clustering areas in South Africa had a lower risk of experiencing underweight (ICC = 0.0102), overweight (ICC = 0.0127), and obesity (ICC = 0.0819). Conclusions: These findings offer a deeper understanding of the close connection between body weights variations and individual factors. Addressing unhealthy body weights among women of childbearing age in Nigeria and South Africa is important in preventing disease burdens associated with body weights in promoting Sustainable Development Goal 3. Strategies for developing preventive sensitization interventions are imperative to extend the perspectives of the clustering effect of body weights on a country level when establishing social and behavioral modifications for body weight concerns in both countries.

Prevalence of Underweight, Overweight and Obesity among Adults in Urban Bissau, Western Africa

Overweight and obesity affect a large proportion of the population and are important causes of death in both developed and low- and middle-income countries. In Guinea-Bissau, there are no previous population-based studies assessing this phenomenon. Therefore, we aimed to quantify the prevalence of underweight, overweight, and obesity among adults in Bissau. A stratified and cluster sample of 935 adults was assembled in 2021 and was evaluated using standardized questionnaires and anthropometric measurements, following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance. Underweight, obesity, and overweight were defined by body mass index based on the World Health Organization definitions. The prevalence of overweight and obesity was 48.7% among women and 25.0% among men. The proportion of women with abdominal obesity was 14 times higher than it was in men (35.3% vs. 2.5%). The prevalence of overweight and obesity increased with age and income. Underweight was more prevalent in the age group of 18 to 24 years (18.4% in women and 28.9% in men) and was less frequent among individuals with higher socioeconomic status. In conclusion, the prevalence of overweight and obesity is similar to the trends that are observed in many other urbanized populations in Africa and is already a major public health issue in urban Guinea-Bissau.

Underweight and overweight/obesity among adults in Afghanistan: prevalence and correlates from a national survey in 2018

BACKGROUND

The study aimed to estimate the prevalence and correlates of underweight and overweight/obesity among adults in Afghanistan.

METHODS

National cross-sectional survey data of 3779 persons aged 18-69 years were analysed. Multinomial logistic regression was used to estimate factors associated with underweight and overweight/obesity relative to normal weight.

RESULTS

In all, 7.8% of the study sample was underweight (BMI < 18.5 kg/m²), 49.5% had normal weight (BMI 18.5-24.9 kg/m²), 25.5% overweight (25.0-29.9 kg/m²), and 17.2% obesity. In adjusted multinomial logistic regression, factors negatively associated with underweight were male sex (adjusted relative risk ratio (ARRR): 0.30, 95% confidence interval (CI): 0.15-0.58) and hypertension (ARRR: 0.51, 95% CI: 0.27-0.95) and factors positively associated with underweight were sedentary behaviour (ARRR: 1.85, 95% CI: 1.11-3.10) and current tobacco use (ARRR: 2.58, 95% CI: 1.08-6.16). Factors positively associated with overweight/obesity were aged 30-44 years (ARRR: 2.00, CI: 1.51-2.66) and aged 45-69 years (ARRR: 1.58, CI: 1.09-2.31) (compared to 18-29 years) (ARRR: 1.28, CI: 1.14-2.18), hypertension (ARRR: 2.74, CI: 1.89-3.96), and type 2 diabetes (ARRR: 1.82, CI: 1.13-2.94), and high physical activity (ARRR: 0.70, CI: 0.50-0.98) was negatively associated with overweight/obesity.

CONCLUSION

Almost one in ten adult respondents were underweight and more than two in five were overweight/obese, confirming a dual burden of malnutrition in Afghanistan.

Overweight and Obesity among Adults in Iraq: Prevalence and Correlates from a National Survey in 2015

This study aimed to estimate the prevalence and correlates of overweight and obesity among adults in Iraq. Data from a 2015 nationally representative cross-sectional survey of 3916 persons 18 years or older (M (median) age = 40 years, IQR (interquartile range) age = 29–52 years; men: M = 41 years, IQR = 29–54 years; women: M = 40 years, IQR = 30–51 years) who responded to a questionnaire, and physical and biochemical measures were analysed. Multinomial logistic regression was utilised to predict the determinants of overweight and obesity relative to under or normal weight. The results indicate that 3.6% of the participants were underweight (body mass index (BMI) <18.5 kg/m²), 30.8% had normal weight (BMI 18.5–24.9 kg/m²), 31.8% were overweight (25.0–29.9 kg/m²), and 33.9% had obesity (BMI ≥30.0 kg/m²). In the adjusted multinomial logistic regression, being aged 40–49 years (compared to 18–39 years old) (adjusted relative risk ratio (ARRR): 4.47, confidence interval (CI): 3.39–5.91), living in an urban residence (ARRR: 1.28, CI: 1.14–2.18), and having hypertension (ARRR: 3.13, CI: 2.36–4.17) were positively associated with obesity. Being male (ARRR: 0.47, CI: 0.33–0.68), having more than primary education (ARRR: 0.69, CI: 0.50–0.94), and having a larger household size (five members or more) (ARRR: 0.45, CI: 0.33–0.60) were negatively associated with obesity. Approximately two in three adult participants were overweight/obese, and sociodemographic and health risk factors were found that can be utilised in targeting interventions.