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Tagbo SO, Abebe D, Oguoma VM. Overweight and obesity among non-pregnant women of reproductive age in Nigeria: findings from the 2008-2018 Nigerian Demographic and Health Survey. Public Health 2021; 198:348-357. [PMID: 34530237 DOI: 10.1016/j.puhe.2021.07.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/19/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Overweight and obesity are known risk factors for diabetes, heart disease, certain cancers and pregnancy-related problems. This study aimed to determine the prevalence and change in prevalence of overweight and obesity among non-pregnant women of reproductive age and relationship with individual- and community-level factors over a decade. STUDY DESIGN This was a cross-sectional survey with two-stage probability sampling design. METHODS Data sets were pooled from the 2008, 2013 and 2018 Nigerian Demographic and Health Survey - a cross-sectional, nationally representative sample of the entire Nigerian population aged 15-49 years. Body mass index (BMI) was used to classify overweight and obesity. Multilevel logistic regression was used to assess associations between overweight (25.0-29.9 kg/m2), obesity (≥30.0 kg/m2) and individual and community factors. RESULTS There were 76,729 non-pregnant women (38.0% in 2008, 44.5% in 2013 vs 17.5% in 2018) with a mean age of 29.0 years and a BMI of 23.0 kg/m2 across the three survey periods. Overweight and obesity prevalence were 16.0% and 6.2% in 2008, 17.2% and 7.5% in 2013 and 18.1% and 9.9% in 2018, respectively. There was 76% (95% confidence interval: 44% to twofold) increased odds of obesity in 2018 compared with 2008 in adjusted analysis. Older women with at least primary education living in urban areas, ever married and from wealthier households are at a greater odd of being overweight and obese. CONCLUSION Over a decade, overweight and obesity prevalence increased among non-pregnant women of reproductive age in Nigeria. There is an urgent need for public health strategies and interventions to improve on deficient knowledge and low awareness about healthy foods and physical activity at individual and community levels especially in urban areas.
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Affiliation(s)
- S O Tagbo
- Oceania University of Medicine, North Rocks, New South Wales, Australia
| | - D Abebe
- Oceania University of Medicine, North Rocks, New South Wales, Australia
| | - V M Oguoma
- Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia; Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
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Soares-Wynter S, Aiken-Hemming SA, Hollingsworth B, Miles DR, Ng SW. Applying Nutrient Profiling Systems to Packaged Foods and Drinks Sold in Jamaica. Foods 2020; 9:foods9010065. [PMID: 31936193 PMCID: PMC7022911 DOI: 10.3390/foods9010065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 11/30/2022] Open
Abstract
The Pan American Health Organization (PAHO) and Chile stage III nutrient profiling systems (NPSs) were applied to packaged beverages/foods sold in Jamaica to: (a) identify products with excess nutrients of concern (NOC) under each NPS; (b) assess differences between these NPS, and (c) discuss the advantages and disadvantages of each NPS when applied to Jamaica’s food supply. Data on 6261 branded multi-ingredient packaged products were collected from the city of Kingston in 2018; of these, 4739 products, comprised of 3423 foods (from 15 food groups) and 1316 beverages (from four beverage groups), provided sufficient information. Products containing excessive NOC under each NPS were identified and the proportions of categories with excess NOC were compared using correlation coefficients. Also assessed were the mean nutrient values among the subset of products exceeding versus not exceeding both NPSs using tests of significance. A larger proportion of packaged beverages and foods exceeds thresholds under PAHO versus Chile Stage III. Additionally, a larger percentage of foods, like fruits, vegetables, legumes, fish and seafood, would be considered as having excess sugar or sodium under PAHO versus Chile. This is the first study in the Caribbean that applies two existing NPSs to packaged products. The results can help to determine an appropriate NPS for use in Jamaica as the basis for food and nutrition policies, to help consumers make improved food choices.
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Affiliation(s)
- Suzanne Soares-Wynter
- Caribbean Institute for Health Research, The University of the West Indies Mona, Kingston 7, Jamaica; (S.S.-W.); (S.-A.A.-H.)
| | - Stacey-Ann Aiken-Hemming
- Caribbean Institute for Health Research, The University of the West Indies Mona, Kingston 7, Jamaica; (S.S.-W.); (S.-A.A.-H.)
| | - Bridget Hollingsworth
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA; (B.H.); (D.R.M.)
| | - Donna R. Miles
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA; (B.H.); (D.R.M.)
| | - Shu Wen Ng
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA; (B.H.); (D.R.M.)
- Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA
- Correspondence: ; Tel.: +1-919-962-6188
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Dugas LR, Bernabé BP, Priyadarshini M, Fei N, Park SJ, Brown L, Plange-Rhule J, Nelson D, Toh EC, Gao X, Dong Q, Sun J, Kliethermes S, Gottel N, Luke A, Gilbert JA, Layden BT. Decreased microbial co-occurrence network stability and SCFA receptor level correlates with obesity in African-origin women. Sci Rep 2018; 8:17135. [PMID: 30459320 PMCID: PMC6244201 DOI: 10.1038/s41598-018-35230-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/28/2018] [Indexed: 02/07/2023] Open
Abstract
We compared the gut microbial populations in 100 women, from rural Ghana and urban US [50% lean (BMI < 25 kg/m2) and 50% obese (BMI ≥ 30 kg/m2)] to examine the ecological co-occurrence network topology of the gut microbiota as well as the relationship of short chain fatty acids (SCFAs) with obesity. Ghanaians consumed significantly more dietary fiber, had greater microbial alpha-diversity, different beta-diversity, and had a greater concentration of total fecal SCFAs (p-value < 0.002). Lean Ghanaians had significantly greater network density, connectivity and stability than either obese Ghanaians, or lean and obese US participants (false discovery rate (FDR) corrected p-value ≤ 0.01). Bacteroides uniformis was significantly more abundant in lean women, irrespective of country (FDR corrected p < 0.001), while lean Ghanaians had a significantly greater proportion of Ruminococcus callidus, Prevotella copri, and Escherichia coli, and smaller proportions of Lachnospiraceae, Bacteroides and Parabacteroides. Lean Ghanaians had a significantly greater abundance of predicted microbial genes that catalyzed the production of butyric acid via the fermentation of pyruvate or branched amino-acids, while obese Ghanaians and US women (irrespective of BMI) had a significantly greater abundance of predicted microbial genes that encoded for enzymes associated with the fermentation of amino-acids such as alanine, aspartate, lysine and glutamate. Similar to lean Ghanaian women, mice humanized with stool from the lean Ghanaian participant had a significantly lower abundance of family Lachnospiraceae and genus Bacteroides and Parabacteroides, and were resistant to obesity following 6-weeks of high fat feeding (p-value < 0.01). Obesity-resistant mice also showed increased intestinal transcriptional expression of the free fatty acid (Ffa) receptor Ffa2, in spite of similar fecal SCFAs concentrations. We demonstrate that the association between obesity resistance and increased predicted ecological connectivity and stability of the lean Ghanaian microbiota, as well as increased local SCFA receptor level, provides evidence of the importance of robust gut ecologic network in obesity.
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Affiliation(s)
- Lara R Dugas
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.
| | | | - Medha Priyadarshini
- Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, IL, USA
| | - Na Fei
- Microbiome Center, Department of Surgery, University of Chicago, Chicago, IL, USA
| | - Seo Jin Park
- Department of Microbiology-Immunology, Northwestern University, Chicago, Illinois, USA
| | - Laquita Brown
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | | | - David Nelson
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, USA
| | - Evelyn C Toh
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, USA
| | - Xiang Gao
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Qunfeng Dong
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Jun Sun
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Stephanie Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Wisconsin, USA
| | - Neil Gottel
- Microbiome Center, Department of Surgery, University of Chicago, Chicago, IL, USA
| | - Amy Luke
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Jack A Gilbert
- Microbiome Center, Department of Surgery, University of Chicago, Chicago, IL, USA
| | - Brian T Layden
- Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, IL, USA.,Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois, USA
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Lie L, Brown L, Forrester TE, Plange-Rhule J, Bovet P, Lambert EV, Layden BT, Luke A, Dugas LR. The Association of Dietary Fiber Intake with Cardiometabolic Risk in Four Countries across the Epidemiologic Transition. Nutrients 2018; 10:E628. [PMID: 29772682 PMCID: PMC5986507 DOI: 10.3390/nu10050628] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/08/2018] [Accepted: 05/14/2018] [Indexed: 01/01/2023] Open
Abstract
The greatest burden of cardiovascular disease is now carried by developing countries with cardiometabolic conditions such as metabolic syndrome, obesity and inflammation believed to be the driving force behind this epidemic. Dietary fiber is known to have protective effects against obesity, type 2 diabetes, cardiovascular disease and the metabolic syndrome. Considering the emerging prevalence of these cardiometabolic disease states across the epidemiologic transition, the objective of this study is to explore these associations of dietary fiber with cardiometabolic risk factors in four countries across the epidemiologic transition. We examined population-based samples of men and women, aged 25⁻45 of African origin from Ghana, Jamaica, the Seychelles and the USA. Ghanaians had the lowest prevalence of obesity (10%), while Jamaicans had the lowest prevalence of metabolic syndrome (5%) across all the sites. Participants from the US presented with the highest prevalence of obesity (52%), and metabolic syndrome (22%). Overall, the Ghanaians consumed the highest dietary fiber (24.9 ± 9.7 g), followed by Jamaica (16.0 ± 8.3 g), the Seychelles (13.6 ± 7.2 g) and the lowest in the USA (14.2 ± 7.1 g). Consequently, 43% of Ghanaians met the fiber dietary guidelines (14 g/1000 kcal/day), 9% of Jamaicans, 6% of Seychellois, and only 3% of US adults. Across all sites, cardiometabolic risk (metabolic syndrome, inflammation and obesity) was inversely associated with dietary fiber intake, such that the prevalence of metabolic syndrome was 13% for those in the lowest quartile of fiber intake, compared to 9% those in the highest quartile of fiber intake. Notably, twice as many of participants (38%) in the lowest quartile were obese compared to those in the highest quartile of fiber intake (18%). These findings further support the need to incorporate strategies and policies to promote increased dietary fiber intake as one component for the prevention of cardiometabolic risk in all countries spanning the epidemiologic transition.
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Affiliation(s)
- Louise Lie
- Public Health Sciences, Stritch School of Medicine, Maywood, IL 60153, USA.
| | - Laquita Brown
- Public Health Sciences, Stritch School of Medicine, Maywood, IL 60153, USA.
| | - Terrence E Forrester
- Solutions for Developing Countries, University of West Indies, Mona, Kingston, Jamaica.
| | - Jacob Plange-Rhule
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Pascal Bovet
- Unit for the Prevention and Control of Cardiovascular Disease, Ministry of Health, Victoria, Mahè Island, Republic of Seychelles.
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne 1010, Switzerland.
| | - Estelle V Lambert
- Division for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa.
| | - Brian T Layden
- Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, IL 60612, USA.
- Section of Endocrinology, Department of Medicine, Jesse Brown VA Medical Center, Chicago, IL 60612, USA.
| | - Amy Luke
- Public Health Sciences, Stritch School of Medicine, Maywood, IL 60153, USA.
| | - Lara R Dugas
- Public Health Sciences, Stritch School of Medicine, Maywood, IL 60153, USA.
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Dugas LR, Kliethermes S, Plange-Rhule J, Tong L, Bovet P, Forrester TE, Lambert EV, Schoeller DA, Durazo-Arvizu RA, Shoham DA, Cao G, Brage S, Ekelund U, Cooper RS, Luke A. Accelerometer-measured physical activity is not associated with two-year weight change in African-origin adults from five diverse populations. PeerJ 2017; 5:e2902. [PMID: 28133575 PMCID: PMC5251933 DOI: 10.7717/peerj.2902] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 12/20/2022] Open
Abstract
Background Increasing population-levels of physical activity (PA) is a controversial strategy for managing the obesity epidemic, given the conflicting evidence for weight loss from PA alone per se. We measured PA and weight change in a three-year prospective cohort study in young adults from five countries (Ghana, South Africa, Jamaica, Seychelles and USA). Methods A total of 1,944 men and women had baseline data, and at least 1 follow-up examination including measures of anthropometry (weight/BMI), and objective PA (accelerometer, 7-day) following the three-year study period. PA was explored as 1-minute bouts of moderate and vigorous PA (MVPA) as well as daily sedentary time. Results At baseline; Ghanaian and South African men had the lowest body weights (63.4 ± 9.5, 64.9 ± 11.8 kg, respectively) and men and women from the USA the highest (93.6 ± 25.9, 91.7 ± 23.4 kg, respectively). Prevalence of normal weight ranged from 85% in Ghanaian men to 29% in USA men and 52% in Ghanaian women to 15% in USA women. Over the two-year follow-up period, USA men and Jamaican women experienced the smallest yearly weight change rate (0.1 ± 3.3 kg/yr; −0.03 ± 3.0 kg/yr, respectively), compared to South African men and Ghanaian women greatest yearly change (0.6.0 ± 3.0 kg/yr; 1.22 ± 2.6 kg/yr, respectively). Mean yearly weight gain tended to be larger among normal weight participants at baseline than overweight/obese at baseline. Neither baseline MVPA nor sedentary time were associated with weight gain. Using multiple linear regression, only baseline weight, age and gender were significantly associated with weight gain. Discussion From our study it is not evident that higher volumes of PA alone are protective against future weight gain, and by deduction our data suggest that other environmental factors such as the food environment may have a more critical role.
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Affiliation(s)
- Lara R Dugas
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago , Maywood , IL , United States
| | - Stephanie Kliethermes
- Department of Orthopedics & Rehabilitation, University of Wisconsin, Madison , Madison , WI , United States
| | - Jacob Plange-Rhule
- Department of Physiology, Kwame Nkrumah University of Science and Technology , Kumasi , Ghana
| | - Liping Tong
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago , Maywood , IL , United States
| | - Pascal Bovet
- Institute of Social & Preventive Medicine, Lausanne University Hospital, Lausanne, VD, Switzerland; Ministry of Health, Victoria, Republic of Seychelles
| | - Terrence E Forrester
- Solutions for Developing Countries, University of West Indies, Mona , Kingston , Jamaica
| | - Estelle V Lambert
- Division of Exercise Science and Sports Medicine, Health Sciences, University of Cape Town , Cape Town , South Africa
| | - Dale A Schoeller
- Nutritional Sciences, University of Wisconsin, Madison , Madison , WI , United States
| | - Ramon A Durazo-Arvizu
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago , Maywood , IL , United States
| | - David A Shoham
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago , Maywood , IL , United States
| | - Guichan Cao
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago , Maywood , IL , United States
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge , Cambridge , United Kingdom
| | - Ulf Ekelund
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom; Department of Sport Medicine, Norwegion School of Sport Sciences, Oslo, Norway
| | - Richard S Cooper
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago , Maywood , IL , United States
| | - Amy Luke
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago , Maywood , IL , United States
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Dugas LR, Fuller M, Gilbert J, Layden BT. The obese gut microbiome across the epidemiologic transition. Emerg Themes Epidemiol 2016; 13:2. [PMID: 26759600 PMCID: PMC4710045 DOI: 10.1186/s12982-015-0044-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 12/15/2015] [Indexed: 12/13/2022] Open
Abstract
The obesity epidemic has emerged over the past few decades and is thought to be a result of both genetic and environmental factors. A newly identified factor, the gut microbiota, which is a bacterial ecosystem residing within the gastrointestinal tract of humans, has now been implicated in the obesity epidemic. Importantly, this bacterial community is impacted by external environmental factors through a variety of undefined mechanisms. We focus this review on how the external environment may impact the gut microbiota by considering, the host’s geographic location ‘human geography’, and behavioral factors (diet and physical activity). Moreover, we explore the relationship between the gut microbiota and obesity with these external factors. And finally, we highlight here how an epidemiologic model can be utilized to elucidate causal relationships between the gut microbiota and external environment independently and collectively, and how this will help further define this important new factor in the obesity epidemic.
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Affiliation(s)
- Lara R Dugas
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, 2160 S. 1st Ave, Maywood, IL 60153 USA
| | - Miles Fuller
- Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University, Evanston, USA
| | - Jack Gilbert
- Argonne National Laboratory, Biosciences Department, Institute for Genomic and Systems Biology, 9700 South Cass Avenue, Argonne, IL 60439 USA ; Department of Ecology and Evolution, University of Chicago, 1101 E 57th Street, Chicago, IL 60637 USA ; Marine Biological Laboratory, 7 MBL Street, Woods Hole, MA 02543 USA ; College of Environmental and Resource Sciences, Zhejiang University, Hangzhou, 310058 China
| | - Brian T Layden
- Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University, Evanston, USA ; Jesse Brown Veterans Affairs Medical Center, Chicago, IL USA
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Ferraz ÁAB, de Siqueira LT, Noronha CG, de Holanda DBR, de Araújo-Júnior JGC, Muniz MG. SURGICAL TREATMENT OF SEVERE OBESITY IN TEENS: LATE RESULTS. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2015; 28 Suppl 1:7-10. [PMID: 26537264 PMCID: PMC4795297 DOI: 10.1590/s0102-6720201500s10004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/06/2015] [Indexed: 11/30/2022]
Abstract
Background : In children is estimated that the prevalence of overweight and obesity has
increased up to five times in developed countries and up to four in developing
countries. In Brazil, the proportion of children and adolescents who are
overweight also increased from approximately 4.1% to 13.9%. Aim : To evaluate the surgical results of severe obesity in adolescents. Methods : Retrospective descriptive study of 2737 patients with severe obesity that
underwent Roux-en-Y gastric bypass selecting from the total 44 patients with mean
age of 18.1 years, 14 males and 30 females, most (37) operated by laparotomy.
There was follow-up of 20 patients (45.45%). All were followed preoperatively by a
multidisciplinary team and had indication confirmed for surgical unanimous
approval of all team members. Results : Among the 20 adolescent, 14 were female. From five teenagers using
anti-hypertension or hypoglycemic drugs before surgery, four (80%) had drug
discontinuation and one (20%) reduced the dose in 50% postoperatively. The average
weight loss was 45.4 kg after a mean follow up of 60 months. There were no deaths
or severe postoperative complications. Among those who underwent postoperative
follow-up with a multidisciplinary team, 18 were with BMI<30. Conclusions : Adolescents undergoing Roux-en-Y gastric bypass has good response in relation to
weight loss and improvement of comorbidities. There was a low rate of
complications and no deaths. All patients were satisfied with their personal
results.
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Toselli S, Gualdi-Russo E, Boulos DNK, Anwar WA, Lakhoua C, Jaouadi I, Khyatti M, Hemminki K. Prevalence of overweight and obesity in adults from North Africa. Eur J Public Health 2015; 24 Suppl 1:31-9. [PMID: 25107996 DOI: 10.1093/eurpub/cku103] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The share of North African immigrants in Europe is growing continuously. In this review, we aimed to systematically analyse and describe the literature on weight status and physical activity in North African adults, both in their home country and after immigration to Europe. Existing data on North African residents and on North African immigrants in Europe were analysed by a systematic search on PUBMED. There is a wide variation among countries in the prevalence of overweight/obesity, with immigrants showing higher values. The overall results revealed a higher prevalence of overweight and obesity in females than in males in North African residents. Females also show higher levels of obesity among immigrants. In particular, literature reports indicate that 1.3-47.8% of North African residents and 3.6-49.4% of North African immigrants in adult age are overweight or obese. Physical inactivity is higher than 20% in males and 40% in females in North African residents. The highest frequency of physically inactive or lightly active people among immigrants was observed in first-generation Sudanese and Moroccans in Amsterdam (males: 57.1%; females: 74.2%), with increasing rates in second-generation females. The results underline a higher health risk in North African immigrants than in residents. Specific public health strategies should be adopted in various populations of North African origin to control the obesity epidemic.
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Affiliation(s)
- Stefania Toselli
- 1 Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Emanuela Gualdi-Russo
- 2 Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Dina N K Boulos
- 3 Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Egypt
| | - Wagida A Anwar
- 3 Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Egypt
| | - Chérifa Lakhoua
- 4 CERP-Tunisia (Centre for Studies and Research Prospects), University of Carthage, Tunisia
| | - Imen Jaouadi
- 4 CERP-Tunisia (Centre for Studies and Research Prospects), University of Carthage, Tunisia
| | | | - Kari Hemminki
- 6 German Cancer Research Center, Heidelberg, Germany7 Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
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Gordon-Strachan G, Cunningham-Myrie C, Fox K, Kirton C, Fraser R, McLeod G, Forrester T. Richer but fatter: the unintended consequences of microcredit financing on household health and expenditure in Jamaica. Trop Med Int Health 2014; 20:67-76. [PMID: 25329229 DOI: 10.1111/tmi.12403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Kristin Fox
- Sir Arthur Lewis Institute of Social and Economic Studies; University of the West Indies; Mona Jamaica
| | - Claremont Kirton
- Department of Economics; University of the West Indies; Mona Jamaica
| | - Raphael Fraser
- Department of Statistics; Florida State University; Tallahassee FL USA
| | - Georgia McLeod
- Department of Economics; University of the West Indies; Mona Jamaica
| | - Terrence Forrester
- UWI Solutions for Developing Countries; University of the West Indies; Mona Jamaica
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Abstract
Type 2 diabetes remains an important cause of morbidity and mortality. The metabolic syndrome affects 25% of the adult US population based on the Third Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults from the National Cholesterol Education Program. Knowledge on the impact of obesity on metabolic health parameters has increased greatly over the past decade. This review discusses the limitations of the National Cholesterol Education Program metabolic syndrome definition and the racial disparities in the clinical presentation of the insulin resistance syndrome. We also examine the current literature with particular emphasis on albuminuria, nonalcoholic fatty liver disease, and intramyocellular lipid content. This review explores potential environmental and genetic reasons for differences in the manifestation of insulin resistance across racial/ethnic groups and highlights several promising areas for further study.
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Affiliation(s)
- Holly Kramer
- Departments of Public Health Sciences and Medicine, Division of Nephrology and Hypertension, Loyola University Chicago Health Sciences Campus, Maywood, IL.
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11
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Cunningham-Myrie C, Younger-Coleman N, Tulloch-Reid M, McFarlane S, Francis D, Ferguson T, Gordon-Strachan G, Wilks R. Diabetes mellitus in Jamaica: sex differences in burden, risk factors, awareness, treatment and control in a developing country. Trop Med Int Health 2013; 18:1365-78. [PMID: 24128301 DOI: 10.1111/tmi.12190] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The objective of this study was to provide valid estimates of the burden of and risk factors for diabetes mellitus by sex in Jamaica, a predominantly Black, middle-income and developing country. METHODS The Jamaica Health and Lifestyle Survey 2008 examined a nationally representative sample of 2848 Jamaicans aged 15-74. Parameter estimates and 95% confidence intervals [CI] were weighted for non-response as well as age and sex of the source population. Sex differences in risk factors and diabetes prevalence, awareness, treatment and control were estimated in multivariable models. Population-attributable fractions (PAFs) of obesity on diabetes mellitus were estimated in both sexes. RESULTS The prevalence of diabetes mellitus was 7.9% (95% CI: 6.7-9.1%), significantly higher in women than men 9.3% vs. 6.4% (P = 0.02) and increasing with age. Seventy-six percentage of persons with diabetes mellitus were aware of their status; urban women and rural men were less likely to be aware. Diabetes control (43% overall) was less common in higher-income men, but more common in higher-income women. Persons without health insurance were less likely to control their diabetes. The prevalence of diabetes risk factors was higher in women than men. Increased waist circumference (≥94 cm [men]/≥80 cm [women]), overweight/obesity (body mass index ≥ 25 kg/m(2)) and low physical activity/inactivity were associated with PAFs for diabetes mellitus of 27%, 37% and 15%, respectively, in men and 77%, 54% and 24%, respectively, in women. CONCLUSIONS Prevalence of diabetes mellitus and its risk factors is high in Jamaica, especially among women, and national programmes to stem the diabetes mellitus epidemic should take these sex differences into consideration.
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Affiliation(s)
- Colette Cunningham-Myrie
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston, Jamaica; Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica
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Lee H, Kershaw KN, Hicken MT, Abdou CM, Williams ES, Rivera-O'Reilly N, Jackson JS. Cardiovascular disease among Black Americans: comparisons between the U.S. Virgin Islands and the 50 U.S. states. Public Health Rep 2013; 128:170-8. [PMID: 23633732 PMCID: PMC3610069 DOI: 10.1177/003335491312800307] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Consistent findings show that black Americans have high rates of cardiovascular disease (CVD) and related behavioral risk factors. Despite this body of work, studies on black Americans are generally limited to the 50 U.S. states. We examined variation in CVD and related risk factors among black Americans by comparing those residing within the U.S. Virgin Islands (USVI) with those residing in the 50 U.S. states and Washington, D.C. (US 50/DC) and residing in different regions of the US 50/DC (Northeast, Midwest, South, and West). METHODS Using data from the 2007 and 2009 Behavioral Risk Factor Surveillance System, we compared CVD and CVD risk factor prevalence in non-Hispanic black people (≥20 years of age) in the USVI and US 50/DC, examining the relative contributions of health behaviors, health insurance, and socioeconomic status (SES). RESULTS Accounting for age, sex, education, health insurance, and health behaviors, US 50/DC black Americans were significantly more likely than USVI black people to report ever having a stroke and coronary heart disease, and to be hypertensive, diabetic, or obese. While there was heterogeneity by region, similar patterns emerged when comparing the USVI with different regions of the US 50/DC. CONCLUSION USVI black people have lower CVD and risk factor prevalence than US 50/DC black people. These lower rates are not explained by differences in health behaviors or SES. Understanding health in this population may provide important information on the etiology of racial/ethnic variation in health in the U.S. and elsewhere, and highlight relevant public health policies to reduce racial/ethnic group disparities.
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Affiliation(s)
- Hedwig Lee
- University of Washington, Department of Sociology, Seattle, WA 98195, USA.
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Ejike CE, Ijeh II. Obesity in young-adult Nigerians: variations in prevalence determined by anthropometry and bioelectrical impedance analysis, and the development of % body fat prediction equations. Int Arch Med 2012; 5:22. [PMID: 22818201 PMCID: PMC3464790 DOI: 10.1186/1755-7682-5-22] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 07/20/2012] [Indexed: 12/26/2022] Open
Abstract
Background Overweight/obesity is a growing global public health concern. The variations in the prevalence of overweight/obesity, defined by Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Height Ratio (WHtR), Waist-to-Hip Ratio (WHpR) and Bioelectrical Impedance Analysis (BIA), were studied and a prediction equation for % body fat (%BF) developed. Methods A total of 1584 subjects (56.4% males) were recruited for the study. Data on age, gender, height, weight, hip circumference and WC were collected from the subjects using standard protocols. BMI, WHtR and WHpR were derived using standard equations. %BF was measured using a BIA device (Omron BF-400). Appropriate statistical tools were used for the data analysis. Results The prevalence of overweight/obesity in the population was 28.4% (36.3% for males; 22.6% for females) (BIA); 20.7% (17.5% for males; 24.8% for females) (BMI); 7.5% (1.3% for males; 16.1% for females) (WC); 2.9% (4.3% for males; 1.2% for females) (WHpR); and 15.4% (14.8% for males; 16.2% females) (WHtR). Taking BIA as the reference point, WC misclassified overweight/obesity the most for males (35%), while for the females, WHpR misclassified both disorders the most (21.4%). Correlation studies showed that only BMI correlated significantly, albeit weakly, with %BF among the males, whereas all the anthropometric measures, but WHpR correlated significantly with % body fat in females. Two prediction equations for %BF were generated, and %BF predicted with the two equations correlated significantly (P < 0.001) with that measured by BIA. Conclusion The prevalence of overweight/obesity in this population vary widely depending on the definition used. The developed prediction equations could be useful in resource-poor settings, but require validation.
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Affiliation(s)
- Chukwunonso Ecc Ejike
- Department of Biochemistry, College of Natural and Applied Sciences, Michael Okpara University of Agriculture, Umudike, PMB 7267, Umuahia, Abia State, Nigeria.
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Colorectal carcinoma: why is there a lower incidence in Nigerians when compared to Caucasians? J Cancer Epidemiol 2011; 2011:675154. [PMID: 22253627 PMCID: PMC3255166 DOI: 10.1155/2011/675154] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 10/31/2011] [Accepted: 11/14/2011] [Indexed: 01/28/2023] Open
Abstract
Carcinoma of the colon and rectum is the 2nd commonest cancer in the United States; the leading cancer being lung cancer. It has been estimated that 130,200 new cases of colorectal cancer will be diagnosed annually while 56,300 sufferers will die from the disease (Murphy et al., 2000). In developing countries especially West Africa, the rate has not yet reached such magnitude. This suggests that there may be factors either anthropomorphic or environmental which may be responsible for this. The paper acknowledges the reduced incidence of colorectal cancer in native West Africans living in Africa and endeavours to highlight the various factors that produce this observation in medical literature. A diligent search through available literature on the aetiology, epidemiology and comparative anthropology of colorectal cancer was done. Internet search using PubMed, British Library Online and Google Scholar was also utilized. The rarity of adenomatous polyposis syndromes in the native West African contributes to the reduced incidence of colorectal cancer. Cancer prevention and cancer-protective factors are deemed to lie in the starchy, high-fiber, spicy, peppery foodstuff low in animal protein which many West African nations consume.
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Kengne AP, Ntyintyane LM, Mayosi BM. A systematic overview of prospective cohort studies of cardiovascular disease in sub-Saharan Africa. Cardiovasc J Afr 2011; 23:103-12. [PMID: 21901226 PMCID: PMC3734756 DOI: 10.5830/cvja-2011-042] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Accepted: 08/15/2011] [Indexed: 11/18/2022] Open
Abstract
Background Cardiovascular diseases (CVDs) are becoming increasingly significant in sub-Saharan Africa (SSA). Reliable measures of the contribution of major determinants are essential for informing health services and policy solutions. Objective To perform a systematic review of all longitudinal studies of CVDs and related risk factors that have been conducted in SSA. Data source We searched electronic databases from 1966 to October 2009. Published studies were retrieved from PubMed and Africa EBSCO. Reference lists of identified articles were scanned for additional publications. Study selection Any longitudinal study with data collection at baseline on major cardiovascular risk factors or CVD, including 30 or more participants, and with at least six months of follow up were included. Data extraction Data were extracted on the country of study, year of inception, baseline evaluation, primary focus of the study, outcomes, and number of participants at baseline and final evaluation. Results Eighty-one publications relating to 41 studies from 11 SSA countries with a wide range of participants were included. Twenty-two were historical/prospective hospital-based studies. These studies focused on risk factors, particularly diabetes mellitus and hypertension, or CVD including stroke, heart failure and rheumatic heart disease. The rate of participants followed through the whole duration of studies was 72% (64–80%), with a significant heterogeneity between studies (for heterogeneity, p < 0.001). Outcomes monitored during follow up included trajectories of risk markers and mortality. Conclusions Well-designed prospective cohort studies are needed to inform and update our knowledge regarding the epidemiology CVDs and their interactions with known risk factors in the context of common infectious diseases in this region.
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Affiliation(s)
- Andre Pascal Kengne
- The George Institute for International Health, University of Sydney, Sydney, Australia
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SOUCIE JM, WANG C, SIDDIQI A, KULKARNI R, RECHT M, KONKLE BA. The longitudinal effect of body adiposity on joint mobility in young males with Haemophilia A. Haemophilia 2011; 17:196-203. [DOI: 10.1111/j.1365-2516.2010.02400.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
The objective of this study was to define the types of disease seen at the only endocrine clinic in Jamaica. The diagnoses of all patients attending the endocrinology clinic of the University Hospital of the West Indies over a 7-year period were analysed. Of the 1503 patients attending 263 weekly endocrinology clinics, 1251 patients had thyroid-related diseases, of which 684 patients had thyrotoxicosis and 233 patients had hypothyroidism. There were 17 pituitary tumours, eight cases of Cushing's syndrome and four of acromegaly. Cases of Sheehan's syndrome (n=11), hypopituitarism (n=17), hypoadrenalism (n=13), hypogonadism (n=9), primary hyperparathyroidism (n=3) and phaeochromocytoma (n=3) were rare. Thyroid disease was the most common diagnosis. New emerging endocrine disorders that are public health problems, such as obesity (n 21) and hyperlipidaemia (n=1), were rare. More traditional diseases, such as Sheehan's syndrome have become rare with improvements in obstetric care.
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Affiliation(s)
- R Wright-Pascoe
- Department of Medicine, University of the West Indies, Jamaica, West Indies.
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Gordon L, Ragoobirsingh D, Morrison E, McGrowder D, Choo-Kang E, Martorell E. Dyslipidaemia in hypertensive obese type 2 diabetic patients in Jamaica. Arch Med Sci 2010; 6:701-8. [PMID: 22419928 PMCID: PMC3298338 DOI: 10.5114/aoms.2010.17084] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 05/13/2010] [Accepted: 06/23/2010] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Hypertension and obesity are common problems among diabetic patients accelerating progression of vascular diabetic complications. MATERIALS AND METHODS A two-stage stratified random sampling design was used, and individuals aged 15 years and over were interviewed. This cross-sectional study evaluated lipid abnormalities of 117 obese type 2 diabetic patients (28 males and 89 females), and 56 hypertensive obese type 2 diabetic patients (22 males and 34 females). Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C) and high-density lipoprotein cholesterol (HDL-C) concentrations were assayed using standard biochemical methods. RESULTS Hypertensive obese type 2 diabetic females had significantly higher mean serum concentrations of TC (p = 0.043), TG (p = 0.046), LDL-C (p= 0.040), TC/HDL-C ratio (p = 0.001) and LDL-C/HDL-C ratio (p = 0.003) compared with hypertensive obese non-diabetic females. Similar results were found in hypertensive obese type 2 diabetic males compared with hypertensive obese non-diabetic males. Hypertensive obese type 2 diabetic females had significantly higher serum TC, TG and TC/HDL-C ratio (p < 0.05) than hypertensive obese type 2 diabetic males. Hypertensive obese type 2 diabetic females had significantly higher mean serum concentrations of TG (p = 0.03) and TC (p = 0.01) than obese type 2 diabetic females. There was a significant association between blood glucose and LDL-C concentrations in type 2 diabetic subjects (r = 0.36; p< 0.05). CONCLUSION Obese hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidaemia compared with males.
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Affiliation(s)
- Lorenzo Gordon
- Department of Medicine, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Dalip Ragoobirsingh
- Department of Basic Medical Sciences (Biochemistry Section), Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Errol Morrison
- Department of Basic Medical Sciences (Biochemistry Section), Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Donovan McGrowder
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Eric Choo-Kang
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - E. Martorell
- Department of Epidemiology, Provincial Centre of Hygiene and Epidemiology of Santiago de Cuba, Cuba
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Ziraba AK, Fotso JC, Ochako R. Overweight and obesity in urban Africa: A problem of the rich or the poor? BMC Public Health 2009; 9:465. [PMID: 20003478 PMCID: PMC2803188 DOI: 10.1186/1471-2458-9-465] [Citation(s) in RCA: 248] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Accepted: 12/15/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity is a well recognized risk factor for various chronic diseases such as cardiovascular diseases, hypertension, and type 2 diabetes mellitus. The aim of this study was to shed light on the patterns of overweight and obesity in sub-Saharan Africa, with special interest in differences between the urban poor and the urban non-poor. The specific goals were to describe trends in overweight and obesity among urban women; and examine how these trends vary by education and household wealth. METHODS The paper used Demographic and Health Surveys data from seven African countries where two surveys had been carried out with an interval of at least 10 years between them. Among the countries studied, the earliest survey took place in 1992 and the latest in 2005. The dependent variable was body mass index coded as: Not overweight/obese; Overweight; Obese. The key covariates were time lapse between the two surveys; woman's education; and household wealth. Control variables included working status, age, marital status, parity, and country. Multivariate ordered logistic regression in the context of the partial proportional odds model was used. RESULTS Descriptive results showed that the prevalence of urban overweight/obesity increased by nearly 35% during the period covered. The increase was higher among the poorest (+50%) than among the richest (+7%). Importantly, there was an increase of 45-50% among the non-educated and primary-educated women, compared to a drop of 10% among women with secondary education or higher. In the multivariate analysis, the odds ratio of the variable time lapse was 1.05 (p < 0.01), indicating that the prevalence of overweight/obesity increased by about 5% per year on average in the countries in the study. While the rate of change in urban overweight/obesity did not significantly differ between the poor and the rich, it was substantially higher among the non-educated women than among their educated counterparts. CONCLUSION Overweight and obesity are on the rise in Africa and might take epidemic proportions in the near future. Like several other public health challenges, overweight and obesity should be tackled and prevented early as envisioned in the WHO Global strategy on diet, physical activity and health.
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Affiliation(s)
- Abdhalah K Ziraba
- African Population and Health Research Center (APHRC), PO Box 10787, 00100 Nairobi, Kenya
- Department of Epidemiology and Population Health, Centre for Population Studies. London School of Hygiene and Tropical Medicine, 49-51 Bedford Square, London, WC1B 3DP, UK
| | - Jean C Fotso
- African Population and Health Research Center (APHRC), PO Box 10787, 00100 Nairobi, Kenya
| | - Rhoune Ochako
- African Population and Health Research Center (APHRC), PO Box 10787, 00100 Nairobi, Kenya
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Murray R, Battista M. Managing the risk of childhood overweight and obesity in primary care practice. Curr Probl Pediatr Adolesc Health Care 2009; 39:146-65. [PMID: 19501339 DOI: 10.1016/j.cppeds.2009.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Robert Murray
- Department of Pediatrics, The Ohio State University School of Medicine, The Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
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