Obesity in young-adult Nigerians: variations in prevalence determined by anthropometry and bioelectrical impedance analysis, and the development of % body fat prediction equations

Temporal trends in overweight and obesity and chronic disease risks among adolescents and young adults: A ten-year review at a tertiary institution in Nigeria

There is an increasing prevalence of obesity among college/university students in low- and middle-income countries, similar to the trend observed in high-income countries. This study aimed to describe the trend and burden of overweight/obesity and emerging associated chronic disease risks among students at the University of Ibadan (UI), Nigeria. This is a ten-year retrospective review of medical records of students (undergraduate and post-graduate) admitted between 2009 and 2018 at UI. Records of 60,168 participants were analysed. The Body Mass Index (BMI) categories were determined according to WHO standard definitions, and blood pressure was classified according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7). The mean age of the participants was 24.8, SD 8.4 years. The majority were ≤ 40 years (95.1%). There was a slight male preponderance (51.5%) with a male-to-female ratio of 1.1:1; undergraduate students constituted 51.9%. The prevalence of underweight, overweight, and obesity were 10.5%, 18.7% and 7.2%, respectively. We found a significant association between overweight/obesity and older age, being female and undergoing postgraduate study (p = 0.001). Furthermore, females had a higher burden of coexisting abnormal BMI characterised by underweight (11.7%), overweight (20.2%) and obese (10.4%). Hypertension was the most prevalent obesity-associated non-communicable disease in the study population, with a prevalence of 8.1%. Also, a third of the study population (35.1%) had prehypertension. Hypertension was significantly associated with older age, male sex, overweight/obesity and family history of hypertension (p = 0.001). This study identified a higher prevalence of overweight and obesity than underweight among the participants, a double burden of malnutrition and the emergence of non-communicable disease risks with potential lifelong implications on their health and the healthcare system. To address these issues, cost-effective interventions are urgently needed at secondary and tertiary-level educational institutions.

Prevalence and trends of adult overweight and obesity in Nigeria - A systematic review and meta-analysis

Background

The prevalence of obesity and its attendant complications are on the increase globally-sub-Saharan Africa inclusive. Obesity confers an increased risk of coronary artery disease, type 2 diabetes, ischemic stroke, and some cancers. In Nigeria, several individual reports estimate an exponential increase in the prevalence of overweight and obesity.

Aim

In this study, we aimed to estimate the current prevalence of overweight and obesity in Nigeria through a systematic review and meta-analyses.

Materials and Methods

A systematic review and meta-analysis were conducted on the prevalence of obesity in Nigeria using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format following searches on major search engines, performed in PubMed, Science Direct, Google Scholar, Africa Journals Online (AJOL), and the WHO African Index Medicus database. Studies on the subject area conducted from the year 2000 to 2018 were included. The forest plot was used to graphically present the results, while confidence interval at 95% was used to display the rates.

Results

A total of 77 articles on the prevalence of obesity involving 107, 781 individuals were used in the study. We found a pooled estimate of overweight of 26.0% (95% CI: 23.0-29.0) and that of obesity as 15.0% (95% CI: 13.0-16.0). There was an increasing trend in the prevalence of obesity in Nigeria from the study especially among urban dwellers.

Conclusion

The prevalence of obesity and overweight in Nigeria is high with a rising trend over the years. A Nigerian national health survey of non-communicable diseases especially the burden of overweight/obesity is recommended to through more light on the subject. There is need for concerted effort to tame the tide of rising obesity rates in Nigeria.

ThE profile of anthRopometRy and psyChosocial issuEs on campus (TERRACE) study: A study protocol and preliminary results

Background

Obesity among the youth is a major public health problem. Globally, the burden of obesity has been on the increase, particularly among young persons, with associated psychosocial issues. This study aimed to present the rationale and design of ThE profile of anthRopometRy And psyChosocial issuEs on campus (TERRACE) Study and as well report some preliminary findings obtained on the anthropometric and psychosocial profile of young persons in some tertiary institutions in Oyo State, Nigeria.

Methods

This study first described the methodology of the main study (TERRACE Study) and also provided a report of the preliminary data. The TERRACE study adopted a cross-sectional design of eligible and consenting adults between 16-35 years of age. A three-stage multi-stage sampling technique was used to recruit the participants. Questionnaire, weighing scales, and other tools were used to collect data on socio-demographic, cardiovascular profile, sleep, anthropometric, and psychological variables. Descriptive and inferential statistics were used for data analysis, using SPSS version 23 software.

Result

The preliminary data were obtained from 225 participants recruited from three tertiary institutions in Ibadan metropolis, with mean age of 21.5 ± 3.8 years. The majority were females (77.3%) and self-employed, with an average income less than 10,000 naira monthly (less than $25/month at an exchange rate of 400 naira/dollar). The males had higher systolic blood pressure compared to females and constituted a higher proportion of current smokers compared to females (was significant (p < 0.0001 and 0.011 respectively). A fifth (20.4%) of the population were underweight, while overweight and obese people accounted for 12%. They were mostly depressed, (183(87.9%) were moderate to severe depression), more of the females compared to males were anxious.

Conclusion

The preliminary results revealed a high burden of underweight, obesity and psychosocial issues among the young people in Ibadan, Nigeria. Further findings to be obtained from the TERRACE Study would enhance the development of an effective public intervention in addressing anthropometric- and psychosocial-related health problems as well as provide baseline data for further studies among this population.

Relationships between anthropometric measurements, muscle strength and body awareness

Most studies on body awareness offer data on assessment and treatment in disease situations. The aim of this study is to investigate the relationship between anthropometric measurements and body awareness level of healthy people. The study was carried out with 289 volunteer students between the ages of 18-25 who studied at university. Anthropometric measurements included height, weight, circumference measurements and measurement rates, skinfold thicknesses. In addition, grip strength and lower limb muscle strength was evaluated. The level of body awareness was evaluated by the Body Awareness Questionnaire. The mean age of the participants included in the study was 19.34 ± 1.48. Sixty five percent were female and 35% were male. A negative correlation was found between body weight and body awareness level (p = 0.02). According to the results of canonical correlation analysis, the model created with circumference measurement rates and sub-dimensions of the Body Awareness Questionnaire was found significant. There was significantly correlated between the changes in the body process and attention to responses, which are sub-dimension, and total right measurement of the lower limb (r:0.124; p: 0.035). In addition, there was a significant relationship between sleep-wakefulness cycle and waist-to-thigh ratios (r:- 0.172; p: 0.003). Our study showed that body awareness is directly related to body weight, lower limb circumference measurements, and waist-to-thigh ratio. These data revealed the effect of body awareness on anatomical structures.

Clustering of cardiovascular disease risk factors among first-year students at the University of Ibadan, Nigeria: a cross-sectional study

BACKGROUND

Cardiovascular disease (CVD) is the second leading cause of death in sub-Saharan Africa. Globally, there is substantial evidence that modifiable risk factors for CVD are increasing in adolescents. Unfortunately, there is a paucity of information on the prevalence and clustering of these risk factors in adolescents.

OBJECTIVES

This study explores the modifiable risk factors for CVD among first-year students at the University of Ibadan, Nigeria.

DESIGN AND SETTING

This cross-sectional study was conducted at the University of Ibadan, Nigeria.

METHODS

A total of 546 newly admitted students at the University of Ibadan, Nigeria, were recruited using stratified random sampling. An interviewer-administered questionnaire was used to obtain information from study participants between January and February 2016.

RESULTS

The mean age of respondents was 19 ± 2.2 years with a male-to-female ratio of 1:1. The reported risk factors for CVD were smoking (1.6%), abdominal obesity (3.3%), alcohol consumption (3.7%), overweight/obesity (20.7%), unhealthy diet (85.3%), and physical inactivity (94.5%). Clustering of ≥ 2 risk factors was reported in 23.4% of students. Female students were twice as probably overweight/obese as male students (adjusted odds ratio [AOR] = 2.2; confidence interval [CI] = 1.41-3.43). Students whose fathers were skilled workers were 3.5 times more likely to be physically inactive (AOR = 1.7; CI = 0.97-2.96). The clustering of ≥ 2 risk factors was significantly higher among women and Muslims in bivariate analysis, whereas no significant association was found in multivariate analysis.

CONCLUSIONS

Public health strategies to prevent CVD risk factors should begin in schools and extend to the entire community.

Analyzing Trio-Anthropometric Predictors of Hypertension: Determining the Susceptibility of Blood Pressure to Sexual Dimorphism in Body Stature

Background

Several studies had suggested that complex body stature could be a risk factor of hypertension.

Objectives

We aim to correlate body mass index (BMI), waist-hip ratio (WHR), and waist-height ratio (WHtR) of rural dwellers in Afikpo community, Ebonyi State, Nigeria, with blood pressure parameters. Furthermore, we aim to ascertain how each of the anthropometric variables affects blood pressure in men and women, respectively.

Materials and Methods

A sample of 400 (200 males and 200 females) adults aged 18–89 years were selected for the correlation cross-sectional study. Data for weight, height, waist, and hip circumferences were collected by means of anthropometric measurement protocol with the aid of a calibrated flexible tape and health scale and mercury sphygmomanometer for measurement of blood pressure. A participant was classified as being hypertensive if systolic blood pressure (SBP) was >140 mmHg and diastolic blood pressure (DBP) >90 mmHg. Pulse pressure was recorded as the numeric difference of SBP and DBP.

Results

The result revealed that male BMI and WHR were higher than those of females while female WHtR was higher than that of males (P < 0.01). The prevalence of hypertension failed to correlate with sex among participants in the study (χ² = 0.567; P < 0.05). Variation in SBP and DBP of both sexes was dependent on BMI, WHtR, and waist and hip circumference, but not on WHR. The SBP of both sexes and female pulse pressure did correlate with age (P < 0.001). Waist circumference, BMI, and WHtR correctly predicted the variations in SBP, DBP, and pulse pressure.

Conclusion

The strength of association of BMI, WHtR, and waist girth with SBP and DBP of both sexes was robust and similar, but inconsistent with WHR. Thus, a simple estimation of the trio-anthropometric predictors could serve as a means for routine check or preliminary diagnosis of a patient with hypertension.

Socio-Demographic and Lifestyle Factors Predict 5-Year Changes in Adiposity among a Group of Black South African Adults

The rising prevalence of obesity and excessive adiposity are global public health concerns. Understanding determinants of changes in adiposity over time is critical for informing effective evidence-based prevention or treatment. However, limited information is available to achieve this objective. Cultural, demographic, environmental, and behavioral factors including socio-economic status (SES) likely account for obesity development. To this end, we related these variables to anthropometric measures in 1058 black adult Tswana-speaking South Africans who were HIV negative in a prospective study over five years. Body mass index (BMI) and waist circumference increased in both sexes, whereas triceps skinfold thickness remained the same. Over the five years, women moved to higher BMI categories and more were diagnosed with central obesity. Age correlated negatively, whereas SES, physical activity, energy, and fat intake correlated positively with adiposity markers in women. In men, SES, marital status, physical activity, and being urban predicted increases in adiposity. For women, SES and urbanicity increased, whereas menopause and smoking decreased adiposity. Among men, smokers had less change in BMI than those that never smoked over five years. Our findings suggest that interventions, focusing on the urban living, the married and those with the highest SES-the high-risk groups identified herein-are of primary importance to contain morbidity and premature mortality due to obesity in black South Africans.

Not a ‘Straitjacket Affair’: Anthropometrically Derived Obesity Index Correlates of Elevated Blood Pressure among University Undergraduates

Obesity is known to correlate with measures of blood pressure (BP). The nature of the correlations has, however, remained a subject of scientific enquiry, especially when BP phenotypes are disaggregated and obesity is determined by a variety of methods. This study examined the relationship between obesity and BP in young-adult Nigerians. A total of 1610 subjects (53.9% females) were recruited from five universities in the Igbo-speaking part of Nigeria. Relevant BP and anthropometric data were obtained following standard protocols. Appropriate statistical tools were used for data analyses. The results show that 42.2% (49.5% males, 36.1% females) and 13.3% (15.2% males, 11.6% females) of the population had point prehypertension and hypertension, respectively. By body mass index (BMI) standards, 20.6% (12.4% males, 27.5% females) of the population were overweight/obese. Despite the weak positive and significant correlations between BP and the measures of obesity in both males and females in the general population (r = +0.110 to +0.261; p < 0.05), the correlations were found to exist essentially in normotensives, taper in the prehypertensives, and disappear (or became negative) among hypertensives. When analysed along weight status lines, a discordant relationship was found between the sexes. Overall, the relationship between blood pressure and measures of obesity is not linear throughout the BP spectrum. Clearly the said relationship is not a ‘straitjacket affair’.

Body shape dissatisfaction is a 'normative discontent' in a young-adult Nigerian population: A study of prevalence and effects on health-related quality of life

This study investigates the prevalence of weight misperception, weight preference, and body shape dissatisfaction (BSD) among young-adult Nigerians and assesses the impact of these factors on population quality-of-life (QOL). Relevant anthropometric data were collected according to internationally accepted protocols. Weight perception, weight preference, and BSD were measured using Stunkard silhouettes, while QOL was determined by subjective self-reporting. The results show that 26.7% of the population (18.8% for males and 34.5% for females) misperceived their weight. Among overweight participants, 56.6% (males) and 38.3% (females) thought they were thinner, while 11.5% (males) and 43.3% (females) thought they were heavier. Thin and obese males misperceived their weights more than their female counterparts. BSD was found in 62% of the population (52% for males and 71% for females) and was highest among obese participants (91.9%) and lowest among normal-weight participants (58.2%), irrespective of sex. In participants with BSD, QOL was worse in thin and normal-weight respondents who preferred to be heavier and in overweight respondents who preferred to be thinner. The high prevalence of weight misperception may lead to inappropriate weight loss habits, while BSD, a normative discontent in this population, negatively impacts subject QOL.

Prevalence and Socio-Demographic Determinants of Overweight and Obesity in a Nigerian Population

Objective

This survey explored prevalence of overweight and obesity and their associations with socio-demographic variables in a Nigerian population.

Methods

This cross-sectional survey involved 1521 adults in Nnewi. Age, sex, educational and occupational status, and BMI were recorded.

Results

Prevalence of overweight was higher in males (32.3%; 95% CI, 29.5%–35.2%) than in females (29.8%; 95% CI, 26.8%–33.0%); the reverse was the case for prevalence of obesity (19.6%; 95% CI, 17.3%–22.2% in males and 36.0%; 95% CI, 32.8%–39.4% in females). Higher odds ratios (ORs) for overweight and obesity were observed in participants aged 41–60 years (OR 2.03; 95% CI, 1.57–2.61 for overweight and OR 4.29; 95% CI, 3.25–5.67 for obesity) and those >60 years (OR 1.72; 95% CI, 1.21–2.43 for overweight and OR 4.21; 95% CI, 2.86–6.19 for obesity) compared to those aged 18–40 years. Female sex was associated with higher ORs for overweight (OR 1.20; 95% CI, 0.96–1.51) and obesity (OR 2.21; 95% CI, 1.73–2.83). Participants with secondary education had marginally higher ORs for overweight (OR 1.15; 95% CI, 0.88–1.51) and obesity (OR 1.17; 95% CI, 0.86–1.59) than those with tertiary education, and so were those with primary education for obesity (OR 1.19; 95% CI, 0.74–1.89) but higher OR for overweight (OR 1.44; 95% CI, 0.98–2.13). Unskilled participants had about the same OR for overweight and obesity as professionals, and while skilled participants had about the same OR for overweight as professionals, their OR for obesity (OR 1.27; 95% CI, 0.67–2.43) was fairly higher than that for professionals.

Conclusions

Prevalence of overweight is higher in males than in females, but the reverse is the case for prevalence of obesity. Older age and female sex are associated with increased risk of overweight and obesity, while working at a skilled occupation is associated with obesity, and tertiary educational attainment is associated with overweight.

Obesity epidemic has emerged among Nigerians

Background

Data from the WHO shows that the prevalence of overweight and obesity increased by ~20% between 2002 and 2010 in Nigeria. We conducted this study to examine the correlates of this fast growing epidemic.

Methods

We conducted a cross-sectional study among a random sample of 1058 adults, who were visitors and staff of a government worksite in Abuja, an urban city in Nigeria. The study participants had varying socio-economic status and a wide range of occupations, including skilled labor and professionals. Log-binomial regression models were used to estimate the multivariable-adjusted associations of potential determinants with the prevalence of overweight and obesity.

Result

The mean age and body-mass index of the study population were 42 years ± (9.3) and 27 kg/m² ± (4.8). The overall prevalence of overweight or obesity (body-mass index ≥ 25 kg/m²) was 64% (74% of the women and 57% of the men). For women compared to men, the prevalence ratio (PR) and (95% confidence interval, CI) was 1.24 (95% CI 1.08, 1.43, p = 0.004), for overweight, and 2.54 (95% CI 2.08, 3.10, p = <0.0001), for obesity. Individuals aged 40 – 49 years were more likely to be overweight or obese. The PR for overweight and obesity was 1.45 (95% CI 1.07, 1.97), p for age trend = 0.002 and 8.07(95% CI 3.01, 21.66, p for age trend = <0.0001) for those aged 40 – 49 years, compared with those aged <30 years. Compared with the individuals in the lower socio-economic status, the PR for obesity among those in the middle and high socio-economic statuses, were 1.39 (95% CI 1.13, 1.72) and 1.24 (95% CI 0.97, 1.59) respectively, p for trend = 0.003.

Conclusion

About two-thirds of urban, professional, high socio-economic status Nigerian adults are either overweight or obese. The prevalence of overweight and obesity among this population of adult Nigerians, is as high as it is in the United Kingdom. Female gender and older age were independent predictors of overweight and obesity; while middle or high socio-economic status were independently associated with obesity.

New insights on diabetes mellitus and obesity in Africa-part 1: prevalence, pathogenesis and comorbidities

Evidence continues to accumulate on the rising burden of diabetes mellitus at a higher pace in Africa. In a series of two papers, we sought to summarise recent evidence on diabetes and obesity in Africa based on a systematic review of studies published between January 2002 and October 2012. This first paper on the prevalence, pathogenesis and comorbidities shows that the increase in diabetes prevalence has paralleled that of obesity in Africa. Recent surveys on diabetes and obesity have been largely suboptimal. Hence, the need for more representative and robust continent-wide prevalence figures, which may be somehow achieved through pooling of existing data. Prospective studies linking environmental risk factors to disease occurrence and outcomes remain scarce, and genetic factors for diabetes or obesity have not been extensively assessed. The health consequences of diabetes are manifold, and include a complex interaction with other conditions like HIV infection and sickle cell disease/trait.

Short-term role of the dietary total antioxidant capacity in two hypocaloric regimes on obese with metabolic syndrome symptoms: the RESMENA randomized controlled trial

Background

Dietary strategies seem to be the most prescribed therapy in order to counteract obesity regarding not only calorie restriction, but also bioactive ingredients and the composition of the consumed foods. Dietary total antioxidant capacity (TAC) is gaining importance in order to assess the quality of the diet.

Methods

Ninety-six obese adults presenting metabolic syndrome (MetS) symptoms completed an 8-week intervention trial to evaluate the effects of a novel dietary program with changes in the nutrient distribution and meal frequency and to compare it with a dietary pattern based on the American Heart Association (AHA) guidelines.

Anthropometric and biochemical parameters were assessed at baseline and at the endpoint of the study, in addition to 48-hours food dietary records.

Results

Both diets equally (p > 0.05) improved MetS manifestations. Dietary TAC was the component which showed the major influence on body weight (p = 0.034), body mass index (p = 0.026), waist circumference (p = 0.083) and fat mass (p = 0.015) reductions. Transaminases (ALT and AST) levels (p = 0.062 and p = 0.004, respectively) were associated with lower TAC values.

Conclusion

RESMENA diet was as effective as AHA pattern for reducing MetS features. Dietary TAC was the most contributing factor involved in body weight and obesity related markers reduction.

Trial registration

http://www.clinicaltrials.gov; NCT01087086