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Were JM, Kyeremeh E, Annor BOH, Campbell MK, Stranges S. Rural-Urban Divide in the Prevalence and Correlates of Overweight and Obesity Among Women of Reproductive Age in Nigeria: A Multilevel Analysis of Repeated Cross-Sectional Data. Ecol Food Nutr 2024; 63:489-518. [PMID: 38944041 DOI: 10.1080/03670244.2024.2373227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
We examined rural and urban prevalence and correlates of overweight/obesity among women of reproductive age using survey data from Nigeria. Overweight and obesity prevalence increased from 16.1% and 6.1% in 2008 to 18.2% and 10.0% in 2018, while underweight prevalence consistently averaged at 12%. Regardless of the residential setting, age, marital status, education, occupation, wealth, and year were associated with higher risk of overweight/obesity, whereas breastfeeding showed a protective effect. Unique risk factors for overweight/obesity in urban areas were higher parity and female-headed households, while ethnicity, media exposure, and state of residence were unique risk factors in rural areas.
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Affiliation(s)
- Jason Mulimba Were
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Emmanuel Kyeremeh
- Department of Geography and Environmental studies, Toronto Metropolitan University, Ontario, Canada
| | | | - M Karen Campbell
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Department of Pediatrics, Western University, London, Ontario, Canada
- Department of Obstetrics and Gynecology, Western University, London, Ontario, Canada
- Division of Children's Health and Therapeutics, Children's Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Departments of Family Medicine and Medicine, Western University, London, Ontario, Canada
- The Africa Institute, Western University, London, Ontario, Canada
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Nakaganda A, Mbarusha I, Spencer A, Patterson L, Gemmell I, Jones A, Verma A. Prevalence, trends and distribution of lifestyle cancer risk factors in Uganda: a 20-year systematic review. BMC Cancer 2023; 23:311. [PMID: 37020195 PMCID: PMC10077672 DOI: 10.1186/s12885-023-10621-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/07/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Cancer is becoming an important public health problem in Uganda. Cancer control requires surveillance of lifestyle risk factors to inform targeted interventions. However, only one national Non-Communicable Disease (NCD) risk factor survey has been conducted in Uganda. This review assessed the prevalence, trends and distribution of lifestyle risk factors in Uganda. METHODS The review identified studies up to January 2019 by searching Medline, Embase, CINAL and Cochrane databases. Further literature was identified from relevant websites and journals; scanning reference lists of relevant articles; and citation searching using Google Scholar. To be eligible, studies had to have been conducted in Uganda, and report prevalence estimates for at least one lifestyle cancer risk factor. Narrative and systematic synthesis was used to analyse the data. RESULTS Twenty-four studies were included in the review. Overall, unhealthy diet (88%) was the most prevalent lifestyle risk factor for both males and females. This was followed by harmful use of alcohol (range of 14.3% to 26%) for men, and being overweight (range of 9% to 24%) for women. Tobacco use (range of 0.8% to 10.1%) and physical inactivity (range of 3.7% to 4.9%) were shown to be relatively less prevalent in Uganda. Tobacco use and harmful use of alcohol were more common in males and more prevalent in Northern region, while being overweight (BMI > 25 kg/m2) and physical inactivity were more common in females and more prevalent in Central region. Tobacco use was more prevalent among the rural populations compared to urban, while physical inactivity and being overweight were more common in urban than in rural settings. Tobacco use has decreased overtime, while being overweight increased in all regions and for both sexes. CONCLUSION There is limited data about lifestyle risk factors in Uganda. Apart from tobacco use, other lifestyle risk factors seem to be increasing and there is variation in the prevalence of lifestyle risk factors among the different populations in Uganda. Prevention of lifestyle cancer risk factors requires targeted interventions and a multi-sectoral approach. Most importantly, improving the availability, measurement and comparability of cancer risk factor data should be a top priority for future research in Uganda and other low-resource settings.
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Affiliation(s)
- Annet Nakaganda
- Cancer Epidemiology and Clinical Trials Unit, Uganda Cancer Institute, Kampala, Uganda.
- Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
| | - Immaculate Mbarusha
- Cancer Epidemiology and Clinical Trials Unit, Uganda Cancer Institute, Kampala, Uganda
| | - Angela Spencer
- Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Lesley Patterson
- Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Isla Gemmell
- Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Andrew Jones
- Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Arpana Verma
- Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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Kwansa AL, Akparibo R, Cecil JE, Infield Solar G, Caton SJ. Risk Factors for Overweight and Obesity within the Home Environment of Preschool Children in Sub-Saharan Africa: A Systematic Review. Nutrients 2022; 14:nu14091706. [PMID: 35565675 PMCID: PMC9100775 DOI: 10.3390/nu14091706] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.
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Affiliation(s)
- Albert L. Kwansa
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Robert Akparibo
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Joanne E. Cecil
- School of Medicine, Population and Behavioural Sciences, University of St Andrews, St Andrews KY16 9TF, UK;
| | | | - Samantha J. Caton
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
- Correspondence:
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Ng'endo M, Connor M. One Size Does Not Fit All—Addressing the Complexity of Food System Sustainability. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.816936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Food system sustainability has been highlighted as one of the major strategies to ensure healthy diets. A plethora of approaches to stabilize food systems have been suggested, including agroecology, climate-smart agriculture, and other forms of sustainable agriculture. However, a disconnect between sustainable production and consumption exists, which may hinder further progress toward achieving Sustainable Development Goal 2. This discourse was needed to connect these intersectional perspectives. To meet this need, we bring together the disconnected socio-environmental pillars and show how together they contribute to the food system sustainability agenda. We discuss the complexity of food system sustainability to cater to different geographies, building on evidence from development projects worldwide. We account for factors such as the need to incorporate intersectionality factors, food-system-related policy issues, food waste, food injustice, and undernutrition. While these intersectional inequalities can be solved through various human interventions, policy implementation, and dietary choices, we found that connecting the different policymakers remains a significant challenge for a sustainable food system. We propose implementing specific food system sustainability strategies that will be useful for policymakers and other stakeholders to enable the inclusion of a socio-environmental perspective for food systems that connect agricultural production with consumption.
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Afolabi RF, Palamuleni ME. Multilevel analysis of unhealthy bodyweight among women in Malawi: Does urbanisation matter? PLoS One 2021; 16:e0249289. [PMID: 33780505 PMCID: PMC8006991 DOI: 10.1371/journal.pone.0249289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/15/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Underweight and overweight constitute unhealthy bodyweight and their coexistence is symptomatic of the dual burden of malnutrition (DBM) of high public health concern in many sub-Saharan Africa countries. Little is known about DBM and its correlates in Malawi, a country undergoing urbanisation. The study examined net effects of urban residence on unhealthy weights amidst individual- and community-level factors among women in Malawi. METHODS Data on 7231 women aged 15-49 years nested within 850 communities extracted from 2015-16 Malawi Demographic and Health Survey were analysed. Women's weight status measured by body mass index, operationally categorised as underweight, normal and overweight, was the outcome variable while urban-rural residence was the main explanatory variable. Multilevel multinomial logistic regression analysis was employed at 5% significant level; the relative-risk ratio (RR) and its 95% confidence interval (CI) were presented. RESULTS Urban residents had a significantly higher prevalence of overweight than rural (36.4% vs. 17.2%; p< 0.001) but a -non-significant lower prevalence of underweight (6.2% vs. 7.4%; p = 0.423). Having adjusted for both individual- and community-level covariates, compared to rural, living in urban (aRR = 1.25; CI: 1.02-1.53) accounted for about 25% higher risk of being overweight relative to normal weight. Higher education attainment, being married and belonging to Chewa, Lomwe or Mang'anja ethnic group significantly reduced the risk of being underweight but heightened the risk of being overweight. Being older and living in wealthier households respectively accounted for about 3- and 2-times higher likelihood of being overweight, while breastfeeding (aRR = 0.65; CI: 0.55-0.76) was protective against overweight. Living in communities with higher poverty and higher education levels reduced and increased the risk of being overweight, respectively. Evidence of community's variability in unhealthy weights was observed in that 11.1% and 3.0% respectively of the variance in the likelihood of being overweight and underweight occurred across communities. CONCLUSIONS The study demonstrated association between urban residence and women overweight. Other important associated factors of overweight included breastfeeding, community education- and poverty-level, while education attainment, marital status and ethnicity were associated with the dual unhealthy weight. Thus, both individual- and community-level characteristics are important considerations for policy makers in designing interventions to address DBM in Malawi.
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Affiliation(s)
- Rotimi Felix Afolabi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Population Studies and Demography Programme & Population and Health Research Entity, Faculty of Humanities, North-West University, Mmabatho, South Africa
| | - Martin Enock Palamuleni
- Population Studies and Demography Programme & Population and Health Research Entity, Faculty of Humanities, North-West University, Mmabatho, South Africa
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Macicame I, Prista A, Parhofer KG, Cavele N, Manhiça C, Nhachungue S, Saathoff E, Rehfuess E. Social determinants and behaviors associated with overweight and obesity among youth and adults in a peri-urban area of Maputo City, Mozambique. J Glob Health 2021; 11:04021. [PMID: 33868672 PMCID: PMC8038757 DOI: 10.7189/jogh.11.04021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Overweight and obesity are important risk factors for non-communicable diseases (NCDs) such as cardiovascular diseases (CVD), type 2 diabetes and certain cancers. NCDs are responsible for an increased number of deaths worldwide, including in developing countries. We aimed to determine the prevalence of overweight and obesity among youth and adults in a peri-urban area of Maputo city, Mozambique, and to assess their social and behavioral determinants. METHODS A cross-sectional study was conducted in a Health and Demographic Surveillance System (HDSS) area in Maputo city. We measured BMI and interviewed 15-64-year-old inhabitants to assess sociodemographic and behavioral characteristics using the STEPwise Approach methodology. A household wealth index was derived through Principal Component Analysis of various household assets and physical activity (PA) was measured using pedometers and accelerometers. Univariable and multivariable analyses were conducted to determine associations between overweight/obesity and social and behavioral determinants. RESULTS Among a total of 931 participants, the prevalence of overweight (BMI≥25 kg/m2) and obesity (BMI≥30 kg/m2) was 30.9% (95% confidence interval (CI) = 28.0, 33.9) and 12.6% (95% CI = 10.4, 14.7), respectively; one in every 10 youths and adults were underweight. Being female, older and living in a wealthier household were found to be significantly associated with overweight and obesity. Those with higher levels of education were found to have a reduced risk of being obese compared to those with no or lower levels of education. Behavioral risk factors (diet, alcohol and tobacco consumption and physical activity) did not significantly increase the risk of overweight and obesity. CONCLUSIONS Overweight and obesity are highly prevalent in this peri-urban part of the Mozambican capital, where underweight is still present in youth and adults, confirming that the country is facing a double burden of malnutrition. Social determinants of health should be taken into consideration in the design and implementation of NCD prevention programs.
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Affiliation(s)
- Ivalda Macicame
- Instituto Nacional de Saúde, Maputo City, Mozambique
- Center for International Health (CIH), Ludwig-Maximilians-Universität München (LMU) Munich, Germany
| | | | - Klaus G Parhofer
- Medizinische Klinik IV – Grosshadern, Klinikum der Ludwig-Maximilians-Universität München (LMU), Munich, Germany
| | - Nílzio Cavele
- Instituto Nacional de Saúde, Maputo City, Mozambique
| | | | | | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany
- German Centre for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Eva Rehfuess
- Institute of Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
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Ahmad K, Khanam T, Keramat SA, Islam MI, Kabir E, Khanam R. Interaction between the place of residence and wealth on the risk of overweight and obesity in Bangladeshi women. PLoS One 2020; 15:e0243349. [PMID: 33284836 PMCID: PMC7721197 DOI: 10.1371/journal.pone.0243349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/20/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The prevalence of overweight and obesity in women has increased significantly over the last few decades in Bangladesh, a rapidly urbanising developing country. However, little is known regarding the association between the interaction of the place of residence and household wealth with overweight and obesity, particularly in women from developing countries. OBJECTIVE The objective of this study is to find the association between the interaction of the place of residence and wealth with overweight and obesity among Bangladeshi women. METHODS This study utilised data from the four Bangladesh Demographic Health Surveys conducted in 2004, 2007, 2011 and 2014 with a total of 54337 women aged 15-49 years. Multivariate logistic regression was used for the analyses. RESULTS The prevalence of overweight and obesity among women aged 15-49 years in Bangladesh has considerably increased from 9.96% in 2004 to 24.43% in 2014. The interaction between wealth and place of residence has been found to be associated with obesity. Urban wealthy and richest women were 4.23 (OR: 4.23, 95% CI: 1.25-14.34) and 5.99 (OR: 5.99, 95% CI: 1.91-18.74) times more likely to be obese compared to their rural counterparts in the period 2004. Urban richest were 2.94 times (OR: 2.94, 95% CI: 1.20-7.24) more likely to be obese against their rural counterparts for the survey year 2014. CONCLUSIONS The place of residence is not associated with obesity, but its interaction with wealth is significant.
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Affiliation(s)
- Kabir Ahmad
- Research Unit, Purple Informatics, Dhaka, Bangladesh
- School of Commerce, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
- * E-mail: ,
| | | | - Syed Afroz Keramat
- School of Commerce, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
- Economics Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Md. Irteja Islam
- School of Commerce, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Enamul Kabir
- School of Commerce, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensland, Australia
- School of Sciences, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Rasheda Khanam
- School of Commerce, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
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Were JM, Stranges S, Creed IF. Fertility is a key predictor of the double burden of malnutrition among women of child-bearing age in sub-Saharan Africa. J Glob Health 2020; 10:020423. [PMID: 33110582 PMCID: PMC7568927 DOI: 10.7189/jogh.10.020423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The ongoing nutrition transition in sub-Saharan Africa (SSA) is exhibiting spatial heterogeneity and temporal variability leading to different forms of malnutrition burden across SSA, with some regions exhibiting the double burden of malnutrition. This study aimed to develop a predictive understanding of the malnutrition burden among women of child-bearing age. METHODS Data from 34 SSA countries were acquired from the Demographic and Health Survey, World Bank, and Swiss Federal Institute of Technology. The SSA countries were classified into malnutrition classes based on their national prevalence of underweight, overweight, and obesity using a 10% threshold. Next, random forest analysis was used to examine the association between country-level demographic variables and the national prevalence of underweight, overweight and obesity. Finally, random forest analysis and multinomial logistic regression models were utilized to investigate the association between individual-level social and demographic variables and Body Mass Index (BMI) categories of underweight, normal weight, and combined overweight and obesity. RESULTS Four malnutrition classes were identified: Class A had 5 countries with ≥10% of the women underweight; Class B had 11 countries with ≥10% each of underweight and overweight; Class C1 had 7 countries with ≥10% overweight; and Class C2 had 11 countries with ≥10% obesity. At the country-level, fertility rate predicted underweight, overweight and obesity prevalence, but economic indicators were also important, including the gross domestic product per capita - a measure of economic opportunity that predicted both overweight and obesity prevalence, and the GINI coefficient - a measure of economic inequality that predicted both underweight and overweight prevalence. At the individual-level, parity was a risk factor for underweight in underweight burdened countries and a risk factor for overweight/obesity in overweight/obesity burdened countries, whereas age and wealth were protective factors for underweight but risk factors for overweight/obesity. CONCLUSIONS Beyond the effect of economic indicators, this study revealed the important role of fertility rate and parity, which may represent risk factors for both underweight and combined overweight and obesity among women of child-bearing age. Health professionals should consider combining reproductive health services with nutritional programs when addressing the challenge of malnutrition in SSA.
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Affiliation(s)
- Jason Mulimba Were
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Department of Family Medicine, Western University, London, Ontario, Canada
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
- The Africa Institute, Western University, London, Ontario, Canada
| | - Irena F Creed
- Department of Biology, Western University, London, Ontario, Canada
- Department of Geography, Western University, London, Ontario, Canada
- School of Environment and Sustainability, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Epidemiologic Profile of Overweight and Obesity in Abidjan, Ivory Coast: A Cross-Sectional Study. Ann Glob Health 2020; 86:46. [PMID: 32377511 PMCID: PMC7193754 DOI: 10.5334/aogh.2755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: In sub-Saharan Africa, the prevalence of overweight and obesity is high, and it is estimated to increase within the next ten years. In Ivory Coast, the rise in and public health consequences of overweight and obese people are evident. Moreover, data concerning this status are scarce, old, local, and describe only a small sample of the population. Objective: This study has been conducted in order to describe the epidemiologic profile of overweight and obese people in Ivory Coast and identify the potential risk factors of obesity. Methods: From January 2014 to July 2017, 2,643 patients aged 17–70 years old from Abidjan of Ivory Coast were recruited. Statistical analysis was carried out using SPSS 20.0. Chi-square test and binary logistic regression analysis were used to identify risk factors for overweight and obesity. Results: Most of our patients were females (86.3%) with an estimated average age of 43.7 ± 12.19 years. Among 2,643 patients recruited in this study, 83.3% were obese and 87.2% were affected by central abdominal obesity. Binary logistic regression analysis identified seven factors significantly associated with overweight and obesity, including females (OR: 2.06; 95% CI [1.58–2.68]), >54 years old of age (OR: 3.71; 95% CI [1.84–7.50]), occupation of salesperson and traders (OR: 2.42; 95% CI [1.78–3.29]), ethnic group of North Mande ethnicity (OR: 1.47; 95% CI [1.07–2.02]), family history of obesity (OR: 1.96; 95% CI [1.46–2.63]), ≥150 minutes of sport practice (OR:0.72; 95% CI [0.55–0.96]), and parous females (OR: 1.63; 95% CI [1.11–2.38]). Conclusions: Overall, gender (female), older age, and occupation were associated with greater risks of overweight and obesity in patients. Ethnic group, pregnancy and family history of obesity posed a lower but significant risk for obesity. More sport practice played a protective role against the acquisition of overweight and obesity.
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Victora C, Boerma T, Requejo J, Mesenburg MA, Joseph G, Costa JC, Vidaletti LP, Ferreira LZ, Hosseinpoor AR, Barros AJD. Analyses of inequalities in RMNCH: rising to the challenge of the SDGs. BMJ Glob Health 2019; 4:e001295. [PMID: 31297251 PMCID: PMC6590961 DOI: 10.1136/bmjgh-2018-001295] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/19/2019] [Accepted: 02/25/2019] [Indexed: 01/31/2023] Open
Abstract
The Sustainable Development Goal (SDG) 17.18 recommends efforts to increase the availability of data disaggregated by income, gender, age, race, ethnicity, migratory status, disability and geographic location in developing countries. Surveys will continue to be the leading data source for disaggregated data for most dimensions of inequality. We discuss potential advances in the disaggregation of data from national surveys, with a focus on the coverage of reproductive, maternal, newborn and child health indicators (RMNCH). Even though the Millennium Development Goals were focused on national-level progress, monitoring initiatives such as Countdown to 2015 reported on progress in RMNCH coverage according to wealth quintiles, sex of the child, women’s education and age, urban/rural residence and subnational geographic regions. We describe how the granularity of equity analyses may be increased by including additional stratification variables such as wealth deciles, estimated absolute income, ethnicity, migratory status and disability. We also provide examples of analyses of intersectionality between wealth and urban/rural residence (also known as double stratification), sex of the child and age of the woman. Based on these examples, we describe the advantages and limitations of stratified analyses of survey data, including sample size issues and lack of information on the necessary variables in some surveys. We conclude by recommending that, whenever possible, stratified analyses should go beyond the traditional breakdowns by wealth quintiles, sex and residence, to also incorporate the wider dimensions of inequality. Greater granularity of equity analyses will contribute to identify subgroups of women and children who are being left behind and monitor the impact of efforts to reduce inequalities in order to achieve the health SDGs.
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Affiliation(s)
- Cesar Victora
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Ties Boerma
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Gary Joseph
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Janaína Calu Costa
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Luis Paulo Vidaletti
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | - Ahmad Reza Hosseinpoor
- Partnership for Maternal, Newborn & Child Health, World Health Organization, Geneva, Switzerland
| | - Aluisio J D Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
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Nutrition transition, overweight and obesity among rural-to-urban migrant women in Kenya. Public Health Nutr 2019; 22:3200-3210. [PMID: 31159907 DOI: 10.1017/s1368980019001204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the effect of rural-to-urban migration on nutrition transition and overweight/obesity risk among women in Kenya. DESIGN Secondary analysis of data from nationally representative cross-sectional samples. Outcome variables were women's BMI and nutrition transition. Nutrition transition was based on fifteen different household food groups and was adjusted for socio-economic and demographic characteristics. Stepwise backward multiple ordinal regression analysis was applied. SETTING Kenya Demographic and Health Survey 2014. PARTICIPANTS Rural non-migrant, rural-to-urban migrant and urban non-migrant women aged 15-49 years (n 6171). RESULTS Crude data analysis showed rural-to-urban migration to be associated with overweight/obesity risk and nutrition transition. After adjustment for household wealth, no significant differences between rural non-migrants and rural-to-urban migrants for overweight/obesity risk and household consumption of several food groups characteristic of nutrition transition (animal-source, fats and sweets) were observed. Regardless of wealth, migrants were less likely to consume main staples and legumes, and more likely to consume fruits and vegetables. Identified predictive factors of overweight/obesity among migrant women were age, duration of residence in urban area, marital status and household wealth. CONCLUSIONS Our analysis showed that nutrition transition and overweight/obesity risk among rural-to-urban migrants is apparent with increasing wealth in urban areas. Several predictive factors were identified characterising migrant women being at risk for overweight/obesity. Future research is needed which investigates in depth the association between rural-to-urban migration and wealth to address inequalities in diet and overweight/obesity in Kenya.
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Examining the connection between residential histories and obesity among Ghanaians: evidence from a national survey. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0983-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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