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Try out PMC Labs and tell us what you think. Learn More. Overweight and obesity are risk factors for many chronic diseases globally. However, the extent of the problem in low-income countries like Sub-Saharan Africa is unclear. We assessed the magnitude and disparity of both phenomena by place of residence, level of education and wealth quintile using cross-sectional data from 32 countries.
A total of women aged 15—49 years were analyzed. Trained personnel using a standardized procedure measured body weight and height. Body mass index BMI was calculated by dividing body weight by height squared. Prevalence of overweight Analysis of the relationships of overweight and obesity with place of residence, education and wealth index were carried out using logistic regression. The pooled prevalence of overweight for the region was Similarly, the prevalence of obesity was also lowest in Madagascar 1.
The women in urban residence and those who were classified as rich, with respect to the quintile of the wealth index, had higher likelihood of overweight and obesity. In the pooledhigh education was ificantly associated with overweight and obesity.
The prevalence of overweight Fat women Tampere obesity varied highly between the countries and wealth index rich vs. Interventions that will address the socio-cultural barriers to maintaining healthy body size can contribute to curbing the overweight and obesity epidemic in Africa. Obesity has become a major public health problem both in developed and developing countries [ 1 ]. Overweight and obesity are the fifth leading risk for global deaths [ 2 ]. At least 2. According to a recent research reports, the burden of obesity is increasing in developing countries and also no ificant reduction has been seen in its burden in developed countries over the past few decades [ 1 ].
For example, in West Africa, the prevalence of obesity rapidly increased during the last two decades of the 20th century and it continues to increase in the 21st century. Overweight and obesity is as a result of energy imbalance that consumes more calories than what is equivalently expended in physical activities. Westernization and Urbanization are said to be among the main reasons for this energy imbalance in the African region and they are viewed from two perspectives [ 7 ]. First, urbanization and westernization lead to decreased physical activity.
Second, urbanization and westernization result in increased food supply, which include access to high caloric fast foods and sugar sweetened beverages fatty foods [ 8 ]. studies have found socioeconomic differences in obesity and overweight [ 9 ], and in developing countries the direction is not consistent [ 9 ]. While some studies found the likelihood of being obese or overweight to the detriment of those with higher socio-economic status SES [ 1011 ], others reported higher chances of being overweight or obese among those with lower SES [ 12 ]. Height, which is a component of BMI is itself socioeconomically patterned because past socioeconomic status and nutrition during the Fat women Tampere stages of life childhood and adolescence affect height.
Over all, some few studies on obesity in Africa have been conducted [ 13 — 15 ].
While these studies have made various contributions to understanding the phenomenon in the region, their focuses differ from the present studies. For instance, Steyn and Mchiza [ 13 ] focused on understanding whether changes in nutrition diet and obesity have taken place over the past three decades in Sub-Saharan Africa.
Ziraba et al. Another challenge with these findings is that they used different data sets, which have varying representativeness and methodological procedures. Therefore, the findings are not comparable across countries. To address these constraints, this study used nationally representative data from 32 Sub-Saharan African countries with similar method of data collection to explore the prevalence of overweight and obesity in the region.
Furthermore, the study explored disparity in the phenomenon by place of residence, level of education and wealth quintile. Thirty-two nationally representative cross-sectional data from the most recent Demographic and Health survey DHS conducted between January 1,and December 31, in Sub-Saharan Africa were used. The DHS survey data were collected at about 5-year intervals across low and middle-income countries. DHS collect data on health and welfare by interviewing women of reproductive age 15—49 yearstheir children, and their households.
In this analysis only women who had information on age and height were included. All 32 countries, DHS survey followed the same standard procedures. Briefly, the DHS used a stratified two-stage random sampling approach, consisting of a selection of census enumeration areas Fat women Tampere on a probability, followed by a random selection of household from a complete listing of a household within the selected enumeration areas.
In this study, all together women from 32 countries responded to the surveys with the response rates varying from Women granted written informed consent before interviewing them. In all DHS survey, trained personnel measured the height and weight using a standardized procedure. Weight was measured using solar-powered scales with accuracy of 0. Body mass index BMI was calculated by dividing body weight kg by squared height m 2.
Overweight and obesity were defined as recommended by World Health Organization [ 5 ]: overweight Only the respondents who had information on BMI were included in the analyses. The wealth index was then generated as a composite variable by demographic and health survey DHS staff using principal components analysis. Continuous scale of relative wealth was then categorized into five poorest, poorer, middle, richer, and richest according to the quintile of the sample.
Wealth index was not available from the DHS data from Chad. Maternal education was assessed from Fat women Tampere of the completed educational level no education, primary, secondary, or higher. Sample weights were applied to the data to remove the bias due to unequal selection probabilities. The pooled prevalence for the region was also estimated. Scatterplots were used to visualize the relationship between no education and overweight and obesity with the size of a marker relative to the of outcome events to reflect their influence on the correlation.
Analyses of the relationships between overweight and obesity and place of residence, education and wealth index were carried out. All the analyses were performed using the SPSS statistical software package version 21 and Stata version Data from a total of women from 32 countries in Sub-Saharan Africa were analysed in this study. Table 1 shows the country level characteristics Fat women Tampere the study participants. The mean age of the studied women varied from The overall mean age of the study participants was Only On the average, According to wealth index, Lesotho had the fewest poorest The largest of women who had no education Similarly, women in Lesotho also had the lowest mean of children 1.
Similarly, the lowest and the highest prevalence of obesity were also found in the same countries; lowest Fat women Tampere Madagascar 1. Scatterplot of overweight prevalence of women in each country by no education weighted by total sample size of the country. Scatterplot of obesity prevalence of women in each country by no education weighted by total sample size of the country. Scatterplot of overweight obesity prevalence of women in each country by no education weighted by total sample size of the country.
The place of residence, education and wealth index strongly predicted overweight and obesity among Sub-Saharan African women. ificantly, the largest variation of overweight and obesity was between urban and rural OR 7. Likewise, the least variation of overweight and obesity was by urban vs. Urban residents compared to rural had higher odds of overweight and obesity. Also, in many countries women with high education had higher odds of overweight and obesity except in Benin, Comoros, Sao Tome and Senegal. In almost all studied countries the overweight and obesity was more common among rich women compared to poor with an average odds of 2.
A of studies have reported the emergence of obesity and overweight in developing countries [ 1101617 ].
Although these earlier studies provide aggregate picture of the epidemic in developing countries, they lack in-depth analysis of the phenomenon in specific regions, alongside socio-demographic dimensions. Furthermore, with the exception of few studies [ 110 ], the studies used data collected from different sources using varied methodologies and therefore it was difficult for comparison across the diverse regions within the developing countries.
An additional constraint of a of the studies is that the BMI was estimated from self-reported weight and height and therefore it may be biased by the social desirability regarding weight in the respective countries and communities within these Fat women Tampere. To build on these studies and to address the aforementioned gaps, the present study used a large sample of the data which were collected using similar methods among women aged 15 to 49 years in 32 African countries to explore the prevalence of overweight and obesity in the region and to investigate the socio-demographic disparities in the two outcomes across the region.
Our study found high variation in overweight and obesity problem across Sub-Saharan African countries. Urban residents, women with high education and rich women as measured by wealth index quintile had higher odds of overweight and obesity in general. These findings put these countries at the risk of high burden of obesity related morbidity and mortality in the future. There exist some systematic reviews and meta-analyses [ 16912 ] therefore we did not perform a systematic review of the scientific literature.
However we search the recent literature published in English, employing no date restrictions. We identified 20 relevant primary research articles based on low- and middle-income countries. Only very few of them were based on national data. Considerable differences in overweight and obesity across Sub-Saharan Africa were found.
This ranged from low overweight and obesity of 6. Unlike in studies [ 1018 ] where the characteristics of overweight and obesity have been associated with the level of development in the countries, it seems that the prevalence in the present study does not reflect the developmental level of countries.
The emerging prevalence of overweight and obesity in Africa has been largely attributed to the rising level of urbanisation in the region and its attendant global nutrition transition [ 19 ]. Urbanization in Africa is increasing rapidly, for example, for the first time, the Ghana Population and Housing Census shows that more Ghanaians are living in Fat women Tampere areas than rural areas [ 20 ].
The growing urbanization comes along with sedentary lifestyle, "motorised culture", availability of refined foods and physical inactivity related recreations such as cinema houses and video games are all implicated in the rising overweight and obesity in Sub-Saharan Africa.
These risk factors for obesity are similar to those found in several studies across the world as ing for the increasing overweight and obesity epidemic in developing countries and the stall in the phenomenon in developed countries [ 22 — 25 ].
Our study found differences in overweight and obesity to the disadvantage of those in urban settings similar to a recent study [ 26 ]. These rural-urban disparities could be Fat women Tampere by the differences in lifestyle and dietary pattern between urban and rural dwellers in Africa. In rural areas, residents mainly eat fresh food from the farm, and mostly green and fresh fruits and vegetables are available from backyards. Therefore, the dietary pattern of rural folks, although unintentional, tends to be healthy compared to that of urban folks.
Apart from diet, the lifestyle of urban residents is tilted towards westernization and the blind adoption of the so-called western lifestyle. There are growing s of western food outlets and urban residents perceive eating at such ts as a of affluence. Transnational fast-food companies in the region are aggressively exploiting this perception [ 21 ].
The nature of occupation prevailing in rural and urban setting in Africa also contributes to the differences in obesity and overweight between the two settings.Fat women Tampere
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Overweight and obesity among women: analysis of demographic and health survey data from 32 Sub-Saharan African Countries