Trends and determinants of underweight and overweight/obesity among urban Ethiopian women from 2000 to 2016
Tóm tắt
Nutritional, epidemiological and demographic transitions have been associated with the emergence of the double burden of malnutrition globally. In Ethiopia, there has been no nationally representative investigation of trends and determinants of both underweight and overweight/obesity among urban women. This study examined the trends and determinants of underweight and overweight/obesity in urban Ethiopian women from 2000 to 2016. Trends in the prevalence of underweight and overweight/obesity were investigated based on a series of the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n = 2559), 2005 (n = 1112), 2011 (n = 3569), and 2016 (n = 3106). Multivariable multinomial logistic regression was used to investigate the association between socioeconomic, demographic, behavioural, and community-level factors with underweight and overweight/obesity. The prevalence of underweight in urban Ethiopian women reduced significantly from 23.2% (95% confidence interval [CI]: 20.3, 26.3%) in 2000 to 14.8% (95% CI: 13.1, 16.7%) in 2016, while overweight/obesity increased significantly from 10.9% (95% CI: 9.1, 13.0%) in 2000 to 21.4% (95% CI: 18.2, 25.1%) in 2016. Urban women from rich households and those who had never married were less likely to be underweight. Urban women who were from wealthy households and those who attained at least secondary education were more likely to be overweight/obese. Women who were informally employed and listened to the radio were less likely to be overweight/obese compared to those who were unemployed and did not listen to the radio, respectively. The prevalence of overweight/obesity increased from 2000 to 2016, with a concurrent reduction in the prevalence of underweight. Interventions aiming to reduce overweight and obesity should target urban women with higher education, those who resided in wealthier households and those who watched the television.
Tài liệu tham khảo
Batal M, Steinhouse L, Delisle H. The nutrition transition and the double burden of malnutrition. Med Sante Trop. 2018;28(4):345–50.
Broyles ST, Denstel KD, Church TS, Chaput JP, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert EV, Maher C, et al. The epidemiological transition and the global childhood obesity epidemic. Int J Obes Suppl. 2015;5(Suppl 2):S3–8.
Shetty P. Nutrition transition and its health outcomes. Indian J Pediatr. 2013;80(1):21–7.
World Health Organisation. The double burden of malnutrition: policy brief. Geneva: World Health Organisation; 2016.
Amugsi DA, Dimbuene ZT, Mberu B, Muthuri S, Ezeh AC. Prevalence and time trends in overweight and obesity among urban women: an analysis of demographic and health surveys data from 24 African countries, 1991-2014. BMJ Open. 2017;7(10):e017344.
Lash MM, Armstrong A. Impact of obesity on women's health. Fertil Steril. 2009;91(5):1712–6.
Must A, Naumova EN, Phillips SM, Blum M, Dawson-Hughes B, Rand WM. Childhood overweight and maturational timing in the development of adult overweight and fatness: the Newton girls study and its follow-up. Pediatrics. 2005;116(3):620–7.
Himes JH. Examining the evidence for recent secular changes in the timing of puberty in US children in light of increases in the prevalence of obesity. Mol Cell Endocrinol. 2006;254-255:13–21.
Freire WB, Waters WF, Rivas-Marino G, Belmont P. The double burden of chronic malnutrition and overweight and obesity in Ecuadorian mothers and children, 1986-2012. Nutr Health. 2018;24(3):163–70.
Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics. 2004;114(1):e29–36.
Bygbjerg IC. Double burden of noncommunicable and infectious diseases in developing countries. Science. 2012;337(6101):1499–501.
Allen LN, Pullar J, Wickramasinghe KK, Williams J, Roberts N, Mikkelsen B, Varghese C, Townsend N. Evaluation of research on interventions aligned to WHO ‘best buys’ for NCDs in low-income and lower-middle-income countries: a systematic review from 1990 to 2015. BMJ Glob Health. 2018;3(1):e000535.
NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet. 2016;387(10026):1377–96.
Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, Marczak L, Mokdad AH, Moradi-Lakeh M, Naghavi M, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377(1):13–27.
Overweight and obesity In: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. [Accessed 15 Aug 2019].
Prevalence of underweight among adults, BMI < 18, crude estimates by WHO region [http://apps.who.int/gho/data/view.main.NCDBMILT18CREGv].
Rawal LB, Kanda K, Mahumud RA, Joshi D, Mehata S, Shrestha N, Poudel P, Karki S, Renzaho A. Prevalence of underweight, overweight and obesity and their associated risk factors in Nepalese adults: data from a nationwide survey, 2016. PLoS One. 2018;13(11):e0205912.
Biswas T, Garnett SP, Pervin S, Rawal LB. The prevalence of underweight, overweight and obesity in Bangladeshi adults: data from a national survey. PLoS One. 2017;12(5):e0177395.
Kamal SM, Hassan CH, Alam GM. Dual burden of underweight and overweight among women in Bangladesh: patterns, prevalence, and sociodemographic correlates. J Health Popul Nutr. 2015;33(1):92–105.
Ajayi IO, Adebamowo C, Adami H-O, Dalal S, Diamond MB, Bajunirwe F, Guwatudde D, Njelekela M, Nankya-Mutyoba J, Chiwanga FS, et al. Urban–rural and geographic differences in overweight and obesity in four sub-Saharan African adult populations: a multi-country cross-sectional study. BMC Public Health. 2016;16(1):1126.
Seyda Seydel G, Kucukoglu O, Altinbasv A, Demir OO, Yilmaz S, Akkiz H, Otan E, Sowa JP, Canbay A. Economic growth leads to increase of obesity and associated hepatocellular carcinoma in developing countries. Ann Hepatol. 2016;15(5):662–72.
Tebekaw Y, Teller C, Colón-Ramos U. The burden of underweight and overweight among women in Addis Ababa, Ethiopia. BMC Public Health. 2014;14:1126.
Abrha S, Shiferaw S, Ahmed KY. Overweight and obesity and its socio-demographic correlates among urban Ethiopian women: evidence from the 2011 EDHS. BMC Public Health. 2016;16:636.
Rothman KJ, Lash TL, Greenland S. Modern epidemiology. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008.
Ethiopia sensitizes stakeholders on its new food and nutrition policy [https://www.unicef.org/ethiopia/stories/ethiopia-sensitizes-stakeholders-its-new-food-and-nutrition-policy].
Ethiopia approves national food and nutrition policy [https://ethiopia.savethechildren.net/news/ethiopia-approves-national-food-and-nutrition-policy].
SDG-UN. Transforming our world: the 2030 agenda for sustainable development. New York: UN; 2015.
World Health Organisation. Global action plan for the prevention and control of noncommunicable diseases: 2013–2020. Geneva: World Health Organisation; 2013.
Croft TN, Marshall AMJ, Allen CK, et al. Guide to demographic and health survey statistics. Rockville: ICF; 2018.
Central Statistics Agency (CSA) [Ethiopia] and ORC Macro. Ethiopian demographic and health survey 2000. Addis Ababa and Calverton: CSA and ORC Macro; 2001.
Central Statistics Agency (CSA) [Ethiopia] and ORC Macro. Ethiopia demographic and health survey 2005. Addis Ababa and Calverton: CSA and ORC Macro; 2006.
Central Statistics Agency (CSA) [Ethiopia] and ICF International. Ethiopia demographic and health survey 2011. Addis Ababa and Calverton: Central Statistical Agency and ICF International; 2012.
Central Statistics Agency (CSA) [Ethiopia] and ICF International. Ethiopia demographic and health survey 2016. Addis Ababa and Rockville: Central Statistical Agency (CSA) and ICF International; 2016.
Ogbo FA, Nguyen H, Naz S, Agho KE, Page A. The association between infant and young child feeding practices and diarrhoea in Tanzanian children. Trop Med Health. 2018;46:2.
Ogbo FA, Page A, Agho KE, Claudio F. Determinants of trends in breast-feeding indicators in Nigeria, 1999-2013. Public Health Nutr. 2015;18(18):3287–99.
Ahmed KY, Page A, Arora A, Ogbo FA. Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016. Int Breastfeed J. 2019;14(1):40.
Tanwi TS, Chakrabarty S, Hasanuzzaman S. Double burden of malnutrition among ever-married women in Bangladesh: a pooled analysis. BMC Womens Health. 2019;19(1):24.
Araujo FG, Velasquez-Melendez G, Felisbino-Mendes MS. Prevalence trends of overweight, obesity, diabetes and hypertension among Brazilian women of reproductive age based on sociodemographic characteristics. Health Care Women Int. 2019;40(4):386–406.
Doku DT, Neupane S. Double burden of malnutrition: increasing overweight and obesity and stall underweight trends among Ghanaian women. BMC Public Health. 2015;15(1):670.
Hasan M, Sutradhar I, Shahabuddin A, Sarker M. Double burden of malnutrition among Bangladeshi women: a literature review. Cureus. 2017;9(12):e1986.
Neupane S, Prakash KC, Doku DT. Overweight and obesity among women: analysis of demographic and health survey data from 32 sub-Saharan African countries. BMC Public Health. 2016;16:30.
Abou-ElWafa HS, El-Gilany AH. Maternal work and exclusive breastfeeding in Mansoura, Egypt. Fam Pract. 2018;36(5):568–72.
Filmer D, Pritchett LH. Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India. Demography. 2001;38(1):115–32.
Lakew Y, Tabar L, Haile D. Socio-medical determinants of timely breastfeeding initiation in Ethiopia: evidence from the 2011 nationwide demographic and health survey. Int Breastfeed J. 2015;10:24.
Ogbo FA, Page A, Idoko J, Claudio F, Agho KE. Trends in complementary feeding indicators in Nigeria, 2003–2013. BMJ Open. 2015;5(10):e008467.
Christensen DL, Eis J, Hansen AW, Larsson MW, Mwaniki DL, Kilonzo B, Tetens I, Boit MK, Kaduka L, Borch-Johnsen K, et al. Obesity and regional fat distribution in Kenyan populations: impact of ethnicity and urbanization. Ann Hum Biol. 2008;35(2):232–49.
Fezeu L, Minkoulou E, Balkau B, Kengne AP, Awah P, Unwin N, Alberti GK, Mbanya JC. Association between socioeconomic status and adiposity in urban Cameroon. Int J Epidemiol. 2006;35(1):105–11.
Lopez RP. Neighborhood risk factors for obesity. Obesity (Silver Spring, Md). 2007;15(8):2111–9.
Sundquist K, Malmstrom M, Johansson SE. Neighbourhood deprivation and incidence of coronary heart disease: a multilevel study of 2.6 million women and men in Sweden. J Epidemiol Community Health. 2004;58(1):71–7.
Bishwajit G. Household wealth status and overweight and obesity among adult women in Bangladesh and Nepal. Obes Sci Pract. 2017;3(2):185–92.
McLaren L. Socioeconomic status and obesity. Epidemiol Rev. 2007;29(1):29–48.
Fernald LC. Socio-economic status and body mass index in low-income Mexican adults. Soc Sci Med. 2007;64(10):2030–42.
Bhurosy T, Jeewon R. Overweight and obesity epidemic in developing countries: a problem with diet, physical activity, or socioeconomic status? ScientificWorldJournal. 2014;2014:964236.
Ogden CL, Fakhouri TH, Carroll MD, Hales CM, Fryar CD, Li X, Freedman DS. Prevalence of obesity among adults, by household income and education - United States, 2011-2014. MMWR Morb Mortal Wkly Rep. 2017;66(50):1369–73.
Murakami K, Ohkubo T, Hashimoto H. Distinct association between educational attainment and overweight/obesity in unmarried and married women: evidence from a population-based study in Japan. BMC Public Health. 2017;17(1):903.
Cohen AK, Rai M, Rehkopf DH, Abrams B. Educational attainment and obesity: a systematic review. Obes Rev. 2013;14(12):989–1005.
Ford ND, Patel SA, Narayan KM. Obesity in low- and middle-income countries: burden, drivers, and emerging challenges. Annu Rev Public Health. 2017;38:145–64.
Martorell R, Khan LK, Hughes ML, Grummer-Strawn LM. Obesity in women from developing countries. Eur J Clin Nutr. 2000;54(3):247–52.
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.
Goryakin Y, Suhrcke M. Economic development, urbanization, technological change and overweight: what do we learn from 244 demographic and health surveys? Econ Hum Biol. 2014;14:109–27.
Oddo VM, Bleich SN, Pollack KM, Surkan PJ, Mueller NT, Jones-Smith JC. The weight of work: the association between maternal employment and overweight in low- and middle-income countries. Int J Behav Nutr Phys Act. 2017;14(1):66.
Oddo VM, Surkan PJ, Hurley KM, Lowery C, de Ponce S, Jones-Smith JC. Pathways of the association between maternal employment and weight status among women and children: qualitative findings from Guatemala. Matern Child Nutr. 2018;14(1):e12455.
Günther I, Launov A. Informal employment in developing countries: opportunity or last resort? J Dev Econ. 2012;97(1):88–98.
Frantz JM, Ngambare R. Physical activity and health promotion strategies among physiotherapists in Rwanda. Afr Health Sci. 2013;13(1):17–23.
Patnode CD, Evans CV, Senger CA, Redmond N, Lin JS. U.S. preventive services task force evidence syntheses, formerly systematic evidence reviews. In: Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated systematic review for the us preventive services task Force. Rockville: Agency for Healthcare Research and Quality (US); 2017.
Ghose B. Frequency of TV viewing and prevalence of overweight and obesity among adult women in Bangladesh: a cross-sectional study. BMJ Open. 2017;7(1):e014399.
Healy GN, Wijndaele K, Dunstan DW, Shaw JE, Salmon J, Zimmet PZ, Owen N. Objectively measured sedentary time, physical activity, and metabolic risk: the Australian diabetes, obesity and lifestyle study (AusDiab). Diabetes Care. 2008;31(2):369–71.
Das Gupta R, Sajal IH, Hasan M, Sutradhar I, Haider MR, Sarker M. Frequency of television viewing and association with overweight and obesity among women of the reproductive age group in Myanmar: results from a nationwide cross-sectional survey. BMJ Open. 2019;9(3):e024680.
Miles A, Rapoport L, Wardle J, Afuape T, Duman M. Using the mass-media to target obesity: an analysis of the characteristics and reported behaviour change of participants in the BBC’s ‘fighting fat, fighting fit’ campaign. Health Educ Res. 2001;16(3):357–72.
Wardle J, Rapoport L, Miles A, Afuape T, Duman M. Mass education for obesity prevention: the penetration of the BBC’s ‘fighting fat, fighting fit’ campaign. Health Educ Res. 2001;16(3):343–55.
Rai RK, Jaacks LM, Bromage S, Barik A, Fawzi WW, Chowdhury A. Prospective cohort study of overweight and obesity among rural Indian adults: sociodemographic predictors of prevalence, incidence and remission. BMJ Open. 2018;8(8):e021363.