The association between dietary consumption, anthropometric measures and body composition of rural and urban Ghanaian adults: a comparative cross-sectional study
Tóm tắt
Overweight and obesity have become threats to public health in all regions across the globe including sub-Saharan Africa where prevalence used to be low. Policies to regulate the food environment and promote healthy food consumption look promising to reducing the prevalence of obesity but in Ghana there is not enough data to elicit a policy response. This study assessed the association between dietary consumption, anthropometric measures, body composition and physical activity among rural and urban Ghanaian adults. This was a cross-sectional study involving 565 Ghanaian adults. Structured interviewer administered questionnaires were used to collect information on socio-demographics. Dietary consumption was assessed using household food frequency questionnaire and 24-h recall. Height, weight, BMI, waist circumference and body composition of all participants were determined. The World Health Organization’s Global Physical Activity Questionnaire (GPAQ) was used to assess physical activity levels. Mann-Whitney U test was used to analyze differences in anthropometric measures, body composition and consumption among rural and urban participants. Principal component analysis was used to analyze household food frequency data and nutrient analysis template was used to analyze 24-h recall. Chi-square was used to measure differences in obesity prevalence by community and gender. Multinomial logistic regression was used to model the risk factors associated with obesity. The prevalence of overweight and obesity using BMI were 29.9 and 22.9% respectively. Use of waist circumference measurement resulted in the highest overall obesity prevalence of 41.5%. Prevalence of obesity was higher among females compared to males across all measures with the exception of visceral fat that showed no significant difference. Four different patterns were derived from principal component analysis. Among urban participants, the staple pattern showed a significant negative correlation with visceral fat (r − 0.186, p-value 0.013) and BMI (r − 0.163, p-value 0.029). Multinomial logistic regression revealed that males (AOR 19.715, CI 9.723–39.978, p-value < 0.001) had higher odds of being of normal weight compared to females. Prevalence of overweight and obesity continue to rise in Ghana, especially among females. Public education and screening as well as interventions that regulate the food environment and make affordable and available healthy food options are needed to control the rise in obesity prevalence.
Tài liệu tham khảo
WHO Non communicable diseases. 2018. http://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases. Accesses 6 June 2018.
WHO Overweight and obesity report. 2017. http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed 6 June 2018.
United Nations Sustainable Development Goals. 2018. https://www.un.org/sustainabledevelopment /poverty/. Accessed 6 June 2018.
Kelly T, Yang W, Chen C-S, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes. 2008;32(9):1431.
Dake FA. Obesity among Ghanaian women: past prevalence, future incidence. Public Health. 2013;127(6):590–2 Elsevier.
Henriques A, Teixeira V, Cardoso HF, Azevedo A. The influence of stunting on obesity in adulthood: results from the EPIPorto cohort. Public Health Nutr. 2018:1–8. https://doi.org/10.1017/S1368980018000460.
Dake FA, Thompson AL, Ng SW, Agyei-mesnsah S, Cudjoe SNA. The local food environment and body mass index among the urban poor in Accra. J Urban Health. 2016;93(3):438–55. https://doi.org/10.1007/s11524-016-0044-y.
Wright SM, Aronne LJ. Causes of obesity. Abdominal Radiology. 2012;37(5):730–2.
Hawkes C, Harris J, Gillespie S. Urbanization and the nutrition transition. In Global Food Policy Report. 2017;(4, 41):34. https://doi.org/10.2499/9780896292529_04.
WHO Global health risks. Mortality and burden of disease attributable to selected major risks. http://www.who.int/healthinfo/global_burden_disease/ GlobalHealthRisks_report_full.pdf.
Fukunaka A, Fujitani Y. Role of zinc homeostasis in the pathogenesis of diabetes and obesity. Int J Mol Sci. 2018;19(2):476..
Ziraba AK, Fotso CJ, Ochako R. Overweight and obesity in urban Africa: a problem of the rich or the poor? 2010. https://doi.org/10.1186/1471-2458-9-465.
Hawkes C. Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases. Glob Health. 2006;2(4):18.
Tuoyire DA, Kumi-Kyereme A, Doku DT. Socio-demographic trends in overweight and obesity among parous and nulliparous women in Ghana. BMC obesity. 2016;3(1):44. https://doi.org/10.1186/s40608-016-0124-2.
WHO. Global health observatory. Geneva: World Health Organization; 2016.
Jackson AS, Stanforth PR, Gagnon J, Rankinen T, Leon AS, Rao DC, Skinner JS, Bouchard C, Wilmore JH. The effect of sex, age and race on estimating percentage body fat from body mass index: the heritage family study. Int J Obes Relat Metab Disord. 2002;26(6):789–96.
NHLBI (1998) NHLBI obesity education initiative expert panel on the identification, evaluation, and treatment of Overweight and obesity in adults. NIH publication no. 98-4083.
Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88. 19320986.
Cornier MA, Despres JP, Davis N, Grossniklaus DA, Klein S, Lamarche B, et al. Assessing adiposity: a scientific statement from the American Heart Association. Circulation. 2011;124:1996–2019. 21947291.
Nutrition indicator data 2014. https://www.dhsprogram.com/topics/Nutrition/Index.cfm. Accessed 14 November 2019.
Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000;72(3):694–701.
Ghana Statistical Service (GSS), Ghana Demographic and Health Survey. Accra, Ghana; 2014..
Benkeser RM, Biritwum R, Hill AG. Prevalence of overweight and obesity and perception of healthy and desirable body size in urban, Ghanaian women. Ghana Med J. 2012;46(2):66–75.
Ofori-Asenso R, Agyeman AA, Laar A, Boateng D. Overweight and obesity epidemic in Ghana—a systematic review and meta-analysis. BMC Public Health. 2016;16(1):1239.
Atuahene M, Ganle JK, Adjuik M, Atuahene NF, Kampitib GB. Overweight and obesity prevalence among public servants in Nadowli district, Ghana, and associated risk factors: a cross-sectional study. BMC Obesity. 2017;4(1):15.
Agyemang C, Owusu-Dabo E, de Jonge A, Martins D, Ogedegbe G, Stronks K. Overweight and obesity among Ghanaian residents in the Netherlands: how do they weigh against their urban and rural counterparts in Ghana? Public Health Nutr. 2009;12(7):909–16.
Bixby H, Bentham J, Zhou B, Di Cesare M, Paciorek CJ, Collaboration NRF. Rising rural body-mass index is the main driver of the global obesity epidemic. Nature. 2019;569:260–4.
Cockx L, Colen L, De Weerdt J. From corn to popcorn? Urbanization and food consumption in sub-saharan Africa: evidence from rural-urban migrants in Tanzania.
Anderson AK. Prevalence of Anemia, Overweight/obesity, and undiagnosed hypertension and diabetes among residents of selected communities in Ghana. Int J Chronic Dis. 2017;2017. https://doi.org/10.1155/2017/7836019.
Negash S, Agyemang C, Matsha TE, Peer N, Erasmus RT, Kengne AP. Differential prevalence and associations of overweight and obesity by gender and population group among school learners in South Africa: a cross-sectional study. BMC Obesity. 2017;4(1):29.
Hruby A, Manson JE, Qi L, Malik VS, Rimm EB, Sun Q, et al. Determinants and consequences of obesity. Am J Public Health. 2016;106(9):1656–62.
Yakusheva O, Kapinos K, Weiss M. Maternal weight after childbirth versus aging-related weight changes. Womens Health Issues. 2017 Mar 1;27(2):174–80.
Catalano P. Maternal obesity and metabolic risk to the offspring: why lifestyle interventions may have not achieved the desired outcomes. Int J Obes. 2015;39(4):642.