1. Regional and sex-specific variation in BMI distribution in four sub-Saharan African countries: The H3Africa AWI-Gen study
- Author
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Michèle Ramsay, Nigel J. Crowther, Godfred Agongo, Stuart A. Ali, Gershim Asiki, Romuald P. Boua, F. Xavier Gómez-Olivé, Kathleen Kahn, Christopher Khayeka-Wandabwa, Felistas Mashinya, Lisa Micklesfield, Freedom Mukomana, Engelbert A. Nonterah, Cassandra Soo, Hermann Sorgho, Alisha N. Wade, Ryan G. Wagner, Marianne Alberts, Scott Hazelhurst, Catherine Kyobutungi, Shane A. Norris, Abraham R. Oduro, Osman Sankoh, Halidou Tinto, Stephen Tollman, and as members of AWI-Gen and the H3Africa Consortium
- Subjects
Male ,obesity ,Distribution (economics) ,Body Mass Index ,0302 clinical medicine ,Risk Factors ,CMD ,Prevalence ,030212 general & internal medicine ,media_common ,2. Zero hunger ,Geography ,030503 health policy & services ,Health Policy ,lcsh:Public aspects of medicine ,1. No poverty ,Middle Aged ,Sex specific ,3. Good health ,Variation (linguistics) ,Regional variation ,Female ,Original Article ,0305 other medical science ,Adult ,Adolescent ,Demographic history ,media_common.quotation_subject ,Genetic genealogy ,Black People ,03 medical and health sciences ,BMI ,medicine ,Humans ,Sex Distribution ,SSA ,Africa South of the Sahara ,Aged ,sex-specific variation ,business.industry ,Public Health, Environmental and Occupational Health ,regional variation ,lcsh:RA1-1270 ,Overweight ,medicine.disease ,Obesity ,Cross-Sectional Studies ,Social Class ,business ,human activities ,Demography ,Diversity (politics) - Abstract
Background: African populations are characterised by diversity at many levels including: demographic history, genetic ancestry, language, wealth, socio-political landscape, culture and behaviour. Several of these have a profound impact on body fat mass. Obesity, a key risk factor for cardiovascular and metabolic diseases, in the wake of the epidemiological and health transitions across the continent, requires detailed analysis together with other major risk factors. Objective: To compare regional and sex-specific body mass index (BMI) distributions, using a cross-sectional study design, in adults aged 40–60 years across six study sites in four sub-Saharan African (SSA) countries and to compare the determinants of BMI at each. Methods: Anthropometric measurements were standardised across sites and BMI calculated. Median BMI and prevalence of underweight, lean, overweight and obesity were compared between the sexes and across sites. Data from multivariable linear regression models for the principal determinants of BMI were summarised from the site-specific studies. Results: BMI was calculated in 10,702 participants (55% female) and was significantly higher in women than men at nearly all sites. The highest prevalence of obesity was observed at the three South African sites (42.3–66.6% in women and 2.81–17.5% in men) and the lowest in West Africa (1.25–4.22% in women and 1.19–2.20% in men). Across sites, higher socio-economic status and educational level were associated with higher BMI. Being married and increased dietary intake were associated with higher BMI in some communities, whilst smoking and alcohol intake were associated with lower BMI, as was HIV infection in the regions where it was prevalent. Conclusion: In SSA there is a marked variation in the prevalence of obesity both regionally and between men and women. Our data suggest that the drive for social upliftment within Africa will be associated with rising levels of obesity, which will require the initiation of targeted sex-specific intervention programmes across specific African communities.
- Published
- 2018