Abstract MP23: Does Predictors Of Overweight/obesity Among Women Vary Based On The Residential Setting? A Multilevel Analysis Of Repeated Cross-sectional Data In Nigeria

Abstract

Background: Overweight/obesity is increasingly becoming a major public health problem in Nigeria despite the persistence of underweight burden. A major contributor of this is the urban sprawl experienced in the country with approximately half of the Nigerian population living in urban areas. Evidence suggests that similar socio-demographic factors could have different influences on an individual’s nutrition status by virtue of their residential setting. Yet, little is known about this phenomenon in the Nigerian context. Objectives: This study aimed to explore the following objectives: 1) to determine whether the anticipated increase in overweight/obesity prevalence is subsequently paralleled by substantial decrease in undernutrition in the last decade; and 2) to examine both the individual and household predictors’ overweight/obesity among women of reproductive age in rural and urban Nigeria. Methods: We used data acquired from the 2008, 2013 and 2018 Nigeria Demographic and Health Surveys (DHS). Our outcome was defined using standard Body Mass Index (BMI) categories calculated from height and weight measurements of the study participants. The national and stratified (urban/rural) prevalence estimates of underweight (BMI <18.5 Kg/m 2 ), overweight (BMI 25 - 29.9 Kg/m 2 ), and obese (BMI ≥ 30 Kg/m 2 ) were computed for each survey. Afterwards, the underweight subjects were excluded from the study. Two-level (individual and household) logistic regression models were applied to examine the influence of individual and household characteristics on women’s overweight/obese status. Results: Findings show a steady increase in both the prevalence of overweight and obesity from 16.1% and 6.1% in 2008 to 18.2% and 10.0% in 2018, respectively, while underweight prevalence was averagely 12% across each survey. Regardless of the residential setting, age, marital status, education, occupation, household wealth and survey year were consistently associated with increased risk of overweight/obesity, whereas breastfeeding showed a protective association with overweight/obesity. Having multiple children and living in female-headed homes were unique risk factors for overweight/obesity among urban women while ethnicity, media exposure and state of residence were unique risk factors for overweight/obesity among rural women. Conclusion: Public health interventions aimed at lowering the risk of overweight/obesity should embrace the differences in risk factors that exists between rural and urban dwellers.