Abstract
BackgroundUnderstanding environmental factors related to obesity can inform interventions for the world wide obesity epidemic, yet no study has been conducted in this context in Africa. This study examined associations between neighbourhood environment variables and overweight in Nigerian adults.MethodsA total of 1818 randomly selected residents (age: 20-65 years, 40% female, 31% overweight and 61.2% response) living in high and low socioeconomic (SES) neighbourhoods in Metropolitan Maiduguri, Nigeria, participated in a cross-sectional study. Anthropometric measurements of height and weight and an interview-assisted self-reported measure of 16 items of perceived neighborhood environments were conducted. The primary outcome was overweight (body mass index [BMI] > or = 25 kg/m2) vs. normal weight (BMI = 18.5-24.9 kg/m2).ResultsAfter adjustment for sociodemographic variables, overweight was associated with distant access to commercial facilities (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.02- 2.18), poor neighbourhood aesthetics (OR, 1.58; 95% CI, 1.16-2.09), perceiving garbage and offensive odours in the neighbourhood (OR, 1.41; 95% CI, 1.05-1.89) and feeling unsafe from crime at night (OR, 1.47; 95% CI, 1.13- 1.91) and unsafe from traffic (OR, 1.56; 95% CI, 1.17-2.07) in the total sample. Significant interactions regarding overweight were found between gender and four environmental variables, with low residential density (OR, 1.39; 95% CI, 1.02-1.93) and poorly maintained pedestrian pathways (OR, 1.89; 95% CI, 1.13-3.17) associated with overweight in men only, and absence of beautiful things (OR, 2.23; 95% CI, 1.42-3.50) and high traffic making it unsafe to walk (OR, 2.39; 95% CI, 1.49-3.83) associated with overweight in women only. There were few significant interactions between environmental factors and neighborhood SES regarding overweight.ConclusionNeighbourhood environment factors were associated with being overweight among Nigerian adults. These findings support previous reports in international literature, but should be replicated in other African studies before any firm conclusions can be drawn.
Highlights
Understanding environmental factors related to obesity can inform interventions for the world wide obesity epidemic, yet no study has been conducted in this context in Africa
The associations between neighbourhood environmental factors and physical activity have been reported in many countries across the continents [22,23], but no study has examined the independent association of environmental variables with overweight and obesity in African countries
Significant interactions regarding overweight were found between gender and four of the environmental factors (Table 3)
Summary
Understanding environmental factors related to obesity can inform interventions for the world wide obesity epidemic, yet no study has been conducted in this context in Africa. The ecological models based on the principle that health behaviours are influenced by multiple levels, indicate that the environment has a significant effect on diet, physical activity and obesity [18,19] These models have been recommended as a framework for studying health behaviours [20], because they can guide interventions that affect large populations over a long period of time [21]. In this context, the associations between neighbourhood environmental factors and physical activity have been reported in many countries across the continents [22,23], but no study has examined the independent association of environmental variables with overweight and obesity in African countries
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