Magnitude and predictors of normal-weight central obesity– the AWI-Gen study findings

Christopher Khayeka-Wandabwa,Tilahun Nigatu Haregu,Stella Kagwiria Muthuri,Shukri F Mohamed,Catherine Kyobutungi

doi:10.1080/16549716.2019.1685809

Abstract

ABSTRACTBackground: Normal-weight central obesity is associated with higher mortality than general obesity as defined by body mass index, particularly in the absence of central fat distribution.Objective: The aim of this study was to examine the magnitude and predictors of normal-weight central obesity in an urban informal settlement setting in Kenya.Methods: We used data from the AWI-Gen study, a cross-sectional survey targeting randomly selected consenting adults between the ages of 40–60 in two urban informal settlements of Nairobi between 2014 and 2016. Central obesity was determined using waist circumference, waist to hip ratio, visceral fat thickness, and subcutaneous fat thickness. General obesity was determined using body mass index (BMI).Results: About 20.0% of participants in the study had general obesity. The prevalence of central obesity as measured by waist circumference was 52.0%, by waist-to-hip ratio was 53.5%, by visceral fat thickness was 32.4% and by subcutaneous fat thickness was 49.2%. The prevalence of normal-weight central obesity in the study population was highest when measured by waist to hip ratio (38.1%) and lowest when measured by visceral fat thickness (18.1%). Factors associated with normal-weight central obesity as assesses by waist circumference were being female, of older age, and in full-time employment. Older age was associated with normal-weight central obesity as assessed by waist to hip ratio.Conclusion: The findings highlight a significant prevalence of normal-weight central obesity among adults in a poor urban setting in Kenya, pointing to women as a key target group for focused interventions. Longitudinal studies are needed to establish whether there is a link between normal-weight central obesity and mortality in such settings as has been found in other settings.

Highlights

Normal-weight central obesity is associated with higher mortality than general obesity as defined by body mass index, in the absence of central fat distribution
This study provides important estimates for the burden of and factors associated with normal-weight central obesity in two urban informal settlement communities in Nairobi under the AWI-Gen study [18], using different measures of central obesity
The results show a high burden of general obesity and a higher burden of normal-weight central obesity among older women in the communities suggesting the need for targeted interventions focusing on this vulnerable population

Summary

Introduction

Normal-weight central obesity is associated with higher mortality than general obesity as defined by body mass index, in the absence of central fat distribution. Obesity was considered a problem for developed countries; current research shows that obesity is increasing in low and middle-income countries, including in poor urban settings [1,2,3]. By 2014, about 13% of the world’s adult population (11% of men and 15% of women) and 39% of adults aged 18 years and over (38% of men and 40% of women) were obese and overweight, respectively. Two billion adults aged 18 years and older were overweight, and of those, over 600 million adults were obese. Many low- and middle-income countries, which are still struggling to address the problems of under-nutrition, are already facing a rapid upsurge of obesity and overweight, in their urban settings. In many urban settings of these countries, it is common to find co-existing obesity and undernutrition in the same community and even within the same household [4,5,6]

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