Abstract
There is a surge in chronic diseases in the developing world, driven by a high prevalence of cardio-metabolic risk factors. This study described differences in prevalence of obesity and cardio-metabolic risk factors between urban and rural settlements in the Ashanti Region of Ghana. This comparative cross-sectional study included 672 participants (median age 50 years), of which 312 were from Kumasi (urban) and 360 from Jachie-Pramso (rural). Demographic, anthropometric and other cardio-metabolic risk factors were gathered and venous blood samples were drawn for biochemical assays. Results suggested significant differences in diastolic blood pressure (80.0 mmHg vs 79.5 mmHg; p = 0.0078), and fasting blood sugar (5.0 mmo/l vs 4.5 mmol/l; p < 0.0001) between the two groups. Further differences in anthropometric measures suggested greater adiposity amongst participants in the urban area. Participants in the urban area were more likely than rural participants, to have high total cholesterol and LDL-c (p < 0.0001 respectively). Risk factors including BMI ≥ 25 (p < 0.0001), BMI ≥ 30 (p < 0.0001), high waist circumference (p < 0.0001), high waist-to-height ratio (p < 0.0001) and alcohol consumption (p = 0.0186) were more prevalent amongst participants in the urban area. Markers of adiposity were higher amongst females than males in both areas (p < 0.05). In the urban area, hypertension, diabetes and lifestyle risk factors were more prevalent amongst males than females. Differences in risk factors by urban / rural residence remained significant after adjusting for gender and age. Obesity and cardio-metabolic risk factors are more prevalent amongst urban settlers, highlighting an urgent need to avert the rise of diet and lifestyle-related chronic diseases.
Highlights
The increase in non-communicable and chronic diseases in the developing world is an issue of major concern and can lead to reduced quality of life and premature deaths [1]
The Body Mass Index (BMI), is the crude method of measure of overweight and obesity [11] but there are other popular but simple measures of obesity employed in recent times, which include the waist-to hip ratio (WHR), waist-to-height ratio (WHtR) and the percentage body fat (BF%) [5, 12], whose validity has been supported [13, 14]
This comparative cross-sectional study was conducted in two locations, Kumasi and JachiePramso, both located in the Ashanti Region of Ghana, from January to July 2013
Summary
The increase in non-communicable and chronic diseases in the developing world is an issue of major concern and can lead to reduced quality of life and premature deaths [1]. The prevalence of diabetes amongst adults in Africa as at 2010 was 3.8% and this is estimated to increase to 4.6% by the year 2030 [2]. The 1.2 million death toll attributed to cardiovascular diseases in Africa is expected to double by the year 2030 [3]. Prevalence of cardiovascular disease and diabetes is largely driven by cardio-metabolic risk factors such as smoking, lack of physical activity, low fruit and vegetable intake, high fat and salt intake, hypertension, abdominal obesity, dyslipidaemia, and excess alcohol intake [4]. Overweight and obesity (abnormal or excessive fat accumulation that presents a risk to health) are strong risk factors for cardio-metabolic and other chronic medical conditions [5,6,7], including hypertension [8] and dyslipidaemia [9, 10]. The Body Mass Index (BMI), is the crude method of measure of overweight and obesity [11] but there are other popular but simple measures of obesity employed in recent times, which include the waist-to hip ratio (WHR), waist-to-height ratio (WHtR) and the percentage body fat (BF%) [5, 12], whose validity has been supported [13, 14]
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