Abstract
ABSTRACTBackground: Obesity and associated cardiometabolic diseases are increasing in urban sub-Saharan Africa due to a complex epidemiological and nutritional transition. Related data on rural communities is scarce.Objectives: The study characterized the socio-demographic and behavioural factors influencing body mass index (BMI) among adults in rural Northern GhanaMethods: A population-based cross-sectional study involving adults aged 40–60 years residing in the Kassena-Nankana districts was undertaken. Demographic, socio-economic and behavioural data were collected along with measures of anthropometry. We determined factors associated with BMI among women and men.Results: A total of 2014 adults were studied. The median age was 51 (IQR 45–57) years and 54% were women. The prevalence of overweight/obesity was higher among women than men (18.4% vs. 7.2%; p < 0.001), whilst underweight was more prevalent in men (18.3% vs. 13.1%; p = 0.001). Participants with the highest level of education and a high household socio-economic status had higher BMIs than those in the lowest strata in both men (β = 0.074, p = 0.028 and β = 0.072, p < 0.001, respectively) and women (β = 0.174, p = 0.001 and β = 0.109, p < 0.001, respectively). Men (β = −0.050; p < 0.001) and women (β = −0.073; p < 0.001) of the Nankana ethnic group had a lower BMI than the Kassena ethnic group. Among men, alcohol consumption (β = −0.021; p = 0.001) and smoking (β = −0.216; p < 0.001) were associated with lower BMI. Smokeless tobacco was associated with lower BMI among women. Pesticide exposure was associated with higher BMI (β = 0.022; p = 0.022) among men.Conclusion: Age, sex, ethno-linguistic group and prevailing socio-demographic and behavioural factors within this rural community in Northern Ghana influence BMI. The observed positive association between pesticide use and BMI warrants further investigation.
Highlights
Obesity and associated cardiometabolic diseases are increasing in urban subSaharan Africa due to a complex epidemiological and nutritional transition
The prevalence of overweight/obesity was higher among women than men (18.4% vs. 7.2%; p < 0.001), whilst underweight was more prevalent in men (18.3% vs. 13.1%; p = 0.001)
Pesticide exposure was associated with higher body mass index (BMI) (β = 0.022; p = 0.022) among men
Summary
Obesity and associated cardiometabolic diseases are increasing in urban subSaharan Africa due to a complex epidemiological and nutritional transition. Cardiometabolic diseases have become a major global health concern and are increasing in subSaharan Africa (SSA) [1,2]. Countries in SSA are at different stages of the transition, with the majority moving from under- to over-nutrition [3,4,5]. This is largely due to the consumption of energy-rich foods and falling levels of energy expenditure [6]. The overall contribution of malnutrition (both over-nutrition and under-nutrition) and Supplemental data for this article can be accessed here
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