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      Overweight and obesity among women: analysis of demographic and health survey data from 32 Sub-Saharan African Countries

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      Author(s): , ,
      Publication date (Electronic):
      Journal: BMC Public Health
      Publisher: BioMed Central
      Keywords: Overweight, Obesity, Women, BMI, DHS, Sub-Saharan Africa

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          Abstract

          Background

          Overweight and obesity are risk factors for many chronic diseases globally. However, the extent of the problem in low-income countries like Sub-Saharan Africa is unclear. We assessed the magnitude and disparity of both phenomena by place of residence, level of education and wealth quintile using cross-sectional data from 32 countries.

          Methods

          Demographic and Health Survey (DHS) data collected in 32 Sub-Saharan African countries between January 2005 and December 2013 were used. A total of 250651 women (aged 15–49 years) were analyzed. Trained personnel using a standardized procedure measured body weight and height. Body mass index (BMI) was calculated by dividing body weight by height squared. Prevalence of overweight (25.0–29.9 kg/m 2) and obesity (≥30.0 kg/m2) were estimated for each country. Analysis of the relationships of overweight and obesity with place of residence, education and wealth index were carried out using logistic regression.

          Results

          The pooled prevalence of overweight for the region was 15.9 % (95 % CI, 15.7–16.0) with the lowest in Madagascar 5.6 % (95 % CI, 5.1–6.1) and the highest in Swaziland 27.7 % (95 % CI, 26.4–29.0). Similarly, the prevalence of obesity was also lowest in Madagascar 1.1 % (95 % CI, 0.9–1.4) and highest in Swaziland 23.0 (95 % CI, 21.8–24.2). The women in urban residence and those who were classified as rich, with respect to the quintile of the wealth index, had higher likelihood of overweight and obesity. In the pooled results, high education was significantly associated with overweight and obesity.

          Conclusions

          The prevalence of overweight and obesity varied highly between the countries and wealth index (rich vs. poor) was found to be the strongest predictor in most of the countries. Interventions that will address the socio-cultural barriers to maintaining healthy body size can contribute to curbing the overweight and obesity epidemic in Africa.

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          Most cited references23

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          Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

          Marie Ng, Tom Fleming, Margaret W. Robinson … (2015)
          In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

            Stephen S Lim, Theo Vos, Abraham D. Flaxman … (2012)
            The Lancet, 380(9859), 2224-2260
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              The obesity epidemic in the United States--gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis.

              Youfa Wang, May Beydoun (2007)
              This review of the obesity epidemic provides a comprehensive description of the current situation, time trends, and disparities across gender, age, socioeconomic status, racial/ethnic groups, and geographic regions in the United States based on national data. The authors searched studies published between 1990 and 2006. Adult overweight and obesity were defined by using body mass index (weight (kg)/height (m)(2)) cutpoints of 25 and 30, respectively; childhood "at risk for overweight" and overweight were defined as the 85th and 95th percentiles of body mass index. Average annual increase in and future projections for prevalence were estimated by using linear regression models. Among adults, obesity prevalence increased from 13% to 32% between the 1960s and 2004. Currently, 66% of adults are overweight or obese; 16% of children and adolescents are overweight and 34% are at risk of overweight. Minority and low-socioeconomic-status groups are disproportionately affected at all ages. Annual increases in prevalence ranged from 0.3 to 0.9 percentage points across groups. By 2015, 75% of adults will be overweight or obese, and 41% will be obese. In conclusion, obesity has increased at an alarming rate in the United States over the past three decades. The associations of obesity with gender, age, ethnicity, and socioeconomic status are complex and dynamic. Related population-based programs and policies are needed.
              Article 0 comments Cited 639 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Subas Neupane: subas.neupane@uta.fi
                Prakash K.C.: Prakash.kc@uta.fi
                David Teye Doku: +233248940731 , dokudavid@gmail.com
                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2458
                Publication date (Electronic): 13 January 2016
                Publication date PMC-release: 13 January 2016
                Publication date Collection: 2015
                Volume: 16
                Electronic Location Identifier: 30
                Affiliations
                [ ]School of Health Sciences, FI – 33014 University of Tampere, Tampere, Finland
                [ ]Department of Population and Health, University of Cape Coast, Private Mail Bag, University Post Office, Cape Coast, Ghana
                Article
                Publisher ID: 2698
                DOI: 10.1186/s12889-016-2698-5
                PMC ID: 4710980
                PubMed ID: 26758204
                SO-VID: c2604515-6bae-4fd8-905e-7c915368aa83
                Copyright © © Neupane et al. 2016
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 24 July 2015
                Date accepted : 7 January 2016
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2016

                ScienceOpen disciplines: Public health
                Keywords: overweight,obesity,women,bmi,dhs,sub-saharan africa
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: overweight, obesity, women, bmi, dhs, sub-saharan africa

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