Restricted accessResearch articleFirst published online 2023-3
Sociodemographic and behavioural risk factors for obesity among community-dwelling older adults in Ghana and Nigeria: A secondary analysis of data from the SIREN study
To explore the prevalence and risk factors of obesity among older adults from low- and middle-income countries (LMICs).
Methods
This is a secondary analysis of data obtained from the SIREN study through in-person interviews and measurements from healthy stroke-free older adults (≥60 years). Overweight/obesity was defined as body mass index ≥25 kg/m2. Abdominal obesity was defined as waist-to-hip ratio (WHR) of >0.90 for males and >0.85/females or waist circumference (WC) of >102 cm for males/>88 cm for females. Adjusted odds ratio (aORs) with 95% confidence interval (CIs) of the relationship between obesity and sociodemographic factors were assessed at P< 0.05.
Results
Overall, 47.5% of participants were overweight/obese, 76.6% had a larger than recommended WHR, and 54.4% had a larger than recommended WC. Abdominal obesity (WC; aOR: 9.43, CI: 6.99–12.50), being a Nigerian (aOR: 0.55; CI: 0.42–0.72), living in an urban setting (aOR: 1.92; CI: 1.49–2.46), earning >$100/month (aOR: 1.53; CI: 1.19–1.96), and having formal education (aOR: 1.42; CI: 1.08–1.87) were associated with overweight/obesity.
Conclusion
Living in urban settings, earning a higher income, and having a formal education were associated with a higher odds of obesity among older adults from LMICs.
DerrickCCetinGN. BA Obesity in the elderly: more complicated than you think. Cleve Clin J Med2014; 81: 51–61. January 2014. DOI: 10.3949/ccjm.81a.12165.
2.
VillarealDTApovianCMKushnerRF, et al.Obesity in older adults: technical review and position statement of the American society for nutrition and NAASO, The obesity society. Am J Clin Nutr2005; 82: 923–934.
3.
SchmidtDSSalahudeenAK. Obesity-survival paradox-still a controversy?Semin Dial2007; 20: 486–492.
4.
AlbertiKGZimmetPShawJ. International diabetes federation: a consensus on type 2 diabetes prevention. Diabet Med2007; 24: 451–463.
5.
World Health Organization. Global status report on noncommunicable diseases 2014. WHO 2014 ; WHO/NMH/NVI/15.1. https://apps.who.int/iris/handle/10665/148114.
6.
LuppinoFSde WitLMBouvyPF, et al.Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry2010; 67: 220–229.
7.
DornerTERiederA. Obesity paradox in elderly patients with cardiovascular diseases. Int J Cardiol2012; 155: 56–65.
8.
World Health Organization. Obesity; Situation and Trends, http://www.who.int/gho/ncd/risk_factors/obesity_text/en/ (2017, accessed 28-Nov 2017 2017).
9.
World Health Organization. Obesity and overweight: Fact sheet, http://www.who.int/mediacentre/factsheets/fs311/en/ (2017, accessed 28-Nov 2017 2017).
10.
AmaryaSSinghKSabharwalM. Health consequences of obesity in the elderly. J Clin Gerontol Geriatr2014; 5: 63–67.
11.
YanLLDaviglusMLLiuK, et al.BMI And health-related quality of life in adults 65 years and older. Obes Res2004; 12: 69–76.
12.
HanTSTajarALeanMEJ. Obesity and weight management in the elderly. Br Med Bull2011; 97: 169–196.
13.
GouldingMRogersMSmithS. Trends in aging–United States and worldwide. Morb Mortal Wkly Rep2003; 52: 101–104. 106. 2003/03/21.
14.
FlegalKMKruszon-MoranDCarrollMD, et al.Trends in obesity among adults in the United States, 2005 to 2014Trends in obesity among adults in the United States, 2005 to 2014Trends in obesity Among adults in the United States, 2005 to 2014. JAMA2016; 315: 2284–2291.
15.
HajekALehnertTErnstA, et al.Prevalence and determinants of overweight and obesity in old age in Germany. BMC Geriatr2015; 15: 83.
16.
AdrianaG. Prevalence of obesity in a group of elderly. Eur Sci J2014; 10: 1857–7881. March 2014.
17.
NeriSGRGadelhaABCorreiaALM, et al.Association between obesity, risk of falls and fear of falling in older women. Rev Bras Cineantropometria Desempenho Humano2017; 19: 450–458.
18.
HoustonDKNicklasBJZizzaCA. Weighty concerns: the growing prevalence of obesity among older adults. J Am Diet Assoc2009; 109: 1886–1895.
19.
KyrouITsigosC. Obesity in the elderly diabetic patient. Diabetes Care2009; 32: S403.
20.
InelmenEMSergiGCoinA, et al.Can obesity be a risk factor in elderly people?Obes Rev2003; 4: 147–155.
21.
WangSRenJ. Obesity paradox in aging: from prevalence to pathophysiology. Prog Cardiovasc Dis2018; 61: 182–189.
22.
ToselliSGualdi-RussoEBoulosDNK, et al.Prevalence of overweight and obesity in adults from north Africa. Eur J Public Health2014; 24: 31–39.
23.
BoatengGOAdamsEAOdei BoatengM, et al.Obesity and the burden of health risks among the elderly in Ghana: a population study. PLoS One2017; 12: e0186947.
24.
NonterahEADebpuurCAgongoG, et al.Socio-demographic and behavioural determinants of body mass index among an adult population in rural northern Ghana: the AWI-Gen study. Glob Health Action2018; 11: 1467588.
25.
AyoguRNBNwajuakuCUdentaEA. Components and risk factors of metabolic syndrome among rural Nigerian workers. Niger Med J2019; 60: 53–61.
26.
OkekeECNnanyelugoDONgwuE. The prevalence of obesity in adults by age, sex, and occupation in anambra state, Nigeria. Growth1983; 47: 263–271. 1983/01/01.
27.
LarteySTMagnussenCGSiL, et al.Rapidly increasing prevalence of overweight and obesity in older Ghanaian adults from 2007 to 2015: evidence from WHO-SAGE waves 1 & 2. PLoS One2019; 14: e0215045.
28.
PriceAJCrampinACAmberbirA, et al.Prevalence of obesity, hypertension, and diabetes, and cascade of care in sub-saharan Africa: a cross-sectional, population-based study in rural and urban Malawi. Lancet Diabetes Endocrinol2018; 6: 208–222.
29.
AkpaluASarfoFSOvbiageleB, et al.Phenotyping stroke in Sub-saharan Africa: stroke investigative research and education network (SIREN) phenomics protocol. Neuroepidemiology2015; 45: 73–82.
30.
OwolabiMOSarfoFAkinyemiR, et al.Dominant modifiable risk factors for stroke in Ghana and Nigeria (SIREN): a case-control study. Lancet Glob Health2018; 6: e436–e446.
31.
AkpaluAGebregziabherMOvbiageleB, et al.Differential impact of risk factors on stroke occurrence Among Men versus women in West Africa. Stroke2019; 50: 820–827.
32.
FeiginVLRothGANaghaviM, et al.Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the global burden of disease study 2013. The Lancet Neurology2016; 15: 913–924.
33.
OkekunleAPWuXDuanW, et al.Dietary intakes of branched-chained amino acid and risk for type 2 diabetes in adults: the harbin cohort study on diet, nutrition and chronic Non-communicable diseases study. Can J Diabetes2018; 42: 484–492.e487.
34.
O'DDonnellMJChinSLRangarajanS, et al.Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. The Lancet2016; 388: 761–775.
35.
SarfoFSOvbiageleBGebregziabherM, et al.Stroke Among young West Africans. Stroke2018; 49: 1116–1122.
36.
Expert panel on detection E and treatment of high blood cholesterol in A. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA2001; 285: 2486–2497.
37.
FanHLiXZhengL, et al.Abdominal obesity is strongly associated with cardiovascular disease and its risk factors in elderly and very elderly community-dwelling Chinese. Sci Rep2016; 6: 21521–21521.
38.
AndersonCAMongraw-ChaffinM. Central obesity in older adults: what should Be the priority?J Am Heart Assoc2018; 7: e010119.
39.
DiehrPBildDEHarrisTB, et al.Body mass index and mortality in nonsmoking older adults: the cardiovascular health study. Am J Public Health1998; 88: 623–629. 1998/04/29.
40.
CooperJAManiniTMPatonCM, et al.Longitudinal change in energy expenditure and effects on energy requirements of the elderly. Nutr J2013; 12: 73.
41.
MooradianADHabibMPDickersonF. Effect of simple carbohydrates, casein hydrolysate, and a lipid test meal on ethane exhalation rate. J Appl Physiol (1985)1994; 76: 1119–1122. 1994/03/01.
42.
EliaMRitzPStubbsRJ. Total energy expenditure in the elderly. Eur J Clin Nutr2000; 54: S92–S103.
43.
SvendsenOLHassagerCChristiansenC. Age- and menopause-associated variations in body composition and fat distribution in healthy women as measured by dual-energy X-ray absorptiometry. Metab Clin Exp1995; 44: 369–373. 1995/03/01.
44.
AbubakariARLauderWAgyemangC, et al.Prevalence and time trends in obesity among adult West African populations: a meta-analysis. Obes Rev2008; 9: 297–311.
45.
CoggonDReadingICroftP, et al.Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord2001; 25: 622–627. 2001/05/22.
46.
Prevention CfDCa. State-specific prevalence of obesity among adults with disabilities–eight states and the district of Columbia, 1998–1999. Morb Mortal Wkly Rep2002; 51: 805–808. 2002/09/25.
47.
CohenSACookSKKelleyL, et al.A closer Look at rural-urban health disparities: associations between obesity and rurality vary by geospatial and sociodemographic factors. J Rural Health2017; 33: 167–179.
48.
HuFB. Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care2011; 34: 1249–1257.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
