Geographic variation of overweight and obesity among women in Nigeria : a case for nutritional transition in sub-saharan Africa

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Kandala, Ngianga-Bakwin ; Stranges, Saverio (2014)
  • Publisher: Public Library of Science
  • Journal: PLoS ONE, volume 9, issue 6 (eissn: 1932-6203)
  • Related identifiers: doi: 10.1371/journal.pone.0101103, doi: 10.1371/journal.pone.0101103, pmc: PMC4076212
  • Subject: Global Health | Research Article | Biology and Life Sciences | RA0421 | Physiology | HQ | RA | Body Weight | Epidemiology | RC | Nutrition | Population Biology | Physiological Parameters | Public and Occupational Health | Spatial Epidemiology | Medicine and Health Sciences | Obesity

Background: Nutritional research in sub-Saharan Africa has primarily focused on under-nutrition. However, there is evidence of an ongoing nutritional transition in these settings. This study aimed to examine the geographic variation of overweight and obesity prevalence at the state-level among women in Nigeria, while accounting for individual-level risk factors.\ud \ud Methods: The analysis was based on the 2008 Nigerian Demographic and Health Survey (NDHS), including 27,967 women aged 15–49 years. Individual data were collected on socio-demographics, but were aggregated to the country's states. We used a Bayesian geo-additive mixed model to map the geographic distribution of overweight and obesity at the state-level, accounting for individual-level risk factors.\ud \ud Results: The overall prevalence of combined overweight and obesity (body mass index ≥25) was 20.9%. In multivariate Bayesian geo-additive models, higher education [odds ratio (OR) & 95% Credible Region (CR): 1.68 (1.38, 2.00)], higher wealth index [3.45 (2.98, 4.05)], living in urban settings [1.24 (1.14, 1.36)] and increasing age were all significantly associated with a higher prevalence of overweight/obesity. There was also a striking variation in overweight/obesity prevalence across ethnic groups and state of residence, the highest being in Cross River State, in south-eastern Nigeria [2.32 (1.62, 3.40)], the lowest in Osun State in south-western Nigeria [0.48 (0.36, 0.61)].\ud \ud Conclusions: This study suggests distinct geographic patterns in the combined prevalence of overweight and obesity among Nigerian women, as well as the role of demographic, socio-economic and environmental factors in the ongoing nutritional transition in these settings.
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