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Assessment of Overweight, Obesity and Lifestyle-Related Factors Among Women Aged 18-49 Years in Kizinda, Bushenyi District

Kkunsa Hadson

Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda.

ABSTRACT

The trend of overweight and obesity was growing with shifts in individual and behavioral factors. Globally, overweight and obesity becoming a major problem, yet extensive data especially in Africa is still lacking. The objectives of the study were to determine the prevalence, socio-economic, and lifestyle-related factors associated with overweight and obesity among women aged 18-49 years in Kizinda in Bushenyi district. A cross-sectional analytical study design was used. Data on prevalence was collected through anthropometric measurements using the BMI (Body Mass Index) while those of socio-economic and individual factors were collected with a structured questionnaire. 271 women aged 18-49 years in Kizinda Trading Center, Bushenyi district were sampled. The prevalence of overweight and obesity among women of reproductive age in Bushenyi town was 47.24% and 19.92% respectively. Housewives were twice as likely to be overweighed and obese [AOR: 2.10, 95% CI (0.87-3.15)]. Unemployed women have 74% [AOR: 1.26, 95% CI (0.50-2.36)] higher odds of being overweight or obese and those who earn >700000 shillings have 37% [AOR: 1.63, 95% CI (0.56-2.25)] higher odds to be overweight and obese. Compared with women who live in rented houses, those who live in their own houses were 48% [AOR: 1.52, 95% CI (0.78-2.94)] higher odds of being overweight or obese. Women who engaged in physical activity had 65% [AOR: 0.35, 95% CI (0.17-1.27)] less odds of being overweight or obese compared to those who did not. Participants whose food intake is mostly rice and ghee had 55% [AOR: 1.45, 95% CI (0.40-1.27)] and 44% [AOR: 1.56, 95% CI (0.53-2.11)] more odds of being overweight or obese respectively compared to those who take Posho. Women whose food intake was mostly milk were two times [AOR: 2.01, 95% CI (0.55-2.75)] more likely to be overweighed or obese compared to those who take Posho. The high prevalence of overweight and obesity among women of reproductive age in Bushenyi calls for serious attention. Public health interventions through awareness programs about the consequences of overall and abdominal obesity should be implemented.

Keywords: Overweight, Obesity, Posho, Women, Housewives.

INTRODUCTION

Being overweight and obesity as well as associated comorbidities are major challenges to the health system and present an important public health problem in the world. Persons who are overweight are said to have their body weight exceed a certain level for a given body height. While excessive overweight on the other hand is referred to as obesity and classified as a disease [1, 2]. Obesity is a risk factor linked to chronic diseases such as type 2 diabetes mellitus [3, 4], and cardiovascular diseases [5]. It is also associated with a higher risk of premature death [6]. According to the World Health Organization, the prevalence of overweight has nearly tripled since 1975. [7]. Substantive evidence shows that the prevalence of overweight among children and adults has continued to increase. For instance, in 1980, the prevalence of overweight among men stood at 28.8 % this increased to 36.9 % in 2013 and among women from 29.8 % in the same year to 38.0 % in 2013 globally [3]. In 2014, the global prevalence of overweight and obesity among adults was estimated at 39 % (38 % of men and 40% of women) and 13% (11 % of men and 15 % of women) respectively. In 2016, more than 1.9 billion adults, 18 years and above were overweight. Of these, over 650 million were obese. Overall, about 13% of the world’s adult population (11% of men and 15% of women) were obese in the same year [7]. Across the WHO regions,  America has the highest prevalence of overweight and obesity standing at 61 % and 27 %, respectively, with the lowest reported in the South-East Asia  region  22 %  overweight  and  5%  obesity [8].  More than 50 % of women in the European, Eastern Mediterranean and American regions are overweight, with almost 50 % of the overweight women in the same regions being obese.  Specific  to  the  African,  Eastern Mediterranean  and  South-East  Asian  regions,  the  prevalence  of  obesity  among  women  has  almost  doubled  that  of  men[3].  In Africa, an  estimated  20-50  %  of  urban  populations  are  either  overweight  or  obese [9].  According to  WHO, the adult prevalence of  obesity in  Africa was about  6 %  among men and  15 %  among women in  2014 [4].  In Eastern sub-Saharan Africa (SSA), the prevalence of overweight and obesity among men was estimated at 14.9 % and 4.4 % in 2013 respectively. In the same year, the prevalence of overweight and obesity among women was estimated at 23.7 % and 8.8 %  respectively [10].  In Uganda, an increasing trend in the prevalence of overweight and obesity among women of reproductive age from 8 % in 1995 to 18.8 % in  2011 has been reported by the Uganda Demographic Health Surveys[11].Uganda’s recent national NCD risk factor survey reported 19.1 % adult prevalence of overweight (11.3 % of men  and  27.1 % of women); obesity was 4.6 % (1.8 % of men and 7.5 % of women) [12]; [13]. A study in rural south-western Uganda among individuals aged 13 years and above reported that 3.6 % of males and 14.5 % of females were overweight and 0.5 % of males and 3.9 % of females were obese [14]. Similarly, a study among 35–60 years old adults in rural eastern Uganda reported overweight prevalence of 12.3 % (7.5 % of men and 16.9 % of women) and obesity of 5.3 % (2.2 % of men and 8.2 % of women) [15]. In south western Uganda, the prevalence of overweight of 11.8% in men and 16.9  %  of women was reported [16].  Notably was a study in Kasese district which reported that among adults aged  25  years  and  more,  overweight was 15.6 % (14.7 % of men and 16.7 % of women) and obesity was 6.7 % (4.9 % of men and 9.0 % of women) [17]. The trend of overweight and obesity is growing with shifts in  individual and behavioral factors [18]. Individual factors such as age, sex, marital status and parity, educational level, income and occupation have been reported to play important roles in the development of overweight and obesity among women [19]. Dietary intake and physical activity patterns of an individual are behavioral variables which influences weight gain when they are not balanced [19]. In Uganda, the nutritional transition taking place is not different from other low and middle income countries, and is associated with accelerating growth of chronic, non-communicable diseases [20]. This study therefore sought to assess overweight, obesity and lifestyle-related factors among women aged 18-49 in Kizinda, Bushenyi district.

The prevalence of overweight and obesity are on the rise worldwide [21]. While underweight prevalence is still high, overweight and obesity are now prevalent in low- and middle-income countries, including those in Africa [2], at a prevalence of 20–50 % [22],  in urban areas and 7–30 % in rural areas [15]. Underweight, overweight and obesity are known risk factors for NCDs [23]. Similarly, the Uganda Demographic and Health Surveys (UDHS) from 1995 to 2011 reported an increasing prevalence of overweight and obesity from 8 to 18.8 % while underweight prevalence stagnated at 10 – 12 % [24].  However, evidence examining the influence of the individual, social-economic as well as environment on overweight/obesity is still sketchy and limited to urban and suburban populations in high-income countries which cannot be generalized to low- and middle-income countries and this is even true in rural settings. In Bushenyi district, there is paucity of research data regarding overweight/obesity and lifestyle-related factors among women which this study investigated in Kizinda.

CONCLUSION

The findings of this study showed that majority of the women in Bushenyi town are either overweight, obese or both. This implies that due to their sedentary lifestyles and consistent consumption of fatty and starchy food from milk and carbohydrates will continue to have a toll of the women and their health. Being a housewife, unemployed, earning high and owning a house (s) were socio-economic factors associated with overweight and obesity.Living sedentarily, taking carbohydrates and milk, consuming alcohol (AOR = 2.134) and not exercising often are lifestyle-related factors associated with overweight and obesity.

REFERENCES

  1. Lazzari, C., Shoka, A., Nusair, A., & Rabottini, M. Weight gain and obesity in general adult psychiatric inpatients: a longitudinal and cross-sectional study. Rivista di Psichiatria, 2021; 56(4), 211-216.
  2. Adeoye, A. O., Adebayo, I. A., & Ajijolakewu, K. A. Roles of Phytometabolites in the Management of Obesity. Medicinal and Aromatic Plants: Healthcare and Industrial Applications, 2021; 353-372.
  3. Alum, E. U., Ugwu, O. P. C., Obeagu, E. I., Aja, P. M., Ugwu, C. N., Okon, M.B. Nutritional Care in Diabetes Mellitus: A Comprehensive Guide. International Journal of Innovative and Applied Research. 2023; 11(12):16-25. Article DOI: 10.58538/IJIAR/2057DOIURL: http://dx.doi.org/10.58538/IJIAR/2057.
  4. Alum, E. U., Umoru, G. U., Uti, D. E., Aja, P. M., Ugwu, O. P. C., Orji, O. U., et al. Hepato-protective effect of Ethanol Leaf Extract of Datura stramonium in Alloxan-induced Diabetic Albino Rats. Journal of Chemical Society of Nigeria. 2022; 47 (3): 1165 – 1176. https://doi.org/10.46602/jcsn.v47i5.819.
  5. Uti, D.E., Ibiam, U.A., Omang, W.A., Udeozor, P.A., Umoru, G.U., Nwadum, S.K., Bawa, I., Alum, E.U., Mordi, J.C., Okoro, E.O., Obeten, U.N., Onwe, E.N., Zakari, S., Opotu, O.R., Aja, P.M.: Buchholzia coriacea Leaves Attenuated Dyslipidemia and Oxidative Stress in Hyperlipidemic Rats and Its Potential Targets In Silico. Pharmaceutical Fronts. (2023). https://doi.org/10.1055/s-0043-1772607
  6. Peer, N., Lombard, C., Steyn, K., Gwebushe, N., Levitt, N.: Differing patterns of overweight and obesity among black men and women in Cape Town: The CRIBSA study. PLoS ONE. 9,(2014).https://doi.org/10.1371/journal.pone.0107471
  7. WHO: Obesity and overweight Factsheet No. 311,http://www.who.int/mediacentre/factsheets/fs311/en/%0Ahttp://who.int/mediacentre/factsheets/fs311/en/
  8. Peltzer, K., Pengpid, S., Alafia Samuels, T., ??zcan, N.K., Mantilla, C., Rahamefy, O.H., Wong, M.L., Gasparishvili, A.: Prevalence of overweight/obesity and its associated factors among university students from 22 countries. International Journal of Environmental Research and Public Health. 11, 7425–7441 (2014). https://doi.org/10.3390/ijerph110707425
  9. Kandala, N.B., Stranges, S.: Geographic variation of overweight and obesity among women in Nigeria: A case for nutritional transition in Sub-Saharan Africa. PLoS ONE. 9,(2014).https://doi.org/10.1371/journal.pone.0101103
  10. Abrha, S., Shiferaw, S., Ahmed, K.Y.: Overweight and obesity and its socio-demographic correlates among urban Ethiopian women: Evidence from the 2011 EDHS. BMC Public Health. 16, (2016). https://doi.org/10.1186/s12889-016-3315-3
  11. UBOS: Uganda demographic and health survey 2011. Uganda Demographic and Health Survey. 1–45 (2011)
  12. MOH: Non- Communicable Disease Risk Factor Baseline Survey UGANDA 2014 REPORT MINISTRY OF HEALTH. (2014)
  13. Wesonga, R., Guwatudde, D., Bahendeka, S.K., Mutungi, G., Nabugoomu, F., Muwonge, J.: Burden of cumulative risk factors associated with non-communicable diseases among adults in Uganda: evidence from a national baseline survey. International Journal for Equity in Health. 1–10 (2016). https://doi.org/10.1186/s12939-016-0486-6
  14. Murphy, G.A.V., Asiki, G., Young, E.H., Seeley, J., Nsubuga, R.N., Sandhu, M.S., Kamali, A.: Cardiometabolic risk in a rural ugandan population (Diabetes Care (2013) 36 (e143)), (2014)
  15. Kirunda, B.E., Fadnes, L.T., Wamani, H., den Broeck, J., Tylleskär, T.: Population-based survey of overweight and obesity and the associated factors in peri-urban and rural Eastern Uganda. BMC Public Health. 15, 1–11 (2015). https://doi.org/10.1186/s12889-015-2506-7
  16. Asiki, G., Murphy, G., Nakiyingi-Miiro, J., Seeley, J., Nsubuga, R.N., Karabarinde, A., Waswa, L., Biraro, S., Kasamba, I., Pomilla, C., Maher, D., Young, E.H., Kamali, A., Sandhu, M.S.: The general population cohort in rural south-western Uganda: a platform for communicable and non-communicable disease studies. International journal of epidemiology. 42,129–41(2013). https://doi.org/10.1093/ije/dys234
  17. Mondo, C.K., Otim, M.A., Akol, G., Musoke, R., Orem, J.: The prevalence and distribution of non-communicable diseases and their risk factors in Kasese district, Uganda. Cardiovascular journal of Africa. 24, 52–7 (2013). https://doi.org/10.5830/CVJA-2012-081
  18. Mosha, T.C.E., Fungo, S.: Prevalence of overweight and obesity among children aged 6-12 years in Dodoma and Kinondoni municipalities, Tanzania. Tanzania Journal of Health Research. 12, 1 (2010). https://doi.org/10.4314/thrb.v12i1.56202
  19. Mbochi, R.W., Kuria, E., Kimiywe, J., Ochola, S., Steyn, N.P.: Predictors of overweight and obesity in adult women in Nairobi Province, Kenya. BMC Public Health. 12, 823 (2012). https://doi.org/10.1186/1471-2458-12-823
  20. Schwartz, J.I., Guwatudde, D., Nugent, R., Kiiza, C.M.: Looking at non-communicable diseases in Uganda through a local lens : an analysis using locally derived data. 1–9 (2014). https://doi.org/10.1186/s12992-014-0077-5
  21. Ogden, C.L., Fakhouri, T.H., Carroll, M.D., Hales, C.M., Fryar, C.D., Li, X., Freedman, D.S.: Prevalence of Obesity Among Adults, by Household Income and Education — United States, 2011–2014. MMWR. Morbidity and Mortality Weekly Report. 66, 1369–1373 (2017). https://doi.org/10.15585/mmwr.mm6650a1
  22. Yoo, E.G.: Waist-to-height ratio as a screening tool for obesity and cardiometabolic risk, (2016)
  23. Ofori-Asenso, R., Agyeman, A.A., Laar, A., Boateng, D.: Overweight and obesity epidemic in Ghana—a systematic review and meta-analysis. BMC Public Health. 16, 1239 (2016). https://doi.org/10.1186/s12889-016-3901-4
  24. UBOs, U.B. of S.-, International, I.C.F.: Uganda Demographic and Health Survey 2011. (2012)
  25. Jung, S.-H.: Stratified Fisher’s exact test and its sample size calculation. Biometrical Journal. 56, 129–140 (2014). https://doi.org/10.1002/bimj.201300048
  26. WHO: Obesity and Overweight, http://www.who.int/mediacentre/factsheets/fs311/en/index.html
  27. Mayega, R.W., Makumbi, F., Rutebemberwa, E., Peterson, S., Östenson, C.-G., Tomson, G., Guwatudde, D.: Modifiable Socio-Behavioural Factors Associated with Overweight and Hypertension among Persons Aged 35 to 60 Years in Eastern Uganda. PLOS ONE. 7, e47632(2012).https://doi.org/10.1371/journal.pone.0047632
  28. Gomes, A., Damasceno, A., Azevedo, A., Prista, A., Silva-Matos, C., Saranga, S., Lunet, N.: Body mass index and waist circumference in Mozambique: urban/rural gap during epidemiological transition. Obes Rev. 11, 627–634 (2010). https://doi.org/10.1111/j.1467-789X.2010.00739.x
  29. Samadoulougou, S., Diallo, M., Cissé, K., Ngwasiri, C., Aminde, L.N., Kirakoya-Samadoulogou, F.: High Urban-Rural Inequities of Abdominal Obesity in Malawi: Insights from the 2009 and 2017 Malawi Noncommunicable Disease Risk Factors Surveys. Int J Environ Res Public Health. 19, 11863(2022).https://doi.org/10.3390/ijerph191911863
  30. Rudatsikira, E., Muula, A.S., Mulenga, D., Siziya, S.: Prevalence and correlates of obesity among Lusaka residents, Zambia: a population-based survey. Int Arch Med. 5, 14 (2012). https://doi.org/10.1186/1755-7682-5-14
  31. Kamadjeu, R.M., Edwards, R., Atanga, J.S., Kiawi, E.C., Unwin, N., Mbanya, J.C.: Anthropometry measures and prevalence of obesity in the urban adult population of Cameroon: An update from the Cameroon Burden of Diabetes Baseline Survey. BMC Public Health. 6, (2006). https://doi.org/10.1186/1471-2458-6-228
  32. Karki, A., Shrestha, A., Subedi, N.: Prevalence and associated factors of childhood overweight/obesity among primary school children in urban Nepal. BMC Public Health. 19,1055(2019).https://doi.org/10.1186/s12889-019-7406-9
  33. Rehm, C.D., Moudon, A. V, Hurvitz, P.M., Drewnowski, A.: Residential property values are associated with obesity among women in King County, WA, USA. Social science & medicine (1982). 75, 491–5 (2012). https://doi.org/10.1016/j.socscimed.2012.03.041
  34. Cohen, S.S., Matthews, C.E., Signorello, L.B., Schlundt, D.G., Blot, W.J., Buchowski, M.S.: Sedentary and Physically Active Behavior Patterns Among Low-Income African-American and White Adults Living in the Southeastern United States. PLoS One. 8, e59975(2013).https://doi.org/10.1371/journal.pone.0059975
  35. Traversy, G., Chaput, J.-P.: Alcohol Consumption and Obesity: An Update. Curr Obes Rep. 4, 122–130 (2015). https://doi.org/10.1007/s13679-014-0129-4
  36. Aja, P. M., Igwenyi, I. O., Okechukwu, P. U., Orji, O. U., & Alum, E. U. Evaluation of anti-diabetic effect and liver function indices of ethanol extracts of Moringa oleifera and Cajanus cajan leaves in alloxan induced diabetic albino rats. Global Veterinaria, 14(3), 439-447(2015).
  37. Ugwu. O.P.C, and Amasiorah, V. I. The In Vivo Antioxidant Potentials of the Crude Ethanol Root Extract and Fractions of Sphenocentrum jollyanum on Oxidative Stress Indices in Streptozotocin-Induced Diabetic albino rats. IDOSR Journal Of Biology, Chemistry and Pharmacy, 5(1), 26-35(2020).
  38. Enechi, O. C., Oluka, I. H., Ugwu, O. P., & Omeh, Y. S. Effect of ethanol leaf extract of Alstonia boonei on the lipid profile of alloxan induced diabetic rats. World Journal Of Pharmacy and Pharmaceutical Sciences, 2(3), 782-795 (2013).
  39. Ude C.M. and T.J. Iornenge M.C. Udeh Sylvester, O.F.C. Nwodo, O.E. Yakubu, E.J. Parker, S. Egba, E. Anaduaka, V.S. Tatah, O.P. Ugwu, E.M. Ale (2022). Effects of Methanol Extract of Gongronema latifolium Leaves on Glycaemic Responses to Carbohydrate Diets in Streptozotocin-induced Diabetic Rats. Journal of Biological Sciences, 22. 70-79. https://ascidatabase.com/
  40. Ugwu Okechukwu, P. C., Nwodo Okwesili, F. C., Joshua Parker, E., Odo Christian, E., & Ossai Emmanuel, C.. Effect of ethanol leaf extract of Moringa oleifera on lipid profile of mice. Research Journal of Pharmaceutical, Biological and Chemical Sciences, 4(1), 1324-1332 (2013).
  41. Enechi, O. C., Manyawo, L., & Ugwu, P. O. Effect of ethanol seed extract of Buccholzia coriacea (wonderful kola) on the lipid profile of albino rats. African Journal of Biotechnology, 12(32) (2013).
  42. Ugwu Okechukwu, P. C., Onwe, S. C., & Okon, M. B. The effect of Methanol Extract of Rauwolfia vomitoria on Lipid Profile of Chloroform intoxicated Wistar Albino Rats. IAA Journal of ScientificResearch,8(1),73-82 (2022).
  43. Aja, P. M., Ibekwe, V. I., Ekpono, E. U., Ugwu, P. C. and Okechukwu, P. C. Effect of ethanol extract of Cajanus cajan leaf on plasma lipid level in albino rats. Inter J Cur Res Acad Rev, 3(1), 161-167 (2015).
  44. Ugwu O.P.C. and Amasiorah, V. I.The effects of crude ethanol root extract and fractions of sphenocentrum jollyanum on the lipid profile of streptozotocin-induced diabetic wistar albino rats. IDOSR Journal of Biology, Chemistry And Pharmacy, 5(1), 36-46 (2020).
  45. Anaduaka, E. G., Egba, S. I., Ugwu, J. U., Apeh, V. O., & Ugwu, O. P. C. Effects of dietary tyrosine on serum cholesterol fractions in rats. Afr J Biochem Res, 8(5), 95e100(2014).
  46. Eze-Steven, P. E., Udeozo, I. P., Chidiebere, E. U., Emmanuel, O., Okechukwu, P. U., & Egba, J. J.. Anti-Lipidemic Effects of Desmodium velutinum Water Leaf Exract on Albino Wistar Rats Fed with High Fat Diet. American-Eurasian Journal of Scientific Research, 9(2), 26-30 (2014).
  47. Ezekwe, C. I., Okorie, A., Ugwu O. P.C, Nwodo O.F.C. and, E.S.C Blood Pressure Lowering Effect of Extract of Gongronema latifolium. Research Journal of Pharmaceutical, Biological and Chemical Sciences, 5(2), 952-959 (2014).

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