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.
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.
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.
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