Gender differences in sociodemographic and behavioural factors associated with BMI in an adult population in rural Burkina Faso – an AWI-Gen sub-study

Abstract

Background: The global health transition is linked with an increased burden of non-communicable diseases with cardiovascular diseases leading the epidemic. In sub-Saharan Africa (SSA), the prevalence of obesity has increased during the past decades and there is a need to investigate the associated driving factors. In Burkina Faso obesity remains low, especially in rural areas. In this study we recruited middle-aged adults, as part of a larger study on genetic and environmental contributions to cardiometabolic disease among Africans. Objectives: To investigate the distribution of BMI and prevalence of obesity in a cross-sectional population-based study and to determine the sociodemographic and behavioural correlates with BMI. Methods: Participants (N = 2,076) were recruited from the Nanoro Health and Demographic Surveillance System area and were aged 40–60 years. We applied hierarchical modelling to identify factors associated with BMI and structural equation modelling to identify mediated effects of sociodemographic and behavioural variables on BMI. Results: Data are presented on 2,076 participants (49.9% female). Men had significantly higher BMI than women with medians of 21.1 (19.2 – 23.4) vs 19.8 (18.1 – 21.6) (p < 0.001), and there were significantly more underweight women compared to men (31.0% vs 17.4%) (p < 0.001). More men were overweight and obese than women (11.9% vs 5.2% and 2.2% vs 1.4%). Socioeconomic status was the major contributor to increased BMI for men, and education was the main contributor in women. Tobacco smoking and chewing, and problematic alcohol consumption were associated with a decrease in BMI in men and women. Conclusion: Overweight and obesity are relatively low among adults in rural Burkina Faso, and men had a higher median BMI than women. Behavioural factors, including tobacco use and alcohol consumption, contributed to a decrease in BMI, whereas socioeconomic status and education (which were both generally low in this community) contributed to an increase in BMI.

Regional and sex-specific variation in BMI distribution in four sub-Saharan African countries: The H3Africa AWI-Gen study

“…lean, overweight and obesity between the six AWI-Gen Centres. In the accompanying set of papers, including one from each Centre, the risk factors and correlates with obesity were examined [7][8][9][10][11][12]. At five of the six study sites women had significantly higher BMI compared to men, whereas in Nanoro, men had higher BMI.…”

“…Marital status: Being married or co-habiting is associated with higher BMI. Details for each study site are provided in the Special Issue [7][8][9][10][11][12].…”

“…In the Human Heredity and Health in African (H3Africa) Consortium AWI-Gen Study (Africa Wits-INDEPTH partnership for Genomic studies) we have collected data from 10,702 participants between the ages of 40 and 60 years, from six study sites in four African countries [5,6]. In this special issue of Global Health Action, each of the six AWI-Gen participant Centres has reported individually on the distribution of BMI and its determinants [7][8][9][10][11][12]. They have analysed BMI in the context of participant socio-demographic factors (sex, age, ethnicity, educational status, employment, household assets, partner/marital status), behaviour (smoking/ tobacco exposure, alcohol consumption and exercise) and other environmental factors (infections and pesticide exposure), and used an hierarchical modelling approach, and in one case multiple linear regression, to examine their association with BMI.…”

The H3Africa Consortium: Publication Outputs of a Pan-African Genomics Collaboration (2013 to 2020)

“…In this section we describe 25 publications that examined and compared the distributions of several traits and associated risk factors, including body mass index (BMI), obesity, stroke, carotid intima-media thickness (cIMT) and hypertension. A series of publications described the BMI distribution and obesity in older adults in a population cross-sectional study by the AWI-Gen group, and included data from over 10,000 individuals sampled from six centres, both rural and urban, across four African countries, (Ramsay et al, 2016;Ramsay et al, 2018;Asiki et al, 2018;Haregu et al, 2018;Micklesfield et al, 2018;Wagner et al, 2018;Boua et al, 2018;Nonterah et al, 2018;Mohamed et al, 2019;Mashinya et al, 2018). These studies emphasised differences in the BMI distribution among East, West and South African populations, with higher BMI in the South and East, compared to the West (Ramsay et al, 2018).…”

Patterns of adult body mass in sub-Saharan Africa

“…HIV, malaria and tuberculosisin combination with the effects of clinical treatments and approaches to these epidemics in different African countriescontribute to body composition and at a population level will influence the prevalence and morbidity associated with obesity. The site-specific papers presented in this Special Issue [8][9][10][11][12][13] make important contributions to understanding some of the correlates with obesity in six communities in four African countries, highlighting the diversity of contributing factors and revealing some interesting regional differences. From a public health perspective it is clear that interventions to address the sequelae of increases in obesity in several African countries will require careful assessment and targeted strategies, informed by good quality data.…”