Obesity epidemic in urban Tanzania: a public health calamity in an already overwhelmed and fragmented health system

Abstract

Background Worldwide, the epidemiological and demographic transitions have resulted in nutrition shift characterized by an increased consumption of high energy fast food products. In just over 3 decades, overweight and obesity rates have nearly tripled to currently affecting over a third of the global population. Notwithstanding the ever present under-nutrition burden, sub Saharan Africa (SSA) is witnessing a drastic escalation of overweight and obesity. We aimed to explore the prevalence and associated factors for obesity among residents of Dar es Salaam city in Tanzania. Methods Participants from this study were recruited in a community screening conducted during the Dar es Salaam International Trade Fair. Sociodemographic and clinical data were gathered using a structured questionnaire during enrollment. Dietary habits and anthropometric measurements were assessed using standard methods. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student’s T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with BMI ≥ 25. All tests were 2-sided and p < 0.05 was used to denote a statistical significance. Results A total of 6691 participants were enrolled. The mean age was 43.1 years and males constituted 54.2% of all participants. Over two-thirds of participants were alcohol consumers and 6.9% had a positive smoking history. 88.3% of participants were physically inactive, 4.7% had a history of diabetes mellitus and 18.1% were known to have elevated blood pressure. Overweight and obesity were observed in 34.8 and 32.4% of participants respectively. Among overweight and obese participants, 32.8% had a misperception of having a healthy weight. Age ≥ 40, female gender, a current working status, habitual breakfast skipping, poor water intake, high soft drink consumption, regular fast food intake, low vegetable and fruit consumption, alcohol consumption and hypertension were found to be independent associated factors for obesity. Conclusion Amidst the ever present undernutrition in SSA, a significant proportion of participants had excess body weight. Concomitantly, the rates of physical inactivity and unhealthy eating are disproportionately high in Dar es Salaam. In view of this, community-based and multilevel public health strategies to promote and maintain healthy eating and physical activity require an urgent step-up in urban Tanzania.

Non-Communicable Disease Risk Factors Among Caregivers of Patients Attending a Tertiary Cardiovascular Hospital in Tanzania

“…Reported by about 3% of participants in this study, tobacco use was the least prevalent risk factor in this setting. Similar tobacco use rates have been reported in Dar es Salaam city by a couple of previous community-based studies, 32 , 33 however, as per the WHO statistics of 2017 at least 14% of Tanzanian adults were current tobacco users. 34 Variable rates of tobacco use ranging from 2.9% in Nigeria to 49.9% in Bangladesh are reported by studies conducted in different communities.…”

“…54 With the rapidly rising rates of overweight, hypertension and diabetes in Tanzania, it is increasingly becoming evident that the soaring rates of consumption of highly processed foods together with low levels of physical activity are playing a dominant role in the NCD epidemic. 33 , 55 , 56 Nonetheless, despite the wide variability in the rates of unhealthy eating (41.9–99.7%) and low physical activity (14.5–86.4%) from studies worldwide, the message is clear that both risks are increasing at a staggering rate. 12 , 15 , 23–28 , 35–46 , 49–51 , 57 , 58 …”

Food Environment in and around Primary School Children’s Schools and Neighborhoods in Two Urban Settings in Kenya

“…The percentage of prepared food sources that served healthy food options were quite similar across the two cities. Food retail outlets' HFAS ranged from 0 to 11 with a median of 2 (1,5). The HFAS in Nairobi-based retail outlets were significantly higher than in Kisumu-based outlets [a median of 4 (2, 7) versus a median of 1 (1, 2), p-value < 0.0001].…”

“…Countries in the East African region are undergoing a nutrition transition with increasing prevalence of overweight and obesity among different population groups [ 1 , 2 , 3 , 4 , 5 ]. The most recent nationally-representative demographic health survey conducted in Kenya in 2014 showed that 23% of women of reproductive age were overweight while 10% were obese [ 1 ].…”

Nutrition Behavior and Body Mass Index in Tanzania. Survey from a Cancer Prevention and Awareness Campaign in Northern Tanzania, 2019‪-‬ 2020‬‬‬‬

“…Questionnaires were used as the data collection tool. BMI, according to the World Health Organization standard measurements, was assessed with scale and measure tape [23].…”