Overweight and Obesity in Kaoma and Kasama Rural Districts of Zambia: Prevalence and Correlates in 2008-2009 Population Based Surveys

Abstract

Background:Overweight and obesity (overweight/obesity) is associated with hypertension. Low-and middleincome countries are experiencing an obesity epidemic. There is growing evidence that the epidemic is on the increase in urban settings of developing countries. However, there is scanty information on the magnitude of this epidemic and its correlates in rural settings. The objective of the current study was to establish levels of overweight/obesity and its correlates in rural areas of Zambia. Designing interventions based on the correlates for overweight/obesity to reduce its prevalence may in turn lead to a reduction in the prevalence of hypertension. Methods:Cross sectional studies using a modified WHO Stepwise questionnaire were conducted. Logistic regression analyses were used to determine factors that were associated with overweight/obesity. Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) and their 95% confidence intervals are reported.Results: Totals of 895 participants from Kaoma and 1198 from Kasama took part in the study. Altogether, 7.6% of the participants were overweight and 2.5% were obese, with a combined prevalence of overweight/obesity of 10.1%. Factors that were independently associated with overweight/obesity were sex, education, vegetable consumption, smoking and hypertension. Female participants were 78% (AOR=1.78, 95% CI [1.46, 2.17]) more like to be overweight/ obese compared to males. Participants with secondary or higher education level were 2.04 (95% CI [1.56, 2.67]) times more likely to be overweight/obese compared to participants with lower levels of education. Participants who consumed vegetables 5 to 7 days in a week were 35% (AOR=1.35, 95% CI [1.06, 1.72]) more likely to be overweight/ obese compared to participants who ate vegetables less than 5 days in a week. Non smokers were 2.06 (95% CI [1.42, 2.98]) times more likely to be overweight/obese than smokers. Participants who were non hypertensive were 30% (AOR=0.70, 95% CI [0.59, 0.82]) less likely to be overweight/obese compared to participants who were hypertensive. Conclusions:Prevalence of overweight/obesity was low and this is the time to start instituting interventions to control the obesity epidemic in rural districts of Zambia.

Rural-urban differentials in the prevalence of overweight and obesity among women of child bearing age in Zambian

“…Moreover the odds of being overweight increased with the level of education in urban areas. Earlier studies in Kasama, Kaoma [45], Kitwe [46] and Lusaka [39] districts of Zambia as well as other developing countries [42, 47, 48,] found similar results. [46] for example notes that this positive relationship could be explained by changes in lifestyle, increased access to motorized transportation, increa sed rates of sedentary employment and sedentary lifestyles in general, and increased ability to eat fast food.…”

Obesity matters but is not perceived: A cross-sectional study on cardiovascular disease risk factors among a population-based probability sample in rural Zambia

“…We found that 26.8% of participants had BMI ≥25 kg/m 2 ; this proportion was much higher in women (36.7%) than in men (16.1%). The overall prevalence of 26.8% is close to the national estimates by WHO in 2010 (26.4%), 2014 (29.2%), and 2017 (24.2%) [10,28], but much higher than in other rural districts such as Kaoma (9.8%) and Kasama (10.3%), which were surveyed in 2008–2009 [17]. However, the prevalence of 26.8% was lower than in the Lusaka (39.3%) and Kitwe (41.6%) urban districts, surveyed in 2007 and 2011, respectively [18,24].…”

“…People who were overweight or obese were more likely to have elevated blood pressure and HbA1c, and abnormal blood lipid profiles compared to those with normal body weight. The association between high blood pressure and obesity is well documented in SSA countries, including both urban and rural areas of Zambia [6,17]. Although the relationship of blood glucose and blood lipid profile with obesity is well established in industrialized countries, as well as in SSA [5,47–49], our findings are the first in Zambia.…”

“…Previous studies in SSA have reported that alcohol consumption is not related or negatively associated with obesity [6,17,45,46], suggesting that alcohol consumption might play at most a minor role, in overweight or obesity in the current SSA context, including Zambia. However, it should be noted again that we only measured the frequency but not the actual amount of alcohol consumed.…”

“…However, research on overweight and obesity remains scarce both in amount and depth in many SSA countries, including Zambia [5]. In Zambia, prevalence studies have been conducted only in a few districts including the capital city, with the results already outdated in view of rapid social changes [6,17,18]. There have been no studies that involved biological measurements to assess the metabolic effects of overweight and obesity or have evaluated the perception of overweight and obesity in consideration of the local cultural context in Zambia.…”