Population-based survey of overweight and obesity and the associated factors in peri-urban and rural Eastern Uganda

Abstract

BackgroundIn sub-Saharan Africa (SSA), the rising prevalence of overweight, obesity and non-communicable diseases co-exists with the high burden of under-nutrition. The paucity of data on adulthood overweight and obesity, disaggregated by socio-demographic characteristics and in rural settings in SSA calls for research. We determined the prevalence of underweight, overweight/obesity and associated factors among adults in peri-urban and rural Uganda.MethodsA cross-sectional study of 1210 randomly selected adults aged ≥ 18 years was conducted in Iganga-Mayuge Health and Demographic Surveillance Site in eastern Uganda in 2013. Height, weight and socio-demographic variables were assessed. Overweight was defined as BMI = 25.0-29.99 kg/m2, obesity ≥ 30 kg/m2 and overweight/obesity ≥ 25 kg/m2. Logistic regression was used to identify factors associated with overweight/obesity.ResultsOf the participants, 7 % were underweight (8.1 % of men; 5.9 % of women, p = 0.99); 17.8 % were overweight (12.4 % of men; 23.1 % of women, p < 0.001); and 7 % were obese (2.0 % of men; 12.7 % of women, p < 0.001). Overweight prevalence was 15.8 % and 23.8 % among rural and peri-urban adults, respectively (p < 0.001). Obesity prevalence was 3.9 % and 17.8 % among rural and peri-urban adults, respectively (p < 0.001). Factors associated with overweight/obesity were: being female, adjusted odds ratio (AOR) 4.3 (95 % confidence interval (PloS one 8:e75640, 20013) 3.2–5.9); peri-urban residence AOR 2.6 (1.9–3.6); being in age group 35–44, AOR 3.1 (1.8–5.3); 45–54 AOR 4.1 (2.3–7.3); 55–64 AOR 2.6 (1.4–5.0); ≥ 65 years AOR 3.1 (1.6–6.0); and having socio-economic status (SES) in the third AOR 2.8 (1.7–4.6), fourth 2.5 (1.5–4.2) and fifth 2.7 (1.6–4.4) quintile.ConclusionsOverweight/obesity was prevalent among adults. Overweight/obese was associated with being female, being aged 35 years and older, residing in a peri-urban area and having a higher SES. The time has come to develop interventions to prevent and control overweight/obesity.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2506-7) contains supplementary material, which is available to authorized users.

Obesity in Low- and Middle-Income Countries: Burden, Drivers, and Emerging Challenges

“…The increase in overweight and obesity prevalence has occurred alongside large burdens of underweight in many LMICs (29,67,70). Although the prevalence of overweight exceeded that of underweight among adult women in most LMICs by 2000, levels of underweight are much higher than what is observed in HICs (90).…”

Urban–rural and geographic differences in overweight and obesity in four sub-Saharan African adult populations: a multi-country cross-sectional study

“…In Tanzania, a study reported prevalence of obesity to be 13 % and 36 % compared with <10 % and 6 % among urban men and women, respectively [25, 26]. In Uganda, a study reported overweight to be 15.8 % and 23.8 %, and obesity to be 3.9 % and 17.8 %, respectively in rural and urban dwellers [27]. In Nigeria, 40 % and 30 % of females in urban and rural areas were reported to be overweight and obese by Sola et al [28].…”

“…The documented attributable determinants of over-nutrition across African countries including our study sites include female sex, being married, living in urban areas, higher socio-economic category, being African/White, physical inactivity [31, 32, 34] globalization of food production and marketing [34] and increasing age [27]. Furthermore, in Nigeria and South Africa [31, 32], residing in areas of high crime rates have been associated with overweight and obesity because the activities of the criminals prevent the residents from outdoor exercise such as walking due to fear of being harmed.…”

Sociodemographic, socioeconomic, clinical and behavioural predictors of body mass index vary by sex in rural South African adults-findings from the AWI-Gen study

“…Similar differences were evident in rural Ghana where the prevalence of obesity in women was seven times that in men [24]. The sex disparity in obesity appears independent of urbanicity with females in rural and peri-urban Uganda being 4.3 times as likely to be obese as males [25] and the prevalence of obesity in females 20–75 years of age in urban Cameroon being 4 times that of their male counterparts [26]. This female preponderance of obesity may be due to several factors including female perceptions of ‘ideal’ body weight, differential effects of childhood undernutrition and adult socioeconomic status [27], although in our study, socioeconomic status did not attenuate the relationship between sex and BMI.…”

“…The effect of both of these predictors on BMI appears to depend on the wealth and education status in the broader society. Higher BMI is often seen in the wealthier and better-educated in low and middle-income countries as evidenced by studies in peri-urban and rural Uganda and urban Nigeria and national South African studies [25,34,35]. In contrast, in high income countries, obesity appears to be more prevalent in poorer, less-educated individuals [36,37].…”