Sodjinou Roger, Agueh Victoire, Fayomi Benjamin, Delisle Hélène
TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, Université de Montréal, C,P, 6128 Succursale centre-ville, Montréal Qc H3C 3J7, Canada.
BMC Public Health. 2008 Mar 4;8:84. doi: 10.1186/1471-2458-8-84.
There is a dearth of information on diet-related chronic diseases in West Africa. This cross-sectional study assessed the rate of obesity and other cardiovascular disease (CVD) risk factors in a random sample of 200 urban adults in Benin and explored the associations between these factors and socio-economic status (SES), urbanisation as well as lifestyle patterns.
Anthropometric parameters (height, weight and waist circumference), blood pressure, fasting plasma glucose, and serum lipids (HDL-cholesterol and triglycerides) were measured. WHO cut-offs were used to define CVD risk factors. Food intake and physical activity were assessed with three non-consecutive 24-hour recalls. Information on tobacco use and alcohol consumption was collected using a questionnaire. An overall lifestyle score (OLS) was created based on diet quality, alcohol consumption, smoking, and physical activity. A SES score was computed based on education, main occupation and household amenities (as proxy for income).
The most prevalent CVD risk factors were overall obesity (18%), abdominal obesity (32%), hypertension (23%), and low HDL-cholesterol (13%). Diabetes and hypertriglyceridemia were uncommon. The prevalence of overall obesity was roughly four times higher in women than in men (28 vs. 8%). After controlling for age and sex, the odds of obesity increased significantly with SES, while a longer exposure to the urban environment was associated with higher odds of hypertension. Of the single lifestyle factors examined, physical activity was the most strongly associated with several CVD risk factors. Logistic regression analyses revealed that the likelihood of obesity and hypertension decreased significantly as the OLS improved, while controlling for potential confounding factors.
Our data show that obesity and cardio-metabolic risk factors are highly prevalent among urban adults in Benin, which calls for urgent measures to avert the rise of diet-related chronic diseases. People with higher SES and those with a longer exposure to the urban environment are priority target groups for interventions focusing on environmental risk factors that are amenable to change in this population. Lifestyle interventions would appear appropriate, with particular emphasis on physical activity.
西非地区缺乏与饮食相关的慢性病信息。这项横断面研究评估了贝宁200名城市成年人随机样本中的肥胖率及其他心血管疾病（CVD）风险因素，并探讨了这些因素与社会经济地位（SES）、城市化以及生活方式模式之间的关联。
测量了人体测量参数（身高、体重和腰围）、血压、空腹血糖和血脂（高密度脂蛋白胆固醇和甘油三酯）。采用世界卫生组织的临界值来定义心血管疾病风险因素。通过三次非连续的24小时膳食回顾来评估食物摄入量和身体活动情况。使用问卷收集有关烟草使用和酒精消费的信息。基于饮食质量、酒精消费、吸烟和身体活动创建了一个总体生活方式评分（OLS）。根据教育程度、主要职业和家庭设施（作为收入的替代指标）计算社会经济地位评分。
最常见的心血管疾病风险因素是总体肥胖（18%）、腹型肥胖（32%）、高血压（23%）和低高密度脂蛋白胆固醇（13%）。糖尿病和高甘油三酯血症并不常见。女性总体肥胖的患病率大约是男性的四倍（28%对8%）。在控制年龄和性别后，肥胖几率随社会经济地位显著增加，而更长时间暴露于城市环境与高血压几率较高相关。在所研究的单一生活方式因素中，身体活动与多种心血管疾病风险因素的关联最为密切。逻辑回归分析显示，在控制潜在混杂因素的情况下，随着总体生活方式评分的改善，肥胖和高血压的可能性显著降低。
我们的数据表明，肥胖和心血管代谢风险因素在贝宁城市成年人中非常普遍，这需要采取紧急措施以避免与饮食相关的慢性病增加。社会经济地位较高以及更长时间暴露于城市环境的人群是针对该人群中易于改变的环境风险因素进行干预的优先目标群体。生活方式干预似乎是合适的，尤其应强调身体活动。
