Bosu William K
West African Health Organisation,175 Ouzzein Coulibaly Avenue,01 BP 153 Bobo-Dioulasso,Burkina Faso.
Proc Nutr Soc. 2015 Nov;74(4):466-77. doi: 10.1017/S0029665114001669. Epub 2014 Dec 22.
The nutrition landscape in West Africa has been dominated by the programmes to address undernutrition. However, with increasing urbanisation, technological developments and associated change in dietary patterns and physical activity, childhood and adult overweight, and obesity are becoming more prevalent. There is an evidence of increasing intake of dietary energy, fat, sugars and protein. There is low consumption of fruit and vegetables universally in West Africa. Overall, the foods consumed are predominantly traditional with the component major food groups within recommended levels. Most of the West African countries are at the early stages of nutrition transition but countries such as Cape Verde, Ghana and Senegal are at the latter stages. In the major cities of the region, children consume energy-dense foods such as candies, ice cream and sweetened beverages up to seven times as frequently as fruit and vegetables. Adult obesity rates have increased by 115 % in 15 years since 2004. In Ghana, the prevalence of overweight/obesity in women has increased from 12·8 % in 1993 to 29·9 % in 2008. In Accra, overweight/obesity in women has increased from 62·2 % in 2003 to 64·9 % in 2009. The age-standardised proportion of adults who engage in adequate levels of physical activity ranges from 46·8 % in Mali to 94·7 % in Benin. The lingering stunting in children and the rising overweight in adults have resulted to a dual burden of malnutrition affecting 16·2 % of mother-child pairs in Cotonou. The prevalence of hypertension has been increased and ranges from 17·6 % in Burkina Faso to 38·7 % in Cape Verde. The prevalence is higher in the cities: 40·2 % in Ougadougou, 46·0 % in St Louis and 54·6 % in Accra. The prevalence of diabetes ranges from 2·5 to 7·9 % but could be as high as 17·9 % in Dakar, Senegal. The consequences of nutrition transition are not only being felt by the persons in the high socioeconomic class, but also in cities such as Accra and Ouagadougou, where at least 19 % of adults from the poorest households are overweight and 19-28 % have hypertension. Concerted national action involving governments, partners, private sector and civil society is needed to re-orient health systems and build capacity to address the dual burden of malnutrition, to regulate the food and beverage industry and to encourage healthy eating throughout the life course.
西非的营养状况一直以解决营养不良问题的项目为主导。然而，随着城市化进程的加快、技术发展以及饮食模式和身体活动的相关变化，儿童和成人超重及肥胖现象日益普遍。有证据表明膳食能量、脂肪、糖和蛋白质的摄入量在增加。西非普遍存在水果和蔬菜消费量低的情况。总体而言，所消费的食物主要是传统食物，主要食物组的成分在推荐水平之内。大多数西非国家正处于营养转型的早期阶段，但佛得角、加纳和塞内加尔等国已处于后期阶段。在该地区的主要城市，儿童食用能量密集型食物（如糖果、冰淇淋和含糖饮料）的频率高达水果和蔬菜的七倍。自2004年以来的15年里，成人肥胖率上升了115%。在加纳，女性超重/肥胖的患病率从1993年的12.8%上升到2008年的29.9%。在阿克拉，女性超重/肥胖的患病率从2003年的62.2%上升到2009年的64.9%。从事适当身体活动水平的成年人的年龄标准化比例从马里的46.8%到贝宁的94.7%不等。儿童中长期存在的发育迟缓以及成人中超重现象的增加，导致营养不良的双重负担影响了科托努16.2%的母婴对。高血压患病率有所上升范围从布基纳法索 的17.6%到佛得角的38.7%。城市中的患病率更高：瓦加杜古为40.2%，圣路易斯为46.0%，阿克拉为54.6%。糖尿病患病率在2.5%至7.9%之间，但在塞内加尔达喀尔可能高达17.9%。营养转型的后果不仅高社会经济阶层的人能感受到，在阿克拉和瓦加杜古等城市也是如此，那里至少19%最贫困家庭的成年人超重，19%至28%的人患有高血压。需要政府、合作伙伴、私营部门和民间社会采取协调一致的国家行动，以重新调整卫生系统并建设应对营养不良双重负担的能力，规范食品和饮料行业，并鼓励人们在一生中保持健康饮食。
