Lartey Stella T, Si Lei, Otahal Petr, de Graaff Barbara, Boateng Godfred O, Biritwum Richard Berko, Minicuci Nadia, Kowal Paul, Magnussen Costan G, Palmer Andrew J
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; The George Institute for Global Health, University of New South Wales, Kensington, NSW, 2042, Australia.
Soc Sci Med. 2020 Jan 28;247:112821. doi: 10.1016/j.socscimed.2020.112821.
Overweight/obesity is becoming increasingly prevalent in sub-Saharan Africa including Ghana. However, transition probabilities, an essential component to develop cost-effective measures for weight management is lacking in this population. We estimated annual transition probabilities between three body mass index (BMI) categories: normal weight (BMI ≥18.5 and <25.0 kg/m), overweight (BMI ≥25.0 and <30.0 kg/m), and obesity (BMI ≥30.0 kg/m), among older adults aged ≥50 years in Ghana. Data were used from a nationally representative, multistage sample of 1496 (44.3% females) older adults in both Waves 1 (2007/8) and 2 (2014/15) of the Ghana WHO SAGE. A multistage Markov model was used to estimate annual transition probabilities. We further examined the impact of specific socio-economic factors on the transition probabilities. At baseline, 22.8% were overweight and 11.1% were obese. The annual transition probability was 4.0% (95% CI: 3.4%, 4.8%) from normal weight to overweight, 11.1% (95% CI: 9.5%, 13.0%) from overweight to normal weight and 4.9% (95% CI: 3.8%, 6.2%) from overweight to obesity. For obese individuals, the probability of remaining obese, transitioning to overweight and completely reverting to normal weight was 90.2% (95% CI: 87.7%, 92.3%), 9.2% (95% CI: 7.2%, 11.6%) and 0.6% (95% CI: 0.4%, 0.8%) respectively. Being female, aged 50-65 years, urban residence, having high education and high wealth were associated with increased probability of transitioning into the overweight or obese categories. Our findings highlight the difficulty in transitioning away from obesity, especially among females. The estimated transition probabilities will be essential in health economic simulation models to determine sustainable weight management interventions.
超重/肥胖在包括加纳在内的撒哈拉以南非洲地区正变得越来越普遍。然而，这一人群缺乏过渡概率，而过渡概率是制定具有成本效益的体重管理措施的重要组成部分。我们估计了加纳50岁及以上老年人中三种体重指数（BMI）类别之间的年度过渡概率：正常体重（BMI≥18.5且<25.0kg/m）、超重（BMI≥25.0且<30.0kg/m）和肥胖（BMI≥30.0kg/m）。数据来自加纳世界卫生组织全球老龄化与成人健康研究（WHO SAGE）第1阶段（2007/8年）和第2阶段（2014/15年）的1496名（44.3%为女性）具有全国代表性的多阶段抽样老年人。使用多阶段马尔可夫模型来估计年度过渡概率。我们进一步研究了特定社会经济因素对过渡概率的影响。在基线时，22.8%的人超重，11.1%的人肥胖。从正常体重到超重的年度过渡概率为4.0%（95%CI：3.4%，4.8%），从超重到正常体重的年度过渡概率为11.1%（95%CI：9.5%，13.0%），从超重到肥胖的年度过渡概率为4.9%（95%CI：3.8%，6.2%）。对于肥胖个体，保持肥胖、转变为超重和完全恢复到正常体重的概率分别为90.2%（95%CI：87.7%，92.3%）、9.2%（95%CI：7.2%，11.6%）和0.6%（95%CI：0.4%，0.8%）。女性、年龄在50 - 65岁、城市居住、高学历和高财富与转变为超重或肥胖类别的概率增加有关。我们的研究结果突出了摆脱肥胖的困难，尤其是在女性中。估计的过渡概率对于健康经济模拟模型确定可持续的体重管理干预措施至关重要。
