Cham Bai, Scholes Shaun, Ng Fat Linda, Badjie Omar, Groce Nora Ellen, Mindell Jennifer S
Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
Department of Public Health, University of The Gambia, Brikama, The Gambia.
BMJ Open. 2020 Jun 1;10(6):e033882. doi: 10.1136/bmjopen-2019-033882.
Non-communicable diseases account for 70% of global deaths; 80% occur in low-income and middle-income countries. The rapid increase of obesity in sub-Saharan Africa is a concern. We assessed generalised and abdominal obesity and their associated risk factors among adults in The Gambia.
Nationwide cross-sectional health examination survey using the WHO STEPwise survey methods.
The Gambia.
This study uses secondary analysis of a 2010 nationally representative random sample of adults aged 25-64 years (78% response rate). The target sample size was 5280, and 4111 responded. Analysis was restricted to non-pregnant participants with valid weight and height measurements (n=3533).
The primary outcome variable was generalised obesity, using WHO body mass index (BMI) thresholds. Analyses used non-response weighting and adjusted for the complex survey design. We conducted multinomial logistic regression analysis to identify factors associated with BMI categories. The secondary outcome variable was abdominal obesity, defined as high waist circumference (using the International Diabetes Federation thresholds for Europeans).
Two-fifths of adults were overweight/obese, with a higher obesity prevalence in women (17%, 95% CI 14.7 to 19.7; men 8%, 95% CI 6.0 to 11.0). 10% of men and 8% of women were underweight. Urban residence (adjusted relative risk ratio 5.8, 95% CI 2.4 to 14.5), higher education (2.3, 1.2 to 4.5), older age, ethnicity, and low fruit and vegetable intake (2.8, 1.1 to 6.8) were strongly associated with obesity among men. Urban residence (4.7, 2.7 to 8.2), higher education (2.6, 1.1 to 6.4), older age and ethnicity were associated with obesity in women.
There is a high burden of overweight/obesity in The Gambia. While obesity rates in rural areas were lower than in urban areas, obesity prevalence was higher among rural residents in this study compared with previous findings. Preventive strategies should be directed at raising awareness, discouraging harmful beliefs on weight, and promoting healthy diets and physical activity.
非传染性疾病占全球死亡人数的70%；其中80%发生在低收入和中等收入国家。撒哈拉以南非洲肥胖率的迅速上升令人担忧。我们评估了冈比亚成年人的全身性肥胖和腹部肥胖及其相关危险因素。
采用世界卫生组织的逐步调查方法进行全国性横断面健康检查调查。
冈比亚。
本研究对2010年全国具有代表性的25至64岁成年人随机样本进行二次分析（应答率为78%）。目标样本量为5280人，4111人做出应答。分析仅限于体重和身高测量有效的非孕妇参与者（n = 3533）。
主要结局变量为全身性肥胖，采用世界卫生组织的体重指数（BMI）阈值。分析采用无应答加权法，并针对复杂的调查设计进行了调整。我们进行了多项逻辑回归分析，以确定与BMI类别相关的因素。次要结局变量为腹部肥胖，定义为高腰围（采用欧洲人的国际糖尿病联合会阈值）。
五分之二的成年人超重/肥胖，女性肥胖患病率更高（17%，95%置信区间14.7至19.7；男性8%，95%置信区间6.0至11.0）。10%的男性和8%的女性体重过轻。城市居住（调整后的相对风险比5.8，95%置信区间2.4至14.5）、高等教育（2.3，1.2至4.5）、年龄较大、种族以及水果和蔬菜摄入量低（2.8，1.1至6.8）与男性肥胖密切相关。城市居住（4.7，2.7至8.2）、高等教育（2.6，1.1至6.4）、年龄较大和种族与女性肥胖有关。
冈比亚超重/肥胖负担较重。虽然农村地区的肥胖率低于城市地区，但与之前的研究结果相比，本研究中农村居民的肥胖患病率更高。预防策略应旨在提高认识、摒弃对体重的有害观念，并促进健康饮食和体育活动。
