Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.
Department of Public Health, The University of Dodoma, Dodoma, Tanzania.
PLoS One. 2021 Jan 13;16(1):e0244813. doi: 10.1371/journal.pone.0244813. eCollection 2021.
The prevalence of overweight and obesity is rising at a rapid pace and is associated with negative health consequences like cardiovascular diseases, type 2 diabetes and cancer. Obesity is a multifactorial problem that develops mainly from lifestyle factors including physical inactivity and poor dietary intake. Dietary diversity is a simplified method for assessing the adequacy and quality of diet and is associated with nutritional need and overall health status. Therefore, we conducted this study to synthesize the associations between consumption of a diversified diet and overweight/ obesity among adults living in pastoral communities in Monduli district in Tanzania.
This was a cross-sectional study conducted among 510 adults aged ≥ 18 years old in the Monduli district, Arusha region in Tanzania. We conducted face-to-face interviews to collect information about socio-demographic characteristics, 24-hours dietary recall, and anthropometric measurements. The dietary diversity score (DDS) was constructed and used to determine the diversity of the diet consumed. We performed the multivariate Poisson regressions to determine the prevalence ratio (PR) with 95% confidence intervals (CI). The dependent variables were overweight and general obesity as measured by body mass index (BMI), abdominal obesity measured by waist-hip ratio (WHR) and waist circumference (WC).
The prevalence of general obesity based on BMI was 20.2% (95%CI; 16.9-23.9), abdominal obesity based on WHR was 37.8% (95%CI; 33.7-42.1), and WC was 29.1% (95%CI; 25.2-33.1). More than half (54.3%) of the participants consumed an adequate dietary diversity (DDS ≥4). After adjustment for potential confounders, the prevalence of abdominal obesity by WHR decreased with higher DDS among male (APR = 0.42; 95% CI, 0.22-0.77) and female participants (APR = 0.63; 95% CI, 0.41-0.94). There were inconsistent positive associations between DDS and prevalence of overweight and general obesity among male and female. There was no association between DDS and abdominal obesity by WC.
More than half of the pastoralists have consumed an adequate diversified diet. Given the inconsistent findings on associations between dietary diversity and obesity measures, this study suggests that targeting dietary diversity as an overweight/obesity prevention strategy requires careful consideration.
超重和肥胖的患病率正在迅速上升，与心血管疾病、2 型糖尿病和癌症等负面健康后果有关。肥胖是一种多因素问题，主要由包括身体活动不足和不良饮食摄入在内的生活方式因素发展而来。饮食多样性是评估饮食充足性和质量的简化方法，与营养需求和整体健康状况有关。因此，我们进行了这项研究，以综合评估坦桑尼亚蒙杜利地区牧民社区成年人中饮食多样化与超重/肥胖之间的关系。
这是一项横断面研究，在坦桑尼亚阿鲁沙地区蒙杜利区 510 名年龄≥18 岁的成年人中进行。我们进行了面对面访谈，以收集社会人口统计学特征、24 小时饮食回忆和人体测量学数据。构建了饮食多样性评分（DDS），用于确定所消耗饮食的多样性。我们进行了多变量泊松回归，以确定具有 95%置信区间（CI）的患病率比（PR）。因变量是体重指数（BMI）测量的超重和普通肥胖、腰臀比（WHR）测量的腹部肥胖和腰围（WC）。
BMI 测量的普通肥胖患病率为 20.2%（95%CI；16.9-23.9），WHR 测量的腹部肥胖患病率为 37.8%（95%CI；33.7-42.1），WC 为 29.1%（95%CI；25.2-33.1）。超过一半（54.3%）的参与者饮食多样性充足（DDS≥4）。在调整潜在混杂因素后，男性（APR=0.42；95%CI，0.22-0.77）和女性参与者（APR=0.63；95%CI，0.41-0.94）中，WHR 测量的腹部肥胖患病率随 DDS 升高而降低。在男性和女性中，DDS 与超重和普通肥胖患病率之间呈不一致的正相关。DDS 与 WC 测量的腹部肥胖无关联。
超过一半的牧民食用了充足多样的饮食。鉴于饮食多样性与肥胖测量之间关联的不一致发现，本研究表明，将饮食多样性作为超重/肥胖预防策略的目标需要仔细考虑。
