Okyere Joshua, Ayebeng Castro, Dickson Kwamena Sekyi, Duodu Precious Adade
School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK.
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
Trop Med Health. 2025 Jul 1;53(1):88. doi: 10.1186/s41182-025-00753-1.
Beyond the socio-demographic and lifestyle factors, it is imperative to understand how early-life factors contribute to the development of overweight and obesity. One of such early-life factors is early sexual debut defined as first sexual intercourse before age 16. The study examines the association between early sexual debut and women's risk of overweight/obesity in Ghana using a nationally representative data.
Data from the 2022 Ghana Demographic and Health survey was used. We analyzed the data of 6,478 women aged 16-49 years. The outcome variable was obesity status which was computed using the body mass index. The main explanatory variable was early sexual debut. We utilized multilevel logistic regression models to examine the association between early sexual debut and women's risk of overweight/obesity, controlling for both individual (age, education, internet use, parity, wealth index, anemia status) and community level (residence and ecological zone) confounders.
An estimated 3,183 (48.8% [95% CI 46.9-50.6]) were overweight/obese while 11.7% experienced early sexual debut. After adjusting for individual and community level factors, we found that women with an early sexual debut had a 25% higher likelihood of being overweight or obese compared to those without early sexual debut [AOR = 1.25; 95% CI 1.04-1.51]. The significant confounders associated with higher odds of obesity were increasing age, higher educational level, higher wealth index, parity, and frequent use of the internet. Rural residence and residence in the savannah ecological zone were associated with lower odds.
This study suggests that early sexual debut, a key life course event, may be linked to long-term health consequences including higher risk of overweight/obesity. The results underscore the importance of addressing early-life factors in the prevention of obesity. Public health interventions aimed at delaying sexual initiation could be vital in mitigating the growing burden of obesity in Ghana.
除了社会人口统计学和生活方式因素外，了解早期生活因素如何导致超重和肥胖的发展至关重要。早期首次性行为就是这样一个早期生活因素，其定义为16岁之前的首次性交。本研究使用具有全国代表性的数据，考察了加纳早期首次性行为与女性超重/肥胖风险之间的关联。
使用了2022年加纳人口与健康调查的数据。我们分析了6478名16至49岁女性的数据。结果变量是肥胖状况，通过体重指数计算得出。主要解释变量是早期首次性行为。我们利用多水平逻辑回归模型来考察早期首次性行为与女性超重/肥胖风险之间的关联，同时控制个体（年龄、教育程度、互联网使用情况、生育次数、财富指数、贫血状况）和社区层面（居住地和生态区）的混杂因素。
估计有3183人（48.8%[95%置信区间46.9 - 50.6]）超重/肥胖，而11.7%的人经历过早期首次性行为。在调整个体和社区层面因素后，我们发现，与没有早期首次性行为的女性相比，有早期首次性行为的女性超重或肥胖的可能性高25%[调整后比值比=1.25；95%置信区间1.04 - 1.51]。与肥胖几率较高相关的显著混杂因素包括年龄增长、教育水平提高、财富指数较高、生育次数以及频繁使用互联网。农村居住以及居住在萨凡纳生态区与较低几率相关。
本研究表明，早期首次性行为这一关键的生命历程事件，可能与包括超重/肥胖风险增加在内的长期健康后果有关。研究结果强调了在预防肥胖过程中应对早期生活因素的重要性。旨在推迟性初次体验的公共卫生干预措施对于减轻加纳日益增长的肥胖负担可能至关重要。
