Co-Occurrence of Overweight/Obesity, Anemia and Micronutrient Deficiencies among Non-Pregnant Women of Reproductive Age in Ghana: Results from a Nationally Representative Survey

Christian, Aaron Kobina; Steiner-Asiedu, Matilda; Bentil, Helena; Rohner, Fabian; Wegmüller, Rita; Petry, Nicolai; Wirth, James P.; Donkor, William E S; Amoaful, Esi Foriwa; Adu‐Afarwuah, Seth

doi:10.3390/nu14071427

Cited by 10 publications

(20 citation statements)

References 47 publications

(49 reference statements)

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“…These levels of obesity and anemia in Volta region cast doubt that obesity reduces anemia risk. Nonetheless, elsewhere, in Saudi Arabia obese pregnant women, about three-fifths were anemic [48], whereas analysis of a National data from Ghana indicated below 10% co-occurrence of overweight/obesity and anemia in WIFA, [36] but more than half were shown to have co-occurrence of overweight and anemia [35].…”

Section: Discussionmentioning

confidence: 91%

“…This is consistent with National surveys. In particular, the Ghana Demographic Health Survey data revealed a higher burden of maternal malnutrition, varying substantially by individual nutritional status, economic status, parity, and ethnicity [14,35,36]. These are paradoxically linked predisposition factors of malnutrition common to LMICs [1,4,37].…”

Section: Discussionmentioning

confidence: 99%

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Improved income status increased obesity and decreased anemia risk compared to high parity and low-income in pregnant south Ghanaian women: Analysis of hospital-acquired data

Awuni

Matsui

Ellahi

et al. 2022

Preprint

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Background Women of reproductive age (WIFA, 15-49 years) in Ghana are experiencing an upsurge in excess body mass index (BMI) and anemia (low hemoglobin concentration (Hb of £ 10.9 g/dl)). Regions of Southern Ghana (Central, Eastern, and Volta) are recognized to have high rates of adolescent pregnancies, and is known to be associated with high risk of anemia. However, little is known for pregnant South Ghanaian women. This study aimed to examine anthropometry – maternal stature and early pregnancy BMI – and socio-demographic measures as independent risk factors for anemia in antenatal women in Southern Ghana. Methodology Baseline data on anemia from healthy pregnant women (15-49 years; n = 1278) collected through antenatal attendance in an observational cohort study was included in the descriptive and logistic regression analysis using STATA (Stata Corp LLC [US]). Anemia (dependent) and the independent variables: high parity (³5 children/woman); short stature (145£155cm); underweight (BMI <18.5kg/m2), normal (BMI 18.5-24.9kg/m2), overweight (BMI 25-29.9kg/m2), and obesity (BMI >30 kg/m2) assessed with weight (kg) before the 20th week of gestation divided by height (m2) were defined following standards. Wealth status was constructed using Principal Component Analysis of durable assets, housing characteristics, water/sanitation, and toilets facilities. All estimates were evaluated at the 5% significance level (p < 0.05). Results Of the sample, 45.85% had moderate/severe anemia with 9.67(±0.04) average hemoglobin (g/dl) concentration. Overweight/obesity was approximately (47%; overweight 29% vs obesity 18%), short stature (4.77%), and underweight (4.61%) in the 1278 women interviewed. Obesity was highest in the highest income women (26.24% (69/263)) in whom anemia decreased (34.78%, 80/230)) compared to highest prevalence of anemia in short stature (59.01%, 36/61), underweight (57.62%, 34/59), and overweight (44.68%, 164/367) women. The risk of anemia increased with high parity (adjusted odds ratio; aOR 3.91; 95%CI: 1.79-8.52; p = 0.001); lowest income quintile (aOR:2.10; 95%CI: 1.35-3.26; p = 0.001); second income quintile (aOR:1.52; 95%CI: 1.01-2.30 p = 0.045); being Ewe ethnicity (aOR:2.09; 95%CI: 1.35-3.24; p = 0.001); and Akan (aOR:1.79; 95%CI: 1.16-2.74; p = 0.008); while obesity reduced the risk (aOR:0.70; 95%CI: 0.50-0.99; p = 0.045). Conclusion Anemia in pregnancy and overweight, and obesity as double burden of malnutrition remain significantly high in pregnant South Ghanaian women. The AIP exceeded the WHO defined threshold and was particularly highest in women having high parity, short stature, and underweight. While high parity and income status increased overweight/obesity, obese women were more likely to have a reduced risk of anemia. However, across the ethnicity, high parity and low-income status posed significant risk of anemia in women. Further research examining the nexus between underweight or short stature versus high rates of anemia or overweight/obesity and income and anemia to better explain, and prevent the increasing trend of anemia in pregnant Ghanaian women is recommended.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Improved income status increased obesity and decreased anemia risk compared to high parity and low-income in pregnant south Ghanaian women: Analysis of hospital-acquired data

Awuni

Matsui

Ellahi

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…In a regional study in Latin America in 3254 women aged 15 to <45 years, Herrera-Cuenca et al [ 41 ] found that 58.7% were overweight, associated with adequate iron intake. Christian et al [ 42 ] conducted a national study in Ghana in 1063 women aged 15–49 years and found that the prevalence of overall overweight was 39%, anemia 22%, and deficiency of a micronutrient 62%.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Anemia and Iron Deficiency in Women of Reproductive Age in Cuba and Associated Factors

Pita-Rodríguez

Basabe-Tuero

Díaz‐Sánchez

et al. 2023

IJERPH

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This study aims to evaluate the prevalence of anemia and iron deficiency in women of reproductive age and the association with inflammation, global overweight, adiposity, and menorrhagia. A sample design of women of reproductive age from the Eastern, Central, and Havana Regions was carried out. Biochemical determinations of hemoglobin, serum ferritin, soluble transferrin receptors, leukocytes, C-reactive protein, alpha-1 acid glycoprotein, and homocysteine were performed. Serum ferritin was also adjusted by inflammation. Nutritional status was assessed, and menstrual characteristics were collected by survey. A total of 742 women were studied. The prevalence of anemia was 21.4%, iron storage deficiency at 16.0%, and erythropoietic dysfunction at 5.4%, with inflammation at 47.0% and elevated homocysteine at 18.6%. Global overweight was 46.2% and increased adiposity at 58.4%. Anemia is associated with iron deposition deficiency (OR = 3.023 (1.816–5.033)) and with erythropoietic deficiency (OR = 5.62 (3.03–10.39)), but not with inflammation, global overweight, and adiposity. Global overweight was found to be associated with inflammation (OR = 2.23 (1.41–3.53)). Anemia was associated with heavy menstrual bleeding (OR = 1.92 (1.34–2.76)). Homocysteine was associated with inflammation (OR = 2.05 (1.08–3.90)), but not with anemia. In conclusion, anemia in Cuba is classified as a moderate public health problem, but not iron deficiency. A high prevalence of overweight and obesity was found, associated with inflammation, but not with anemia or iron deficiency. Heavy menstrual bleeding is a factor associated with anemia.

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“…Folate deficiency was observed in 18% of research participants, comparatively lower than other African studies, where folate deficiency was noted in 54% obese and non-obese women in Ghana ( 39 ). The Ghanaian study ( 40 ) notes that folate deficiency may be particularly high in West Africa where folate-deficient diets are consumed. In the same way, Modjadji et al ( 41 ) demonstrated low folate levels in 28% of non-pregnant women of childbearing age in Limpopo, South Africa.…”

Section: Discussionmentioning

confidence: 99%

Nutritional deficiency in South African adults scheduled for bariatric surgery

et al. 2023

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BackgroundGlobally, there is a rising trend in obesity, known to increase morbidity and mortality. Metabolic surgery and adequate weight loss decrease mortality but may worsen pre-existing nutrient deficiencies. Most data on pre-existing nutritional deficiencies in the population undergoing metabolic surgery is from the developed world, where an extensive micronutrient assessment is achievable. In resource-constrained environments, the cost of a comprehensive micronutrient assessment must be weighed against the prevalence of nutritional deficiencies and the potential harm if one or more nutritional deficiencies are missed.MethodsThis cross-sectional study investigated the prevalence of micronutrient and vitamin deficiencies in participants scheduled to undergo metabolic surgery in Cape Town, South Africa, a low-middle income country. 157 participants were selected and 154 reported on; who underwent a baseline evaluation from 12 July 2017 to 19 July 2020. Laboratory measurements were conducted, including vitamin B12 (Vit B12), 25-hydroxy vitamin D (25(OH)D), folate, parathyroid hormone (PTH), thyroid-stimulating hormone (TSH), thyroxine (T4), ferritin, glycated haemoglobin (HbA1c), magnesium, phosphate, albumin, iron, and calcium.ResultsParticipants were predominantly female, aged 45 years (37-51), with a preoperative BMI of 50.4 kg/m2 (44.6-56.5). A total of 64 individuals had Type 2 diabetes mellitus (T2D), with 28 undiagnosed cases at study entry (18% of study population). 25(OH)D deficiency was most prevalent (57%), followed by iron deficiency (44%), and folate deficiency (18%). Other deficiencies (vitamin B12, calcium, magnesium, phosphate) were rarely encountered and affected ≤1% of participants. Folate and 25(OH)D deficiency were related to obesity classification, with a higher prevalence in participants with a BMI ≥40 kg/m2 (p <0.01).ConclusionA higher prevalence of some micronutrient deficiencies was noted compared with data from similar populations in the developed world. The minimum baseline/preoperative nutrient evaluation in such populations should include 25(OH)D, iron studies, and folate. Additionally, screening for T2D is recommended. Future efforts should seek to collate broader patient data on a national scale and include longitudinal surveillance after surgery. This may provide a more holistic picture of the relationship between obesity, metabolic surgery and micronutrient status inform more appropriate evidence-based care.

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Co-Occurrence of Overweight/Obesity, Anemia and Micronutrient Deficiencies among Non-Pregnant Women of Reproductive Age in Ghana: Results from a Nationally Representative Survey

Cited by 10 publications

References 47 publications

Improved income status increased obesity and decreased anemia risk compared to high parity and low-income in pregnant south Ghanaian women: Analysis of hospital-acquired data

Improved income status increased obesity and decreased anemia risk compared to high parity and low-income in pregnant south Ghanaian women: Analysis of hospital-acquired data

Prevalence of Anemia and Iron Deficiency in Women of Reproductive Age in Cuba and Associated Factors

Nutritional deficiency in South African adults scheduled for bariatric surgery

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