Diet and overweight and obesity in populations of African origin: Cameroon, Jamaica and the UK

Abstract

Objectives: To determine the relationship of diet to overweight and obesity among populations of African origin. Design and setting: Cross-sectional data were obtained from adults aged 25-74 years in rural Cameroon (n ¼ 686), urban Cameroon (n ¼ 975), Jamaica (n ¼ 924) and Afro-Caribbeans in the UK (n ¼ 257). Dietary data were collected using foodfrequency questionnaires specifically designed for each site. Body mass index (BMI) was used as a measure of overweight. Results: The expected gradient in the distribution of overweight across sites was seen in females (rural Cameroon, 9.5%; urban Cameroon, 47.1%; Jamaica, 63.8%; UK, 71.6%); however, among males overweight was less prevalent in Jamaica (22.0%) than urban Cameroon (36.3%). In developing countries increased risks of overweight (BMI $ 25 kg m 22 ) were influenced by higher energy (urban Cameroonian men) and protein (Jamaican women) intakes. No dietary variables were associated with obesity (BMI $ 30 kg m 22 ) in Cameroon or Jamaica. In the UK, energy intakes were inversely related with overweight whereas increased risks of being overweight were associated with higher protein (men) and fat (women) intakes. Similarly, whereas higher protein and fat intakes in UK men and women were associated with obesity, carbohydrate intakes were associated with decreased risks of obesity in men. Conclusions: Diet and overweight were associated in the UK but few dietary variables were related to overweight in Jamaica and the Cameroon. These findings suggest that associations between diet and overweight/obesity are not generalisable among populations. Keywords Diet Overweight African originObesity in adult populations is recognised as a growing epidemic worldwide 1 and appears to be increasing more rapidly in developing countries 2 . Importantly, obesity is associated with non-communicable diseases, including non-insulin-dependent diabetes, hypertension, dyslipidaemia, cardiovascular diseases, certain types of cancers and psychological problems 1 . The disproportionate increase in the developing world has been attributed to the 'nutrition transition', a shift from traditional diets and lifestyle to the pattern of Western societies 2 . Its serious implications for the health of these populations are clear through the link between overweight and chronic non-communicable diseases.Little is known about diet and its contribution to adiposity in the African Diaspora. We have previously reported on the variation in diet across three populations that share a common genetic ancestry but different environmentsrural and urban Cameroon, Jamaica and Afro-Caribbeans the UK 3 . Our investigation of adult Jamaicans of African descent regarding the relationships between body mass index (BMI) and diet showed that BMI was not explained by energy and that higher protein intake was associated with increased BMI in females only 4 . In the present study we investigated the relationship of diet to overweight and obesity across these different populations.It was hypothesised that, relative t...

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