Malnutrition, Hypertension Risk, and Correlates: An Analysis of the 2014 Ghana Demographic and Health Survey Data for 15–19 Years Adolescent Boys and Girls

Abstract

The sex differences in malnutrition and hypertension during adolescence is largely inconclusive. There is also a paucity of data on the sex-specific correlates of malnutrition and hypertension for adolescents. Hence, this study aimed to assess the association between malnutrition, pre-hypertension/hypertension (PHH) and sex among adolescents. The study also aimed to determine and contrast the factors associated with these risks in Ghana. We analysed data of non-pregnant adolescent girls (n = 857) and adolescent boys (n = 870) aged 15–19 years from the 2014 Ghana Demographic and Health Survey (DHS). We modelled the prevalence risk ratio (PRR) of malnutrition and PHH using Cox proportional hazard models. Compared to adolescent girls, boys were more than twice likely to be stunted (PRR = 2.58, 95% C.I (1.77, 3.76)) and underweight (PRR = 2.67, 95% C.I (1.41, 5.09)) but less likely to be overweight/obese (PRR = 0.85, 95% C.I (0.08, 0.29)). Boys were also about twice likely to have PHH (PRR = 1.96, 95% C.I (1.47, 2.59)) compared to their female peers. Girls were more at risk of the detrimental effects of poor education on stunting and PHH. Empowerment index while protective of stunting for girls (PRR = 0.82, 95% C.I (0.67, 0.99)) also increased their risk of overweight/obesity (PRR = 1.31, 95% C.I (1.02, 1.68)). A higher household wealth index (HWI) increased the risk of overweight/obesity for adolescent girls but was protective of stunting and PHH for adolescent boys. Improvement in household water, hygiene, and sanitation (WASH) reduced the risk of stunting by 15% for adolescent boys. Overall, our findings suggest a double-burden of malnutrition with an up-coming non-communicable disease burden for adolescents in Ghana. Our findings may also be highlighting the need to target adolescent boys alongside girls in nutrition and health intervention programmes.

Maternal nutritional status, decision-making autonomy and the nutritional status of adolescent girls: a cross-sectional analysis in the Mion District of Ghana

“…However, a study in India among children below 5 years showed a marginal and small decrease in the risk of anaemia with a unit increase in maternal height (17) ; this was partly attributed to the poor living conditions of mothers with short stature. The prevalence of overweight/obesity (2⋅7 % v. 11⋅8 %) in the present study was lower compared with the national average for girls but thinness (9⋅0 % v. 1⋅6 %) was higher (40) . Anaemia and stunting were analysed using logistic regression, whereas the BAZ category (thinness, normal weight and overweight) was analysed using multinomial logistic regression.…”

“…11⋅8 %) in the present study was lower compared with the national average for girls but thinness (9⋅0 % v . 1⋅6 %) was higher (40) . Overall, dietary patterns in Ghana are shifting, with noticeable differences between urban and rural settings (41) .…”

Paediatric Hypertension in Africa: A Systematic Review and Meta-Analysis

“…Of the 53 studies, 37 reported obesity and/or overweight prevalence in their respective samples [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , with the prevalence of obesity ranging from 0·3% to 50% These studies consistently found a higher prevalence of elevated BP and/or hypertension in participants with obesity, overweight, or central obesity. A case-control study where authors compared prevalence of hypertension in children with and with out obesity found that only the children in the obesity group had hypertension (25%), and this group had significantly more cases of elevated BP than the non-obesity group (19·4% vs 6·5%) (Chedjou-Nono et al [68] ).…”

Low calf circumference can predict nutritional risk and mortality in adults with metabolic syndrome aged over 80 years

“…Some research has shown that malnutrition or nutritional risk is associated with a high incidence rate of long hospital stays and high mortality [ 8 , 9 ]. Some studies have identified that diabetes [ 10 ], obesity [ 11 ], and hypertension [ 12 ] are associated with malnutrition or nutritional risk increases in both young and old people. As a cluster of multiple metabolic abnormalities, the nutritional risk of MetS has not received much attention.…”