Overweight and obesity epidemic in Ghana—a systematic review and meta-analysis

Abstract

BackgroundIn many low and middle income countries (LMICs), the distribution of adulthood nutritional imbalance is shifting from a predominance of undernutrition to overnutrition. This complex problem poses a huge challenge to governments, non-state actors, and individuals desirous of addressing the problem of malnutrition in LMICs. The objective of this study was to systematically review the literature towards providing an estimate of the prevalence of overweight and obesity among adult Ghanaians.MethodsThis study followed the recommendations outlined in the PRISMA statement. Searches were performed in PubMed, Science Direct, google scholar, Africa Journals Online (AJOL) and the WHO African Index Medicus database. This retrieved studies (published up to 31st March 2016) that reported overweight and obesity prevalence among Ghanaians. All online searches were supplemented by reference screening of retrieved papers to identify additional studies.ResultsForty-three (43) studies involving a total population of 48,966 sampled across all the ten (10) regions of Ghana were selected for the review. Our analysis indicates that nearly 43% of Ghanaian adults are either overweight or obese. The national prevalence of overweight and obesity were estimated as 25.4% (95% CI 22.2–28.7%) and 17.1% (95% CI = 14.7–19.5%), respectively. Higher prevalence of overweight (27.2% vs 16.7%) and obesity (20.6% vs 8.0%) were estimated for urban than rural dwellers. Prevalence of overweight (27.8% vs 21.8%) and obesity (21.9% vs 6.0%) were also significantly higher in women than men. About 45.6% of adult diabetes patients in Ghana are either overweight or obese. At the regional level, about 43.4%, 36.9%, 32.4% and 55.2% of residents in Ashanti, Central, Northern and Greater Accra region, respectively are overweight or obese. These patterns generally mimic the levels of urbanization. Per studies’ publication years, consistent increases in overweight and obesity prevalence were observed in Ghana in the period 1998–2016.ConclusionsThere is a high and rising prevalence of overweight and obesity among Ghanaian adults. The possible implications on current and future population health, burden of chronic diseases, health care spending and broader economy could be enormous for a country still battling many infectious and parasitic diseases. Public health preventive measures that are appropriate for the Ghanaian context, culturally sensitive, cost-effective and sustainable are urgently needed to tackle this epidemic.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3901-4) contains supplementary material, which is available to authorized users.

Socio-demographic and behavioural determinants of body mass index among an adult population in rural Northern Ghana: the AWI-Gen study

“…The latter observation mirrors reports from other low- and middle-income countries (LMIC) [6,41,42] but differs from many findings emanating from western countries which have often reported higher BMI among families with lower SES [43]. The data from LMICs may be due to a high purchasing power of those with higher SES who undergo a faster nutritional transition onto energy-dense foods.…”

“…The sex-specific pattern of overweight and obesity reflects the general distribution reported across Africa [8,38] and in previous reports from Ghana [6,39,40]. The roles of endogenous and exogenous steroid exposure and biological differences in body fat distribution have been used to explain gender differences in overweight and obesity [16].…”

“…Recent studies among Ghanaians had also found a strong association between higher household income levels, higher educational status and type 2 diabetes (T2D) and obesity [44]. Possible reasons include the fact that higher education is associated with a higher likelihood of engaging in white-collar or more sedentary jobs [6]. The subsequent inactivity associated with these jobs will likely result in increased BMI.…”

“…Countries in SSA are at different stages of the transition, with the majority moving from under- to over-nutrition [3–5]. This is largely due to the consumption of energy-rich foods and falling levels of energy expenditure [6]. …”

“…It is a convenient measure of total body fat mass in resource constrained settings and has been demonstrated to correlate directly with co-morbidities and mortalities [6]. …”