Urbanization and obesity in The Gambia: a country in the early stages of the demographic transition

Abstract

Objective: To investigate the distribution of overweight and obesity and its relationship with socio-economic and behavioural factors in a developing-country population undergoing rapid nutritional transition. Design: Cross-sectional house-to-house survey in urban Gambia. Subjects: Four groups of 50 subjects were sampled as follows: young men (YM, 14-25 years), young women (YW, 14-25 years), older men (OM, 35-50 years) and older women (OW,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50). Measurements: Several socio-economic and behavioural factors were investigated. Composite indices for socio-economic status, education, healthy lifestyle and western influences were created. Body weight, height, waist and hip circumferences were measured and body mass index (BMI) was calculated. Body composition was assessed by leg-to-leg bioimpedance. Overweight was defined as BMI ¼ 25.0-29.9 kg/m 2 and obesity as BMIX30.0 kg/m 2 . Results: There were highly significant gender and age differences in overweight (YM ¼ 0%, YW ¼ 10%, OM ¼ 6% and OW ¼ 34%) and obesity (YM ¼ 0%, YW ¼ 4%, OM ¼ 6% and OW ¼ 50%). Only 16% of OW were neither overweight nor obese compared to 88% of OM. OW had a higher fat mass percent (38.4%) than other groups, while fat-free mass (kg) was significantly higher in males than females with YW having the lowest value. Young generations were more educated and more influenced by western ideals than OM and OW. Weight gain was not always associated with weight concern and many overweight/obese subjects did not perceive themselves as overweight. Conclusion: Social and behavioural changes are already creating a perceptible 'generational gap' among this population undergoing rapid transition. The improved education and current lean status of the younger adults offers opportunities for preventative interventions. These need to be specially targeted at women.

Socio-spatial disparities of obesity among adults in the urban setting of Ouagadougou, Burkina Faso

“…Studies in subSaharan urban adults in Nigeria, The Gambia, Ghana, Senegal, Cameroon and South Africa reported prevalence of obesity between 5 and 7 % in men and between 19 and 50 % in women depending on the age category of the studied population (4)(5)(6)(7)(8)(9)(10)(11)(12) . In the foreseeable future, the prevalence of obesity is expected to continue to rise in lower-income countries (13) .…”

Seasonal variations and trends in weight and arm circumference of non-pregnant rural Senegalese women, 1990–1997

“…In 2004 in Banjul, the capital city of the Gambia, 34% of women aged 35-50 years were overweight, while 50% were obese, leaving only 16% who had normal weight (Siervo et al, 2006). In comparison, young women (14-25 years) were seldom overweight or obese (10 and 4%, respectively; Siervo et al, 2006).…”

“…Their capital cities, on the other hand, face a sharply increasing prevalence of overweight and obesity among women, and prevention is hindered by women's view of overweight as a healthy and desirable condition (Holdsworth et al, 2004;Siervo et al, 2006). This perception probably has roots in the traditional rural lifestyle characterized by poverty, associated with strong physical activity and food shortage during the rainy season.…”

Ethnic differences in the association between body mass index and impedance index (Ht2/Z) in adult women and men using a leg-to-leg bioimpedance method

“…Recruitment was conducted within a typical urban population and a house-tohouse strategy was used to recruit a random sample. The characteristics of the population are described elsewhere (Siervo et al, 2006).…”