SOCIO-DEMOGRAPHIC PREDICTORS OF OVERWEIGHT AND OBESITY AMONG ADULTS IN EKPOMA, NIGERIA IJPHCS

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International Journal of Public Health and Clinical Sciences e-ISSN : 2289-7577. Vol. 5:No. 2 March/April 2018

Nmorsi O.P., Suriani .I., Rosliza A.M.,Oyibo, P.G. 219

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SOCIO-DEMOGRAPHIC PREDICTORS OF OVERWEIGHT AND OBESITY AMONG ADULTS IN EKPOMA, NIGERIA

Nmorsi Ogechi P.

1

, Suriani, I.

2

, Rosliza, A. M.

2

, Oyibo, P.G

3

1 Postgraduate Student, Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

2 Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

3Department of Community, Faculty of Clinical Medicine College of Health Science, Delta State University, Abraka, Delta state.

Corresponding author: Suriani Ismail, e-mail: si_suriani@upm.edu.my

ABSTRACT

Background: Being overweight and obese are major causes of weight related health risks which are linked to morbidity and mortality. It is also rated as the sixth most essential threat in terms of number of deaths in the world and a major public health challenge globally. While this epidemic is prominent among developed countries, the prevalence is also increasing in developing countries such as Nigeria. The objective of this study is to determine the prevalence of overweight and obesity among adults in Ekpoma, Nigeria and also its socio- demographic predictors.

Materials and Method: A cross sectional study was conducted in 2017 among adults in Ekpoma, Nigeria. The inclusion criteria included adults aged between 18 – 65 years. Data was collected using a pretested self-administered questionnaire and analysed using IBM SPSS version 22. Respondents’ body mass index (BMI) was categorised into 2 categories namely

‘overweight and obese’ and ‘not overweight and obese’. Chi square, simple and multiple logistic regressions were used to determine socio-demographic associations and predictors of

‘overweight and obesity’ among the respondents.

Results: A total of 445 respondents were recruited. Most respondents’ were aged between 18- 44 years (69.2%), female (51.2%), single (50.8%) and from the Edo ethnic group (72.1%), with 60.7% of them found to be ‘overweight and obese’. There were statistically significant associations between ‘overweight and obese’ with age (p = 0.001), gender (p = 0.033), marital status (p = 0.001) and ethnicity (p = 0.008). However the significant predictor for

‘overweight and obese’ was only marital status (AOR = 0.238, 95% CI = 0.143-0.398).

Conclusion: The findings in this study showed that there is a high prevalence of overweight and obesity among adults in Ekpoma, Nigeria, and it is significantly associated with age, gender, marital status, and ethnicity, but only marital status is a significant predictor.

Keywords: Overweight, obesity, socio-demography, adult, Ekpoma, Nigeria

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International Journal of Public Health and Clinical Sciences e-ISSN : 2289-7577. Vol. 5:No. 2 March/April 2018

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1.0 Introduction

Overweight and obesity are the state of abnormal or excessive body fat accumulated in adipose tissue which may lead to impaired health. This condition constitutes an important public health problem globally in developed and developing regions where they are escalating and leading to an increased incidence of non-communicable diseases. These conditions now occur in several parts of the globe and in such extensive proportions that many now refer to it as an epidemic. Thus, overweight and obesity have been publicly declared as chronic conditions which require treatment; given their association with increased morbidity and mortality.

More than 2.5 million deaths each year are attributed to overweight and obesity, and its associated disease conditions (WHO, 2000). Indeed, it is the sixth most essential health threat in terms of the number of deaths in the world (Rosiek, Maciejewska, Leksowski, Rosiek- Kryszewska and Leksowski, 2015).Individuals with excess body weight are predisposed to obesity-related conditions such as diabetes, cardiovascular diseases than those with normal body mass index (BMI). When BMI exceeds 30 kg/m2, the relative risk of death connected to obesity increases by 50% and if preventive measures are not set in place, the problem can escalate which may then overburden the health care system in the affected areas. Being overweight reduces life expectancy and shortens lifespan by three to seven years for an individual aged 40 year old with a BMI of 30 kg/m2 or more (Schlenker and Long, 2007).For this reason, there is a need to set measures in place to arrest the problem of overweight and obesity in order to avoid the harmful effects of these conditions.

Recent studies conducted in Nigeria show that there is a growing drift of overweight and obesity in this region. For instance, a study conducted by Ekpenyong, Akpan, Nyebuk, Daniel and Ibu (2011) in Uyo Metropolis, Nigeria among adults reported the prevalence of overweight and obesity at 28.7%. Adebayo et al., (2014) also revealed that among their respondents in rural communities in south west Nigeria, prevalence of overweight and obesity was 29.2%. Another study by Akarolo-Anthony, Willett, Spiegelman and Adebamowo (2014) also showed that 64% of their respondents in Abuja, Nigeria were overweight and obese and this indicates that there is a fast spread within the region and therefore a need for public health intervention.

There is an indication that numerous determinants have a role to play as far as overweight and obesity are concerned. Among the key determinants are age, gender, marital status and ethnicity (Rolfes, Pinna, and Whitney, 2006). Also included is the environmental factor referring to the circumstances encountered daily as an individual that pushes toward gaining weight.

In summary, overweight and obesity play a considerable role not only in causing poor health among individuals but also in affecting the quality of life; as well as limiting life span.The aim of this paper is to assess current epidemiological information on the prevalence of adult overweight and obesity specifically in Ekpoma, Nigeria and also to ascertain its association with socio-demographic characteristics.

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2.0 Materials and Methods

A cross sectional study was conducted in 2017; among adults in Ekpoma, Nigeria. A total number of 445 respondents were recruited through stratified random sampling. The inclusion criteria included adults aged between 18 – 65 years who were permanent residence.

Data was obtained using a pretested structured self-administered questionnaire. BMI was calculated using the formula of weight(kg) / height (m2). The BMI was then divided into four categories using WHO standard, namely; underweight (<18.5kg/m2), normal weight (≥ 18.5 - 24.9kg/m2), overweight (25 -29.9kg/m2) and obese ( ≥30kg/m2). The 4 categories were then collapsed into two categories namely ‘overweight and obese’ and ‘not overweight and obese’.

The socio-demographic variables collected include age, gender, marital status and ethnicity.

Data was analysed using IBM SPSS version 22. Descriptive analysis was done for all variables, where frequencies and percentages are presented. Chi square, simple and multiple logistic regressions were used to determine the association and predictors of overweight and obesity among respondents.

Ethics approval was obtained from Universiti Putra Malaysia Ethics Committee for Research Involving Human Subject (FPSK (EXP16)134) and permission to carry out the study was obtained from the Local Government of Esan West Edo State, Nigeria.

3.0 Result

3.1 Socio-demographic characteristics and prevalence of overweight and obesity among respondents

A total number of 445 eligible respondents were recruited with an overall 99.8% response rate. Table 1 shows that most respondents were between the age group of 18-44 (69.2%), majority were female (51.2%), single (50.8%) and from the Edo ethnic group (72.1%). The prevalence of overweight and obesity among the respondents was 270 (60.7%)

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International Journal of Public Health and Clinical Sciences e-ISSN : 2289-7577. Vol. 5:No. 2 March/April 2018

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Table 1: Socio-demographic distribution of respondents (N= 445)

Variables n (%)

Age

18-44 308 (69.2)

45-65 137 (30.8)

Gender

Male 217 (48.8)

Female 228 (51.2)

Marital status

Single 226 (50.8)

Married 219 (49.2)

Ethnicity

Edo 321 (72.1)

Others 124 (27.9)

Overweight and obesity status Not Overweight and obese 172 39.3) Overweight and obese 270 (60.7)

3.2 Association between overweight and obesity with socio-demographic factors

The proportion of ‘overweight and obese’ is higher among respondents from the age group of 45-65 (85.4%), among males (65.9%), married (83.1%) and from the Edo ethnic group (64.5%).

Table 2 shows a statistically significant association between ‘overweight and obesity’ and age (p = <0.001), gender (p = 0.033), marital status (p = <0.001) and ethnicity (p = 0.008).

Table 2: Association between socio-demographic characteristics and overweight and obesity among respondents (N =445)

*significance level (p) < 0.05

Variable Overweight and obese Yes

n(%)

No n(%)

p-value Age

18-44 45-65

153(49.7) 117(85.4)

155(58.3) 20(14.6)

0.001 * Gender

Male Female

143(65.9) 127(55.7)

74(34.1) 101 (44.3)

0.033 * Marital status

Single Married

88 (38.9) 182(83.1)

138(61.1) 37(16.9)

0.001 * Ethnicity

Edo Other

207(64.5) 63(50.8)

114(35.5) 61 (49.2)

0.008 *

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International Journal of Public Health and Clinical Sciences e-ISSN : 2289-7577. Vol. 5:No. 2 March/April 2018

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3.4 Predictors of overweight and obesity

Simple logistic regression analysis was conducted to look at the predicting factors influencing overweight and obesity among respondents using the “ENTER” method. The result from the simple logistic regression showed that respondents who are within the age group of 18-44 are less likely to be overweight and obese than those from the of 45-65 age group (OR=0.169, 95% CI= 0.100 – 0.285). Higher odds were predicted in males compared to females (OR=1.537, 95% CI = 1.047 – 2.255). Those who are single are less likely to be overweight and obese than those who are married (OR = 0.130, 95% CI =0.083 – 0.202) and respondents who belong to the Edo ethnic group has higher odds than others (OR = 1.758, 95% CI = 1.155 – 2.675). The variables that were significant at p < 0.05 at the initial model were selected and entered into the final model (Hosmer & Lemeshow 1989). This includes age, gender, marital status and ethnicity and all were analyzed by using the backward and forward stepwise likelihood test (“backward- L-R” and forward- L-R) and entered into the final model by using the “ENTER” method. Results show that, the variable that was significant in the final model was marital status. The prediction of ‘overweight and obesity’ is that those who are single are less likely to be overweight and obese than those who are married (AOR = 0.238, 95% CI

=0.143 – 0.398).

Table 3: Predictors of overweight and obesity among respondents (N=445)

Variable Simple Logistic Regression Multiple Logistic Regression Crude

Odds Ratio

95% CI p value

Adjusted Odds Ratio

95% CI p value

Lower Upper Lower Upper

Age 18-44 [45-65]

Gender Male [Female]

Marital Single [Married]

Ethnicity Edo [Others]

0.169 1 1.537 1 0.130 1 1.758 1

0.100

1.047

0.083

1.155 0.285

2.255

0.202

2.675

0.001*

0.001*

0.008*

0.008*

0.238 0.143 0.398 0.001*

[ ] Reference category *significant at p value <0.05

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4.0 Discussion

This study result revealed that among the respondents 60.7% were overweight and obese.

This prevalence level is slightly higher from a previous study conducted among the adult population in Eastern region Nnewi, Nigeria which stated that 58.1%% were overweight and obese (Maruf & Udoji 2015). This is also higher compared to a study conducted by Desalu, Salami, Oluboyo and Olarinoye (2008) on the prevalence and socio-demographic determinants of obesity among adults in an urban Nigerian population, which also reported a lower prevalence of 44.9%. Thus the prevalence in this study was higher than previous studies when compared due to the reported regional differences within Nigeria (Okafor, Gezawa, Sabir, Raimi and Enang, 2014). This could be because the living standard or dietary pattern of people located in Ekpoma might be different from people in other parts of Nigeria.

It was found that the percentage of overweight and obesity were higher among the older age group of 45-65 (85.4%) compared to those within the category of 18-44, and the difference was statistically significant. This study concurs with a study by Omoleke, Oyeyemi, Umar and Oyeyemi (2013) on overweight and obesity in Nigeria adults which reported that overweight and obesity rate tends to increase with an increasing age category among their respondents. This study finding is also consistent with another study conducted by Kandala and Stranges (2014) among women in Nigeria which stated that higher age has an association with overweight and obesity and the association with age is due to the process of natural ageing which is a difficult stage for weight reduction. However, further analysis shows that age was not a significant predictor of overweight and obesity in this study.

It was revealed that the percentage of overweight and obese is higher among males (65.9%) compared to females, which showed statistically significant association. This finding corresponds with a similar study conducted by Maruf and Nwannedimma, (2015) in the population in Nnewi, Nigerian which also revealed that males were more overweight and obese than females. Another study which examined the prevalence and assessment of overweight and obesity factors among adult population in Uyo state by Ekpenyong et al.

(2011) also showed that overweight was higher in males than in females. However, in this study further analysis showed that gender was not a significant predictor of overweight and obesity among the respondents

The percentage of overweight and obese respondents, among those who were married is higher (83.1%) compared to respondents who were single. This result is consistent with another study by Kaplan, Huguet, Newsom, Mcfarland and Lindsay (2003) among older adults in Canada which showed being married has a significant association with overweight and obesity. This could be because partners influence each other over eating decisions after marriage and that can lead to excess weight gain (Ipatenco, 2015). Furthermore, in this study marital status was also observed as a significant predictor of overweight and obesity among the respondents.

The study shows that the percentage of overweight and obesity is higher among those from the Edo ethnic group (64.5%) compared to other ethnicity. A study conducted among Kanuri or Shuwa ethnic group revealed that due to their pattern of living, overweight and obesity was positively associated with ethnicity (Omoleke et al., 2013). Negative lifestyles such as poor diet and being physically inactive increases the risk of being overweight (Gu, et al., 2015).

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5.0 Conclusion and recommendation

The result showed high prevalence of overweight and obesity accompanied by a statistically significant association between age, gender, marital status and ethnicity on overweight and obesity with marital status as a significant predictor. Therefore, the factors and predictors identified should be focused on in developing interventions to reduce prevalence of overweight and obesity among adults in Ekpoma, Nigeria.

Acknowledgement

The authors would like to acknowledge the local government for giving permission for data collection (Ekpoma, Nigeria) and all participants who agreed to participate in this study.

Declaration

Author(s) declare that this article is our original work.

Author’s contribution

Author 1: preparing research proposal, data collection, analysis and preparing the draft manuscript

Author 2: research concept and design, supervising the research process, actively involved in the data analysis and reviewing the manuscript

Author 3: supervising the research, reviewing the manuscript

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