Partnership research on nutrition transition and chronic diseases in West Africa – trends, outcomes and impacts
ABSTRACT Nutrition-related chronic diseases (NRCD) are rising quickly in developing countries, and the nutrition transition is a major contributor. Low-income countries have not been spared. Health issues related to nutritional deficiencies also persist, creating a double burden of malnutrition (DBM). There is still a major shortage of data on NRCD and DBM in Sub-Saharan Africa. A research program has been designed and conducted in partnership with West African institutions since 2003 to determine how the nutrition transition relates to NRCD and the DBM in order to support prevention efforts.
In Benin, cross-sectional studies among apparently healthy adults (n=540) from urban, semi-urban and rural areas have examined cardiometabolic risk (hypertension, obesity, dyslipidemia, insulin resistance) in relation to diet and lifestyle, also factoring in socio-economic status (SES). Those studies were followed by a longitudinal study on how risk evolves, opening the way for mutual aid groups to develop a prevention strategy within an action research framework. In Burkina Faso, a cross-sectional study on the nutritional status and dietary patterns of urban school-age children (n=650) represented the initial stages of an action research project to prevent DBM in schools. A cross-sectional study among adults (n=330) from the capital of Burkina Faso explored the coexistence, within these individuals, of cardiometabolic risk factors and nutritional deficiencies (anemia, vitamin A deficiency, chronic energy deficiency), as they relate to diet, lifestyle and SES.
The studies have shown that the prevalence of NRCD is high among the poor, thereby exacerbating social inequalities. The hypothesis of a positive socio-economic (and rural-urban) gradient was confirmed only for obesity, whereas the prevalence of hypertension, insulin resistance and dyslipidemia did not prove to be higher among affluent city dwellers. Women were particularly affected by abdominal obesity, at 48% compared to 6% of men. Protective factors against the risk of NRCD were physical activity and adequate micronutrient intake. The research also showed that nutritional deficiencies were not restricted to schoolchildren in rural areas because in the capital of Ouagadougou, for example, 40% of schoolchildren were anaemic and 40% were vitamin A deficient. Partnership research has expanded to include advocacy and human resources training.
These initial studies on NRCD in West Africa indicate the relevance and urgency of prevention, even among low-income groups and countries. They show that the fight against NRCD as well as nutritional deficiencies should focus on women. Seeing how researchers from the African partner institutions have connections with decision-making authorities, the research findings could have an impact on prevention policies and programs in communities and schools alike. Greater support must nevertheless be provided to lobbying and advocacy work for an even greater impact. As well, the sustainability of the research program remains a challenge that requires resource mobilization and training for the purpose.
SourceAvailable from: Zandile June-Rose Mchiza[Show abstract] [Hide abstract]
ABSTRACT: This review illustrates the outcomes of the nutrition transition in Sub-Saharan Africa (SSA) and its association with overweight and obesity; the relationship with the double burden of malnutrition is also explored. We describe the increase in overweight in nearly all Sub-Saharan African countries and present data on associated increased gross domestic product, and availability of energy, protein, fat, and sugar at country national levels. Predictors of overweight are described by means of various studies undertaken in SSA, and dietary intakes of numerous countries are presented. Overall, we show that socioeconomic status, gender, age, parity, physical inactivity, and increased energy, fat, and sugar intake are powerful predictors of overweight and/or obesity. The urgency for health interventions in countries in the early stages of the nutrition transition is emphasized, particularly in view of the fact that fat intake is still less than 30% of energy intake in nearly all Sub-Saharan African countries.Annals of the New York Academy of Sciences 04/2014; 1311(1). DOI:10.1111/nyas.12433 · 4.31 Impact Factor
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ABSTRACT: There is a mounting body of evidence regarding the challenge posed by diabetes and obesity on the health systems of many Sub-Sahara African countries. This trend has been linked to the changing demographic profile together with rapid urbanization and changing lifestyles in both rural and urban settings in Africa. Africa is expected to witness the greatest increase in the number of people with diabetes from 19.8 million in 2013 to 41.4 million in 2035 if current trends persist. Excess weight alone currently accounts for at least 2.8 million deaths globally each year through increased risk for type 2 diabetes and cardiovascular complications. This review highlights recent literature on the problem of obesity and type 2 diabetes in Sub-Sahara Africa. It exposes the need for concrete interventions based on the now available wealth of evidence.Current Diabetes Reports 07/2014; 14(7):501. DOI:10.1007/s11892-014-0501-5 · 3.38 Impact Factor