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Comparative Study
. 2011 Feb;34(2):491-6.
doi: 10.2337/dc10-0990.

Urbanization, physical activity, and metabolic health in sub-Saharan Africa

Felix K Assah  1 , Ulf Ekelund, Soren Brage, Jean Claude Mbanya, Nicholas J Wareham
Affiliations
Comparative Study

Urbanization, physical activity, and metabolic health in sub-Saharan Africa

Felix K Assah et al. Diabetes Care. 2011 Feb.

Abstract

Objective: We examined the independent associations between objectively measured free-living physical activity energy expenditure (PAEE) and the metabolic syndrome in adults in rural and urban Cameroon.

Research design and methods: PAEE was measured in 552 rural and urban dwellers using combined heart rate and movement sensing over 7 continuous days. The metabolic syndrome was defined using the National Cholesterol Education Program-Adult Treatment Panel III criteria.

Results: Urban dwellers had a significantly lower PAEE than rural dwellers (44.2 ± 21.0 vs. 59.6 ± 23.7 kJ/kg/day, P < 0.001) and a higher prevalence of the metabolic syndrome (17.7 vs. 3.5%, P < 0.001). In multivariate regression models adjusted for possible confounders, each kJ/kg/day of PAEE was associated with a 2.1% lower risk of prevalent metabolic syndrome (odds ratio 0.98, P = 0.03). This implies a 6.5 kJ/kg/day difference in PAEE, equivalent to 30 min/day of brisk walking, corresponds to a 13.7% lower risk of prevalent metabolic syndrome. The population attributable fraction of prevalent metabolic syndrome due to being in the lowest quartile of PAEE was 26.3% (25.3% in women and 35.7% in men).

Conclusions: Urban compared with rural residence is associated with lower PAEE and higher prevalence of metabolic syndrome. PAEE is strongly independently associated with prevalent metabolic syndrome in adult Cameroonians. Modest population-wide changes in PAEE may have significant benefits in terms of reducing the emerging burden of metabolic diseases in sub-Saharan Africa.

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Figures

Figure 1
Figure 1
Population distribution of PAEE and clustered metabolic z-score in adults in rural and urban Cameroon.
See this image and copyright information in PMC

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