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Multicenter Study
. 2016 Oct 21;14(1):166.
doi: 10.1186/s12916-016-0709-0.

Obesity and type 2 diabetes in sub-Saharan Africans - Is the burden in today's Africa similar to African migrants in Europe? The RODAM study

Charles Agyemang  1 , Karlijn Meeks  2 , Erik Beune  2 , Ellis Owusu-Dabo  3 , Frank P Mockenhaupt  4 , Juliet Addo  5 , Ama de Graft Aikins  6 , Silver Bahendeka  7 , Ina Danquah  8 , Matthias B Schulze  8 , Joachim Spranger  9 , Tom Burr  10 , Peter Agyei-Baffour  3 , Stephen K Amoah  4   11 , Cecilia Galbete  8 , Peter Henneman  12 , Kerstin Klipstein-Grobusch  13   14 , Mary Nicolaou  2 , Adebowale Adeyemo  15 , Jan van Straalen  16 , Liam Smeeth  5 , Karien Stronks  2
Affiliations
Multicenter Study

Obesity and type 2 diabetes in sub-Saharan Africans - Is the burden in today's Africa similar to African migrants in Europe? The RODAM study

Charles Agyemang et al. BMC Med. .

Abstract

Background: Rising rates of obesity and type 2 diabetes (T2D) are impending major threats to the health of African populations, but the extent to which they differ between rural and urban settings in Africa and upon migration to Europe is unknown. We assessed the burden of obesity and T2D among Ghanaians living in rural and urban Ghana and Ghanaian migrants living in different European countries.

Methods: A multi-centre cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin). Comparisons between groups were made using prevalence ratios (PRs) with adjustments for age and education.

Results: In rural Ghana, the prevalence of obesity was 1.3 % in men and 8.3 % in women. The prevalence was considerably higher in urban Ghana (men, 6.9 %; PR: 5.26, 95 % CI, 2.04-13.57; women, 33.9 %; PR: 4.11, 3.13-5.40) and even more so in Europe, especially in London (men, 21.4 %; PR: 15.04, 5.98-37.84; women, 54.2 %; PR: 6.63, 5.04-8.72). The prevalence of T2D was low at 3.6 % and 5.5 % in rural Ghanaian men and women, and increased in urban Ghanaians (men, 10.3 %; PR: 3.06; 1.73-5.40; women, 9.2 %; PR: 1.81, 1.25-2.64) and highest in Berlin (men, 15.3 %; PR: 4.47; 2.50-7.98; women, 10.2 %; PR: 2.21, 1.30-3.75). Impaired fasting glycaemia prevalence was comparatively higher only in Amsterdam, and in London, men compared with rural Ghana.

Conclusion: Our study shows high risks of obesity and T2D among sub-Saharan African populations living in Europe. In Ghana, similarly high prevalence rates were seen in an urban environment, whereas in rural areas, the prevalence of obesity among women is already remarkable. Similar processes underlying the high burden of obesity and T2D following migration may also be at play in sub-Saharan Africa as a consequence of urbanisation.

Keywords: Ethnic minority groups; Europe; Migrants; Obesity; Sub-Saharan Africa; Type 2 diabetes.

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Figures

Fig. 1
Fig. 1
Age-standardised prevalence of obesity (BMI ≥ 30 kg/m2) by locality in men (a) and women (b). Error bars are 95 % confidence intervals
Fig. 2
Fig. 2
Age-standardised prevalence of abdominal obesity (waist circumference, men: > 102 cm, women: > 88 cm) by locality in men (a) and women (b). Error bars are 95 % confidence intervals
Fig. 3
Fig. 3
Prevalence ratios of obesity (BMI ≥ 30 kg/m2) and abdominal obesity by locality and sex (models are adjusted for age and education)
Fig. 4
Fig. 4
Age-standardised prevalence of type 2 diabetes by locality in men (a) and women (b). Error bars are 95 % confidence intervals
Fig. 5
Fig. 5
Age-standardised prevalence of impaired fasting glucose by locality in men (a) and women (b). Error bars are 95 % confidence intervals
Fig. 6
Fig. 6
Prevalence ratio of type 2 diabetes and impaired fasting glycaemia by locality and sex (models adjusted for age and education)
Fig. 7
Fig. 7
Probability of type 2 diabetes by BMI in men (a) and women (b) (models are adjusted for age)
Fig. 8
Fig. 8
Probability of type 2 diabetes by waist circumference in men (a) and women (b) (models are adjusted for age)
See this image and copyright information in PMC

References

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