BMC Medicine
Volume 14, Issue 1, 2016

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 (Article) (Open Access)

Agyemang C.* , Meeks K. , Beune E. , Owusu-Dabo E. , Mockenhaupt F.P. , Addo J. , de Graft Aikins A. , Bahendeka S. , Danquah I. , Schulze M.B. , Spranger J. , Burr T. , Agyei-Baffour P. , Amoah S.K. , Galbete C. , Henneman P. , Klipstein-Grobusch K. , Nicolaou M. , Adeyemo A. , van Straalen J. , Smeeth L. , Stronks K.
  • a University of Amsterdam, Department of Public Health, Academic Medical Center, Meibergdreef 9, Amsterdam, 1105 AZ, Netherlands
  • b University of Amsterdam, Department of Public Health, Academic Medical Center, Meibergdreef 9, Amsterdam, 1105 AZ, Netherlands
  • c University of Amsterdam, Department of Public Health, Academic Medical Center, Meibergdreef 9, Amsterdam, 1105 AZ, Netherlands
  • d Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana
  • e Institute of Tropical Medicine and International Health, Charité - University Medicine Berlin, Augustenburger Platz 1, Berlin, 13353, Germany
  • f London School of Hygiene and Tropical Medicine, Department of Non-communicable Disease Epidemiology, London, United Kingdom
  • g University of Ghana, Regional Institute for Population Studies, P.O. Box LG 96, Legon, Ghana
  • h MKPGMS-Uganda Martyrs University, Kampala, Uganda
  • i German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Molecular Epidemiology, Arthur-Scheunert-Allee 114-116, Nuthetal, 14558, Germany
  • j German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Molecular Epidemiology, Arthur-Scheunert-Allee 114-116, Nuthetal, 14558, Germany
  • k Charite Universitaetsmedizin Berlin, Department of Endocrinology and Metabolism, DZHK (German Centre for Cardiovascular Research), partner site Berlin, Center for Cardiovascular Research (CCR), Berlin, Germany
  • l Source BioScience, Nottingham, United Kingdom
  • m Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana
  • n Institute of Tropical Medicine and International Health, Charité - University Medicine Berlin, Augustenburger Platz 1, Berlin, 13353, Germany, ResearchGate, Invalidenstrasse 115, Berlin, D-10115, Germany
  • o German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Molecular Epidemiology, Arthur-Scheunert-Allee 114-116, Nuthetal, 14558, Germany
  • p Academic Medical Center, Department of Clinical Genetics, Amsterdam, Netherlands
  • q University Medical Center Utrecht, Julius Global Health, Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands, University of the Witwatersrand, Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
  • r University of Amsterdam, Department of Public Health, Academic Medical Center, Meibergdreef 9, Amsterdam, 1105 AZ, Netherlands
  • s Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, 12 South Drive, MSC 5635, Bethesda, MD, United States
  • t Academic Medical Center, Department of Clinical Chemistry, Amsterdam, Netherlands
  • u London School of Hygiene and Tropical Medicine, Department of Non-communicable Disease Epidemiology, London, United Kingdom
  • v University of Amsterdam, Department of Public Health, Academic Medical Center, Meibergdreef 9, Amsterdam, 1105 AZ, Netherlands

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. © 2016 The Author(s).

Author Keywords

Sub-Saharan Africa Migrants Obesity Europe ethnic minority groups type 2 diabetes

Index Keywords

urban population Netherlands Germany Africa south of the Sahara multicenter study clinical trial Europe non insulin dependent diabetes mellitus sex ratio Diabetes Mellitus, Type 2 human abdominal obesity middle aged statistics and numerical data rural population obesity Aged geographic distribution ethnology Cross-Sectional Studies cross-sectional study migrant Humans Black person African Continental Ancestry Group male England female prevalence Article adult migration age distribution Transients and Migrants Ghanaian impaired glucose tolerance
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84992028323&doi=10.1186%2fs12916-016-0709-0&partnerID=40&md5=fc1352ec5adc9a7f4cb8f7c15468d33c
DOI: 10.1186/s12916-016-0709-0
ISSN: 17417015
Cited by: 50
Original Language: English