Metabolic Syndrome Parameters and their Associated Factors among Older Prisoners in the Ashanti Region of Ghana

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Prison environments had been characterized by high rates of communicable diseases until recently when prevalence of non-communicable diseases have been assessed and high rates found especially among older inmates. This transition has been blamed primarily on inappropriate diets fed to inmates. In Ghana, little is known about diet and nutrient provisions and intakes among prisoners and their relationship with nutritional status and health. This study assessed food provision, dietary patterns and nutrient intakes and their relationship with metabolic syndrome among older prisoners. Household food record was used to estimate nutrients provision within the prisons and a single 24-hour recall was used to estimate the actual intakes of inmates. A total of one hundred and sixty inmates from the Kumasi central (131), Kumasi female (10) and Manhyia local prisons (19) were included in the study. Nutrient provision for protein, fibre, vitamin E, vitamin C, vitamin B12, folate and zinc were inadequate for male inmates but in excess for female prisoners. However, differences were observed between nutrient provision and actual intakes. This may be due to over or underestimation by inmates with a general probable underestimation. Metabolic syndrome was defined by the NCEP ATP III criteria. The mean systolic blood pressure of study participants was 141.1±23.2 mmHg, diastolic 88.9±15 mmHg, BMI 22.8±4.1kg/m2, waist circumference 81±10.3cm, FBS 4.3±0.9mmol/L, HDL 1.4±0.4mmol/L and triglycerides 1.1±0.6mmol/L. The overall prevalence of metabolic syndrome was 8.1%; 61.9% had one metabolic parameter and 21.9% had two parameters. Correlational analysis revealed a weak positive relationship between sodium intake and serum triglyceride (r= 0.212, p= 0.007); potassium and systolic (r=0.172, p= 0.030) and diastolic blood pressure (r=0.164, p= 0.039), vitamin B12 (r= 0.226, p= 0.004) and folate (r=0.186, p=0.018) and systolic blood pressure. No association was found between nutrient intakes and metabolic syndrome. In conclusion, nutrients provided were outside ranges of recommendations and higher than actual intakes. Prevalence of dyslipidaemia and elevated blood pressure were high among inmates. Adequacy of prison diets should be checked in order to prevent deficiencies and excesses and resultant increase in morbidity and mortality. Further studies should assess serum levels of these nutrients in order to determine more concrete association
A thesis submitted to the Department of Biochemistry and Biotechnology in partial fulfilment of the requirements for the award of Master of Philosophy Degree in Human Nutrition and Dietetics