Prevalence of Obesity, Oxidative Stress and Perception of Body Image among Adults in the Wa Municipality, Ghana

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The rising prevalence of overweight and obesity globally and in Ghana is considered as a pandemic with public health implications because of the corresponding rising prevalence of diabetes, hypertension and other non-communicable diseases, which are known causes/risk factors of morbidity and mortality. In spite of this rising trend, little is known of the perception of body image in Ghana and how that contributes to the situation. With scanty data on national and regional level about overweight/obesity, hypertension and diabetes, a cross-sectional survey was conducted in Wa Municipality to determine the prevalence of overweight and obesity, oxidative stress among adults and how body image perception inform this. Multi-stage cluster sampling proportional to size was used to select 320 adult (≥18 years) participants living in 30 communities in the Wa Municipality, Ghana for the study. Anthropometry, blood pressure and fasting blood sugar levels were determined using standard instruments. Glutathione levels were determined in blood serum in the laboratory using the 5,5'-dithiobis (2-nitrobenzoic acid) method. A structured questionnaire was used to elicit responses on a single 24-hour dietary recall, general health knowledge of respondents and body image perception. Statistical Package for Social Sciences (SPSS) version 20 was used to analyze the data. Pearson Chi-square correlation, regression and cross tabulations were used to draw relationships between various variables. The study revealed a 9.1±0.72% obesity prevalence with a combined overweight and obesity prevalence of 32.2%. Male gender was protective against obesity (OR: 0.40 CI: 0.22 – 0.71), implying males have 60% less risk of being obese compared to females. Obesity was highest among age 40-59 years relative to other age groups, and urban dwellers were generally more obese (12.3%) compared to rural dwellers(4.0%) p=0.045. Few respondents (18%) had no knowledge about the causes of obesity whilst 30% had no knowledge about any adverse health effects associated with obesity. Close to 6 in 10 participants had a wrong perception of their BMI status. Moreover 8 in 10 overweight and 8.5 in 10 obese participants had a wrong perception of their BMI status. Contrary to these misrepresentations, most (70%) of the obese participants desired to lose weight. Participants who desired to lose weight had 6.73 increased odds of being obese (CI: 3.65 – 12.41). Multinomial logistics regression showed that kilocalories intake was a predictor of overweight/obesity with 1.7 (CI: 1.02 -2.13, p=0.049) and 1.5 (CI: 0.99 – 2.34, p=0.043) times higher risk for the upper and middle tertiles respectively. No significant variations were observed in serum glutathione (GSH) levels of respondents and their nutritional status although 4 in 10 participants had low GSH status. Systolic hypertension was high among overweight (21.6%) and obese (31.0%) respondents relative to the underweight (11.5%) and normal (7.5%). Similarly, hyperglycaemia was high among overweight (12.3%) and obese (17.2%) relative to the underweight (11.1%) and normal (5.5%). In this adult population in North Western Ghana, overweight/obesity prevalence was high, with high body image misconception. Overweight/obese participants had high calorie intake and are more likely to be hypertensive/hyperglycaemic. Further research to identify underlying causes of obesity and formulate effective public health interventions is recommended.
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