Prevalence and Determinants of Overweight and Obesity among the Catholic University of Eastern Africa Staff, Langata Campus, Nairobi, Kenya

  

    
Variables
    
N
    
Percent (%)
  
  

    
Alcohol    consumption status
  
  

    
Yes
    
184
    
61.1
  
  

    
No
    
117
    
38.9
  
  

    
Frequent    of alcohol consumption per week (N=184)
  
  

    
= 2 days
    
152
    
82.6
  
  

    
= 3 days
    
32
    
17.4
  
  

    
Standard    drinks per drinking occasion (N=184)
  
  

    
1-3 standard drinks
    
84
    
45.7
  
  

    
>3 standard drinks
    
100
    
54.3
  
  

    
Relationship    between alcohol consumption and physical measurements
  
  

    
Variables
    
Standard drinks per drinking    occasion
    
p-value
  
  

    
1 - 3 standard drinks
    
= 3 standard drinks
  
  

    
Mean BMI
    
26.2
    
39.6
    
0.002
  
  

    
Mean WC in cm
    
85.3
    
94.7
    
0.005
  
  

    
Key    abbreviations: BMI: Body Mass Index; WC: Waist Circumference.
      
Analysis    with:*One-Way ANOVA; **Independent Samples T test. 
  

Table 5: Relationship between alcohol consumption and physical measurements.

Discussion

Our study findings revealed that age, gender, physical activity, consumption of fruits, vegetables, fast foods and alcohol were the variables significantly associated with overweight and obesity among the study respondents. The subsequent discussion will be based on these findings.

Relationship between respondents’ age and gender and physical measurements

Using BMI, the prevalence of overweight and obesity among the respondents were 47.5% and 36.3% respectively. Of the obese respondents, 30.2% had obesity I, 3.4% obesity II and 2.7% obesity III. Using the European Group for study of Insulin Resistance (EGIR, 2004) definition, majority, (79.8%) men and (76.3%) women had abnormal high Waist Circumference (WC) measurements (= 94 cm for men and = 80 cm for women). Based on WC, the prevalence of overweight and obesity among men were 42.6% and 37.2% respectively. While among the women the prevalence of overweight and obesity were 56.8% and 19.5% respectively. The prevalence of overweight is higher in women at 56.8% compared to 42.6% in men, while, the prevalence of obesity is higher in men at 37.2% compared to 19.5% in women. In the current study, this prevalence of overweight/ obese (42.6%) among Kenyan women is higher than the prevalence recorded in 2009 at 39% in Nairobi, the main capital city of Kenya [10]. The observed high prevalence rate of overweight/obese in this study could be due to the fact that the respondents were University staff with higher standards of living than the general population and also the nature of their work, sedentary behavior, might predispose them to overweight/obese than the general population.

Further analyses revealed that mean BMI and the mean WC were significantly higher among respondents aged =40 years old compared to respondents aged above 40 years. Additionally, the mean WC was significantly higher among male respondents compared to the female counterparts (p=0.044). This finding is in agreement with many previous studies which found that young adults (below 40 years old) had abnormal higher BMI and WC compared to individuals above 40 years old [11-14]. Young adults are more prone to obesity than older adults because of several reasons. Firstly, young adults eat a lot of fast foods and drink more alcohols than older adults which might put them at higher risk of obesity. People younger than 40s have higher chances of engaging in socialization and involving in unhealthy lifestyles (eating and drinking) than individuals above 40s, characteristics which might put them to overweight/obese. Fast foods are high in calories, salt and sugar, which are known risk factors for obesity [15]. WHO data revealed that consumption of processed foods and/or fast foods promotes obesity due to their high contents of salt, sugar and fats compared to low-energy foods such as fruits and vegetables [16]. Secondly, adults above 40 years old are more knowledgeable about lifestyle changes because they visit health facilities more frequently than young adults which might play a significant role in adapting healthier lifestyle behavior. Obesity has negative health consequences, both in increased morbidity and mortality as well as social stigma and limitations to healthy social functioning.

Relationship between dietary intake patterns and physical measurements

The study revealed that daily consumption of vegetables and fruits were significantly associated with lower WC. While, higher WC and BMI were significantly associated with daily consumption of fast foods. Dietary intake has been cited as one of the leading forces in the development of overweight and obesity. Over the years, the diets of populations have been changing towards diets that favour the weight gain as traditional diets are gradually replaced with modern diets and this is particularly significant in Nairobi (the capital city of Kenya) where the study was carried out. The adoption of unhealthy eating habits such as increased consumption of soft drinks, sweets, fried and processed foods, favours an increase in the amount of body fat and thus obesity [10]. Fruits and vegetables on the other hand reduce weight because they have low energy density, high water, fiber, and low fat content. The high-fiber content is attributed to weight loss through the feeling of stomach fullness or enhance satiety without additional calories. On the other hand, fast foods, high calorie beverages and diet rich in calories, but lacking fruits and vegetables are associated with weight gain [15,17-19]. WHO data revealed that consumption of processed foods and/or fast foods promotes obesity due to their high contents of salt, sugar and fats compared to lowenergy foods such as fruits and vegetables [16]. Consumption of unhealthy diets and changing lifestyles has resulted in increased levels of obesity, cardiovascular diseases, cancers and diabetes and represent a significant development challenge [10].

Relationship between physical activity and physical measurements

Majority, (89.4%) and (87.7%) of the respondents’ work did not involve vigorous intensity and moderate intensity physical activities respectively. Of the respondents, most, (64.8%) did not involve in any vigorous intensity sports or recreation activities. Majority, (90%) of the respondents had spent seating for =5 hours per day. The WHO defines insufficient physical activity as less than five times 30 minutes of moderate physical activity per week, or less than three times 20 minutes of vigorous physical activity per week [20]. Further analysis revealed that respondents who had involved in vigorous intensity physical activity for =20 minutes for =3 days in a week had significantly lower mean BMI and mean WC compared to respondents who did not involve in any vigorous intensity physical activity for =20 minutes for =3 days in a week respectively. Additionally, respondents who had involved in moderate intensity physical activity for =30 minutes for =5 days in a week had significantly lower mean BMI and mean WC than respondents who did not involve in in moderate intensity physical activity for =30 minutes for =5 days in a week respectively.

This finding is in line with other studies which found that engaging in physical activities reduces both BMI and WC [21-24]. Physical activity contributes to energy consumption, prevents obesity, favors weight loss, and reduces the risk of developing cardiovascular diseases, type 2 diabetes mellitus and some forms of cancer [25,26]. Adequate physical activity has been shown to have many health promoting properties and has a direct, independent role in reducing CVDs mortality. Inactivity on the other hand is one of the most important factors that have been known to fuel overweight and obesity.

Kenyans today rely more on personal and public vehicles to move even the shortest of distance. This is particularly significant for people, who work in teaching institutions; they usually drive from home to work place and then drive back to home after sitting the whole day in office, sedentary behaviors which predispose them to obesity. Physical inactivity is recognized as one of the four major risk factors for the four major Non-communicable diseases which contribute for multiple deaths and disability. People who do not involve in physical activity have a 20-30% increased risk of all-cause mortality compared to those who involve in at least 30 minutes of moderate intensity physical activity for =5 days in a week [WHO, 2009a]. Research revealed that weekly engagement in 150 minutes of moderate intensity physical activity reduces the risk of ischaemic heart disease by approximately 30%, the risk of diabetes by 27% and the risk of breast and colon cancer by 21-25% [20]. Regular physical activity also helps the body cells take up glucose and thus lower blood glucose levels. Adequate physical activity can prevent the development of diabetes by reducing body weight, increasing insulin sensitivity and blood sugar control. It also helps control blood cholesterol and blood pressure. Conversely, insufficient physical activity decreases insulin sensitivity, which can lead to diabetes [27].

Relationship between alcohol consumption and physical measurements

Most, (61.1%) of the respondents consume alcohol. Of those who consume alcohol, majority, (67.6%) consumed =3 standard drinks in one drinking occasion. Further analyses with One-Way ANOVA and independent samples T-test revealed that both mean BMI and mean WC were significantly higher among respondents who had drunk =3 standard drinks per drinking occasion as compared to respondents who drink less than 3 standard drinks per drinking occasion. The amount and frequency of alcohol consumption have been found to correlate with BMI and WC. A study using national surveys in the United States found that people who consumed =4 drinks per day had significantly higher BMI than those who consumed one drink per day [28-31]. There are several reasons alcohol and weight gain are linked. Alcohol can cause weight gain simply because it has calories. If there is too much alcohol, it can also turn into fat in the liver, which then turns into fat which is likely to be stored as fat in the body and thus weight gaining. Alcohol is an appetite stimulant, so people may be more likely to eat more and also make poorer food choices if they’re drinking [32,33]. Alcohol may also fail to trigger the physiologic mechanism that produces the feeling of fullness in the short term, long-term, frequent drinkers which may predispose heavy drinkers to overeating and thus weight gain [34].

Conclusion

Our findings show that there is high prevalence of overweight and obesity among the respondents. Consumption of fast foods and excessive alcohol are predictors for obesity. While high consumption of fruits and vegetable and engaging in both moderate and vigorous physical activities are protective against obesity. Institution like The Catholic University of Eastern Africa should be involved in lifestyle modification including supervised weight loss programs leading to improved nutrition, physical activity and behavioral change.

Acknowledgment

The authors are grateful for all study participants who took part in the study for their time.

Availability of Data and Materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Authors’ Contributions

Both authors were instrumental in conception, research development and study design. FO contributed in data collection. OT was instrumental in statistical analysis. OT contributed in discussion and manuscript revision. Both authors read and gave final approval for the manuscript’s submission and publication.

Ethics Approval and Consent to Participate

The ethical approval to conduct the study was obtained from Kenyatta National Hospital-University of Nairobi Ethical Review Committee (KNH-UoN ERC) (Approval number (UP 592/10/2017). The institutional permission was granted by the administration of the Catholic University of Eastern Africa. The consent was obtained from the respondents after explanation regarding the study both verbally and in written before data collection was commenced.

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