High prevalence of obesity among women in urban Haiti: Findings from a population-based cohort
Eliezer Dade, Miranda Metz, Jean Lookens Pierre, Vanessa Rouzier, Rodney Sufra, Elizabeth Fox, Fabyola Preval, Stephano St-Preux, Jean Ronald Zephir 2nd, Wilson Ariste, Rehana Rasul, Shalom Sabwa, Nicholas Roberts, Marie Marcelle Deschamps, Patrice Severe, Daniel Fitzgerald, Jean William Pape, Lily Du Yan, Margaret L McNairy, Eliezer Dade, Miranda Metz, Jean Lookens Pierre, Vanessa Rouzier, Rodney Sufra, Elizabeth Fox, Fabyola Preval, Stephano St-Preux, Jean Ronald Zephir 2nd, Wilson Ariste, Rehana Rasul, Shalom Sabwa, Nicholas Roberts, Marie Marcelle Deschamps, Patrice Severe, Daniel Fitzgerald, Jean William Pape, Lily Du Yan, Margaret L McNairy
Abstract
Introduction: Obesity is associated with increased risk of non-communicable diseases and death and is increasing rapidly in low- and middle-income countries, including Haiti. There is limited population-based data on body mass index (BMI) and waist circumference (WC) and associated risk factors in Haiti. This study describes BMI and WC, and factors associated with obesity using a population-based cohort from Port-au-Prince.
Methods: Baseline sociodemographic and clinical data were collected from participants in the Haiti CVD Cohort Study between March 2019 and August 2021. Weight was categorized by BMI (kg/m2) with obesity defined as ≥30 kg/m2. Abdominal obesity was defined using WC cutoffs of ≥80 cm for women and ≥94 cm for men based on WHO guidelines. Sociodemographic and behavioral risk factors, including age, sex, educational attainment, income, smoking status, physical activity, fat/oil use, daily fruit/vegetable consumption, and frequency of fried food intake were assessed for their association with obesity using a Poisson multivariable regression.
Results: Among 2,966 participants, median age was 41 years (IQR: 28-55) and 57.6% were women. Median BMI was 24.0 kg/m2 (IQR: 20.9-28.1) and 508 (17.1%) participants were obese. Women represented 89.2% of the population with BMI ≥30 kg/m2. A total of 1,167 (68.3%) women had WC ≥80 cm and 144 (11.4%) men had WC ≥94 cm. BMI ≥30 kg/m2 was significantly more prevalent among women than men [PR 5.7; 95% CI: (4.3-7.6)], those 40-49 years compared to 18-29 years [PR 3.3; 95% CI: (2.4-4.6)], and those with income >10 USD per day compared to ≤1 USD [PR 1.3; 95% CI: (1.0-1.6)]. There were no significant associations with other health and behavioral risk factors.
Discussion: In Haiti, women have an alarming 6-fold higher obesity prevalence compared to men (26.5 vs. 4.3%) and 89.2% of participants with obesity were women. Abdominal obesity was high, at 44.3%. Haiti faces a paradox of an ongoing national food insecurity crises and a burgeoning obesity epidemic. Individual, social, and environmental drivers of obesity, especially among women, need to be identified.
Keywords: Haiti; cardiovascular disease; food insecurity; nutrition transition; obesity; overweight.
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Copyright © 2022 Dade, Metz, Pierre, Rouzier, Sufra, Fox, Preval, St-Preux, Zephir, Ariste, Rasul, Sabwa, Roberts, Deschamps, Severe, Fitzgerald, Pape, Yan and McNairy.
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