|
 
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| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 5
| Issue : 2 | Page : 70-76 |
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The meal pattern and incidence of overweight and obesity among market women in a Southwest community, Nigeria
Israel O Dada
Department of Human Nutrition, College of Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
| Date of Web Publication | 29-Dec-2017 |
Correspondence Address:
Israel O Dada
Department of Human Nutrition, College of Medicine, Afe Babalola University, Ado-Ekiti
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/sjo.sjo_14_17
Background and objectives: Overweight as well as obesity is a risk factor of maternal morbidity and mortality in Nigeria. This study assessed the meal pattern and incidence of overweight and obesity among market women in a Southwest community, Nigeria.
Materials and Methods: This cross-sectional study involved 250 market women randomly selected by multistage sampling technique. Respondents’ personal characteristics and meal pattern were obtained through a pretested interviewer-administered questionnaire. Their weight and height were measured and used to calculate their body mass index (BMI), which was categorized into underweight (BMI < 18.5 kg/m2), normal weight (BMI = 18.5–24.9 kg/m2), overweight (BMI = 25.0–29.9 kg/m2), and obesity (BMI ≥ 30 kg/m2). Data were analyzed using the Statistical Package for the Social Sciences version 16.0.
Results: The mean age of the market women was 37.31 ± 15.31 years and 50 (20.0%) of them had no formal education. Majority of participants ate three meals (64%) while 27% ate more than three meals per day. Breakfast meal was usually skipped by 163 (65.2%) of the women and 155 (62.0%) and 190 (76.0%) women often ate breakfast and lunch meals, respectively, outside the home. The prevalence of underweight, overweight, and obesity was 25.2, 16.0, and 8.0%, respectively. Women’s BMI was significantly associated with their age, marital status, family type, and level of education.
Conclusion: This study reveals the high prevalence of overweight and obesity among the market women. Older age, marriage, and monogamous family adversely influenced overweight/obesity. Nutrition education is recommended as an intervention strategy.
Keywords: Market women, meal pattern, Nigeria, obesity, overweight, underweight
How to cite this article:
Dada IO. The meal pattern and incidence of overweight and obesity among market women in a Southwest community, Nigeria. Saudi J Obesity 2017;5:70-6 |
| Introduction | |  |
Globally, about 2.8 million adults die yearly due to overweight and obesity.[1] In Nigeria, obesity is an emerging public health problem, especially among the women of childbearing age and coexists with underweight in the same population and household.[2] Nigeria national survey showed that 11% of women were underweight and 25% were overweight or obese.[3] Overweight and obesity have been associated with physical discomfort, psychological trauma, diabetes, cancer, osteoarthritis, hypertension, and caesarean delivery.[4],[5],[6],[7],[8],[9] Underweight mothers can suffer from low resistance to disease, low productivity,[3] high morbidity and mortality,[6] and bring forth undernourished children.[10].
Studies in Nigeria revealed the higher prevalence of overweight and obesity in female than male.[8],[11],[12],[13],[14],[15],[16],[17] Women form a greater proportion of traders in Nigerian markets; they sit down for long hours and engage in sedentary activities.[18] Hence, their mean daily energy intake is higher than recommended levels.[19] These characteristics may increase their risk of developing overweight and obesity, which may trigger other non-communicable diseases. Traders in Oyo town consumed street foods,[20] and eating outside the home encourages increased consumption of diet that is laden with processed, fast foods, and sugar or calories.[21] Energy dense food which may translate into higher BMI is a risk factor to the development of non-communicable diseases.[22],[23] Market women have been observed to miss meals[18],[24] and consume snacks which correlated with their BMI.[18]
Previous studies on market women in Nigeria revealed the prevalence of overweight ranging between 20.4 and 31.3%, whereas that of obesity was between 12.3 and 48%.[8],[18],[25],[26],[27],[28] A low (1.7%) and (1.0%) prevalence of underweight was observed among female traders in Sokoto[27] and Ondo State,[28] respectively. These findings show that both overweight or obesity and underweight exist among market women in Nigeria.
The predisposing factors of overweight and obesity include age, level of education, socioeconomic status, marital status, and level of physical activity.[11],[15],[29] A higher prevalence of overweight or obesity was found among older people, married individuals, people with higher education and high socioeconomic status, and sedentary life style. Mean BMI has been found to increase significantly with increasing maternal parity.[30]
Maternal nutrition has been linked with fetal growth and child’s health.[31] Underweight and obesity have potential to trigger various disease conditions, which could be prevented through adequate dietary practices. The assessment of women’s nutritional status will assist to identify the risks of disease and promote improved health. Hence, there is need for continuous study on this important health issue across various groups of the population and in different locations. Providing information on the prevalence of underweight, overweight, and obesity will help to trigger planning intervention strategies before they become an epidemic. The objectives of this study are to assess the meal pattern and the prevalence of overweight and obesity of the market women in Okeho, Southwest Nigeria.
| Materials and methods | | |
Study area
Okeho is an ancient community where the secretariat of Kajola Local Government Council was situated. It is about 95 km from Ibadan, the Capital of Oyo State. It is a rural community but it has some urban features such as electricity supply, post office, banks, and hotels. It has a population of about 12,964 people. The residents of the community are majorly Yoruba with traces of other ethnic groups including the Fulani, Igbo, and Hausa. The people are predominantly farmers and traders. Other vocations include artisans, teachers, and civil servants.
Study design
The study was a cross-sectional survey of market women in Okeho, a Southwest community in Nigeria and it was performed in August 2016.
Study population and sample size determination
A sample size of 250 market women was used for the study. This was obtained by using the formula:[32]
where n is the sample desirable, z is the confidence level at 95% with a standard value of 1.96, d is the desired precision of error at 5%, p is the national prevalence of overweight women in Nigeria (17%),[3] and q is 1−p which is equal to 0.83. The calculated sample size was 217 and this was increased to 250 to take care of attrition. The prevalence of overweight was used because it is higher than that of obesity and underweight. These women were selling various items, which include foodstuff, clothing and textile materials, plastic containers, and other household items. Those women who were <18 years of age and those who were <6 months in the market were excluded from the study.
Sampling procedure
A multistage sampling procedure was adopted in selecting the market women. The first stage involved the selection of two largest out of the four markets in the community. In the second stage, the two selected markets were each partitioned into five sections and 25 market women were randomly selected from each section. A sampling interval of three was used and the first woman was selected between one and three, and this was followed by selecting every third woman to obtain the needed sample size.[18]
Data collection
A validated questionnaire was used to collect information on the personal characteristics of the market women and their meal pattern. The content of the questionnaire included women’s age, marital status, family type, number of children, household size, living arrangement (that is if the woman is living alone or with an husband), and level of education. Information on meal pattern includes the number of meal taken in a day, skipping of meals, and places where meals were taken. Anthropometry measurements were height and weight, which were used to calculate the BMI. The questionnaire was validated by nutrition experts in the Department of Human Nutrition, University of Ibadan. This was pretested among selected market women in the nearby market in the same Local Government Area. Necessary adjustment was performed based on the observations made during the pretest. Research assistants were properly trained before they were used to collect data.
Anthropometry measurements
The weight of the market women was measured using a bathroom scale (Model BR9011, Camry Brand, Supplied by Zhongshan Camry Electronic Co. Ltd., Zhongshan, Guagdong, China), which was standardized before used and adjusted to zero in-between measurements. The women stood on the scale without shoes and readings were taken to the nearest 0.5 kg. Height was measured by a calibrated stadiometer (Standard Steel Brand, manufactured by Standard Steel, Ambala, Haryana, India). The respondents stood erect, arms by the side, and looking straight. The readings were taken to the nearest 0.5 cm. The BMI was calculated from weight and height using the formula: BMI = weight (kg)/height (m2). This was used as an indicator of nutritional status. The BMI was classified as underweight (BMI < 18.5 kg/m2), normal (BMI = 18.5–24.9 kg/m2), overweight (BMI = 25.0–29.9 kg/m2), and obesity (BMI ≥ 30.0 kg/m2).
Statistical analysis
Data were analyzed using the Statistical Package for the Social Sciences version 16.0 software (SPSS Inc., Chicago, IL, United State). Continuous variables such as age and BMI are presented as means and standard deviations and then categorized. Categorized variables were presented in frequencies and percentages. Chi-square analysis was performed to establish the relationship between BMI and women’s personal characteristics at 5% level of significance.
Ethical consideration
The permission of the head of the market women was sought and the approval to conduct the study was obtained. All the participants were briefed about the study and their consents were obtained.
| Results | | |
The personal characteristics, which include demographic, birth, and education of the market women, are shown in [Table 1] and [Table 2]. The mean age of the women was 37.31 ± 15.31 years. Overall, more than half (145; 58.0%) of the women were below 40 years of age and majority (188; 75.2%) of them were married. About one quarter and 85 (34.0%) of the women had a household size of 1–3 and ≥7 members, respectively. The predominant family type was monogamy (153; 61.2%) with 190 (76.0%) of the women living with a man. More than 2/3 of women had four or less children. One-third of the women were still bearing children and (34.0%) of them had children below 2 years of age and still breastfeeding (20.8%). Overall, (20.0%) of the women had no formal education while (80%) had some education.
The meal pattern of the market women is presented in [Table 3]. Eating three meals in a day was reported by (64.4%) of the participants while 65% of them skipped breakfast. Most of participants (90%) ate snacks daily.
[Figure 1] reveals the distribution of the market women’s BMI. The mean BMI was 21.87 ± 4.95 kg/m2. About 50% of women were having normal weight, 25% were underweight, 16% were overweight while 8% suffering from obesity.
The BMI of the market women was related to their personal characteristics and the results are presented in [Table 4]. Underweight, overweight, and obesity were present in both the young adult (20–39 years) and older adult (40 years and above). The prevalence of underweight (28; 44.4%) was higher among young adult women and that of overweight was higher (30; 75.0%) among older adult women. This relationship was significant. The occurrence of underweight (30; 47.6%), overweight (35; 87.5%), and obesity (18; 90.0%) was higher among married market women compared to the single or widow. The prevalence of underweight (22; 34.9%), overweight (17; 42.5%), and obesity (10; 50.0%) was insignificantly higher among women with four to six household members than those with one to three household members. Underweight, overweight, and obesity occurred in women from both monogamous and polygamous families. Women from monogamous family significantly had a higher prevalence of underweight (48; 76.2%) and obesity (13; 65.0%) whereas more (30; 75.0%) women from polygamous family were overweight. Women who lived with a man had insignificantly a higher prevalence of underweight (40; 63.5%), overweight (33; 82.5%), and obesity (15; 75.0%) than those who lived alone. The prevalence of overweight and obesity was higher than underweight. Among those women who were underweight, a good proportion (23; 36.5%) were breastfeeding. | Table 4: Association between body mass index and characteristics of market women
Click here to view |
Underweight, overweight, and obesity cut across all the levels of education with significant higher prevalence of underweight (28; 44.4%) and overweight (22; 55.0%) among women with secondary education; women with primary education were more obese (13; 65.0%) than those with other levels of education [Table 5]. | Table 5: Body mass index according to education and meal pattern of market women
Click here to view |
There was a higher prevalence of underweight (43; 68.3%), overweight (26; 65.0%), and obesity (12; 60.0%) among women who ate three meals a day than those who ate less than three meals [Table 5]. The prevalence of underweight (45; 71.4%), overweight (30; 75.0%), and obesity (13; 65.0%) was higher in the women who ate breakfast outside the home compared to those who ate breakfast at home.
| Discussion | | |
In the household, women are directly involved in childcare, food preparation, and economic activity. Their nutritional status is related to that of their children. This study was designed to assess the meal pattern and incidence of overweight and obesity among market women in a Southwest community, Nigeria. A good number of the market women was young adult, still bearing children, had children below 2 years of age and was breastfeeding. Malnutrition in mothers has been associated with adverse birth outcomes;[31] hence, the nutritional status of these market women deserves an attention.
Most of the market women ate three or more meals in a day. Comparing this finding with that of Ahmed et al.[24] on market women in Sudan, there is a great disparity. In the current study, more than half of the women took three meals in a day; this is far greater than that of the market women in Sudan. Breakfast was mostly skipped by the women. The proportion of women that skipped breakfast was slightly higher than that of market women in Umuahia.[18] Missing of meal may prompt over eaten at the next meal and this coupled with sedentary lifestyle might make individuals accumulate weight.[18] A great proportion of the market women ate breakfast and lunch outside the home. Eating outside the home has been linked with increased consumption of diet that is laden with processed and fast foods, which are calories dense[21] and may translate to accumulation of fat and increase in weight. Most of the market women consumed snacks. Snack consumption was associated with overweight and obesity among market women in Umuahia.[18]
About half of the market women studied were malnourished with a quarter being underweight and about a quarter were overweight or obese. Comparing these results with previous study on market women, the prevalence of overweight and obesity is lower than those of Balogun and Owoaje,[25] Odugbemi et al.,[26] Awosan et al.,[27] and Ukegbu et al.[18] The prevalence of underweight is far higher than those of female traders in Sokoto[27] and women in Ota[6] and Jos.[29] This disparity may be due to the fact that those previous studies were conducted on urban market women whereas the market women in this current study were from less urban community. Some of the women were still bearing children, had children below 2 years, and were still breastfeeding. Studies have shown that prepregnancy obesity is a risk factor for delay initiation of lactation, short duration of breastfeeding, and less adequate milk supply.[33],[34],[35] Obese mothers were found to discontinue breastfeeding within 6 months. This development may adversely affect the growth and nutritional status of children.
Overweight and obesity have been linked with several non-communicable diseases.[6],[7],[8] The high proportion of these market women took more than three meals in a day, ate most of their meals outside the home and took snacks, coupled with sitting down for hours might explain a high prevalence of overweight and obesity. More so, the consumption of street foods has been associated with high calorie intake,[21] which may translate to gaining of weight. Snack consumption has been correlated with BMI.[18]
The BMI was found to be significantly associated with age, marital status, family type, and level of education, whereas it was insignificantly associated with living arrangement, household size, breastfeeding, number of meals eaten in a day, and place where breakfast was taken. These findings agree with those of Akarolo-Anthony et al.[15] in Abuja and Bello et al.[36] in Lagos, Nigeria where a higher prevalence of overweight and obesity was observed among older people, married individuals, and people with primary education. However, the current study contradicts their findings in that a higher prevalence of overweight was observed among women with secondary education than other levels of education. Overweight in older women may suggest occurrence of non-communicable diseases in this age group. Overweight and obesity in married women have the possibility of compromising mother’s health and constrain their childcare capacity. Large household size may encourage the occurrence of malnutrition. Where there is no assistant, mother may be stressed as a result of overwork leading to the loss of weight. Where there are other household members who share household activity with mother, she may work less and accumulate weight. The high incidence of obesity in women from monogamous family may be explained by economic status. Both low and high socioeconomic statuses have potential to promote obesity. In high socioeconomic status family, there is a possibility of diet to be high in calories leading to overweight or obesity. Similarly, it has been observed that low socioeconomic individuals consume more energy food than protein and vitamin foods, which they assume to be expensive.[37]
In conclusion, a high prevalence of overweight and obesity was present among the market women in the study community. Older age, marriage, secondary education, and monogamous family were associated with a high prevalence of overweight or obesity. Nutrition education as an intervention strategy is needed to increase market women awareness about the problem of overweight and obesity, and thereby maintained lifestyle that will prevent these problems.
Limitation of study
The dietary pattern of the market women to evaluate their diet adequacy was not assessed.
Acknowledgements
The author appreciates the cooperation of all the market women who participated in and made the study possible. Contributions of research assistants are also acknowledged.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Figure 1]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]
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