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We read with interest the paper ‘Prevalence and sociodemographic determinants of adult obesity: a large representative household survey in a resource-constrained African setting with double burden of undernutrition and overnutrition’(1). Chigbu et al., (2018) provide valuable data on obesity prevalence among adults in Enugu State in Nigeria and recommend using their information for the development of Nigerian obesity prevention policy (1). However, the authors do not explore the limitations of their data when recommending its use for development of health policy. We focus our discussion on the limitations of this data.
Firstly, Chigbu et al collected data in Enugu State, which is only one of 36 states in Nigeria and the obesity prevalence is likely to differ in other states (2). Kandala and Stranges (2017) reported obesity prevalence among women in Nigeria varies considerably between states (2). South-eastern states of Nigeria generally have higher female obesity rates than northern and western states (2). We recommend that the differences in obesity prevalence across Nigeria be considered when using the data in Enugu State to inform obesity prevention policy.
Secondly, they have collected anthropometric measurements and sociodemographic information, but not nutrition and physical activity data. Overnutrition and physical activity data is important for obesity prevention and research on this is limited in Nigeria. The Demographic Health S...
Secondly, they have collected anthropometric measurements and sociodemographic information, but not nutrition and physical activity data. Overnutrition and physical activity data is important for obesity prevention and research on this is limited in Nigeria. The Demographic Health Survey 2014 only measured women for body mass index (BMI) and the most recent STEPwise surveillance was 16 years ago in Lagos state only (1, 3). Oyeyemi et al. (2018) reported major gaps in physical activity research in Nigeria (4). Overnutrition and physical activity data, in our view, should be a research priority when developing obesity prevention policy.
Thirdly, Chigbu and colleagues measured body mass index (BMI), waist circumference and tricep skinfold thickness, yet only BMI was used for obesity classification (1). BMI does not measure fat tissue percentage or where fat tissue is located, and these are both important health indicators (5). There are more accurate measures of fat mass than BMI, such as bioelectrical impedance methods (5), although these may not be appropriate for population studies in resource-constrained settings. However, waist circumference can be used with BMI as a more accurate, yet cost effective, measure of health risk (5).
Finally, although Chigbu and associates have provided valuable information, we suggest that identification of limitations in their research would be helpful especially when using information for the development of obesity prevention policy in Nigeria.
1. Chigbu CO, Parhofer KG, Aniebue UU, et al. Prevalence and sociodemographic determinants of adult obesity: a large representative household survey in a resource-constrained African setting with double burden of undernutrition and overnutrition. J Epidemiol Community Health. 2018;72(8):702-7.
2. Kandala NB, Stranges S. Geographic variation of overweight and obesity among women in Nigeria: a case for nutritional transition in sub-Saharan Africa. PLoS One. 2014;9(6):e101103.
3. Nigerian Heart Foundation and Federal Minstry of Health and Social Services. Health Behaviour Monitor Among Nigerian Adult Popultaion. 2003 [Date accessed: March 2019]. Available from: https://www.who.int/ncds/surveillance/steps/2003_STEPS_Report_Nigeria.pdf
4. Oyeyemi AL, Oyeyemi AY, Omotara BA, et al. Physical activity profile of Nigeria: implications for research, surveillance and policy. Pan Afr Med J. 2018;30:175.
5. Nuttall FQ. Body Mass Index: Obesity, BMI, and Health: A Critical Review. Nutri Today. 2015;50(3):117-28.