Food intake and cardiometabolic risk factors in rural Uganda

• Type of Material: Article
• Authors: Therese LF Holmager, University of Copenhagen; Dan W Meyrowitsch, University of Copenhagen; Silver Bahendeka, Uganda Martyrs University; Jannie Nielsen, Emory University
• Language: English
• Date: 2021-02-25
• Publisher: BMC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2021
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s13690-021-00547-x
• Title of Journal or Parent Work: ARCHIVES OF PUBLIC HEALTH
• Volume: 79
• Issue: 1
• Start Page: 24
• End Page: 24
• Grant/Funding Information: The data collection in Kasese District, Uganda was funded by Novo Nordisk Fonden (grant no. 29847), Thorvald Madsens Fond, Aase and Ejnar Danielsens Fond, and Christian and Otilia Brorsons Rejselegat. None of the sponsors had any influence on the study design; data collection, analysis, or interpretation; or the writing of this article.
• Keywords: Overweight; Science & Technology; Type 2 diabetes; Public, Environmental & Occupational Health; Diet; Life Sciences & Biomedicine; Sub-Saharan Africa; Cardiometabolic
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Background: Along with a nutritional transition in Sub-Saharan Africa, the prevalence of non-communicable diseases is increasing rapidly. We assess the association between food intake and cardiometabolic risk factors in a rural population in Uganda. Methods: The present study was based on data from a household-based case-control study of diabetic and non-diabetic households in Southwestern Uganda, 2012–2013. We analysed food intake in 359 individuals age ≥ 13 years from 87 households, using a household food frequency questionnaire, and measures of glycated haemoglobin (HbA1c), height and weight. We used multinomial logistic regression to model abnormal HbA1c (≥5.7%) and weight status (underweight, normal weight and overweight) as an outcome of total food intake and by nine food groups. Results were reported as odds ratios (OR) with 95% confidence intervals (CI). Models were adjusted for three nested sets of covariates. Results: The diet primarily consisted of staple food (cassava and plantain). High-Glycaemic Index staple food was the most consumed food group (median = 14 servings/week, p25-p75: 11–17). Milk, meat, fish and vegetables were the least consumed food groups (medians: 0–3 servings/week). Median intake of sugary food was 6 servings/week (p25-p75: 2–9). The OR of having abnormal HbA1c or being overweight increased with every weekly serving of food (1.02, 95% CI: 1.00–1.04 and 1.01 95% CI: 1.00–1.03, respectively). Of specific food groups, each weekly serving of meat increased the OR of being overweight with 33% (95% CI: 1.08–1.64), and fruit intake decreased the OR of abnormal HbA1c (0.94, 95% CI: 0.88–1.00), though this latter association was attenuated after adjustment for weight status, aerobic capacity, and socioeconomic status. Conclusion: Diet was monotonous, mainly consisting of cassava and plantain, and increasing food intake was associated with abnormal HbA1c and overweight. To prevent non-communicable diseases a diet with higher intake of fish and vegetables, and less sugary food is recommended.