Skip to main content

Advertisement

SpringerLink
Log in

Patterns, distribution, and determinants of under- and overnutrition among women in Nigeria: a population-based analysis

  • Original Article
  • Published:
Journal of Public Health Aims and scope Submit manuscript

Abstract

Objective

To determine the patterns and determinants of nutritional status among women in Nigeria.

Methods

Using a body mass index (BMI) category of 18.5–24.99 kg/m2 (normal weight) as the reference, set of univariable and multivariable multinomial logistic regression models were fitted to investigate the independent association between different sociodemographic characteristics and nutritional status. Results were presented in the form of relative risk ratios (RRR) with significance levels and 95% confidence intervals (95% CI).

Results

Almost two-thirds of women had BMIs in the normal range. Of the total sample, 14.5% of subjects were classified as underweight, 14.3% as overweight and 5.5% as obese. The youngest women are the most likely subgroup to be thin; one-quarter of women aged 15–19 have a BMI of less than 18.5 kg/m2. There is significant regional variation, with the prevalence of thinness ranging from 6% in the north central area to 22% in the northeast. There was a clear socioeconomic distribution underlying patterns of nutritional status, with women in low socioeconomic positions (SEP) experiencing a greater risk of being underweight and those in high SEPs experiencing the greatest risk of being overweight and obese.

Conclusions

The results show that women in low SEPs are more likely to be underweight, and women in high SEPs are more likely to be obese. There is a need for public health programs to promote nutritious food and a healthy lifestyle to address both types of malnutrition at the same time. It will also be important for these programs to be age and region sensitive.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • al-Nuaim AR, al-Rubeaan K, al-Mazrou Y, al-Attas O, al-Daghari N, Khoja T (1996) High prevalence of overweight and obesity in Saudi Arabia. Int J Obes Relat Metab Disord 20(6):547–552

    PubMed  CAS  Google Scholar 

  • Amoah AG (2003a) Obesity in adult residents of Accra, Ghana. Ethn Dis 13(2 Suppl 2):S97–S101

    PubMed  Google Scholar 

  • Amoah AG (2003b) Sociodemographic variations in obesity among Ghanaian adults. Public Health Nutr 6(8):751–757

    Article  PubMed  Google Scholar 

  • Ball K, Crawford D (2005) Socioeconomic status and weight change in adults: a review. Soc Sci Med 60(9):1987–2010

    Article  PubMed  Google Scholar 

  • Blair SN, Kohl HW 3rd, Barlow CE, Paffenbarger RS Jr, Gibbons LW, Macera CA (1995) Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men. JAMA 273(14):1093–1098

    Article  PubMed  CAS  Google Scholar 

  • Brownson RC, Zahm SH, Chang JC, Blair A (1989) Occupational risk of colon cancer. An analysis by anatomic subsite. Am J Epidemiol 130(4):675–687

    PubMed  CAS  Google Scholar 

  • Brownson RC, Chang JC, Davis JR, Smith CA (1991) Physical activity on the job and cancer in Missouri. Am J Public Health 81(5):639–642

    Article  PubMed  CAS  Google Scholar 

  • Caballero B (2005) A nutrition paradox-underweight and obesity in developing countries. N Engl J Med 352(15):1514–1516

    Article  PubMed  CAS  Google Scholar 

  • Camacho TC, Roberts RE, Lazarus NB, Kaplan GA, Cohen RD (1991) Physical activity and depression: evidence from the Alameda County Study. Am J Epidemiol 134(2):220–231

    PubMed  CAS  Google Scholar 

  • Caulfield LE, de Onis M, Blossner M, Black RE (2004) Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. Am J Clin Nutr 80(1):193–198

    PubMed  CAS  Google Scholar 

  • Chang VW, Christakis NA (2005) Income inequality and weight status in US metropolitan areas. Soc Sci Med 61(1):83–96

    Article  PubMed  Google Scholar 

  • Chow WH, Dosemeci M, Zheng W, Vetter R, McLaughlin JK, Gao YT et al (1993) Physical activity and occupational risk of colon cancer in Shanghai, China. Int J Epidemiol 22(1):23–29

    Article  PubMed  Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320(7244):1240–1243

    Article  PubMed  CAS  Google Scholar 

  • Cooper R, Rotimi C, Ataman S, McGee D, Osotimehin B, Kadiri S et al (1997) The prevalence of hypertension in seven populations of west African origin. Am J Public Health 87(2):160–168

    Article  PubMed  CAS  Google Scholar 

  • Cummings SR, Black DM, Nevitt MC, Browner WS, Cauley JA, Genant HK et al (1990) Appendicular bone density and age predict hip fracture in women. The Study of Osteoporotic Fractures Research Group. JAMA 263(5):665–668

    Article  PubMed  CAS  Google Scholar 

  • de Onis M, Habicht JP (1996) Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee. Am J Clin Nutr 64(4):650–658

    PubMed  Google Scholar 

  • Deurenberg-Yap M, Deurenberg P (2003) Is a re-evaluation of WHO body mass index cut-off values needed? The case of Asians in Singapore. Nutr Rev 61(5 Pt 2):S80–S87

    Article  PubMed  Google Scholar 

  • Deurenberg-Yap M, Schmidt G, van Staveren WA, Deurenberg P (2000) The paradox of low body mass index and high body fat percentage among Chinese, Malays and Indians in Singapore. Int J Obes Relat Metab Disord 24(8):1011–1017

    Article  PubMed  CAS  Google Scholar 

  • Deurenberg P, Deurenberg-Yap M, Guricci S (2002) Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 3(3):141–146

    Article  PubMed  CAS  Google Scholar 

  • Dhurandhar NV, Kulkarni PR (1992) Prevalence of obesity in Bombay. Int J Obes Relat Metab Disord 16(5):367–375

    PubMed  CAS  Google Scholar 

  • Diez-Roux AV, Link BG, Northridge ME (2000) A multilevel analysis of income inequality and cardiovascular disease risk factors. Soc Sci Med 50(5):673–687

    Article  PubMed  CAS  Google Scholar 

  • Doak CM, Adair LS, Monteiro C, Popkin BM (2000) Overweight and underweight coexist within households in Brazil, China and Russia. J Nutr 130(12):2965–2971

    PubMed  CAS  Google Scholar 

  • Dosemeci M, Hayes RB, Vetter R, Hoover RN, Tucker M, Engin K et al (1993) Occupational physical activity, socioeconomic status, and risks of 15 cancer sites in Turkey. Cancer Causes Control 4(4):313–321

    Article  PubMed  CAS  Google Scholar 

  • Farmer ME, Harris T, Madans JH, Wallace RB, Cornoni-Huntley J, White LR (1989) Anthropometric indicators and hip fracture. The NHANES I epidemiologic follow-up studyx. J Am Geriatr Soc 37(1):9–16

    PubMed  CAS  Google Scholar 

  • Filmer D, Pritchett LH (2001) Estimating wealth effects without expenditure data-or tears: an application to educational enrollments in states of India. Demography 38(1):115–132

    PubMed  CAS  Google Scholar 

  • Forrest KY, Bunker CH, Kriska AM, Ukoli FA, Huston SL, Markovic N (2001) Physical activity and cardiovascular risk factors in a developing population. Med Sci Sports Exerc 33(9):1598–1604

    Article  PubMed  CAS  Google Scholar 

  • Fox KR (1999) The influence of physical activity on mental well-being. Public Health Nutr 2(3A):411–418

    Article  PubMed  CAS  Google Scholar 

  • Fulton-Kehoe D, Hamman RF, Baxter J, Marshall J (2001) A case-control study of physical activity and non-insulin dependent diabetes mellitus (NIDDM). the San Luis Valley Diabetes Study. Ann Epidemiol 11(5):320–327

    Article  PubMed  CAS  Google Scholar 

  • Gill T, King L, Caterson I (2005) Obesity prevention: necessary and possible. A structured approach for effective planning. Proc Nutr Soc 64(2):255–261

    Article  PubMed  Google Scholar 

  • Gorelick PB, Sacco RL, Smith DB, Alberts M, Mustone-Alexander L, Rader D et al (1999) Prevention of a first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA 281(12):1112–1120

    Article  PubMed  CAS  Google Scholar 

  • Gurrici S, Hartriyanti Y, Hautvast JG, Deurenberg P (1998) Relationship between body fat and body mass index: differences between Indonesians and Dutch Caucasians. Eur J Clin Nutr 52(11):779–783

    Article  PubMed  CAS  Google Scholar 

  • Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr (1991) Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 325(3):147–152

    PubMed  CAS  Google Scholar 

  • Hu FB, Stampfer MJ, Colditz GA, Ascherio A, Rexrode KM, Willett WC et al (2000) Physical activity and risk of stroke in women. JAMA 283(22):2961–2967

    Article  PubMed  CAS  Google Scholar 

  • Hu FB, Leitzmann MF, Stampfer MJ, Colditz GA, Willett WC, Rimm EB (2001) Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men. Arch Intern Med 161(12):1542–1548

    Article  PubMed  CAS  Google Scholar 

  • Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG et al (2001) Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 345(11):790–797

    Article  PubMed  CAS  Google Scholar 

  • Jaglal SB, Kreiger N, Darlington G (1993) Past and recent physical activity and risk of hip fracture. Am J Epidemiol 138(2):107–118

    PubMed  CAS  Google Scholar 

  • Jaglal SB, Kreiger N, Darlington GA (1995) Lifetime occupational physical activity and risk of hip fracture in women. Ann Epidemiol 5(4):321–324

    Article  PubMed  CAS  Google Scholar 

  • Jinabhai CC, Taylor M, Sullivan KR (2005) Changing patterns of under- and over-nutrition in South African children-future risks of non-communicable diseases. Ann Trop Paediatr 25(1):3–15

    Article  PubMed  Google Scholar 

  • Kaye SA, Folsom AR, Sprafka JM, Prineas RJ, Wallace RB (1991) Increased incidence of diabetes mellitus in relation to abdominal adiposity in older women. J Clin Epidemiol 44(3):329–334

    Article  PubMed  CAS  Google Scholar 

  • Kohrt WM, Snead DB, Slatopolsky E, Birge SJ Jr (1995) Additive effects of weight-bearing exercise and estrogen on bone mineral density in older women. J Bone Miner Res 10(9):1303–1311

    Article  PubMed  CAS  Google Scholar 

  • Lawoyin TO, Asuzu MC, Kaufman J, Rotimi C, Owoaje E, Johnson L et al (2002) Prevalence of cardiovascular risk factors in an African, urban inner city community. West Afr J Med 21(3):208–211

    PubMed  CAS  Google Scholar 

  • Lee IM, Paffenbarger RS Jr (2000) Associations of light, moderate, and vigorous intensity physical activity with longevity. The Harvard Alumni Health Study. Am J Epidemiol 151(3):293–299

    PubMed  CAS  Google Scholar 

  • Lee IM, Hsieh CC, Paffenbarger RS Jr (1995) Exercise intensity and longevity in men. The Harvard Alumni Health Study. JAMA 273(15):1179–1184

    Article  PubMed  CAS  Google Scholar 

  • Malik M, Bakir A (2007) Prevalence of overweight and obesity among children in the United Arab Emirates. Obes Rev 8(1):15–20

    Article  PubMed  CAS  Google Scholar 

  • Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH (2002) Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr 75(6):978–985

    PubMed  CAS  Google Scholar 

  • Mendez MA, Monteiro CA, Popkin BM (2005) Overweight exceeds underweight among women in most developing countries. Am J Clin Nutr 81(3):714–721

    PubMed  CAS  Google Scholar 

  • Meyer HE, Tverdal A, Falch JA (1993) Risk factors for hip fracture in middle-aged Norwegian women and men. Am J Epidemiol 137(11):1203–1211

    PubMed  CAS  Google Scholar 

  • Meyer HE, Henriksen C, Falch JA, Pedersen JI, Tverdal A (1995) Risk factors for hip fracture in a high incidence area: a case-control study from Oslo, Norway. Osteoporos Int 5(4):239–246

    Article  PubMed  CAS  Google Scholar 

  • Mishra V (2004) Effect of obesity on asthma among adult Indian women. Int J Obes Relat Metab Disord 28(8):1048–1058

    Article  PubMed  CAS  Google Scholar 

  • Mohan B, Kumar N, Aslam N, Rangbulla A, Kumbkarni S, Sood NK et al (2004) Prevalence of sustained hypertension and obesity in urban and rural school going children in Ludhiana. Indian Heart J 56(4):310–314

    PubMed  Google Scholar 

  • Montgomery MR, Gragnolati M, Burke KA, Paredes E (2000) Measuring living standards with proxy variables. Demography 37(2):155–174

    Article  PubMed  CAS  Google Scholar 

  • National Population Commision, & ORC Macro (2004) Nigeria demographic and health survey 2003. Calverton, Maryland

    Google Scholar 

  • Nichols DL, Sanborn CF, Bonnick SL, Ben-Ezra V, Gench B, DiMarco NM (1994) The effects of gymnastics training on bone mineral density. Med Sci Sports Exerc 26(10):1220–1225

    PubMed  CAS  Google Scholar 

  • Okesina AB, Oparinde DP, Akindoyin KA, Erasmus RT (1999) Prevalence of some risk factors of coronary heart disease in a rural Nigerian population. East Afr Med J 76(4):212–216

    PubMed  CAS  Google Scholar 

  • Paffenbarger RS Jr, Hyde RT, Wing AL, Lee IM, Jung DL, Kampert JB (1993) The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 328(8):538–545

    Article  PubMed  Google Scholar 

  • Paffenbarger RS Jr, Kampert JB, Lee IM, Hyde RT, Leung RW, Wing AL (1994) Changes in physical activity and other lifeway patterns influencing longevity. Med Sci Sports Exerc 26(7):857–865

    PubMed  Google Scholar 

  • Paluska SA, Schwenk TL (2000) Physical activity and mental health: current concepts. Sports Med 29(3):167–180

    Article  PubMed  CAS  Google Scholar 

  • Pfohl M, Schatz H (2001) Strategies for the prevention of type 2 diabetes. Exp Clin Endocrinol Diabetes 109 Suppl 2:S240–S249

    Article  Google Scholar 

  • Popkin BM, Gordon-Larsen P (2004) The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord 28 Suppl 3:S2–S9

    Article  Google Scholar 

  • Popkin BM, Richards MK, Montiero CA (1996) Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J Nutr 126(12):3009–3016

    PubMed  CAS  Google Scholar 

  • Raglin JS (1990) Exercise and mental health. Beneficial and detrimental effects. Sports Med 9(6):323–329

    Article  PubMed  CAS  Google Scholar 

  • Razak F, Anand SS, Shannon H, Vuksan V, Davis B, Jacobs R et al (2007) Defining obesity cut points in a multiethnic population. Circulation 115(16):2111–2118

    Article  PubMed  Google Scholar 

  • Ross CE, Hayes D (1988) Exercise and psychologic well-being in the community. Am J Epidemiol 127(4):762–771

    PubMed  CAS  Google Scholar 

  • Rubin K, Schirduan V, Gendreau P, Sarfarazi M, Mendola R, Dalsky G (1993) Predictors of axial and peripheral bone mineral density in healthy children and adolescents, with special attention to the role of puberty. J Pediatr 123(6):863–870

    Article  PubMed  CAS  Google Scholar 

  • Sesso HD, Paffenbarger RS Jr, Lee IM (2000) Physical activity and coronary heart disease in men: The Harvard Alumni Health Study. Circulation 102(9):975–980

    PubMed  CAS  Google Scholar 

  • Shetty PS, James WPT (1994) Body mass index - a measure of chronic energy deficiency in adults. FAO Food and Nutrition Paper 56: FAO, Rome, Italy

  • Shukla HC, Gupta PC, Mehta HC, Hebert JR (2002) Descriptive epidemiology of body mass index of an urban adult population in western India. J Epidemiol Community Health 56(11):876–880

    Article  PubMed  CAS  Google Scholar 

  • Sidhu S, Kaur A, Prabhjot (2005) Prevalence of overweight and obesity among urban and rural adult females of Punjab. Anthropol Anz 63(3):341–345

    PubMed  Google Scholar 

  • Slattery ML, Potter JD (2002) Physical activity and colon cancer: confounding or interaction? Med Sci Sports Exerc 34(6):913–919

    Article  PubMed  Google Scholar 

  • Subramanian SV, Smith GD (2006) Patterns, distribution, and determinants of under- and overnutrition: a population-based study of women in India. Am J Clin Nutr 84(3):633–640

    PubMed  CAS  Google Scholar 

  • Uusitupa M, Siitonen O, Pyorala K, Aro A, Hersio K, Penttila I et al (1985) The relationship of cardiovascular risk factors to the prevalence of coronary heart disease in newly diagnosed type 2 (non-insulin-dependent) diabetes. Diabetologia 28(9):653–659

    Article  PubMed  CAS  Google Scholar 

  • Vetter R, Dosemeci M, Blair A, Wacholder S, Unsal M, Engin K et al (1992) Occupational physical activity and colon cancer risk in Turkey. Eur J Epidemiol 8(6):845–850

    Article  PubMed  CAS  Google Scholar 

  • Wannamethee SG, Shaper AG (1999) Physical activity and the prevention of stroke. J Cardiovasc Risk 6(4):213–216

    PubMed  CAS  Google Scholar 

  • Wannamethee SG, Shaper AG (2001) Physical activity in the prevention of cardiovascular disease: an epidemiological perspective. Sports Med 31(2):101–114

    Article  PubMed  CAS  Google Scholar 

  • Wannamethee SG, Shaper AG (2002) Physical activity and cardiovascular disease. Semin Vasc Med 2(3):257–266

    Article  PubMed  Google Scholar 

  • Weyerer S (1992) Physical inactivity and depression in the community. Evidence from the Upper Bavarian Field Study. Int J Sports Med 13(6):492–496

    Article  PubMed  CAS  Google Scholar 

  • World Health Organization (1995) Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 854:1–452

    Google Scholar 

  • World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894, i-xii, 1–253

  • World Health Organization (2002) The world health report 2002: reducing risks, promoting healthy life: WHO. Geneva, Switzerland

    Google Scholar 

  • World Health Organization (2004a) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363(9403):157–163

    Article  Google Scholar 

  • World Health Organization (2004b) Global strategy on diet, physical activity and health: who. Geneva, Switzerland

    Google Scholar 

  • Xu F, Yin XM, Zhang M, Leslie E, Ware R, Owen N (2005) Family average income and body mass index above the healthy weight range among urban and rural residents in regional Mainland China. Public Health Nutr 8(1):47–51

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The author is grateful to Measure DHS for providing Nigeria 2003 DHS data.

Conflict of interest

The author confirms that there are no any relevant associations that might pose a conflict of interest.

Authors’ contributions

OAU conceived the study, extracted the data, did the analyses and interpretation and wrote the first and final draft of the manuscript.

Author information

Authors and Affiliations

  1. Public Health, Epidemiology and Biostatistics, The Public Health Building, The University of Birmingham, Birmingham, B15 2TT, UK

    Olalekan A. Uthman

  2. Center for Evidence-Based Global Health, Save the Youth Initiative, Ilorin, Nigeria

    Olalekan A. Uthman

Authors
  1. Olalekan A. Uthman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Olalekan A. Uthman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Uthman, O.A. Patterns, distribution, and determinants of under- and overnutrition among women in Nigeria: a population-based analysis. J Public Health 17, 289–299 (2009). https://doi.org/10.1007/s10389-009-0251-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10389-009-0251-z

Keywords

Search

Navigation