Wealth and obesity in pre-adolescents and their guardians: A first step in explaining non-communicable disease-related behaviour in two areas of Nairobi City County

PLOS Glob Public Health. 2023 Feb 28;3(2):e0000331. doi: 10.1371/journal.pgph.0000331. eCollection 2023.

Abstract

The prevalence of non-communicable diseases is increasing in lower-middle-income countries as these countries transition to unhealthy lifestyles. The transition is mostly predominant in urban areas. We assessed the association between wealth and obesity in two sub-counties in Nairobi City County, Kenya, in the context of family and poverty. This cross-sectional study was conducted among of 9-14 years old pre-adolescents and their guardians living in low- (Embakasi) and middle-income (Langata) sub-counties. The sociodemographic characteristics were collected using a validated questionnaire. Weight, height, mid-upper arm circumference, and waist circumference were measured using standard approved protocols. Socioeconomic characteristics of the residential sites were accessed using Wealth Index, created by using Principal Component Analysis. Statistical analyses were done by analysis of variance (continuous variables, comparison of areas) and with logistic and linear regression models.A total of 149 households, response rate of 93%, participated, 72 from Embakasi and 77 from Langata. Most of the participants residing in Embakasi belonged to the lower income and education groups whereas participants residing in Langata belonged to the higher income and education groups. About 30% of the pre-adolescent participants in Langata were overweight, compared to 6% in Embakasi (p<0.001). In contrast, the prevalence of adults (mostly mothers) with overweight and obesity was high (65%) in both study areas. Wealth (β = 0.01; SE 0.0; p = 0.003) and income (β = 0.29; SE 0.11; p = 0.009) predicted higher BMI z-score in pre-adolescents. In, pre-adolescent overweight was already highly prevalent in the middle-income area, while the proportion of women with overweight/obesity was high in the low-income area. These results suggest that a lifestyle promoting obesity is high regardless of socioeconomic status and wealth in Kenya. This provides a strong justification for promoting healthy lifestyles across all socio-economic classes.

Grants and funding

This study was part of a collaborative project “The Kenya-Finland Education and Research Alliance (KENFIN-EDURA)” (state grant HEL7M0453-82, sum 527,000 EUR awarded to MF. and VO) funded by the Finnish Ministry of Foreign Affairs through The Higher Education Institutions Institutional Cooperation Instrument (HEI ICI; https://www.oph.fi/en/programmes/hei-ici-programme). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.