IJPPHS International Journal of Preventive and Public Health Sciences 2454-9223 Smile Nation - Lets Smile Together India IJPPHS-1-2 10.17354/ijpphs/2015/02 Original Article Prevalence of Obesity and its Comorbidities among Motor Park Workers in Sagamu, Southwest Nigeria Osinubi Adetola 1 Jeminusi Olubukunola 2 Adebambo Olumide 1 Osinulu Oluwaseun 1 Student, Department of Community Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu, Southwest Nigeria Senior Lecturer, Department of Community Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu, Southwest Nigeria CORRESPONDING AUTHOR: Osinubi Adetola Ifeoluwa, P.M.B 2001, Obafemi Awolowo College of Health Sciences, Sagamu, Ogun State, Nigeria. E-mail: ife_oluwa_2003@yahoo.co.uk May–June 2015 06 2015 1 1 2 5 042015 052015 062015 Copyright: © International Journal of Preventive and Public Health Sciences 2015

International Journal of Preventive and Public Health Sciences by IROLHS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Background:

Obesity is a risk factor for many non-communicable diseases including diabetes and hypertension. The lifestyle of an individual ultimately affects his/her body mass index (BMI) profile. This risk is particularly increased in motor park workers because of their sedentary lifestyle.

Materials and Methods:

A descriptive cross-sectional study was carried out among 233 motor park workers in Sagamu, Nigeria using the total sampling technique. Data were collected using validated semi-structured interviewer-administered questionnaires, a stadiometer, and mercury sphygmomanometer. Data were analyzed using Statistical Package for Social Sciences version 17.0. Relevant descriptive and inferential statistics (P < 0.05) were calculated.

Results:

There were 24.9% female and 75.1% male respondents with a mean age of 40.8 ± 2.27 years. Mean BMI, systolic blood pressure, and diastolic blood pressure were 25.68 ± 5.06 kg/m2, 111.6 ± 8.22 mmHg, 89.9 ± 2.74 mmHg, respectively. About 2.1% and 19.2% reported an earlier diagnosis of diabetes mellitus and hypertension, respectively. About 53.6%, 29.2%, and 15.4% of the respondents were found to be of normal weight, overweight, and obese, respectively. About 44.6% of the respondents were found to be hypertensive (≥140/90 mmHg). Only increased diastolic blood pressure (P = 0.003) had a significant association with BMI. However, increased systolic blood pressure (P = 0.161), history of diabetes (P = 0.606), alcohol intake (P = 0.898), and smoking (P = 0.617) were not statistically significant with BMI.

Conclusion:

Most of those with high BMI had high blood pressure with the majority being smokers and alcoholics. Lifestyle modification should be encouraged as this would help optimize the health status of the community.

Body mass index Blood pressure Obesity Prevalence Smoking
INTRODUCTION

Obesity has been recorded as a major disease in Africa alongside HIV/AIDS and malnutrition.1 Obesity is a risk factor for many non-communicable diseases particularly heart disease, hypertension, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.

Obesity is described as a medical condition in which there is accumulation of excess body fat to the extent that it may have an adverse effect on health, leading to increased morbidity and mortality.2

Energy imbalance over a period is said to result in overweight and obesity. Obesity is fast becoming a global epidemic given the high prevalence in the world today and the adoption of the Western culture by the developing countries. In 2008, more than 1.4 billion adults, 20 years and older, were overweight. Of these, over 200 million men and nearly 300 million women were obese. 35% of adults aged 20 years and over were overweight in 2008, and 11% were obese. Overweight and obesity are the fifth leading risk for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese. In addition, 44% of the diabetes burden, 23% of the ischemic heart disease burden, and between 7 and 41% of certain cancer incidence are attributable to overweight and obesity.3

Several anthropometric measures such as body mass index (BMI), waist circumference, and waist-to-hip ratio have been proposed to define obesity.4

The BMI is, however, the most commonly used indicator of body fat; it provides the basis for categorizing someone as being underweight, normal, overweight or obese. A BMI equal to or more than 25 kg/m2 is considered overweight while a BMI equal to or more than 30 kg/m2 is considered obese.5

Environmental factors such as leisure activities, reduced commuting time, access to healthy foods, and increased physical activities have been shown to be inversely related to obesity.6 The prevalence of obesity can also be attributed to knowledge gap as indicated in a study done in Western Australia where half (50.1%) of adults do not measure up to the recommended levels of physical activity, majority of the adults (89%) do not consume the recommended daily serves of vegetables, and almost half (47.8%) do not eat adequate amounts of fruit.7

Motor park workers are at increased risk of obesity and its comorbidities because of the sedentary lifestyle associated with their nature of the occupation. Most of them sit down to drive cars for most of the day. The traders own shop and do little or no physical exercise when attending to customers at the park. The aim of this study, therefore, was to determine the prevalence of obesity and its comorbidities among motor park workers in Sagamu, Nigeria. The result from this study will provide useful data for researchers, medical and health practitioners, planners, as well as policy makers.

MATERIALS AND METHODS Study Location

The Isale Oko park is located in the Ilaye community of Sagamu. It is located close to the Northern boundary of Sagamu local Government Area. It is one of the busiest parks in the Remo area of Ogun State. It accommodates people including traders, drivers, passengers, and motorbike riders. Sagamu serves as a transit zone between Lagos and South-Eastern and South-Western parts of Nigeria. It is home to the only state-owned teaching hospital in Ogun State, Nigeria.

The names of the respondents were not requested for so as to ensure strict confidentiality. Consent was obtained from the Chairman of National Union of Road Transport Workers, the Chairman of the Road Transport Employers Association of Nigeria, the Chairman of Amalgamated Commercial Motorcycle Riders Association of Nigeria and the head of the traders before carrying out the study and individual consent was also taken from the respondents before data acquisition.

This study was a descriptive cross-sectional study conducted between May 20 and June 14, 2013 on the Isale Oko park users of Sagamu. A simple random sampling was employed to select the Isale oko motor park out of the five motor parks in Sagamu. Then a total sampling method was used in choosing the population for screening because the park users, especially the drivers and motorbike riders were not permanently resident at the park during the time of this screening because of the nature of their job.

Ethical Clearance

Those included in this study were participants registered with an association in the park and they include; drivers in the park, traders with shops, kiosks or stands in and around the park, motorcyclist in the park, others include vulcanizers, auto mechanics resident in the park. All participants were also above 18 years of age. Passengers in the parks were exempted from this study because they were not working at the park.

Study Design

Data collection comprised a personal interview and biophysical assessment (anthropometric and blood pressure measurement).

Semi-structured interviewer’s administered questionnaires that had four subsections including bio-data, lifestyle, assessment of knowledge about hypertension, and biophysical profiles were used. A pretest was also done at the Ijoku park to check the reliability of our questionnaire with the administration of 20 questionnaires and necessary corrections were effected before doing the main study at the Isale Oko park.

A bathroom scale was used to measure the weight of the respondents without wearing shoes and was calculated to the nearest 1 kg. A standard weight was used to set the measurement to avoid zero error. A stadiometer was used to measure the height of the respondent without shoes and calculated to the nearest 0.1 m. A non-invasive mercury sphygmomanometer and a stethoscope (Littmann) were used to measure the blood pressure of the respondents. The measurement was taken with all tight clothings or other materials removed from the arm and allowing the arm to rest on the table such that the arm is proximal and almost at the same level of the heart in a sitting position. Two readings of the blood pressure assessment were taken, one before the interview and the other at the end of the interview. The average of these two measurements was used in the data analysis. A total of 233 questionnaires were administered.

Data Analysis

Data were collected and analyzed by Statistical Package for Social Sciences 17.0. software which was manufactured by International Business Machine Co-operation. Results were calculated in percentages and frequencies and presented in tables and figures. Relevant cross-tabulation of constant variables was also made. P < 0.05 was considered scientifically significant.

RESULTS

A total of 250 questionnaires were administered and only 233 were used in this analysis. The age of the park workers ranged from 20 to 65 years with the mean age being 40.8 ± 2.27 years. There was a major male preponderance (75.1%) with the majority being the 40-49 age group as shown in Table 1.

Demographic characteristics of the respondents

Majority of the park workers were commercial drivers (53.65%) with the least being the motorcyclist (6.44%) as shown in Figure 1.

The occupational distribution of the respondents

The prevalence of overweight and obesity among the motor park workers were 29.2% and 15.4%, respectively, as shown in Table 2.

The BMI of the park workers

The prevalence of increased systolic blood pressure (>140 mmHg) and increased diastolic blood pressure (>90 mmHg) were 24.9% and 43.8%, respectively, as shown in Table 3.

The systolic and diastolic blood pressure of the respondents

Only increased diastolic blood pressure (P = 0.003) had a significant association with BMI. However, increased systolic blood pressure (P = 0.161), history of diabetes (P = 0.606), alcohol intake (P = 0.898), and smoking (P = 0.617) were not statistically significant with BMI as shown in Table 4.

The association of BMI and some related factors

DISCUSSION

In this study, we found that the prevalence of obesity and overweight was 15.4% and 29.2%, respectively, and this is similar to the prevalence of obesity (28.1%) and overweight (28.9%) among traders in Sokoto central market, Nigeria.8 It is also at par with a reported 31.3 and 16.3% prevalence of overweight and obesity, respectively, among female traders in Ibadan, Nigeria.9 This similarity in prevalence may be due to the same sedentary lifestyle associated with traders and other related occupations found at motor parks. This may also be attributable to degree of urbanization and adoption of westernization observed in this area as it is close to Lagos (the most populous area of Nigeria and one of the fastest growing cities in the world) where there have been a record of high prevalence of obesity/overweight owing to the adoption of the westernized culture.10 Obesity was more prevalent among the males (12%) as against the females (3.4%) giving a male:female ratio of 3:1 and this is at variance with a study carried out among the indigenous residents of Kalabari communities in the Niger Delta region of South-South Nigeria which shows that of the total population, 30.48% were obese females and 16.78% were obese males, giving a male:female ratio of 1:2.11 This variance in male: female ratio could be as a result of increased number of times and quantity of food the males consume which is believed to be due to their magnitude of workload. The low prevalence of obesity among these park workers is due to the large number of respondents who partake in regular exercise or are involved in regular physical activity (72%) and this is collaborated by reports that show that physical activity levels are a major influence on obesity.12

There is a high prevalence of regular consumption of carbonated drinks (78.0%) among the participants in this study, another study reported a lower prevalence (17.1%) of consumption of carbonated drinks among the undergraduates of the University of Ibadan, Nigeria which is a younger population.13

A relatively high prevalence of current cigarette smoking (20.6%) and alcohol consumption (57.9%) was recorded among the participants in this study compared to the low prevalence of smoking cigarette (5.2%) and alcohol consumption(10.8%) among the traders of Sokoto Central market, Northern Nigeria.8 This study is, however, similar to another study which has a prevalence of smoking (29.3%) and alcohol consumption (38.4%) reported in a study among 11-16 years old adolescents in Buenos Aires, Argentina.14 The high prevalence of cigarette smoking and alcohol consumption could be due to the increased accessibility of the respondents to the substances because they are been sold indiscriminately at the park.

Substance use disorders (such as alcohol consumption and smoking) have been found to be related to obesity and its comorbidities.15,16

The 24.1% prevalence of hypertension observed among the participants in this study was less than half of the prevalence of hypertension reported among an elderly population of traditional chiefs in an urban population in South - South Nigeria as 68.9%.17 This marked difference may be due to the relatively younger population of respondents in this study, as age has been associated with increased prevalence of hypertension. It is similar to the prevalence of hypertension of 31.0% in rural and urban populations of Abia State, Nigeria.18 This similarity may be due to the same urban-rural nature of the population. It is higher than the 13.16% prevalence of hypertension reported by in a rural adult population of Osun State, Nigeria.19 This may be due to the dominant rural nature of the respondents. Increased BMI was only significantly associated with increased diastolic pressure as against similar studies where obesity/overweight were associated with not only hypertension but with diabetes, high cholesterol levels.20

CONCLUSION

It is evident from this study and other collaborated studies that the majority of the risk factors for obesity and its comorbidities are modifiable. It is, therefore, important that necessary steps are put in place to ensure that the menace of obesity is put in check to reduce its attendant mortality and morbidity. Health education on lifestyle modification, which includes careful dietary practices and increased physical activity, is therefore advocated for the populace.

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