Abstract:
Obesity and hypertension are risk factors for diet-related non-communicable diseases and
are associated with poor quality of life, increased morbidity and mortality. There is a
growing burden of obesity in Nigeria, especially the South South geopolitical zone.
However, information on the interplay between diet quality, lifestyle factors, burden of
obesity and hypertension in the zone is scarce. This study was designed to assess the
associations between diet quality, physical activity, obesity and hypertension among adults
in Akwa Ibom and Cross River states, Nigeria.
This descriptive cross-sectional study adopted a three-stage random sampling technique to
select 12 Local Government Areas, 36 communities and 1,320 adults from Akwa Ibom and
Cross River states. Information on socio-demographic characteristics, dietary intakes and
physical activity were obtained using interviewer-administered questionnaire. Dietary
intake was assessed using multi-pass 24-hour dietary recall to determine diet quality (Diet
Quality Index-International, DQI-I), categorised into terciles. Physical activity was assessed
using International Physical Activity (PA) Questionnaire and analysed using standard
procedures. Weight (kg) and height (m) were measured to calculate Body Mass Index (BMI)
to define overweight and obesity as BMI 25.0-29.9kg/m2 and ≥30.0kg/m2 respectively.
Waist Circumference (WC) was measured to define Abdominal Obesity (AO) as WC
≥102cm for men and WC ≥88cm for women. Blood Pressure (BP) measurements were taken
and hypertension was defined as Systolic BP (SBP) ≥140mmHg and or Diastolic BP (DBP)
≥90mmHg. Data were analysed using descriptive statistics, Chi square test and logistic
regressions at α0.05.
Respondents’ age was 35.4±11.2 years, 50.4% were female and 54.1% were married. Total
DQI-I score was 56.4±7.4 comprising variety (11.4±3.9), adequacy (24.8±4.9), moderation
(19.6±6.0) and overall balance (0.7±1.5). Physical activity score was 4306.0 Metminutes/week, 29.7% and 60.7% had moderate and high PA patterns, respectively.
Prevalence of overweight and obesity were 20.5% and 12.5%, respectively. Waist
circumference scores were 82.7±11.3cm for men and 85.5±15.1cm for women andvii
prevalence of AO was 37.6%. The SBP and DPB were 122.2±14.9 mmHg and 79.1±12.6
mmHg, respectively and prevalence of hypertension was 29.5%. There were non-significant
increases in the risks of obesity (Adjusted Odds Ratio (AOR) = 1.1; CI: 0.8-1.4) and AO
(AOR = 1.0; CI: 0.8-1.4) across DQI-I terciles. Risk of hypertension increased significantly
across DQI-I terciles (AOR = 1.4; CI: 1.0-1.8). There was a significant decrease in the risk
of obesity (AOR = 0.5; CI: 0.3-0.7) and a non-significant decrease in the risk of AO (AOR
= 0.7; CI: 0.43-1.1) among adults with moderate-to-high PA patterns, compared to low PA
patterns. There was a non-significant increase in the risk of hypertension among adults with
moderate-to-high PA patterns (AOR = 1.14; CI: 0.7-1.8). The risk of hypertension increased
significantly among adults with higher BMI values (AOR = 2.3; CI: 1.7-3.1).
The risk of obesity was not related to high diet quality, but was inversely related to increased
physical activity in Akwa Ibom and Cross River States, Nigeria. Increased physical activity
should be promoted to reduce the burden of obesity.
