Central obesity and diet quality in rural farming women of Ngamiland, Botswana

Abstract

Rapid economic growth in Botswana like in other countries has led to the emergence of nutrition transition. Overweight/obesity, central adiposity and associated co-morbidities are on the rise, especially amongst women. Urban women have been shown to be more prone to overweight/obesity compared to men. However, the situation in rural women has not been studied. Therefore, this paper assesses the prevalence of central obesity in rural female farmers (N=113) of Ngamiland, Botswana over two years. Estimation of central obesity was made through assessment of waist circumference (WC) and waist hip ratios (WHR). The WHO Indicator cut-off points (WC: low risk= <80 cm; increased= 80-87.9 cm; and substantially increased= >88 cm and WHR: low risk= ≤0.85 and high risk=0.85+) for risk of metabolic complication were used to categorize women according to body fatness levels. A non-quantified dietary diversity questionnaire was also administered to individuals with responsibility over food, to assess the participant’s dietary diversity. Women were assigned dietary diversity scores (DDS) ranging from 0 to 8, depending on the number of food groups represented in their diet in the past 24 hours. The higher the number the more diversified the diet. These measurements were collected in August 2010 and September 2011. Between 2010 and 2011 the mean WC increased from 87±11.8 to 90.2±14.5 while the WHRs in 2010 increased from 0.83±0.1 to 0.86±0.1 respectively. Diets comprised mostly of starchy foods, milk and miscellaneous foods such as fats/oils, sugars, and condiments. Mean DDS for both periods was 3 showing poor quality diet and little change over the two years. Central adiposity was observed amongst the women as shown by a significant increase in WC between 2010 and 2011 (t=2.818, df=112, p=0.006). Contrary to expectations that rural female farmers in Ngamiland Botswana would be healthy compared to their non-farming counterparts, there seems to be an observable similar trend of overweight. Furthermore, quality of traditional diets seems to be deteriorating with less consumption of healthy protective and nutrient dense foods, which are likely to influence a rise in metabolic complications. The authors therefore recommend strategies that will facilitate reduction of waist sizes to 80.0 cm such as farming and consumption of healthier foods such as fruits and vegetables along with the commonly produced ones in the fields. Farming communities should also value and include traditional and wild foods in their diets to increase dietary diversity and reduce the risk of development of chronic diseases.

Keywords: Central obesity, Rural Female Farmers, Overweight, Obesity, Ngamiland, Botswana