A total of 565 participants took partconsented to be part of in thethis study; 292 from rural and 272 from urban. The median age of participants was 40(26) years and there was no statistical difference between rural and urban participants. The overall median body mass index of participants was 25.6(7.4) with urban dwellers residents recording a significant higher value. Visceral fat was also significantly higher for urban dwellers participants compared to rural participants. Calorie, carbohydrate and fibre intakes were significantly higher among rural participants. while Uurban participants were shown to consumed higher amounts of Vvitamin A. Other nutrients did not show any significant difference. Rural participants had higher metabolic equivalents compared to their urban counterparts. Table 1 shows socio-demographics, nutritional intake and body composition characteristics of study participants.
Table 1. Descriptive Statistics
DESCRIPTIVE VARIABLES
|
Total
N=565
|
STATISTICS AND BALANCE CHECK
|
|
|
RURAL
n=292
|
URBAN
n=272
|
P-VALUE
|
|
|
n(%)or
Median(IQR)
|
n(%)or
Median(IQR)
|
|
Age
|
40(26)
|
40(26)
|
38(26)
|
0.737
|
Gender
|
|
|
|
|
Male
|
113(19.8)
|
43(14.7)
|
70(25.7)
|
0.001*
|
Female
|
452(79.2)
|
249(85.3)
|
202(74.3)
|
|
Level of Education
|
|
|
|
|
No formal education
|
98(17.2)
|
60(21.4)
|
38(16.7)
|
<0.001*
|
Primary
|
50(8.8)
|
27(9.6)
|
23(10.1)
|
|
Junior secondary
|
176(30.8)
|
120(42.9)
|
56(24.7)
|
|
Senior secondary
|
132(23.1)
|
64(22.9)
|
66(29.1)
|
|
Tertiary
|
53(9.3)
|
9(3.2)
|
44(19.4)
|
|
Weight (kg)
|
65.9(20.2)
|
62.4(18.3)
|
69.9(20.65)
|
<0.001*
|
Height (cm)
|
159.3(9.83)
|
158.0(8.60)
|
160.5(11.2)61.7
|
<0.001*
|
BMI (kg/m2)
|
25.6(7.40)
|
25.0(6.7)
|
26.1(7.65)
|
0.016*
|
Waist circumference (cm)
|
87.4(19.80)
|
87.0(17.55)
|
89.0(22.0)
|
0.115
|
Muscle mass
|
26.9(6.13)
|
26.8(5.05)
|
27.0(6.95)
|
0.526
|
Body fat
|
35.7(15.22)
|
35.2(14.33)
|
36.9(16.35)
|
0.341
|
Visceral fat
|
7.0(4.0)
|
7.0(4.0))
|
7.0(5.0)
|
0.015*
|
Energy intake (Kcal)
|
1434.0(951.1)
|
1601.4(999.04)
|
1330.7(899.84)
|
0.004*
|
Fat (g)
|
42.5(44.08)
|
44.2(50.8)
|
41.0(39.2)
|
0.781
|
Protein (g)
|
42.6(32.5)
|
42.6(32.7)
|
42.9(33.06)
|
0.838
|
Carbohydrate (g)
|
208.0((137.0)
|
223.5(128.8)
|
187.9(137.6)
|
0.001*
|
Fibre (g)
|
18.3(13.3)
|
20.0(13.8)
|
16.9(13.5)
|
0.001*
|
Sugar (g)
|
29.6(41.4)
|
28.0(35.6)
|
33.9(50.04)
|
0.242
|
Folate (µg)
|
225.6(240)
|
234(241.2)
|
216.4(237.0)
|
0.222
|
Iron (mg)
|
9.2(6.6)
|
9.5(6.33)
|
8.8(6.8)
|
0.569
|
Zinc (mg)
|
5.92(4.7)
|
6.1(4.9)
|
5.7(4.7)
|
0.860
|
Vitamin B12 (µg)
|
1.76(3.2)
|
1.92(3.81)
|
1.73(2.64)
|
0.296
|
Vitamin A (µg)
|
120.6(139.8)
|
111.2(121.6)
|
128.8(165.3)
|
0.022*
|
Vitamin E (mg)
|
5.6(6.4)
|
5.6(6.4)
|
5.5(6.3)
|
0.658
|
Saturated fat (g)
|
12.2(15.3)
|
11.1(15.8)
|
13.1(14.6)
|
0.143
|
Monounsaturated fat (g)
|
14.7(18.3)
|
14.8(20.33)
|
14.7(17.0)
|
0.930
|
Polyunsaturated fat (g)
|
7.9(8.4)
|
8.37(9.17)
|
7.3(7.7)
|
0.285
|
Dietary diversity score
|
6.0(2.01)
|
6(3)
|
6(2.01)
|
0.118
|
Physical activity (total metabolic equivalent per week)
|
600(3280)
|
960(4360)
|
360(1890)
|
<0.001*
|
Some variable responses were missing and therefore does not sum up to 565. *Significant at p-value <0.05
Some variable responses were missing and therefore does not sum up to 565. *Significant at p-value <0.05
Using BMI, there was no difference in the prevalence of obesity among rural and urban participants. Visceral and body fat cut offs showed a higher prevalence of obesity in urban compared to rural participants. Prevalence of obesity by all parameters was higher among females compared to males with the exception of visceral fat that showed no difference. Table 2 and 3 shows the prevalence of obesity by community and gender respectively.
Table 2. Prevalence of obesity stratified by community and gender
Variable
|
Total
|
Rural n=292
|
Urban n=272
|
p-value
|
Male
n=113
|
Female n=452
|
P-value
|
BMI
|
|
|
|
|
|
|
|
Underweight
|
9(1.6)
|
5(1.7)
|
4(1.5)
|
0.110
|
0(0)
|
9(2.0)
|
|
Normal
|
247(43.3)
|
140(48.3)
|
104(39.4)
|
|
74(67.3)
|
171(38.4)
|
<0.001*
|
Overweight
|
171(29.9)
|
87(30.0)
|
83(31.4)
|
|
25(25.7)
|
145(32.6)
|
|
Obese
|
131(22.9)
|
58(20.0)
|
73(27.7)
|
|
11(10.0)
|
120(27.0)
|
|
Visceral fat
|
|
|
|
|
|
|
Normal
|
434(76.0)
|
246(85.1)
|
184(71.0)
|
<0.001*
|
84(77.1)
|
347(78.9)
|
0.385
|
Obese
|
118(20.7)
|
43(14.9)
|
75(29.0)
|
|
25(22.9)
|
93(21.1)
|
|
Body fat
|
|
|
|
|
|
|
|
Underweight
|
48(8.4)
|
29(10.0)
|
19(7.3)
|
0.023*
|
22(20)
|
26(5.9)
|
|
Normal
|
198(34.7)
|
117(40.3)
|
80(30.8)
|
|
49(44.5)
|
149(33.8)
|
<0.001*
|
Overweight
|
130(22.8)
|
66(22.8)
|
64(24.6)
|
|
20(18.2)
|
110(24.9)
|
|
Obese
|
175(30.6)
|
78(26.9)
|
97(37.3)
|
|
19(17.3)
|
156(35.4)
|
|
Waist circumference
|
|
|
|
|
|
Normal
|
171(29.9)
|
95(33.3)
|
76(33.0)
|
0.976
|
81(79.4)
|
90(21.8)
|
<0.001*
|
Overweight
|
107(18.7)
|
60(21.1)
|
47(20.4)
|
|
9(8.8)
|
98(23.7)
|
|
Obese
|
237(41.5)
|
130(45.6)
|
107(46.5)
|
|
12(11.8)
|
225(54.5)
|
|
Some variable measurements were missing and may therefore not sum up to 565. *Significant at p-value <0.05.
Table 3 shows the community and weight status of study participants by their physical activity category. Across all measures, with the exception of visceral fat, higher proportion of overweight and obese participants did not meet WHO recommendation for physical activity per week. A higher proportion of rural and female participants did notcompared to urban meet the WHO recommendation for physical activity.
Table 3. Community and weight status by physical activity category
Variable
|
Total
|
Not meeting WHO recommendation
|
Meeting WHO recommendation
|
P-value
|
BMI
|
|
|
|
|
Underweight
|
9(1.7)
|
5(1.9)
|
4(1.5)
|
|
Normal
|
237(43.9)
|
95(35.8)
|
142(51.6)
|
0.003
|
Overweight
|
167(30.9)
|
91(34.3)
|
76(27.6)
|
|
Obese
|
127(23.5)
|
74(27.9)
|
53(19.3)
|
|
Visceral fat
|
|
|
|
|
Normal
|
419(78.5)
|
187(71.6)
|
232(85.0)
|
<0.001
|
Obese
|
115(21.5)
|
74(28.4)
|
41(15.0)
|
|
Body fat
|
|
|
|
|
Underweight
|
46(8.6)
|
17(6.5)
|
29(10.6)
|
|
Normal
|
192(35.9)
|
81(31.0)
|
111(40.5)
|
0.007
|
Overweight
|
125(23.4)
|
63(24.1)
|
62(22.6)
|
|
Obese
|
172(32.1)
|
100(38.3)
|
72(26.3)
|
|
Waist circumference
|
|
|
|
|
Normal
|
166(33.3)
|
62(25.8)
|
104(40.2)
|
|
Overweight
|
104(20.8)
|
48(20.0)
|
56(21.6)
|
0.001
|
Obese
|
229(45.9)
|
130(54.2)
|
99(38.2)
|
|
Community
|
|
|
|
|
Rural
|
280(51.1)
|
115(42.6)
|
165(59.4)
|
<0.001
|
Urban
|
268(48.9)
|
155(57.5)
|
113(40.6)
|
|
Gender
|
|
|
|
|
Male
|
|
43(16.0)
|
68(24.8)
|
0.010
|
Female
|
|
226(84.0)
|
211(75.6)
|
|
WHO recommendation is equivalent to 600 or more of Metabolic equivalents per week.
Table 4-6 shows the difference in nutrient intakes among BMI, waist circumference and body composition categories. Most macro and micro nutrient intakes were significantly higher among the obese group in the rural sample but little differences were observed for the urban sample.
Table 4. Nutrient intakes for BMI, waist circumference and body composition categories.
Rural
|
Urban
|
|
BMI
|
Energy
|
Protein
|
Fat
|
CHO
|
Fibre
|
Sugar
|
Energy
|
Protein
|
Fat
|
CHO
|
Fibre
|
Sugar
|
Underweight
|
1056.5
(697.5)
|
38.7
(52.6)
|
31.2
(18.6)
|
164.4
(116.6)
|
13.1
(10.3)
|
12.1
(47.5)
|
1126.1
(862.5)
|
29.2
(26.1)
|
41.7
(38.2)
|
138.2
(138.8)
|
8.1
(8.4)
|
11.1
(24.0)
|
Normal
|
1320.5
(844.8)
|
35.8
(30.2)
|
35.0
(39.1)
|
200.3
(128.6)
|
18.1
(11.1)
|
23.2
(27.1)
|
1209.2
(758.9)
|
41.0
(35.1)
|
40.4
(41.0)
|
178.7
(114.2)
|
16.2
(13.0)
|
34.0
(41.2)
|
Overweight
|
1669.2
(955.6)
|
51.4
(33.1)
|
50.3
(47.9)
|
233.5
(118.6)
|
21.7
(12.9)
|
36.7
(45.2)
|
1414.0
(990.8)
|
41.0
(33.6)
|
38.9
(36.8)
|
188.6
(131.4)
|
15.6
(13.1)
|
32.4
(61.6)
|
Obese
|
2105.3
(695.2)
|
50.7
(26.8)
|
64.8
(53.4)
|
280.7
(160.7)
|
25.3
(13.2)
|
44.3
(46.7)
|
1448.1
(962.0)
|
46.8
(33.8)
|
47.6
(44.8)
|
202.3
(162.8)
|
18.4
(13.6)
|
38.3
(64.3)
|
P-value
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
0.001
|
<0.001
|
0.006
|
0.336
|
0.261
|
0.036
|
0.064
|
0.133
|
Visceral Fat
|
|
|
|
|
|
|
|
|
|
|
|
|
Normal
|
1514.0
(942.0)
|
42.1
(33.9)
|
41.8
(45.7)
|
217.2
(127.9)
|
19.4
(13.6)
|
26.6
(35.5)
|
1279.3
(920.8)
|
41.1
(34.0)
|
39.3
(40.0)
|
185.7
(134.8)
|
16.7
(14.3)
|
34.7
(50.4)
|
Obese
|
2060.0
(984.5)
|
41.2
(37.8)
|
66.4
(76.4)
|
277.3
(134.2)
|
23.5
(11.1)
|
41.8
(52.8)
|
1448.1
(845.8)
|
45.0
(30.4)
|
45.5
(40.2)
|
200.4
(151.9)
|
17.4
(13.2)
|
35.8
(58.2)
|
P-value
|
<0.001
|
0.046
|
0.018
|
0.003
|
0.016
|
0.007
|
0.064
|
0.299
|
0.394
|
0.062
|
0.190
|
0.612
|
Body Fat
|
|
|
|
|
|
|
|
|
|
|
|
|
Underweight
|
1421.4
(1103.6)
|
41.2
(49.2)
|
35.5
(42.0)
|
187.7
(152.6)
|
17.9
(17.6)
|
19.7
(31.6)
|
1322.4
(768.0)
|
45.6
(37.9)
|
33.6
(33.6)
|
188.1
(94.8)
|
12.7
(13.3)
|
25.6
(36.3)
|
Normal
|
1376.4
(814.6)
|
38.1
(30.0)
|
38.9
(47.3)
|
212.3
(126.1)
|
18.2
(10.9)
|
25.4
(28.7)
|
1209.2
(1028.1)
|
38.0
(35.5)
|
43.1
(44.4)
|
171.4
(143.1)
|
14.0
(12.5)
|
30.2
(44.8)
|
Overweight
|
1633.2
(930.3)
|
48.1
(34.8)
|
43.0
(46.2)
|
223.6
(120.2)
|
21.0
(10.7)
|
32.2(30.4)
|
1393.2
(859.7)
|
47.7
(36.6)
|
37.5
(36.9)
|
193.2
(143.3)
|
19.3
(13.8)
|
39.6
(61.3)
|
Obese
|
2048.0
(907.7)
|
50.1
(29.7)
|
61.7
(59.6)
|
278.9
(168.0)
|
24.6
(13.7)
|
40.4
(54.3)
|
1421.6
(871.1)
|
42.9
(29.3)
|
43.5
(41.3)
|
196.4
(130.8)
|
18.0
(13.0)
|
37.7
(61.0)
|
P-value
|
<0.001
|
0.003
|
0.023
|
<0.001
|
0.030
|
0.005
|
0.070
|
0.432
|
0.375
|
0.186
|
0.009
|
0.622
|
Waist Circumference
|
|
|
|
|
|
|
|
|
|
|
|
Normal
|
1403.7
(856.5)
|
39.3
(30.2)
|
36.8
(43.6)
|
212.9
(128.6)
|
19.5
(12.0)
|
24.7
(29.6)
|
1327.4
(902.1)
|
40.1
(34.2)
|
42.3
(41.2)
|
187.7
(148.4)
|
16.8
(15.4)
|
33.5
(48.1)
|
Overweight
|
1366.4
(978.9)
|
34.0
(40.2)
|
34.9
(39.2)
|
212.5
(156.8)
|
18.3
(13.7)
|
30.4
(33.8)
|
1379.6
(902.7)
|
46.8
(40.9)
|
43.6
(44.5)
|
187.9
(148.9)
|
19.7
(15.1)
|
33.1
(51.6)
|
Obese
|
1712.3
(1054.3)
|
48.1
(30.2)
|
52.6
(55.8)
|
238.0
(129.9)
|
21.8
(13.6)
|
32.2
(41.9)
|
1404.9
(879.8)
|
42.2
(28.2)
|
39.3
(42.3)
|
194.0
(130.8
|
16.6
(12.8)
|
38.2
(61.8)
|
P-value
|
0.001
|
0.008
|
0.005
|
0.024
|
0.127
|
0.090
|
0.290
|
0.767
|
0.735
|
0.528
|
0.564
|
0.589
|
Significant p-values are in bold
Table 5. Differences in micronutrient intakes for BMI, waist circumference and body composition categories.
Rural
|
Urban
|
BMI
|
Folate
|
Iron
|
Zinc
|
Vit. B12
|
Vit.A
|
Vit. E
|
DDS
|
Folate
|
Iron
|
Zinc
|
Vit.
B12
|
Vit.
A
|
Vit.
E
|
DDS
|
Under
weight
|
93.2
(227.1)
|
6.7
(6.6)
|
4.3
(4.2)
|
2.4
(15.7)
|
37.1
(93.1)
|
4.5
(3.9)
|
6(4)
|
137.6
(208.4)
|
7.0
(8.2)
|
3.9
(3.7)
|
1.4
(1.4)
|
66.1
(108.9)
|
5.8
(5.3)
|
3.0
(2.3)
|
Normal
|
193.7
(195.8)
|
8.5
(6.6)
|
5.1
(4.4)
|
16.0
(3.5)
|
98.5
(105.9)
|
4.7
(5.4)
|
6(3)
|
214.9
(225.7)
|
8.4
(6.8)
|
5.5
(5.4)
|
1.8
(2.7)
|
127.4
(155.0)
|
5.1
(6.8)
|
6.0
(2.0)
|
Overweight
|
271.4
(273.0)
|
10.1
(6.4)
|
6.5
(5.1)
|
2.7
(4.1)
|
118.4
(130.4)
|
6.3
(7.5)
|
6(3)
|
216.7
(275.6)
|
9.2
(6.1)
|
5.6
(4.4)
|
1.7
(2.6)
|
133.3
(198.5)
|
5.4
(6.7)
|
6.0
(2.0)
|
obese
|
315.6
(224.1)
|
12.1
(5.2)
|
7.2
(4.1)
|
1.7
(5.5)
|
149.6
(131.0)
|
6.8
(5.6)
|
7(4)
|
221.4
(2.2)
|
9.1
(8.2)
|
6.5
(4.2)
|
1.7
(2.5)
|
131.8
(150.1)
|
5.6
(5.5)
|
6.0
(2.0)
|
P-value
|
<0.001
|
<0.001
|
<0.001
|
0.034
|
0.001
|
0.008
|
0.189
|
0.544
|
0.397
|
0.232
|
0.849
|
0.249
|
0.693
|
0.179
|
Visceral Fat
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Normal
|
230.5
(260.4)
|
9.2
(6.4)
|
6.0
(4.9)
|
2.0
(3.7)
|
107.6
(120.5)
|
5.5
(6.5)
|
6.0
(3.0)
|
224.5
(236.3)
|
8.4
(7.1)
|
5.5
(5.0)
|
1.6
(2.5)
|
128.1
(183.1)
|
5.7
(6.5)
|
6.0
(2.0)
|
Obese
|
272.6
(172.0)
|
12.0
(5.6)
|
6.9
(4.0)
|
1.6
(4.7)
|
135.7
(146.0
|
6.6
(5.7)
|
7.0
(3.0)
|
199.7
(244.9)
|
9.7
(5.4)
|
6.2
(4.2)
|
1.9
(2.6)
|
131.6
(127.7)
|
5.2
(5.1)
|
6.0
(2.0)
|
P-value
|
0.200
|
0.014
|
0.037
|
0.879
|
0.155
|
0.526
|
0.537
|
0.940
|
0.178
|
0.381
|
0.069
|
0.624
|
0.582
|
0.596
|
Body Fat
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Underweight
|
176.6
(226.5)
|
9.4
(6.9)
|
5.2
(4.1)
|
1.5
(4.1)
|
92.7
(124.7)
|
5.6
(5.6)
|
6.0
(3.0)
|
240
(243.8)
|
9.0
(6.1)
|
5.9
(5.5)
|
1.5
(2.1)
|
90.7
(173.8)
|
3.6
(5.2)
|
6
(2.0)
|
Normal
|
208.3
(237.3)
|
8.7
(6.5)
|
5.5
(4.4)
|
1.8
(3.7)
|
102.1
(116.4)
|
4.8
(6.5)
|
6.0
(3.0)
|
197.9
(227.0)
|
7.6
(6.0)
|
4.7
(4.9)
|
1.8
(3.6)
|
127.4
(168.4)
|
5.2
(7.3)
|
6
(2.0)
|
Overweight
|
257.8
(251.4)
|
9.7
(6.4)
|
6.4
(5.3)
|
2.7
(3.6)
|
115.8
(134.3)
|
5.2(6.8)
|
6.0
(3.0)
|
236.9
(254.5)
|
9.5
(6.3)
|
6.6
(5.1)
|
1.6
(2.5)
|
135.2
(192.0)
|
5.8
(6.3)
|
6
(2.0)
|
Obese
|
281.3
(243.7)
|
11.4
(6.1)
|
6.8
(4.5)
|
1.7
(4.5)
|
128.1
(120.5)
|
6.8
(5.6)
|
7.0
(3.0)
|
205.4
(212.0)
|
8.9
(6.6)
|
5.8
(4.0)
|
1.7
(1.9)
|
133.2
(162.5)
|
5.5
(5.6)
|
6
(2.0)
|
P-value
|
0.006
|
0.004
|
0.014
|
0.092
|
0.091
|
0.201
|
0.608
|
0.276
|
0.242
|
0.245
|
0.708
|
0.233
|
0.359
|
0.899
|
Waist Circumference
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Normal
|
209.5
(283.8)
|
9.0
(6.7)
|
5.7
(4.4)
|
1.8
(3.1)
|
101.3
(110.6)
|
4.8
(6.8)
|
6.0
(3.0)
|
207.1
(196.7)
|
8.9
(7.1)
|
5.6
(5.8)
|
1.8
(2.5)
|
131.2
(186.5)
|
5.6
(6.6)
|
6
(2.0)
|
Overweight
|
210.1
(212.8)
|
8.7
(6.3)
|
5.5
(5.0)
|
1.4
(3.9)
|
110.6
(117.4)
|
4.7
(4.7)
|
6.0
(4.0)
|
237.6
(275.0)
|
9.4
(7.3)
|
6.6
(5.7)
|
1.8
(2.6)
|
164.5
(212.3)
|
5.8
(7.2)
|
6
(2.0)
|
Obese
|
272.0
(261.0)
|
10.2
(6.0)
|
6.5
(5.2)
|
2.1
(4.3)
|
117.4
(138.0)
|
6.7
(6.3)
|
6(4)
|
224.5
(234.1)
|
9.2
(6.2)
|
5.8
(4.0)
|
1.6
(2.9)
|
123.6
(148.4)
|
5.2
(6.0)
|
6
(2.0)
|
P-value
|
0.096
|
0.035
|
0.069
|
0.206
|
0.077
|
0.040
|
0.348
|
0.650
|
0.570
|
0.789
|
0.903
|
0.236
|
0.649
|
0.982
|
Significant P-values are in bold
Table 6. Differences in fat intake by body weight category.
|
Rural
|
Urban
|
BMI
|
Saturated fatty acid
|
Monounsaturated fatty acid
|
polyunsaturated fatty acid
|
Saturated fatty acid
|
Monounsaturated fatty acid
|
polyunsaturated
fatty acid
|
Underweight
|
11.7(7.6)
|
11.9(7.0)
|
6.9(4.2)
|
16.2(19.8)
|
14.8(14.3)
|
6.1(5.4)
|
Normal
|
8.8(12.9)
|
12.1(15.4)
|
6.2(8.1)
|
12.7(13.8)
|
14.6(17.1)
|
6.5(6.6)
|
Overweight
|
12.5(17.5)
|
17.8(22.8)
|
9.5(9.9)
|
12.5(17.2)
|
13.9(13.5)
|
7.5(7.4)
|
obese
|
18.2(19.0)
|
22.5(25.0)
|
12.1(9.3)
|
14.5(14.0)
|
16.1(19.7)
|
8.3(9.8)
|
P-value
|
0.009
|
0.001
|
<0.001
|
0.794
|
0.507
|
0.562
|
Visceral Fat
|
|
|
|
|
|
|
Normal
|
11.0(15.4)
|
14.4(19.0)
|
8.0(8.4)
|
13.2(15.2)
|
14.8(16.6)
|
6.9(7.1)
|
Obese
|
13.8(21.5)
|
21.6(29.0)
|
12.4(13.3)
|
12.2(15.4)
|
14.1(19.3)
|
7.9(8.0)
|
P-value
|
0.170
|
0.086
|
0.032
|
0.626
|
0.906
|
0.658
|
Body Fat
|
|
|
|
|
|
|
Underweight
|
12.9(12.8)
|
15.1(16.2)
|
8.6(8.2)
|
10.8(111.7)
|
10.5(14.0)
|
6.1(5.2)
|
Normal
|
9.5(16.0)
|
12.6(19.1)
|
6.5(7.9)
|
14.2(17.4)
|
15.4(18.1)
|
6.3(7.1)
|
Overweight
|
11.3(13.0)
|
14.0(21.7)
|
11.3(13.1)
|
13.0(15.7)
|
13.8(14.0)
|
6.8(6.3)
|
Obese
|
13.9(19.5)
|
20.4(27.3)
|
13.9(19.5)
|
13.1(13.4)
|
14.9(18.0)
|
8.7(8.0)
|
P-value
|
0.311
|
0.046
|
0.006
|
0.585
|
0.566
|
0.357
|
Waist Circumference
|
|
|
|
|
|
Normal
|
11.6(13.4)
|
12.9(18.5)
|
7.5(7.4)
|
12.3(13.3)
|
14.8(18.9)
|
6.4(7.2)
|
Overweight
|
8.3(10.9)
|
11.5(13.6)
|
6.4(8.4)
|
16.5(18.5)
|
15.7(15.1)
|
8.1(7.5)
|
Obese
|
13.0(18.7)
|
18.0(23.9)
|
9.9(10.5)
|
12.9(14.0)
|
14.0(18.5)
|
8.2(7.9)
|
P-value
|
0.106
|
0.011
|
0.013
|
0.695
|
0.946
|
0.827
|
Significant P-values are in bold
Table 7 and 8 show principal component analysis of household food frequency. A total of four components were extracted for each community. The four components explained 32. 4% and 30.9% of the total variance for rural and urban respectively. Table 8 and 9 show partial spearman correlation between the four components and body composition measures. Among urban participants component 3 (staple pattern) showed a negative correlation with BMI -0.163(0.029) and visceral fat -0.186(0.013).
Table 7. Principal component analysis (PCA) of household food frequency (RURAL)
Food items in the PCA
|
Diverse diet
|
Vegetable convenience pattern
|
Non convenience pattern
|
Fast food pattern
|
Instant noodles
|
0.642
|
|
|
|
Processed milk
|
0.568
|
|
|
|
Salty snacks
|
0.556
|
|
|
|
Sugar sweetened beverages
|
0.555
|
|
|
|
Tea or coffee
|
0.531
|
|
0.379
|
|
Meat
|
0.522
|
|
|
|
Confectionery
|
0.504
|
|
|
|
Eggs
|
0.474
|
|
|
|
Commercial bread
|
0.455
|
-0.364
|
|
|
Rice
|
0.433
|
|
|
|
Vegetables raw fresh
|
0.424
|
|
-0.365
|
|
breakfast cereal
|
0.42
|
|
0.322
|
|
Organ meat
|
0.418
|
|
|
|
chicken
|
0.417
|
|
|
|
friedfish
|
0.415
|
|
|
0.318
|
sweets
|
0.404
|
|
|
|
Margarine or butter
|
0.358
|
|
|
|
Processed meat
|
0.34
|
|
|
|
Legumes
|
|
|
|
|
Fish
|
|
|
|
|
Milk
|
|
|
|
|
Salted dried fish
|
|
|
|
Diet beverages
|
|
0.571
|
|
|
Vegetables fried
|
0.504
|
|
|
Fast food
|
0.356
|
0.500
|
|
0.331
|
Restaurant meals
|
0.380
|
0.469
|
|
0.361
|
Nuts
|
|
0.337
|
0.307
|
|
Sugar
|
0.363
|
|
0.497
|
|
Ready to eat meals
|
-0.377
|
-0.470
|
|
Pasta
|
0.371
|
|
-0.310
|
-0.454
|
Vegetables cooked
|
0.434
|
0.320
|
-0.438
|
Fried potatoes
|
0.303
|
|
-0.367
|
-0.402
|
Fruit
|
0.325
|
|
|
0.376
|
Roots tubers
|
|
|
|
0.356
|
Kaiser-Meyer-Olkin Measure of Sampling Adequacy 0.740, Bartlett's Test of Sphericity <0.001
Table 8. Principal component analysis (PCA) of household food frequency (URBAN)
Food items in PCA
|
Diverse diet
|
Meat pattern
|
Staple pattern
|
Non-meat pattern
|
eggs
|
0.606
|
|
|
|
sweets
|
0.587
|
|
|
|
confectionery
|
0.573
|
|
|
|
Processed milk
|
0.519
|
|
|
|
Margarine or butter
|
0.492
|
|
|
|
milk
|
0.431
|
|
|
|
Sugar sweetened beverages
|
0.429
|
|
|
|
sugar
|
0.412
|
-0.358
|
|
|
Instant noodles
|
0.397
|
|
|
|
Processed meat
|
0.377
|
|
-0.356
|
|
Vegetables fried
|
0.368
|
|
|
|
Fried potatoes
|
0.363
|
|
|
|
Ready to eat meals
|
|
0.535
|
-0.341
|
|
Tea or coffee
|
0.404
|
-0.534
|
|
|
Vegetable cooked
|
0.335
|
-0.511
|
|
|
Organ meat
|
0.317
|
0.455
|
|
|
meat
|
|
0.455
|
|
-0.32
|
Fried fish
|
|
0.432
|
0.346
|
|
chicken
|
|
0.357
|
|
|
fruit
|
|
0.336
|
|
|
rice
|
|
|
|
|
maize
|
|
|
0.524
|
|
Salted dried fish
|
0.333
|
|
0.501
|
|
Commercial bread
|
0.341
|
|
-0.377
|
|
Vegetables raw fresh
|
|
|
0.332
|
|
Diet beverages
|
|
|
|
|
Roots tubers
|
|
|
|
|
nuts
|
|
|
|
0.498
|
fish
|
|
|
|
0.457
|
Breakfast cereal
|
0.337
|
|
|
0.389
|
Fast food
|
0.325
|
|
|
-0.38
|
legumes
|
0.305
|
0.302
|
|
0.309
|
Salty snacks
|
|
|
|
0.301
|
Kaiser-Meyer-Olkin Measure of Sampling Adequacy 0.651, Bartlett's Test of Sphericity <0.001
Table 8. Partial correlation between body measures and PCA (RURAL)
Variables
|
Component 1
Diverse diet
r(p-value)
|
Component 2
Vegetable convenience pattern
|
Component 3
Non-convenience pattern
r(p-value)
|
Component 3
Fast food pattern
r(p-value)
|
visceral fat
|
0.091(0.141)
|
-0.076(0.215)
|
-0.091(0.139)
|
0.043(0.490)
|
body fat
|
0.823(0.183)
|
-0.111(0.072)
|
-0.039(0.522)
|
0.061(0.319)
|
BMI
|
0.085(0.166)
|
-0.052(0.402)
|
-0.088(0.152)
|
0.025(0.684)
|
waist circumference
|
0.069(0.266)
|
0.121(0.050)
|
0.023(0.715)
|
0.017(0.782)
|
Controlled for age, gender and metabolic equivalent category
Table 9. Partial correlation between body measures and PCA (URBAN)
Variables
|
Component 1
Diverse diet
r(p-value)
|
Component 2
Meat pattern
|
Component 3
Staple pattern
r(p-value)
|
Component 4 Non meat pattern
r(p-value)
|
visceral fat
|
0.077(0.308)
|
0.092(0.222)
|
-0.186(0.013)*
|
-0.086(0.254)
|
body fat
|
0.844(0.266)
|
0.019(0.799)
|
-0.075(0.316)
|
-0.125(0.095)
|
BMI
|
0.106(0.159)
|
0.094(0.209)
|
-0.163(0.029)*
|
-0.105(0.163)
|
waist circumference
|
0.078(0.297)
|
0.037(0.626)
|
-0.101(0.180)
|
-0.020(0.795)
|
Controlled for age, gender and metabolic equivalent category. *P-value <0.05
Table 10 shows a partial spearman correlation adjusted for age and gender between waist circumference, BMI and body composition measures. All variables showed significant correlations but the strongest correlations were between visceral fat and BMI r=0.905(p<0.001), body fat and BMI r=0.851 (p<0.001) and BMI and waist circumference r=0.845(p<0.001).
Table 10 Partial correlation between body composition, waist circumference and BMI.
Control Variables
|
Variables
|
visceral fat
r(p-value)
|
body fat
r(p-value)
|
BMI
r(p-value)
|
waist circumference
r(p-value)
|
Age in years, Gender
|
visceral fat
|
|
0.746(<0.001)
|
0.905(<0.001)
|
0.799(<0.001)
|
|
body fat
|
0.746(<0.001)
|
|
0.851(<0.001)
|
0.766(<0.001)
|
|
BMI
|
0.905(<0.001)
|
0.851(<0.001)
|
|
0.845(<0.001)
|
Table 11 shows two models of multinomial logistic regression for risk factors of central obesity determined by waist circumference. Multicollinearity was checked and carbohydrate and fibre had strong correlations with energy intake and protein respectively and were therefore excluded from the model. In model 1 the obese group was set as reference for the outcome variable and urban and female were set as reference for the explanatory variables, community and gender respectively. Metabolic equivalent category was added to model 1 to generate model 2. In model 1 males had about 22 times odds of being normal compared to females at p-value <0.001 while rural dwellers had odds of about 1.7 times of being normal compared to urban participants and this was significant at p<0.01. The predictability of gender for obesity persisted in model 2 but community showed no significant predictability.
Table 11. Multinomial logistic regression of predictors of obesity
Model 1
|
Model 2
|
waist circumference category
|
Explanatory variables
|
Odds ratios
|
waist circumference category
|
Explanatory variables
|
Odds ratios
|
Normal+
|
|
|
Normal+
|
Energy
|
0.999(0.999-1.000)*
|
|
Energy
|
0.999(0.999-1.000)*
|
|
Protein
|
1.008(0.997-1.019)
|
|
Protein
|
1.008(0.997-1.019)
|
|
Fat
|
0.996(0.987-1.005)
|
|
Fat
|
0.996(0.987-1.005)
|
|
Sugar
|
0.998(0.992-1.004)
|
|
Sugar
|
0.998(0.992-1.004)
|
|
Community
|
|
|
Community
|
|
|
Rural
|
1.449(0.881-2.385)
|
|
Rural
|
1.449(0.881-2.385)
|
|
Urbana
|
|
|
Urbana
|
|
|
Gender
|
|
|
Gender
|
|
|
Male
|
(9.72310.876-3944.)***
|
|
Male
|
19.715(9.723-39.978)***
|
|
Femalea
|
|
|
Femalea
|
|
Overweight
|
Intercept
|
|
|
Metabolic equivalent category
Not meeting WHO recommendation
|
0.585(0.363-0.943)*
|
|
Energy
|
0.999(0.999-1.000)*
|
|
Meeting WHO recommendationa
|
|
|
Protein
|
1.004(0.994-1.016)
|
|
|
|
|
Fat
|
0.999(0.990-1.007)
|
Overweight
|
Intercept
|
|
|
Sugar
|
1.001(0.995-1.008)
|
|
Energy
|
0.999(0.999-1.000)*
|
|
Community
|
|
|
Protein
|
1.004(0.994-1.016)
|
|
Rural
|
1.198(0.675-1.823)
|
|
Fat
|
0.999(0.990-1.007)
|
|
Urbana
|
|
|
Sugar
|
1.001(0.995-1.008)
|
|
Gender
|
|
|
Community
|
|
|
Male
|
1.991(0.790-5.018)
|
|
Rural
|
1.109(0.675-1.823)
|
|
Femalea
|
|
|
Urbana
|
|
|
|
|
|
Gender
|
|
|
|
|
|
Male
|
1.903(0.753-4.810)
|
|
|
|
|
Femalea
|
|
|
|
|
|
Metabolic equivalent category
Not meeting WHO recommendation
|
0.729(0.449-1.182)
|
|
|
|
|
Meeting WHO recommendationa
|
|
|
|
|
|
|
|
- p<0.05, **p<0.01, ***p<0.001. aVariable set as reference. +Reference for weight category is obesity. Cox and Snell R-Squared is 0.243 and Naglekerke R-Squared is 0.277.
- *p<0.05, **p<0.01, ***p<0.001. aVariable set as reference. +Reference for weight category is obesity. Cox and Snell R-Squared is 0.248 and Naglekerke R-Squared is 0.283.