CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 5, June 2012
260
AFRICA
Obesity and blood pressure levels of adolescents in
Abeokuta, Nigeria
IO SENBANJO, KA OSHIKOYA
Abstract
Background:
We determined the prevalence of general and
central obesity and their relationship with blood pressure
levels among adolescents in Abeokuta, Nigeria.
Methods:
We selected 423 adolescents from seven schools
in Abeokuta, Nigeria, using a multistage random-sampling
technique. Body mass index (BMI), waist circumference
(WC) and blood pressures were measured.
Results:
Twenty-one (5%) children had general obesity and
109 (24.5%) had central obesity. Of those with general obesi-
ty, 20 (95.1%) children were centrally obese. With simple
linear regression analysis, BMI and WC explained 10.7 and
8.4%, respectively of the variance in systolic blood pressure
(SBP), and 3.6 and 2.7%, respectively of the variance in
diastolic blood pressure (DBP). Following logistic regression
analysis, BMI was the major factor determining SBP levels
(OR 0.8, 95% CI: 0.65–0.99,
p
<
0.05).
Conclusion:
BMI remains an important anthropometric
screening tool for high blood pressure in Nigerian adoles-
cents.
Keyword:
overweight, obesity, central obesity, blood pressure,
adolescents, Nigeria
Submitted 30/1/11, accepted 11/7/11
Cardiovasc J Afr
2012;
23
: 260–264
DOI: 10.5830/CVJA-2011-037
Obesity is a disease in which excess body fat has accumulated
to such an extent that the person’s health may be adversely
affected.
1
The International Obesity Task Force (IOTF) has
reported that one in 10 children are overweight, with at least
155 million schoolchildren worldwide being affected.
2
About 30
to 45 million of the overweight children are classified as obese
and account for 2–3% of the world’s children aged five to 17
years old.
2
In the United Kingdom,
3
Canada
4
and the USA,
5
obesity has
risen to epidemic levels among children, with the prevalence
having more than doubled in the last two to three decades.
Under-nutrition is the major nutritional problem in developing
countries. Unfortunately, overweight and obesity are now
becoming significantly prevalent in developing countries as a
result of an environment characterised by easily available, cheap,
energy-dense foods, combined with increasingly sedentary
lifestyles such as prolonged time spent watching television,
playing video games or using computers. This is found
particularly in families from a higher socio-economic status in
developing countries.
6,7
In India, the prevalence of obesity among
adolescent schoolchildren from affluent families was found to be
7.4%.
8
In Nigeria, among the privileged Nigerian schoolchildren
the prevalence of obesity was 18%.
9
Several epidemiological studies support the relationship
between accumulation of body fat and the occurrence of
non-communicable diseases such as hypertension and diabetes
mellitus.
10,11
More importantly, the accumulation of fat in the
central region of the body is a good, proven clinical correlate of
increased risk of these chronic diseases.
12
Traditionally in clinical practice, general obesity is measured
using body mass index (BMI). For the estimation of central
obesity, there are several anthropometric parameters proposed for
its reasonable estimation and they include sub-scapular skin-fold
thickness, waist circumference (WC), waist-to-hip circumference
ratio, and waist-to-height ratio. Waist circumference measures
both the subcutaneous and visceral fat and has been shown to
have the most consistent and generally the strongest correlation
with adverse lipid concentrations and increased blood pressure
levels among children and adolescents.
13
In developing countries, both children and adult populations
are characterised by lean body mass, and a high prevalence of
underweight, wasting and stunting. According to Bogin, there
is preferential accumulation of fat in the central portion of the
body relative to peripheral fat storage in nutritionally stressed
populations, with its attendant consequences of hypertension,
coronary heart disease and diabetes mellitus.
14
Information on the pattern of obesity and its influence on
blood pressure levels among children in Nigeria is limited.
Therefore the aim of this study was to determine the prevalence
of general and central obesity and their relationship with blood
pressure levels among adolescents in Abeokuta, south-west
Nigeria.
Methods
This was part of a larger study on anthropometric measures
and body composition of children and adolescents in Abeokuta,
Nigeria.
15
It was carried out in randomly selected primary and
secondary (both public and private) schools in Abeokuta. It was
a questionnaire-based, cross-sectional study.
Abeokuta is located on longitude 7° 10
″
N and latitude 3°
26
″
E and is the capital of Ogun State in south-western Nigeria.
It is about 100 km north of Lagos, with an estimated population
of four million people. Abeokuta is predominantly a Yoruba
city but urbanisation and industrialisation have brought in many
other ethnic groups.
Ethical clearance was obtained from the Federal Medical
Centre Research/Ethics Committee. Approval of the study came
Department of Paediatrics and Child Health, Lagos State
University College of Medicine, Ikeja, Lagos, Nigeria
IO SENBANJO, MB ChB, FWACP,
Pharmacology Department, Lagos State University College
of Medicine, Ikeja, Lagos, Nigeria, and Academic Division
of Child Health, Medical School, University of Nottingham,
Derbyshire Children’s Hospital, Derby, UK
KA OSHIKOYA, MBBS, MSc
