Charles Sossa

Lifestyle and Dietary Factors Associated with the Evolution of Cardiometabolic Risk over Four Years in West-African Adults: The Benin Study

Aim. To assess in adults from Benin changes in cardiometabolic risk (CMR) using both the Framingham risk score (FRS) and metabolic syndrome (MetS) and to examine the effects of diet, and lifestyles, controlling for location and socioeconomic status. Methods. Apparently healthy subjects (n = 541) aged 25–60 years and randomly selected in the largest city, a small town, and rural areas were included in the four-year longitudinal study. Along with CMR factors, socioeconomic, diet and lifestyle data were collected in individual interviews. A food score based on consumption frequency of four “sentinel” food groups (meat and poultry, dairy, eggs, and vegetables) was developed. Lifestyle included physical activity, alcohol and tobacco use. Education and income (proxy) were the socioeconomic variables. Results. Among the subjects with four-year follow-up data (n = 416), 13.5% were at risk at baseline, showing MetS or FRS ≥ 10%. The incidence of MetS and FRS ≥ 10% during follow-up was 8.2% and 5%, respectively. CMR deteriorated in 21% of subjects. Diet and lifestyle mediated location and income effects on CMR evolution. Low food scores and inactivity increased the likelihood of CMR deterioration. Conclusion. Combining MetS and FRS might be appropriate for surveillance purposes in order to better capture CMR and inform preventive measures.

Insulin resistance status and four-year changes in other cardiometabolic risk factors in West-African adults: the Benin study

Background: The association of insulin resistance (IR) with other cardiometabolic risk (CMR) factors in sub-Saharan Africans is poorly documented. This study examined the links between IR and the evolution of blood pressure (BP), glycaemia, serum lipids and abdominal obesity in the population of Benin. Design: Population-based longitudinal study. Methods: This study initially included 541 apparently healthy Beninese adults (50% women) aged 25–60 years who were randomly selected in a large city, a small town and a rural area. After a baseline survey, our subjects were followed up after 2 years, and again at 4 years. IR based on homeostasis model assessment (HOMA), blood glucose, BP, waist circumference (WC), triglycerides, total cholesterol and HDL-cholesterol were measured. Complete data at the end of the follow-up periods was available for 416 subjects. Results: IR was more prevalent in women than in men (33.2% versus 17.8%) and it was generally associated with more adverse values of CMR factors, excepting BP. In controlling for baseline age, sex, WC, diet, lifestyle variables and WC changes; the relative risk (RR) of hyperglycemia over 4 years was as least 3-fold in IR subjects, compared to normal subjects. The RR of abdominal obesity was 5.3 (1.04–26.93) in IR women, compared to non-IR. The association of IR with the evolution of dyslipidemia was inconsistent, but IR tended to exacerbate low HDL-cholesterol. Conclusion: Over 4 years, IR exacerbated hyperglycemia in both men and women, and abdominal obesity in women, but IR did not affect blood pressure. Further research on the link found between IR and dyslipidemia, particularly low HDL-C, is needed in sub-Saharan Africa.

Four-Year Trends in Cardiometabolic Risk Factors according to Baseline Abdominal Obesity Status in West-African Adults: The Benin Study

The study examined whether abdominal obesity (AO) according to waist circumference was associated with more unfavourable changes in other cardiometabolic risk (CMR) factors in sub-Saharan Africans. The study included 541 randomly selected and apparently healthy subjects (50% women) aged 25–60 years. Complete data at baseline, 24, and 48 months later was available in 366 subjects. AO was associated with higher CMR at baseline and over the follow-up period, except for high blood pressure. A significantly higher incidence of high ratio of total cholesterol : HDL-cholesterol (TC/HDL-C) was associated with AO. Controlling for WC changes, age, baseline diet, and lifestyles, the relative risk (RR) of low HDL-C and high TC/HDL-C was 3.2 (95% CI 1.06–9.61) and 7.4 (95% CI 2.01–25.79), respectively, in AO men; the RR was not significant in women. Over a four-year period, AO therefore appeared associated with an adverse evolution of cholesterolemia in the study population.

Prévalence et facteurs associés à la surcharge pondérale chez les adolescents dans une ville secondaire au Bénin

L’augmentation de la prevalence de la surcharge ponderale chez les adolescents dans les pays en developpement est un probleme preoccupant. Cette etude avait pour objectif d’etudier l’ampleur de la surcharge ponderale et les facteurs associes chez les adolescents dans la ville de Ouidah au Benin. Il s’agit d’une etude transversale, descriptive et analytique qui a concerne un echantillon de 142 adolescents et leurs parents choisis par technique aleatoire a deux degres dans la ville de Ouidah. La prevalence de la surcharge ponderale etait de 5% chez les adolescents enquetes. Les principaux facteurs significativement associes a la surcharge ponderale etaient la consommation frequente d’aliments sucres (p<0,001), le faible niveau d’activite physique (p<0,001), le grignotage (p<0,001) et le nombre d’heures de sommeil par nuit (p=0,002). La prise en compte de ces facteurs dans l’elaboration et la mise en oeuvre des strategies de prevention va contribuer a la reduction de la prevalence de la surcharge ponderale ainsi que ses consequences morbides ulterieures dans la couche juvenile. Mots cles : Surcharge ponderale, obesite, facteurs associes, adolescents, Benin.