Wealth and obesity in pre-adolescents and their guardians: A first step in explaining non-communicable disease-related behaviour in two areas of Nairobi City County.

The prevalence of non-communicable diseases is increasing in lower-middle-income countries as these countries transition to unhealthy lifestyles. The transition is mostly predominant in urban areas. We assessed the association between wealth and obesity in two sub-counties in Nairobi City County, Kenya, in the context of family and poverty. This cross-sectional study was conducted among of 9-14 years old pre-adolescents and their guardians living in low- (Embakasi) and middle-income (Langata) sub-counties. The sociodemographic characteristics were collected using a validated questionnaire. Weight, height, mid-upper arm circumference, and waist circumference were measured using standard approved protocols. Socioeconomic characteristics of the residential sites were accessed using Wealth Index, created by using Principal Component Analysis. Statistical analyses were done by analysis of variance (continuous variables, comparison of areas) and with logistic and linear regression models.A total of 149 households, response rate of 93%, participated, 72 from Embakasi and 77 from Langata. Most of the participants residing in Embakasi belonged to the lower income and education groups whereas participants residing in Langata belonged to the higher income and education groups. About 30% of the pre-adolescent participants in Langata were overweight, compared to 6% in Embakasi (p<0.001). In contrast, the prevalence of adults (mostly mothers) with overweight and obesity was high (65%) in both study areas. Wealth (ß = 0.01; SE 0.0; p = 0.003) and income (ß = 0.29; SE 0.11; p = 0.009) predicted higher BMI z-score in pre-adolescents. In, pre-adolescent overweight was already highly prevalent in the middle-income area, while the proportion of women with overweight/obesity was high in the low-income area. These results suggest that a lifestyle promoting obesity is high regardless of socioeconomic status and wealth in Kenya. This provides a strong justification for promoting healthy lifestyles across all socio-economic classes.

Wealth and Sedentary Time Are Associated With Dietary Patterns Among Preadolescents in Nairobi City, Kenya.

OBJECTIVE: The study aimed to compare dietary patterns in preadolescents in urban areas with different physical activity and socioeconomic profiles in Nairobi, Kenya. DESIGN: Cross-sectional. PARTICIPANTS: Preadolescents aged 9-14 years (n = 149) living in low- or middle-income areas in Nairobi. VARIABLES MEASURED: Sociodemographic characteristics were collected using a validated questionnaire. Weight and height were measured. Diet was assessed using a food frequency questionnaire and physical activity by accelerometer. ANALYSIS: Dietary patterns (DP) were formed through principal component analysis. Associations of age, sex, parental education, wealth, body mass index, physical activity, and sedentary time with DPs were analyzed with linear regression. RESULTS: Three DPs explained 36% of the total variance in food consumption: (1) snacks, fast food, and meat; (2) dairy products and plant protein; and (3) vegetables and refined grains. Higher wealth was associated with higher scores of the first DP (P < 0.05). CONCLUSIONS AND IMPLICATIONS: Consumption of foods often deemed unhealthy (eg, snacks and fast food) was more frequent among preadolescents whose families were wealthier. Interventions that seek ways to promote healthy lifestyles among families residing in urban areas of Kenya are warranted.

Food insecurity among Finnish private service sector workers: validity, prevalence and determinants.

OBJECTIVE: To examine the prevalence and determinants of food insecurity among private sector service workers in Finland and assess validity of the Household Food Insecurity Access Scale (HFIAS) tool. DESIGN: In this cross-sectional study, food insecurity and background characteristics were collected from Finnish private service workers via electronic questionnaires (2019) and national register data (2018-2019). We conducted univariate and multivariate logistic regression analyses to determine the variables explaining food insecurity. Validity of HFIAS was assessed with rotated principal component analysis and Cronbach's α. SETTING: Members of the trade union for private sector service workers, Service Union United (PAM), from all municipalities in Finland participated in the study in 2019. PARTICIPANTS: The subjects were 6435 private sector workers that were members of the Service Union United (PAM) in Finland. Mean age of participants was 44 years (sd 12·7 years). RESULTS: Two-thirds of the participants (65 %) were food insecure with over a third (36 %) reporting severe food insecurity. Reporting great difficulties in covering household expenses and young age markedly increased the risk of severe food insecurity (OR 15·05; 95 % CI 10·60, 21·38 and OR 5·07; 95 % CI 3·94, 6·52, respectively). Not being married, low education, working in the hospitality industry, being male and living in rented housing also increased the probability of severe food insecurity. The HFIAS tool demonstrated acceptable construct and criterion validity. CONCLUSIONS: Severe food insecurity was widespread and associated with low socio-economic status, young age and being male among Finnish private sector service workers, emphasising the need for regular monitoring of food insecurity in Finland.