Weight, chronic disease risk and physical activity levels of rural and urban women in Zimbabwe.
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Introduction: In developing countries there is a shift from traditional diets and lifestyles to western diets and lifestyles particularly in rapidly growing urban populations. This is a major cause of overweight and obesity. Obesity is a well-recognised risk factor for various chronic diseases. Chronic diseases are the largest cause of death in the world. They include cardiovascular disease, some cancers, chronic lung diseases and raised blood pressure. Maintaining a physically active lifestyle by doing regular moderate physical activities helps to keep a healthy weight and lower the risks of chronic diseases. Aims: The aim of this study was to compare weight, chronic risk diseases and physical activity levels of rural and urban women in selected Zimbabwean communities. Methods: A cross sectional descriptive and comparative design was followed in the study. The study population included all black Zimbabwean women aged 18 to 60 years residing in Bulawayo Metropolitan Province (Urban) and Matabeleland North Province (Rural). A sample size of 280 women participated in this study. One hundred and forty were urban residents from high density suburbs and 140 were rural residents. Anthropometric variables (mass, stature, waist and hip circumferences) were measured. Three questionnaires were administered; International Physical Activity Questionnaires (IPAQ), Quality of Life, and Nutritional questionnaires. Descriptive statistics including means and standard deviations were used. The Chi-square goodness-of-fit-test, a univariate test was used for categorical variables to test response options and the independent t-tests and Chi-square test of independence were used to compare group cases and the significance was set at p≤0.05. The SPSS version 22 statistical package was used to conduct data analysis. Results: The average weight for urban women 71.19±15.23kg was significantly higher than that for rural women 66.58±13.74kg, t (278) = -2.657, p=0.008. When considering Body Mass Index (BMI) classification, a significant number were either normal (117) or overweight (96), χ2 (4) =181.500, p˂0.0005. There was a significant difference between rural and urban women in terms of BMI (p = 0.009). There was a significant relationship between age and BMI (p < 0.05). Older women 30 years and above were classified as overweight and obese compared to the younger women. There was a significant difference between urban and rural women 0.80± 0.60 and 0.78± 0.68), t (278) = -2.055, p= 0.003 in terms of waist to hip ratio (WHR). On chronic disease risk the urban women were at high and very high risk, while rural women were not at risk (χ2 (4) = 11.762, p=0.019). There was no significant difference in blood glucose levels between urban and rural women. A significant difference was shown across age groups of blood glucose levels (Welch (3, 51.868) = 3.205, p=0.031). A significant difference across age groups of cholesterol was noted; levels (F (3, 133) = 7.123, p < 0.0005). There was a significant relationship between location and blood pressure p=0.025, with rural women having a higher raised blood pressure than urban women. Both rural women and urban women were physically active and a significant difference was noted in the transport domain, t (278), 2.002, p=0.46. There was no significant difference in quality of life between rural and urban women. There was a significant difference between energy consumption and location, t (278) = -5.202, p<0.0005. Urban women had significantly high protein consumption p=0.007, and fat consumption p<0.0005. Conclusion: The study findings highlight a higher prevalence of overweight and obesity in urban women compared to rural women in terms of BMI and waist to hip ratio. The Zimbabwean women show an increased risk for chronic health problems with higher prevalence in urban women than rural women especially raised blood pressure. There was a low prevalence of raised blood glucose in both the groups. Raised blood cholesterol prevalence was higher in urban than rural women. Both rural and urban women had good quality of life scores. Urban women had high consumption of macronutrients than rural women. Both urban and rural women showed high levels of physical activity.