title: The distribution and mortality impact of chronic energy deficiency among adult Nigerian men and women.
abstract: OBJECTIVE
  To determine the prevalence of chronic energy deficiency (CED) and associated mortality risk in a cohort of adult Nigerians followed from 1992 to 1997.
  
  
  METHODS
  The data for this investigation were derived from an international collaborative study on chronic diseases in populations of the African diaspora. Body mass index (BMI) was used to define three grades of CED in 4061 men and women aged 25 years and older: Grade I (mild CED) as BMI 17.5-18.4, Grade II (moderate CED) as BMI 16.0-17.4, and Grade III (severe CED) as BMI < 16.0 and BMI > or = 18.5 was considered normal. The odds of mortality associated with differing grades of CED was estimated with logistic regression analysis.
  
  
  RESULTS
  The prevalence of CED (BMI < 18.5) increased from 14.3% in 1992 to 19.6% in 1997, both genders combined. The prevalence of CED was similar for both sexes in 1992 (14%) but increased to 22.4% in men and 17.4% in women by 1997. The prevalence of CED was 8.5%, 7.6 and 3.4 for Grades I, II and III, respectively. Two hundred and seven deaths occurred during the follow-up period. The mortality rate for the 5.5 y of follow-up was 5.1% (207/4061). The odds ratios (95% CIs) for all cause mortality were 1.4 (0.5, 3.8), 2.4 (1.2, 4.9) and 2.5 (1.0, 6.2), respectively, for CED grades I, II and III adjusting for age and sex.
  
  
  CONCLUSIONS
  Under nutrition is an increasing problem in Nigerian men and women. The economic reforms (structural adjustment program (SAP)) introduced in 1986 in combination with the continued economic woes brought on by political instability, corruption and nepotism have been advanced by several investigators as the main factors in the growing problem of inadequate calorie intake. Intervention strategies both at the government and private sectors are urgently needed to increase food availability.
authors.affiliation: Department of Preventive Medicine and Epidemiology, Loyola University Stritch School of Medicine, Maywood, IL 60153, USA. crotimi@wpo.it.luc.edu
authors.forename: C
authors.initials: C
authors.lastname: Rotimi
authors.forename: I
authors.initials: I
authors.lastname: Okosun
authors.forename: L
authors.initials: L
authors.lastname: Johnson
authors.forename: E
authors.initials: E
authors.lastname: Owoaje
authors.forename: T
authors.initials: T
authors.lastname: Lawoyin
authors.forename: M
authors.initials: M
authors.lastname: Asuzu
authors.forename: J
authors.initials: J
authors.lastname: Kaufman
authors.forename: A
authors.initials: A
authors.lastname: Adeyemo
authors.forename: R
authors.initials: R
authors.lastname: Cooper
mesh_terms: D000328:Adult; D017677:Age Distribution; D000886:Anthropometry; D001794:Blood Pressure; D002908:Chronic Disease; D015331:Cohort Studies; D003677:Deficiency Diseases / Q000145:classification* / Q000453:epidemiology*; D002149:Energy Intake; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009549:Nigeria / Q000453:epidemiology; D009749:Nutrition Surveys; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution