title: Obesity and type 2 diabetes in sub-Saharan Africans - Is the burden in today's Africa similar to African migrants in Europe? The RODAM study.
abstract: Rising rates of obesity and type 2 diabetes (T2D) are impending major threats to the health of African populations, but the extent to which they differ between rural and urban settings in Africa and upon migration to Europe is unknown. We assessed the burden of obesity and T2D among Ghanaians living in rural and urban Ghana and Ghanaian migrants living in different European countries.
  
  
  
  A multi-centre cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin). Comparisons between groups were made using prevalence ratios (PRs) with adjustments for age and education.
  
  
  
  In rural Ghana, the prevalence of obesity was 1.3 % in men and 8.3 % in women. The prevalence was considerably higher in urban Ghana (men, 6.9 %; PR: 5.26, 95 % CI, 2.04-13.57; women, 33.9 %; PR: 4.11, 3.13-5.40) and even more so in Europe, especially in London (men, 21.4 %; PR: 15.04, 5.98-37.84; women, 54.2 %; PR: 6.63, 5.04-8.72). The prevalence of T2D was low at 3.6 % and 5.5 % in rural Ghanaian men and women, and increased in urban Ghanaians (men, 10.3 %; PR: 3.06; 1.73-5.40; women, 9.2 %; PR: 1.81, 1.25-2.64) and highest in Berlin (men, 15.3 %; PR: 4.47; 2.50-7.98; women, 10.2 %; PR: 2.21, 1.30-3.75). Impaired fasting glycaemia prevalence was comparatively higher only in Amsterdam, and in London, men compared with rural Ghana.
  
  
  
  Our study shows high risks of obesity and T2D among sub-Saharan African populations living in Europe. In Ghana, similarly high prevalence rates were seen in an urban environment, whereas in rural areas, the prevalence of obesity among women is already remarkable. Similar processes underlying the high burden of obesity and T2D following migration may also be at play in sub-Saharan Africa as a consequence of urbanisation.
authors: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands. c.o.agyemang@amc.uva.nl.
authors: Charles
authors: C
authors: Agyemang
authors: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
authors: Karlijn
authors: K
authors: Meeks
authors: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
authors: Erik
authors: E
authors: Beune
authors: School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors: Ellis
authors: E
authors: Owusu-Dabo
authors: Institute of Tropical Medicine and International Health, Charité - University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors: Frank P
authors: FP
authors: Mockenhaupt
authors: Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
authors: Juliet
authors: J
authors: Addo
authors: Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Ghana.
authors: Ama
authors: A
authors: de Graft Aikins
authors: MKPGMS-Uganda Martyrs University, Kampala, Uganda.
authors: Silver
authors: S
authors: Bahendeka
authors: Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
authors: Ina
authors: I
authors: Danquah
authors: Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
authors: Matthias B
authors: MB
authors: Schulze
authors: Department of Endocrinology and Metabolism; DZHK (German Centre for Cardiovascular Research), partner site Berlin; Center for Cardiovascular Research (CCR), Charite Universitaetsmedizin Berlin, Berlin, Germany.
authors: Joachim
authors: J
authors: Spranger
authors: Source BioScience, Nottingham, UK.
authors: Tom
authors: T
authors: Burr
authors: School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors: Peter
authors: P
authors: Agyei-Baffour
authors: Institute of Tropical Medicine and International Health, Charité - University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.|ResearchGate, Invalidenstrasse 115, D-10115, Berlin, Germany.
authors: Stephen K
authors: SK
authors: Amoah
authors: Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
authors: Cecilia
authors: C
authors: Galbete
authors: Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands.
authors: Peter
authors: P
authors: Henneman
authors: Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.|Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors: Kerstin
authors: K
authors: Klipstein-Grobusch
authors: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
authors: Mary
authors: M
authors: Nicolaou
authors: Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, 12 South Drive, MSC 5635, Bethesda, MD, USA.
authors: Adebowale
authors: A
authors: Adeyemo
authors: Department of Clinical Chemistry, Academic Medical Center, Amsterdam, The Netherlands.
authors: Jan
authors: J
authors: van Straalen
authors: Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
authors: Liam
authors: L
authors: Smeeth
authors: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
authors: Karien
authors: K
authors: Stronks
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology / Q000208:ethnology; D000368:Aged; D044383:Black People; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D014171:Transients and Migrants / Q000706:statistics & numerical data
keywords: Ethnic minority groups; Europe; Migrants; Obesity; Sub-Saharan Africa; Type 2 diabetes