International Journal of Clinical Nutrition
ISSN (Print): 2376-1385 ISSN (Online): 2376-1393 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
International Journal of Clinical Nutrition. 2014, 2(3), 60-68
DOI: 10.12691/ijcn-2-3-3
Open AccessArticle

Predictors of Overweight/Obesity in Urban Ghanaian Women

Collins A. Appiah1, , Matilda Steiner-Asiedu2 and Gloria E. Otoo2

1Department of Dietetics, School of Allied Health Sciences, University of Ghana, Accra, Ghana

2Department of Nutrition and Food Science, University of Ghana, Accra, Ghana

Pub. Date: September 21, 2014

Cite this paper:
Collins A. Appiah, Matilda Steiner-Asiedu and Gloria E. Otoo. Predictors of Overweight/Obesity in Urban Ghanaian Women. International Journal of Clinical Nutrition. 2014; 2(3):60-68. doi: 10.12691/ijcn-2-3-3


Body size preference as well as diet, and physical activity could be important determinants of overweight/obesity among urban Ghanaian women. The study was designed to determine the relationship between dietary intake, physical activity level, body size preference and body mass index (BMI) in women in Kumasi metropolis, Ghana. A cross-sectional study was conducted among 394 women, aged 20 years and above, in 6 randomly selected churches in the Kumasi metropolis. Subjects were assessed through 24-hr dietary intake, physical activity levels using the WHO global physical activity questionnaire and anthropometry. Participants were asked to select their preferred body size from photographic silhouettes consisting of six images of women of known BMI (20, 24, 28, 30, 33 and 38kg/m2) arranged in random order. The silhouettes were transformed on a scale of 1 to 6, in ascending BMI, as continuous variables for analysis. Binary logistic regression analysis was used to assess the predictors of overweight/obesity among the women. Based on BMI, 31.3% of the women were overweight and 37.1% obese. The significant predictors of overweight/obesity among the women were total dietary energy intake (OR=1.001, p=0.012), low physical activity (OR=3.136, p=0.011), preference for large body size (OR=5.197, p=0.032), being of age 40 years and above (OR=2.558, p=0.017) and having at least one child (OR=3.878, p=0.002). Diet high in calories, low physical activity levels coupled with preference for large body size could contribute to the high prevalence of overweight/obesity among the women. Clinical and public health intervention strategies should be culturally-tailored in mitigating the emerging overweight/obesity problem.

body size preference dietary intake physical activity overweight/obesity women

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


Figure of 5


[1]  Caballero B. Symposium: Obesity in developing countries: Biological and Ecological Factors. J. Nutri; 131: 866S- 870S. 2001.
[2]  Prentice AM. The emerging epidemic of obesity in developing countries. Int J Epidemiol; 35: 93-99. 2006.
[3]  World Health Organisation. (2003a).Global Strategy on Diet, Physical Activity & Health. Obesity and Overweight. World Health Organisation: Geneva. publications/facts/obesity/en/print.html. Visited 29/05/2009.
[4]  Ziraba AK, Fotso JC and Ochako R. Overweight and obesity in urban Africa: a problem of the rich or the poor? BMC Public Health; 9: 465. 2009.
[5]  Popkin BM and Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obesity; 28: S2-S9. 2004.
[6]  McLaren L. Socioeconomic status and obesity. Epidemiol Rev; 29: 29-48. 2007.
[7]  Craig P, Halavatu V, Comino E, and Caterson I. Perception of body size in the Tongan community: differences from and similarities to an Australian sample. Int J Obesity; 23: 1288-1294. 1999.
[8]  Pollock NJ.Cultural elaborations of obesity-Fattening practices in pacific societies. Asia Pacific J ClinNutr; 4: 357-360. 1995.
[9]  Holdsworth M, Gartner A, Landais E, Maire B, and Delpeuch F. Perceptions of healthy and desirable body size in urban Senegalese women. Int J Obesity; 28: 1561-1568. 2004.
[10]  Puoane T, Fourie JM, Shapiro M, Rosling L, and Tshaka NC. ‘Big is beautiful’- an exploration with urban black community health workers in a South African township. South Afri J ClinNutri; 18(1): 6-15. 2005.
[11]  Rguibi M and Belahsen R. Body size preferences and sociocultural influences on attitudes towards obesity among Moroccan Sahraoui women. Body Image; 3: 395-400.2006.
[12]  World Health Organisation. Global Database on Body Mass Index. World Health Organisation: Geneva. 2006.
[13]  World Health Organisation. Global Database. Ghana Demographic and Health Survey 2003. World Health Organisation: Geneva. 2003.
[14]  Popkin BM. The nutrition transition and obesity in the developing world. J Nutri; 131: 871S-873S. 2001.
[15]  Kumasi Metropolitan Health Profile Report. Kumasi Metropolitan District Health Directorate, Kumasi Metropolitan Assembly, Kumasi, Ghana. 2008.
[16]  Kumasi Metropolitan Assembly. Visited 22/09/2009.
[17]  Bush HM, Williams RG, Lean ME, and Anderson AS. Body image and weight consciousness among South Asian, Italian and general population women in Britain. Appetite; 37: 207-215. 2001.
[18]  Duda RB, Darko R, Seffah J, Adanu RMK, Anarfi JK, and Hill AG. Prevalence of obesity in women of Accra, Ghana.Afri. J Health Sci; 14: 154-159. 2007.
[19]  Amoah AG. Obesity in adult residents of Accra, Ghana. Ethnicity and Disease;13 (2 Suppl 2): S29-S101. 2003.
[20]  Mokhtar N, Elati J, Chabir R, Bour A, Elkari K, Schlossman NP, Caballero B and Aguenaou H. Diet culture and Obesity in Northern Africa. J Nutri; 131: 887S-892S. 2001.
[21]  Puoane T, Steyn K, Bradshaw D, Laubscher R, Fourie J, Lambert V, and Mbanga N. Obesity in South Africa: The South African Demographic and Health Survey. Obesity Research; 10: 1038-1048. 2002.
[22]  Prentice AM and Jebb SA. Obesity in Britain: gluttony or sloth? Br. Med. J; 311: 437-439. 1995.
[23]  Willett WC. Is dietary fat a major determinant of body fat? Am J ClinNutr: 67(suppl): 556S-62S. 1998.
[24]  Goran MI, Shewchuk R, Gower BA, Nagy TR, Carpenter WH, and Johnson R. Longitudinal changes in fatness in white children: no effect of childhood energy expenditure. Am J ClinNutr; 67: 309-316. 1998.
[25]  Treuth MS, Figueroa-Colon R, Hunter GR, Weinsier RL, Butte NF and Goran MI. Energy expenditure and physical fitness in overweight vs non-overweight prepubertal girls. Int J ObesRelatMetab Disorder; 22: 440-447. 1998.
[26]  Bray GA and Popkin BM. Dietary fat intake does affect obesity! Am. J.Clin.Nutr; 68: 1157-1173. 1998.
[27]  Lanza E, Schatzkin A, Daston C, Corle D, Freedman L, Ballard-Barbash R, Caan B, Lance P, Marshall J, Ibert F, Shike M, Weissfeld J, Slattery M, Paskett E, Mateski D and Albert P. Implementation of a 4-y, high fiber, high-fruit-and-vegetable, low-fat dietary intervention: results of dietary changes in the Polyp Prevention trial. Am J ClinNutri; 74(3): 387-401. 2001.
[28]  Bes-Rastrollo M, Van Dam RM, Martinez-Gonzalez MA, Li TY, Sampson LL and Hu FB. Prospective study of dietary energy density and weight gain in women. American J ClinNutr; 88: 769-777. 2008.
[29]  SW, Pisarska K, Berman ER, Pestone M, Dowling H, Offenbacher E, Weisel H, Heshka S, Matthews DE, and Heymsfield SB. Discrepancy between self-reported and actual calorie intake and exercise in obese subjects. N. Engl. J. Med; 327: 1893-1898. 1992.
[30]  Poppitt SD, Swann D, Black AE and Prentice AM. Assessment of selective under-reporting of food intake by both obese and non-obese women in metabolic facility. Int. J. Obesity; 22: 303-311. 1998.
[31]  Bourne LT, Langenhoven ML, Steyn K, Jooste PL, Laubscher JA, Van der Vyver E. Nutrient intake in the urban African population of the Cape Peninsula, South Africa. The Brisk Study. Cent Afr. J Med; 39 (12): 238-247. 1993.
[32]  Monteiro CA, Benicio MHDA, Mondini L, and Popkin BM. Shifting obesity trends in Brazil. Eur. J. Clin. Nutr; 54: 342-346. 2000.
[33]  Rissanen AM, Heliovaara M, Knekt P, Reunanen A, and Aromaa A. Determinants of weight gain and overweight in adult Finns. Eur. J. Clin. Nutr; 45: 419-430. 1991.
[34]  JebbSA, and Moore MS. Contribution of a sedentary lifestyle and inactivity to the aetiology of overweight and obesity: current evidence and research issues. Med Sci Sports Exerc; 31(11):S534-541. 1999.
[35]  Kaestner R. and Xu X. Effects of Title IX and Sports Participation on Girls’ Physical Activity and Weight. Advances in Health Economics and Health Services Research; 17: 79-111. 2006.
[36]  Kimm SY, Barton BA, Obarzanek E, McMahon RP, Sabry ZI, Waclawiw MA, Schreiber GB, Morrison JA, Similo S and Daniels SR. Racial divergence in adiposity during adolescence: The NHLBI Growth and Health Study. Pediatrics; 107(3): E34. 2001.
[37]  Bogaert N, Steinbeck KS, Baur LA, Brock K, and Bermingham MA. Food, activity and family: environmental vs biochemical predictors of weight gainin children. European J ClinNutr.; 57 :1242-1249. 2003.
[38]  Faber M and Kruger HS. Dietary intake perceptions regarding body weight and attitudes toward weight control of normal weight, overweight and obese Black females in a rural village in South Africa. Ethnicity and Disease; 15: 352. 2005.
[39]  Sanchez-Johnsen LAP, Fitzgibbon ML, Martinovich Z, Stolley MR, Dyer AR, and Horn LV. Ethnic differences in correlates of obesity between Latin-American and Black women. Obesity Research; 12(4): 652-660. 2004.
[40]  Mvo Z, Dick J, and Steyn K. Perceptions of overweight African women about acceptable body size of women and children. Curatonis; 22(2): 27-31. 1999.