Epidemiology of obesity in Tunisia: HSHS4 study (Hammam Sousse Sahloul Heart Study)

##plugins.themes.academic_pro.article.sidebar##

Published Jul 11, 2022
Download
pdf
Vol. 100 No. 7 (2022): Issue Jul 2022

##plugins.themes.academic_pro.article.main##

Mohamed Khelil
Asma Ben Abdelaziz
Youssef Zanina
Faten Yahia
Donia Ben Hassine
Nabila Ben Rejeb
Asma Omezzine
Ali Bouslama
Ahmed Ben Abdelaziz

Abstract

Introduction: The HSHS study is a community-based survey focused on cardiovascular risk factors.

Aim: The objectives of this specific analysis were to determine the prevalence of obesity and overweight in the general population of Hammam Sousse
(Tunisia) and to identify their predisposing factors.

Methods: HSHS was conducted with a random sample of households, composed by the EPI (Expanded Program on Immunization) technique. All people aged
20 and over, met on the day of the survey, at their homes, were included. Obesity, overweight and weight overload were defined with reference to Body Mass
Index (BMI): Obesity (BMI≥30 kg/m²), Overweight (25≤BMI<30 kg/m²), weight overload (BMI≥25 kg/m²). Physical activity was evaluated according to the level of
energy equivalents (Metabolic Equivalent Task) or MET, this level was considered low below 600 MET min/week. The calculated prevalences were accompanied
by their 95%CI (Confidence Intervals). The multivariate study was conducted by logistic regression, measuring the adjusted Odds Ratio (ORa)

Results: The study population was composed of 481 men and 960 women, (sex-ratio=0.50). The age ranged from 20 to 96 years with an average of
49.6±16444 years in men and 46.6±16.2 in women (p<0.05). After adjusting for age and sex, the prevalence rates of overweight, obesity, and weight
overload were respectively 36.18%, 95%CI [35.38%-36.62%], 28.11%; 95%CI [27.42%-28.58%] and 64.28%; 95%CI [63.38%-64.62%]. Obesity was
determined, in addition to female sex, age 40 or over and low level of education, by low level of physical activity (ORa=1.56; 95%CI [1.21-2.03], p<10-2).

Conclusion: In adults, the prevalence of obesity and overweight were high and determined by insufficient physical activity. The results of this study, which
can be extrapolated to other Tunisian cities, should motivate the general population to establish a heart health promotion plan, in partnership with civil society.

Keywords:

Cardiovascular disease - Prevalence - Epidemiology - Risk Factors - Obesity - Overweight - Exercise - Tobacco Smoking - Tunisia.

##plugins.themes.academic_pro.article.details##

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. World Health Organization, Regional Office for Europe. WHO European Regional Obesity: Report 2022 [En ligne]. 2022 [consulté le 19 août 2022]. 206 p. Disponible sur: https://apps.who.int/iris/handle/10665/353747
  2. Organisation mondiale de la santé. Obesité [En ligne]. 2011 [consulté le 8 juill 2011]. Disponible sur: http://www.who.int/ topics/obesity/fr/
  3. Charles MA. Obésité: que nous dit l’épidémiologie ? Cah Nutr Diététique. 1 sept 2011;46(4):167-72.
  4. Flegal KM, Ogden CL, Carroll MD. Prevalence and trends in overweight in Mexican-american adults and children. Nutr Rev. juill 2004;62(7 Pt 2):S144-148.
  5. Ghannem H. The challenge of preventing cardiovascular disease in Tunisia. Prev Chronic Dis. janv 2006;3(1):A13.
  6. Mokhtar N, Elati J, Chabir R, Bour A, Elkari K, Schlossman NP, et al. Diet culture and obesity in northern Africa. J Nutr. mars 2001;131(3):887S-892S.
  7. Organisation de coopération et de développement économiques. L’obésité et l’économie de la prévention [En ligne]. Éditions OCDE; 2010 [consulté le 23 août 2022]. 292 p. Disponible sur: https://www.oecd-ilibrary.org/social-issues-migration-health/lobesite-et-l-economie-de-la-prevention_9789264084889-fr
  8. Ben Abdelaziz A, Drissi L, Tlili H, Gaha K, Soltane I, Amrani R, et al. [Epidemiologic and clinical features of patients with type 2 diabetes mellitus in primary care facilities (Sousse, Tunisie)]. Tunis Med. juill 2006;84(7):415-22.
  9. Popkin BM, Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord J Int Assoc Study Obes. nov 2004;28 Suppl 3:S2-9.
  10. Organisation mondiale de la Santé. Bureau régional de l’Europe. Déclaration d’Athènes sur les Villes-Santé [En ligne]. Organisation mondiale de la Santé. Bureau régional de l’Europe; 1998 [consulté le 21 sept 2022]. Disponible sur: https://apps.who. int/iris/handle/10665/347603
  11. Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med J Br Diabet Assoc. mai 2006;23(5):469-80.
  12. Nolin B. Intensité de pratique d’activité physique: définitions et commentaires. Montréal: Institut national de santé publique du Québec; 2007. 11 p.
  13. Pasquereau A, Andler R, Guignard R, Soullier N, Gautier A, Richard JB, et al. Consommation de tabac parmi les adultes en 2020 : résultats du Baromètre de Santé publique France. Bull Epidemiol Hebd. 2021;(8):132 9.
  14. Institut national de la statistique. | INS [En ligne]. 2022 [consulté le 24 août 2022]. Disponible sur: http://www.ins.tn/
  15. Letonturier P. L’obésité devenue épidémie mondiale. Presse Médicale. 1 déc 2007;36(12, Part 1):1773 5.
  16. Guilouzi O. Prévalence de l’obesité dans la commune de Ksar Hellal (Tunisie). [Sousse]: Faculté de Médecine de Sousse; 2008.
  17. Ghannem H, Hadj Fredj A. Prevalence of cardiovascular risk factors in the urban population of Soussa in Tunisia. J Public Health Med. déc 1997;19(4):392-6.
  18. Ghannem H, Limam K, Ben Abdelaziz A, Mtiraoui A, Hadj Fredj A, Marzouki M. [Risk factors in cardiovascular diseases in a semi-urban community of the Tunisian Sahel]. Rev Epidemiol Sante Publique. 1992;40(2):108-12.
  19. Elasmi M, Feki M, Sanhaji H, Jemaa R, Haj Taeib S, Omar S, et al. Prévalence des facteurs de risque cardiovasculaires conventionnels dans la population du Grand Tunis. Rev DÉpidémiologie Santé Publique. 1 avr 2009;57(2):87-92.
  20. Kamoun M, Hajem S, Imen S, Achour N, Slimane H. Prevalence of obesity and overweight in Tunisia on 2001. Tunis Med. juill 2008;86(7):649-52.
  21. Okati-Aliabad H, Ansari-Moghaddam A, Kargar S, Jabbari N. Prevalence of Obesity and Overweight among Adults in the Middle East Countries from 2000 to 2020: A Systematic Review and Meta-Analysis. J Obes. 2022;2022:8074837.
  22. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. NCHS Data Brief. 2020;(360):1-8.
  23. Jacobi D, Buzelé R, Couet C. Peut-on parler de pandémie d’obésité ? Presse Médicale. 1 sept 2010;39(9):902-6.
  24. Organisation for economic co-operation and development. Obesity Update - OECD [En ligne]. 2017 [consulté le 18 août 2022]. Disponible sur: https://www.oecd.org/health/healthsystems/Obesity-Update-2017.pdf
  25. Hauner H, Bramlage P, Lösch C, Steinhagen-Thiessen E, Schunkert H, Wasem J, et al. Prevalence of obesity in primary care using different anthropometric measures-- results of the German Metabolic and Cardiovascular Risk Project (GEMCAS). BMC Public Health. 11 août 2008;8:282.
  26. Adeloye D, Ige-Elegbede JO, Ezejimofor M, Owolabi EO, Ezeigwe N, Omoyele C, et al. Estimating the prevalence of overweight and obesity in Nigeria in 2020: a systematic review and meta-analysis. Ann Med. 2021;53(1):495-507.
  27. Branca F, Nikogosian H, Lobstein T. Le défi de l’obésité dans la région européenne de l’OMS et les stratégies de lutte : résumé [En ligne]. Organisation mondiale de la Santé. Bureau régional de l’Europe; 2007 [consulté le 24 août 2022]. xiii, 68 p. Disponible sur: https://apps.who.int/iris/handle/10665/326512
  28. Schlienger JL, Luca F, Pradignac A. Quoi de neuf dans la prise en charge de l’obésité ? Rev Médecine Interne. 1 mars 2010;31(3):185-7.
  29. Laaksonen DE, Lindström J, Lakka TA, Eriksson JG, Niskanen L, Wikström K, et al. Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study. Diabetes. janv 2005;54(1):158-65.
  30. Directorate-General for Education Y, TNS Opinion & Social. Sport and physical activity: report [En ligne]. Luxembourg: Publications Office of the European Union; 2017 [consulté le 24 août 2022]. Disponible sur: https://data.europa.eu/doi/10.2766/483047
  31. World health organisation. Noncommunicable diseases: Risk factors [En ligne]. [consulté le 19 août 2022]. Disponible sur: https:// www.who.int/data/gho/data/themes/topics/noncommunicablediseases-risk-factors
  32. Organisation mondiale de la santé. Obésité : prévention et prise en charge de l’épidémie mondiale : rapport d’une consultation de l’OMS [En ligne]. Genève: Organisation mondiale de la Santé; 2003 [consulté le 24 août 2022] p. 284. Disponible sur: https://apps.who.int/iris/handle/10665/42734
  33. Romon M. Obésité : quelle prévention ? Presse Médicale. 1 sept 2010;39(9):969-73.
  34. Harrabi I, Maatoug J, Gaha M, Kebaili R, Gaha R, Ghannem H. School-based Intervention to Promote Healthy Lifestyles in Sousse, Tunisia. Indian J Community Med Off Publ Indian Assoc Prev Soc Med. janv 2010;35(1):94-9.
  35. Galani C, Schneider H. Prevention and treatment of obesity with lifestyle interventions: review and meta-analysis. Int J Public Health. 2007;52(6):348-59.