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Trends in obesity, underweight, and wasting among women attending prenatal clinics in urban Tanzania, 1995–2004^1,2,3

¹ From the Departments of Nutrition (EV, PP, DJH, and WWF), Epidemiology (DS, DJH, and WWF), and Biostatistics (DS), Harvard School of Public Health, Boston, MA, and the Departments of Community Health (GM) and Microbiology and Immunology (WU), Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania

Background: Many developing countries are currently burdened by both undernutrition and increasing rates of overweight and obesity. Scarce data are available from population studies on the recent trends and current epidemiology of obesity in African settings.

Objectives: The objectives were to evaluate changes in the prevalence of obesity, underweight, and wasting in women of reproductive age from Dar es Salaam, Tanzania, during the past 10 y and to identify contemporary sociodemographic correlates of these indicators.

Design: We estimated the prevalence of obesity [body mass index (BMI; in kg/m²) 30], underweight (BMI < 18.5), and wasting (midupper arm circumference <22 cm) in 73 689 women aged 14–52 y who attended antenatal care clinics in the city of Dar es Salaam, Tanzania, between 1995 and 2004.

Results: The prevalence of obesity rose steadily and progressively from 3.6% in 1995 to 9.1% in 2004 [adjusted prevalence ratio (PR): 1.97; 95% CI: 1.66, 2.33; P for trend for year < 0.0001]. Underweight showed only a modest decline from 3.3% in 1995 to 2.6% in 2004 (adjusted PR: 0.91; 95% CI: 0.75, 1.10; P for trend for year = 0.003), whereas no change was observed in the prevalence of wasting. In the most recent years (2003 and 2004), obesity was positively associated with age, parity, and socioeconomic status and inversely with HIV infection. Underweight was inversely related to socioeconomic status and positively to HIV status.

Conclusion: The recent, rapid, and large increase in the prevalence of obesity in women represents a new competing public health priority in urban Tanzania, where underweight and wasting have not decreased substantially.

Key Words: Obesity • underweight • wasting • women • pregnancy • Africa • secular trends • nutrition transition