Human Nutrition & Metabolism (Sep 2022)
Lifestyle habits and perceived wellbeing of adults presenting with metabolic syndrome at a diabetic clinic in Ghana: A case-control study
Abstract
Background: Heightened by the epidemiological transition associated with excess energy intake, sedentary lifestyle and urbanisation, metabolic syndrome (MetS), previously uncommon in sub-Sahara Africa, is increasingly becoming a public health concern. Methods: We retrospectively assessed the association of diet and socio-demographic indicators as exposure factors to the development of MetS in typical peri-urban and rural settings in Ghana and examined the effect of MetS on the perceived quality of life of patients. One-on-one age- and sex-matched case-control study involving 152 adults aged 45–65 years were recruited from a diabetic clinic. Controls were recruited from communities where cases resided. Case definition was concurrent adiposity, hypertension, diabetes and dyslipidaemia. Lifestyle was assessed using a lifestyle and habits questionnaire, whereas diet history was assessed using a food frequency questionnaire. Differences were tested using McNemar and paired t-tests. To determine which exposure variables significantly predicted the development of MetS, we conducted a conditional logistic regression and reported the Mantel Haenszel crude and adjusted odds ratio (OR). Results: Markers for MetS among the cases and controls were abdominal obesity (98.7% vs 36.8%), hypertension (90.8% vs 2.6%) and diabetes (72.4% vs 1.3%). Controls (77.6%) consumed more diversified diets compared to the cases (10.5%) (p = 0.001). Lower risk for MetS was linked to secondary education (COR = 0.17) and long duration of residence (COR = 0.30) in a peri-urban setting (COR = 0.22) whereas being unemployed (COR = 9.00) increased the risk. Abdominal obesity (COR = 28.51) was a stronger predictor of MetS compared to BMI ≥30 kg/m2 (COR = 14.80). Comparatively, the controls had a better self-perception of their physical wellbeing (73.7% vs 2.6%), fitness (88.2% vs 13.2%), nutrition and weight control (14.5% vs 1.3%) and psychological health (19.7% vs 0%). Conclusion: Considering that socio-demographic indicators were key exposures to MetS, we recommend interventions that promote the holistic wellbeing of the individual and should be integrated into existing health, social and community-based support services.
