Abdominal obesity explains the positive rural-urban gradient in the prevalence of the metabolic syndrome in Benin, West Africa

This cross-sectional study was designed to verify the hypothesis that there is a positive rural-urban gradient in the overall prevalence of the metabolic syndrome (MetS) and its components and that the differences are associated with socioeconomic status, a sedentary lifestyle, and poor diet quality. A sample of 541 Beninese adults apparently healthy was randomly selected from rural (n = 170), semi-urban (n = 171), and urban (n = 200) areas. The MetS was defined according to the International Diabetes Federation. Diet and physical activity were assessed with a 3-day recall. Socioeconomic and additional lifestyle information was obtained during personal interviews. A positive rural-urban gradient (rural to semi-urban to urban) was observed for the overall prevalence of the MetS (4.1%, 6.4%, and 11%, respectively; P = .035), which reflected that of abdominal obesity (28.2%, 41.5%, 52.5%; P < .001) but not for the other prominent features of the MetS, that is, high blood pressure (HBP; 24.1%, 21.6%, and 26.5%; P > .05) and reduced high-density lipoprotein cholesterol (HDL-C; 25.3%, 18.1%, 37.5%; P < .001). Diet quality and physical activity were higher in rural and semi-urban compared to urban subjects. Physical activity appeared protective for obesity, HBP, and low HDL-C. Micronutrient adequacy was an independent predictor of HDL-C and was associated with a lower likelihood of HBP. Socioeconomic status was positively associated with abdominal obesity only, which was more widespread in women than in men. This study shows that the nutrition transition is ongoing in Benin and suggests that cardiovascular disease risk could be reduced substantially by promoting physical activity and a more adequate diet. (c) 2009 Elsevier Inc. All rights reserved.