The double burden of malnutrition and cardiometabolic risk widens the gender and socio-economic health gap: a study among adults in Burkina Faso (West Africa)

Objective: To document the double burden of malnutrition and cardiometabolic risk factors (CMRF) in adults and its occurrence according to different sociodemographic parameters. Design: Population-based cross-sectional observational study. We first randomly selected 330 households stratified by tertile of the income levels proxy as low, middle and high income. Setting: Northern district of Ouagadougou, the capital city of Burkina Faso. Subjects: In each income stratum, 110 individuals aged 25-60 years and who had lived permanently in Ouagadougou for at least 6 months were randomly selected, followed with collection of anthropometric, socio-economic and clinical data, and blood samples. Results: The overall obesity/overweight prevalence was 24.2% and it was twice as high in women as in men (34.1% v. 15.5%, P < 0.001). Hypertension, hyperglycaemia and low HDL cholesterol prevalence was 21.9%, 22.3% and 30.0%, respectively, without gender difference. The prevalence of the metabolic syndrome was 10.3%. Iron depletion and vitamin A deficiency affected 15.7% and 25.7% of participants, respectively, with higher rates in women. Coexistence of at least one nutritional deficiency and one CMRF was observed in 23.5% of participants, and this 'double burden' was significantly higher in women than in men (30.4% v. 16.1%, P = 0.008) and in the low income group. Conclusions: CMRF are becoming a leading nutritional problem in adults of Ouagadougou, while nutritional deficiencies persist. The double nutritional burden exacerbates health inequities and calls for action addressing both malnutrition and nutrition-related chronic diseases.