Africa, Sub-Saharan

In parts of sub-Saharan Africa, there has been a tradition of some rulers being overweight or obese, a tradition that has continued through to the modern era. As well as this, the increasing affluence of some areas has led to a rise in the prevalence of obesity among the middle class, particularly westernized families. From the late 1980s, but especially during the 1990s and the 2000s, the impact of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) has been devastating, and AIDS is often called “slim” in Africa because of the wasting effect it has on its victims. This has led some people to think that those who are overweight or obese are less likely to be suffering from AIDS, although this, obviously, is not the case.

In former French West Africa, especially the northern region, obesity has not been a major problem until recently. A 1975 study by Dutch researchers R. De Hertogh, I. V. Vanderheyden, and M. de Gasparo of the glucose tolerance in the Toubou Broayas of northeastern Niger found that obesity was unknown in their community because of diet and physical activity. Although obesity remains relatively rare in Mauritania, it has been found that a very significant number of patients involved in treatment for cardiology problems have been suffering from obesity. In a study conducted in 2000 by M. L. Ba of the Centre Hospitalier National, Nouakchott, Mauritania, he found that just over a third of patients involved in cardiology treatment were obese. Of the 227, 187 were women and 40 were men, illustrating a much higher level of obesity among women. There have been a number of studies in Burkina Faso, which aimed to confirm the study by Dr. Ba in Mauritania, linking obesity to cardio-vascular problems. A study in 2001 by D. Ye, Y. J. Drabo, D. Ouedraogo, A. Samandoulougou and A. Sawadogo in Ouagadougou, the capital of Burkina Faso, showed the extremely low levels of obesity. Of the 1,470 students from primary schools and secondary schools, there were only 28 overweight cases, and only 4 of obesity—one of these four students having high blood pressure.

In Senegal, with a much higher urban population, there is an increased prevalence of obesity. These people have been shown to have a much greater likelihood of having problems from heart disease and asthma. In Guinea, a study by N. M. Balde, et al. of the Endocrinology Service, into tuberculosis and diabetes in Conakry, the capital of the country, the condition was closely associated with obesity. The much higher levels of the urban population in the Côte d'Ivoire, and the affluence of the population in Abidjan, the capital, has seen an increase in obesity in recent years among the urban middle class, as has also happened in Lome, the capital of Togo, and Cotonou, the capital of Benin.

In the former British colonies of West Africa, obesity has also been a problem in some areas. In Gambia, where there has been much tourism and increased urbanization, a study in 2006 by M. Siervo, et al. of the MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, United Kingdom, has shown the Gambian population to be far more accepting of [Page 14]obesity, perhaps influenced by the increasing levels of obesity in their society, than Americans. A 1998 study in Sierra Leone has shown that the Mende tribe—which makes up nearly a third of the country's population—has an increased prevalence of obesity—the war and widespread food shortages in Sierra Leone resulting in a decline in obesity levels in recent years, even though the recent civil war has ended.

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