Association of Socioeconomic Status, Dietary Pattern, and Lifestyle Behaviours with Obesity among Adults in Ngozi: A Case Control Approach

Abstract

Introduction: Obesity is an emerging public health challenge in low-income countries undergoing rapid nutritional and socio-economic transition. Local analytical evidence remains limited in Burundi. Methodology: An analytical case-control study was conducted by involving 90 participants, including 30 obese cases (BMI ≥ 30 kg/m²) and 60 normal-weight controls (BMI 18.5-24.9 kg/m²). Data were collected using structured questionnaires, anthropometric measurements (weight, height, BMI), blood pressure assessment and capillary blood glucose testing. Statistical analyses included bivariate tests (Chi-square, Student's t-test) and multivariate logistic regression. The significance threshold was set at p < 0.05. Results and Conclusion: Findings revealed that non-consumption of legumes and nuts (ORa = 5.85; 95% CI: 1.34-25.53; p=0.019) and low dietary diversity (OR = 2.29; 95% CI: 1.09-5.14; p=0.030) were significantly associated with obesity. Female sex (ORa = 2.71; 95% CI: 1.04-7.09; p=0.042) and higher household income (>300,000 BIF) (ORa = 4.32; 95% CI: 1.45-12.89; p=0.009) were also significantly associated. Family history of obesity was identified as the strongest independent risk factor (ORa = 4.19; 95% CI: 1.51-11.61; p=0.006). Although hypertension and hyperglycemia were more frequent among obese participants, these associations were not statistically significant. However, elevated diastolic blood pressure at the second measurement showed a significant association (p=0.014), suggesting early cardiovascular alterations. Behavioral factors — including physical inactivity, sedentary lifestyle and stress — were not significantly associated with obesity. In conclusion, obesity in Ngozi Commune appears as a multifactorial condition driven by nutritional transition, socio-economic changes and familial susceptibility. These findings underscore the need for integrated prevention strategies focusing on dietary diversification, promotion of traditional diets and early risk screening.