Body mass index and waist circumference in Mozambique: urban/rural gap during epidemiological transition

In 2005 we evaluated a nationally representative sample of the Mozambican adult population (n = 2913; 25-64 years old) following the STEPwise approach to chronic disease risk factor surveillance to estimate urban-rural differences in overweight and obesity and waist circumferences. The prevalences of obesity and overweight were, respectively, 6.8% (95% CI: 5.1-8.6) and 11.8% (95% CI: 8.4-15.4) among women, and 2.3% (95% CI: 1.1-3.6) and 9.4% (95% CI: 5.7-13.1) among men. Overweight/obesity was more frequent in urban settings (age-, income- and education-adjusted prevalence ratios; women, 2.76, 95% CI: 1.82-4.18; men, 1.76, 95% CI: 0.80-3.85). The average waist circumference in Mozambique was 75.2 cm (95% CI: 74.3-76.0) in women, significantly higher in urban than rural areas (age-, income- and education-adjusted β = 3.6 cm, 95% CI: 1.6-5.5) and 76.1 cm (95% CI: 75.0-77.3) in men, with no urban-rural differences (adjusted β = 1.3 cm, 95% CI: -0.9 to 3.5). Our results show urban-rural differences, as expected in a country under epidemiological transition, with urban areas presenting a higher prevalence of overweight/obesity, but age- and education-specific estimates suggesting a trend towards smaller divergences. The development and implementation of strategies to manage the foreseeable obesity-related healthcare demands are needed.