Obesity in African migrant and nonmigrant
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1 Obesity in African migrant and nonmigrant populations Karlijn Meeks Postdoctoral researcher Academic Medical Centre - University of Amsterdam
2 Migration United Nations (2016). International Migration Report 2015: Highlights (ST/ESA/SER.A/375).
3 Worldwide migration International migrants worldwide 173 milion in million in 2017 High-income countries host 2 /3 of all migrants In cities such as London and Amsterdam 1 in 3 is of migrant descent In Washington DC 49% of population of African descent
4 Three ways for assessing migrant health Compare ethnic minorities with host population Ethnic differences or inequalities Compare same ethnic minority group living in different countries The role of national context Compare ethnic minorities with compatriots in home countries The role of migration
5 Snijder et al. BMJ Open 2017 Dec 14;7(12):e Ethnic inequalities
6 Diversity within high income countries Prevalence overweight including obesity among adults, 2015 (or nearest year)
7 The role of national context It matters where one migrates to! National context differs and can influence: Opportunities in life (e.g. SES) Lifestyle and related factors (e.g. diet) Health care (e.g. access, policy) Pinpoint national contextual factors driving the risk Knowledge beneficial to the host population
8 The role of national context Age-standardised prevalence of smoking among Dutch and English ethnic groups Agyemang et al. Nicotine Tob Res 2010;12:
9 The role of migration Important for ethnic minorities and their home countries alike Ethnic minorities: Reveal real lifestyle changes upon migration Pinpoint key predisposing factors for poor health Results taken more seriously by minorities (hit home message) Ethnic minority peers in home countries Provides indication of future threat of diseases
10 The role of migration Prevalence of overweight + obesity (BMI 25) by age & three localities in Ghanaians Men Women Agyemang et al. Public Health Nutrition 2009;12:909-16
11 The RODAM study Research on Obesity and Diabetes among African Migrants
12 Data collection RODAM Amsterdam Random sample of 1250 participants per location London Berlin Source: Agyemang et al Urban Rural
13 Rural Ghana
14 Urban Ghana
15 Europe
16 Age-standardised prevalence of overweight + obesity (BMI 25kg/m 2 ) by locality Men Women Agyemang et al. BMC Medicine 2016
17 Age-standardised prevalence of obesity (BMI 30kg/m 2 ) by locality Men Women Agyemang et al. BMC Medicine 2016
18 Age-standardised prevalence of abdominal obesity (waist) by locality Men Women Agyemang et al. BMC Medicine 2016
19 Age-standardised prevalence of type 2 diabetes (WHO criteria) by locality Men Women Agyemang et al. BMC Medicine 2016
20 Age-adjusted predicted probability of diabetes by BMI and Waist in men by locality BMI Waist circumference Men Men Predicted Probability of diabetes Probability of diabetes Body mass index (BMI, Kg) rural-ghanaian urban-ghanaian Amsterdam-Ghanaian Berlin-Ghanaian London-Ghanaian Predicted Probability of diabetes Waist circumference (cm) rural-ghanaian urban-ghanaian Amsterdam-Ghanaian Berlin-Ghanaian London-Ghanaian Agyemang et al. BMC Medicine 2016
21 Underlying factors Environmental component Genetic component Overweight & Obesity Epigenetic component
22 Environmental component
23 Genetic component Over 80 loci associated with polygenic obesity Explain only small fraction of heritability Limited data on Africans Popejoy & Fullerton Nature News 2016
24 Epigenetic component Epigenetics = cellular mechanisms that regulate gene expression Lifestyle can alter epigenetics Epigenetics associated with obesity in the RODAM study Novel loci associated with obesity in Africans identified Meeks et al. Clinical Epigenetics 2017
25 Key messages High burden of overweight + obesity among African migrants in Europe Increasing burden of overweight + obesity in African region Lower burden observed 10 years ago among Ghanaians in Ghana is no longer the case, especially among women Obesity independent risk factor for diabetes but context matters Rural Ghanaians seem to be more protected from developing diabetes given similar level of BMI Need to unravel the complex interplay between genetic and environmental determinants of obesity in Africans
26 RODAM partners Amsterdam AMC (Coordinating center) Berlin Charité - Universitätsmedizin Berlin German Institute of Human Nutrition Potsdam London London School of Hygiene & Tropical Medicine Ghana University of Ghana Kwame Nkrumah University of Science & Technology, Ghana IDF, Africa Region SME SourceBioscience, Nottingham
27 Thanks!
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Agyemang, C; Meeks, K; Beune, E; Owusu-Dabo, E; Mockenhaupt, FP; Addo, J; de Graft Aikins, A; Bahendeka, S; Danquah, I; Schulze, MB; Spranger, J; Burr, T; Agyei-Baffour, P; Amoah, SK; Galbete, C; Henneman,
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Meeks, KA; Stronks, K; Adeyemo, A; Addo, J; Bahendeka, S; Beune, E; Owusu-Dabo, E; Danquah, I; Galbete, C; Henneman, P; Klipstein- Grobusch, K; Mockenhaupt, FP; Osei, K; Schulze, MB; Spranger, J; Smeeth,
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