A DULT N UTRITIONAL S TATUS .1 Nutritional Status of Women .1 Nutritional Status of Women

The 2014 GDHS collected anthropometric data on height and weight for women age 15-49 who were interviewed in the survey and were eligible for biomarker data collection. These data were used to assess low maternal height and body mass index (BMI). Women who were pregnant and women who had given birth in the two months preceding the survey were excluded from the BMI calculations. For only 1

Nutrition of Children and Women • 173 percent of women, there was no information on height and/or weight and a BMI could not be estimated,

and these women were excluded from this analysis.

Maternal height is an outcome of genetics combined with the effects of nutrition during childhood and adolescence. It helps to predict a risk of difficult delivery because small stature is frequently associated with small pelvic size. The risk of low birth weight babies is also higher for short women. The cutoff point—that is, the height below which a woman is considered to be at risk for poor birth outcomes and obstetric complications—is defined as 145 centimeters. Table 11.10.1 shows that 1 percent of Ghanaian women age 15-49 measure below this height.

Information on BMI is also presented in Table 11.10.1. BMI is calculated by dividing weight in kilograms by height in meters squared (kg/m²). Pregnant women and women who had a birth in the two months preceding the survey were excluded from the calculation of BMI. A BMI cutoff point of 18.5 has been recommended for assessing chronic energy deficiency among nonpregnant women. At the other end of the BMI scale, women are considered overweight if their BMI falls between 25.0 and 29.9 and obese if their BMI is 30.0 or greater.

Overall, 54 percent of Ghanaian women have a BMI in the normal range, 6 percent are thin, and 40 percent are overweight or obese. Five percent of women are classified as mildly thin, and 1 percent are moderately or severely thin. Overweight and obesity seem be of greater concern in Ghana compared with thinness. The mean BMI for women age 15-49 in Ghana is 24.8 kg/m².The mean BMI generally increases with age, with the lowest value (21.3 kg/m²) being observed in the youngest women age 15-19 and the highest value (27.2 kg/m²) being observed for women age 40-45. The mean BMI is positively associated with women’s education and household wealth.

Overall, 25 percent of women in Ghana are overweight, and 15 percent are obese. The proportion of overweight/obese women is positively correlated with women’s age; this proportion increases from 9 percent among women age 15-19 to 56 percent for women age 40-49. Urban women are substantially more likely to be overweight/obese than their rural counterparts (49 percent versus 28 percent). Marked regional differences are notable, with women in Greater Accra being more than four times as likely to be overweight/obese as those in Northern (57 percent versus 12 percent). As expected, the proportion of overweight/obese women correlates positively with household wealth: this percentage increases steadily from 13 percent in the lowest wealth quintile to 60 percent in the highest wealth quintile. Similarly, the proportion of overweight/obese women increases with education, affecting 27 percent of women with no education and 49 percent of those with a secondary or higher education.

Table 11.10.1 Nutritional status of women

Among women age 15-49, the percentage with height under 145 cm, mean body mass index (BMI), and the percentage with specific BMI levels, by background characteristics, Ghana 2014

Background Note: The body mass index (BMI) is expressed as the ratio of weight in kilograms to the square of height in meters (kg/m2).

1 Excludes pregnant women and women with a birth in the preceding two months

Nutrition of Children and Women • 175 The proportion of overweight/obesity among Ghanaian women has increased considerably, from

30 percent in 2008 to 40 percent in 2014 (Figure 11.7).

Figure 11.7 Trends in nutritional status among women age 15-49, Ghana 2003-2014

11.9.2 Nutritional Status of Men

For the first time in a Ghana DHS, anthropometric data on height and weight were collected among men age 15-59. These data are useful in BMI calculations, which can be used as a measure of chronic energy deficiency among men (BMI calculations and cutoff points are the same for men and women). In addition, BMI can be used to measure overweight and obesity, risk factors for nutrition-related chronic diseases such as diabetes mellitus and cardiovascular disease.

Table 11.10.2 shows BMI information for Ghanaian men. Overall, 74 percent of men age 15-49 have a BMI in the normal range, 10 percent are thin, and 16 percent are overweight or obese. Men age 15-19 (27 percent) are more likely to be thin than older men. Further, men with a primary education (18 percent) are three times as likely to be thin as men with a secondary or higher education (6 percent).

Overall, the prevalence of overweight/obesity among men is strikingly lower than the prevalence among women (16 percent versus 40 percent). The percentage of men who are overweight/obese is higher in urban than rural areas (23 percent versus 8 percent), and it is highest among men residing in Greater Accra (30 percent). Similar to women, the proportion of overweight/obese men increases with wealth.

9

25

9

30

6

40

2003 GDHS 2008 GDHS 2014 GDHS Percent

Undernutrition Overnutrition (Chronic Energy Deficiency) (Overweight/obese)

Table 11.10.2 Nutritional status of men

Among men age 15-49, mean body mass index (BMI), and the percentage with specific BMI levels, by background characteristics, Ghana 2014

Background

Normal Thin Overweight/obese

Number of Note: The body mass index (BMI) is expressed as the ratio of weight in kilograms to the square of height in meters (kg/m2).