{
  "abstract": "Introduction Obesity, high blood glucose and high blood pressure are major drivers of global morbidity. Characterising temporal trends in these conditions among people of African origin can direct public health efforts. This longitudinal cohort study aimed to characterise the prevalence and incidence of obesity, high blood glucose and high blood pressure over 8 years in five African-origin middle-aged populations spanning the Human Development Index and to explore temporal between-site and within-site differences.Methods In 2009–2011, the Modeling the Epidemiologic Transition Study (METS) enrolled adults aged 25–45 years from Ghana, South Africa, Jamaica, Seychelles and the USA (n=500 each), with follow-up in 2018–2019. Standardised measurements included anthropometrics, blood pressure and capillary (baseline)/plasma (follow-up) glucose. We calculated prevalence and raw incidence rates (IRs). Generalised estimating equations (GEE) assessed longitudinal associations between outcomes, site and timepoint, adjusting for age, sex and covariates.Results In 855 participants with complete data, the IR per 1000 person-years was 22.0 for obesity, 4.7 for high blood glucose and 27.4 for high blood pressure. Obesity prevalence and incidence were higher among women than among men. In GEE, the adjusted risk of obesity was significantly higher at follow-up than at baseline for Ghana, Jamaica and Seychelles. The prevalence of high blood glucose more than doubled between timepoints; the IR ranged from 3.0 (South Africa) to 7.1 (USA), with no statistically significant site differences in GEE analysis. For high blood pressure, Ghana, Jamaica and Seychelles showed a greater change in risk between baseline and follow-up, compared with the USA.Conclusions The risk of obesity, high blood glucose and high blood pressure increased among middle-aged individuals over 8 years; in Ghana, Jamaica and Seychelles, the change in obesity and high blood pressure risk was statistically significantly greater than in the USA. This highlights the importance of non-communicable disease prevention and management, irrespective of country’s HDI.",
  "authors": [
    {
      "affiliations": [
        "Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa",
        "Julius Global Health, Department of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, Univeristy Medical Center Utrecht, Utrecht, The Netherlands"
      ],
      "name": "Larske M Soepnel"
    },
    {
      "affiliations": [
        "Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa"
      ],
      "name": "Catharina Conradie"
    },
    {
      "affiliations": [
        "Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa"
      ],
      "name": "Hayli Geffen"
    },
    {
      "affiliations": [
        "Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, Illinois, USA"
      ],
      "name": "Candice Choo-Kang"
    },
    {
      "affiliations": [
        "University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland",
        "Republic of Seychelles Ministry of Health, Victoria, Seychelles"
      ],
      "name": "Pascal Bovet"
    },
    {
      "affiliations": [
        "Republic of Seychelles Ministry of Health, Victoria, Seychelles"
      ],
      "name": "Bharathi Viswanathan"
    },
    {
      "affiliations": [
        "Kwame Nkrumah University of Science and Technology, Kumasi, Ghana"
      ],
      "name": "Kweku Bedu-Addo"
    },
    {
      "affiliations": [
        "Kwame Nkrumah University of Science and Technology, Kumasi, Ghana"
      ],
      "name": "Prince Oti-Boateng"
    },
    {
      "affiliations": [
        "Kwame Nkrumah University of Science and Technology, Kumasi, Ghana"
      ],
      "name": "Oscar Akunor Dei"
    },
    {
      "affiliations": [
        "Kwame Nkrumah University of Science and Technology, Kumasi, Ghana"
      ],
      "name": "Kingsley Apusiga"
    },
    {
      "affiliations": [
        "Solutions for Developing Countries, The University of the West Indies, Kingston, Jamaica"
      ],
      "name": "Terrence E Forrester"
    },
    {
      "affiliations": [
        "Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa",
        "School of Health and Medical Sciences, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Queensland, Australia"
      ],
      "name": "Estelle V Lambert"
    },
    {
      "affiliations": [
        "Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa"
      ],
      "name": "Dale Rae"
    },
    {
      "affiliations": [
        "Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa"
      ],
      "name": "Nandipha Sinyanya"
    },
    {
      "affiliations": [
        "Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, Western Cape, South Africa"
      ],
      "name": "Julia Goedecke"
    },
    {
      "affiliations": [
        "Department of Pediatrics, University of California San Diego, La Jolla, California, USA",
        "Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA",
        "Center for Microbiome Innovation, University of California San Diego, La Jolla, California, USA"
      ],
      "name": "Jack A Gilbert"
    },
    {
      "affiliations": [
        "Jesse Brown Department of Veterans Affairs Medical Center, Chicago, Illinois, USA",
        "Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA"
      ],
      "name": "Brian T Layden"
    },
    {
      "affiliations": [
        "Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, Illinois, USA"
      ],
      "name": "Amy Luke"
    },
    {
      "affiliations": [
        "Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa",
        "Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, Illinois, USA"
      ],
      "name": "Lara R Dugas"
    }
  ],
  "title": "Eight-year prevalence and incidence of obesity, high blood glucose and high blood pressure in five African-origin populations: data from the Modeling the Epidemiologic Transition Study",
  "uid": "77c02f80-5b87-54c8-8116-5f3983606bae"
}