Nutritional status, tobacco use and alcohol consumption of older persons in Botswana

To describe body mass index (BMI) distribution according to patterns of tobacco use, alcohol consumption and sociodemographic factors of older persons in Botswana.

Data were collected in 1998 as part of a national household survey of 1085 subjects aged 60 years and older. For the purpose of this analysis, data are utilised from a representative 50 % sub-sample (n=393; response rate = 72 %), in which weight and height were measured as part of a medical examination in the subjects' homes.

A high prevalence of underweight (BMI < 18.5) was found in men (20.1 %), while overweight (BMI = 25-29.9) and obesity (BMI > or = 30) were common in women (21.3 % and 27.9 %, respectively). Thirty-four percent of the subjects reported alcohol consumption and 39 % reported tobacco use. Half of the sample used either one or both of the stimulants. Underweight was significantly associated with low socioeconomic status (OR=3.3; 95 % CI=1.3-8.2) and the use of a combination of alcohol and tobacco (OR=2.2; 95 % CI=1.1-4.4). Obesity was significantly associated with female gender (OR=4.9; 95 % CI=2.5-9.7) and younger age (60-69 years, compared to older groups; OR=3.2; 95 % CI=1.3-7.7). A higher than expected clustering of the three health-related risk factors (underweight, tobacco use and alcohol consumption) was found at 6.7 % (observed:expected ratio = 2.9).

A double burden of undernutrition and overnutrition was found in this sample of older persons in an African country. A clustering of the three risk factors for increased morbidity (tobacco use, alcohol consumption and underweight) was evident. These findings indicate a need for health education to effect lifestyle behavioural change in older adults in the subregion.