Undernutrition, overweight and obesity prevalences among community-dwelling elderly in Africa-a systematic review

Background & aims Undernutrition, overweight and obesity are noted among elderly people, but African data were scattered, and no structured synthesis has yet been performed to review studies on nutritional status (NS) of this population. The aim of this study was to assess NS using Body Mass Index (BMI), among elderly living in communities in Africa. Methods Literature was extracted from six databases looking for studies addressing NS among the people aged≥60y. The systematic search was performed up to January 31st, 2021. Countries and overall prevalences were calculated. Link between NS and Human Development Index (HDI) was assessed through Pearson's correlation. Results Thirty-two studies conducted in 14 countries covering almost all socio-geographical areas of the African continent were included. The sample size was from 62 to 2091 participants and the mean age ranged from 65 to 79.7 years. Undernutrition (20.9±8.6%) was higher in Central African Republic (33.4%) and lower in South Africa (3.4%). Overweight (13.8±7.2%) was higher in South Africa (27.6%) and lower in Ethiopia (2.3%) when obesity (13.2:0.7–50.4%) was higher in South Africa (50.4%) and lower in Tanzania (0.7%). Overweight and obesity were positively correlated with HDI (r=0.7, p=0.023; r=0.7, p=0.016, respectively). This study was the first structured one about NS of elderly in Africa. Conclusion Nearly one among five older people in Africa is undernourished and about 30% are overweight or obese. This should be a challenge to African authorities, especially since excess weight could be a problem in the future due to the nutritional transition.