Cardiovascular disease (CVD) is the leading cause of mortality and morbidity worldwide.
In Sub-Saharan Africa, rates of CVD are increasing rapidly, but there is little evidence
about the potential determinants of CVD risk in this population.
This thesis investigated CVD risk factors in Gaborone, capital city of Botswana, by (i)
documenting CVD risk factors in this population, (ii) investigating the association between
diet and CVD risk factors and (iii) assessing the association between diet and risk of CVD.
787 adults were recruited. Of these 566 were generally “healthy” with no history of CVD,
while 221 (“diseased”) had at least one reported CVD condition, hypertension or
diabetes. The median (interquartile range) age was 27 (23, 32) and 52 (42, 62) years for
healthy and diseased participants respectively. All participants completed an interview
administered questionnaire, including a food frequency questionnaire. Height, weight,
waist circumference and blood pressure were measured, and a non-fasting blood sample
was obtained for analysis of lipids, lipoproteins and glucose.
A high prevalence of overweight and obesity (36.8%), particularly in women (50.0%), and
low HDL cholesterol (<1.0 mmol/L men and <1.3 mmol/L women) (62.6%) was found.
High levels of triglycerides, LDL cholesterol, glucose and high blood pressure were also
found in this population of young adults in Gaborone.
Total fat and/or saturated fat intake (as percentage energy) was significantly linearly
associated with increased LDL cholesterol (p=0.017), triglycerides (p=0.048), glucose
(p=0.044) and with decreased HDL cholesterol (p=0.021). However, fibre, polyunsaturated
fatty acids and dietary patterns were not independently associated with CVD risk factors.
Carbohydrates intake was significantly associated with increased risk of disease.
Unexpectedly, saturated fat intake was associated with reduced disease risk, but
weakened after nutrients adjustment.
CVD risk factors are relatively high in this population. These results suggest a need for
further research on CVD in Botswana.