Human food has evolved over time and these changes are adapted to the lifestyle and environment evolution. However, this development retains the main goal of ensuring people physiological needs and good health [1].

Food and nutritional transitions have been characterized by the most marked changes such as the passage from hunting and gathering to the era of agriculture and breeding or that of a period of recurrent famine to a greater food prosperity one [2] [3].

The industrialized societies are generally confronted today with a growing challenge of imbalance between the abundance of food supplies on the one hand and the considerable drop in the energy needs of individuals [4].

The nutrition transition refers to the changes that populations experience in the quality and quantity of dietary behaviors and patterns. These changes go hand in hand with other lifestyle-related factors such as physical activity, work and family environments, and general health and socioeconomic well-being, all of which ultimately influence energy expenditure [5].

This might concern developed countries facing an incredible diversity and quantity of foodstuffs, but surveys in developing and low incomes countries showed that the rate of obesity and non-communicable diseases (NCDs) are increased [6].

In 2012, the World Health Organization have revealed that approximately 46% of all NCD-related deaths in 2012 were due to cardiovascular diseases (CVDs), followed by cancers (22%), respiratory disease (11%) and diabetes (4%) [7].

About low and middle-income countries (LMICs), it’s noted nearly 80% of NCD-related deaths and 82% of all NCDs premature deaths occur [7].

Ivory Coast is considered as a lower-middle-income country, which is in rapid economic growth [8]. Surveys have shown that this kind of country is going through an epidemiological transition which results in the increasing prevalence of NCDs and their risk factors [9].

The available evidence suggests this pattern is changing among those adult populations with longer exposure to modernisation. The latter is leading to rapid lifestyle changes associated with increases in CVD and diabetes [10].

The present study was designed to provide information on the magnitude of the NCD risk factors among the Ivorian adult population and a baseline for monitoring the trends, guiding decision making, and implementing appropriate interventions. To reach this goal, the study has concerned three different sociodemographic populations of Ivory Coast: an urban (Cocody), peri-urban (Abobo) and rural (Yocoboué) area.

Our results showed a high prevalence of NCDS risk factor among study population. Concerning behavioral risk factors, 15.2% of participant consumed tobacco. This prevalence represented the half of those which was in France (32%) [16].

About alcohol, 57.71% of participants have used alcohol. This consumption reached those observed in previous surveys leaded in 2015 in Ivory Cost [17].

Alcohol and tobacco were most prevalent among male than women. Similar results were observed in others study [18] [19].

Physical inactivity and sedentariness prevailed respectively 58.84% and 24.71%. And women’s prevalence was the most important in the two cases. Current study in Australia has showed the same remarks [20].

Certain dietary habits like skipping breakfast, having late dinner and snacking have been found among study population. Two behaviors such as skipping breakfast and late dinner were more prevalent among men than women [21].

Many countries of Asia have accessed the prevalence of some NCDs risk factor [22].

Concerning anthropometric risk factors, our study have showed in this case that the prevalence of overweigh and obesity were respectively 31.33% and 22.41% (55.47% the two together). This rate is close to those observed with Olamedji and coworker’s study [23]. But lower than those reported in United States (60%) [24].

Data showed a higher prevalence of overweight and obesity in urban (Cocody, 59.6%) and peri-urban (Abobo; 42.09%) in contrast to rural area of Yocoboué (25.07%). Rarau and co-worker in 2017 reported that overweight and obesity prevalence were the highest in urban living place relative to rural place [25]. And again our results were in accordance to data from survey reported in Burkina Faso [26] [27].

In term of abdominal obesity (AO), it’s was found high rate in urban living place (Cocody) than peri-urban (Abobo) and rural (Yocoboué) area. The prevalence of AO was also high among women than men. Previous study in India has showed the same results [28].

We found certain biological risk factors among the participants of the study. High blood pressure was observed among the population. It’s less than quarter (14.61%) of participants who were concerned by this case. This prevalence was relatively high and reached those revealed by Sackou and et al. in Abidjan [29].

Raised blood pressure in our study was prevalent with men than women. Similar results was observed by Everett and Zajacova who have determined than male was most hypertensive [30] [31].

The prevalence of high blood sugar was 23.37 for the global population of this study. This rate is reached to those found in South African [32] [33].

Gender distribution of high blood sugar in our study is unsteady. A study in South Africa and other in Senegalese revealed higher rate among women [33] [34]. But in others surveys in Nigeria and Tunisia showed the contrary [35] [36].

Concerning HDL-C, we have observed in general a prevalence of 18.51%. This prevalence increased among women 22.26% than men (12.88%). Data from analysis among African American adults has described a high rate of HDL-C with women [37].

The results concerning association between certain sociodemographic caracteristics (age, gender, residence place), lifestyle (alcohol and tobacco consumption, physical activity and sedentariness), eating behavior (eating frequency, skipping breakfast, late dinner and snacking) and anthropometric and biological risk factors (overweight/obesity, abdominal obesity, high blood pressure, high blood sugar and low HDL-C) have been demonstrated in the study.

Being overweight or obese was associated with much of the risk factors but the most strongly associated one was female gender. The same observation was found in a study in kaduna [38] and others authors have showed similar results [39]. This female predominance could be explained by pregnancies and sociocultural motivations [40]. These differences among female may due to the fact that in subsaharan countries being overweight or obese is a sign of beauty, fertility, well-being [39]. Another explanation could be attributable to kind of daily activities practiced by women which was recognize as a light physical activity and they also prolonged sitting’s time [41].

Our investigation about abdominal obesity was associated with greater odds of female gender. Women were about 26 times to be concerned by AO. Certains authors have found that these results are in line with ours [42]. Several ways can be explained this difference, first difference in sex steroid hormone cause divergence in body composition [43]. Secondly contrary to men, women have a genetic ability to accumulate fat [44]. Visceral fat and post partum abdominal caused by pregnancy were blamed [13]. With women, during post menopausal the body fat redistribution in abdominal area was important [45].

In our study; many factors were associated to hypertension such as age, urban area, male gender, tobacco and alcohol consumption, prolonged sitting time (≥7 hours). But the most strongly associated factor of high blood pressure mainly concerned age and particularly age group of 50 - 60 years old. That observation was found in other surveys [46]. Also it was confirmed in a study from cameroon [47] [48].

These results could be the fact that when age increases, the cells get old and arteries become rigid. Therefore this rigidity makes difficult the blood circulation which finally increases blood pressure [49].

Sedentary time (sitting time ≥ 7 hours) was main risk factor associated to raised blood sugar, it »s followed by urban residence place and light physical activity. The probable explanation of this association was due that certainly it’s plausible that excess body fat could be the reason in part why sedentary lifestyle lead to a risk of raised blood sugar. Physical activity has resulted an acute contraction of active skeletal muscle which improves insulin action [50] [51].

Finding from participants of study revealed that the most important factor associated to low HDL-C was age (50 - 60 years old). Previous study observed the same results [52] [53].

This result could be due to the fact that when age increase, it causes biological change [54].

In conclusion, we observed that the population of study whether it’s from the urban, peri-urban area or rural area, has some behavioral risk factors for NCDs. Those were very important were alcohol (respectively 57.81%; 50.26%; 1.58%), physical inactivity (respectively 65.4%; 38.9%; 10.6%), sedentariness (sitting at least 7 h) (36.78%, 20.58%, 6.29%) and late dinner (81.77%, 71.87%, 28.84%). Concerning biological risk factors for NCDs, we reported a rural-urban positive gradient for the prevalence of all of them.

Also, we have seen some interesting patterns of relation between socio-demographic, behavioral risk factors and biochemical risk factors. The most commons behavioral risk factors associated to NCDs were age, urban area, female gender, harmful alcohol, sedentary, physical inactivity and late dinner. We noted that biological risk factors were most important with females than males. Overweight/obesity and abdominal obesity were most positively associated to the female gender, raised blood pressure to age particularly (50 - 60 years). Those of raised blood sugar were most associated with sedentary time (≥7 h) and low HDL-C to age (50 - 60 years). There was also observed a significant level of clustering of NCD risk factors and that concerned 80% of the participants. This study shows that the nutrition transition is ongoing in Ivory Coast and NCDs could be reduced substantially. So public health interventions against NCDs might be provided by promoting an active lifestyle, a more adequate diet and using the urban residence place as a platform of fighting.

The authors declare no conflict of interest.

Ahouéfa, N.L., Cissé, I., Soro, L.C., Yépié, A.H., Diagou, J.J., Yao, J.-B.K. and Atchibri, L.A. (2021) Associated Risk Factors of Non-Commu- nicable Disease in Three Sites across Ivory Coast: An Urban (Cocody), Peri-Urban (Abobo) and Rural (Yocoboué) Area. Food and Nutrition Sciences, 12, 462-478. https://doi.org/10.4236/fns.2021.125036