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Marianne A. B. van der Sande, MD, PhD, Sana M. Ceesay, PhD, Paul J. M. Milligan, PhD, Ousman A. Nyan, MSc, MB, ChB, MRCP, DipRCPath, DTMandH, Winston A. S. Banya, MSc, DipEd, Andrew Prentice, PhD, Keith P. W. J. McAdam, MA, MB, BChir, FRCP, Fwacp and Gijs E. L. Walraven, MD, PhD, MPH

Marianne A. B. van der Sande, Sana M. Ceesay, Paul J. M. Milligan, Ousman A. Nyan, Winston A. S. Banya, Keith P. W. J. McAdam, and Gijs E. L. Walraven are with the Medical Research Council Laboratories, Fajara, the Gambia. Sana M. Ceesay and Andrew Prentice are with DUNN Nutrition Unit, Cambridge, United Kingdom.

Correspondence: Requests for reprints should be sent to Marianne A. B. van der Sande, MRC, PO Box 273, Banjul, the Gambia (e-mail: mvdsande{at}mrc.gm).

Objectives. This study documented the prevalence of and cardiovascular risk factors associated with obesity and undernutrition in the Gambia.

Methods. Adults (15 years; N = 5373) from rural and urban areas completed a questionnaire; their height, weight, and waist and hip circumferences were measured, and their cardiovascular risk factors were assessed.

Results. Prevalence of undernutrition (body mass index < 18 kg/m²) was 18.0%; all strata of society were affected. Prevalence of obesity (body mass index 30 kg/m²) was 4.0% but was higher (32.6%) among urban women 35 years or older. Cardiovascular risk factors were more prevalent among obese participants.

Conclusions. Undernutrition coexists with obesity, demonstrating a "double burden of disease." Differential interventions should focus on high-risk groups; prevention needs a multisectorial approach.

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