In urban South Africa, 16 year old adolescents experience greater health equality than children

Griffiths, Paula; Johnson, Will; Cameron, Noël; Pettifor, John M.; Norris, Shane A.

doi:10.1016/j.ehb.2013.05.004

Cited by 17 publications

(19 citation statements)

References 34 publications

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“…The pattern of increased risk in lower SEP groups, apparent in middle-income countries, is evident here ( 10 , 12 – 14 , 17 ) . The neighbourhood variables have been used previously in this cohort, relating SEP to anthropometric measures at 16 years ( 36 ) . This previous study found no neighbourhood SEP effect on anthropometric outcomes (although underweight was not investigated).…”

Section: Discussionmentioning

confidence: 99%

“…Despite growing evidence of the importance of an ecological approach to understanding nutritional outcomes in high-income countries, there has been little research using this approach to study adolescent nutrition in LMIC. Previous research conducted in South African adolescents aged 16 years focused on the relationship between household/neighbourhood SEP and anthropometric outcomes such as BMI, overweight/obesity, fat mass and lean mass ( 36 ) . However, the prevalence of underweight was not investigated and thus the dual burden of malnutrition was not studied.…”

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confidence: 99%

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Socio-economic influences on anthropometric status in urban South African adolescents: sex differences in the Birth to Twenty Plus cohort

Pradeilles

Griffiths

Norris

et al. 2015

Public Health Nutr.

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ObjectiveTo investigate the associations of household and neighbourhood socio-economic position (SEP) with indicators of both under- and overnutrition in adolescents and to explore sex differences.DesignAnalysis of anthropometric, household and neighbourhood SEP data from the Birth to Twenty Plus cohort born in 1990. Anthropometric outcomes were BMI (thinness, overweight and obesity) and percentage body fat (%BF; low, high). Associations between these and the household wealth index, caregiver education and neighbourhood SEP tertile measures were examined using binary logistic regression.SettingJohannesburg–Soweto, South Africa.SubjectsAdolescents aged 17–19 years (n 2019; 48·2 % men).ResultsWomen had a significantly higher combined prevalence of overweight/obesity (26·2 %) than men (8·2 %) whereas men had a significantly higher prevalence of thinness than women (22·2 % v. 10·6 %, respectively). Having a low neighbourhood social support index was associated with higher odds of high %BF in women (OR=1·59; 95 % CI 1·03, 2·44). A low household wealth index was associated with lower odds of both overweight (OR=0·31; 95 % CI 0·12, 0·76) and high %BF in men (OR=0·28; 95 % CI 0·10, 0·78). A low or middle household wealth index was associated with higher odds of being thin in men (OR=1·90; 95 % CI 1·09, 3·31 and OR=1·80; 95 % CI 1·03, 3·15, respectively). For women, a low household wealth index was associated with lower odds of being thin (OR=0·49; 95 % CI 0·25, 0·96).ConclusionsThe study highlights that even within a relatively small urban area the nutrition transition manifests itself differently in men and women and across SEP indicators. Understanding the challenges for different sexes at different ages is vital in helping to plan public health services.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Socio-economic influences on anthropometric status in urban South African adolescents: sex differences in the Birth to Twenty Plus cohort

Pradeilles

Griffiths

Norris

et al. 2015

Public Health Nutr.

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“…Household socio‐economic status was assessed using an asset index which scored each participant according to the number of assets that they possessed out of a possible 11 (electricity, radio, television, refrigerator, mobile phone, personal computer, bicycle, motorcycle/scooter, car, agricultural land, and farm animals). This was based on standard measures used in the Demographic and Health Surveys household questionnaire (available at http://www.measuredhs.com) and has been extensively utilised in this setting (Griffiths, Johnson, Cameron, Pettifor, & Norris, ; Kagura et al, ).…”

Section: Methodsmentioning

confidence: 99%

“…Household socio-economic status was assessed using an asset index which scored each participant according to the number of assets that they possessed out of a possible 11 (electricity, radio, television, and has been extensively utilised in this setting (Griffiths, Johnson, Cameron, Pettifor, & Norris, 2013;Kagura et al, 2016).…”

Section: According To South Africa's National Prevention Of Mother-tomentioning

confidence: 99%

A maternal “mixed, high sugar” dietary pattern is associated with fetal growth

Wrottesley

Prioreschi

Kehoe

et al. 2019

Maternal & Child Nutrition

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This study examined associations between a maternal “mixed, high sugar” dietary pattern during pregnancy and ultrasound‐determined fetal growth in 495 urban African women and explored whether these associations were independent of maternal baseline body mass index (BMI) and gestational weight gain (GWG). Linear mixed effects modelling (LMM) was used to test the associations between maternal mixed, high sugar dietary pattern score, baseline BMI (kg/m2), and GWG (kg/week) and the following fetal growth outcomes: (a) biparietal diameter (cm), (b) head circumference (cm), (c) abdominal circumference (cm), and (d) femur length (cm). In the pooled LMM, a +1 standard deviation (SD) increase in the mixed, high sugar dietary pattern score was associated with higher biparietal diameter (0.03 cm/+1 SD; p = .007), head circumference (0.07 cm/+1 SD; p = .026), abdominal circumference (0.08 cm/+1 SD; p = .038), and femur length (0.02 cm/+1 SD; p = .015). Although these associations were independent of maternal BMI and GWG, higher baseline BMI was independently and positively associated with abdominal circumference (0.03 cm/+1 kg/m2; p = .011) and femur length (0.01 cm/+1 kg/m2; p = .007) and 1 kg/week greater GWG was associated with a 0.82 cm increase in abdominal circumference (p = .007). In urban African settings, where preconception maternal obesity prevalence is high and processed, high sugar diets are common, improving maternal dietary intake and BMI prior to conception should be prioritised for optimising pregnancy and birth outcomes as well as longer‐term offspring health. In addition, dietary management strategies during pregnancy may be beneficial in facilitating healthy fetal growth.

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“…Household socio-economic status (SES) was assessed using an asset index, which scored each participant according to the number of assets that they possessed out of a possible nine (electricity, radio, television, refrigerator, mobile phone, personal computer, bicycle, motorcycle/scooter, car). This was based on standard measures used in the Demographic and Health Surveys household questionnaire (available at: www.measuredhs.com) and has been extensively used in this setting (18,19) . Asset index scores were subsequently grouped into low (<5), medium (5-7) and high (>7) SES categories.…”

Section: Maternal Variablesmentioning

confidence: 99%

Maternal traditional dietary pattern and antiretroviral treatment exposure are associated with neonatal size and adiposity in urban, black South Africans

et al. 2018

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This study examines the associations between maternal Traditional dietary pattern adherence and HIV/treatment with neonatal size and adiposity in urban, black South Africans, as well as how specific maternal factors - that is BMI and gestational weight gain (GWG) - may influence these associations. Multiple linear regression models were used to examine associations among maternal Traditional diet pattern adherence (pattern score), HIV/treatment status (three groups: HIV negative, HIV positive (antenatal antiretroviral treatment (ART) initiation), HIV positive (pre-pregnancy ART initiation)), BMI and GWG (kg/week), and newborn (1) weight:length ratio (WLR, kg/m) in 393 mother-neonate pairs, and (2) Peapod estimated fat mass index (FMI, kg/m3) in a 171-pair subsample. In fully adjusted models, maternal obesity and GWG were associated with 0·25 kg/m (P=0·008) and 0·48 kg/m (P=0·002) higher newborn WLR, whereas Traditional diet pattern score was associated with lower newborn WLR (-0·04 kg/m per +1 sd; P=0·033). In addition, Traditional diet pattern score was associated with 0·13 kg/m3 (P=0·027) and 0·32 kg/m3 (P=0·005) lower FMI in the total sample and in newborns of normal-weight women, respectively. HIV-positive (pre-pregnancy ART) v. HIV-negative (ref) status was associated with 1·11 kg/m3 (P=0·002) higher newborn FMI. Promotion of a Traditional dietary pattern, alongside a healthy maternal pre-conception weight, in South African women may reduce newborn adiposity and metabolic risk profiles. In HIV-positive women, targeted monitoring and management strategies are necessary to limit treatment-associated effects on in utero fat deposition.

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In urban South Africa, 16 year old adolescents experience greater health equality than children

Abstract: Highlights•Health inequalities reduce in adolescence compared to childhood in South Africa.•Biological & socio-economic status factors should be considered to understand change in inequality.•Obesity prevention in South Africa should target girls whose mothers have a high BMI.

Cited by 17 publications

References 34 publications

Socio-economic influences on anthropometric status in urban South African adolescents: sex differences in the Birth to Twenty Plus cohort

Socio-economic influences on anthropometric status in urban South African adolescents: sex differences in the Birth to Twenty Plus cohort

A maternal “mixed, high sugar” dietary pattern is associated with fetal growth

Maternal traditional dietary pattern and antiretroviral treatment exposure are associated with neonatal size and adiposity in urban, black South Africans

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