Modifiable risk factors for Type 2 diabetes mellitus in a peri‐urban community in South Africa

Levitt, Naomi; Steyn, Krisela; Lambert, Estelle V.; Reagon, Gavin; Lombard, Carl; Fourie, Jean; Rossouw, K.; Hoffman, Margaret

doi:10.1046/j.1464-5491.1999.00185.x

Cited by 67 publications

(67 citation statements)

References 30 publications

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“…The negative relationship between physical activity and diabetes was not observed in studies that used simple classification of subjects among inactive and active groups, 41,42 but has been reported in the few investigations that attempted a more precise evaluation of physical activity. 43 When addressing the dose -response issue in the relationship between physical activity and health-related outcomes, a review of existing evidence concluded that, despite the non-standardized measurements of physical activity in population studies and the need for further investigations, physical activity tended to relate to obesity, cardiovascular disease and diabetes in an inverse dose -response fashion. 44 -46 In both sexes of the urban and rural dwellers in the present study, there was a step-wise decrease in BMI, blood pressure and blood glucose levels across the increasing physical activity levels.…”

Section: Discussionmentioning

confidence: 99%

Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon

et al. 2002

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OBJECTIVE:To evaluate and compare physical activity patterns of urban and rural dwellers in Cameroon, and study their relationship with obesity, diabetes and hypertension. METHODS: We studied 2465 subjects aged ! 15 y, recruited on the basis of a random sampling of households, of whom 1183 were urban dwellers from Yaoundé, the capital city of Cameroon and 1282 rural subjects from Bafut, a village of western Cameroon. They all had an interviewer-administered questionnaire for the assessment of their physical activity and anthropometric measurements, blood pressure and fasting blood glucose determination. The procedure was satisfactorily completed in 2325 (94.3%) subjects. Prevalences were age-adjusted and subjects compared according to their region, sex and age group. RESULTS: Obesity was diagnosed in 17.1 and 3.0% urban and rural women, respectively (P < 0.001), and in 5.4 vs 1.2% urban and rural men, respectively (P < 0.001). The prevalence of hypertension was significantly higher in urban vs rural dwellers (11.4 vs 6.6% and 17.6 vs 9.1% in women and men, respectively; P < 0.001). Diabetes was more prevalent in urban compared to rural women (P < 0.05), but not men. Urban subjects were characterized by lower physical activity (P < 0.001), light occupation, high prevalence of multiple occupations, and reduced walking and cycling time compared to rural subjects. Univariate analysis showed significant associations between both physical inactivity and obesity and high blood pressure. The relationship of physical inactivity with hypertension and obesity were independent in both urban and rural men, but not in women. Body mass index, blood pressure and glycaemia were higher in the first compared with the fourth quartiles of energy expenditure. CONCLUSION: Obesity, diabetes and hypertension prevalence is higher in urban compared to rural dwellers in the populations studied. Physical activity is significantly lower and differs in pattern in urban subjects compared to rural. Physical inactivity is associated with these diseases, although not always significant in women.

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Section: Discussionmentioning

confidence: 99%

Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon

et al. 2002

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“…[5][6][7][8][9] The only data available to represent black Africans living in a rural area were collected in the former homeland of QwaQwa. 8 The study by Levitt et al 5 demonstrated a clear increase in the prevalence of diabetes associated with the length of stay in the urban area, and the 1998 South African Demographic and Health Survey (SADHS) 14 showed that the prevalence of overweight and obesity among black Africans was twice as high in the urban setting compared with the rural setting.…”

Section: Methodsmentioning

confidence: 99%

“…However, a number of epidemiological studies have been conducted in selected communities in the 1980s and 1990s. [5][6][7][8][9][10] These revealed a clear rural-urban gradient with higher prevalence in urban settings, in addition to a gradient across different population groups. Studies reported the highest prevalence in the Indian population, followed by the coloured and then the black population.…”

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confidence: 99%

Estimating the burden of disease attributable to diabetes in South Africa in 2000

Bradshaw

Pieterse

Levitt

2007

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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“…Indeed in the community of mixed ancestral origin, the prevalence of diabetes is 10% [8], hypertension 18% [9] and low birthweight 14% [10]. Furthermore, an association between low birthweight and higher systolic and diastolic blood pressures (BP) and fasting blood glucose concentrations, but not measures of insulin sensitivity or secretion, has been reported in 20-year-old adults [11].…”

Section: Introductionmentioning

confidence: 99%

Adult BMI and fat distribution but not height amplify the effect of low birthweight on insulin resistance and increased blood pressure in 20-year-old South Africans

et al. 2005

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Aims/hypothesis: We examined whether associations between low birthweight and adult chronic cardiometabolic disease were dependent upon birthweight alone, or on interactions with BMI, fat accumulation either generally or abdominally, or attained height in young South African adults. Methods: Blood pressure (BP), lipids, glucose tolerance, insulin sensitivity and secretion (homeostasis model) were measured in 20-year-olds (n=132) born at full term and with birthweights on or below the tenth centile (underweight for gestational age [UFA]) or between the 25th and 75th centiles for gestational age (appropriate weight for gestational age, [AFA]). Sex-specific median measurements of BMI, waist circumference, percentage body fat and height defined current anthropometric status, providing four groups for each measure: UFA-low or UFAhigh and AFA-low or AFA-high. Results: The UFA-high BMI group was more insulin-resistant than both low BMI groups (p<0.04), but not the AFA-high BMI group. In contrast, plasma triglycerides and systolic BP were higher in the UFA-high than in all other groups (all p<0.04). When characterised by body fatness, both high percentage (%) body fat groups had higher fasting [insulin] than low percentage (%) body fat groups (p<0.03), and higher [total cholesterol] and [LDL cholesterol] than the UFA-low percentage (%) body fat group (p<0.05). The UFA-high group had higher systolic and diastolic BP than all other groups (all at least p<0.03). A similar pattern was observed when groups were characterised by waist circumference; however, current height status had no effect. Conclusions/ interpretation: These data indicate that the "fetal origins" expression of the chronic disease phenotype is not dependent on birthweight alone, but on its interaction with subsequent fat accumulation, though not on attained height, in this cohort of young adults.

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Modifiable risk factors for Type 2 diabetes mellitus in a peri‐urban community in South Africa

Abstract: This previously unstudied community has an intermediate prevalence on the international scale of Type 2 DM, which is linked to potentially modifiable risk factors.

Cited by 67 publications

References 30 publications

Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon

Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon

Estimating the burden of disease attributable to diabetes in South Africa in 2000

Adult BMI and fat distribution but not height amplify the effect of low birthweight on insulin resistance and increased blood pressure in 20-year-old South Africans

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