Perceptions of overweight in a Caribbean population: the role of health professionals

Carrère, Philippe; Moueza, Nycrees; Cornely, V.; Atallah, V.; Hélène-Pelage, J.; Inamo, Jocelyn; Atallah, A.; Lang, Thierry

doi:10.1093/fampra/cmw061

Cited by 9 publications

(4 citation statements)

References 19 publications

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“…A 2014 study in the French West Indies showed that out of 10 overweight participants, 4 participants perceived themselves as having a normal body weight. Meanwhile, 6 out of 10 patients claimed that no health professional ever told them they were overweight before ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Nutritional and Socioeconomic Determinants of Overweight and Obesity in the French Amazon: The Health Barometer Study

2022

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ObjectivesFrench Guiana is a multicultural overseas territory where obesity is a major public health problem. This study aimed to highlight the nutritional and socioeconomic determinants of overweight and obesity in different populations in French Guiana.MethodsA two-stage random sample of 1390 individuals aged 15 to 75 years was surveyed by telephone, and the participants were initially screened for diabetes. Logistic regression was fitted on the sample to adjust for potential confounding factors.ResultsOverweight and obesity were found in 54.7% of the respondents, a higher proportion than in mainland France. There was a significant body image discrepancy in our population, with a higher risk of obesity among single women, often immigrants from the non-French Caribbean and South America, unemployed or low education.ConclusionsThe main factors associated with obesity were being a precariousness immigrant; there was often a mismatch between body image and overweight/obesity, which is a major obstacle to the improvement of dietary behaviors and lifestyle. This information provides operational clues as to where to act and the necessary adaptations to attempt to modify behaviors in a culturally-adapted manner.

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Section: Discussionmentioning

confidence: 99%

Nutritional and Socioeconomic Determinants of Overweight and Obesity in the French Amazon: The Health Barometer Study

2022

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“…A meta-analysis of 27 studies in the Caribbean found that women are 3.1 times (95% CI: 2.4–3.9) more likely to have obesity than men ( 23 ), and our study found a 6-fold difference. The large gap in obesity prevalence by sex is likely due to a confluence of risk factors unique to women, including lower status, diet patterns, child bearing history, gender inequality, and cultural preferences about body size and shape ( 21 – 23 , 25 , 26 ). In many LMICs, including the Caribbean, obesity among women has historically been associated with wealth and perceived as a sign of strength and good health ( 26 – 29 ).…”

Section: Discussionmentioning

confidence: 99%

“…The large gap in obesity prevalence by sex is likely due to a confluence of risk factors unique to women, including lower status, diet patterns, child bearing history, gender inequality, and cultural preferences about body size and shape ( 21 – 23 , 25 , 26 ). In many LMICs, including the Caribbean, obesity among women has historically been associated with wealth and perceived as a sign of strength and good health ( 26 – 29 ). In South Africa, weight loss is associated with sickness such as HIV and TB and often stigmatized among black women ( 30 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

High prevalence of obesity among women in urban Haiti: Findings from a population-based cohort

Dade

Metz

Pierre

et al. 2022

Front. Public Health

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IntroductionObesity is associated with increased risk of non-communicable diseases and death and is increasing rapidly in low- and middle-income countries, including Haiti. There is limited population-based data on body mass index (BMI) and waist circumference (WC) and associated risk factors in Haiti. This study describes BMI and WC, and factors associated with obesity using a population-based cohort from Port-au-Prince.MethodsBaseline sociodemographic and clinical data were collected from participants in the Haiti CVD Cohort Study between March 2019 and August 2021. Weight was categorized by BMI (kg/m2) with obesity defined as ≥30 kg/m2. Abdominal obesity was defined using WC cutoffs of ≥80 cm for women and ≥94 cm for men based on WHO guidelines. Sociodemographic and behavioral risk factors, including age, sex, educational attainment, income, smoking status, physical activity, fat/oil use, daily fruit/vegetable consumption, and frequency of fried food intake were assessed for their association with obesity using a Poisson multivariable regression.ResultsAmong 2,966 participants, median age was 41 years (IQR: 28–55) and 57.6% were women. Median BMI was 24.0 kg/m2 (IQR: 20.9–28.1) and 508 (17.1%) participants were obese. Women represented 89.2% of the population with BMI ≥30 kg/m2. A total of 1,167 (68.3%) women had WC ≥80 cm and 144 (11.4%) men had WC ≥94 cm. BMI ≥30 kg/m2 was significantly more prevalent among women than men [PR 5.7; 95% CI: (4.3–7.6)], those 40–49 years compared to 18–29 years [PR 3.3; 95% CI: (2.4–4.6)], and those with income >10 USD per day compared to ≤1 USD [PR 1.3; 95% CI: (1.0–1.6)]. There were no significant associations with other health and behavioral risk factors.DiscussionIn Haiti, women have an alarming 6-fold higher obesity prevalence compared to men (26.5 vs. 4.3%) and 89.2% of participants with obesity were women. Abdominal obesity was high, at 44.3%. Haiti faces a paradox of an ongoing national food insecurity crises and a burgeoning obesity epidemic. Individual, social, and environmental drivers of obesity, especially among women, need to be identified.

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“…Obesity was often cited by Pacific SIDS as a non-priority; in fact, it was seen rather as reflecting love, belonging and care, and a personal freedom separate from disease (27,45,62,63). Similar norms are found in Caribbean populations where traditions of food preparation and consumption favor high-calorie ingredients and perceptions of body image favor larger body sizes (64)(65)(66). In addition, fat policy interventions that were enacted, such as bans on turkey tail imports in Samoa and mutton flap sales in Fiji (67), were wrought with political conflict between the ministries of commerce and health, individual stakeholders (mutton traders), and adherence to trade agreements (68).…”

Section: Policy Interventionsmentioning

confidence: 93%

Interventions and policies aimed at improving nutrition in Small Island Developing States: a rapid review

Brown

Rocke

Murphy

et al. 2022

Revista Panamericana De Salud Pública

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Objective. To describe features of nutritional interventions implemented in Small Island Developing States (SIDS) in the past 20 years. Methods. A rapid scoping review was conducted by searching PubMed and Web of Science databases for interventions conducted in SIDS that sought to improve the nutrition of their populations between 2000 and 2019 inclusive. The Noncommunicable diseases progress monitor 2020 was also examined to assess nutritional policies in SIDS. Results. A total of 174 interventions were implemented in 49 of the 58 SIDS. The greatest proportion were conducted in the Caribbean (75 interventions; 43%), with the Pacific region, and the Atlantic, Indian Ocean, Mediterranean and South China Sea region each implementing about 30% of interventions. Using the NOURISHING framework, most interventions (67%) were implemented at the community and national or policy level, using multiple components of the framework. The greatest proportion of interventions (35%) were educational and awareness raising. Restrictions on physical availability of and increased taxation on alcohol were the most commonly reported policies that were partially or fully achieved; restrictions on fats were the least commonly reported. These findings were generally consistent across the SIDS regions. Conclusions. There is a paucity of nutritional policies in SIDS; the reasons may be linked to their social, economic, and environmental vulnerabilities. Interventions should be expanded beyond education to encompass multiple components of the NOURISHING framework, with multisectoral inclusion to ensure stronger stakeholder collaboration and buy-in. A systematic review is warranted using a fuller range of sources to assess the effectiveness of interventions.

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Perceptions of overweight in a Caribbean population: the role of health professionals

Abstract: Greater care is required when giving a diagnosis of overweight, particularly in social-cultural contexts where weight norms differ.

Cited by 9 publications

References 19 publications

Nutritional and Socioeconomic Determinants of Overweight and Obesity in the French Amazon: The Health Barometer Study

Nutritional and Socioeconomic Determinants of Overweight and Obesity in the French Amazon: The Health Barometer Study

High prevalence of obesity among women in urban Haiti: Findings from a population-based cohort

Interventions and policies aimed at improving nutrition in Small Island Developing States: a rapid review

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