Socio-cultural, environmental and behavioural determinants of obesity in black South African women : review articles

Background: Obesity and associated cardiometabolic diseases are increasing in urban sub-Saharan Africa due to a complex epidemiological and nutritional transition. Related data on rural communities is scarce. Objectives: The study characterized the socio-demographic and behavioural factors influencing body mass index (BMI) among adults in rural Northern Ghana Methods: A population-based cross-sectional study involving adults aged 40–60 years residing in the Kassena-Nankana districts was undertaken. Demographic, socio-economic and behavioural data were collected along with measures of anthropometry. We determined factors associated with BMI among women and men. Results: A total of 2014 adults were studied. The median age was 51 (IQR 45–57) years and 54% were women. The prevalence of overweight/obesity was higher among women than men (18.4% vs. 7.2%; p < 0.001), whilst underweight was more prevalent in men (18.3% vs. 13.1%; p = 0.001). Participants with the highest level of education and a high household socio-economic status had higher BMIs than those in the lowest strata in both men (β = 0.074, p = 0.028 and β = 0.072, p < 0.001, respectively) and women (β = 0.174, p = 0.001 and β = 0.109, p < 0.001, respectively). Men (β = −0.050; p < 0.001) and women (β = −0.073; p < 0.001) of the Nankana ethnic group had a lower BMI than the Kassena ethnic group. Among men, alcohol consumption (β = −0.021; p = 0.001) and smoking (β = −0.216; p < 0.001) were associated with lower BMI. Smokeless tobacco was associated with lower BMI among women. Pesticide exposure was associated with higher BMI (β = 0.022; p = 0.022) among men. Conclusion: Age, sex, ethno-linguistic group and prevailing socio-demographic and behavioural factors within this rural community in Northern Ghana influence BMI. The observed positive association between pesticide use and BMI warrants further investigation.

Section: Discussionmentioning

confidence: 59%

Socio-demographic and behavioural determinants of body mass index among an adult population in rural Northern Ghana: the AWI-Gen study

Nonterah

Debpuur

Agongo

et al. 2018

“…In a study on urban-dwelling black South Africans, it was suggested that the rapid rise in type 2 diabetes (T2D) prevalence is strongly related to higher adiposity levels, as more than 80% of the diabetic participants were either overweight or obese, and also had higher measures of abdominal adiposity compared to the non-diabetic participants [2,5]. The most recent national statistics on the prevalence of overweight and obesity in South Africa have reported that 64% of adult women and 30.7% of adult men are overweight or obese, with the numbers differing quite significantly between the ethnic groups [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Several sociocultural, environmental and behavioural determinants of obesity have been identified in black South African women [2,5]; however, it is uncertain if these factors predict BMI in black South African men. The sex difference in obesity prevalence in Africa [6,7] is not observed in high-income countries where obesity is more similar between the sexes [6,8].…”

Section: Introductionmentioning

confidence: 99%

Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa

Micklesfield

Kagura

Munthali

et al. 2018

Background: There is a high and increasing prevalence of overweight and obesity in South Africans of all ages. Risk factors associated with overweight and obesity must be identified to provide targets for intervention. Objective: To identify the demographic, socio-economic and behavioural factors associated with body mass index (BMI) in middle-aged black South African men and women. Methods: Data on demographic and socio-economic factors were collected via questionnaire on 1027 men and 1008 women from Soweto Johannesburg, South Africa. Weight and height were measured and BMI was determined. Behavioural factors included tobacco use and consumption of alcohol, and physical activity data were collected using the Global Physical Activity Questionnaire. Menopausal status was determined for the women, and HIV status was available for 93.6% of the men and 39.9% of the women. Results: Significantly more women were overweight or obese than men (87.9 vs. 44.9%). Smoking prevalence (current or former) and minutes spent in moderate to vigorous intensity physical activity was significantly different between the sexes (both p < 0.0001). In the final hierarchical model, marital status (+ married/cohabiting), household asset score (+), current smoking (-), moderate to vigorous physical activity (-) and HIV status (- HIV infected) significantly contributed to 26% of the variance in BMI in the men. In the women, home language (Tswana-speaking compared to Zulu-speaking), marital status (+ unmarried/cohabiting), education (-), current smoking (-) and HIV status (- HIV infected) significantly contributed to 14% of the variance in BMI. Conclusions: The sex difference in BMI and the prevalence of overweight and obesity between black South African men and women from Soweto, as well as the sex-specific associations with various demographic, socio-economic and behavioural factors, highlight the need for more tailored interventions to slow down the obesity epidemic.

“…Black South African women are supposed to have better access to health; however, they are still generally poorer and less educated, and have limited resources compared with the other ethnic groups in the country [2]. Rural-dwelling black South African women also have better activity profiles than urban-dwelling black women, resulting in lower disease risk [7]. With the continual shift of populations to the urban setting, beliefs around acceptable body size are being challenged; such that some obese black South African women perceive their body size to be too large.…”

Section: Introductionmentioning

confidence: 99%

“…With the continual shift of populations to the urban setting, beliefs around acceptable body size are being challenged; such that some obese black South African women perceive their body size to be too large. In the rural setting, being overweight is still associated with wealth and prosperity [7]. Even though these behavioural and psychosocial factors may pose potential challenges for lifestyle modification, they are not yet fully understood.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with obesity and metabolic syndrome in ageing black South African women

Gradidge

2017

Background: The incidence of obesity and related metabolic diseases is high and increasing in sub-Saharan African women. Evidence on the determinants of these diseases is limited, particularly in black South African women. Objective: This PhD review attempts to understand the determinants of obesity and metabolic syndrome (MetS) in a population of ageing urban-dwelling black South African women. Methods: Drawing on the longitudinal Birth-to-Twenty-Plus cohort, data were collected in 2002/03 and 2012/13, including information on behavioural factors (smoking, sitting time, physical activity, smokeless tobacco, and alcohol consumption), body-size perception, body composition (measures of adiposity and lean mass), blood pressure, and cardiometabolic biomarkers (lipid profile, fasting insulin, fasting blood glucose, insulin resistance, leptin, and adiponectin). Results: The prevalence of obesity and related cardiovascular disease risk was high and increased significantly over the 10 year period. Despite most of the study population being physically active, sitting time was high and associated with elevated blood pressure and hypertriglyceridaemia. Two groups of people were observed, those who were happy and those who were unhappy with their body size. In logistic regression analysis, the risk of MetS was lowered by abdominal subcutaneous adipose tissue and adiponectin, and increased by age, smoking, truncal lean mass, and insulin resistance. Conclusions: Obesity was confirmed to be increasing in black South African women, despite most women being sufficiently active according to guidelines of ≥150 min activity/week. Nevertheless, the contribution of sitting time to poor health outcomes is evident in this study population and must be addressed, particularly in women who are content with being obese. The novel finding of the effects of abdominal subcutaneous tissue and truncal lean mass with MetS requires further investigation. The protective effect of adiponectin against MetS is an important finding which highlights the novel interaction between adiposity and cardiometabolic diseases in black South African women.