Obesity among women: A complex setting

No abstract

Association between dietary adherence, anthropometric measurements and blood pressure in an urban black population, South Africa

Objectives: The aim was to determine participants’ dietary adherence by calculating a diet adherence score based on the Dietary Approaches to Stop Hypertension (DASH)-style diet; (2) to determine if there was an association between dietary adherence score, anthropometric measurements (waist circumference, body mass index (BMI), waist–hip ratio, waist-to-height-ratio) and blood pressure (BP) in a South African urban black population. Design: Cross-sectional secondary analysis of data collected for the PURE study was undertaken. Setting: Langa, the urban PURE study site in the Western Cape province, South Africa. Subjects: The PURE study Western Cape urban cohort, 454 participants, aged 32–81 years was utilised. Outcome measures: Dietary adherence scores were calculated and the BP and anthropometric measurements, respectively, of participants in the lowest and highest tertiles of dietary adherence scores were compared. Results: Positive correlations were found between age, for both men and women, and systolic and diastolic BP. A significant positive correlation between added sugar intake and systolic blood pressure (SBP) was present only in the women. A significant positive correlation was found between BMI, diastolic BP and SBP in men only. No significant differences existed between BP of men or women in the lowest and top tertile groups according to dietary adherence score, but a significant inverse correlation between the dietary adherence score and SBP was found in women. Conclusions: BMI was positively associated with BP in men, while dietary adherence score was negatively correlated with SBP in women. Summary: Non-adherence to dietary guidelines presenting overconsumption of unhealthy foods may be associated with high blood pressure

Evaluation of waist-to-height ratio to predict 5 year cardiometabolic risk in sub-Saharan African adults

Simple, low-cost central obesity measures may help identify individuals with increased cardiometabolic disease risk, although it is unclear which measures perform best in African adults. We aimed to: 1) cross-sectionally compare the accuracy of existing waist-to-height ratio (WHtR) and waist circumference (WC) thresholds to identify individuals with hypertension, pre-diabetes, or dyslipidaemia; 2) identify optimal WC and WHtR thresholds to detect CVD risk in this African population; and 3) assess which measure best predicts 5-year CVD riskPeer reviewedFinal Accepted Versio

The relationship between female adiposity and physical attractiveness amongst adults in rural Ranaka village, Botswana

Objective: The aim was to assess the relationship between female adiposity and physical attractiveness among men and women in Botswana. Design: A cross-sectional study was undertaken. Setting: Ranaka rural village, Botswana. Subjects: Randomly selected adults (n = 113, men = 48 and women = 65), 18–50 years old were recruited. Outcome measures: Scores to indicate the attractiveness of 21 images of female bodies that represented different percentage body fat (%BF) according to participants’ age, gender and body mass index (BMI) were recorded. Results: The perceptions of physical attractiveness of female body size were similar among men and women, regardless of significant differences between the BMI of men and women. Younger (18–30 years) and older participants (31–50 years) separately, as well as underweight/normal weight versus overweight/obese groups all gave higher attractiveness scores for images with a lower %BF. All groups gave the highest score for the same image (%BF of 19% and waist:hip ratio (WHR) of 0.72), and the lowest score for an image with %BF of 49% and WHR of 0.81. There was a significant negative correlation between attractiveness score and %BF of the images for all groups, but no significant correlation between the attractiveness scores for the images and WHR. There was a consistent outlier in the graphs between attractiveness score and %BF with a % BF of 32% and a WHR of 0.61, with a relatively high score of 7.4 out of 9 for all groups. Conclusions: Participant groups according to gender, age or BMI gave similar attractiveness scores for leaner female body images

Association between dietary adherence, anthropometric measurements and blood pressure in an urban black population, South Africa

Objectives: The aim was to determine participants’ dietary adherence by calculating a diet adherence score based on the Dietary Approaches to Stop Hypertension (DASH)-style diet; (2) to determine if there was an association between dietary adherence score, anthropometric measurements (waist circumference, body mass index (BMI), waist–hip ratio, waist-toheight- ratio) and blood pressure (BP) in a South African urban black population. Design: Cross-sectional secondary analysis of data collected for the PURE study was undertaken. Setting: Langa, the urban PURE study site in the Western Cape province, South Africa. Subjects: The PURE study Western Cape urban cohort, 454 participants, aged 32–81 years was utilised. Outcome measures: Dietary adherence scores were calculated and the BP and anthropometric measurements, respectively, of participants in the lowest and highest tertiles of dietary adherence scores were compared. Results: Positive correlations were found between age, for both men and women, and systolic and diastolic BP. A significant positive correlation between added sugar intake and systolic blood pressure (SBP) was present only in the women. A significant positive correlation was found between BMI, diastolic BP and SBP in men only. No significant differences existed between BP of men or women in the lowest and top tertile groups according to dietary adherence score, but a significant inverse correlation between the dietary adherence score and SBP was found in women. Conclusions: BMI was positively associated with BP in men, while dietary adherence score was negatively correlated with SBP in women. Summary: Non-adherence to dietary guidelines presenting overconsumption of unhealthy foods may be associated with high blood pressure

The relationship between female adiposity and physical attractiveness amongst adults in rural Ranaka village, Botswana

The obesity problem persists in many countries despite growing evidence on the development of effective strategies directed at promoting healthy eating and physical activity to reduce obesity prevalence globally.1 Botswana as a developing country is not spared from this growing obesity pandemic.2 Reports show a higher prevalence of overweight and obesity among women than in men.

Pregnancy incidence and correlates in a clinical trial preparedness study, North West Province South Africa.

INTRODUCTION: Women in HIV prevention trials often must typically agree to avoid pregnancy. Regardless, some become pregnant. Screening tools predicting pregnancy risk could maximize trial safety and efficiency. OBJECTIVES: We assessed incidence and correlates of pregnancy among women at high HIV risk. METHODS: We enrolled sexually-active, HIV-negative women into an observational cohort (2008-2011). At enrollment demographic, contraceptive, reproductive, pregnancy intention and behavioural data were collected. Women reported if one or both partners wanted or intended for the couple to become pregnant. We measured gender role beliefs using a locally validated eight-point index. We tested HIV and pregnancy, and inquired about sexually transmitted infection symptoms (STIs) at enrollment and monthly. HIV testing included behavioural counselling and condom provision, but did not specifically counsel women to avoid pregnancy. Cox proportional hazard modelling evaluated the associations with pregnancy. The multivariate model included the following variables "Recent pregnancy attempts", "Gender Roles Beliefs", "Self-reported STIs" and "Age". RESULTS: We screened 1068 women and excluded (24.6%, 263/1068) who did not report risk behaviour. Non-pregnant, non-sterilized women aged 18-35 (median = 21 years) enrolled (n = 438). Most women reported one partner (74.7%) and a prior live birth (84.6%). Median follow-up time was 6 months (range 0.7-15.5). Pregnancy incidence was 25.1 per 100 women-years (n = 57 pregnancies). Conservative beliefs on gender roles (Adjusted Hazard Ratio (aHR) 1.8; 95% confidence interval [CI] 1.1-2.9), recent pregnancy attempts (aHR 1.9; 95% CI 1.1-3.4) and baseline self-reported STI (aHR 2.5; 95% CI 1.4-4.4) were associated with increased incident pregnancy. Report of no pregnancy intention was associated with lowered pregnancy risk (aHR 0.3; 95% CI 0.1-0.7). CONCLUSIONS: We identified new and confirmed existing factors that can facilitate screening for pregnancy risk

Added sugar, macro-and micronutrient intakes and anthropometry of children in a developing world context

Objective The objective of this study was to determine the relationship between added sugar and dietary diversity, micronutrient intakes and anthropometric status in a nationally representative study of children, 1-8.9 years of age in South Africa. METHODS: Secondary analysis of a national survey of children (weighted n = 2,200; non weighted n = 2818) was undertaken. Validated 24-hour recalls of children were collected from mothers/caregivers and stratified into quartiles of percentage energy from added sugar (% EAS). A dietary diversity score (DDS) using 9 food groups, a food variety score (FVS) of individual food items, and a mean adequacy ratio (MAR) based on 11 micronutrients were calculated. The prevalence of stunting and overweight/obesity was also determined. RESULTS: Added sugar intake varied from 7.5-10.3% of energy intake for rural and urban areas, respectively. Mean added sugar intake ranged from 1.0% of energy intake in Quartile 1 (1-3 years) (Q1) to 19.3% in Q4 (4-8 years). Main sources of added sugar were white sugar (60.1%), cool drinks (squash type) (10.4%) and carbonated cool drinks (6.0%). Added sugar intake, correlated positively with most micronutrient intakes, DDS, FVS, and MAR. Significant negative partial correlations, adjusted for energy intake, were found between added sugar intake and intakes of protein, fibre, thiamin, pantothenic acid, biotin, vitamin E, calcium (1-3 years), phosphorus, iron (4-8 years), magnesium and zinc. The prevalence of overweight/obesity was higher in children aged 4-8 years in Q4 of %EAS than in other quartiles [mean (95%CI) % prevalence overweight 23.0 (16.2-29.8)% in Q4 compared to 13.0 (8.7-17.3)% in Q1, p = 0.0063]. CONCLUSION: Although DDS, FVS, MAR and micronutrient intakes were positively correlated with added sugar intakes, overall negative associations between micronutrients and added sugar intakes, adjusted for dietary energy, indicate micronutrient dilution. Overweight/obesity was increased with higher added sugar intakes in the 4-8 year old children

Obesity in South Africa: Challenges for government and health professionals

OBJECTIVES: To review data on the prevalence, causes and health consequences of obesity in South Africa and propose interventions to prevent and treat obesity and related outcomes. METHODS: Data from existing literature were reviewed with an emphasis on changing eating and activity patterns, cultural factors, perceptions and beliefs, urbanisation and globalisation. Results of studies on the health consequences of obesity in South Africans are also reviewed. RESULTS: Shifts in dietary intakes and activity patterns to higher fat intakes and lower physical activity are contributing to a higher prevalence of obesity. Few overweight black women view themselves as overweight, and some associate thinness with HIV/AIDS. Glucose and lipid toxicity, associated with insulin resistance, play roles in the pathogenesis of the co-morbid diseases of obesity. Elevated free fatty acids in the black population predispose obese black patients to type 2 diabetes. CONCLUSION & RECOMMENDATIONS: Obesity prevention and treatment should be based on education, behaviour change, political support, intersectoral collaboration and community participation, local actions, wide inclusion of the population, adequately resourced programmes, infiltration of existing initiatives, evidence-based planning, and proper monitoring and evaluation. Interventions should have the following components: reasonable weight goals, healthful eating, physical activity and behavioural change. Genes and mutations affecting susceptibility to the development of co-morbidities of obesity and vulnerable periods of life for the development of obesity should be prioritised. Prevention should be managed in community services, identification of high-risk patients in primary healthcare services and treatment of co-morbid diseases in hospital services