The Role of Lifestyle and Psycho-Social Factors in Predicting Changes in Body Composition in Black South African Women

<div><p>Background</p><p>This study aimed to determine whether lifestyle and psycho-social factors determine changes in body composition over 10 years in a population of black African females with a high prevalence of obesity.</p><p>Materials and Methods</p><p>Data were collected from 430 women at baseline and 10-year follow-up. Dual energy x-ray absorptiometry-derived body fat mass and fat free soft tissue mass, and simple anthropometric measures were taken at both time points. Data on physical activity (PA), diet, smoking, and alcohol intake were collected at baseline. Body size dissatisfaction and body size discrepancy were determined at baseline using the feel minus ideal (FID) index and the perceived minus actual weight status discrepancy score (PAD), respectively.</p><p>Results</p><p>All body composition measurements increased over 10 years (p<0.0005). Two distinct groups of overweight/obese females were identified using PAD and FID: one that was content with their body size and one that wished to be leaner. Vigorous PA at baseline was inversely associated with absolute changes in all measures of adiposity. In subjects who underestimated their body size at baseline (74.0% of the study population) changes in total and peripheral levels of body fat were less than in subjects who correctly identified their body size. In the group that underestimated body size, more women wanted to be leaner than in the group who knew their body size (60.1% vs 47.5%, p<0.05).</p><p>Conclusions</p><p>Underestimation of body size is common and is associated with a lower gain in total body adiposity and a prevalent desire to lose weight.</p></div

Perceptions of female body silhouettes by 17-year-old urban South African boys and girls.

<p>Perceptions of female body silhouettes by 17-year-old urban South African boys and girls.</p

Body composition characteristics at baseline and at 10-year follow-up.

<p>Data presented as mean ± SD for continuous data and % (95% CIs) for categorical data; ^<b>a</b>N at baseline and at 10-year follow-up</p><p>^<b>*</b>p<0.001 versus baseline values</p><p>^†Formula for percent change in prevalence: (follow-up prevalence–baseline prevalence)/baseline prevalence.</p><p>Body composition characteristics at baseline and at 10-year follow-up.</p

General characteristics of 17 year old black African and mixed ancestral urban South_{African boys and girls.}

a<p>Cole et al Age-gender specific BMI cutoffs for age 17.5 years adolescent boys and girls.</p><p>A- Statistical significance for black African and mixed ancestral boys.</p><p>B – Statistical significance for black African and mixed ancestral girl.</p><p>General characteristics of 17 year old black African and mixed ancestral urban South_{African boys and girls.}</p

Longitudinal change between 13 and 17 year old urban South African _Adolescents.

<p><b>P*-</b> P value for the longitudinal change in each ethnic and gender group.</p><p>Longitudinal change between 13 and 17 year old urban South African _Adolescents.</p

Reasons for weight control behaviors among age 13 and 17 black African girls (A); black African boys (B); mixed ancestral girls (C) and mixed ancestral boys (D).

<p>Reasons for weight control behaviors among age 13 and 17 black African girls (A); black African boys (B); mixed ancestral girls (C) and mixed ancestral boys (D).</p

Comparison across baseline FID groups of baseline body composition measures and absolute change in body composition variables over 10-year follow-up.

<p>Data presented as mean ± SD (n)</p><p>^†P<0.05</p><p>^†††P<0.0005 versus subjects who wanted to be fatter</p><p>^*P<0.05</p><p>^***P<0.0005 versus subjects who were content with body shape</p><p>^<b>b</b> baseline values.</p><p>Comparison across baseline FID groups of baseline body composition measures and absolute change in body composition variables over 10-year follow-up.</p

Bone mineral density parameters by sex and ART exposure.

<p>Bone mineral density parameters by sex and ART exposure.</p

Participant characteristics (n = 444).

<p>Participant characteristics (n = 444).</p

Multivariate logistic regression model of associations with low bone density (Z-score < -2 SD) at the hip.

<p>Multivariate logistic regression model of associations with low bone density (Z-score < -2 SD) at the hip.</p