Sociodemographic and lifestyle factors and the risk of metabolic syndrome in taxi drivers: A focus on street food

In South Africa, similar to other populous countries, the taxi industry is an important form of transportation that contributes to the country’s development. As a result, minibus taxi driving is an occupation characterized by strenuous activities such as long hours of driving, limited rest, and challenges related to securing passengers, among several others. Consequently, to combat stress, some commercial drivers resort to smoking, overeating unhealthy food sold at transportation interchange areas (i.e., taxi ranks), and participating in sedentary behaviors. Most of these activities are risk factors for metabolic syndrome (MetS)

Anthropometric indices and cut-off points for screening of metabolic syndrome among South African taxi drivers

Detecting the early onset of metabolic syndrome (MetS) allows for quick intervention which may slow progression to a variety of health consequences, hence, determining the best measurement to detect MetS is essential. This research aimed at examining the MetS predictive power of anthropometric indices, such as body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), body shape index (ABSI), body roundness index (BRI), percentage body fat (%BF), conicity index (CI), and Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE) to determine the cut-o points to identify male South African taxi drivers with MetS

Comparison of the ability of anthropometric indices to predict the risk of diabetes mellitus in South African males: Sanhanes-1

This study aimed to assess the sensitivity of body mass index (BMI) to predict the risk of diabetes mellitus (DM) and whether waist circumference (WC), waist-to-hip (WHR) and waist-toheight (WHtR) ratios are better predictors of the risk of DM than BMI in South African men aged 20 years and older. Data from the first South African National Health and Nutrition Examination Survey (SANHANES-1) were used. Overall, 1405 men who had valid HbA1c outcomes were included. The sensitivity, specificity, and optimal cut-off points for predicting DM were determined using the receiver operating characteristic (ROC) curve analysis. A total of 34.6% percent of the study participants were overweight/obese, while 10.5%, 10.4%, 36.6% and 61.0% had HbA1c, WC, WHR and WHtR above the normal reference ranges, respectively

The risk of metabolic syndrome as a result of lifestyle among Ellisras rural young adults

The study aimed to investigate the association between metabolic syndrome (MetS) and lifestyle risk factors among Ellisras adults. A cross-sectional study was conducted on 624 adults (306 males and 318 females). MetS was defined according to the criteria of the International Diabetes Federation. The prevalence of MetS was 23.1% (8.6% males and 36.8 % females). Females appeared to have higher mean values for waist circumference (WC), fasting blood glucose (FBG), total cholesterol (TCHOL) and low-density lipoprotein cholesterol (LDL-C), while males had high mean values for high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP). No significant age and gender differences were observed for dietary intake. Significantly more females (51.9%) presented with increased WC than males (4.6%). Participants who had a high dietary energy intake were significantly less likely to present with larger WC (OR: 0.250 95% CI [0.161; 0.389]), low HDL-C (OR: 0.306 95% CI [0.220; 0.425]) and high LDL-C (OR: 0.583 95% CI [0.418; 0.812]) but more likely to present with elevated FBG (OR: 1.01 95% CI [0.735; 1.386]), high TCHOL (OR: 1.039 95% CI [0.575; 1.337]), high TG (OR: 1.186 95% CI [0.695; 2.023]) and hypertension (OR: 5.205 95% CI [3.156; 8.585]). After adjusting for age, gender, smoking, and alcohol status, high energy intake was more than two times likely to predict MetS in adults with a large WC (OR: 2.766 95% CI [0.863; 3.477] and elevated FBG (OR: 2.227 95% CI [1.051; 3.328]). Therefore, identifying groups that are at an increased risk and those that are in their early stages of MetS will help improve and prevent the increase of the MetS in the future

Comparison of the Ability of Anthropometric Indices to Predict the Risk of Diabetes Mellitus in South African Males: SANHANES-1

This study aimed to assess the sensitivity of body mass index (BMI) to predict the risk of diabetes mellitus (DM) and whether waist circumference (WC), waist-to-hip (WHR) and waist-to-height (WHtR) ratios are better predictors of the risk of DM than BMI in South African men aged 20 years and older. Data from the first South African National Health and Nutrition Examination Survey (SANHANES-1) were used. Overall, 1405 men who had valid HbA1c outcomes were included. The sensitivity, specificity, and optimal cut-off points for predicting DM were determined using the receiver operating characteristic (ROC) curve analysis. A total of 34.6% percent of the study participants were overweight/obese, while 10.5%, 10.4%, 36.6% and 61.0% had HbA1c, WC, WHR and WHtR above the normal reference ranges, respectively. Based on age-adjusted logistic regression analysis, the highest likelihood of DM was observed for those participants who had increased WC and WHtR (odds ratios [OR] were 6.285 (95% CI: 4.136–9.550; p < 0.001) and 8.108 (95% CI: 3.721–17.667; p < 0.001)). The ROC curve analyses for WC, WHR, and WHtR displayed excellent ability to predict the risk of DM, with their areas under the curve (AUC) being 80.4%, 80.2% and 80.8%, respectively. The overall cut-off points to predict the risk of DM for WC, WHR, and WHtR were ≥88.95 cm, ≥0.92, and >0.54, respectively. The ROC analysis for BMI, on the other hand, showed acceptable ability to predict the risk of DM (AUC = 75.6%), with its cut-off point being ≥24.64 kg/m2. Even after stratifying the data by two age groups, WHtR remained a superior index to predict DM, especially in the younger age group. To conclude, no significant differences were observed between the AUC for BMI the AUCs for other indices. However, the AUCs for these indices showed significant excellent ability as opposed to the significant acceptable ability of BMI to predict DM in adult South African men

Association between Macronutrient and Fatty Acid Consumption and Metabolic Syndrome: A South African Taxi Driver Survey

We aimed to examine the association between macronutrient and fatty acid intake and metabolic syndrome (MetS) and its components in South African male mini-bus taxi drivers. One hundred and eighty-five (n = 185) male taxi drivers, aged 20 years and older, who operate in the Cape Town metropole, South Africa, were included. The International Diabetes Federation (IDF) algorithm was used to define MetS. The association between macronutrient and fatty acid intake (assessed using 24 h recall) and MetS were analyzed using multivariable nutrient density substitution models. Overall, protein consumption significantly increased the likelihood of high blood pressure (HBP) and significantly lowered the likelihood of having low levels of high-density lipoprotein cholesterol (HDL-C). In an isoenergetic state, the intake of protein instead of carbohydrates (CHOs) and total fat, reduced the likelihood of elevated triglycerides by 6.7% and 6.6%, respectively. The intake of CHOs instead of protein and total fat, reduced the likelihood of HBP by 2.2% and 2.8%, respectively. In the same isoenergetic state, the intake of saturated fatty acids (SFAs) instead of mono-unsaturated fatty acids (MUFAs) increased the likelihood of HBP by 9.8%, whereas the intake of polyunsaturated fatty acids (PUFAs) instead of SFAs decreased the likelihood of HBP by 9.4%. The current study showed that when total food energy intake is kept constant, a diet that is high in protein, CHOs and PUFAs reduces triglycerides and BP, whereas the intake of total fat and SFAs had the opposite effect. It should, however, be noted that these outcomes were produced using mathematical models, as such we recommend further prospective studies in real life that will reveal the actual associations between the consumption of macronutrients and fatty acids and MetS and its components

Dietary Fiber Intake and Metabolic Syndrome Risk Factors among Young South African Adults

This study attempts to bridge the research gap regarding the importance of dietary fiber in reducing metabolic syndrome (MetS) risk factors in young rural South Africans. A total of 627 individuals (309 males and 318 females) aged 18–30 years participated in the study. Dietary intake was measured using a validated 24-h recall method. The consumption of different types of dietary fiber (total, soluble, and insoluble) was calculated and presented as grams. Anthropometrics, blood pressure, fasting blood glucose, and lipid profiles were measured according to standard protocols. According to the definition of the International Diabetes Federation (IDF), the prevalence of MetS was 23.1%. Overall, the total median [interquartile range (IQR)] values for total, insoluble, and soluble fiber consumed were 4.6 g [0.0–48.9], 0.0 g [0.0–18.0], and 0.0 g [0.0–15.0], respectively. Females had a higher median [IQR] intake of total (5.1 g [0.0–48.9] vs. 4.3 g [0.0–43.9]), insoluble (0.0 g [0.0–18.0] vs. 0.0 g [0.0–12.0]), and soluble fiber (0.0 g [0.0–14.9] vs. 0.0 g [0.0–7.3]) than males, respectively. The mean values for waist circumference, fasting blood glucose, and total cholesterol were higher in females than males (82.20 cm vs. 75.07 cm; 5.59 mmol/L vs. 5.44 mmol/L; and 4.26 mmol/L vs. 4.03 mmol/L, respectively), with significant differences observed for waist circumference and total cholesterol (p < 0.001 and p = 0.005, respectively). More than 97% of participants had fiber intakes below the recommended levels. After adjusting for all potential confounders (age, gender, and energy), log total fiber was inversely associated with fasting blood glucose (β = −0.019, 95% CI [−0.042 to 0.003], p < 0.05), systolic blood pressure (β = −0.002, 95% CI [−0.050 to 0.002], p < 0.05) and high-density lipoprotein cholesterol (β = −0.085, 95% CI [−0.173 to 0.002], p = 0.051) This study may be of public health relevance, providing a potential link between less dietary fiber intake and fasting blood glucose (FBG) and both systolic and diastolic blood pressure. Therefore, this observational data encourages public health policy measures to increase the consumption of dietary fiber in rural communities in order to lower the burden of MetS and its associated risk factors

Association between Blood Pressure and Birth Weight among Rural South African Children: Ellisras Longitudinal Study

The aim of this cross-sectional study was to investigate the association between birth weight, underweight, and blood pressure (BP) among Ellisras rural children aged between 5 and 15 years. Data were collected from 528 respondents who participated in the Ellisras Longitudinal Study (ELS) and had their birth weight recorded on their health clinic card. Standard procedure was used to measure the anthropometric measurements and BP. Linear regression was used to assess BP, underweight variables, and birth weight. Logistic regression was used to assess the association of hypertension risks, low birth weight, and underweight. The association between birth weight and BP was not statistically significant. There was a significant (p < 0.05) association between mean BP and the sum of four skinfolds (β = 0.26, 95% CI 0.15–0.23) even after adjusting for age (β = 0.18, 95% CI 0.01–0.22). Hypertension was significantly associated with weight for age z-scores (OR = 5.13, 95% CI 1.89–13.92) even after adjusting for age and sex (OR = 5.26, 95% CI 1.93–14.34). BP was significantly associated with the sum of four skinfolds, but not birth weight. Hypertension was significantly associated with underweight. Longitudinal studies should confirm whether the changes in body weight we found can influence the risk of cardiovascular diseases

The Association between Plant-Based Diets and Dietary Patterns with Cardiometabolic Risk in a Sample of Commercial Taxi Drivers in South Africa

The consumption of unhealthy foods and a sedentary lifestyle predispose individuals to non-communicable diseases. This study investigated the distribution and the association of plant-based diets (PBDs) and dietary patterns in relation to the cardiometabolic risks in commercial taxi drivers. A cross-sectional analysis was conducted among males (≥19 years) who consumed street foods sold by vendors in the Cape Metropole. A validated questionnaire was administered, including a quantified 24 h dietary recall, and fasting blood samples were collected for biochemical analyses. Statistical analyses were performed to investigate the association between dietary habits and cardiometabolic risks, while adjusting for confounding variables. The analytic sample consisted of 189 males with a median age of 38 years. The taxi drivers who ranked in the top-third of the healthy plant-based diet index (hPDI) had a 1–4% lower likelihood of having raised triglycerides (TG). Furthermore, consumption patterns including refined grains and meat conferred a 33% lower likelihood of dysglycaemia (p = 0.049), while fish/seafood, potatoes, and vegetables conferred a 43% greater likelihood of low high-density lipoprotein cholesterol (HDL-C) (p = 0.026) and 44% greater probability of raised low-density lipoprotein cholesterol (LDL-C) (p = 0.027). Consumption patterns, including sugar-sweetened beverages and eggs, conferred a 37% greater probability of hypertension (p = 0.047) and 53% greater likelihood of subclinical inflammation (p = 0.017). These preliminary findings require larger and more elaborate studies to explore the associations between PBDs and dietary patterns in at-risk African populations, with or without sedentary lifestyles, and exposure to unhealthy food environments

Association between blood pressure and birth weight among rural south african children: Ellisras longitudinal study

The aim of this cross-sectional study was to investigate the association between birth weight, underweight, and blood pressure (BP) among Ellisras rural children aged between 5 and 15 years. Data were collected from 528 respondents who participated in the Ellisras Longitudinal Study (ELS) and had their birth weight recorded on their health clinic card. Standard procedure was used to measure the anthropometric measurements and BP. Linear regression was used to assess BP, underweight variables, and birth weight. Logistic regression was used to assess the association of hypertension risks, low birth weight, and underweight. The association between birth weight and BP was not statistically significant. There was a significant (p < 0.05) association between mean BP and the sum of four skinfolds (β = 0.26, 95% CI 0.15–0.23) even after adjusting for age (β = 0.18, 95% CI 0.01–0.22). Hypertension was significantly associated with weight for age z-scores (OR = 5.13, 95% CI 1.89–13.92) even after adjusting for age and sex (OR = 5.26, 95% CI 1.93–14.34). BP was significantly associated with the sum of four skinfolds, but not birth weight. Hypertension was significantly associated with underweight. Longitudinal studies should confirm whether the changes in body weight we found can influence the risk of cardiovascular diseases