Factors associated with obesity in South African mothers and their pre-adolescent daughters : a cross-cultural validation and comparison study

Includes abstract.Includes bibliographical references (p. 203-244).The aetiology of obesity is complex, and in addition to intrinsic factors such as the biology of individuals (presented as genetics, age, gender) that contribute to the high obesity epidemic, there are behavioural determinants, along with economic, socio-cultural and environmental factors which are largely extrinsic, that either directly or indirectly influence the development of obesity, therefore are called “obesogenic” (Swinburn et al., 2005; Egger and Swinburn, 1997). In South Africa, these “obesogenic” factors have been only partially explored, and as such, there are gaps in our knowledge. We are also not certain of the extent to which the language, culture and age influence these afore-mentioned factors. As such, this dissertation focused on finding and adapting culturallysensitive and age-appropriate instruments to better understand these obesogenic factors in South African women and girls

Diet therapy and public health

A major threat to the achievement of the Sustainable Development Goals and Universal Health Coverage continues to be malnutrition [1,2]. The term “malnutrition” encompasses both under- and over-nutrition, both of which coexist and interact, especially in low-tomedium- income countries (LMICs) [3]. As a result, the term DBM has been coined [4] to describe this phenomenon, and this is further described as a “malnutrition syndemic” [5] if malnutrition includes micronutrient deficiencies. Research has implicated DBM and syndemic malnutrition in the development of major metabolic diseases, such as coronary heart disease, hypertension, diabetes, and cancer [6]. According to the WHO [7], at a global level, 7 of the 10 leading causes of death in 2019 were metabolic diseases

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

Exploring factors associated with diabetic retinopathy treatment compliance behaviour in Cape Town, South Africa

Complete patient adherence to treatment for diabetic retinopathy (DR) is critical to limit vision loss. There is a dearth of evidence regarding the reasons why South African patients referred for suspected vision-threatening DR stay compliant to or default their treatment. The current study sought to explore factors associated with treatment compliance among patients living with diabetes who have been referred for suspected vision-threatening DR in the Northern/Tygerberg sub-Structure (NTSS) public health care system of Cape Town, South Africa. A qualitative research approach was used where semi-structured in-depth interviews were conducted with 13 adult patients living with DR, and 2 key informants who are primary eye care providers. Thematic data analysis was conducted using taguette.org. Fear of going blind was the most notable patient-related factor associated with compliance. Notable patient-related barriers reported were forgetfulness and a poor state of health. Notable institution-related barriers included suboptimal information received from health care service providers, poor referral management by the organisation delivering retinal screening services, as well as the inaccessibility of the main NTSS hospital via telephone calls. All these factors were confirmed by the key informants of the current study

Meals on wheels: Promoting food and nutrition security among older persons in Cape Town, South Africa

Food insecurity (FI) prevails in Sub-Saharan Africa. Yet, in South Africa, although many people, including the elderly, are vulnerable to FI, little is known about the experiences of older persons (OPs) with FI and the interventions thereof. In South Africa, Meals on Wheels Community Service (MOWCS) provides readymade home meal deliveries for OPs through 209 branches across the country. Therefore, this study investigated MOWCS’ role in the promotion of food security among the OPs at the Brooklyn branch, Cape Town. The study was grounded within the food security framework and focused on the availability, accessibility, utilization, and stability of food at Brooklyn MOWCS. Using qualitative research methods, 10 semi-structured interviews and one focus group discussion (N = 5) were conducted with Brooklyn MOWCS beneficiaries, in addition to three key personnel interviews conducted with staff. Data were analysed using Open Code 4.03. The findings showed Brooklyn MOWCS as a stable source of affordable and nutritious meals to OPs

Consumption patterns of street food consumers in Cape Town

Street foods (SF) contribute significantly to the diet of people living in low- and middle-income countries, however there is a paucity of data on consumption patterns of SF. Since many South Africans consume SF regularly, it is important to determine their purchasing habits, food choices, and nutrition knowledge. A cross-sectional survey conducted in Cape Town metropolitan area, with trained fieldworkers using a structured questionnaire on 1121 SF consumers. The first ten clients who visited a randomly-sampled SF vendor were approached and invited to participate. Data were analysed using IBM Statistics SPSS version 23. Most consumers were black, male, single, and had some high-school education and/or matriculated. Main findings indicated that 38% of these consumers consumed SF almost daily, 43.3% consumed SF frequently (2-3 times per week) and 29% spent between R600 and R899 per month on SF. Items purchased most often in descending order of frequency were fruit, foods and baked products, cold drinks, sweets, peanuts, crisps, fruit juice, biscuits, and chocolates. If healthier SF were available, 96% consumers indicated they would purchase these, with fruit, meat/chicken and vegetable stew, yoghurt and nuts being preferred options. There is a large market for SF consumers in Cape Town. However, most food items consumed, with the exception of fruit and peanuts, are unhealthy by virtue of their high sugar and fat content. SF consumers are however, willing to purchase healthier foods, should these be available.DHE

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.

Body image and the double burden of nutrition among South Africans from diverse sociodemographic backgrounds: SANHANES-1

This study investigated the associations between underweight, obesity and body image (BI) among 15+ year-old South Africans with diverse socio-demographic backgrounds. A cross-sectional survey and the analyses of data for 6411 15+ year-old participants in the first South African National Health and Nutrition Examination Survey was undertaken. Body image was compared to body mass index (BMI) and socio-demography. Data were analyzed using SPSS versions 25. Results are in percentages, means, 95% confidence intervals, p-values, and odds ratios. Overall, participants who were obese of which majority: were females, earned ZAR 9601+, completed grade 6, were non-Black men, were married and resided in urban formal areas, were more likely to underestimate their BMI and desire to be lighter. Participants who were underweight of which majority: were males, had no form of income or education, were black men, were not married, resided in less urban and farm areas, were younger than 25 years, were more likely to overestimate their BMI and desire to be heavier. While underweight and obesity were strong determinants of BI, BI was differentiated by socio-demography. These findings have a public health implication that requires special attention to curb the irrepressible underweight and obesity in South Africa

Nurturing children's development through healthy eating and active living: Time for policies to support effective interventions in the context of responsive emotional support and early learning

Fostering the growth, development, health, and wellbeing of children is a global priority. The early childhood period presents a critical window to influence lifelong trajectories, however urgent multisectoral action is needed to ensure that families are adequately supported to nurture their children's growth and development. With a shared vision to give every child the best start in life, thus helping them reach their full developmental potential, we have formed the International Healthy Eating Active Living Matters (HEALing Matters) Alliance. Together, we form a global network of academics and practitioners working across child health and development, and who are dedicated to improving health equity for children and their families. Our goal is to ensure that all families are free from structural inequality and oppression and are empowered to nurture their children's growth and development through healthy eating and physical activity within the context of responsive emotional support, safety and security, and opportunities for early learning. To date, there have been disparate approaches to promoting these objectives across the health, community service, and education sectors. The crucial importance of our collective work is to bring these priorities for early childhood together through multisectoral interventions, and in so doing tackle head on siloed approaches. In this Policy paper, we draw upon extensive research and call for collective action to promote equity and foster positive developmental trajectories for all children. We call for the delivery of evidence-based programs, policies, and services that are co-designed to meet the needs of all children and families and address structural and systemic inequalities. Moving beyond the “what” is needed to foster the best start to life for all children, we provide recommendations of “how” we can do this. Such collective impact will facilitate intergenerational progression that builds human capital in future generations. © 2022 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd

Body image and the double burden of nutrition among South Africans from diverse sociodemographic backgrounds : SANHANES-1

CITATION: Mchiza, Z.J.-R. et al. 2020. Body image and the double burden of nutrition among South Africans from diverse sociodemographic backgrounds: SANHANES-1. International journal of environmental research and public health, 17(3). doi:10.3390/ijerph17030887The original publication is available at https://www.mdpi.com/journal/ijerphThis study investigated the associations between underweight, obesity and body image (BI) among 15+ year-old South Africans with diverse socio-demographic backgrounds. A cross-sectional survey and the analyses of data for 6411 15+ year-old participants in the first South African National Health and Nutrition Examination Survey was undertaken. Body image was compared to body mass index (BMI) and socio-demography. Data were analyzed using SPSS versions 25. Results are in percentages, means, 95% confidence intervals, p-values, and odds ratios. Overall, participants who were obese of which majority: were females, earned ZAR 9601+, completed grade 6, were non-Black men, were married and resided in urban formal areas, were more likely to underestimate their BMI and desire to be lighter. Participants who were underweight of which majority: were males, had no form of income or education, were black men, were not married, resided in less urban and farm areas, were younger than 25 years, were more likely to overestimate their BMI and desire to be heavier. While underweight and obesity were strong determinants of BI, BI was differentiated by socio-demography. These findings have a public health implication that requires special attention to curb the irrepressible underweight and obesity in South Africa. Keywords: body image; body mass index; socio-demography; body size dissatisfaction; body size misreporting; age; household income; ethnicity; gender; education levelhttps://www.mdpi.com/1660-4601/17/3/887Publishers versio