Abstract
ABSTRACTBackground: 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.
Highlights
There is a high and increasing prevalence of overweight and obesity in South Africans of all ages
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 had higher measures of abdominal adiposity compared to the non-diabetic participants [2,5]
We have shown in this study that double (87.9%) the number of women were classified as overweight or obese compared to the men (44.9%) and we were able to explain significantly more of the variance in body mass index (BMI) in the men (26%) compared to the women (14%)
Summary
There is a high and increasing prevalence of overweight and obesity in South Africans of all ages. 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. 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. Obesity trends in Africa between 1980 and 2014 have shown an increase in age-standardised mean body mass index (BMI) from 21 kg/m2 to 23 kg/m2 in men, and from 21.9 kg/m2 to 24.9 kg/m2 in women [6,8] These data collated by the NCD Risk Factor Collaboration (Africa Working Group) report a mean BMI higher than the global average in northern and southern Africa and lower in central, eastern and western Africa, with the mean BMI across the five regions generally being higher in women than men.
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