Abstract
BackgroundTo determine risk factors for overweight/overfatness in children and adolescents from rural KwaZulu-Natal, South Africa.MethodsAnthropometric data were collected from a cross-sectional sample (n = 1519, ages 7, 11 and 15 years) and linked to demographic information (n = 1310 and n = 1317 in overweight and overfat analyses, respectively). Candidate risk factors for overweight/overfatness were identified and tested for associations with overweight (BMI-for-age >+1SD, WHO reference) and overfatness (>85th centile body fatness, McCarthy reference) as outcomes. Associations were examined using simple tests of proportions (χ2/Mann–Whitney U tests) and multivariable logistic regression.ResultsSex was a consistent variable across both analyses; girls at significantly increased risk of overweight and overfatness (overweight: n = 180, 73.9 and 26.1% females and males, respectively (P < 0.0001); overfat: n = 187, 72.7 and 27.3% females and males, respectively (P < 0.0001)). In regression analyses, sex and age (defined by school grade) were consistent variables, with boys at lower risk of overweight (adjusted odds ratio (AOR) 0.40 (confidence interval (CI) -0.28–0.57)) and risk of overweight increasing with age (AOR 0.65 (CI- 0.44–0.96), 0.50 (CI-0.33–0.75) and 1.00 for school grades 1, 5 and 9, respectively). Results were similar for overfatness.ConclusionsThis study suggests that pre-adolescent/adolescent females may be the most appropriate targets of future interventions aimed at preventing obesity in rural South Africa.
Highlights
This study suggests that pre-adolescent/adolescent females may be the most appropriate targets of future interventions aimed at preventing obesity in rural South Africa
The majority of aetiological research on childhood obesity to date has been conducted in high-income countries; there is a substantial lack of data on the risk factors for child and adolescent obesity from middle-income countries like South Africa,[2,12] and within low- and middle-income countries (LMIC) there is a distinct lack
The present analyses are based on participants successfully matched to their unique ACDIS information using the unique Bounded Structure Identifier (BSID) assigned to their homestead by the Africa Centre (n 1⁄4 1310 for overweight analyses, 587 and 723 males and females, respectively, and n 1⁄4 1317 for McCarthy overfat analyses, 590 and 727 males and females, respectively)
Summary
Risk factors for overweight and obesity consistently highlighted in reviews of this subject are often those directly related to individual energy balance such as diet, physical activity and sedentary behaviour.[5,6,7] obesity is a complex and multifactorial condition which may be determined by a combination of individual-, household- or communitylevel factors.[4,8,9] Despite this, research to date has concentrated on individual factors with very little evidence on ‘higher level’ influences on obesity.[10,11]. The majority of aetiological research on childhood obesity to date has been conducted in high-income countries; there is a substantial lack of data on the risk factors for child and adolescent obesity from middle-income countries like South Africa,[2,12] and within LMIC there is a distinct lack. To determine risk factors for overweight/overfatness in children and adolescents from rural KwaZulu-Natal, South Africa
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