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

Philippe Jean-Luc Gradidge,Nigel J. Crowther,Shane A. Norris,Lisa K. Micklesfield,David B. Allison

doi:10.1371/journal.pone.0132914

Philippe Jean-Luc Gradidge, Nigel J. Crowther + Show 3 more

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https://doi.org/10.1371/journal.pone.0132914

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Abstract

BackgroundThis 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.Materials and MethodsData 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.ResultsAll 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).ConclusionsUnderestimation of body size is common and is associated with a lower gain in total body adiposity and a prevalent desire to lose weight.

Highlights

Recent research has predicted that the proportion of overweight and obese women in developing countries such as South Africa will continue to rise, whereas the reverse applies to developed countries [1]
Two distinct groups of overweight/obese females were identified using PAD and feel minus ideal (FID): one that was content with their body size and one that wished to be leaner
Data from the recent South African (SA) National Health and Nutrition Examination Survey shows that obesity is more prevalent in urban than rural black SA women (42.2% compared to 31.8%) [4], as urbanised women live in an environment that favours unhealthy dietary patterns [5], reduced physical activity (PA) [6, 7], and greater sedentary time [8]

Summary

Introduction

Recent research has predicted that the proportion of overweight and obese women in developing countries such as South Africa will continue to rise, whereas the reverse applies to developed countries [1]. This study showed that a higher percentage of black girls had an EAT-26 (Eating Attitudes Test) score >20 (indicating the possibility of developing eating disorders such as anorexia nervosa, bulimia nervosa, or preoccupation with food), and that a higher proportion of black adolescents girls, compared to white girls, had greater body size dissatisfaction, and were more likely to control what they ate. Another SA study suggested that acculturation may be occurring in young black females, and that there could be a conflict between traditional beliefs and Western ideals around body size [17]. 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

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