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Keino BC, Carrel M. Multilevel factors associated with overweight and obesity in East Africa: Comparative analysis in five countries from 2003 to 2016. Health Place 2024; 89:103326. [PMID: 39067171 DOI: 10.1016/j.healthplace.2024.103326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/03/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024]
Abstract
Rising rates of overweight/obesity in sub-Saharan Africa (SSA) are a growing concern. Regional analysis of sociodemographic factors associated with overweight/obesity, as is common, may mask nationally specific associations. We examine the spatiotemporal trends of overweight/obesity in women (15-49 years) using 13 years of data (2003-2016) from Demographic and Health Surveys in five East African countries. Multivariable logistic regression reveals that urbanization and individual education, wealth, employment, marital status, and age are linked to overweight/obesity in the region, but their influence varied between nations. Variations in sociodemographic risk factors across nations underscore the need for tailored surveillance and interventions to address the increasing burden of overweight/obesity in East Africa.
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Affiliation(s)
- Barbara Chebet Keino
- Department of Geographical Sciences and Sustainability, University of Iowa, Iowa City, Iowa, USA.
| | - Margaret Carrel
- Department of Geographical Sciences and Sustainability, University of Iowa, Iowa City, Iowa, USA.
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Kenney E, Rampalli KK, Samin S, Frongillo EA, Reyes LI, Bhandari S, Boncyk M, Nordhagen S, Walls H, Wertheim-Heck S, Ickowitz A, Cunningham SA, Ambikapathi R, Ekesa B, Matita M, Blake CE. How Livelihood Change Affects Food Choice Behaviors in Low- and Middle-Income Countries: A Scoping Review. Adv Nutr 2024; 15:100203. [PMID: 38462217 PMCID: PMC11007434 DOI: 10.1016/j.advnut.2024.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/29/2024] [Accepted: 03/05/2024] [Indexed: 03/12/2024] Open
Abstract
Livelihoods have changed dramatically over the past decade in low- and middle-income countries (LMIC). These shifts are happening in tandem with shifts in individual and household food choice behaviors. This scoping review aimed to identify and characterize mechanisms through which livelihood changes could affect food choice behaviors in LMIC, including behaviors relating to food production, acquisition, preparation, distribution, and consumption. A literature search was conducted using 4 databases: PubMed, PsycInfo, AGRICOLA, and Embase. The search was further enhanced by expert solicitations. Studies were included if they measured or focused on a livelihood change, described or assessed a change in ≥1 food choice behavior, and focused on LMIC. Studies were excluded if they focused on migration from LMIC to a high-income country. Of the 433 articles that were identified, 53 met the inclusion criteria. Five mechanisms of how livelihood change can affect food choice were identified: occupation, locality, time, income, and social relations. Changes in occupation altered the balance of the availability and affordability of foods in local food environments compared with individual food production. Changes in location, time use, and income influenced where food was purchased, what types of foods were acquired, and how or where foods were prepared. Additionally, changes in social relationships and norms led to expanded food preferences, particularly among urban populations. Time limitations and higher discretionary income were associated with consumption of ultraprocessed foods. Understanding the relationships between the changes in livelihood occuring in LMIC and food choices of households in these countries can inform the development of policies, programs, and other actions to promote sustainable healthy diets and planetary health.
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Affiliation(s)
- Emma Kenney
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
| | - Krystal K Rampalli
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Sharraf Samin
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Ligia I Reyes
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; Division of Nutritional Science, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Shiva Bhandari
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Morgan Boncyk
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; Department of Public Health, Purdue University, West Lafayette, IN, United States
| | - Stella Nordhagen
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland
| | - Helen Walls
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sigrid Wertheim-Heck
- Environmental Policy Group, Department of Social Sciences, Wageningen University, Wageningen, The Netherlands
| | - Amy Ickowitz
- Center for International Forestry Research-World Agroforestry Center, Beit Zayit, Israel
| | - Solveig A Cunningham
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Ramya Ambikapathi
- Department of Public Health, Purdue University, West Lafayette, IN, United States; Department of Global Development, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, United States
| | - Beatrice Ekesa
- Alliance of Bioversity International and CIAT, Kampala, Uganda
| | - Mirriam Matita
- Extension Department, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Christine E Blake
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Pheiffer CF, McGarvey ST, Ginsburg C, Harawa S, White MJ. Dietary patterns and their socio-demographic correlates in the context of migration and urbanisation demonstrate nutrition transitions in South Africa. Glob Public Health 2024; 19:2375541. [PMID: 39048557 PMCID: PMC11346347 DOI: 10.1080/17441692.2024.2375541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 06/19/2024] [Indexed: 07/27/2024]
Abstract
This paper investigates the demographic and socio-economic correlates of dietary patterns in South Africa, drawing on a sample of young adults experiencing internal migration and urbanisation. We use data from the 2018 baseline survey of the Migrant Health Follow-Up Study, an original longitudinal cohort study consisting of 3,087 internal migrants and rural residents aged 18-40 nested within the Agincourt Health and socio-Demographic Surveillance System in rural northeast South Africa. We employ principal components analysis to identify dietary patterns from food frequency questionnaires and ordinary least squares regression to assess whether migration and other socio-economic characteristics correlate with specific dietary patterns at baseline. We observe five distinct dietary patterns characterised by frequent consumption of processed foods, red meat, fruits and vegetables, diverse foods, and high sugar/fat foods. We find migration to be significantly associated with more frequent consumption of both processed foods and fruits and vegetables; we also find the association between migration status and dietary patterns to be heterogenous depending on migrants' destinations. This paper extends current understanding of changing dietary patterns in the context of nutrition transitions with attention to dynamic migration processes rather than static rural-urban differences.
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Affiliation(s)
- Chantel F Pheiffer
- Department of Urban Public Health, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
- Population Studies & Training Center, Brown University, Providence, RI, USA
| | - Stephen T McGarvey
- Population Studies & Training Center, Brown University, Providence, RI, USA
- International Health Institute and Departments of Epidemiology and Anthropology, School of Public Health, Providence, RI, USA
| | - Carren Ginsburg
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sadson Harawa
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michael J White
- Population Studies & Training Center, Brown University, Providence, RI, USA
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Sistia F, Khusun H, Februhartanty J. Plant protein consumption is associated with body mass index among women of reproductive age in Indonesia. Front Nutr 2023; 10:1243635. [PMID: 37927495 PMCID: PMC10622764 DOI: 10.3389/fnut.2023.1243635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction One of the known determinants of obesity in Southeast Asia countries, including Indonesia, is the nutritional transition, which is indicated by fast changes in food production, dietary habits, and physical activity. With rising incomes, plant protein from grains, tubers, and legumes is gradually being replaced by animal protein from poultry, eggs, dairy, and red meat. This change is identified as a protein transition. Different choices of protein sources in the diet have varying health effects. However, there is limited information on the Asian population on the role of protein consumption on the increasing obesity prevalence. Therefore, this study aimed to investigate the association of protein sources consumption with body mass index (BMI) among women of reproductive age in Indonesia. Methods This study used secondary data from the 2018 Indonesia Food Barometer (IFB) conducted using a quantitative cross-sectional survey. A total of 467 Indonesian reproductive-aged women (20-49 years) were included in this study. Dietary intake, including protein consumption, was obtained using 24-h dietary recall. Multiple linear regression was applied to find the association of protein consumption with BMI with a p-value <0.05 considered as a significant outcome variable. Results The Mean BMI was 25.02 kg/m2, median of animal and plant protein was 28.01 g/day and 25.37 g/day, respectively. Consumption of plant protein was significantly associated with BMI after adjusting for marital status and age (p-value = 0.043; R2 = 0.080). The quality of plant protein should be considered to prevent obesity problems among women of reproductive age.
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Affiliation(s)
- Fitra Sistia
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- SEAMEO Regional Centre for Food and Nutrition (RECFON)—Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta, Indonesia
| | - Helda Khusun
- SEAMEO Regional Centre for Food and Nutrition (RECFON)—Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta, Indonesia
- Faculty of Health Sciences, Universitas Muhammadiyah Prof Dr. HAMKA (UHAMKA), Jakarta, Indonesia
| | - Judhiastuty Februhartanty
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- SEAMEO Regional Centre for Food and Nutrition (RECFON)—Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta, Indonesia
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Hisar KM, Yamac SU, Hisar F. Determination of Quality of Life and Related Factors in Overweight Women Living in Rural Areas. Niger J Clin Pract 2023; 26:552-557. [PMID: 37357469 DOI: 10.4103/njcp.njcp_60_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Background Obesity is more common among women living in rural areas of Türkiye and being overweight affects the quality of life of women. Aim Through this study, we aimed to determine the quality of life and related factors of overweight women living in rural areas. Materials and Methods This is a descriptive correlational study. The data were collected using the Personal Information Form and the Scale of Quality-of-Life Overweight Women (SMQLOW) between April and June 2020. The study sample comprised women with a body mass index (BMI) of 25 and above. Results The study included 201 women, 41.8% of the participants were in the 36-51 age group and 50.2% had a BMI between 30 and 49.2 (obese). It was determined that the quality of life of women was at a moderate level. The difference between the total SMQLOW score with respect to age, educational status, economic status, occupation of the spouse, general health status, and BMI were found to be statistically significant (P < 0.05). We examined the correlation of some variables with the total scale score of overweight women. A significant positive and weak correlation was found between weight and the SMQLOW total score (r = 0.390, P = 0.001). There was a positively weak and highly significant, correlation between waist circumference and SMQLOW total score (r = 0.277, P < 0.001). Conclusion Preventing obesity may improve the quality of life among rural women in the study Population.
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Affiliation(s)
- K M Hisar
- Department of Public Health, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - S U Yamac
- Mehmet Akif University, Health High School of Bucak, Department of Midwifery, Burdur, Turkey
| | - F Hisar
- Necmettin Erbakan University, Faculty of Nursing, Konya, Turkey
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Drew SD, Blake CE, Reyes LI, Gonzalez W, Monterrosa EC. Attributes of parenting identities and food practices among parents in Nairobi, Kenya. Appetite 2023; 180:106370. [PMID: 36375600 DOI: 10.1016/j.appet.2022.106370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/26/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Dramatic changes in daily life are leading to increased rates of obesity and non-communicable diseases (NCD) in Kenya, including among children. Parenting plays a vital role in helping children establish healthy eating habits to prevent obesity and NCDs. The objective of this study was to describe parenting identity and how attributes of parenting influence food parenting practices in an urban Kenyan context. A qualitative study design was employed with 18 participants recruited using quota sampling to include parents who were born in (n = 8) or migrated to Nairobi in the last five years (n = 10). In-depth qualitative interviews were conducted by an experienced ethnographic interviewer that inquired about parenting identity and food parenting practices. Transcripts were analyzed using thematic coding in a multi-step and emergent process. Parents described their parenting identities as an integration of tradition and personal experiences during their upbringing with the modern realities of daily life. Their own experiences with discipline, modern urban lifestyles, and social pressures were dominant influences on their identities. Parenting identities included four distinct but related attributes: good disciplinarian, trustworthy, protective, and balanced provider and nurturer. Food parenting practices were described as expressions of parenting identity and included the goals: children becoming better eaters; nourishing through food; impart joy; and bonding. The study findings illustrate the influence of modern urban lifestyles on food parenting identities and practices. Understanding emerging identities and practices in rapidly changing low- and middle-income countries (LMIC) contexts is essential for health promoting policies and programs.
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Affiliation(s)
- Shiny Deepika Drew
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Christine E Blake
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Ligia I Reyes
- Cornell University, Division of Nutritional Sciences, Ithaca, NY, 14850, USA.
| | - Wendy Gonzalez
- Global Alliance for Improved Nutrition, Rue de Varembé 7, 1202, Geneva, Switzerland.
| | - Eva C Monterrosa
- Global Alliance for Improved Nutrition, Rue de Varembé 7, 1202, Geneva, Switzerland.
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Zhang Y, Zhang WQ, Tang WW, Zhang WY, Liu JX, Xu RH, Wang TD, Huang XB. The prevalence of obesity-related hypertension among middle-aged and older adults in China. Front Public Health 2022; 10:865870. [PMID: 36504973 PMCID: PMC9731297 DOI: 10.3389/fpubh.2022.865870] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 09/23/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The aim of our study was to assess the prevalence and geographic variation of obesity-related hypertension in China among adults aged 45 years or older. Methods Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. Stratified sample households covered 150 counties/districts and 450 villages/urban communities from 28 provinces by using household questionnaires, clinical measurements, and blood-based bioassays. A multivariable non-conditional logistic regression model was used to analyze the risk factors correlated with obesity-related hypertension. Results The prevalence of obesity-related hypertension was 22.7%, ~120 million people, among adults aged 45 years or older in China. For people in the age ranges of 45-54, 55-64, 65-74, and ≥75 years, the prevalence of obesity-related hypertension was 16.7, 24.3, 27, and 26.7%, respectively, and the prevalence of obesity-related hypertension among hypertensive participants was 66.0, 60.9, 54.2, and 47.3%, respectively. Compared with non-obesity-related hypertension, the obesity-related hypertensive patients had a higher prevalence of diabetes mellitus, dyslipidemia, and hyperuricemia (all P < 0.0001). The prevalence of obesity-related hypertension showed a decreasing gradient from north to south and from east to west. Multivariate logistic regression analysis showed that female gender, living in urban areas, diabetes mellitus, dyslipidemia, and hyperuricemia were positively correlated with obesity-related hypertension. Conclusion The prevalence of obesity-related hypertension among adults aged 45 years or older was high in China. Among hypertensive participants, older age was negatively correlated with obesity-related hypertension. Obesity-related hypertensive participants are more prone to aggregation of risk factors of atherosclerotic cardiovascular disease.
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Affiliation(s)
- Yang Zhang
- Department of Cardiology, Chengdu Second People's Hospital, Chengdu, China
| | - Wen-Qiang Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wei-Wei Tang
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China,Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China
| | - Wen-Yong Zhang
- Department of Cardiology, Chengdu Second People's Hospital, Chengdu, China
| | - Jian-Xiong Liu
- Department of Cardiology, Chengdu Second People's Hospital, Chengdu, China
| | - Rong-Hua Xu
- Stroke Center, Chengdu Second People's Hospital, Chengdu, China
| | - Tzung-Dau Wang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan,*Correspondence: Tzung-Dau Wang
| | - Xiao-Bo Huang
- Department of Cardiology, Chengdu Second People's Hospital, Chengdu, China,Xiao-Bo Huang
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Huang H, Wang F, Xiao Y, Li Y, Zhou HL, Chen J. To stay or to move? Investigation on residents' migration intention under frequent secondary disasters in Wenchuan earthquake-stricken area. Front Public Health 2022; 10:920233. [PMID: 35979472 PMCID: PMC9376595 DOI: 10.3389/fpubh.2022.920233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
The deterioration of the living environment caused by the earthquake is the main migration motivation of residents in the area of the secondary earthquake disaster, and their migration intention is one of the most important factors affecting residents' happiness. This paper uses 957 effective survey samples from 12 secondary geological disaster areas after the Wenchuan earthquake to research the migration intention of residents and its influencing factors. It can be found that 45.2% of residents are willing to migrate, which means they have an instinctive reaction to profit-seeking and harm-avoiding, but it has not become a realistic choice. Investigation facts and research results show that the instinctive response of profit-seeking and harm-avoiding drives residents to make different choices. The migration of residents in areas where secondary geological disasters occur is affected not only by disasters such as debris flow, landslides, and collapse, but also by many factors such as life convenience, family income, expectations for future life, gender, education level, psychological feeling. The improved life and the optimization of the economic conditions brought about by the success of post-disaster reconstruction have made the vast majority of people more confident in the future of the disaster-stricken areas, which made most people choose to stay in those areas. This paper will provide policy suggestions for residents' migration and the reconstruction of the local social governance system in secondary geological disaster areas, which is helpful to improve ecological livability and residents' happiness in the Wenchuan earthquake-stricken area.
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Affiliation(s)
- Huan Huang
- College of Business, Chengdu University of Technology, Chengdu, China
- Yangtze River Economic Zone Research Institution of RUC, Yibin, China
- Digital Hu Huanyong Line Research Institute, Chengdu University of Technology, Chengdu, China
| | - Fan Wang
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu, China
| | - Yi Xiao
- College of Management Science, Chengdu University of Technology, Chengdu, China
- *Correspondence: Yi Xiao
| | - Yuan Li
- College of Economics, Sichuan University, Chengdu, China
| | - Hui-Ling Zhou
- School of Accountancy, Tianfu College of SWUFE, Mianyang, China
| | - Jing Chen
- School of Architectural and Engineering, Tianfu College of SWUFE, Mianyang, China
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Li G, Liu J, Lu H, Hu W, Hu M, He J, Yang W, Zhu Z, Zhu J, Zhang H, Zhao H, Huang F. Multiple environmental exposures and obesity in eastern China: An individual exposure evaluation model. CHEMOSPHERE 2022; 298:134316. [PMID: 35302002 DOI: 10.1016/j.chemosphere.2022.134316] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/09/2022] [Accepted: 03/12/2022] [Indexed: 06/14/2023]
Abstract
Obesity has caused a huge burden of disease. Few studies have explored individuals' environmental exposure level and the impact of multiple environmental exposures on obesity. The aim of this study was to explore individual air pollution exposure evaluation, and the association between and multiple environmental factors and obesity among adult residents in rural areas of China. In this study, 8400 residents of 14 districts and counties in eastern of China were selected by multistage stratified cluster sampling, and a total of 8377 residents were included in the final analysis. We adopted BMI (Body Mass Index) > 28 kg/m2 as the definition of obesity. First, an individual air pollution evaluation model was established based on the monitoring data of air pollution stations closest to residential address, different demographic characteristics of residents and daily living habits using generalized linear model and random forest model. Then, we used Bayesian Kernel Machine Regression (BKMR) and Quantile g-Computation (QgC) models to explore multiple environmental exposures on obesity. The results showed that six air pollutants were significantly positively associated with obesity, and green space had a significant protective effect on obesity. The BKMR model showed that the effects of different air pollutants on obesity were significantly enhanced by each other, while green space significantly reduced the positive effect of air pollution on obesity. The QgC model showed a significant positive association with obesity when all environmental factors were exposed as a whole, especially in males, higher household incomes and young people. It suggested that relevant authorities should improve regional air quality and green space to reduce the burden of disease caused by obesity.
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Affiliation(s)
- Guoao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jianjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Huanhuan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wenlei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Mingjun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jialiu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wanjun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Zhenyu Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jinliang Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Hanshuang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Huanhuan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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Teixeira de Siqueira-Filha N, Li J, Kibuchi E, Quayyum Z, Phillips-Howard P, Awal A, Mithu MIH, Manzoor F, Karuga R, Saidu S, Smith J, Sai V, Garimella S, Chumo I, Mberu B, Tolhurst R, Mazumdar S, Rao V, Farnaz N, Alam W, Elsey H. Economics of healthcare access in low-income and middle-income countries: a protocol for a scoping review of the economic impacts of seeking healthcare on slum-dwellers compared with other city residents. BMJ Open 2021; 11:e045441. [PMID: 34244254 PMCID: PMC8273471 DOI: 10.1136/bmjopen-2020-045441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION People living in slums face several challenges to access healthcare. Scarce and low-quality public health facilities are common problems in these communities. Costs and prevalence of catastrophic health expenditures (CHE) have also been reported as high in studies conducted in slums in developing countries and those suffering from chronic conditions and the poorest households seem to be more vulnerable to financial hardship. The COVID-19 pandemic may be aggravating the economic impact on the extremely vulnerable population living in slums due to the long-term consequences of the disease. The objective of this review is to report the economic impact of seeking healthcare on slum-dwellers in terms of costs and CHE. We will compare the economic impact on slum-dwellers with other city residents. METHODS AND ANALYSIS This scoping review adopts the framework suggested by Arksey and O'Malley. The review is part of the accountability and responsiveness of slum-dwellers (ARISE) research consortium, which aims to enhance accountability to improve the health and well-being of marginalised populations living in slums in India, Bangladesh, Sierra Leone and Kenya. Costs of accessing healthcare will be updated to 2020 prices using the inflation rates reported by the International Monetary Fund. Costs will be presented in International Dollars by using purchase power parity. The prevalence of CHE will also be reported. ETHICS AND DISSEMINATION Ethical approval is not required for scoping reviews. We will disseminate our results alongside the events organised by the ARISE consortium and international conferences. The final manuscript will be submitted to an open-access international journal. Registration number at the Research Registry: reviewregistry947.
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Affiliation(s)
| | - Jinshuo Li
- Department of Health Sciences, University of York, York, UK
| | - Eliud Kibuchi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Zahidul Quayyum
- BRAC University James P Grant School of Public Health, Dhaka, Bangladesh
| | | | - Abdul Awal
- BRAC University James P Grant School of Public Health, Dhaka, Bangladesh
| | | | - Farzana Manzoor
- BRAC University James P Grant School of Public Health, Dhaka, Bangladesh
| | | | | | | | - Varun Sai
- The George Institute for Global Health India, New Delhi, India
| | | | - Ivy Chumo
- African Population and Health Research Center, Nairobi, Kenya
| | - Blessing Mberu
- African Population and Health Research Center, Nairobi, Kenya
| | - Rachel Tolhurst
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sumit Mazumdar
- Centre for Health Economics, University of York, York, UK
| | - Vinodkumar Rao
- The Society for Promotion of Area Resource Center, Mumbai, India
| | - Nadia Farnaz
- School of Public Health, BRAC University James P Grant School of Public Health, Dhaka, Bangladesh
| | - Wafa Alam
- BRAC University James P Grant School of Public Health, Dhaka, Bangladesh
| | - Helen Elsey
- Department of Health Sciences, University of York, York, UK
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Changes in diet quality over 10 years of nutrition transition in Colombia: analysis of the 2005 and 2015 nationally representative cross-sectional surveys. Int J Public Health 2020; 65:547-558. [PMID: 32632458 DOI: 10.1007/s00038-020-01396-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/07/2020] [Accepted: 05/20/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To describe the changes in diet quality in Colombians using nationally representative samples from the 2005 and 2015 nutrition surveys. METHODS Repeated cross-sectional analyses of the National Nutrition Surveys from 2005 and 2015. Children (4-17 y.o.) and adults (≥ 18 y.o.) were included. The Alternative Healthy-Eating Index (AHEI) was derived from 24-h recall questionnaires and used to examine diet quality. RESULTS A total of 33,971 participants (20,122 children, 13,849 adults) were included in 2005, and 26,445 participants (15,304 children, 11,141 adults) in 2015. Over the ten-year period, the AHEI decreased from 46.3 to 44.3 in children (Cohen's d = 0.19) and from 49.0 to 46.2 in adults. (Cohen's d = 0.25). On average, those in the highest socioeconomic level had the worst diet quality; however, the difference between the less and most affluent groups shrank by 4.0% over the observation period. CONCLUSIONS Between 2005 and 2015, there was a worsening in the diet quality of Colombian children and adults. Less affluent individuals had a greater worsening of diet quality compared to groups from higher socioeconomic levels.
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Gao L, Bhurtyal A, Wei J, Akhtar P, Wang L, Wang Y. Double Burden of Malnutrition and Nutrition Transition in Asia: A Case Study of 4 Selected Countries with Different Socioeconomic Development. Adv Nutr 2020; 11:1663-1670. [PMID: 32529215 PMCID: PMC7666889 DOI: 10.1093/advances/nmaa064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/29/2020] [Accepted: 05/13/2020] [Indexed: 12/24/2022] Open
Abstract
Disease burden and lifestyle patterns have changed rapidly worldwide, especially in some Asian countries over the past 2 decades. However, cross-country comparative research is limited. This study investigated the nutritional status of preschool children and childbearing women in China, India, Nepal, and Pakistan selected based on their socioeconomic status, population size, and urbanization. Nationally representative data were used from the China National Nutrition and Health Surveillance Report, India National Family Health Survey, Nepal Demographic and Health Survey, Pakistan Demographic and Health Survey, the WHO repository, and the World Bank. The prevalence of underweight, overweight, and obesity and some ratios were compared. These rates varied across these 4 countries and were associated with their economic development levels. China's economic status and prevalence of childhood overweight/obesity (11.5%) were highest; India's economic status was higher than that of Nepal and Pakistan, but had higher rates of stunting, wasting, and underweight (38.4%, 21.0%, and 35.7%, respectively) in preschool children. Pakistan had the highest prevalence of overweight/obesity among childbearing women (52.4% in all, 63.0% in urban areas). Nepal had the lowest economic status and overweight/obesity rate in preschool children (1.2%). In general, the prevalence of overweight/obesity was higher in urban than in rural areas, except among childbearing women in China. Nutritional status and health burden are heavily influenced by economic development. The double burden of malnutrition poses prioritization challenges for policymakers and public health efforts. Prevention of obesity is urgently needed, at least in higher-income countries in Asia.
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Affiliation(s)
- Liwang Gao
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Ashok Bhurtyal
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China,Nepal Public Health Foundation, Kathmandu, Nepal,Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Junxiang Wei
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Parveen Akhtar
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA
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Diendéré J, Kaboré J, Somé JW, Tougri G, Zeba AN, Tinto H. Prevalence and factors associated with overweight and obesity among rural and urban women in Burkina Faso. Pan Afr Med J 2019; 34:199. [PMID: 32180873 PMCID: PMC7060945 DOI: 10.11604/pamj.2019.34.199.20250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/24/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction Low- and middle-income countries, including Burkina Faso, are facing increasing urbanization with health challenges related to nutrition transition that impact body weight change. This study reported the prevalence and factors associated with overweight/obesity among women living in rural and urban Burkina Faso. Methods We conducted a secondary analysis using data from the Burkina Faso 2013 WHO STEPwise survey. Data included socio-demographic, clinical (anthropometric, systolic/diastolic blood pressure (SBP/DBP), oral/dental symptoms), biological (total and high-density lipoprotein cholesterol and fasting blood sugar), and alcohol and tobacco consumption data. A total of 2191 participants with complete data were considered in the analysis. We categorized the 13 Burkinabe regions by urbanization rate quartiles. We then performed Student's t, chi-squared, and Fisher's exact tests and backward stepwise regressions. Results The overall prevalence of overweight/obesity was 19.6% (13.1% and 44% in rural and urban women respectively, p=0.0001). Common factors positively associated with overweight/obesity in both rural and urban women were being a resident of a region in the highest urbanization rate quartile, having a high level of total cholesterol (alone or via an interaction with age) and having a high DBP. In urban women only, overweight/obesity was also associated with a high SBP. Conclusion The prevalence of overweight/obesity in urban women in Burkina was among the highest levels in urban sub-Saharan Africa and roughly mimicked the urbanization profile of the country. In overweight/obesity conditions, cardiovascular concerns, such as increase in total cholesterol and blood pressure, were objective, and the blood pressure increase was more severe in urban women than in rural women.
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Affiliation(s)
- Jeoffray Diendéré
- Research Institute for Health Sciences, Bobo-Dioulasso, Burkina Faso.,Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Jean Kaboré
- Research Institute for Health Sciences, Bobo-Dioulasso, Burkina Faso.,Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Jérôme Winbetourefa Somé
- Research Institute for Health Sciences, Bobo-Dioulasso, Burkina Faso.,Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | | | | | - Halidou Tinto
- Centre Muraz, Bobo-Dioulasso, Burkina Faso.,Clinical Research Unit, Research Institute for Health Sciences, Nanoro, Burkina Faso
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Nurwanti E, Hadi H, Chang JS, Chao JCJ, Paramashanti BA, Gittelsohn J, Bai CH. Rural-Urban Differences in Dietary Behavior and Obesity: Results of the Riskesdas Study in 10-18-Year-Old Indonesian Children and Adolescents. Nutrients 2019; 11:nu11112813. [PMID: 31752101 PMCID: PMC6893820 DOI: 10.3390/nu11112813] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/04/2019] [Accepted: 11/14/2019] [Indexed: 12/12/2022] Open
Abstract
Obesity has become a significant problem for developing countries, including Indonesia. High duration of sedentary activity and high intake of unhealthy foods were associated with high risk of overweight and obesity. The objective of this study was to compare the distributions of sedentary activity and dietary behavior with overweight/obesity risks between urban and rural areas among children and adolescents aged 10-18 years in Indonesia. This is a cross-sectional study. Data from a national survey in 33 Indonesian provinces (Basic Health Research /Riskesdas 2013) were analyzed. Multiple logistic regression models were used to calculate the odds ratio (OR) adjusted with all variables, such as age, gender, residency, education level, physical activity, and food intake. An urban-rural residence difference was found in the factors related to obesity. Daily caffeinated soft drinks and energy drinks consumption (OR = 1.12, 95% CI: 1.01-1.23) were related to risk of overweight and obesity in urban areas. Daily grilled foods (OR = 1.32, 95% CI: 1.22-1.42) and salty food (OR = 1.09, 95% CI: 1.04-1.15) consumption were significantly associated with obesity in rural areas but not in urban areas. Furthermore, sedentary activity was correlated with overweight and obesity among those who lived in urban and rural areas. Our findings suggest that education, environmental, and policy interventions may need to specifically target urban settings, where access is high to a wide range of processed and traditional high-sugar, high-fat snack foods and beverages.
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Affiliation(s)
- Esti Nurwanti
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Nutrition, Faculty of Health Science, Universitas Alma Ata, Yogyakarta 55183, Indonesia; (H.H.); (B.A.P.)
- Alma Ata Center for Healthy Life and Foods (ACHEAF), Universitas Alma Ata, Yogyakarta 55183, Indonesia
| | - Hamam Hadi
- Department of Nutrition, Faculty of Health Science, Universitas Alma Ata, Yogyakarta 55183, Indonesia; (H.H.); (B.A.P.)
- Alma Ata Center for Healthy Life and Foods (ACHEAF), Universitas Alma Ata, Yogyakarta 55183, Indonesia
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; (J.-S.C.); (J.C.-J.C.)
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
| | - Jane C.-J. Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; (J.-S.C.); (J.C.-J.C.)
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Bunga Astria Paramashanti
- Department of Nutrition, Faculty of Health Science, Universitas Alma Ata, Yogyakarta 55183, Indonesia; (H.H.); (B.A.P.)
- Alma Ata Center for Healthy Life and Foods (ACHEAF), Universitas Alma Ata, Yogyakarta 55183, Indonesia
- Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolf Street, Baltimore, MD 21205-2179, USA;
| | - Chyi-Huey Bai
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Department of Public Health, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: ; Tel.: +886-2-27361661
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