The Barker hypothesis and obesity: Connections for transdisciplinarity and social justice

Obesity burden by socioeconomic measures between 2000 and 2018 among women in sub-Saharan Africa: A cross-sectional analysis of demographic and health surveys

Background

The increasing global burden of obesity especially in low-and-middle-income countries (LMICs) accentuates the need for critical action. In the absence of evidence-based approaches to mitigate recent obesity trends, the likelihood of reaching global obesity targets will be almost zero.

Objective

This study examined the obesity prevalence in Sub-Sahara Africa and observed transitions on the burden of obesity prevalence over time.

Methods

Data from the Demographic and Health Survey which is based on cross sessional design was used. Most recent surveys carried out in 16 sub-Saharan Africa (SSA) between 2000 and 2018 were included in the analysis. Equiplot by the International Centre for Equity was used to display the inequities by the following socioeconomic measures: wealth index, education, and place of residence. Age-standardized prevalence was measured across these socioeconomic measures using the WHO standard population age distribution, examined changing trends and finally assessed transition in obesity prevalence by percentage point difference of highest and lowest prevalence within each of the three socioeconomic measures.

Results

A total of 496,482 women were included in the analysis. Obesity prevalence among women varied substantially, from 2% in Chad to 27% in Lesotho. Variation in obesity prevalence was observed across countries and by socioeconomic status measures. Among women in all the countries except Comoros, the burden was concentrated among the wealthiest. Out of the 16 countries included, the prevalence of obesity was concentrated among women with no education in eight countries (Benin, Burundi, Chad, Cote d'Ivoire, Guinea, Mali, Niger, Comoros) while it was concentrated in those with primary education in Congo and Lesotho and among those with secondary school education in DR Congo, Gabon, Namibia, Nigeria, and Zimbabwe. The burden of obesity was more concentrated in the urban across the 16 countries except in Comoros and Lesotho where they were higher in the rural (8.9 [7.2, 11.1] and 15.1 [13.0, 17.5] respectively) than in urban (6.6 [5.0, 8.8] and 6.8 [5.2, 8.8] respectively). Finally, the trend analysis with five countries indicated that the prevalence and gap in obesity among women increased between previous and most recent surveys except in Zimbabwe where it reduces across the three socioeconomic measures between 2011 and 2018.

Conclusions

This study examined transition in obesity prevalence among women across three socioeconomic measures in selected sub-Saharan African countries. Increasing prevalence of obesity was found in SSA but transition to women in lower socioeconomic status is already taking place in some countries.

Environmental mismatch and obesity in humans: The Jerusalem Perinatal Family Follow-Up Study

BACKGROUND

According to the hypothesis of Gluckman and Hanson, mismatch between the developmental and postdevelopmental environments may lead to detrimental health impacts such as obesity. While several animal studies support the mismatch theory, there is a scarcity of evidence from human-based studies.

OBJECTIVES

Our study aims to examine whether a mismatch between the developmental and young-adult environments affect obesity in young adults of the Jerusalem Perinatal Family Follow-Up Study.

METHODS

Data from The Jerusalem Perinatal Family Follow-Up Study birth cohort was used to characterize early and late environments using offspring and parental sociodemographic and lifestyle information at birth, age 32 (n = 1140) and 42 (n = 404). Scores characterizing the early and late environments were constructed using factor analysis. To assess associations of mismatch with obesity, regression models were fitted using the first factor of each environment and adiposity measures at age 32 and 42.

RESULTS

Having a stable non-beneficial environment at birth and young-adulthood was most strongly associated with increased adiposity, while a stable beneficial environment was most favorable. The transition from a beneficial environment at birth to a less beneficial environment at young-adulthood was associated with higher obesity measures, including higher BMI (β = 0.979; 95% CI: 0.029, 1.929), waist circumference (β = 2.729; 95% CI: 0.317, 5.140) and waist-hip ratio (β = 0.017; 95% CI: 0.004, 0.029) compared with those experiencing a beneficial environment at both time points. Transition from a less beneficial environment at birth to a beneficial environment at adulthood was also associated with higher obesity measurements (BMI -β = 1.116; 95% CI: 0.085, 2.148; waist circumference -β = 2.736; 95% CI: 0.215, 5.256).

CONCLUSIONS

This study provides some support for the mismatch hypothesis. While there is indication that an accumulation of the effects of the non-beneficial environment has the strongest detrimental impact on obesity outcomes, our results also indicate that a mismatch between the developmental and later environments may result in maladaptation of the individual leading to obesity.

The psychosocial diagnosis of gender in public health: propos and application through a case study

Abstract In this article, we present the development of a methodological diagnostic tool for the field of public health from an interdisciplinary perspective that articulates the biological, psychological, and social dimensions of human health from a post-structuralist and feminist perspective and epistemology. In prior research, we have developed a methodology for the study of chronic pain without an organic cause, or fibromyalgia (FM), that we call the psychosocial diagnosis of gender. That work addresses the analysis of the research object itself and, above all, a critical reconceptualization of health in general. We have also used qualitative fieldwork methods (life stories, discussion groups, and documentary material) in our study of people diagnosed with FM. Here, we present the actual tool we use in the Psychosocial Diagnosis of Gender, using a case study that enacts a displacement of the clinical diagnosis of FM towards its articulation with the psychosocial diagnosis of gender.