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Ndambo MK, Nyondo-Mipando AL, Thakwalakwa C. Eating behaviors, attitudes, and beliefs that contribute to overweight and obesity among women in Lilongwe City, Malawi: a qualitative study. BMC Womens Health 2022; 22:216. [PMID: 35681137 PMCID: PMC9185864 DOI: 10.1186/s12905-022-01811-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Obesity is increasingly a public health concern in low- and middle-income countries, including Malawi where 36% of women have body mass index in overweight/obese categories in urban areas. Eating behaviors, attitudes, and beliefs are associated with body size, but have not been studied in-depth in sub-Saharan African countries. This study therefore, explored eating behaviors, attitudes, and beliefs of women in Lilongwe, Malawi.
Methods This was a descriptive ancillary qualitative study utilising in-depth interviews with 27 women (13 in normal weight range and 14 in overweight/obesity ranges) puporsively selected in Lilongwe City, Malawi from October to November 2017. The concept of data saturation guided data collection, and it was reached with the 27 interviewed participants when there was no new information coming from the participants. All interviews were conducted in the local language, transcribed verbatim, and translated into English. The transcripts were analysed manually using thematic content analysis. Results Majority of participants perceived overweight as an indication of good health such that with food affordability, women deliberately gain weight to demonstrate their good health. Most normal weight respondents said they ate less food than they wanted to because of financial constraints. Most women in overweight/obese ranges in our sample reported that they eat large portions and eat frequently due to the desire to portray a good image of their marital life since there is a societal expectation that when a woman is married, her weight should increase to show that the marriage is successful. The perceived contributors to weight gain include eating behaviors, feelings about weight gain, and gender roles and social expectations to gain weight. Conclusion Beliefs and attitudes related to eating behaviors may have contributed to women being in overweight range and should be considered in designing obesity prevention interventions targeting women in Malawi. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01811-0.
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Affiliation(s)
- Myness Kasanda Ndambo
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi.
| | - Alinane Linda Nyondo-Mipando
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi
| | - Chrissie Thakwalakwa
- Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi
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Reichel K, Prigge M, Latza U, Kurth T, Backé EM. Association of occupational sitting with cardiovascular outcomes and cardiometabolic risk factors: a systematic review with a sex-sensitive/gender-sensitive perspective. BMJ Open 2022; 12:e048017. [PMID: 35135760 PMCID: PMC8830241 DOI: 10.1136/bmjopen-2020-048017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Sedentary behaviour is a modifiable risk factor for cardiovascular health. Although long periods of sedentary behaviour take place at work, evidence of the relationship between such occupational sitting and cardiometabolic health risks remains limited. This systematic review aimed to update the evidence on the associations of occupational sitting with cardiovascular outcomes and cardiometabolic risk factors based on longitudinal studies. DESIGN Systematic review. SETTING Workplace. POPULATION Employees aged 18-65 years. PRIMARY AND SECONDARY OUTCOMES Primary outcomes were cardiovascular diseases and cardiometabolic risk markers. The secondary outcome was all-cause mortality. DATA SOURCES Ten databases, including PubMed, Web of Science and CINAHL (search January 2018, updated February 2019). DATA EXTRACTION AND SYNTHESIS Data were screened, extracted and appraised by three independent reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Studies were markedly heterogeneous in terms of measurement of occupational sitting, cardiometabolic risk factors and cardiovascular morbidity and mortality, so that standards were hardly identifiable and limiting the value of the evidence. The review included 27 high or acceptable quality publications. Of the eight high-quality publications from seven cohorts, three cohort studies found significant associations of occupational sitting with primary outcomes. Additionally, one study described an association with the secondary outcome. Another high-quality publication found an association between occupational sitting and ischaemic heart disease in a subgroup already at risk due to hypertension. For sex/gender analysis, 11 of the 27 high and acceptable quality publications reported sex-stratified results. Five of these found sex differences. CONCLUSIONS Evidence regarding the association of occupational sitting with cardiometabolic health risks was limited because of the lack of standardised measurements for occupational sitting. Occupational sitting combined with an overall sedentary lifestyle was associated with an elevated relative risk for several cardiometabolic outcomes. There is an urgent need for standardised measurements of occupational sitting to facilitate meta-analysis. Sex/gender aspects of this relationship require further investigation.
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Affiliation(s)
- Kathrin Reichel
- Work and Health, Federal Office for Health and Safety in the Workplace Berlin, Berlin, Germany
| | - Michaela Prigge
- Work and Health, Federal Office for Health and Safety in the Workplace Berlin, Berlin, Germany
| | - Ute Latza
- Work and Health, Federal Office for Health and Safety in the Workplace Berlin, Berlin, Germany
| | - Tobias Kurth
- Institute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Eva-Maria Backé
- Work and Health, Federal Office for Health and Safety in the Workplace Berlin, Berlin, Germany
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Torquati L, Mielke GI, Kolbe-Alexander TL, Brown WJ. Associations between indicators of energy intake and expenditure with excess weight and obesity among women in sedentary and less-sedentary jobs. Prev Med 2021; 147:106507. [PMID: 33667468 DOI: 10.1016/j.ypmed.2021.106507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 01/25/2021] [Accepted: 02/27/2021] [Indexed: 11/27/2022]
Abstract
The aim of this study was to compare the associations between indicators of energy intake and expenditure with excess weight and obesity in women who work full-time in sedentary and less sedentary jobs. Data were from 3444 participants the Australian Longitudinal Study on Women's Health, who reported their weight, dietary intake, physical activity and occupation in 2009 (baseline), and weight in 2012 (follow-up). Participants were categorised as being in a 'less sedentary' or 'sedentary' job, based on occupational activity patterns. Odds of excess weight (BMI ≥ 25) at baseline and of being obese (BMI ≥ 30) at follow-up, by indicators of energy intake and expenditure, were compared in the two occupational groups. In multivariate analyses, high non-work sitting time and saturated fat intake were associated with increased odds of obesity at 3-year follow-up in both occupational groups. In the sedentary job group, high physical activity (in leisure and transport) was associated with a 51% reduction in odds of obesity (OR 0.49, 95%CI 0.25-0.97). In the less-sedentary job group, energy intake and high soft drink consumption were associated with markedly increased odds of obesity (OR 1.67 95%CI 1.07-2.61; OR 2.08 95%CI1.42-3.05, respectively). In this cohort of young Australian women, sedentariness at work did not markedly affect the prevalence of excess weight or obesity. Indicators of high energy intake and low energy expenditure were associated with increased odds of both excess weight and obesity, regardless of sedentariness of occupational group.
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Affiliation(s)
- Luciana Torquati
- Department of Sport and Health Sciences, University of Exeter, United Kingdom; Centre for Research in Exercise, Physical Activity, and Health, University of Queensland, Brisbane, Australia.
| | - Gregore I Mielke
- Centre for Research in Exercise, Physical Activity, and Health, University of Queensland, Brisbane, Australia
| | - Tracy L Kolbe-Alexander
- Centre for Research in Exercise, Physical Activity, and Health, University of Queensland, Brisbane, Australia; School of Health & Wellbeing, University of Southern Queensland, Ipswich, Australia; Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town
| | - Wendy J Brown
- Centre for Research in Exercise, Physical Activity, and Health, University of Queensland, Brisbane, Australia
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Morris KA, Arundell L, Cleland V, Teychenne M. Social ecological factors associated with physical activity and screen time amongst mothers from disadvantaged neighbourhoods over three years. Int J Behav Nutr Phys Act 2020; 17:110. [PMID: 32859233 PMCID: PMC7456370 DOI: 10.1186/s12966-020-01015-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 08/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mothers from socioeconomically disadvantaged neighbourhoods are at elevated risk of physical inactivity and high levels of screen time. Yet, little is known regarding the social ecological factors that are longitudinally associated with physical activity and screen time in this target group, and whether the age of their children impacts these relationships. This study aimed to longitudinally examine the social ecological factors associated with physical activity and screen time amongst mothers living in socioeconomically disadvantaged neighbourhoods, and whether these differed according to their child's age. METHODS Data were from 895 mothers living in socioeconomically disadvantaged neighbourhoods (mean age 36.7 years) at baseline and three-year follow-up. Mothers self-reported weekly discretionary physical activity (leisure-time, LTPA; transport-related, TRPA) and screen time durations. Linear regression models assessed associations between five intrapersonal, three social and five physical environmental factors and LTPA, TRPA and screen time, adjusting for confounding factors, clustering by neighbourhood and baseline variables. Interaction analysis was conducted for age of children (younger and older children (n = 442) and mothers with older children (aged 5-12 years) only (n = 453). RESULTS In adjusted models, all intrapersonal factors (self-efficacy, enjoyment, outcome expectations, behavioural intentions and behavioural skill), social support from friends, neighbourhood cohesion and number of televisions were longitudinally associated with LTPA amongst all mothers. Interaction models showed that findings were generally consistent across groups (i.e., those with both younger and older children compared to those with older children only), with three exceptions. Physical activity enjoyment and social support from family were associated with LTPA only among mothers with older children. Neighbourhood cohesion was associated with screen time only amongst mothers with both younger and older children. No associations were detected for TRPA. CONCLUSION Intrapersonal, social and physical environmental factors were longitudinally associated with mother's LTPA, whilst neighbourhood cohesion was longitudinally associated with screen time behaviours amongst mothers. Interventions aimed at increasing LTPA amongst mothers (particularly those from socioeconomically disadvantaged neighbourhoods) may need to target all domains of the social ecological model and may require some tailoring according to the age of children. Further work is needed to identify longitudinal associations with screen time and TRPA in this population group.
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Affiliation(s)
- Kylie A Morris
- Geelong, Australia, School of Exercise and Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
| | - Lauren Arundell
- Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
| | - Verity Cleland
- Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Megan Teychenne
- Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
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Jakicic JM, Powell KE, Campbell WW, DiPietro L, Pate RR, Pescatello LS, Collins KA, Bloodgood B, Piercy KL. Physical Activity and the Prevention of Weight Gain in Adults: A Systematic Review. Med Sci Sports Exerc 2019; 51:1262-1269. [PMID: 31095083 PMCID: PMC6527311 DOI: 10.1249/mss.0000000000001938] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To conduct a systematic literature review to determine if physical activity is associated with prevention of weight gain in adults. METHODS The primary literature search was conducted for the 2018 Physical Activity Guidelines Advisory Committee and encompassed literature through June 2017, with an additional literature search conducted to include literature published through March 2018 for inclusion in this systematic review. RESULTS The literature review identified 40 articles pertinent to the research question. There is strong evidence of an association between physical activity and prevention of weight gain in adults, with the majority of the evidence from prospective cohort studies. Based on limited evidence in adults, however, there is a dose-response relationship and the prevention of weight gain is most pronounced when moderate-to-vigorous intensity physical activity (≥3 METs) is above 150 min·wk. Although there is strong evidence to demonstrate that the relationship between greater time spent in physical activity and attenuated weight gain in adults is observed with moderate-to-vigorous intensity physical activity, there is insufficient evidence available to determine if there is an association between light-intensity activity (<3 METs) and attenuated weight gain in adults. CONCLUSIONS The scientific evidence supports that physical activity can be an effective lifestyle behavior to prevent or minimize weight gain in adults. Therefore, public health initiatives to prevent weight gain, overweight, and obesity should include physical activity as an important lifestyle behavior.
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Affiliation(s)
- John M. Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | | | - Wayne W. Campbell
- Departments of Nutrition Science, Purdue University, West Lafayette, IN
| | - Loretta DiPietro
- Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Russell R. Pate
- Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | - Katherine A. Collins
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | | | - Katrina L. Piercy
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Rockville, MD
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