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Pradeilles R, Holdsworth M, Olaitan O, Irache A, Osei-Kwasi HA, Ngandu CB, Cohen E. Body size preferences for women and adolescent girls living in Africa: a mixed-methods systematic review. Public Health Nutr 2022; 25:738-759. [PMID: 33593472 PMCID: PMC9991778 DOI: 10.1017/s1368980021000768] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To synthesise evidence on body size preferences for females living in Africa and the factors influencing these. DESIGN Mixed-methods systematic review including searches on Medline, CINHAL, ASSIA, Web of Science and PsycINFO (PROSPERO CRD42015020509). A sequential-explanatory approach was used to integrate quantitative and qualitative findings. SETTING Urban and rural Africa. PARTICIPANTS Studies of both sexes providing data on body size preferences for adolescent girls and women aged ≥10 years. RESULTS Seventy-three articles from twenty-one countries were included: fifty quantitative, fifteen qualitative and eight mixed methods. Most studies reported a preference for normal or overweight body sizes. Some studies of adolescent girls/young women indicated a preference for underweight. Factors influencing preferences for large(r) body sizes included: socio-demographic (e.g. education, rural residency), health-related (e.g. current BMI, pubertal status), psycho-social (e.g. avoiding HIV stigma) and socio-cultural factors (e.g. spouse's preference, social standing, cultural norms). Factors influencing preferences for slim(mer) body sizes included: socio-demographic (e.g. higher socioeconomic status, urban residency, younger age), health-related (e.g. health knowledge, being nulliparous), psycho-social (e.g. appearance, body size perception as overweight/obese) and socio-cultural factors (e.g. peer pressure, media). CONCLUSIONS Preference for overweight (not obese) body sizes among some African females means that interventions need to account for the array of factors that maintain these preferences. The widespread preference for normal weight is positive in public health terms, but the valorisation of underweight in adolescent girls/young women may lead to an increase in body dissatisfaction. Emphasis needs to be placed on education to prevent all forms of malnutrition.
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Affiliation(s)
- Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences (SSEHS), Loughborough University, LoughboroughLE11 3TU, UK
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | | | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Christian B Ngandu
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Emmanuel Cohen
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
- UMR CNRS-MNHN 7206 « Eco-anthropologie », Musée de l’Homme, Paris, France
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Mchiza ZJR, Parker WA, Sewpaul R, Onagbiye SO, Labadarios D. Body Image and the Double Burden of Nutrition among South Africans from Diverse Sociodemographic Backgrounds: SANHANES-1. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030887. [PMID: 32023911 PMCID: PMC7037858 DOI: 10.3390/ijerph17030887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/17/2020] [Accepted: 01/24/2020] [Indexed: 12/30/2022]
Abstract
This study investigated the associations between underweight, obesity and body image (BI) among 15+ year-old South Africans with diverse socio-demographic backgrounds. A cross-sectional survey and the analyses of data for 6411 15+ year-old participants in the first South African National Health and Nutrition Examination Survey was undertaken. Body image was compared to body mass index (BMI) and socio-demography. Data were analyzed using SPSS versions 25. Results are in percentages, means, 95% confidence intervals, p-values, and odds ratios. Overall, participants who were obese of which majority: were females, earned ZAR 9601+, completed grade 6, were non-Black men, were married and resided in urban formal areas, were more likely to underestimate their BMI and desire to be lighter. Participants who were underweight of which majority: were males, had no form of income or education, were black men, were not married, resided in less urban and farm areas, were younger than 25 years, were more likely to overestimate their BMI and desire to be heavier. While underweight and obesity were strong determinants of BI, BI was differentiated by socio-demography. These findings have a public health implication that requires special attention to curb the irrepressible underweight and obesity in South Africa.
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Affiliation(s)
- Zandile June-Rose Mchiza
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa;
- Correspondence: ; Tel.: +27-21-959-2632
| | - Whadi-ah Parker
- Social Aspects of Public Health, Human Sciences Research Council, Cape Town 8000, South Africa; (W.-a.P.); (R.S.)
| | - Ronel Sewpaul
- Social Aspects of Public Health, Human Sciences Research Council, Cape Town 8000, South Africa; (W.-a.P.); (R.S.)
| | | | - Demetre Labadarios
- Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa;
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Lal M, Abraham S, Parikh S, Chhibber K. A comparison of eating disorder patients in India and Australia. Indian J Psychiatry 2015; 57:37-42. [PMID: 25657455 PMCID: PMC4314914 DOI: 10.4103/0019-5545.148516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) are an emerging concern in India. There are few studies comparing clinical samples in western and nonwestern settings. AIM The aim was to compare females aged 16-26 years being treated for an ED in India (outpatients n = 30) and Australia (outpatients n = 30, inpatients n = 30). MATERIALS AND METHODS Samples were matched by age and body mass index, and had similar diagnostic profiles. Demographic information and history of eating and exercise problems were assessed. All patients completed the quality-of-life for EDs (QOL EDs) questionnaire. RESULTS Indians felt they overate and binge ate more often than Australians; frequencies of food restriction, vomiting, and laxative use were similar. Indians were less aware of ED feelings, such as, "fear of losing control over food or eating" and "being preoccupied with food, eating or their body." Indians felt eating and exercise had less impact on their relationships and social life but more impact on their medical health. No differences were found in the global quality-of-life, body weight, eating behaviors, psychological feelings, and exercise subscores for the three groups. CONCLUSION Indian and Australian patients are similar but may differ in preoccupation and control of their ED-related feelings.
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Affiliation(s)
- Maala Lal
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, Sydney, NSW 2065, Australia ; Department of Psychiatry, Northside Clinic, Greenwich, NSW 2065, Australia
| | - Suzanne Abraham
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, Sydney, NSW 2065, Australia ; Department of Psychiatry, Northside Clinic, Greenwich, NSW 2065, Australia
| | - Samir Parikh
- Department of Mental Health and Behavioural Sciences, Max Healthcare, Saket, New Delhi, India
| | - Kamna Chhibber
- Department of Mental Health and Behavioural Sciences, Max Healthcare, Saket, New Delhi, India
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Muthuri SK, Francis CE, Wachira LJM, LeBlanc AG, Sampson M, Onywera VO, Tremblay MS. Evidence of an overweight/obesity transition among school-aged children and youth in Sub-Saharan Africa: a systematic review. PLoS One 2014; 9:e92846. [PMID: 24676350 PMCID: PMC3968060 DOI: 10.1371/journal.pone.0092846] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 02/27/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Prevalence of childhood overweight/obesity has increased considerably in recent years. The transition to higher rates of overweight/obesity has been well documented in high income countries; however, consistent or representative data from lower income countries is scarce. It is therefore pertinent to assess if rates of overweight/obesity are also increasing in lower income countries, to inform public health efforts. OBJECTIVE This systematic review aimed to investigate the evidence for an overweight/obesity transition occurring in school-aged children and youth in Sub Saharan Africa. METHODS Studies were identified by searching the MEDLINE, Embase, Africa Index Medicus, Global Health, Geobase, and EPPI-Centre electronic databases. Studies that used subjective or objective metrics to assess body composition in apparently healthy or population-based samples of children and youth aged 5 to 17 years were included. RESULTS A total of 283 articles met the inclusion criteria, and of these, 68 were used for quantitative synthesis. The four regions (West, Central, East, and South) of Sub Saharan Africa were well represented, though only 11 (3.9%) studies were nationally representative. Quantitative synthesis revealed a trend towards increasing proportions of overweight/obesity over time in school-aged children in this region, as well as a persistent problem of underweight. Weighted averages of overweight/obesity and obesity for the entire time period captured were 10.6% and 2.5% respectively. Body composition measures were found to be higher in girls than boys, and higher in urban living and higher socioeconomic status children compared to rural populations or those of lower socioeconomic status. CONCLUSIONS This review provides evidence for an overweight/obesity transition in school-aged children in Sub Saharan Africa. The findings of this review serve to describe the region with respect to the growing concern of childhood overweight/obesity, highlight research gaps, and inform interventions. PROSPERO REGISTRATION NUMBER CRD42013004399.
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Affiliation(s)
- Stella K. Muthuri
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Claire E. Francis
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Allana G. LeBlanc
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Margaret Sampson
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Vincent O. Onywera
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Kenyatta University, Nairobi, Kenya
| | - Mark S. Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- Kenyatta University, Nairobi, Kenya
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Walker AR. Epidemiology and health implications of obesity, with special reference to African populations. Ecol Food Nutr 2010. [DOI: 10.1080/03670244.1998.9991536] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Szabo CP, Allwood CW. Body figure preference in South African adolescent females: a cross cultural study. Afr Health Sci 2006; 6:201-6. [PMID: 17604508 PMCID: PMC1832064 DOI: 10.5555/afhs.2006.6.4.201] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022] Open
Abstract
BACKGROUND Eating disorders have traditionally been associated with the white community in South Africa. The emergence of eating disorders among blacks in the mid 1990's appeared to signal a demographic shift. Subsequent data suggested that eating disorders would increase in prevalence amongst black South Africans. OBJECTIVE The current study sought to explore body figure preference in a cross cultural South African sample, given the established relationship between body dissatisfaction and eating disorders. METHODS The sample comprised a community based, multi-racial adolescent population in both urban (n=1353) and rural (n=361) areas. The Body Figure Preference Test [BFPT] was administered. RESULTS Most urban respondents had a desire to be smaller (white=72%; black=61%), whereas rural black respondents were more evenly divided amongst those who were content (31%), desiring to be larger (29%) and desiring to be smaller (40%) [Chi square value=105.309, df=4, p=0.001]. CONCLUSIONS The findings of the study demonstrate that racial homogenization exists regarding body figure preference within the urban setting. Data from the rural area suggests milieu specific factors in this regard with fewer respondents desiring to be smaller. This may have implications for the emergence of eating disorders in black South African populations, more specifically those in urban areas.
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Affiliation(s)
- Christopher Paul Szabo
- Division of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Parktown,Johannesburg, South Africa.
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Nunes MA, Olinto MTA, Barros FC, Camey S. Influência da percepção do peso e do índice de massa corporal nos comportamentos alimentares anormais. BRAZILIAN JOURNAL OF PSYCHIATRY 2001. [DOI: 10.1590/s1516-44462001000100006] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
OBJETIVO: Estudar a associação entre a percepção do peso corporal, o índice de massa corporal e os comportamentos alimentares anormais. MÉTODOS: Delineamento transversal, de base populacional, com mulheres de 12 a 29 anos, da zona urbana de Porto Alegre, RS (n=513). Para medir a prevalência de comportamentos alimentares anormais utilizou-se o Teste de Atitudes Alimentares 26 (EAT-26) e o Teste de Investigação Bulímica de Edimburgo (BITE), considerados separadamente e em conjunto, e a percepção do peso corporal por meio de 2 perguntas estruturadas: qual era o peso que a mulher julgava ideal e a auto-avaliação sobre seu peso. O índice de massa corporal (IMC) foi calculado por medida de peso e altura aferidos. RESULTADOS: Considerando os instrumentos conjuntamente, 30,2% das mulheres tinham comportamento alimentar de risco, e 11,3% apresentaram comportamento alimentar anormal. Além disso, 82% das mulheres apresentaram IMC normal, sendo que 2% eram magras, e 16% apresentaram IMC de sobrepeso/obesidade. Das mulheres estudadas, 46% tinham o ideal de pesar menos, e 37,8% consideravam-se gordas. Entre as mulheres com IMC normal, 25,2% das que se achavam normais apresentavam comportamento alimentar de risco, e 5,7 % comportamento alimentar anormal. Das mulheres que se consideravam gordas, 47,2% apresentaram comportamento alimentar de risco, e 19,2% tinham comportamento alimentar anormal. Mulheres que se sentiam gordas apresentaram um risco quatro vezes maior de apresentar comportamentos alimentares anormais (razão de odds 4,50; IC 95% 2,88-7,01; p<0,001). CONCLUSÃO: A percepção do peso corporal - sentir-se gorda - mostrou um papel mais importante na determinação dos comportamentos alimentares anormais do que o índice de massa corporal (IMC sobrepeso/obesidade).
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Affiliation(s)
- Maria Angélica Nunes
- Universidade Federal de Pelotas, Brasil; Fundação Universitária Mário Martins, Brasil
| | - Maria Teresa A Olinto
- Universidade Federal de Pelotas, Brasil; Universidade do Vale do Rio dos Sinos, Brasil
| | | | - Suzi Camey
- Universidade Federal do Rio Grande do Sul, Brasil
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Tsai CY, Hoerr SL, Song WO. Dieting behavior of Asian college women attending a US university. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 1998; 46:163-168. [PMID: 9519578 DOI: 10.1080/07448489809595604] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Dieting behavior, body dissatisfaction, self-esteem, and food intake of 73 Asian women attending a US university were investigated and compared retrospectively with attitudes of 247 US-born female students at the same university. The Asian women reported restrained eating and body dissatisfaction only about half as often as the US women did. In both the Asian and US college women, body dissatisfaction scores were significantly correlated to body mass index and self-esteem scores. Fourteen percent of the Asian women in the restrained eating/body dissatisfied group, and 40% of the US students in that group reported intentional vomiting for weight control. Some of the Asian international students practiced undesirable dieting behaviors and reported body dissatisfaction levels similar to those of many US college women. College health professionals should recognize that disordered eating among Asian women must not be overlooked because of stereotypical perceptions about Asian women's body size and type.
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Affiliation(s)
- C Y Tsai
- Department of Food Science and Human Nutrition, College of Human Ecology, Michigan State University, East Lansing, USA
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Musaiger AO. Knowledge and Attitudes of University Female Students toward Obesity. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 1995; 14:337-44. [DOI: 10.2190/2m8d-m26r-8u6x-pwnj] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A cross-sectional study on 203 university female students aged eighteen to thirty years was carried out to determine their knowledge and attitudes toward obesity. The findings revealed that most of the girls believed that overeating (53%) or overeating in addition to inactivity (26.1%) are the main causes of obesity. However, 50 percent of the girls reported that they did not know the health complications of obesity. In general, attitudes toward certain food fads related to obesity was found to be unsatisfactory. Only 50 percent of the girls knew their height compared to 76 percent who knew their weight. Bodyweight perception was found to be inaccurate in 30 percent of girls with acceptable weight, while 80 percent of overweight girls considered themselves obese. Magazines and television are the main sources of nutrition information for these girls. Intervention programs to correct the food fads and change the food habits of adolescent girls are highly recommended.
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