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Manyara AM, Mwaniki E, Gill JMR, Gray CM. Knowledge, perceptions and practices towards diabetes risk in sub-Saharan Africa: a mixed-methods scoping review. Public Health Nutr 2024; 27:e104. [PMID: 38533768 PMCID: PMC11010065 DOI: 10.1017/s1368980024000752] [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: 07/07/2023] [Revised: 03/03/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To synthesise current evidence on knowledge, perceptions and practices towards type 2 diabetes risk in sub-Saharan Africa. DESIGN Mixed-methods scoping review, which included 101 studies (seventy-three quantitative, twenty qualitative and eight mixed methods) from seven electronic databases. SETTING Sub-Saharan Africa, 2000-2023. PARTICIPANTS Men and women without diabetes with mean ages ranging from 20 to 63 years. RESULTS The majority of participants in most studies knew the three main diabetes modifiable risk factors - excess weight, unhealthy diet and physical inactivity. However, most people with excess weight in almost all studies underestimated their weight. Further, the self-described ideal body weight was between midpoint of normal weight and the upper limits of overweight in most quantitative studies and was described as not too skinny but not too fat in qualitative studies. In the majority of studies, participants reported low engagement in weight control, high regular sugar intake, and low regular fruit and vegetable intake but moderate to high engagement in physical activity. Barriers to reducing diabetes risk were social (e.g. societal perceptions promoting weight gain) and environmental (e.g. limited affordability of healthy foods, high accessibility of Western diets and lack of physical activity facilities). CONCLUSION There is a need for multicomponent type 2 diabetes prevention interventions that increase knowledge of identifying diabetes risk (e.g. what constitutes excess weight) and create social and physical environments that support healthy lifestyles (e.g. societal perceptions that promote healthy living, increased availability and affordability of healthy foods and physical activity facilities).
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Affiliation(s)
- Anthony Muchai Manyara
- School of Health and Wellbeing, University of
Glasgow, Glasgow, UK
- Department of Health Systems Management and Public Health,
Technical University of Kenya, Nairobi,
Kenya
- Global Health and Ageing Research Unit, Bristol Medical School,
University of Bristol, Bristol,
UK
| | - Elizabeth Mwaniki
- Department of Health Systems Management and Public Health,
Technical University of Kenya, Nairobi,
Kenya
| | - Jason MR Gill
- School of Cardiovascular and Metabolic Health, University of
Glasgow, Glasgow, UK
| | - Cindy M Gray
- School of Health and Wellbeing, University of
Glasgow, Glasgow, UK
- School of Social and Political Sciences, University of
Glasgow, Glasgow, UK
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Blachman-Braun R, Talavera JO, Pérez-Rodríguez M, Roy-García I, Rivas-Ruiz R, Huitrón-Bravo G, Salmerón J. Risk Assessment of Dyslipidemias, Hyperglycemia, Hyperuricemia, and Hypertension Utilizing Self-Reported Body Silhouettes. J Obes 2023; 2023:4991684. [PMID: 37025979 PMCID: PMC10072955 DOI: 10.1155/2023/4991684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE Self-reported body silhouette is an anthropometric instrument that has been utilized as a screening tool for underweight, overweight, obesity, and other abnormal anthropometric variables. Herein, we analyzed the risk associated with the self-reported body silhouette in the scope of dyslipidemias, hyperglycemia, hyperuricemia, and hypertension. METHODS Adult participants of the Health Workers Cohort Study enrolled between March 2004 and April 2006 were included. Then, risk analysis was performed considering dyslipidemias as serum triglycerides, high total cholesterol, high LDL-C, low HDL-C, hyperglycemia, hyperuricemia, and hypertension. RESULTS A total of 2,297 males and 5,003 females were analyzed. The median ages of the studied population was 39 (30-49) and 41 (31-50) years for males and females, respectively. Overall, there is a stepwise increase in the risk of presenting dyslipidemias, hyperglycemia, hyperuricemia, and hypertension as the self-reported body silhouette number increases, this tendency was observed in both males and females. CONCLUSION Self-reported body silhouette is a useful risk assessment tool for dyslipidemias, hyperglycemia, hyperuricemia, and hypertension in Mexican adults. Applications of questioners containing this silhouette might be considered a valuable public health instrument due to their low cost, relative simplicity, and absence of specialized equipment, training, or respondent knowledge.
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Affiliation(s)
- Ruben Blachman-Braun
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
- Training and Clinical Research Center, Specialty Hospital, Mexican Social Security Institute, National Medical Center XXI, Mexico City, Mexico
| | | | - Marcela Pérez-Rodríguez
- Training and Clinical Research Center, Specialty Hospital, Mexican Social Security Institute, National Medical Center XXI, Mexico City, Mexico
| | - Ivonne Roy-García
- Training and Clinical Research Center, Specialty Hospital, Mexican Social Security Institute, National Medical Center XXI, Mexico City, Mexico
| | - Rodolfo Rivas-Ruiz
- Training and Clinical Research Center, Specialty Hospital, Mexican Social Security Institute, National Medical Center XXI, Mexico City, Mexico
| | - Gerardo Huitrón-Bravo
- Faculty of Medicine, Autonomous University of the State of Mexico, Toluca, State of Mexico, Mexico
| | - Jorge Salmerón
- Center for Research in Policies, Population and Health, National Autonomous University of Mexico, Mexico City, Mexico
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Kamalipour A, Roshanshad A, Nalini M, Hassanzadeh J, Malekzadeh R, Malekzadeh F, Poustchi H, Gandomkar A, Salehi A, Molavi Vardanjani H. Pictogram Is a Valid Instrument to Classify At-Risk Adult Population Based on Abdominal Obesity: Results from Pars Cohort Study. ARCHIVES OF IRANIAN MEDICINE 2022; 25:366-374. [PMID: 35943016 DOI: 10.34172/aim.2022.60] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/21/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Abdominal obesity is associated with increased risk of myocardial infarction and death events. Thus, obtaining data on the status of abdominal obesity is important in risk factor assessment and prevention of non-communicable diseases. This study aimed to evaluate the validity of using pictograms to classify abdominal obesity indices (waist circumference [WC], waist-hip ratio [WHR], and waist-height ratio [WHtR]) into normal and at-risk categories and determine the effects of demographic characteristics on this validity. METHODS This cross-sectional study used data from Pars Cohort Study (PCS). Participants chose the most similar pictogram scores to their body size at 15, 30 years, and current age. Optimal normal/at-risk cut-off values for pictograms were calculated using sensitivity/specificity plots. Receiver operating characteristic curves were used to evaluate the validity of pictograms. Validity measures were analyzed across different subgroups of demographic characteristics. RESULTS A total of 9263 participants (46% males) were included in the study. The estimated area under the curves were 84% for WC, 77% for WHR, and 89% for WHtR in males, and 84% for WC, 73% for WHR, and 90% for WHtR in females. Optimal pictogram cutoffs to classify central obesity for WC, WHR, and WHtR were 4, 4, and 5 in males and 4, 4, and 6 in females, respectively. The majority of demographic characteristics were not associated with the validity of pictograms. CONCLUSION Using pictograms to determine normal and at-risk categories of abdominal obesity indices is valid among adult population with a wide range of demographic characteristics. However, the results need to be interpreted with caution in those with a positive history of weight fluctuation.
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Affiliation(s)
- Alireza Kamalipour
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, United States
| | - Amirhossein Roshanshad
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Nalini
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jafar Hassanzadeh
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Malekzadeh
- Liver, Pancreatic, and Biliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Malekzadeh
- Digestive Disease Research Center, Digestive Research Institute, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Hossein Poustchi
- Liver, Pancreatic, and Biliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdullah Gandomkar
- Non-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Salehi
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Molavi Vardanjani
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Reese TO, Bovet P, Choo-Kang C, Bedu-Addo K, Forrester T, Gilbert JA, Goedecke JH, Lambert EV, Layden BT, Micklesfield LK, Plange-Rhule J, Rae D, Viswanathan B, Luke A, Dugas LR. Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000127. [PMID: 36962336 PMCID: PMC10021870 DOI: 10.1371/journal.pgph.0000127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/31/2022] [Indexed: 01/10/2023]
Abstract
The Pulvers' silhouette showcards provide a non-invasive and easy-to-use way of assessing an individual's body size perception using nine silhouette shapes. However, their utility across different populations has not been examined. This study aimed to assess: 1) the relationship between silhouette perception and measured anthropometrics, i.e., body mass index (BMI), waist circumference (WC), waist-height-ratio (WHtR), and 2) the ability to predict with silhouette showcards anthropometric adiposity measures, i.e., overweight and obesity (BMI ≥ 25 kg/m2), obesity alone (BMI ≥ 30 kg/m2), elevated WC (men ≥ 94 cm; women ≥ 80 cm), and WHtR (> 0.5) across the epidemiological transition. 751 African-origin participants, aged 20-68 years old, from the United States (US), Seychelles, and Ghana, completed anthropometrics and selected silhouettes corresponding to their perceived body size. Silhouette performance to anthropometrics was examined using a least-squares linear regression model. A receiver operator curve (ROC) was used to investigate the showcards ability to predict anthropometric adiposity measures. The relationship between silhouette ranking and BMI were similar between sexes of the same country but differed between countries: 3.65 [95% CI: 3.34-3.97] BMI units/silhouette unit in the US, 3.23 [2.93-3.74] in Seychelles, and 1.99 [1.72-2.26] in Ghana. Different silhouette cutoffs predicted obesity differently in the three countries. For example, a silhouette ≥ five had a sensitivity/specificity of 77.3%/90.6% to predict BMI ≥ 25 kg/m2 in the US, but 77.8%/85.9% in Seychelles and 84.9%/71.4% in Ghana. Ultimately, silhouettes predicted BMI, WC, and WHtR similarly within each country and sex but not across countries. Our data suggest that Pulvers' silhouette showcards may be a helpful tool to predict anthropometric and adiposity measures in different populations when direct measurement cannot be performed. However, no universal silhouette cutoff can be used for detecting overweight or obesity status, and population-specific differences may stress the need to calibrate silhouette showcards when using them as a survey tool in different countries.
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Affiliation(s)
- Tyler O. Reese
- Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois, United States of America
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Pascal Bovet
- Unit for Prevention and Control of Cardiovascular Disease, Ministry of Health, Victoria, Republic of Seychelles
- University Center for Primary Care and Public Health, Lausanne, Switzerland
| | - Candice Choo-Kang
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, United States of America
| | - Kweku Bedu-Addo
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Terrence Forrester
- Solutions for Developing Countries, University of the West Indies, Mona, Kingston, Jamaica
| | - Jack A. Gilbert
- Department of Surgery, Microbiome Center, University of Chicago, Chicago, Illinois, United States of America
| | - Julia H. Goedecke
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Research Centre for Health through Physical Activity, Lifestyle and Sport, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Estelle V. Lambert
- Department of Surgery, Microbiome Center, University of Chicago, Chicago, Illinois, United States of America
| | - Brian T. Layden
- Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois, United States of America
| | - Lisa K. Micklesfield
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Research Centre for Health through Physical Activity, Lifestyle and Sport, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jacob Plange-Rhule
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Dale Rae
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Research Centre for Health through Physical Activity, Lifestyle and Sport, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Bharathi Viswanathan
- Unit for Prevention and Control of Cardiovascular Disease, Ministry of Health, Victoria, Republic of Seychelles
| | - Amy Luke
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, United States of America
| | - Lara R. Dugas
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, United States of America
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Research Centre for Health through Physical Activity, Lifestyle and Sport, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Blachman-Braun R, Talavera JO, Pérez-Rodríguez M, Roy-García I, Rivas-Ruiz R, Huitrón-Bravo G, Salmerón-Castro J. Self-reported body silhouettes: a diagnostic instrument for anthropometric parameters. Public Health 2021; 200:39-46. [PMID: 34662752 DOI: 10.1016/j.puhe.2021.09.001] [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: 05/30/2021] [Revised: 08/15/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Routine body size measurement of anthropometric values requires professionals, standardized techniques, and calibrated tools. Therefore, there is a need for easier screening tools such as the self-reported body silhouette (Self-bosi). The aim of this study was to analyze the performance of Self-bosi as a proxy of anthropometric values. STUDY DESIGN Prospective analytic study of the Health Workers Cohort Study. METHODS Adult participants of the Health Workers Cohort Study were included. Then, through the calculation sensitivity and specificity of Self-bosi to detect abnormal waist circumference (WC) (≥90 cm for male and ≥80 cm for female participants), elevated body fat percentage (BF%) (≥25% for male and ≥35% for female participants), as well as overweight and obesity (≥25 kg/m2) and obesity (≥30 kg/m2). RESULTS A total of 2471 male and 5940 female participants were analyzed. Overall, Self-bosi discriminate high WC values (area under the curve [AUC]; male participants: 0.80, female participants: 0.82); increased BF% (AUC: male participants: 0.78, female participants: 0.83); overweight and obesity (AUC: male participants: 0.81, female participants: 0.86); and obesity (AUC: male participants: 0.83, female participants: 0.89). CONCLUSION Self-bosi is an accurate method to assess increased WC, BF%, obesity, and overweight-obesity in Mexican adults. Given its simplicity and low-cost of the self-reported body silhouette, it might be considered a useful anthropometric screening instrument in large scale epidemiological research.
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Affiliation(s)
- R Blachman-Braun
- Centro de Adiestramiento e Investigación Clínica, Hospital de Especialidades CMN SXXI, Instituto Mexicano del Seguro Social, Ciudad de México, México; Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - J O Talavera
- Jefatura de Enseñanza, Centro Médico ABC, Ciudad de México, México.
| | - M Pérez-Rodríguez
- Centro de Adiestramiento e Investigación Clínica, Hospital de Especialidades CMN SXXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - I Roy-García
- Centro de Adiestramiento e Investigación Clínica, Hospital de Especialidades CMN SXXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - R Rivas-Ruiz
- Centro de Adiestramiento e Investigación Clínica, Hospital de Especialidades CMN SXXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - G Huitrón-Bravo
- Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca, Estado de México, México
| | - J Salmerón-Castro
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Ciudad de México, México
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Analyzing the Influence of Wine and Beer Drinking, Smoking, and Leisure Time Screen Viewing Activity on Body Weight: A Cross-Sectional Study in Germany. Nutrients 2021; 13:nu13103553. [PMID: 34684553 PMCID: PMC8539669 DOI: 10.3390/nu13103553] [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: 08/24/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
The increasing global prevalence of overweight and obesity highlights an urgent need to explore modifiable obesogenic factors. This study investigated the impact of lifestyle factors, such as beer and wine drinking, cigarette smoking, and leisure time screen viewing activities, on body weight and the development of obesity. Individual level data were selected from a random sample of 3471 German adults using a two-stage disproportionate random sampling procedure. The empirical analysis employed a two-stage equations system and combined the endogenous treatment effects model with the quantile regression technique. Our estimations showed that the decisions to smoke and consume wine and beer were positively interrelated, especially in women. Frequent beer/wine drinkers of normal weight were found to have a lower BMI in the male subsample. Quantile regression estimates indicated a significant influence of smoking on BMI in both genders, with smokers’ BMI following an upward trend, especially in the upper quantiles of the distribution. Leisure time screen activity was found to have a major impact on females’ BMI. Prolonged television viewing and regular computer gaming had a strong relationship with weight increase in overweight women, whereas internet surfing was inversely correlated with the BMI of normal weight and slightly overweight female participants. Nutrition and health policies should direct individuals toward alternative recreational activities in order to substitute screen usage and reduce sedentary time. This study also raised doubts about the general belief that smokers have a lower body weight. As unhealthy behaviors usually co-occur or cluster together, obesity prevention interventions might also contribute to a decrease in smoking.
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Matsungo TM, Chopera P. Effect of the COVID-19-induced lockdown on nutrition, health and lifestyle patterns among adults in Zimbabwe. BMJ Nutr Prev Health 2020. [PMID: 33521530 DOI: 10.1101/2020.06.16.20130278] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND The COVID-19 is a global public health emergency resulting in lockdowns, associated diet and lifestyle changes and constrained public health delivery. OBJECTIVE To investigate the impacts of the COVID-19-induced lockdown in Zimbabwe on nutrition, physical activity, alcohol consumption and smoking among Zimbabwean population aged ≥18 years. METHODS A cross-sectional online survey was conducted using a structured questionnaire to collect information on demographics (age, gender, place of residence, current employment), food system dimensions, diet and physical activity patterns, stress and anxiety, body image perceptions, lifestyle behaviours like smoking, alcohol intake, screen time and ease of access to health services. Results The participants (n=507) were mostly women (63.0%) between the ages of 31 and 40 years (48.1%) and had tertiary education (91.3%). The lockdown resulted in increase in food prices (94.8%) and decrease in availability of nutritious foods (64%). Most (62.5%) of the participants reported a reduction in their physical activity levels. The prevalence of generalised anxiety disorder (GAD) was 40.4% and mostly affecting woman (63.5%, p=0.909), 31-40 years age group (49.6%, p=0.886). Based on the Body Mass Index-based Silhouette Matching Test (BMI-SMT) 44.5% gained weight, 24.3% lost weight and 31.2% did not have weight change. The paired samples t-test showed that there was a significant increase in perceived body weight (p<0.001). More than half (59.6%) reported having difficulties accessing medicinal drugs and 37.8% growth monitoring services. CONCLUSIONS The lockdown period was associated with increase in food prices, decrease in dietary diversification, elevated GAD symptoms, disrupted diet and consumption patterns. There were low levels of physical activity and perceived weight gained during the lockdown period, thus increasing the risk of overweight and obesity. Further studies incorporating participants of different socioeconomic status are warranted to get more conclusive results.
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Affiliation(s)
| | - Prosper Chopera
- Department of Nutrition, DIetetics and Food Sciences, University of Zimbabwe, Harare, Zimbabwe
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Matsungo TM, Chopera P. Effect of the COVID-19-induced lockdown on nutrition, health and lifestyle patterns among adults in Zimbabwe. BMJ Nutr Prev Health 2020; 3:205-212. [PMID: 33521530 PMCID: PMC7841831 DOI: 10.1136/bmjnph-2020-000124] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/30/2020] [Accepted: 09/01/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The COVID-19 is a global public health emergency resulting in lockdowns, associated diet and lifestyle changes and constrained public health delivery. OBJECTIVE To investigate the impacts of the COVID-19-induced lockdown in Zimbabwe on nutrition, physical activity, alcohol consumption and smoking among Zimbabwean population aged ≥18 years. METHODS A cross-sectional online survey was conducted using a structured questionnaire to collect information on demographics (age, gender, place of residence, current employment), food system dimensions, diet and physical activity patterns, stress and anxiety, body image perceptions, lifestyle behaviours like smoking, alcohol intake, screen time and ease of access to health services. Results The participants (n=507) were mostly women (63.0%) between the ages of 31 and 40 years (48.1%) and had tertiary education (91.3%). The lockdown resulted in increase in food prices (94.8%) and decrease in availability of nutritious foods (64%). Most (62.5%) of the participants reported a reduction in their physical activity levels. The prevalence of generalised anxiety disorder (GAD) was 40.4% and mostly affecting woman (63.5%, p=0.909), 31-40 years age group (49.6%, p=0.886). Based on the Body Mass Index-based Silhouette Matching Test (BMI-SMT) 44.5% gained weight, 24.3% lost weight and 31.2% did not have weight change. The paired samples t-test showed that there was a significant increase in perceived body weight (p<0.001). More than half (59.6%) reported having difficulties accessing medicinal drugs and 37.8% growth monitoring services. CONCLUSIONS The lockdown period was associated with increase in food prices, decrease in dietary diversification, elevated GAD symptoms, disrupted diet and consumption patterns. There were low levels of physical activity and perceived weight gained during the lockdown period, thus increasing the risk of overweight and obesity. Further studies incorporating participants of different socioeconomic status are warranted to get more conclusive results.
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Affiliation(s)
| | - Prosper Chopera
- Department of Nutrition, DIetetics and Food Sciences, University of Zimbabwe, Harare, Zimbabwe
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Flax VL, Thakwalakwa C, Phuka JC, Jaacks LM. Body size preferences and food choice among mothers and children in Malawi. MATERNAL & CHILD NUTRITION 2020; 16:e13024. [PMID: 32638514 PMCID: PMC7507496 DOI: 10.1111/mcn.13024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/09/2020] [Accepted: 04/23/2020] [Indexed: 12/13/2022]
Abstract
Overweight in mothers and children in sub-Saharan Africa is rapidly increasing and may be related to body size perceptions and preferences. We enrolled 268 mother-child (6-59 months) pairs in central Malawi; 71% of mothers and 56% of children were overweight/obese, and the remainder were normal weight. Interviewers used seven body silhouette drawings and a questionnaire with open- and closed-ended questions to measure mothers' perceptions of current, preferred and healthy maternal and child body sizes and their relation to food choices. Overweight/obese and normal weight mothers' correct identification of their current weight status (72% vs. 64%), preference for overweight/obese body size (68% both) and selection of an overweight/obese silhouette as healthy (94% vs. 96%) did not differ by weight status. Fewer overweight/obese than normal weight mothers' preferred body silhouette was larger than their current silhouette (74% vs. 29%, p < .001). More mothers of overweight than normal weight children correctly identified the child's current weight status (55% vs. 42%, p < .05) and preferred an overweight/obese body size for the child (70% vs. 58%, p < .01), and both groups selected overweight/obese silhouettes as healthy for children. More than half of mothers in both groups wanted their child to be larger than the current size. Mothers said that increasing consumption of fruits, vegetables, meat, milk, grains, fizzy drinks and fatty foods could facilitate weight gain, but many cannot afford to purchase some of these foods. Their desired strategies for increasing weight indicate that body size preferences may drive food choice but could be limited by affordability.
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Affiliation(s)
- Valerie L. Flax
- Public Health Research DivisionRTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | | | - John C. Phuka
- College of MedicineUniversity of MalawiBlantyreMalawi
| | - Lindsay M. Jaacks
- Department of Global Health and PopulationHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
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Jefferies P, Ungar M, Aubertin P, Kriellaars D. Physical Literacy and Resilience in Children and Youth. Front Public Health 2019; 7:346. [PMID: 31803709 PMCID: PMC6877541 DOI: 10.3389/fpubh.2019.00346] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 11/01/2019] [Indexed: 12/19/2022] Open
Abstract
Background: There is growing interest in the relationship between physical and psychosocial factors related to resilience to better understand the antecedents of health and successful adaptation to challenges in and out of school, and across the lifespan. To further this understanding, a trans-disciplinary approach was used to investigate the association between the multidimensional constructs of physical literacy and resilience in children at a key stage in their development. Methods: Cross-sectional data were collected from 227 school children aged 9-12 years old from five schools in Winnipeg, Manitoba, Canada. Resilience was measured using the Child and Youth Resilience Measure, and physical literacy through the Physical Literacy Assessment for Youth tools. Data were provided by self-report, surrogate assessors of the child (physical education teachers and parents), and trained assessors for movement skills. These data were analyzed using correlation and logistic regression. Results: Resilience was significantly correlated with numerous indicators of physical literacy, including movement capacity, confidence, and competence, environmental engagement, and overall perceptions of physical literacy. Regressions indicated that resilience could be predicted by movement confidence and competence, environmental engagement, and overall physical literacy. Conclusions: The findings of this study, using a constellation of sources, provide foundational evidence for the link between resilience and physical literacy among children, encouraging the importance of physical literacy development in schools. Longitudinal studies are required to further examine this relationship and how these previously unrelated fields may work together for a richer understanding of the interplay between the physical and psychological determinants of well-being.
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Affiliation(s)
- Philip Jefferies
- Resilience Research Centre, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Michael Ungar
- Resilience Research Centre, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Patrice Aubertin
- Center for Research Innovation and Transfer in Circus Arts, National Circus School, Montreal, QC, Canada
| | - Dean Kriellaars
- Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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van Tonder E, Dihawa N. BMI-based figure rating scale (FRS) as an adjunctive aid in nutritional screening and assessment in a resource-limited setting. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2019. [DOI: 10.1080/16070658.2019.1679943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- E van Tonder
- Department of Dietetics, Nelson Mandela University, Port Elizabeth, South Africa
| | - N Dihawa
- Department of Dietetics, Nelson Mandela University, Port Elizabeth, South Africa
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Schofield TJ, Robins RW, Fox J, Abraham WT, Cutrona C. Family health and income: A two-sample replication. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2018; 32:632-642. [PMID: 29999344 PMCID: PMC6072564 DOI: 10.1037/fam0000424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The current study examined psychological and family health predictors of change over time in household income, using data from longitudinal studies of African American (N = 889, 93.5% female) and Mexican origin (N = 674, 100% female) families. Participants self-reported their household income, as well as their emotional, personality, and cognitive resources. Participant behavioral and physical resources were coded from observed family interactions. Although income did not predict change in any personal resources, all five classes of personal resources (i.e., emotional, personality, cognitive, behavioral, physical) predicted change in income across a 10-year span (Study 1) and a 6-year span (Study 2). Income is potentially caused by these personal resources, or both income and these personal resources share a common cause. The dominant approach of assuming income causes personal and family health needs stronger support. (PsycINFO Database Record
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Affiliation(s)
| | | | - Jonathan Fox
- Department of Human Development and Family Studies
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Abstract
OBJECTIVE This study examined the mediating role of body dissatisfaction between Body Mass Index (BMI) and subsequent disordered eating (e.g. dieting and restricting/purging) among early adolescent African American girls. STUDY DESIGN Participants included 701 African American girls in 6th and 7th grades in urban schools serving low-income communities, mean age 12.15 (SD = 0.72) years. Participants were assessed at baseline and approximately 6 months later. Objectively measured height and weight were used to calculate BMI z-score. Participants completed questionnaires on body size dissatisfaction and recent dieting and restricting/purging behaviors. RESULTS At baseline, 51.5% of participants were overweight/obese, and 60.4% expressed body dissatisfaction and a desire to be smaller. Path analytic analyses revealed change in body dissatisfaction significantly mediates the relation between initial BMI z-score and increases in dieting behaviors (B = 0.924, SE = 0.280, p = 0.001) but not restricting/purging behaviors (p = 0.05). CONCLUSIONS Body dissatisfaction explains some associations between excess body weight and subsequent disordered eating symptoms among early adolescent, African American girls. Body dissatisfaction, identified by screening, may be an indicator of further negative consequences, including disordered eating behaviors.
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Wells M, Goldstein LN, Bentley A. The Use of Body Habitus Reference Images Improves the Ability of Novices to Accurately Estimate Children's Weight Using the PAWPER XL Tape System. J Emerg Med 2017; 54:165-175. [PMID: 29169918 DOI: 10.1016/j.jemermed.2017.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 09/05/2017] [Accepted: 10/07/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND The original methodology of the PAWPER (Pediatric Advanced Weight Prediction in the Emergency Room) tape relies on a gestalt visual assessment of a child's body habitus to adjust a length-based weight estimation. This assessment is dependent on the user's subjective opinion, which may result in aberrations in accuracy between users and populations. With the development of the second-generation PAWPER XL tape, a more objective method of habitus evaluation was desired. OBJECTIVE The aim of this study was to evaluate a new, more objective figural reference image system and a new checklist system for quantifying body habitus. METHODS Volunteers were asked to assess the body habitus score of 90 children from a sequence of photographic images using the standard gestalt visual assessment system, a new checklist system, and a system using figural reference images. PAWPER XL tape weight estimations were generated from these scores, which were compared between the three test groups. Participants were also surveyed on their preferences for the different methodologies. RESULTS There were 11,505 habitus score assessments from 138 doctor, nurse, and paramedic participants. The figural reference image system significantly outperformed the checklist system and the gestalt visual assessment system in terms of weight estimation accuracy, achieving 70.9%, 61.1%, and 60.9% of estimations within 10% of measured weight, respectively. The participants expressed a strong subjective preference for the image system because of speed of use, ease of use, perceived accuracy, objectivity, and low cognitive load. CONCLUSIONS The figural reference image system was objectively much more accurate than, and subjectively preferable to, the original gestalt visual estimation methodology.
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Affiliation(s)
- Mike Wells
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
| | - Lara Nicole Goldstein
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
| | - Alison Bentley
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
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Yepes M, Maurer J, Stringhini S, Viswanathan B, Gedeon J, Bovet P. Ideal Body Size as a Mediator for the Gender-Specific Association Between Socioeconomic Status and Body Mass Index. HEALTH EDUCATION & BEHAVIOR 2016; 43:56S-63S. [DOI: 10.1177/1090198116630527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. While obesity continues to rise globally, the associations between body size, gender, and socioeconomic status (SES) seem to vary in different populations, and little is known on the contribution of perceived ideal body size in the social disparity of obesity in African countries. Purpose. We examined the gender and socioeconomic patterns of body mass index (BMI) and perceived ideal body size in the Seychelles, a middle-income small island state in the African region. We also assessed the potential role of perceived ideal body size as a mediator for the gender-specific association between SES and BMI. Method. A population-based survey of 1,240 adults aged 25 to 64 years conducted in December 2013. Participants’ BMI was calculated based on measured weight and height; ideal body size was assessed using a nine-silhouette instrument. Three SES indicators were considered: income, education, and occupation. Results. BMI and perceived ideal body size were both higher among men of higher versus lower SES ( p < .001) but lower among women of higher versus lower SES ( p < .001), irrespective of the SES indicator used. Multivariate analysis showed a strong and direct association between perceived ideal body size and BMI in both men and women ( p < .001) and was consistent with a potential mediating role of perceived ideal body size in the gender-specific associations between SES and BMI. Conclusion. Our study emphasizes the importance of gender and socioeconomic differences in BMI and ideal body size and suggests that public health interventions that promote perception of healthy weight could help mitigate SES-related disparities in BMI.
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Affiliation(s)
- Maryam Yepes
- Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | | | | | | | - Jude Gedeon
- NCD Section, Ministry of Health, Victoria, Republic of Seychelles
| | - Pascal Bovet
- Lausanne University Hospital, Lausanne, Switzerland
- NCD Section, Ministry of Health, Victoria, Republic of Seychelles
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