Determinants, Health Problems, and Food Insecurity in Urban Areas of the Largest City in Cape Verde

An Overview of Spirits Made from Sugarcane Juice

Among the family of sugarcane spirits, those made from juice are diverse and often produced in a traditional way. They must be distinguished from other sugarcane spirits, which are more widely produced and made from other sugarcane derivatives, such as molasses. These alcoholic beverages contribute significantly to the socio-economic development of many countries. However, despite ancestral know-how, there is a lack of contemporary data required to characterize some sugarcane juice spirits (SCJSs) and to overcome the current and future threats that producers will have to face. While preserving their authenticity and specificity, SCJS producers expect to improve and ensure sufficient yield and a superior quality product. Even if the scientific knowledge on these spirits is not comparable, the available data could help identify the critical points to be improved in the making process. This review aims to present the main SCJSs encountered worldwide, defining their specific features through some important aspects with, notably, references to the complex notion of terroir. To continue, we discuss the main steps of the SCJS process from harvesting to aging. Finally, we expose an inventory of SCJS's chemical compositions and of their sensory description that define the specific organoleptic properties of these spirits.

Behavioural and biological risk factors of non-communicable diseases among adults in Cabo Verde: a repeated cross-sectional study of the 2007 and 2020 national community-based surveys

OBJECTIVE

The aim of the study is to estimate trends in the prevalence and associated factors of non-communicable disease (NCD) risk factors in adults from 2007 to 2020 in Cabo Verde.

DESIGN

Population-based cross-sectional study.

SETTING

Nationally representative samples of adult population in Cabo Verde from the 2007 and 2020 STEPwise approach to NCD risk factor surveillance (STEPS) surveys.

PARTICIPANTS

The sample included 1760 adults in 2007 and 3721 in 2020.

OUTCOME MEASURES

Included fruit/vegetable consumption, low physical activity, sedentary behaviour, current tobacco use, hazardous alcohol use, diabetes, total elevated cholesterol, hypertension and overweight/obesity. Logistic regressions adjusted for sociodemographic factors were applied to estimate predictors of each of the nine NCD risk factors.

RESULTS

Compared with participants in the study year 2007, participants in the study year 2020 had a significantly higher prevalence of low physical activity (adjusted OR (AOR): 2.21, 95% CI: 1.15 to 4.25) and overweight/obesity (AOR: 1.68, 95% CI: 1.26 to 2.23) and significantly lower rate of hypertension (AOR: 0.77, 95% CI: 0.64 to 0.93). Low physical activity (AOR: 1.61, 95% CI: 1.23 to 2.10), overweight/obesity (AOR: 2.59, 95% CI: 2.10 to 3.20), current tobacco use (AOR: 1.94, 95% CI: 1.36 to 2.75), hypertension (AOR: 5.45, 95% CI: 4.24 to 7.00), diabetes (AOR: 8.40, 95% CI: 4.65 to 15.18) and elevated total cholesterol (AOR: 4.58, 95% CI: 2.83 to 7.39) were more common among the 50-64-year-olds. Being male increased the odds of current tobacco use (AOR: 3.64, 95% CI: 2.75 to 4.81) and hazardous alcohol use (AOR: 4.79, 95% CI: 3.15 to 7.27), and decreased the odds of low physical activity (AOR: 0.48, 95% CI: 0.39 to 0.58) and overweight/obesity (AOR: 0.47, 95% CI: 0.40 to 0.56).

CONCLUSIONS

Of the nine NCD risk factors evaluated from 2007 to 2020 in Cabo Verde, two increased (overweight/obesity and low physical activity) and one decreased (hypertension). Several associated variables were identified for each individual NCD risk factor that can help in guiding interventions.

Recreation and Alcohol Consumption in Sub-Saharan Africa: Addressing Gender and Age Differences in Urban Areas-Praia, Cabo Verde

BACKGROUND

Reducing alcohol consumption and improving urban planning in African cities are public health priorities. The aim of this study was to explore gender and age differences in recreational activity participation and its link with self-reported alcohol consumption in three urban areas of Praia.

METHODS

A questionnaire was applied to a probabilistic sample of 1912 adults, with a median age of 35.0 (IQR: 26.0-48.8) years, living in informal, transition, and formal areas of the capital of Cabo Verde.

RESULTS

More than 80% of the participants reported rarely or never participating in recreational activities. Going daily or weekly to the café was the most reported recreational activity, regardless of the urban area. Participation in recreational activities was higher in men than women, decreasing with age in both cases. Alcohol consumption was significantly higher in men than women (72.4% versus 47.4%, p < 0.001). Multiple logistic regression models showed that going at least once to the bar/nightclub (for men and women) and going to the café (for women) were associated with alcohol consumption. Furthermore, age (for women), in a protective way, and having children (for men) appeared to be associated with alcohol consumption.

CONCLUSIONS

This study provides new data on the recreational environment in Praia and can contribute to the development of local and national public health policies and interventions in line with several SDGs to reduce alcohol consumption, enhance healthy leisure/recreation practices, and promote better living conditions for its inhabitants.

Global Trends in the Availability of Dietary Data in Low and Middle-Income Countries

Individual-level quantitative dietary data can provide suitably disaggregated information to identify the needs of all population sub-groups, which can in turn inform agricultural, nutrition, food safety, and environmental policies and programs. The purpose of this discussion paper is to provide an overview of dietary surveys conducted in low- and middle-income countries (LMICs) from 1980 to 2019, analyzing their key characteristics to understand the trends in dietary data collection across time. The present study analyzes the information gathered by the Food and Agriculture Organization of the United Nations/World Health Organization Global Individual Food consumption data Tool (FAO/WHO GIFT). FAO/WHO GIFT is a growing repository of individual-level dietary data and contains information about dietary surveys from around the world, collected through published survey results, literature reviews, and direct contact with data owners. The analysis indicates an important increase in the number of dietary surveys conducted in LMICs in the past four decades and a notable increase in the number of national dietary surveys. It is hoped that this trend continues, together with associated efforts to validate and standardize the dietary methods used. The regular implementation of dietary surveys in LMICs is key to support evidence-based policies for improved nutrition.

Toxic Metals in Cereals in Cape Verde: Risk Assessment Evaluation

Consumption of cereals and cereal-based products represents 47% of the total food energy intake in Cape Verde. However, cereals also contribute to dietary exposure to metals that may pose a risk. Strengthening food security and providing nutritional information is a high-priority challenge for the Cape Verde government. In this study, toxic metal content (Cr, Ni, Sr, Al, Cd, and Pb) is determined in 126 samples of cereals and derivatives (rice, corn, wheat, corn flour, wheat flour, corn gofio) consumed in Cape Verde. Wheat flour samples stand out, with the highest Sr (1.60 mg/kg), Ni (0.25 mg/kg) and Cr (0.13 mg/kg) levels. While the consumption of 100 g/day of wheat would contribute to 13.2% of the tolerable daily intake (TDI) of Ni, a consumption of 100 g/day of wheat flour would contribute to 8.18% of the tolerable weekly intake (TWI) of Cd. Results show relevant Al levels (1.17-13.4 mg/kg), with the highest level observed in corn gofio. The mean Pb average content in cereals is 0.03-0.08 mg/kg, with the highest level observed in corn gofio. Al and Pb levels are lower in cereals without husks. Without being a health risk, the consumption of 100 g/day of wheat contributes to 17.5% of the European benchmark doses lower confidence limit (BMDL) of Pb for nephrotoxic effects; the consumption of 100 g/day of corn gofio provides an intake of 1.34 mg Al/day (13.7% of the TWI) and 8 µg Pb/day (20% of the BMDL for nephrotoxic effects). A strategy to minimize the dietary exposure of the Cape Verdean population to toxic metals from cereals should consider the continuous monitoring of imported cereals on arrival in Cape Verde, the assessment of the population's total diet exposure to toxic metals and educational campaigns.

Factors influencing obesogenic behaviours of adolescent girls and women in low- and middle-income countries: A qualitative evidence synthesis

This systematic review synthesized the qualitative evidence on factors influencing obesogenic behaviours in adolescent girls and women of reproductive age in low- and middle-income countries (LMICs). This qualitative evidence synthesis followed the framework synthesis approach to extract, analyse and synthesize data. Electronic searches were conducted in the Web of Science, SCOPUS, CABI Abstracts, MEDLINE, PsycINFO and Google Scholar. Studies were eligible if they were conducted in LMICs, of qualitative nature, and reported obesogenic behaviours of female adolescents (10-19 years of age) or women of reproductive age (15-49 years of age). The review resulted in 71 included studies from 27 different countries. Thirty-two studies focused on dietary behaviours, 17 on physical activity and 22 on both behaviours. Gender norms and failures to recognize the importance of healthy behaviours across the life cycle were important factors. The abundance and promotion of affordable but unhealthy food, food safety concerns, taste preferences and social desirability of foods drive consumption of unhealthy foods. Busy lives and limited exercise spaces keep girls and women from being physically active. Obesogenic behaviours of adolescent girls and women of reproductive age are influenced by factors at individual, social, physical and environmental levels and require diverse solutions to address these factors in LMICs.

Factors influencing dietary behaviours in urban food environments in Africa: a systematic mapping review

Objective:

To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research.

Design:

We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro.

Setting:

Urban food environments in Africa.

Participants:

Studies involving adolescents and adults (11–70 years, male/female).

Results:

Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women.

Conclusions:

The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.

Pathways between urbanization and harmful substance use

PURPOSE OF REVIEW

Epidemiological literature suggests that urbanization is potentially linked to a number of stressors that could be associated with harmful substance use and mental disorders. This may vary by country. This review gives attention to emergent literature examining the pathways between urbanization and harmful substance use.

RECENT FINDINGS

Studies examining the links between urbanization, mental health and substance use suggest complex pathways between urbanization and substance use as well as a range of modifying variables that could contribute to these associations. Such variables include increased supply of illicit and licit substances brought about by economic development, globalization and technology as well as an increased demand for particular substances. Rural areas may also have unique factors associated with harmful substance use but these are beyond the scope of this review.

SUMMARY

We have presented evidence to suggest potential associations between urbanization and harmful substance use. We acknowledge that data are limited because of a paucity of longitudinal studies elucidating these relationships.

Food insecurity in relation to obesity in peri-urban Cape Town, South Africa: Implications for diet-related non-communicable disease

In urban informal areas of South Africa, obesity and hunger represent two sides of food insecurity. Despite this, public health and clinical obesity interventions focus on nutrition education, implying dietary choice and thereby overlooking food insecurity. The objective of this paper is to explore peri-urban residents' perspectives of changing food environments, framed by the Food Aid Organization (FAO) definition of food security and demonstrating the interconnectedness of dimensions of food security. We conducted three-part in-depth interviews with 21 participants and nine focus group discussions with a total of 57 participants, consisting primarily of women aged 20-84, in a peri-urban township and informal settlement outside of Cape Town, South Africa. Participants' encounters in clinical settings framed choice as a driver of diet-related non-communicable disease (NCD). Yet participants lacked economic access to food, particularly at the end of the month. Diets consisted of fewer green leafy vegetables relative to their diets in rural areas, despite affirming a preference for these foods. They described consuming more meat, which was also perceived as unhealthy. Based on self-report, residents within this peri-urban area of South Africa were food insecure: they lacked access to food at specific times of the month, they were unable to consume foods they preferred, and they felt that their diets were neither nutritious nor enabled an active and healthy life. When viewed in terms of multiple facets of food security, participants' concurrent experiences of hunger and obesity were unsurprising. Health interventions related to diet should incorporate an understanding of food security as shaped by the interactions of access, availability, utilization and stability.

Changing Neighborhoods and Residents' Health Perceptions: The Heart Healthy Hoods Qualitative Study

Cities, and therefore neighborhoods, are under constant change. Neighborhood changes may affect residents’ health in multiple ways. The Heart Healthy Hoods (HHH) project studies the association between neighborhood and residents’ health. Focusing on a middle–low-socioeconomic neighborhood in Madrid (Spain), our aim was to describe qualitatively its residents’ perceptions on the urban changes and their impacts on health. We designed a qualitative study using 16 semi-structured interviews including adult residents and professionals living or working in the area. Firstly, we described the perceived main social and neighborhood changes. Secondly, we studied how these neighborhood changes connected to residents’ health perceptions. Perceived major social changes were new demographic composition, new socio–cultural values and economic changes. Residents’ negative health perceptions were the reduction of social relationships, increase of stress and labor precariousness. Positive health perceptions were the creation of supportive links, assimilation of self-care activities and the change in traditional roles. Neighborhood changes yielded both negative and positive effects on residents’ health. These effects would be the result of the interrelation of different elements such as the existence or absence of social ties, family responsibilities, time availability, economic resources and access and awareness to health-promoting programs. These qualitative research results provide important insight into crafting urban health policies that may ultimately improve health outcomes in communities undergoing change.

Social Networks and Health: Understanding the Nuances of Healthcare Access between Urban and Rural Populations

Communities and individuals in many sub-Saharan African countries often face limited access to healthcare. Hence, many rely on social networks to enhance their chances for adequate health care. While this knowledge is well-established, little is known about the nuances of how different population groups activate these networks to improve access to healthcare. This paper examines how rural and urban dwellers in the Ashanti Region in Ghana distinctively and systematically activate their social networks to enhance access to healthcare. It uses a qualitative cross-sectional design, with in-depth interviews of 79 primary participants (28 urban and 51 rural residents) in addition to the views of eight community leaders and eight health personnel. It was discovered that both intimate and distanced social networks for healthcare are activated at different periods by rural and urban residents. Four main stages of social networks activation, comprising different individuals and groups were observed among rural and urban dwellers. Among both groups, physical proximity, privacy, trust and sense of fairness, socio-cultural meaning attached to health problems, and perceived knowledge and other resources (mainly money) held in specific networks inherently influenced social network activation. The paper posits that a critical analysis of social networks may help to tailor policy contents to individuals and groups with limited access to healthcare.