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Senekal M, Nel JH, Eksteen G, Steyn NP. Dietary Patterns, Socio-Demographic Predictors Thereof, and Associations of Dietary Patterns with Stunting and Overweight/Obesity in 1-<10-Year-Old Children in Two Economically Active Provinces in South Africa. Nutrients 2023; 15:4136. [PMID: 37836420 PMCID: PMC10574062 DOI: 10.3390/nu15194136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 10/15/2023] Open
Abstract
A review of the literature showed that there were only a few studies that reported on the dietary patterns of children in South Africa. The aim of the present study was to characterise the dietary patterns of children aged 1-<10 years who were studied during the Provincial Dietary Intake Survey (PDIS) in 2018 and to investigate the socio-demographic predictors thereof, as well as the associations with stunting and overweight/obesity. Dietary pattern analysis was conducted within three age groups, namely 1-<3-year-olds, 3-<6-year-olds, and 6-<10-year-olds using iterated principal factor analysis with varimax rotation and 24 h recall data from the PDIS. The dietary patterns that emerged seem to be far from ideal. Energy-dense, nutrient-poor patterns were included in the top three strongest patterns in all three age groupings that were investigated. Few of the dietary patterns included vegetables other than starchy vegetables, fruit, dairy, quality proteins, and unrefined carbohydrates. There were no associations between any of the dietary patterns and stunting or overweight/obesity in the children. Key predictors of greater adherence to the mostly unhealthy patterns included indicators of a higher socio-economic status in all three age groups, as well as having an obese mother in the 6-<10-year-old group. Key predictors of greater adherence to the mostly healthy patterns were a higher wealth index and having an obese mother in the two younger groups, with no predictors in the 6-<10-year-old group. We conclude that the dietary patterns of children in the Western Cape contain strong elements of the energy-dense, nutrient-poor dietary patterns. Interventions to improve the dietary intake of children should be directed at both poorer and higher income communities.
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Affiliation(s)
- Marjanne Senekal
- Department of Human Biology, University of Cape Town, Cape Town 7925, South Africa;
| | - Johanna H. Nel
- Department of Logistics, Stellenbosch University, Stellenbosch 7602, South Africa;
| | - Gabriel Eksteen
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium;
| | - Nelia P. Steyn
- Department of Human Biology, University of Cape Town, Cape Town 7925, South Africa;
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Mukoma G, Bosire EN, Klingberg S, Norris SA. Healthy eating and physical activity: Analysing Soweto's young adults' perspectives with an intersectionality lens. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001429. [PMID: 37467201 DOI: 10.1371/journal.pgph.0001429] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/20/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND AND OBJECTIVES Non-communicable diseases (NCDs) are taking a toll on Africa's youth at younger ages than in other regions. These are attributed to risk factors that usually advance in adolescence, such as unhealthy diets and reduced physical activity. Young adults in South Africa, particularly women, tend to be sedentary, consume energy-dense diets low in micronutrients, and are more likely to develop NCDs much earlier in life than those in high-income countries. With an intersectionality perspective, this study explored young adults' barriers and solutions to addressing these risk factors in Soweto. SETTING Soweto, Johannesburg, South Africa, is one of the most well-known historically disadvantaged townships known for its established communities, and socioeconomic and cultural diversity. Design: A qualitative investigation utilising focus group discussions (FGDs) with a topic guide. FGDs were transcribed verbatim and thematically analysed using a combination of deductive and inductive approaches. PARTICIPANTS 15 Men and 15 women 18-24 years of age living in Soweto (n = 30). Results: South African young adults have a basic understanding of the significance of nutrition, exercise, and their ties to health. However, numerous barriers (like taste, affordability and crime) to such behaviours were reported, arising from the participants' personal, domestic, social, and local community levels. Young women experienced sexism and had safety concerns while exercising in the streets, while young men tended to describe themselves as lazy to engage in exercise as they find it boring. CONCLUSIONS Young adults face a multitude of intersecting barriers, making it difficult to adopt or sustain health-promoting behaviours. It is important that potential solutions focus on the intersections of barriers to healthy eating and physical activity in order to provide more realistic support for such behaviours.
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Affiliation(s)
- Gudani Mukoma
- Faculty of Health Sciences, Department of Paediatrics, SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Biokinetics, Recreation and Sports Science, University of Venda, Thohoyandou, South Africa
| | - Edna N Bosire
- Faculty of Health Sciences, Department of Paediatrics, SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Brain and Mind Institute, Aga Khan University, Karachi, Pakistan
| | - Sonja Klingberg
- Faculty of Health Sciences, Department of Paediatrics, SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- Faculty of Health Sciences, Department of Paediatrics, SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Medicine, School of Human Development and Health, University of Southampton, Southampton, United Kingdom
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Mukoma G, Norris SA, Chikowore T. Nutrient Patterns and Body Mass Index: A Comparative Longitudinal Analysis in Urban Black South African Adolescents and Adults. Nutrients 2023; 15:nu15051075. [PMID: 36904075 PMCID: PMC10004796 DOI: 10.3390/nu15051075] [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: 01/26/2023] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE We set out to evaluate the association between nutrient patterns and general adiposity in black South African adolescents and adults and to determine whether the interactions are longitudinally sustained over 24 months. METHODS Principal Component Analysis (PCA) was used to derive the nutrient patterns of 750 participants (250 adolescents between 13 and 17 years old and 500 adults who were 27 years or 45+ years old). PCA was applied to 25 nutrients, computed from the quantified food frequency questionnaire (QFFQ) over a 24 months period. RESULTS The nutrient patterns between adolescents and adults were similar over time; however, their associations with BMI were different. Among the adolescents, only the "plant-driven nutrients pattern" was significantly associated with a 0.56% (95% CI (0.33; 0.78); p < 0.001) increase in BMI. Among the adults, the "plant-driven nutrient pattern" (0.43% (95% CI (0.03; 0.85); p < 0.001) and the "fat-driven nutrients pattern" (0.18% (95% CI (0.06; 0.29); p < 0.001) were significantly associated with a BMI increase. Furthermore, the "plant-driven nutrient pattern", "fat-driven nutrient pattern" and the animal-driven nutrient pattern revealed sex differences in their association with BMI. CONCLUSION Urban adolescents and adults had consistent nutrient patterns, but their BMI relationships changed with age and gender, an important finding for future nutrition interventions.
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Affiliation(s)
- Gudani Mukoma
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 1862, South Africa
- Correspondence: ; Tel.: +27-799037819
| | - Shane A. Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 1862, South Africa
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Tinashe Chikowore
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 1862, South Africa
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Hyle EP, Martey EB, Bekker LG, Xu A, Parker RA, Walensky RP, Middelkoop K. Diet, physical activity, and obesity among ART-experienced people with HIV in South Africa. AIDS Care 2023; 35:71-77. [PMID: 34913762 PMCID: PMC9200895 DOI: 10.1080/09540121.2021.2012556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
The prevalence of non-communicable diseases (NCDs) is increasing in South Africa, in part due to poor nutrition, physical inactivity, and obesity. We characterized the habits and understanding of diet, exercise, and obesity among people with HIV (PWH) taking antiretroviral therapy (ART). We conducted a cross-sectional study of ART-experienced PWH attending an HIV community health center near Cape Town, South Africa. We included PWH currently prescribed ART, older than 21y, and not pregnant. We collected demographic and clinical information and interviewed participants regarding their behaviors and knowledge related to diet, physical activity, and obesity. From March 2015 - February 2016, we enrolled 458 participants. Self-reported diets were low in nutritional diversity: 202 reported eating only starch and protein without vegetable/fruit in the prior 24 h. Although most participants (96%) acknowledged that exercise had health benefits, only 215 participants engaged in daily 30-minute walking or exercise. One quarter of participants recognized nocontributors to obesity, and almost 20% identified no health problems associated with obesity. Participants had diets low in nutritional diversity, modest exercise habits, and limited understanding of the impact of obesity on health. Further understanding of barriers to improving diet and exercise and reducing obesity are essential, especially as PWH age.
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Affiliation(s)
- Emily P. Hyle
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
- Harvard University Center for AIDS Research (CFAR), Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Emily B. Martey
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine and Department of Medicine Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ai Xu
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Robert A. Parker
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard University Center for AIDS Research (CFAR), Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Rochelle P. Walensky
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
- Harvard University Center for AIDS Research (CFAR), Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Keren Middelkoop
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine and Department of Medicine Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Makura-Kankwende CBT, Gradidge PJ, Crowther NJ, Ratshikombo T, Goedecke JH, Micklesfield LK, Norris SA, Chikowore T. Association of Longitudinal Nutrient Patterns with Body Composition in Black Middle-Aged South African Women: A Five-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12792. [PMID: 36232088 PMCID: PMC9565998 DOI: 10.3390/ijerph191912792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to evaluate the association of longitudinal nutrient patterns with body composition in a cohort of 132 black South African middle-aged women over five years. Nutrient patterns were identified using principal component analysis at baseline and follow-up 5 years later. Associations between nutrient patterns and repeated body composition measures were evaluated using generalized estimating equations, before and after adjusting for baseline education and repeated measures of age, socio-economic status, physical activity and employment. The animal-driven nutrient pattern was associated with increases in repeated measures of visceral adipose tissue (VAT) (β coefficient, 5.79 [95% CI, 0.01-11.57] cm2), fat mass index (FMI) (0.47 [0.01-0.93] kg·m-2) and lean mass index (LMI) (0.50 [0.18-1.17] kg·m-2) (p < 0.05) after adjustment. Vitamin C, sugar, and potassium-driven nutrient pattern was associated with higher FMI (0.50 [0.12-0.88] kg·m-2) and LMI (0.58 [0.07-1.10] kg·m-2) before and after adjustment (p < 0.05). These findings suggest that dietary interventions to curb obesity in black middle-aged South African women should focus on attenuation of nutrient patterns centred on added sugar, animal fat and animal protein.
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Affiliation(s)
- Caroline B. T. Makura-Kankwende
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2198, South Africa
| | - Philippe J. Gradidge
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2198, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2192, South Africa
| | - Tshifhiwa Ratshikombo
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2198, South Africa
| | - Julia H. Goedecke
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2198, South Africa
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa
- University of Stirling, Stirling FK9 4LA, UK
| | - Lisa K. Micklesfield
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2198, South Africa
| | - Shane A. Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2198, South Africa
- School of Human Development and Health, University of Southampton, Southampton SO17 1BJ, UK
| | - Tinashe Chikowore
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2198, South Africa
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Mukoma G, Wrottesley SV, Kagura J, Oni T, Micklesfield L, Norris SA. The relationships between socioeconomic status, dietary knowledge and patterns, and physical activity with adiposity in urban South African women. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2022. [DOI: 10.1080/16070658.2022.2076374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Gudani Mukoma
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephanie V Wrottesley
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Juliana Kagura
- Division of Epidemiology and Biostatistics, University of the Witwatersrand, South Africa
| | - Tolu Oni
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
- Research Initiative for Cities Health and Equity, University of Cape Town, Cape Town, South Africa
| | - Lisa Micklesfield
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
- Institute for Developmental Science and Global Health Research Institute, University of Southampton, Southampton, UK
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Sex Differences in the Associations of Nutrient Patterns with Total and Regional Adiposity: A Study of Middle-Aged Black South African Men and Women. Nutrients 2021; 13:nu13124558. [PMID: 34960108 PMCID: PMC8706560 DOI: 10.3390/nu13124558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/20/2022] Open
Abstract
The study evaluated the association between nutrient patterns with body fat and regional adiposity in middle-aged black South African (SA) men and women and determined if this differed by sex. Body fat and regional adiposity (dual-energy x-ray absorptiometry), and dietary intake (7-day quantified food frequency questionnaire) were measured in black SA men (n = 414) and women (n = 346). Using principal component analysis, nutrient patterns were computed from 25 nutrients in the combined sample. Four nutrient patterns were extracted, explaining 67% of the variance in nutrient intake. Animal and fat, as well as the vitamin C, sugar, and potassium driven patterns, were positively associated with total adiposity. In contrast, the retinol and vitamin B12 pattern was associated with the centralisation of fat. Notably, the strength of the association between the animal-driven nutrient pattern and BMI was greater in men (1.14 kg/m2, 95% CI (0.63–1.66)) than in women (0.81 kg/m2, 95% CI (0.25–1.36)) (Pint = 0.017). In contrast, the plant-driven pattern was associated with higher abdominal subcutaneous adipose tissue (SAT) in women (44 cm2, 95% CI (22–67)) but not men (Pint = 1.54 × 10−4). These differences suggest that although men and women have similar nutrient patterns, their associations with the whole body and regional body fat are different.
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Balakrishna Y, Manda S, Mwambi H, van Graan A. Identifying Nutrient Patterns in South African Foods to Support National Nutrition Guidelines and Policies. Nutrients 2021; 13:nu13093194. [PMID: 34579071 PMCID: PMC8465156 DOI: 10.3390/nu13093194] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 01/18/2023] Open
Abstract
Food composition databases (FCDBs) provide the nutritional content of foods and are essential for developing nutrition guidance and effective intervention programs to improve nutrition of a population. In public and nutritional health research studies, FCDBs are used in the estimation of nutrient intake profiles at the population levels. However, such studies investigating nutrient co-occurrence and profile patterns within the African context are very rare. This study aimed to identify nutrient co-occurrence patterns within the South African FCDB (SAFCDB). A principal component analysis (PCA) was applied to 28 nutrients and 971 foods in the South African FCDB to determine compositionally similar food items. A second principal component analysis was applied to the food items for validation. Eight nutrient patterns (NPs) explaining 73.4% of the nutrient variation among foods were identified: (1) high magnesium and manganese; (2) high copper and vitamin B12; (3) high animal protein, niacin, and vitamin B6; (4) high fatty acids and vitamin E; (5) high calcium, phosphorous and sodium; (6) low moisture and high available carbohydrate; (7) high cholesterol and vitamin D; and (8) low zinc and high vitamin C. Similar food patterns (FPs) were identified from a PCA on food items, yielding subgroups such as dark-green, leafy vegetables and, orange-coloured fruit and vegetables. One food pattern was associated with high sodium levels and contained bread, processed meat and seafood, canned vegetables, and sauces. The data-driven nutrient and food patterns found in this study were consistent with and support the South African food-based dietary guidelines and the national salt regulations.
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Affiliation(s)
- Yusentha Balakrishna
- Biostatistics Research Unit, South African Medical Research Council, Durban 4001, South Africa
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg 3201, South Africa; (S.M.); (H.M.)
- Correspondence: ; Tel.: +27-31-203-4855
| | - Samuel Manda
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg 3201, South Africa; (S.M.); (H.M.)
- Biostatistics Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Statistics, University of Pretoria, Pretoria 0001, South Africa
| | - Henry Mwambi
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg 3201, South Africa; (S.M.); (H.M.)
| | - Averalda van Graan
- Biostatistics Research Unit, SAFOODS Division, South African Medical Research Council, Cape Town 8001, South Africa;
- Division of Human Nutrition, Department of Global Health, Stellenbosch University, Cape Town 8001, South Africa
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Sarfo J, Pawelzik E, Keding GB. Dietary Patterns as Characterized by Food Processing Levels and Their Association with the Health Outcomes of Rural Women in East Africa. Nutrients 2021; 13:2866. [PMID: 34445024 PMCID: PMC8399242 DOI: 10.3390/nu13082866] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 12/18/2022] Open
Abstract
Overweight and obesity are rapidly rising in Sub-Saharan Africa including in rural areas. However, most studies focus on urban centers, and have attributed this epidemic to the consumption of processed foods without their clear characterization. This study investigated food intake patterns defined by food processing levels and their association with overweight/obesity in rural areas. Four 24-h dietary recalls, anthropometric measurements, and socio-demographic characteristics were collected from 1152 women in Kenya, Tanzania, and Uganda. The PCA method was used to extract patterns characterized by food processing levels. The association between patterns and overweight/obesity was ascertained with regression models. The overweight/obesity rate was 47%, 42%, 26%, and 38% in Kenya, Tanzania, Uganda, and East Africa (as pooled data), respectively. Several patterns were identified, yet a "plant-based pattern" largely characterized by unprocessed and minimally processed foods and a "purchase pattern" mainly distinguished by highly processed foods were dominant. The "plant-based pattern" was inversely or not associated with overweight/obesity, while the "purchase pattern" had a positive association or no association. A clear distinction on processed foods as healthy and unhealthy should be made based on their nutrient provision to avoid their mischaracterization as unhealthy. Policies to reverse consumption of unhealthy processed foods while promoting healthy ones should be pursued.
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Affiliation(s)
- Jacob Sarfo
- Division Quality of Plant Products, Department of Crop Sciences, University of Goettingen, 37075 Göttingen, Germany; (E.P.); (G.B.K.)
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"Selected Papers from the 2nd Ellisras Longitudinal Study and Other Non-Communicable Diseases Studies International Conference" Special Issue Editorial. CHILDREN-BASEL 2021; 8:children8020146. [PMID: 33669203 PMCID: PMC7919821 DOI: 10.3390/children8020146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 11/25/2022]
Abstract
Epidemics of non-communicable diseases (NCDs) are presently emerging and on the increase in South Africa. It is increasingly recognized that the occurrence of adult chronic disease are influenced by factors operating from childhood, which are sustained throughout the individual’s life course. Increased risk may start in infancy or even before birth and will continue to be influenced by health related behavior during adulthood. The academic level of people in the community influence the level of their health status. Commitment to the promotion of health through prevention, education, and suitable management is the building block for creating a healthy society. The community must make strides to shift from traditional knowledge and medication, and seek new innovative ways of addressing issues facing the population with regard to obesity, overweight, hypertension health, smoking cessation, alcohol abuse, and low physical activity in line with a healthy living lifestyle. The NCDs pose health problems in South Africa and deserve more attention. Poor control of obesity, hypertension, and diabetes, to name just a few, only adds to the current problems. The South African government and the business sector of South Africa should provide safe walking/riding trails in the cities and in rural area to combat emerging NCDs that are killing our community members indiscriminately without considering race, gender, age, and place of residence. Compulsory introduction of physical education lessons to all public schools cannot be over emphasized in the current escalating NCD situation in South Africa.
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Teymoori F, Mokhtari E, Salehi P, Hosseini-Esfahani F, Mirmiran P, Azizi F. A nutrient pattern characterized by vitamin A, C, B6, potassium, and fructose is associated with reduced risk of insulin-related disorders: A prospective study among participants of Tehran lipid and glucose study. Diabetol Metab Syndr 2021; 13:12. [PMID: 33499915 PMCID: PMC7836167 DOI: 10.1186/s13098-021-00629-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/13/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Insulin-related disorders, including insulin resistance, insulin insensitivity, and insulinemia, is considered early predictors of major chronic disease risk. Using a set of correlated nutrient as nutrient patterns to explore the diet-disease relationship has drawn more attention recently. We aimed to investigate the association of nutrient patterns and insulin markers' changes prospectively among adults who participated in the Tehran Lipid and Glucose Study (TLGS). METHODS For the present study, 995 men and women aged 30-75 years, with complete information on insulin and dietary intake in survey III TLGS, were selected and followed three years until survey IV. Dietary intakes at baseline were assessed using a valid and reliable food frequency questionnaire (FFQ). Nutrient patterns were derived using principal component analysis (PCA). We extracted five dominant patterns based on the scree plot and categorized them into quartiles. Linear regression analysis was conducted to investigate the association between Nutrient patterns and three-year insulin markers changes, including fasting insulin, HOMA-IR, and HOMA-S. RESULTS The mean (SD) age and BMI of participants (43.1 % male) were 46.2(10.9) year and 28.0(4.7) kg/m2, respectively. The median (IQR, 25, 75) of 3 years changes of insulin, HOMA-IR and HOMA-S were 0.35 (- 1.71, 2.67) mU/mL, 0.25 (- 0.28, 0.84) and - 6.60 (- 22.8, 7.76), respectively. In the fully adjusted model for potential confounders, per each quartile increment of the fifth nutrient pattern, the β coefficients (95 % CI) of changes in insulin, HOMA-IR, and HOMA-S were - 0.36 (- 0.62, - 0.10); P value = 0.007, -0.10 (-0.19, -0.01); P value = 0.022, and 1.92 (0.18, 3.66); P value = 0.030, respectively. There were no significant association between other nutrient patterns and insulin related indices. CONCLUSIONS Present study showed that high adherence to a nutrient pattern rich in vitamin A, vitamin C, pyridoxine, potassium, and fructose is inversely associated with 3-years changes in insulin, HOMA-IR, and directly associated with HOMA-S.
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Affiliation(s)
- Farshad Teymoori
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985717413, Tehran, Iran
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Mokhtari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985717413, Tehran, Iran
| | - Pantea Salehi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Firoozeh Hosseini-Esfahani
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985717413, Tehran, Iran.
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985717413, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Nutrient Patterns and Body Composition Parameters of Black South African Women. Nutrients 2020; 13:nu13010006. [PMID: 33375014 PMCID: PMC7822018 DOI: 10.3390/nu13010006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 02/05/2023] Open
Abstract
Obesity is more prevalent in black South African women than men. However, little is known about the nutrient patterns associated with body composition indices in black African women. Principle Component Analysis (PCA) was applied to 25 nutrients derived from quantified food frequency questionnaires (QFFQs) in 498 middle aged black South African women. Three nutrient patterns, the plant driven, animal driven and Vitamin C, sugar and potassium driven nutrient patterns, accounted for 59% of the variance of nutrient intake. Linear models of the body composition parameters as outcome variables indicated that a standard deviation increase in the animal driven nutrient pattern was significantly associated with increases in body mass index (BMI) (1.29 kg·m−2 (95% CI, 0.54–2.04; p = 0.001), subcutaneous adipose tissue (SAT) (26.30 cm2 (7.97–44.63); p = 0.005), visceral adipose tissue (VAT) (9.88 cm2 (5.13–14.63); p < 0.001), VAT/SAT ratio (0.01 (0.00–0.02); p = 0.018), whole body fat mass index (0.74 kg·m−2 (0.25–1.22); p = 0.003), and whole body lean mass index (0.53 kg·m−2 (0.23–0.83); p = 0.001). An increase in plant driven nutrient pattern was significantly associated with an increase in SAT of 20.45 cm2 (0.47–40.43); p = 0.045. This study demonstrates that animal driven nutrient pattern, characterised by the consumption of more animal protein and fat nutrients, similar to the western diet is associated with increased body fat and lean mass.
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Thakwalakwa C, Flax VL, Phuka JC, Garcia H, Jaacks LM. Drivers of food consumption among overweight mother-child dyads in Malawi. PLoS One 2020; 15:e0243721. [PMID: 33332387 PMCID: PMC7745992 DOI: 10.1371/journal.pone.0243721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/29/2020] [Indexed: 11/19/2022] Open
Abstract
To address the increase in overweight and obesity among mothers and children in sub-Saharan Africa, an understanding of the factors that drive their food consumption is needed. We hypothesized food consumption in Malawi is driven by a combination of factors, including season, food accessibility (area of residence, convenience of purchasing food, female autonomy), food affordability (household resources, food expenditures, household food insecurity), food desirability (taste preferences, body size preferences), demographics, and morbidity. Participants in Lilongwe and Kasungu Districts were enrolled across three types of mother-child dyads: either the mother (n = 120), child (n = 80), or both (n = 74) were overweight. Seven-day dietary intake was assessed using a quantitative food frequency questionnaire during the dry and rainy seasons. Drivers associated with intake of calories, macronutrients, and 11 food groups at p<0.1 in univariate models were entered into separate multivariate linear regression models for each dietary intake outcome. Mother-child dyads with an overweight child had a higher percent of calories from carbohydrates and lower percent of calories from fat compared to dyads with a normal weight child (both p<0.01). These mothers also had the highest intake of grains (p<0.01) and their children had the lowest intake of oil/fat (p = 0.01). Household food insecurity, maternal taste preferences, and maternal body size preferences were the most consistent predictors of food group consumption. Household food insecurity was associated with lower intake of grains, fruits, meat and eggs, oil/fat, and snacks. Maternal taste preferences predicted increased consumption of grains, legumes/nuts, vegetables, fish, and oil/fat. Maternal body size preferences for herself and her child were associated with consumption of grains, legumes/nuts, dairy, and sweets. Predictors of food consumption varied by season, across food groups, and for mothers and children. In conclusion, indicators of food affordability and desirability were the most common predictors of food consumption among overweight mother-child dyads in Malawi.
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Affiliation(s)
- Chrissie Thakwalakwa
- Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi
| | - Valerie L. Flax
- RTI International, Research Triangle Park, North Carolina, United States of America
- * E-mail:
| | - John C. Phuka
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Harrison Garcia
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Lindsay M. Jaacks
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Danquah FI, Ansu-Mensah M, Bawontuo V, Yeboah M, Kuupiel D. Prevalence, incidence, and trends of childhood overweight/obesity in Sub-Saharan Africa: a systematic scoping review. Arch Public Health 2020; 78:109. [PMID: 33292679 PMCID: PMC7599109 DOI: 10.1186/s13690-020-00491-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/20/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The growing burden of non-communicable diseases (NDC), particularly in low-and middle-income countries, poses a significant threat to global health. Obesity and overweight constitute major risk factors of NCDs such as heart diseases, diabetes, and kidney disease, and as a result, contribute significantly to the development of chronic morbidities, reduced quality of life, and increased risk of premature death. This study described evidence on the prevalence, incidence, and trends of childhood overweight and obesity in sub-Sahara Africa (SSA). METHODS We conducted a systematic scoping review employing the Arksey and O'Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. To obtain relevant published articles for this review, we performed a comprehensive keywords search in PubMed, Google Scholar, Web of Science, and CINAHL via EBSCOhost platform for studies published between 2009 and June 2019. Guided by the eligibility criteria, title and abstracts, as well as the full-text articles were independently screened in parallel by two investigators. All relevant data were independently extracted by two investigators using a piloted form designed in Microsoft and thematic analysis conducted. RESULTS Of the 81 included studies obtained from 250,148 potentially eligible articles, the majority (25) conducted in South Africa followed by 18 in Nigeria. Six studies were conducted in Ethiopia (6), Tanzania (5), Kenya (4), Cameroon (4), Ghana (3), Uganda (2), Mozambique (2), and Sudan (2). One study each was conducted in Botswana, Gambia, Lesotho, Mauritius, Seychelles, Togo, and Zimbabwe. The remaining three articles were multi-country studies. Most (81.5%) of the included studies were cross-sectional surveys and the majority (79) focused on both male and female participants. The majority (80/81) of the included studies reported on the prevalence of childhood overweight/obesity, 8 on the trends of childhood overweight/obesity, and one presented evidence on the incidence of childhood overweight and obesity in SSA. CONCLUSION This review demonstrates limited studies on childhood overweight/obesity in most SSA countries although the included studies suggest an increasing burden. Considering the consequences of childhood obesity, there is a need for more primary researches to inform policies decision and implementation to halt the rise of childhood obesity/overweight in SSA.
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Affiliation(s)
- Frederick Inkum Danquah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Monica Ansu-Mensah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Vitalis Bawontuo
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
- Research for Sustainable Development Consult, Sunyani, Ghana
| | - Matilda Yeboah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Desmond Kuupiel
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
- Research for Sustainable Development Consult, Sunyani, Ghana
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001 South Africa
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Danquah FI, Ansu-Mensah M, Bawontuo V, Yeboah M, Udoh RH, Tahiru M, Kuupiel D. Risk factors and morbidities associated with childhood obesity in sub-Saharan Africa: a systematic scoping review. BMC Nutr 2020; 6:37. [PMID: 32884829 PMCID: PMC7460801 DOI: 10.1186/s40795-020-00364-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/24/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA. METHODS Guided by the Arksey and O'Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted. RESULTS A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region. CONCLUSION This review findings suggest a paucity of literature on the risk factors of childhood obesity and morbidities in most SSA countries. Hence, there is the need to intensify research efforts, especially experimental study designs using innovative strategies to promote healthy lifestyle choices that will prevent or minimize the risks and health consequences of childhood obesity in SSA.
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Affiliation(s)
- Frederick Inkum Danquah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Monica Ansu-Mensah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Vitalis Bawontuo
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
- Research for Sustainable Development Consult, Sunyani, Ghana
| | - Matilda Yeboah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Roseline H. Udoh
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Mohammed Tahiru
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Desmond Kuupiel
- Research for Sustainable Development Consult, Sunyani, Ghana
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Durban, 4001 South Africa
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Mottaghian M, Salehi P, Teymoori F, Mirmiran P, Hosseini-Esfahani F, Azizi F. Nutrient patterns and cardiometabolic risk factors among Iranian adults: Tehran lipid and glucose study. BMC Public Health 2020; 20:653. [PMID: 32393204 PMCID: PMC7216539 DOI: 10.1186/s12889-020-08767-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/23/2020] [Indexed: 12/15/2022] Open
Abstract
Background The present study aimed to assess the relation between nutrient patterns and changes in adult anthropometric and cardiometabolic factors. Methods This study was conducted on 1637 adults participating in the Tehran Lipid and Glucose Study (2005–2008), who were free of cardiovascular diseases and cancer and had completed dietary data. They were followed to the next survey (2008–2011). Dietary intakes were collected and nutrient patterns were obtained. Three year changes in anthropometric and cardiometabolic factors were measured. Results Five nutrient patterns were extracted. The first pattern was characterized by “plant protein, thiamine, niacin, and minerals including phosphorus, zinc, copper, magnesium, manganese, and selenium”. Animal protein, lactose, vitamin D, riboflavine, pantothenic acid, vitamin B12, calcium, phosphorus, and zinc" were loaded in the second pattern. The third and fourth patterns were characterized by “vitamin K, fiber, calcium, iron, manganese, and potassium”, and “high correlation with starch, thiamine and folate, and negative correlation with mono and poly unsaturated fatty acids and vitamin E”, respectively. The fifth pattern was high in Fructose, vitamins A, C, pyridoxine, and potassium. There was no association between nutrient patterns and 3-year changes in blood pressure and fasting blood glucose; whereas, per each quartile increment of the fifth pattern adjusted for potential confounders, triglyceride change was decreased [β = − 3.66, 95% CI (− 6.57, − 0.57); P for trend = 0.014]. Conclusion Present study indicates that nutrient patterns may have an association with cardiometabolic factors, particularly a pattern rich in fructose, vitamins A, C, pyridoxine, and potassium which decreases triglyceride level.
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Affiliation(s)
- Mohammad Mottaghian
- Student Research committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pantea Salehi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshad Teymoori
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985717413, Tehran, Iran.,Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985717413, Tehran, Iran.
| | - Firoozeh Hosseini-Esfahani
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985717413, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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Cross-country comparison of dietary patterns and overweight and obesity among adult women in urban Sub-Saharan Africa. Public Health Nutr 2020; 24:1393-1403. [PMID: 32390577 DOI: 10.1017/s1368980019005202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To derive dietary patterns (DP) among women of reproductive age (WRA) and older women in urban Sub-Saharan Africa (SSA), and to examine their association with body mass index (BMI), overweight and obesity. DESIGN We used principal component analysis to derive DP. Their association with BMI, overweight and obesity was assessed using linear and multinomial logistic regression models controlling for age, marital status, education and wealth. SETTING Cross-sectional data from prospective studies in Accra, Ghana (2008-2009), Dar es Salaam, Tanzania (2014) and Lilongwe and Kasungu, Malawi (2017-2018) were used. PARTICIPANTS We compared WRA in Ghana (18-54 years, n 1762) and Malawi (19-48 years, n 137), and older women in Ghana (≥55 years, n 514) and Tanzania (≥50 years, n 134). RESULTS Among WRA, protein and healthy DP were identified in both Ghana and Malawi. In Ghana, the protein DP was associated with higher odds of overweight or obesity (adjusted OR 1·82, 95 % CI 1·27, 2·60 for quintile 2). Among older women, three DP were identified in Ghana (cereal, protein and healthy) and two DP in Tanzania (protein and healthy). The protein DP was associated with higher BMI in Ghana (adjusted mean difference 2·83, 95 % CI 0·95, 4·71 for quartile 3). CONCLUSIONS Higher quintiles of the protein DP were associated with higher BMI and odds of overweight or obesity among women in urban Ghana, but not in Malawi or Tanzania. Further research is needed to understand how DP influence overweight and obesity among adult women in urban SSA.
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18
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Shakya PR, Melaku YA, Page AJ, Gill TK. Nutrient patterns and depressive symptoms among Australian adults. Eur J Nutr 2020; 60:329-343. [PMID: 32328747 DOI: 10.1007/s00394-020-02243-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 04/01/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE Much of the current literature on the associations between diet and depression focus on single nutrients rather than nutrient patterns (NPs). We investigated the association between NPs and depressive symptoms (DepS) in an Australian adult population. METHODS DepS were examined at two different time points, in 2010 (Stage 3, n = 1743, 49.0% males) and 2015 [North West 2015 (NW15), n = 1,024, 46.6% males] of the North West Adelaide Health Study (NWAHS). Dietary habits were evaluated using a food frequency questionnaire (FFQ) at Stage 3. DepS were assessed using the Center for Epidemiological Studies Depression (CES-D) scale at Stage 3 and NW15. Principal component analysis was used to identify NPs as well as the factor structure of the CES-D. Log- and negative binomial regression analyses were used to assess the association between NPs and DepS scores. Ordinal logistic regression analysis was undertaken between the NPs and identified factors of the CES-D score. RESULTS Three NPs (from the FFQ) and two-factors (from the CES-D score) were obtained. After adjusting for known confounding variables, a 'plant-sourced' NP (β-carotene, fibre, vitamin C, potassium and α-carotene) was inversely associated with DepS at Stage 3 [prevalence ratio (PR)Q4VsQ1, 0.78; 95% CI 0.66-0.92; p = 0.003], whereas an 'animal-sourced' (ω-3 fatty acid, monounsaturated fat, vitamin E and cholesterol) or 'mixed-source' (phosphorous, protein, vitamin B2, iodine and zinc) NP was not associated with DepS. There was an inverse relationship between the 'plant-sourced' NP and the '(absence of) positive-affect' factor from the CES-D in both stages. CONCLUSION The 'plant-sourced' NP is consistently and inversely associated with DepS; however, longitudinal studies are recommended to confirm these results.
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Affiliation(s)
- Prem R Shakya
- Vagal Afferent Research Group, University of Adelaide, Adelaide, 5005, SA, Australia.,Diabetes, Nutrition and Gut Health, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, 5005, SA, Australia
| | - Yohannes A Melaku
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, 5042, SA, Australia
| | - Amanda J Page
- Vagal Afferent Research Group, University of Adelaide, Adelaide, 5005, SA, Australia.,Diabetes, Nutrition and Gut Health, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, 5005, SA, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, 5005, SA, Australia.
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Adeomi AA, Adelusi IO, Adedeji PO, Awofeso AE, Oroleye OO, Gbadegesin DL. Nutritional status and Cardiometabolic health among adolescents; findings from southwestern Nigeria. BMC Nutr 2019; 5:45. [PMID: 32153958 PMCID: PMC7050742 DOI: 10.1186/s40795-019-0308-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/29/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Obesity has been associated with an increased risk for cardio-metabolic diseases. The prevalence of obesity among adolescents is increasing worldwide, including Nigeria, but only little data exist on the relationship of nutritional status with cardio-metabolic health among adolescents in Nigeria. This study therefore investigated the relationship of nutrition status, raised blood pressure, glucose intolerance and risk for metabolic diseases among adolescents in southwestern Nigeria. METHODS This was a cross-sectional study conducted among 313 in-school adolescents in Ile-Ife, southwestern Nigeria. The respondents were selected using multi-stage sampling technique, and data were collected using pre-tested structured questionnaires. Anthropometric, blood pressure and random blood glucose measurements were done using standard protocols. Nutritional assessment was done using the World Health Organization (WHO) 2007 reference. Pre-hypertension and hypertension were measured using percentiles for gender, age and height. Analysis was done using IBM SPSS and the level of significance was set at p ≤ 0.05. RESULTS The mean age of the respondents was 14.4 ± 2.0 years. The prevalence of overweight and obesity was 10.2%, and it was significantly higher among females (12.5%) than males (7.0%). The prevalence of systolic and diastolic pre-hypertension was 10.9 and 11.5% respectively, while the prevalence for systolic and diastolic hypertension were 14.4 and 8.6% respectively. Using WHtR to assess cardio-metabolic risk, 7.3% of the respondents were at risk. There were statistically significant relationships between BMI, WHtR and blood pressure levels (< 0.05). CONCLUSIONS The prevalence of overweight/obesity among the adolescents was relatively high, and this was significantly associated with elevated blood pressure and increased risk for cardio-metabolic diseases. There is need for more interest and intervention by stakeholders into the cardio-metabolic health of adolescents in Nigeria.
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Affiliation(s)
- Adeleye Abiodun Adeomi
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Iyanuoluwa Odunayo Adelusi
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Praise Oluwatooni Adedeji
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Adedoyin Esther Awofeso
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Olajumoke Omotoyosi Oroleye
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Doyinfunmi Lydia Gbadegesin
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
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Mariotti F. Animal and Plant Protein Sources and Cardiometabolic Health. Adv Nutr 2019; 10:S351-S366. [PMID: 31728490 PMCID: PMC6855969 DOI: 10.1093/advances/nmy110] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/24/2018] [Accepted: 11/09/2018] [Indexed: 12/22/2022] Open
Abstract
The sources or types of protein in the diet have long been overlooked regarding their link to cardiometabolic health. The picture is complicated by the fact that animal and plant proteins are consumed along with other nutrients and substances which make up the "protein package" so plant and animal protein come with clear nutrient clusters. This review aimed at deciphering the relation between plant and animal protein and cardiometabolic health by examining different nutritional levels (such as amino acids, protein type, protein foods, protein patterns, and associated overall dietary and nutrient patterns) and varying levels of scientific evidence [basic science, randomized controlled trials (RCTs), observational data]. Plant protein in Western countries is a robust marker of nutrient adequacy of the diet, whereas the contribution of animal protein is highly heterogeneous. Yet recent data from large cohorts have confirmed that total and animal proteins are associated with the risk of cardiovascular disease and diabetes, even when fully adjusting for lifestyle and dietary or nutritional factors. Here again, there is marked variability depending on the type of animal protein. Protein from processed red meat and total red meat on the one hand, and from legumes, nuts, and seeds on the other, are often reported at the extremes of the risk range. RCTs using purified proteins have contributed little to the topic to date, inasmuch as the findings cannot readily be extrapolated to current or near-future diets, but RCTs studying whole protein foods have shown a beneficial effect of pulses. Despite the fact that many of the benefits of plant protein reported in observational or interventional studies may stem from the protein package that they convey and the nutrients that they displace, there are also important indications that protein per se may affect cardiometabolic health via the many amino acids that are present in typically contrasting levels in plant compared with animal proteins.
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Affiliation(s)
- François Mariotti
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, 75005, Paris, France
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21
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Nansseu JR, Noubiap JJ, Bigna JJ. Epidemiology of Overweight and Obesity in Adults Living in Cameroon: A Systematic Review and Meta-Analysis. Obesity (Silver Spring) 2019; 27:1682-1692. [PMID: 31411372 DOI: 10.1002/oby.22566] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/29/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE This study aimed to summarize current data on overweight and obesity among adults living in Cameroon. METHODS PubMed, Embase, Web of Science, Global Index Medicus, African Journals Online, and local databases were searched for population-based cross-sectional studies conducted in the general population from January 2000 to December 2017. A random-effects model was used to pool data. RESULTS Overall, 26 studies (55,155 participants) were included. The prevalence of overweight was 26.0% (95% CI: 17.6%-35.3%) based on BMI. Furthermore, the overall prevalence of obesity was 15.1% (95% CI: 9.3%-22.1%) based on BMI, 16.4% (95% CI: 10.8%-22.8%) based on waist circumference ≥ 102 cm for males and ≥ 88 cm for females, 36.7% (95% CI: 26.8%-47.2%) based on waist circumference ≥ 94 cm for males and ≥ 80 cm for females, 32.6% (95% CI: 26.9%-38.7%) based on waist to hip ratio ≥ 0.90 for males and ≥ 0.85 for females, and 31.9% (95% CI: 27.8%-36.2%) based on percent body fat ≥ 25% for males and ≥ 35% for females. Overall, the burden was higher in females compared with males; there was no difference between urban and rural settings or between studies conducted in 2000 to 2009 and 2010 to 2016. CONCLUSIONS The burden of overweight and obesity is high among adults in Cameroon, putting many at increased risk for developing associated metabolic and cardiovascular complications.
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Affiliation(s)
- Jobert Richie Nansseu
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
- Department of Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaoundé, Cameroon
| | - Jean Jacques Noubiap
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon
- School of Public Health, Faculty of Medicine, University of Paris Sud XI, Le Kremlin Bicêtre, France
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Kelishadi R, Heidari-Beni M, Esmaeil-Motlagh M, Pourmasoumi M, Malekshah AFT, Qorbani M. Association of nutrient patterns with anthropometric indices in children and adolescents: The weight disorders survey of the CASPIAN-IV study. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2019. [DOI: 10.3233/mnm-180278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Makan Pourmasoumi
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | | | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Wrottesley SV, Pedro TM, Fall CH, Norris SA. A review of adolescent nutrition in South Africa: transforming adolescent lives through nutrition initiative. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2019. [DOI: 10.1080/16070658.2019.1607481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Stephanie V Wrottesley
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Titilola M Pedro
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Caroline H Fall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
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24
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Olorunfemi G, Ndlovu N, Masukume G, Chikandiwa A, Pisa PT, Singh E. Temporal trends in the epidemiology of cervical cancer in South Africa (1994-2012). Int J Cancer 2018; 143:2238-2249. [PMID: 29786136 PMCID: PMC6195436 DOI: 10.1002/ijc.31610] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 05/02/2018] [Accepted: 05/07/2018] [Indexed: 02/06/2023]
Abstract
Cervical cancer (CC) is the leading cause of cancer death among female South Africans (SA). Improved access to reproductive health services following multi-ethnic democracy in 1994, HIV epidemic, and the initiation of CC population-based screening in early 2000s have influenced the epidemiology of CC in SA. We therefore evaluated the trends in CC age-standardised incidence (ASIR) (1994-2009) and mortality rates (ASMR) (2004-2012) using data from the South African National Cancer Registry and the Statistics South Africa, respectively. Five-year relative survival rates and average per cent change (AAPC) stratified by ethnicity and age-groups was determined. The average annual CC cases and mortalities were 4,694 (75,099 cases/16 years) and 2,789 (25,101 deaths/9 years), respectively. The ASIR was 22.1/100,000 in 1994 and 23.3/100,000 in 2009, with an average annual decline in incidence of 0.9% per annum (AAPC = -0.9%, p-value < 0.001). The ASMR decreased slightly by 0.6% per annum from 13.9/100,000 in 2004 to 13.1/100,000 in 2012 (AAPC = -0.6%, p-value < 0.001). In 2012, ASMR was 5.8-fold higher in Blacks than in Whites. The 5-year survival rates were higher in Whites and Indians/Asians (60-80%) than in Blacks and Coloureds (40-50%). The incidence rate increased (AAPC range: 1.1-3.1%, p-value < 0.001) among young women (25-34 years) from 2000 to 2009. Despite interventions, there were minimal changes in overall epidemiology of CC in SA but there were increased CC rates among young women and ethnic disparities in CC burden. A review of the CC national policy and directed CC prevention and treatment are required to positively impact the burden of CC in SA.
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Affiliation(s)
- Gbenga Olorunfemi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Ntombizodwa Ndlovu
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Gwinyai Masukume
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Admire Chikandiwa
- Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Pedro T. Pisa
- Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
- Department of Human Nutrition and Dietetics, Sefako Makgatho Health Sciences University, South Africa
| | - Elvira Singh
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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25
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Pisa PT, Pisa NM. Economic growth and obesity in South African adults: an ecological analysis between 1994 and 2014. Eur J Public Health 2018; 27:404-409. [PMID: 27543922 DOI: 10.1093/eurpub/ckw119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background To assess the trend associations between South Africa's economic growth using various economic growth indicators (EGIs) with adult obesity prevalence over a specified period of time. Data for obesity levels reported were obtained from national surveys conducted in South African adults in 1998, 2003 and 2012. EGIs incorporated in the current analysis were obtained from the World Bank and IHS Global insight databases. Obesity prevalence is presented by gender, urbanisation level and ethnicity. EGIs congruent to the time points where obesity data are available are presented. Unadjusted time trend plots were applied to assess associations between obesity prevalence and EGIs by gender, urbanisation level and ethnicity. Females present higher levels of obesity relative to males for all time points. For both males and females, an overall increase in prevalence was observed in both rural and urban settings over-time, with urban dwellers presenting higher obesity levels. An overall increase in Gross Domestic Product (GDP) per capita and Household Final Consumption Expenditure (HFCE) per capita was observed. The Gini coefficient for all ethnicities except the White population increased between 1998 and 2003 but declined by 2012. Overtime per capita GDP and HFCE increased with increasing obesity prevalence in both genders. The trend association between the Gini coefficient for all ethnicities and obesity prevalence was similar for both genders in that as the Gini coefficient increased obesity prevalence declined, and when the coefficient decreased obesity prevalence increased. Trend associations exist between South Africa's economic growth and adult obesity.
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Affiliation(s)
- Pedro T Pisa
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Noleen M Pisa
- Department of Transport and Supply Chain Management, University of Johannesburg, Johannesburg, South Africa
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26
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Abstract
OBJECTIVE To identify predominant dietary patterns in four African populations and examine their association with obesity. DESIGN Cross-sectional study.Setting/SubjectsWe used data from the Africa/Harvard School of Public Health Partnership for Cohort Research and Training (PaCT) pilot study established to investigate the feasibility of a multi-country longitudinal study of non-communicable chronic disease in sub-Saharan Africa. We applied principal component analysis to dietary intake data collected from an FFQ developed for PaCT to ascertain dietary patterns in Tanzania, South Africa, and peri-urban and rural Uganda. The sample consisted of 444 women and 294 men. RESULTS We identified two dietary patterns: the Mixed Diet pattern characterized by high intakes of unprocessed foods such as vegetables and fresh fish, but also cold cuts and refined grains; and the Processed Diet pattern characterized by high intakes of salad dressing, cold cuts and sweets. Women in the highest tertile of the Processed Diet pattern score were 3·00 times more likely to be overweight (95 % CI 1·66, 5·45; prevalence=74 %) and 4·24 times more likely to be obese (95 % CI 2·23, 8·05; prevalence=44 %) than women in this pattern's lowest tertile (both P<0·0001; prevalence=47 and 14 %, respectively). We found similarly strong associations in men. There was no association between the Mixed Diet pattern and overweight or obesity. CONCLUSIONS We identified two major dietary patterns in several African populations, a Mixed Diet pattern and a Processed Diet pattern. The Processed Diet pattern was associated with obesity.
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Micklesfield LK, Kagura J, Munthali R, Crowther NJ, Jaff N, Gradidge P, Ramsay M. Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa. Glob Health Action 2018; 11:1448250. [PMID: 30079826 PMCID: PMC6084500 DOI: 10.1080/16549716.2018.1448250] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 03/02/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND There is a high and increasing prevalence of overweight and obesity in South Africans of all ages. Risk factors associated with overweight and obesity must be identified to provide targets for intervention. OBJECTIVE To identify the demographic, socio-economic and behavioural factors associated with body mass index (BMI) in middle-aged black South African men and women. METHODS Data on demographic and socio-economic factors were collected via questionnaire on 1027 men and 1008 women from Soweto Johannesburg, South Africa. Weight and height were measured and BMI was determined. Behavioural factors included tobacco use and consumption of alcohol, and physical activity data were collected using the Global Physical Activity Questionnaire. Menopausal status was determined for the women, and HIV status was available for 93.6% of the men and 39.9% of the women. RESULTS Significantly more women were overweight or obese than men (87.9 vs. 44.9%). Smoking prevalence (current or former) and minutes spent in moderate to vigorous intensity physical activity was significantly different between the sexes (both p < 0.0001). In the final hierarchical model, marital status (+ married/cohabiting), household asset score (+), current smoking (-), moderate to vigorous physical activity (-) and HIV status (- HIV infected) significantly contributed to 26% of the variance in BMI in the men. In the women, home language (Tswana-speaking compared to Zulu-speaking), marital status (+ unmarried/cohabiting), education (-), current smoking (-) and HIV status (- HIV infected) significantly contributed to 14% of the variance in BMI. CONCLUSIONS The sex difference in BMI and the prevalence of overweight and obesity between black South African men and women from Soweto, as well as the sex-specific associations with various demographic, socio-economic and behavioural factors, highlight the need for more tailored interventions to slow down the obesity epidemic.
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Affiliation(s)
- Lisa K. Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Juliana Kagura
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Munthali
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Jaff
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Philippe Gradidge
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - http://orcid.org/0000-0001-7124-3788NorrisShane A.
a
as members of AWI-Gen the H3Africa Consortium
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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28
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Association between nutrient patterns and bone mineral density among ageing adults. Clin Nutr ESPEN 2017; 22:97-106. [DOI: 10.1016/j.clnesp.2017.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 08/08/2017] [Indexed: 01/16/2023]
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29
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Humphries DL, Dearden KA, Crookston BT, Woldehanna T, Penny ME, Behrman JR. Household food group expenditure patterns are associated with child anthropometry at ages 5, 8 and 12 years in Ethiopia, India, Peru and Vietnam. ECONOMICS AND HUMAN BIOLOGY 2017; 26:30-41. [PMID: 28222325 PMCID: PMC5555831 DOI: 10.1016/j.ehb.2017.02.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/30/2017] [Accepted: 02/05/2017] [Indexed: 06/06/2023]
Abstract
UNLABELLED Population-level analysis of dietary influences on nutritional status is challenging in part due to limitations in dietary intake data. Household expenditure surveys, covering recent household expenditures and including key food groups, are routinely conducted in low- and middle-income countries. These data may help identify patterns of food expenditure that relate to child growth. OBJECTIVES We investigated the relationship between household food expenditures and child growth using factor analysis. METHODS We used data on 6993 children from Ethiopia, India, Peru and Vietnam at ages 5, 8 and 12y from the Young Lives cohort. We compared associations between household food expenditures and child growth (height-for-age z scores, HAZ; body mass index-for-age z scores, BMI-Z) using total household food expenditures and the "household food group expenditure index" (HFGEI) extracted from household expenditures with factor analysis on the seven food groups in the child dietary diversity scale, controlling for total food expenditures, child dietary diversity, data collection round, rural/urban residence and child sex. We used the HFGEI to capture households' allocations of their finances across food groups in the context of local food pricing, availability and pReferences RESULTS: The HFGEI was associated with significant increases in child HAZ in Ethiopia (0.07), India (0.14), and Vietnam (0.07) after adjusting for all control variables. Total food expenditures remained significantly associated with increases in BMI-Z for India (0.15), Peru (0.11) and Vietnam (0.06) after adjusting for study round, HFGEI, dietary diversity, rural residence, and whether the child was female. Dietary diversity was inversely associated with BMI-Z in India and Peru. Mean dietary diversity increased from age 5y to 8y and decreased from age 8y to 12y in all countries. CONCLUSION Household food expenditure data provide insights into household food purchasing patterns that significantly predict HAZ and BMI-Z. Including food expenditure patterns data in analyses may yield important information about child nutritional status and linear growth.
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Affiliation(s)
- Debbie L Humphries
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, P.O. Box 208034, New Haven, CT 06520-8034, USA.
| | - Kirk A Dearden
- Department of Global Health, Boston University, Boston, MA, USA.
| | | | - Tassew Woldehanna
- Department of Economics, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Mary E Penny
- Instituto de Investigación Nutricional, Lima, Peru.
| | - Jere R Behrman
- Departments of Economics and Sociology, University of Pennsylvania, Philadelphia, PA, USA.
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30
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Nutrient patterns and chronic inflammation in a cohort of community dwelling middle-aged men. Clin Nutr 2017; 36:1040-1047. [DOI: 10.1016/j.clnu.2016.06.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 06/14/2016] [Accepted: 06/27/2016] [Indexed: 11/23/2022]
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Nutrient Patterns Associated with Fasting Glucose and Glycated Haemoglobin Levels in a Black South African Population. Nutrients 2017; 9:nu9010009. [PMID: 28106816 PMCID: PMC5295053 DOI: 10.3390/nu9010009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/13/2016] [Accepted: 12/19/2016] [Indexed: 12/31/2022] Open
Abstract
Type 2 diabetes (T2D) burden is increasing globally. However, evidence regarding nutrient patterns associated with the biomarkers of T2D is limited. This study set out to determine the nutrient patterns associated with fasting glucose and glycated haemoglobin the biomarkers of T2D. Factor analysis was used to derive nutrient patterns of 2010 participants stratified by urban/rural status and gender. Principal Component Analysis (PCA) was applied to 25 nutrients, computed from the quantified food frequency questionnaires (QFFQ). Three nutrient patterns per stratum, which accounted for 73% of the variation of the selected nutrients, were identified. Multivariate linear regression models adjusted for age, BMI, smoking, physical activity, education attained, alcohol intake, seasonality and total energy intake were computed. Starch, dietary fibre and B vitamins driven nutrient pattern was significantly associated with fasting glucose (β = −0.236 (−0.458; −0.014); p = 0.037) and glycated haemoglobin levels (β = −0.175 (−0.303; −0.047); p = 0.007) in rural women. Thiamine, zinc and plant protein driven nutrient pattern was associated with significant reductions in glycated haemoglobin and fasting glucose ((β = −0.288 (−0.543; −0.033); p = 0.027) and (β = −0.382 (−0.752; −0.012); p = 0.043), respectively) in rural men. Our results indicate that plant driven nutrient patterns are associated with low fasting glucose and glycated haemoglobin levels.
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Lee HA, Hwang HJ, Oh SY, Park EA, Cho SJ, Kim HS, Park H. Which Diet-Related Behaviors in Childhood Influence a Healthier Dietary Pattern? From the Ewha Birth and Growth Cohort. Nutrients 2016; 9:nu9010004. [PMID: 28025537 PMCID: PMC5295048 DOI: 10.3390/nu9010004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/07/2016] [Accepted: 12/15/2016] [Indexed: 01/09/2023] Open
Abstract
This study was performed to examine how childhood dietary patterns change over the short term and which changes in diet-related behaviors influence later changes in individual dietary patterns. Using food frequency questionnaire data obtained from children at 7 and 9 years of age from the Ewha Birth and Growth Cohort, we examined dietary patterns by principal component analysis. We calculated the individual changes in dietary pattern scores. Changes in dietary habits such as eating a variety of food over two years were defined as “increased”, “stable”, or “decreased”. The dietary patterns, termed “healthy intake”, “animal food intake”, and “snack intake”, were similar at 7 and 9 years of age. These patterns explained 32.3% and 39.1% of total variation at the ages of 7 and 9 years, respectively. The tracking coefficient of snack intake had the highest coefficient (γ = 0.53) and that of animal food intake had the lowest (γ = 0.21). Intra-individual stability in dietary habits ranged from 0.23 to 0.47, based on the sex-adjusted weighted kappa values. Of the various behavioral factors, eating breakfast every day was most common in the “stable” group (83.1%), whereas consuming milk or dairy products every day was the least common (49.0%). Moreover, changes in behavior that improved the consumption of milk or dairy products or encouraged the consumption of vegetables with every meal had favorable effects on changes in healthy dietary pattern scores over two years. However, those with worsened habits, such as less food variety and more than two portions of fried or stir-fried food every week, had unfavorable effects on changes in healthy dietary pattern scores. Our results suggest that diet-related behaviors can change, even over a short period, and these changes can affect changes in dietary pattern.
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Affiliation(s)
- Hye Ah Lee
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hyo Jeong Hwang
- Biomaterials Research Institute, Sahmyook University, Seoul 01795, Korea.
| | - Se Young Oh
- Department of Food & Nutrition, Research Center for Human Ecology, College of Human Ecology, Kyung Hee University, Seoul 02447, Korea.
| | - Eun Ae Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hae Soon Kim
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
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33
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Kang K, Sohn SY. Relationships between nutrient patterns and geodemographic characteristics in Korea. Nutr Diet 2016. [DOI: 10.1111/1747-0080.12290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kiyeon Kang
- Department of Information and Industrial Engineering; Yonsei University; Seoul Republic of Korea
| | - So Young Sohn
- Department of Information and Industrial Engineering; Yonsei University; Seoul Republic of Korea
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A comparison of body composition estimates using dual-energy X-ray absorptiometry and air-displacement plethysmography in South African neonates. Eur J Clin Nutr 2016; 70:1254-1258. [PMID: 27245207 DOI: 10.1038/ejcn.2016.91] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Neonatal body composition is an important predictor of future metabolic risk; however, the comparability of objective assessment techniques, particularly in African populations undergoing rapid health transition, is not known. This paper compares body composition estimates by air-displacement plethysmography (ADP) and dual-energy X-ray absorptiometry (DXA) in South African neonates. SUBJECTS/METHODS Fat mass, fat-free mass and body fat percentage (%fat) estimates by ADP and DXA were compared in 88 urban, black South African neonates. The level of agreement between the techniques was assessed using Bland-Altman analyses. RESULTS Significant correlations were observed between ADP and DXA measurements of fat mass (r=0.766), fat-free mass (r=0.942) and %fat (r=0.630); however, ADP estimates of fat mass (408±172 g vs 337±165 g; P<0.001) and %fat (12.9±4.4% vs 9.9±4%; P<0.001) were significantly higher and fat-free mass (2681±348 g vs 2969±375 g; P<0.001) significantly lower than those by DXA. Fat-free mass estimates showed greater consistency in the level of agreement between the techniques compared with fat and %fat estimates where the differences between methods were less predictable. CONCLUSION Although ADP and DXA body composition estimates are highly correlated in neonates, significant differences are observed between the techniques. This is particularly relevant for fat mass and %fat estimates, where differences are highly variable between methods. Further investigation is needed to minimise inter-method differences to ensure accurate and comparable assessment of body composition at birth and across longitudinal study follow-up.
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35
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Mayén AL, Bovet P, Marti-Soler H, Viswanathan B, Gedeon J, Paccaud F, Marques-Vidal P, Stringhini S. Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles. PLoS One 2016; 11:e0155617. [PMID: 27214139 PMCID: PMC4877066 DOI: 10.1371/journal.pone.0155617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 05/02/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND In high income countries, low socioeconomic status (SES) is related to unhealthier dietary patterns, while evidence on the social patterning of diet in low and middle income countries is scarce. OBJECTIVE In this study, we assess dietary patterns in the general population of a middle income country in the African region, the Republic of Seychelles, and examine their distribution according to educational level and income. METHODS Data was drawn from two independent national surveys conducted in the Seychelles among adults aged 25-64 years in 2004 (n = 1236) and 2013 (n = 1240). Dietary patterns were assessed by principal component analysis (PCA). Educational level and income were used as SES indicators. Data from both surveys were combined as no interaction was found between SES and year. RESULTS Three dietary patterns were identified: "snacks and drinks", "fruit and vegetables" and "fish and rice". No significant associations were found between SES and the "snacks and drinks" pattern. Low vs. high SES individuals had lower adherence to the "fruit and vegetables" pattern [prevalence ratio (95% CI) 0.71 (0.60-0.83)] but a higher adherence to the traditional "fish and rice" pattern [1.58 (1.32-1.88)]. Income modified the association between education and the "fish and rice" pattern (p = 0.02), whereby low income individuals had a higher adherence to this pattern in both educational groups. CONCLUSION Low SES individuals have a lower consumption of fruit and vegetables, but a higher consumption of traditional foods like fish and rice. The Seychelles may be at a degenerative diseases stage of the nutrition transition.
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Affiliation(s)
- Ana-Lucia Mayén
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - Pascal Bovet
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
- * E-mail:
| | - Helena Marti-Soler
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | | | - Jude Gedeon
- Ministry of Health, Victoria, Republic of Seychelles
| | - Fred Paccaud
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Silvia Stringhini
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
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36
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Review of the importance of nutrition during the first 1000 days: maternal nutritional status and its associations with fetal growth and birth, neonatal and infant outcomes among African women. J Dev Orig Health Dis 2015; 7:144-62. [PMID: 26279311 DOI: 10.1017/s2040174415001439] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Maternal nutritional status (MNS) is a strong predictor of growth and development in the first 1000 days of life and may influence susceptibility to non-communicable diseases in adulthood. However, the role of nutrition during this window of developmental plasticity in Africa is unclear. This paper reviews published data to address whether maternal nutrition during the first 1000 days is important for Africa, with a focus on MNS and its associations with fetal growth and birth, neonatal and infant outcomes. A systematic approach was used to search the following databases: Medline, EMBASE, Web of Science, Google Scholar, ScienceDirect, SciSearch and Cochrane Library. In all, 26 studies met the inclusion criteria for the specific objectives. MNS in Africa showed features typical of the epidemiological transition: higher prevalences of maternal overweight and obesity and lower underweight, poor diet quality 1 and high anaemia prevalence. Maternal body mass index and greater gestational weight gain (GWG) were positively associated with birth weight; however, maternal overweight and obesity were associated with increased risk of macrosomia and intrauterine growth restriction. Maternal anaemia was associated with lower birth weight. Macro- and micronutrient supplementation during pregnancy were associated with improvements in GWG, birth weight and mortality risk. Data suggest poor MNS in Africa and confirms the importance of the first 1000 days as a critical period for nutritional intervention to improve growth, birth outcomes and potential future health risk. However, there is a lack of data beyond birth and a need for longitudinal data through infancy to 2 years of age.
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