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Okekunle AP, Asowata OJ, Akpa OM, Fakunle AG, Chikowore T, Mohamed SF, Obiako R, Komolafe M, Osaigbovo GO, Ogbole G, Arulogun O, Sarfo FS, Wahab K, Owolabi L, Akinyemi J, Akpalu A, Uvere E, Akinyemi R, Jenkins C, Arnett DK, Lackland D, Ovbiagele B, Ramsay M, Owolabi M. Factors associated with frequency of fruit and vegetable consumption among selected sub-Saharan African populations: evidence from the Cardiovascular H3Africa Innovation Resource Project. Int J Epidemiol 2024; 53:dyad171. [PMID: 38199785 PMCID: PMC10859155 DOI: 10.1093/ije/dyad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Frequent fruit and vegetable consumption is considered a promising dietary behaviour that protects health. However, most existing studies about the factors associated with this phenomenon among Africans are based on single-country reports, apart from one meta-regression combining smaller studies. This study harmonized large datasets and assessed factors associated with the frequency of fruit and vegetable consumption in this population. METHODS Individual-level data on sociodemographics, lifestyle and diet from 20 443 participants across five African countries (Burkina Faso, Ghana, Kenya, South Africa and Nigeria), from the Stroke Investigative Research and Educational Network (SIREN) and Africa Wits-INDEPTH partnership for Genomic Research (AWI-Gen) studies, were harmonized. Total frequency of fruit and vegetable consumption (in portions/week) was classified as 'low' (≤6), 'moderate' (7-14) and 'high' (≥15). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of factors associated with the total frequency of fruit and vegetable consumption (using 'low' consumption as the reference) were estimated using multinomial regression models. RESULTS Mean age of participants was 54.3 ± 11.8 years, 10 641 (52.1%) were female, and the median (interquartile range) frequency of total fruit and vegetable consumption was 10.0 (4.0, 21.0) portions/week. Participants with a family history of cardiovascular disease [moderate (aOR, 0.92; 95% CI, 0.85, 1.00) and high (aOR, 0.85; 95% CI, 0.78, 0.92)], current smokers [moderate (aOR, 0.83; 95% CI, 0.74, 0.94) and high (aOR, 0.78; 95% CI, 0.69, 0.88)], current alcohol users [moderate (aOR, 0.92; 95% CI, 0.85, 1.00) and high (aOR, 0.82; 95% CI, 0.76, 0.89)] and physically inactive participants [moderate (aOR, 0.85; 95% CI, 0.75, 0.96) and high (aOR, 0.80; 95% CI, 0.70, 0.90)] were less likely to consume fruits and vegetables frequently. CONCLUSION Africans with lifestyle risk factors for cardiovascular disease were less likely to consume fruit and vegetables frequently.
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Affiliation(s)
- Akinkunmi Paul Okekunle
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
| | - Osahon Jeffery Asowata
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Adekunle Gregory Fakunle
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Public Health, College of Health Sciences, Osun State University, Osogbo, Nigeria
| | - Tinashe Chikowore
- 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, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shukri F Mohamed
- Health and Well-Being Program, African Population and Health Research Center, Nairobi, Kenya
| | - Reginald Obiako
- Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Morenikeji Komolafe
- Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Godwin Ogbole
- Department of Radiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oyedunni Arulogun
- Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Fred Stephen Sarfo
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kolawole Wahab
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Lukman Owolabi
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Joshua Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Albert Akpalu
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | - Ezinne Uvere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rufus Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training College of Medicine, University of Ibadan, Ibadan, Nigeria
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Carolyn Jenkins
- Department of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Donna K Arnett
- Office of the Provost, University of South Carolina, Charleston, SC, USA
| | - Daniel Lackland
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Bruce Ovbiagele
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular, Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Mayowa Owolabi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- School of Medicine, Lebanese American University, Beirut, Lebanon
- Department of Medicine, University College Hospital, Ibadan, Nigeria
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Kaur S. Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review. Nutr Res Rev 2023; 36:420-447. [PMID: 36004512 DOI: 10.1017/s0954422422000166] [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] [Indexed: 11/06/2022]
Abstract
This review provides an overview of the barriers to the consumption of fruits and vegetables (FVs) as well as strategies to improve the intake of FVs in low- and middle-income countries (LMICs). The importance of the consumption of FVs and its role in disease prevention are discussed briefly. Trends in the consumption of FVs in LMICs are also summarised. The WHO recommends that every individual should consume at least five servings or 400 grams of FVs per day. Epidemiological and clinical investigations have demonstrated that FVs contain numerous bioactive compounds with health-protecting activities. Despite their health benefits, the intake of FVs in LMICs remains low. Major barriers identified were socio-demographic factors, environmental conditions, individual and cultural factors, and macrosystem influences. These barriers may be lowered at the household, school, community, and national level through multi-component interventions including behaviour change communication (BCC) initiatives, nutrition education (NE), gardening initiatives, farm to institution programs (FIPs), food baskets, cash transfers, nutrition-agriculture policy and program linkages, and food-market environment-based strategies. This review has research implications due to the positive outcomes of strategies that lower such barriers and boost consumption of FVs in LMICs.
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Affiliation(s)
- Sukhdeep Kaur
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana, Punjab141004, India
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Zhang G, Kang J, Jing S, Chen Y, Deng T, Xu H, Wu H, Xu F. Meat, vegetable, and fruit consumption among urban and rural elders aged 60+ years in regional China: a population-level nutritional study. J Nutr Sci 2023; 12:e120. [PMID: 38155810 PMCID: PMC10753460 DOI: 10.1017/jns.2023.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 12/30/2023] Open
Abstract
The aim was to assess epidemiological characteristics of the most recent consumption patterns of meat, vegetable, and fruit among representative urban and rural residents aged 60+ years in regional China. In this cross-sectional survey conducted in mid-2018, participants aged 60+ years were randomly chosen from urban and rural communities in Nanjing municipality of China. Meat, vegetable, and fruit intake were assessed with a validated food frequency questionnaire. Multivariate logistic regression models were applied to compute odds ratio (OR) and 95 % confidence interval (CI) to investigate the association of socio-demographic characteristics with a likelihood of meeting intake recommendation. Among the 20 867 participants, 49⋅5 % were men and 45⋅0 % urban elders, and 6⋅5 % aged 80+ years. The mean values of consumption frequency of red meat, white meat, vegetable, and fruit were 2⋅99 ± 2⋅28, 1⋅37 ± 1⋅13, 5⋅24 ± 6⋅43, and 2⋅64 ± 2⋅91 times/week, respectively, among overall participants. Moreover, there were 14⋅9, 23⋅7, and 12⋅1 % of participants meeting intake recommendations of meat, vegetable, and fruit, separately, in this study. After adjustment for potential confounders, age, gender, residence area, and educational attainment each was associated with the likelihood of meeting intake recommendation of meat, vegetable, or fruit. The consumption frequency and proportion of participants meeting intake recommendations of meat, vegetable, or fruit were not high among elders in regional China. Socio-demographic characteristics were associated with intake recommendations of meat, vegetables, and fruit. It has public health implications that participants' socio-demographic attributes shall be considered for precision intervention on meat, vegetable, and fruit consumption in healthy eating campaigns among elders in China.
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Affiliation(s)
- Guilin Zhang
- Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Jian Kang
- The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Shibao Jing
- Nanjing Liuhe District Center for Disease Control and Prevention, Nanjing, China
| | - Yinhao Chen
- Wenzhou Center for Disease Control and Prevention, Wenzhou, China
| | - Tianrui Deng
- Nanjing Medical University School of Public Health, Nanjing, China
| | - Huiqing Xu
- Nanjing Medical University School of Public Health, Nanjing, China
| | - Haidi Wu
- Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention Affiliated to Nanjing Medical University, Nanjing, China
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Bhatia M, Dixit P, Kumar M, Dwivedi LK. A longitudinal study of incident hypertension and its determinants in Indian adults aged 45 years and older: evidence from nationally representative WHO-SAGE study (2007-2015). Front Cardiovasc Med 2023; 10:1265371. [PMID: 38034379 PMCID: PMC10682706 DOI: 10.3389/fcvm.2023.1265371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives Hypertension (HT) is a leading cause of mortality and morbidity in developing countries. This study aimed to estimate the incidence of HT among adults aged 45 years and older in India and its associated risk factors. Methods This study used longitudinal data from the Indian sample of the first and second waves of the World Health Organization Study on Global Ageing and Adult Health (WHO-SAGE). A bivariate analysis using Pearson's chi-square test was done to examine the associations of individual, lifestyle, and household characteristics with HT status reported in Wave 2. Incident HT changes were analyzed by adjusting for various covariates in the generalized estimating equation (logit link function) with an exchangeable correlation matrix and robust standard errors. Results The study found that during the 8-year period from 2007 to 2015, the incidence of HT in individuals aged 45 years and over was 20.8%. Pre-hypertensive individuals had an overall incidence rate of 31.1 per 1,000 [95% confidence interval (CI): 26.20-35.9] and a 2.24 times higher odds ratio: 2.24 (95% CI: 1.65-3.03) of developing incident HT compared to those who were normotensive. Adults aged 45 years and older, overweight/obese individuals, and women were more at risk of incident HT. Conclusion One in five individuals had developed HT over 8 years, with a greater risk of incident HT among women than men. Pre-hypertensive individuals were at a greater risk of developing incident HT compared to normotensive individuals. The study recommends comprehensive and effective management of pre-HT to tackle the burden of HT.
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Affiliation(s)
- Mrigesh Bhatia
- Department of Health Policy, London School of Economics, London, United Kingdom
| | - Priyanka Dixit
- Centre for Health and Social Sociences, Tata Institute of Social Sciences, Mumbai, India
| | | | - Laxmi Kant Dwivedi
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
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Bolbinski P, Nascimento-Souza MA, Lima-Costa MF, Peixoto SV. Consumption of fruits and vegetables among older adults: findings from the ELSI-Brazil study. CAD SAUDE PUBLICA 2023; 39:e00158122. [PMID: 37466546 PMCID: PMC10494691 DOI: 10.1590/0102-311xen158122] [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: 09/02/2022] [Revised: 03/28/2023] [Accepted: 04/10/2023] [Indexed: 07/20/2023] Open
Abstract
This study aimed to assess the prevalence of recommended consumption of fruits and vegetables and their associated factors in a national sample representative of the Brazilian population aged 60 or over. Baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted from 2015 to 2016, including 4,982 older individuals, were used. The recommended consumption of fruits and vegetables was assessed based on questions on the weekly and daily frequency of fruits, natural fruit juice, and vegetables. Intake of five or more servings of these foods on five or more days per week was considered as recommended consumption. Exploratory variables included socio-demographic characteristics, health behaviors, health conditions, and use of health services. Univariate and multiple logistic regression were used to examine the factors associated with the recommended consumption of fruits and vegetables. The prevalence of recommended consumption of fruits and vegetables was 12.9% (95%CI: 11.5-14.3). This consumption showed associations with gender (women - OR = 1.40; 95%CI: 1.08-1.82), age group (80 years or older - OR = 1.66; 95%CI: 1.16-2.37), education level (8 years or more - OR = 2.07; 95%CI: 1.51-2.86), smoking (former smokers - OR = 0.69; 95%CI: 0.55-0.85 and current smokers - OR = 0.50; 95%CI: 0.33-0.77) and medical appointments in the previous 12 months (OR = 1.88; 95%CI: 1.31-2.71). Our findings showed a low prevalence of the recommended consumption of fruits and vegetables among older Brazilian adults, drawing attention to the need for policies aimed at increasing this consumption in the studied population.
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Affiliation(s)
- Paula Bolbinski
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
| | | | - Maria Fernanda Lima-Costa
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
- Programa de Pós-graduação em Saúde Púbica, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Sérgio Viana Peixoto
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Estimating the burden of disease attributable to a diet low in fruit and vegetables in South Africa for 2000, 2006 and 2012. S Afr Med J 2022; 112:617-626. [DOI: 10.7196/samj.2022.v112i8b.16486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Indexed: 11/08/2022] Open
Abstract
Background. Low intake of fruit and vegetables is associated with an increased risk of various non-communicable diseases, including major causes of death and disability such as cardiovascular disease, diabetes mellitus and cancers. Diets low in fruit and vegetables are prevalent in the South African (SA) population, and average intake is well below the internationally recommended threshold.
Objectives. To estimate the burden of disease attributable to a diet low in fruit and vegetables by sex and age group in SA for the years 2000, 2006 and 2012.
Methods. We followed World Health Organization and Global Burden of Disease Study comparative risk assessment methodology. Population attributable fractions – calculated from fruit and vegetable intake estimated from national and local surveys and relative risks for health outcomes based on the current literature – were applied to the burden estimates from the second South African National Burden of Disease Study (SANBD2). Outcome measures included deaths and disability-adjusted life years (DALYs) lost from ischaemic heart disease, stroke, type 2 diabetes, and five categories of cancers.
Results. Between 2000 and 2012, the average intake of fruit of the SA adult population (≥25 years) declined by 7%, from 48.5 g/d (95% uncertainty interval (UI) 46.6 - 50.5) to 45.2 g/d (95% UI 42.7 - 47.6). Vegetable intake declined by 25%, from 146.9 g/d (95% UI 142.3 - 151.8) to 110.5 g/d (95% UI 105.9 - 115.0). In 2012, these consumption patterns are estimated to have caused 26 423 deaths (95% UI 24 368 - 28 006), amounting to 5.0% (95% UI 4.6 - 5.3%) of all deaths in SA, and the loss of 514 823 (95% UI 473 508 - 544 803) healthy life years or 2.5% (95% UI 2.3 - 2.6%) of all DALYs. Cardiovascular disease comprised the largest proportion of the attributable burden, with 83% of deaths and 84% of DALYs. Age-standardised death rates were higher for males (145.1 deaths per 100 000; 95% UI 127.9 - 156.2) than for females (108.0 deaths per 100 000; 95% UI 96.2 - 118.1); in both sexes, rates were lower than those observed in 2000 (–9% and –12%, respectively).
Conclusion. Despite the overall reduction in standardised death rates observed since 2000, the absolute burden of disease attributable to inadequate intake of fruit and vegetables in SA remains of significant concern. Effective interventions supported by legislation and policy are needed to reverse the declining trends in consumption observed in most age categories and to curb the associated burden.
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Negash WD, Tsehay CT, Yazachew L, Asmamaw DB, Desta DZ, Atnafu A. Health system responsiveness and associated factors among outpatients in primary health care facilities in Ethiopia. BMC Health Serv Res 2022; 22:249. [PMID: 35209882 PMCID: PMC8867670 DOI: 10.1186/s12913-022-07651-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background Health system responsiveness is defined as the outcome of designing health facility relationships so that they are familiar and responsive to patients’ universally legitimate expectations. Even though different strategies have been implemented to measure responsiveness, only limited evidence exists in Sub-Saharan Africa. In Ethiopia, information about health system responsiveness among outpatients is limited. Assessing responsiveness could help facilities in improving service delivery based on patient expectations. Objective The study aimed to assess health system responsiveness and associated factors among outpatients in primary health care facilities, Asagirt District, Ethiopia, 2021. Methods Facility-based cross-sectional quantitative study was implemented between March 30 and April 30/2021. A systematic random sampling technique was employed to select 423 participants, and interviewer-administered data were collected using structured and pretested questionnaires. Both bivariable and multivariable logistic regressions were employed to identify factors associated with health system responsiveness. Adjusted Odds Ratio with their corresponding 95% CI was used to declare factors associated with health system responsiveness. A p-value less than 0.05 was used to declare significant statistical variables. Results The overall health system responsiveness performance was 66.2% (95% CI: 61.4—70.7). Confidentiality and dignity were the highest responsive domains. Health system responsiveness was higher among satisfied patients (AOR: 9.9, 95% CI: 5.11–19.46), utilized private clinics (AOR: 8.8, 95% CI: 4.32–18.25), and no transport payment (AOR: 1.7, 95% CI: 1.03–2.92) in the study setting. Conclusion Overall, health system responsiveness performance was higher than a case-specific study in Ethiopia. To improve the health systems responsiveness and potentially fulfil patients’ legitimate expectations, we need to facilitate informed treatment choice, provide reasonable care within a reasonable time frame, and give patients the option of consulting a specialist. Aside from that, enhancing patient satisfaction, using input from service users, Collaboration, and exchanging experiences between public and private facilities will be important interventions to improve HSR performance.
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Affiliation(s)
- Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
| | - Chalie Tadie Tsehay
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Lake Yazachew
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Dawit Zenamarkos Desta
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Napier C, Grobbelaar H, Oldewage-Theron W. An introduction to the Food-Based Dietary Guidelines for the Elderly in South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2021. [DOI: 10.1080/16070658.2021.1950376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Carin Napier
- Department of Food & Nutrition Consumer Sciences, Durban University of Technology, Durban, South Africa
- Centre for Longitudinal Research, The University of Auckland, Auckland, New Zealand
| | - Heleen Grobbelaar
- Department of Food & Nutrition Consumer Sciences, Durban University of Technology, Durban, South Africa
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
- Department of Sustainable Food Systems and Development, University of the Free State, Bloemfontein, South Africa
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Saha S, Mukherjee U, Miller M, Peng LL, Napier C, Grobbelaar H, Oldewage-Theron W. Food and beverages promoting elderly health: six food-based dietary guidelines to plan good mixed meals for elderly South Africans. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2021. [DOI: 10.1080/16070658.2021.1956232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sanjoy Saha
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Upasana Mukherjee
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Makenzie Miller
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Li-Ling Peng
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Carin Napier
- Department of Food & Nutrition Consumer Sciences, Durban University of Technology, Durban, South Africa
- Centre for Longitudinal Research, The University of Auckland, Auckland, New Zealand
| | - Heleen Grobbelaar
- Department of Food & Nutrition Consumer Sciences, Durban University of Technology, Durban, South Africa
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
- Department of Sustainable Food Systems and Development, University of the Free State, Bloemfontein, South Africa
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Farm Production Diversification and Dietary Diversity among Subsistence Farming Households: Panel Data Evidence from South Africa. SUSTAINABILITY 2021. [DOI: 10.3390/su131810325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Improving the production of a variety of foods by subsistence farmers has been identified as a key strategy for improving dietary diversity. However, there is limited evidence in South Africa on how one’s own production is linked to dietary diversity. This study relies on nationally representative panel data to investigate the extent to which farm production diversity is correlated with dietary diversity. The data indicated a moderate level of household dietary diversity that has been on a declining trend between 2008 and 2017. The farm households produced three food groups (meat, cereals, and vegetables), suggesting more reliance on food purchases than own production. The study found a positive relationship between own production diversification and dietary diversity and that dietary diversity varied by demographics and socio-economic characteristics of households. However, production diversity was not significantly associated with the consumption of micronutrient-rich foods such as fruits or vegetables. Higher levels of education, income per capita, food expenditure, and geographic location were some of the key drivers of dietary diversity among subsistence households. The findings suggest that encouraging subsistence farming households to produce various crop and animal species can be an effective strategy to improve dietary diversity among poor households in South Africa.
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Bokaba M, Modjadji P, Mokwena KE. Undiagnosed Hypertension in a Workplace: The Case of a Logistics Company in Gauteng, South Africa. Healthcare (Basel) 2021; 9:healthcare9080964. [PMID: 34442101 PMCID: PMC8394589 DOI: 10.3390/healthcare9080964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/16/2021] [Indexed: 11/21/2022] Open
Abstract
A large proportion of the population with hypertension remains undiagnosed, untreated, or inadequately treated, contributing to the rising burden of cardiovascular diseases in South Africa. A workplace may either mitigate or accentuate the risk factors for hypertension. A cross sectional study was conducted to determine the prevalence of undiagnosed hypertension and associated factors among 312 employees in a Logistics Company, South Africa. A modified, validated, self-administered WHO STEPwise questionnaire was used to collect data on demography, lifestyle factors, anthropometry and blood pressure (BP). Hypertension was defined at BP ≥ 140/90 mmHg. Data was analysed using STATA 14. Mean age of employees was 40 ± 10 years, with a 50% prevalence of undiagnosed hypertension. No significant association was observed between occupation and undiagnosed hypertension, except for high prevalence of undiagnosed hypertension among truck drivers and van assistants (43%), and general workers (27%), having higher odds of increased waist-to-height ratio. Hypertension was associated with age (OR = 2.3, 95%CI; 1.21–4.27), alcohol use (AOR = 1.8, 95%CI; 1.05–2.93), waist circumference (AOR = 2.3, 95%CI; 1.29–4.07) and waist-to-height-ratio (AOR = 3.7, 95%CI; 1.85–7.30). Improved and effective workplace health programs and policies are necessary for management of undiagnosed hypertension among employees. Longitudinal studies on mediation of occupation in association of demographic and lifestyle factors with hypertension in workplaces are needed.
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Odunitan-Wayas FA, Faber M, Mendham AE, Goedecke JH, Micklesfield LK, Brooks NE, Christensen DL, Gallagher IJ, Myburgh KH, Hunter AM, Lambert EV. Food Security, Dietary Intake, and Foodways of Urban Low-Income Older South African Women: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3973. [PMID: 33918829 PMCID: PMC8069086 DOI: 10.3390/ijerph18083973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/20/2022]
Abstract
This cross-sectional study explored the differences in sociodemographics, dietary intake, and household foodways (cultural, socioeconomic practices that affect food purchase, consumption, and preferences) of food secure and food insecure older women living in a low-income urban setting in South Africa. Women (n = 122) aged 60-85 years old were recruited, a sociodemographic questionnaire was completed, and food security categories were determined. The categories were dichotomised into food secure (food secure and mild food insecurity) and food insecure (moderate and severe). A one-week quantified food frequency questionnaire was administered. Height and weight were measured to calculate body mass index (BMI, kg/m2). Most participants (>90%) were overweight/obese, unmarried/widowed, and breadwinners with a low monthly household income. Food insecure participants (36.9%) more frequently borrowed money for food (57.8% vs. 39.0%, p = 0.04), ate less so that their children could have more to eat (64.4%. vs. 27.3%, p = 0.001), and had higher housing density (1.2 vs. 1.0, p = 0.03), compared to their food-secure counterparts. Overall, <30% of participants met the WHO (Geneva, Switzerland) recommended daily servings of healthy foods (fruits, vegetables, and dairy products), but >60% perceived that they consumed an adequate amount of healthy foods. The overall low-quality diet of our cohort was associated with poor nutritional perceptions and choices, coupled with financial constraints.
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Affiliation(s)
- Feyisayo A Odunitan-Wayas
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (A.E.M.); (J.H.G.); (L.K.M.); (E.V.L.)
| | - Mieke Faber
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa;
| | - Amy E Mendham
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (A.E.M.); (J.H.G.); (L.K.M.); (E.V.L.)
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Julia H Goedecke
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (A.E.M.); (J.H.G.); (L.K.M.); (E.V.L.)
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa;
| | - Lisa K Micklesfield
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (A.E.M.); (J.H.G.); (L.K.M.); (E.V.L.)
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Naomi E Brooks
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK; (N.E.B.); (I.J.G.); (A.M.H.)
| | - Dirk L Christensen
- Section of Global Health, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark;
| | - Iain J Gallagher
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK; (N.E.B.); (I.J.G.); (A.M.H.)
| | - Kathryn H Myburgh
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch 7600, South Africa;
| | - Angus M Hunter
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK; (N.E.B.); (I.J.G.); (A.M.H.)
| | - Estelle V Lambert
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (A.E.M.); (J.H.G.); (L.K.M.); (E.V.L.)
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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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Tachi K, Tetteh J, Yawson AE, Agyei-Nkansah A, Archampong T. Alcohol consumption and fruits and vegetable intake among older adults in Ghana: a cross-sectional survey based on WHO-SAGE Wave 2 data. BMJ Nutr Prev Health 2020; 3:220-228. [PMID: 33521532 PMCID: PMC7841822 DOI: 10.1136/bmjnph-2020-000102] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Alcohol consumption and inadequate fruits and vegetable (FnV) intake are major reasons for the shift from communicable to non-communicable diseases (NCDs) over the years. The older Ghanaian adult is at high risk of NCD and data on alcohol and FnV consumption are required to guide policy to mitigate its effect. This analysis aimed to determine the factors associated with alcohol consumption and assess the relationship between alcohol consumption and FnV intake among Ghanaians aged 50 years and older. METHODS This analysis used WHO Study on Global Ageing and Adult Health (SAGE) Wave 2, Ghana data set conducted between 2014 and 2015. Data on demographic characteristics, FnV intake, and alcohol consumption were collated and analysed. Multivariable Poisson, logistic and probit regression analyses were performed to assess the associations between alcohol consumption and inadequate FnV intake. RESULTS A total of 3533 Ghanaians aged 50 years and older, 41.0% men and 59.0% women, were included in this study. The prevalence of lifetime alcohol consumption was 22.8% (95% CI 20.7% to 25.1%). Alcohol consumption was significantly associated with sex, age group, marital status, religion, place of residence and history of smoking. The prevalence of adequate FnV intake was 52.6% with a mean daily intake of 6.45 servings: 2.98 for fruits and 3.47 for vegetables. There was a significant positive correlation between inadequate FnV intake and alcohol consumption. Inadequate FnV consumption was significantly higher among lifetime alcohol consumers compared with non-alcohol consumers. (Poisson estimate; adjusted Prevalence Ratio (aPR) (95% CI)=1.35 (1.12 to 1.63), logistic estimate; adjusted Old Ratio (aOR) (95% CI)=1.13 (1.05 to 1.21) and probit estimate; adjusted normalized coefficient (aβ) (95% CI)=0.19 (0.07 to 0.31)). CONCLUSION About a quarter and nearly half of older Ghanaian adults consume alcohol and inadequate FnV, respectively. Alcohol consumption is significantly associated with inadequate FnV intake. Interventions to address inadequate FnV intake among older adults in Ghana should also include policies that regulate the use of alcohol in this population.
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Affiliation(s)
- Kenneth Tachi
- Department of Medicine and Therapeutics, College of Health Sciences, University of Ghana Medical School, Korle Bu, Greater Accra, Ghana
| | - John Tetteh
- Department of Community Health, College of Health Sciences, University of Ghana Medical School, Korle Bu, Greater Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, College of Health Sciences, University of Ghana Medical School, Korle Bu, Greater Accra, Ghana
| | - Adwoa Agyei-Nkansah
- Department of Medicine and Therapeutics, College of Health Sciences, University of Ghana Medical School, Korle Bu, Greater Accra, Ghana
| | - Timothy Archampong
- Department of Medicine and Therapeutics, College of Health Sciences, University of Ghana Medical School, Korle Bu, Greater Accra, Ghana
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Sinyolo S, Ndinda C, Murendo C, Sinyolo SA, Neluheni M. Access to Information Technologies and Consumption of Fruits and Vegetables in South Africa: Evidence from Nationally Representative Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134880. [PMID: 32645827 PMCID: PMC7370009 DOI: 10.3390/ijerph17134880] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/16/2020] [Accepted: 06/23/2020] [Indexed: 02/07/2023]
Abstract
Extensive evidence indicates that fruit and vegetable (F+V) consumption leads to reduced chances of diet related non-communicable diseases (NCDs). However, the F+V consumption levels remain low. This paper investigates the extent to which access to information technologies improves F+V consumption in South Africa. A nationally representative sample of 20,908 households was analysed using the Poisson and logit regression models. The study results indicated that most households do not consume sufficient F+V per day. Only 26% of the household heads consumed F+V at least five times a day. Access to mobile phones, radio, television, and internet was associated with increasing frequency of F+V consumption, and higher chances that a household would consume the minimum recommended levels. The association between the communication technologies and F+V consumption varied. Television access had the highest association with both foods, while internet was only significantly associated with vegetable consumption. Several demographic and socio-economic factors played a key role in shaping F+V consumption patterns. The results show that there is scope to disseminate nutrition awareness and education programs, through mobile phones, internet, radio and television in South Africa. The interventions to promote F+V consumption should be tailored according to the different socio-economic profiles of the population.
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Affiliation(s)
- Sikhulumile Sinyolo
- Human Sciences Research Council, 134 Pretorius Street, Pretoria 0001, South Africa; (C.N.); (M.N.)
- Correspondence:
| | - Catherine Ndinda
- Human Sciences Research Council, 134 Pretorius Street, Pretoria 0001, South Africa; (C.N.); (M.N.)
| | - Conrad Murendo
- International Crops Research Institute for the Semi-Arid Tropics, Box 776, Bulawayo 263, Zimbabwe;
- Link Development Analytics, 70079 Zengeza 4, Chitungwiza 263, Zimbabwe
| | - Sithembile A. Sinyolo
- Agriculture Sector Education and Training Authority, 529 Belvedere Street, Arcadia, Pretoria 0002, South Africa;
| | - Mudzunga Neluheni
- Human Sciences Research Council, 134 Pretorius Street, Pretoria 0001, South Africa; (C.N.); (M.N.)
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Mensah DO, Nunes AR, Bockarie T, Lillywhite R, Oyebode O. Meat, fruit, and vegetable consumption in sub-Saharan Africa: a systematic review and meta-regression analysis. Nutr Rev 2020; 79:651-692. [PMID: 32556305 DOI: 10.1093/nutrit/nuaa032] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
CONTEXT The dietary choices people make affect personal health and have consequences for the environment, both of which have serious implications for the 2030 Sustainable Development Agenda. In global reviews, the literature on meat, fruit, and vegetable consumption in sub-Saharan Africa (SSA) is limited. OBJECTIVE This systematic review set out to quantify meat, fruit, and vegetable consumption in SSA populations and to answer the following question: How much meat, fruit, and/or vegetables are being consumed daily by which individuals in SSA over the years? DATA SOURCES Following the PRISMA guidelines, the authors systematically searched the MEDLINE, EMBASE, ASSIA CINAHL, Web of Science, POPLINE, and Google Scholar databases to identify 47 (out of 5922 search results) studies reporting meat, fruit, and/or vegetable consumption in SSA populations. DATA EXTRACTION Three independent investigators extracted data on year of data collection, study country, study population and geographical context, and population intake of meat, fruit, and/or vegetables. DATA ANALYSIS Using STATA SE version 15 software, random-effects meta-regression analyses were used to test the effect of year of data collection and method of data collection on population meat, fruit, and vegetable consumption. The analyses also tested any association between age, sex, rural/urban residence, or a country's economic development and population intake of meat, fruits, and/or vegetables. The review was started in 2017 and completed in 2019. RESULTS Richer SSA countries were likely to consume more meat (ß = 36.76, P = 0.04) and vegetables (ß =43.49, P = 0.00) than poorer countries. Vegetable intake has increased dramatically over the last 3 decades from ≈10 g to ≈110 g (ß = 4.43, P = 0.00). Vegetable (ß= -25.48, P = 0.00) consumption was higher in rural than in urban residents. Although the trend of meat consumption has risen (≈25 g to ≈75 g), the trend is nonsignificant (ß = 0.63, N.S.). Daily average per capita meat consumption was 98 g - above the 70 g recommendation - while fruit and vegetable intake (268 g) remain below the World Health Organization's recommendation (400 g). CONCLUSIONS Given the low intake of plant-based foods, it is likely that SSA populations may be deficient in high-quality protein and micronutrients as suggested by the EAT-Lancet Commission. There is a need to promote both an adequate supply and demand of plant-based protein and micronutrients, including fruit, vegetables, nuts, seeds, and legumes, in SSA countries. While dietary changes in SSA may offer large absolute benefits, consideration of the magnitude of dietary change, particularly increasing or reducing meat consumption, will need to occur in a way that ensures that policy and interventions support the reduction of undernutrition and micronutrient deficiencies without worsening the prevalence and environmental impacts of noncommunicable diseases. There is also the need for preventive action that ensures that SSA populations do not increase their meat consumption as disposable incomes increase and countries' economic development rises, as is seen in most countries undergoing economic transformation. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42018090497.
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Affiliation(s)
- Daniel O Mensah
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Ana R Nunes
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Tahir Bockarie
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rob Lillywhite
- School of Life Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Oyinlola Oyebode
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Factors influencing dietary behaviours in urban food environments in Africa: a systematic mapping review. Public Health Nutr 2020; 23:2584-2601. [PMID: 32450938 PMCID: PMC7116038 DOI: 10.1017/s1368980019005305] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objective: To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research. Design: We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro. Setting: Urban food environments in Africa. Participants: Studies involving adolescents and adults (11–70 years, male/female). Results: Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women. Conclusions: The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.
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Sociodemographic differences affecting insufficient fruit and vegetable intake: a population-based household survey of Thai people. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-07-2019-0150] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThe sociodemographic determinants of insufficient fruit and vegetable (FV) consumption in the general population in Thailand remain understudied. The purpose of this study was to investigate the association between sociodemographic characteristics and insufficient FV consumption in Thailand.Design/methodology/approachThis nationally representative survey employed a cross-sectional multi-stage sampling design. A total of 6,991 individuals aged 15 years or older participated in the study. Information on participants' FV consumption and sociodemographic characteristics were collected via questionnaire. The data were analyzed using binary logistic regression.FindingsThe overall prevalence of insufficient FV consumption in the study sample was 65.6%. Age of the participants, sex, marital status, place of residence, occupation, income and education were found to be significantly associated with insufficient FV consumption among this sample of the Thai population.Originality/valueFindings suggest the need for promotion of FV consumption and intervention policies aimed at increasing FV intake by taking into account sociodemographic characteristics of the population.
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Amegbor PM, Braimah JA, Adjaye-Gbewonyo D, Rosenberg MW, Sabel CE. Effect of cognitive and structural social capital on depression among older adults in Ghana: A multilevel cross-sectional analysis. Arch Gerontol Geriatr 2020; 89:104045. [PMID: 32416461 DOI: 10.1016/j.archger.2020.104045] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 11/25/2022]
Abstract
Evidence from existing studies suggests social capital has mixed effects on depression and other common mental disorders. There is little knowledge of the possible association between social capital and depression among the growing older population in sub-Saharan Africa. This study investigates the effect of cognitive social capital (trust and sense of safety) and structural social capital (social participation or engagement in social activities) on depression among older adults in Ghana. Utilizing multilevel mixed-effect analysis, we investigate the effect of individual-level and neighborhood-level social capital (cognitive and structural) on depression using data from the World Health Organization Study on Global Ageing and Adult Health (WHO-SAGE) survey (Wave 1). The findings show that at an individual level, older adults who felt safe at home were less likely to have depression. We observed mixed results for elements of structural social capital at the individual level. Older adults who frequently engaged in club or group meetings, worked with neighbors and engaged in social outings were more likely to have depression; while attending public meetings and socializing with co-workers were associated with reduced likelihood of having depression. At the neighborhood level, increased trust in neighbors was associated with an increased likelihood of having depression (OR = 1.01, p < 0.05) while higher levels of neighborhood safety and structural social capital were associated with a reduced likelihood of having depression. The findings suggest that the differential associations between elements of social capital and depression may be the result of contextual factors.
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Affiliation(s)
- Prince M Amegbor
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark.
| | - Joseph A Braimah
- Department of Geography and Planning, Queen's University, Mackintosh-Corry Hall, Room E208, Kingston, Ontario, K7L 3N6, Canada
| | - Dzifa Adjaye-Gbewonyo
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark W Rosenberg
- Department of Geography and Planning, Queen's University, Mackintosh-Corry Hall, Room E208, Kingston, Ontario, K7L 3N6, Canada
| | - Clive E Sabel
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark
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Keetile M, Navaneetham K, Letamo G, Bainame K, Rakgoasi SD, Gabaitiri L, Masupe T, Molebatsi R. Socioeconomic and behavioural determinants of overweight/obesity among adults in Botswana: a cross-sectional study. BMJ Open 2019; 9:e029570. [PMID: 31818834 PMCID: PMC6924755 DOI: 10.1136/bmjopen-2019-029570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To undertake a comprehensive assessment of socioeconomic and behavioural determinants of overweight/obesity among adult population in Botswana. DESIGN The study adopted a cross-sectional design by selecting adult respondents in 3 cities and towns, 15 urban villages and 15 rural areas across Botswana using a multistage probability sampling technique. SETTING The study was conducted in selected rural and urban areas of Botswana. PARTICIPANTS The study sample consisted of 1178 adult males and females aged 15 years and above. PRIMARY OUTCOME MEASURES Objectively measured overweight/obesity. RESULTS Prevalence of overweight/obesity in the study population was estimated at 41%. The adjusted OR (AOR) of overweight/obesity were highest among women (AOR=2.74, 95% CI 1.92 to 3.90), in ages 55-64 years (AOR=5.53, 95% CI 2.62 to 11.6), among individuals with secondary (AOR=1.70, 95% CI 1.11 to 2.61) and tertiary education (AOR=1.99, 95% CI 1.16 to 3.38), smokers (AOR=2.16, 95% CI 1.22 to 3.83) and people with poor physically activity (AOR=1.46, 95% CI 1.03 to 3.24). These were statistically significant at 5% level. CONCLUSION Women, older adults, people with high education level, smokers and people who reported poor physical activity were found to have higher odds of being overweight/obesity. These findings suggest the need for broad based strategies encouraging physical activity among different socioeconomic groups.
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Affiliation(s)
- Mpho Keetile
- Department of Population Studies, University of Botswana, Gaborone, Botswana
| | - Kannan Navaneetham
- Department of Population Studies, University of Botswana, Gaborone, Botswana
| | - Gobopamang Letamo
- Department of Population Studies, University of Botswana, Gaborone, Botswana
| | - Kenabetsho Bainame
- Department of Population Studies, University of Botswana, Gaborone, Botswana
| | | | | | - Tiny Masupe
- Department of Family Medicine & Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
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Mokari_yamchi A, Sadeghian-Sharif S, Nattagh-Eshtivani E, Salehi-Sahlabadi A, Ghavami A, Barati M, Ebrahimi-Mameghani M. Socioeconomic Inequality in Fruit and Vegetable Consumptions in Elderly People: A Cross Sectional Study in North West of Iran. NUTRITION AND FOOD SCIENCES RESEARCH 2019. [DOI: 10.29252/nfsr.6.4.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Bosu WK, Aheto JMK, Zucchelli E, Reilly ST. Determinants of systemic hypertension in older adults in Africa: a systematic review. BMC Cardiovasc Disord 2019; 19:173. [PMID: 31331284 PMCID: PMC6647089 DOI: 10.1186/s12872-019-1147-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/04/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An estimated 55% of older adults in Africa have systemic hypertension, a major risk factor for stroke, heart failure and dementia in the region. The risk factors associated with hypertension in this population group in Africa have not been systematically evaluated. We, therefore, undertook a systematic review to identify these risk factors. METHODS We searched for population-based studies of adults aged ≥50 years living in Africa and reporting an estimate of hypertension and associated risk factors. We included articles published in any language between January 1980 and May 2018 using a comprehensive search strategy. We extracted data including the sample characteristics, prevalence of hypertension and risk factors with their effect sizes. RESULTS From an initial 10,719 records, we retained 63 eligible full text articles for review out of which we analyzed 23 studies made up of 19 primary and four multiple publications which had data on risk factors from bivariate or multivariable analysis. The primary studies, published from 2010 to 2018, involved a total of 30,500 participants in 12 different countries with mean ages ranging from 62.7 ± 9 years to 76.9 ± 8.4 years. Through narrative synthesis, we found consistent determinants of hypertension (overweight/obesity and history of stroke), less consistent but frequent determinants (including older age group, female sex and urban residence), inconsistent determinants (including education, wealth index, alcohol intake and physical activity) and nonsignificant covariates (marital status and having health insurance). Overall, the highest adjusted odds ratios were those associated with obesity and history of stroke. CONCLUSION The key determinants of systemic hypertension in older adults in Africa are older age group, overweight/obesity, history of stroke and female sex. Health programmes should promote weight reduction throughout the life course, including during the middle and older age of African adults.
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Affiliation(s)
- William Kofi Bosu
- Department of Public Health and Research, West African Health Organisation, Bobo-Dioulasso, 01 BP 153 Burkina Faso
- Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG UK
| | - Justice Moses Kwaku Aheto
- Department of Biostatistics, School of Public Health, University of Ghana, PO Box LG 13, Legon, Accra Ghana
| | - Eugenio Zucchelli
- Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG UK
- Madrid Institute for Advanced Study (MIAS), Universidad Autonoma de Madrid, C/ Einstein, 13 Pabellón C 1a planta, E-28049 Madrid, Spain
| | - Siobhan Theresa Reilly
- Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG UK
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Ahmed SH, Meyer HE, Kjøllesdal MK, Marjerrison N, Mdala I, Htet AS, Bjertness E, Madar AA. The prevalence of selected risk factors for non-communicable diseases in Hargeisa, Somaliland: a cross-sectional study. BMC Public Health 2019; 19:878. [PMID: 31272414 PMCID: PMC6611144 DOI: 10.1186/s12889-019-7101-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/03/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs), particularly cardiovascular diseases, diabetes, respiratory conditions and cancers, are the most common causes of morbidity and mortality globally. Information on the prevalence estimates of NCD risk factors such as smoking, low fruit & vegetable intake, physical inactivity, raised blood pressure, overweight, obesity and abnormal blood lipid are scarce in Somaliland. The aim of this study was to determine the prevalence of these selected risk factors for NCDs among 20-69 year old women and men in Hargeisa, Somaliland. METHODS A cross-sectional study was conducted in five districts of Hargeisa (Somaliland), using the STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) to collect data on demographic and behavioral characteristics and physical measurements (n = 1100). The STEPS approach is a standardized method for collecting, analysing and disseminating data on NCD risk factor burden. Fasting blood sugar, serum lipids (total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides) were collected in half of the participants. RESULTS The vast majority of participants had ≤1 serving of fruits daily (97.7%) and ≤ 1 serving of vegetables daily (98.2%). The proportion of participants with low physical activity levels was 78.4%. The overall prevalence of high salt intake was 18.5%. The prevalence of smoking and khat chewing among men was 27 and 37% respectively, and negligible among women. In women, the prevalence of hypertension increased from 15% in the age group 20-34 years to 67% in the age group 50-69 years, the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) from 51 to 73%, and the prevalence of diabetes from 3 to 22%. Similar age-trends were seen in men. CONCLUSION Most of the selected risk factors for noncommunicable diseases were high and increased by age in both women and men. Overweight and obesity and low physical activity needs intervention in women, while hypertension and low fruit and vegetable consumption needs intervention in both men and women. Somaliland health authorities should develop and/or strengthen health services that can help in treating persons with hypertension and hyperlipidaemia, and prevent a future burden of NCDs resulting from a high prevalence of NCD risk factors.
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Affiliation(s)
- Soheir H. Ahmed
- College of Medicine & Health Science, University of Hargeisa, Hargeisa, Somaliland
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Haakon E. Meyer
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Marte K. Kjøllesdal
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Niki Marjerrison
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Aung Soe Htet
- International Relations Division, Ministry of Health and Sports, Nay Pyi, Taw, 15011 Myanmar
| | - Espen Bjertness
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ahmed A. Madar
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Trends of mortality attributable to child and maternal undernutrition, overweight/obesity and dietary risk factors of non-communicable diseases in sub-Saharan Africa, 1990-2015: findings from the Global Burden of Disease Study 2015. Public Health Nutr 2018; 22:827-840. [PMID: 30509334 DOI: 10.1017/s1368980018002975] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess trends of mortality attributable to child and maternal undernutrition (CMU), overweight/obesity and dietary risks of non-communicable diseases (NCD) in sub-Saharan Africa (SSA) using data from the Global Burden of Disease (GBD) Study 2015. DESIGN For each risk factor, a systematic review of data was used to compute the exposure level and the effect size. A Bayesian hierarchical meta-regression analysis was used to estimate the exposure level of the risk factors by age, sex, geography and year. The burden of all-cause mortality attributable to CMU, fourteen dietary risk factors (eight diets, five nutrients and fibre intake) and overweight/obesity was estimated. SETTING Sub-Saharan Africa.ParticipantsAll age groups and both sexes. RESULTS In 2015, CMU, overweight/obesity and dietary risks of NCD accounted for 826204 (95 % uncertainty interval (UI) 737346, 923789), 266768 (95 % UI 189051, 353096) and 558578 (95 % UI 453433, 680197) deaths, respectively, representing 10·3 % (95 % UI 9·1, 11·6 %), 3·3 % (95 % UI 2·4, 4·4 %) and 7·0 % (95 % UI 5·8, 8·3 %) of all-cause mortality. While the age-standardized proportion of all-cause mortality accounted for by CMU decreased by 55·2 % between 1990 and 2015 in SSA, it increased by 63·3 and 17·2 % for overweight/obesity and dietary risks of NCD, respectively. CONCLUSIONS The increasing burden of diet- and obesity-related diseases and the reduction of mortality attributable to CMU indicate that SSA is undergoing a rapid nutritional transition. To tackle the impact in SSA, interventions and international development agendas should also target dietary risks associated with NCD and overweight/obesity.
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Adequate and excessive food consumption in Suriname: a multiethnic middle-income country. Int J Public Health 2018; 63:1059-1069. [PMID: 30076423 DOI: 10.1007/s00038-018-1148-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 06/30/2018] [Accepted: 07/19/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To explore food consumption among different sex, age, ethnic, urban, education and income groups in Suriname. METHODS Data from a cross-sectional population study (n = 5748; 15-64 year) were used. Food consumption was defined adequate if (1) fruit and vegetable intake was conformable to WHO recommendations, (2) mostly vegetable oil was used, and (3) whole-wheat products were used ≥ 3 days/week. Food consumption was defined excessive if 3 out of the following 5 items scored positive: consumption of (1) snack, (2) sweet, (3) fast food, or (4) soft drink ≥ 3 days/week, or (5) salt was always added while preparing a hot meal. RESULTS 6.4% (95% CI 5.8-7.1) had an adequate and 21.9% (95% CI 20.9-23.0) an excessive food consumption pattern, with differences among ethnic groups (p < 0.05). Adequate consumption increased, while excessive consumption decreased with increasing age (p < 0.05). Both adequate and excessive consumption increased with higher degree of urbanization, level of education and income (p < 0.05). Except for level of education for adequate consumption, all characteristics remained in both models with adequate and excessive consumption as outcome (p < 0.09). CONCLUSIONS Our study suggests interventions to promote adequate food consumption in general and to limit excessive food consumption mainly focused on youngsters and those living in urbanized areas of higher socioeconomic status.
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Phaswana-Mafuya N, Peltzer K. Racial or Ethnic Health Disparities among Older Adults in Four Population Groups in South Africa. Ann Glob Health 2018; 84:7-13. [PMID: 30873780 PMCID: PMC6748227 DOI: 10.29024/aogh.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Racial or ethnic health disparities have been evidently apparent during the apartheid era in South Africa. This study aims to assess ethnic health disparities in four elderly population groups. METHODS Data for this study emanated from the 2008 study of "Global AGEing and adult health (SAGE) wave 1" (N = 3284) aged 50 years or older in South Africa. Associations between exposure variables and outcome variables (health status variables and chronic conditions) were examined through bivariate analyses and multivariable logistic regression. RESULTS Indians or Asians reported the highest prevalence of poor self-rated health (23.7%) and functional disability (11.6% and 29.1%). Coloureds had the lowest grip strength (55.3%) and Whites the highest cognitive functioning (80.1%). Coloureds had the highest prevalence of hypertension (85.0%), stroke and/or angina (15.0%), edentulism (26.8%) and low vision (50.6%); and Indians or Asians had the highest prevalence of arthritis (43.5%) and diabetes (24.4%). In adjusted analysis, Whites (Odds Ratio [OR]: 0.24, Confidence Interval [CI]: 0.11, 0.57) and Coloureds (OR: 0.50, CI: 0.29, 0.87) had lower odds of self-reported health status compared to Black Africans. Coloureds (OR: 0.36, CI: 0.22, 0.61) had lower odds of grip strength than Black Africans. Indians or Asians had higher odds of functional disability (OR: 1.87, CI: 1.03, 3.02) and diabetes (OR: 2.65, CI: 1.45, 4.83) than Black Africans. Whites (OR: 3.92, CI: 1.63, 9.41) and Coloureds (OR: 2.14, CI: 1.21, 3.78) had higher odds of cognitive functioning than Black Africans. Whites had lower odds (OR: 0.54, CI: 0.31, 0.93) and Indians or Asians had higher odds (OR: 1.91, CI: 1.91, 1.01, 3.59) of arthritis than Black Africans. Coloureds had a higher prevalence of hypertension (OR: 1.71, CI: 1.14, 2.58), stroke and/or angina (OR: 1.74, CI = 1.36, 2.22), edentulism (OR: 6.51, CI: 4.07, 10.41) and low vision (OR: 1.68, CI: 1.29, 2.19) than Black Africans. CONCLUSION There are still ethnic health disparities in South Africa in the post-apartheid era (i.e., Black Africans [lower cognitive functioning], Whites [poor self-reported health status and edentulism], Coloureds [poor self-reported health status, lower grip strength, arthritis, hypertension, stroke and/or angina, edentulism and low vision], Indians or Asians [poor functional disability, arthritis and diabetes]). Understanding these ethnic health disparities may help in developing better strategies to improve health across population groups.
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Affiliation(s)
- Nancy Phaswana-Mafuya
- Office of Deputy Vice Chancellor, Research and Innovation, North West University, Potchestroom, ZA
- HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria 0001, ZA
| | - Karl Peltzer
- HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria 0001, ZA
- Department of Research and Innovation, University of Limpopo, Sovenga 0727, ZA
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Umuhoza SM, Ataguba JE. Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys. Int J Equity Health 2018; 17:52. [PMID: 29703215 PMCID: PMC5921793 DOI: 10.1186/s12939-018-0762-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/10/2018] [Indexed: 11/18/2022] Open
Abstract
Background Socioeconomic inequalities in health have been documented in many countries including those in the Southern African Development Community (SADC). However, a comprehensive assessment of health inequalities and inequalities in the distribution of health risk factors is scarce. This study specifically investigates inequalities both in poor self-assessed health (SAH) and in the distribution of selected risk factors of ill-health among the adult populations in six SADC countries. Methods Data come from the 2002/04 World Health Survey (WHS) using six SADC countries (Malawi, Mauritius, South Africa, Swaziland, Zambia and Zimbabwe) where the WHS was conducted. Poor SAH is reporting bad or very bad health status. Risk factors such as smoking, heavy drinking, low fruit and vegetable consumption and physical inactivity were considered. Other environmental factors were also considered. Socioeconomic status was assessed using household expenditures. Standardised and normalised concentration indices (CIs) were used to assess socioeconomic inequalities. A positive (negative) concentration index means a pro-rich (pro-poor) distribution where the variable is reported more among the rich (poor). Results Generally, a pro-poor socioeconomic inequality exists in poor SAH in the six countries. However, this is only significant for South Africa (CI = − 0.0573; p < 0.05), and marginally significant for Zambia (CI = − 0.0341; P < 0.1) and Zimbabwe (CI = − 0.0357; p < 0.1). Smoking and inadequate fruit and vegetable consumption were significantly concentrated among the poor. Similarly, the use of biomass energy, unimproved water and sanitation were significantly concentrated among the poor. However, inequalities in heavy drinking and physical inactivity are mixed. Overall, a positive relationship exists between inequalities in ill-health and inequalities in risk factors of ill-health. Conclusion There is a need for concerted efforts to tackle the significant socioeconomic inequalities in ill-health and health risk factors in the region. Because some of the determinants of ill-health lie outside the health sector, inter-sectoral action is required.
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Affiliation(s)
- Stella M Umuhoza
- Department of Health Policy, Economics and Management, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.,Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa
| | - John E Ataguba
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa.
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Pires AC, Fleck MP, Power M, da Rocha NS. Psychometric properties of the EUROHIS-QOL 8-item index (WHOQOL-8) in a Brazilian sample. ACTA ACUST UNITED AC 2018; 40:249-255. [PMID: 29590264 PMCID: PMC6899392 DOI: 10.1590/1516-4446-2017-2297] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 08/03/2017] [Indexed: 11/22/2022]
Abstract
Objective: To test the psychometric properties of the EUROHIS-QOL 8-item index in a Brazilian sample. Methods: The sample consisted of 151 patients and 174 healthy controls (n=325). Several psychometric properties were tested. Results: Reliability showed good internal consistency (Cronbach’s alpha = 0.81). The measure showed good discriminant validity between patients and healthy controls (mean1 = 3.32, SD1 = 0.70; mean2 = 3.77, SD2 = 0.63, t = 6.12, p < 0.001). Convergent validity showed significant correlations (p < 0.001) between the EUROHIS-QOL 8-item index and all domains of the WHOQOL-Bref (overall r = 0.47; general health r = 0.54; physical r = 0.69; psychological r = 0.62; social relationship r = 0.55; environment r = 0.55) and between the EUROHIS-QOL 8-item index and the domains of the SF-36, except for the social domain (p = 0.38). On Rasch analysis of unidimensionality, general fit measures showed adequate performance. The EUROHIS-QOL 8-item index also showed good fit on confirmatory factor analysis (CFA) (chi-square = 18.46, degrees of freedom [df] = 15; comparative fit index [CFI] = 0.99; root mean square error of approximation [RMSEA] = 0.03; goodness of fit index [gfi] = 0.99; root mean square residual [RMR] = 0.03; p = 24). Conclusion: The EUROHIS-QOL 8-item index showed good psychometric properties. It is a reliable quality of life measure that can be used in Brazilian populations.
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Affiliation(s)
- Ana Caroline Pires
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Marcelo P Fleck
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Mick Power
- National University of Singapore, Singapore
| | - Neusa S da Rocha
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Insufficient Fruit and Vegetable Intake in a Low- and Middle-Income Setting: A Population-Based Survey in Semi-Urban Tanzania. Nutrients 2018; 10:nu10020222. [PMID: 29462925 PMCID: PMC5852798 DOI: 10.3390/nu10020222] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 02/05/2018] [Accepted: 02/13/2018] [Indexed: 11/25/2022] Open
Abstract
A daily intake of 5 portions of fruit and vegetables (FV) is recommended for protection against non-communicable diseases (NCDs). Inadequate FV intake is a global problem but resource-poor countries like Tanzania are most deprived and constitute settings where little is known for informing public health interventions. This study aimed to describe the prevalence of inadequate FV intake, frequency of FV intake, portions of FV intake and their associations with socio-demographic/lifestyle factors in South-Eastern Tanzania. Data on FV dietary indicators, socio-demographic factors, smoking, alcohol and healthcare use were collected from 7953 participants (≥15 years) of the population-based MZIMA open community cohort (2012–2013). Multivariable logistic regression was used to examine associations between FV intake outcomes and their socio-demographic/lifestyle determinants. Most (82%) of the participants did not meet the recommended daily FV intake While only a fraction consumed fruits daily (15.5%), almost half consumed vegetables daily (44.2%). However, the median (IQR) number of vegetable portions consumed was lower (2(1)/person/day) than that for fruits (2(2)/person/day) People with higher education were more likely to consume fruits daily. Independent correlates of inadequate FV intake included young age, being male, low education, low-income occupations, low alcohol, high tobacco and low healthcare use. Public health interventions should target the socio-economically deprived and culturally-rooted preferences while prioritizing promotion of vegetable for most immediate gain in overall FV intake.
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Appiah D, Capistrant BD. Cardiovascular Disease Risk Assessment in the United States and Low- and Middle-Income Countries Using Predicted Heart/Vascular Age. Sci Rep 2017; 7:16673. [PMID: 29192146 PMCID: PMC5709399 DOI: 10.1038/s41598-017-16901-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/15/2017] [Indexed: 12/27/2022] Open
Abstract
Almost 80% of the global burden of cardiovascular disease (CVD) occurs in low- and middle-income countries (LMICs). However, LMICs do not have well-established, low-technology ways to quantify and communicate CVD risk at population or individual levels. We examined predicted heart/vascular age (PHA) in six LMICs and the United States. Data were from CVD-free adults in World Health Organization Study on Global Aging and Adult Health (n = 29094) and US National Health and Nutritional Examination Survey (n = 6726). PHA was calculated using the non-laboratory Framingham CVD risk equation. High excess PHA (HEPHA) was defined as the differences between PHA and chronological age >5 years. Logistic regression models were used to identify factors associated with HEPHA. Age-standardized prevalence of HEPHA was higher in Russia 52%; China 56%; Mexico 59%; and South Africa 65% compared to the US 45%, Ghana 36%; and India 38%. In LMICs, higher income, being divorced/widowed, alcohol intake and abdominal obesity had higher odds of HEPHA; higher education, fruit intake and physical activity had lower odds of HEPHA. The use of PHA may offer a useful avenue to communicate CVD risk. Interventions tailored at socioeconomic and cultural factors that influence CVD risk factors may be necessary to prevent CVD in LMICs.
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Affiliation(s)
- Duke Appiah
- Department of Public Health, Texas Tech University Health Sciences Center, Abilene, TX, USA.
| | - Beatrix D. Capistrant
- Statistical & Data Sciences, Smith College, Northampton, MA, USA
- Division of Epidemiology and Community Health, University of Minnesota Minneapolis, Minneapolis, MN, USA
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Abstract
The prevalence of metabolic syndrome is increasing in African populations, and is particularly high in Black South African women (42%) vs women in the United Kingdom (23%) and the United States of America (36%). This population group is also known to have the highest prevalence of obesity in the sub-Saharan African region (42%), and consequently, a high risk of non-communicable diseases. In this article, we discuss factors (abdominal subcutaneous fat, visceral fat, lean mass, adiponectin, leptin, vitamin D, smoking and menopausal status) that have been investigated for their possible association with metabolic syndrome in African women, and discuss some recommendations for management of the syndrome. In particular, the infrastructural development of HIV/AIDS clinics in South Africa provides an ideal integrated platform to cater to the treatment needs of patients with multiple chronic morbidities.
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Affiliation(s)
- Philippe Jean-Luc Gradidge
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa
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Mashinya F, Alberts M, Colebunders R, Van Geertruyden JP. Weight status and associated factors among HIV infected people on antiretroviral therapy in rural Dikgale, Limpopo, South Africa. Afr J Prim Health Care Fam Med 2016; 8:e1-e8. [PMID: 28155318 PMCID: PMC5153409 DOI: 10.4102/phcfm.v8i1.1230] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/12/2016] [Accepted: 09/08/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Underweight in human immunodeficiency virus (HIV)-infected people on antiretroviral therapy (ART) complicates the management of HIV infection and contributes to mortality, whereas overweight increases the risk of cardiovascular disease (CVD). AIM The study determined weight status and associated factors in people with HIV infection receiving ART. SETTING Rural primary health care clinics in Dikgale, Limpopo province, South Africa. METHODS A cross-sectional study in which data were collected using the World Health Organization (WHO) stepwise approach to surveillance (STEPS) questionnaire and calculated using WHO analysis programmes guide. Weight and height were measured using standard WHO procedures, and body mass index was calculated as weight (kg)/height (m2). Data on ART duration were extracted from patients' files. CD4 lymphocyte counts and viral load were determined using standard laboratory techniques. RESULTS Of the 214 participants, 8.9%, 54.7% and 36.4% were underweight, normal weight and overweight, respectively. Physical activity (OR: 0.99, p = 0.001) and male gender (OR: 0.29, p = 0.04) were negatively associated with overweight. Men who used tobacco were more likely to be underweight than non-tobacco users (OR: 10.87, p = 0.02). Neither ART duration nor viral load or CD4 count was independently associated with underweight or overweight in multivariate analysis. CONCLUSION A high proportion of people on ART were overweight and a smaller proportion underweight. There is a need to simultaneously address the two extreme weight problems in this vulnerable population through educating them on benefits of avoiding tobacco, engaging in physical activity and raising awareness of CVD risk.
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Affiliation(s)
- Felistas Mashinya
- Department of Pathology and Medical Science, Faculty of Health Sciences, University of Limpopo.
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SOCIO-DEMOGRAPHIC FACTORS ASSOCIATED WITH DIETARY BEHAVIOUR AMONG YOUNG GHANAIANS AGED 15–34 YEARS. J Biosoc Sci 2016; 49:187-205. [DOI: 10.1017/s0021932016000456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
SummaryThis study used data from the 2008 Ghana Demographic and Health Survey to investigate the association between selected socio-demographic factors and dietary behaviour as measured by fruit and vegetable consumption among a sample of 6139 young people aged 15–34 years in Ghana. Overall, fruit and vegetable consumption was low in young people, but females were likely to consume more fruit and vegetables than their male counterparts. Respondents from the Mande ethnic group, those who resided in rural areas and those living in the Brong/Ahafo, Ashanti and the Eastern regions consumed more fruit and vegetables than those from other regions. Females who were Catholic/Anglican, Methodist/Presbyterian and Pentecostal/Charismatic were more likely than those of other religions to consume fruit and vegetables, while Muslim males generally consumed more fruit and vegetables. The findings point to the need for interventions to educate young people in Ghana about the health benefits of eating fruit and vegetables.
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Vaccaro JA, Huffman FG. Dietary risk factors by race/ethnicity, age-group, and gender in a representative sample of us older adults. J Nutr Health Aging 2016. [DOI: 10.1007/s12603-016-0778-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Maimela E, Alberts M, Modjadji SEP, Choma SSR, Dikotope SA, Ntuli TS, Van Geertruyden JP. The Prevalence and Determinants of Chronic Non-Communicable Disease Risk Factors amongst Adults in the Dikgale Health Demographic and Surveillance System (HDSS) Site, Limpopo Province of South Africa. PLoS One 2016; 11:e0147926. [PMID: 26882033 PMCID: PMC4755539 DOI: 10.1371/journal.pone.0147926] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 01/11/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The aim of the study was to determine the prevalence and determinants of chronic non-communicable disease (NCD) risk factors in a rural community in the Limpopo Province of South Africa. METHODS This survey was conducted using the WHO "STEPwise approach to the surveillance of non-communicable diseases" (STEPS) methodology. Participants were residents of the Dikgale HDSS site and standardised international protocols were used to measure behavioural risk factors (smoking, alcohol consumption, fruit and vegetable intake and, physical activity) and physical characteristics (weight, height, waist and hip circumferences and blood pressure-BP). Fasting blood glucose, triglyceride, cholesterol and HDL-C were determined in 732 participants. Data were analysed using STATA 12 for Windows. RESULTS The prevalence of current smokers amongst the participants was 13.7%, of which 81.3% were daily smokers. Alcohol was consumed by 16.3% of the participants. The majority of participants (88.6%) had low daily intake of fruit and vegetables and low physical activity (66.5%). The prevalence of hypertension amongst the participants was 38.2%. Overweight, obesity and high waist circumference were prevalent in females. The cardio-metabolic risk profile was not significantly different between men and women. People who were older than 40 years, overweight or obese and those who consumed alcohol were more likely to be hypertensive. Smoking was associated significantly with older age, males, never married and divorced people. Alcohol consumption was associated with older age, males, low educational status and low income. CONCLUSION High levels of risk factors for NCDs among adults in the Dikgale HDSS suggest an urgent need for health interventions to control these risk factors at the population level in order to reduce the prevalence of NCDs.
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Affiliation(s)
- Eric Maimela
- Department of Medical Sciences, Public Health and Health Promotion, University of Limpopo (Turfloop Campus), Polokwane, South Africa
- International Health Unit, University of Antwerp, Antwerp, Belgium
| | - Marianne Alberts
- Department of Medical Sciences, Public Health and Health Promotion, University of Limpopo (Turfloop Campus), Polokwane, South Africa
| | - Sewela E. P. Modjadji
- Department of Medical Sciences, Public Health and Health Promotion, University of Limpopo (Turfloop Campus), Polokwane, South Africa
| | - Solomon S. R. Choma
- Department of Medical Sciences, Public Health and Health Promotion, University of Limpopo (Turfloop Campus), Polokwane, South Africa
| | - Sekgothe A. Dikotope
- Department of Medical Sciences, Public Health and Health Promotion, University of Limpopo (Turfloop Campus), Polokwane, South Africa
| | - Thembelihle S. Ntuli
- Department of Medical Sciences, Public Health and Health Promotion, University of Limpopo (Turfloop Campus), Polokwane, South Africa
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Okwali M, Greenlee H, Ginindza T, Jolly P, Akinyemiju TF. Adherence to cancer prevention guidelines in South Africa is associated with health care access. Int Health 2015. [PMID: 26198028 DOI: 10.1093/inthealth/ihv044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Cancer prevention guidelines have been developed to improve knowledge and adherence to modifiable cancer risk factors. The implementation of these guidelines has largely been studied in North American and European populations. The aim of this study was to examine the association between health care access and adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention guidelines in South Africa, where the cancer incidence is rising. METHODS Data from the 2003 South Africa World Health Survey was used to assess adherence to WCRF/AICR cancer prevention guidelines on alcohol, body mass index, nutrition, physical activity and smoking. Health care affordability, availability, accessibility, accommodation and acceptability in the past 12 months were assessed via self-report. RESULTS Residing in a high socio-economic status household (affordability), visiting a non-governmental health care facility (availability), perception of health care provider skills as adequate (accommodation) and lack of perception of worse treatment based on social class (acceptability) were each associated with higher levels of adherence to the WCRF/AICR guidelines. CONCLUSIONS In South Africa, better access to health care is associated with better patient adherence to cancer prevention guidelines. Future studies and efforts can focus on improving access to quality health care in this population.
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Affiliation(s)
- Michelle Okwali
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Heather Greenlee
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Themba Ginindza
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Pauline Jolly
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tomi F Akinyemiju
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Stival MM, Lima LRD, Karnikowski MGDO. Relações hipotéticas entre os determinantes sociais da saúde que influenciam na obesidade em idosos. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2015. [DOI: 10.1590/1809-9823.2015.14023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Os elevados índices de prevalência de obesidade em idosos suscitam a necessidade de compreender os fatores envolvidos nesta desordem nutricional, por meio de métodos quantitativos que permitam uma análise relacional desses determinantes. O objetivo deste estudo foi propor um modelo hipotético que estabeleça as relações entre os determinantes sociais da saúde associados à obesidade em idosos. Para a construção do modelo hipotético, foram delineadas as variáveis latentes e observadas de acordo com a análise de 45 artigos nacionais e internacionais e em concordância com o referencial da Modelagem de Equações Estruturais. Foi construído um diagrama representativo para evidenciar as correlações entre os 11 determinantes sociais da saúde relacionados à obesidade no idoso: atividade física, tabagismo, etilismo, consumo alimentar, contato social, ocupação, renda, escolaridade, idade, sexo e estado civil. Espera-se que as relações hipotéticas estabelecidas no estudo contribuam para a compreensão das relações dos fatores que estão envolvidos nesse contexto visando ao desenvolvimento de estratégias para a saúde da pessoa idosa.
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Mayén AL, Marques-Vidal P, Paccaud F, Bovet P, Stringhini S. Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review. Am J Clin Nutr 2014; 100:1520-31. [PMID: 25411287 DOI: 10.3945/ajcn.114.089029] [Citation(s) in RCA: 234] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In high-income countries, high socioeconomic status (SES) is generally associated with a healthier diet, but whether social differences in dietary intake are also present in low- and middle-income countries (LMICs) remains to be established. OBJECTIVE We performed a systematic review of studies that assessed the relation between SES and dietary intake in LMICs. DESIGN We carried out a systematic review of cohort and cross-sectional studies in adults in LMICs and published between 1996 and 2013. We assessed associations between markers of SES or urban and rural settings and dietary intake. RESULTS A total of 33 studies from 17 LMICs were included (5 low-income countries and 12 middle-income countries; 31 cross-sectional and 2 longitudinal studies). A majority of studies were conducted in Brazil (8), China (6), and Iran (4). High SES or living in urban areas was associated with higher intakes of calories; protein; total fat; cholesterol; polyunsaturated, saturated, and monounsaturated fatty acids; iron; and vitamins A and C and with lower intakes of carbohydrates and fiber. High SES was also associated with higher fruit and/or vegetable consumption, diet quality, and diversity. Although very few studies were performed in low-income countries, similar patterns were generally observed in both LMICs except for fruit intake, which was lower in urban than in rural areas in low-income countries. CONCLUSIONS In LMICs, high SES or living in urban areas is associated with overall healthier dietary patterns. However, it is also related to higher energy, cholesterol, and saturated fat intakes. Social inequalities in dietary intake should be considered in the prevention and control of noncommunicable diseases in LMICs.
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Affiliation(s)
- Ana-Lucia Mayén
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Fred Paccaud
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Pascal Bovet
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Silvia Stringhini
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
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Yawson AE, Baddoo A, Hagan-Seneadza NA, Calys-Tagoe B, Hewlett S, Dako-Gyeke P, Mensah G, Minicuci N, Naidoo N, Chatterji S, Kowal P, Biritwum R. Tobacco use in older adults in Ghana: sociodemographic characteristics, health risks and subjective wellbeing. BMC Public Health 2013; 13:979. [PMID: 24138966 PMCID: PMC3924352 DOI: 10.1186/1471-2458-13-979] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 10/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use over the life-course threatens to increase disease burden in older adulthood, including lower income countries like Ghana. This paper describes demographic, socioeconomic, health risks and life satisfaction indices related to tobacco use among older adults in Ghana. METHODS This work was based on the World Health Organization's multi-country Study on global AGEing and adult health (SAGE), conducted in six countries including Ghana. Wave one of SAGE in Ghana was conducted in 2007-2008 as collaboration between WHO and the University of Ghana Medical School through the Department of Community Health. A nationally representative sample of 4305 older adults aged 50 years and above were interviewed. Associations between tobacco consumption and sociodemographic, socioeconomic, health risk and life satisfaction were evaluated using chi-square and odds ratio (OR). Logistic regression analyses, adjusted for age, sex and other variables, were conducted to determine predictors of tobacco consumption in older persons. RESULTS Overall prevalence of current daily smokers among older adults in Ghana was 7.6%. Tobacco use (i.e. ever used tobacco) was associated with older males, (AOR = 1.10, CI 1.05-1.15), older adults residing in rural locations (AOR = 1.37, CI 1.083-1.724), and older adults who used alcohol (AOR = 1.13, CI 0.230-2.418). Tobacco use was also associated (although not statistically significant per p-values) with increased self-reporting of angina, arthritis, asthma, chronic lung disease, depression, diabetes, hypertension, and stroke. Older adults who used tobacco and with increased health risks, tended to be without health insurance (AOR = 1.41, CI 1.111-1.787). Satisfaction with life and daily living was much lower for those who use tobacco. Regional differences existed in tobacco use; the three northern regions (Upper East, Northern and Upper West) had higher proportions of tobacco use among older adults in the country. Quitting tobacco use was higher in the 70+ years age group, in women, among urban residents and in those with at least secondary education. Quitting tobacco use also increased with increasing income levels. CONCLUSIONS Tobacco use among older adults in Ghana was associated with older men living in rural locations, chronic ill-health and reduced life satisfaction. A high proportion of older adults have stopped using tobacco, demonstrating the possibilities for effective public health interventions. Health risk reduction strategies through targeted anti-smoking health campaigns, improvement in access to health and social protection (such as health insurance) will reduce health risks among older persons who use tobacco.
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Affiliation(s)
- Alfred E Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, Room 46, P. O. Box 4236, Korle-Bu, Accra, Ghana
- Public Health Unit, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Akosua Baddoo
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, Room 46, P. O. Box 4236, Korle-Bu, Accra, Ghana
- Public Health Unit, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Nana Ayegua Hagan-Seneadza
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, Room 46, P. O. Box 4236, Korle-Bu, Accra, Ghana
- Public Health Unit, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Benedict Calys-Tagoe
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, Room 46, P. O. Box 4236, Korle-Bu, Accra, Ghana
- Public Health Unit, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Sandra Hewlett
- University of Ghana Dental School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - Phyllis Dako-Gyeke
- Department of Social and Behavioral Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - George Mensah
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, Room 46, P. O. Box 4236, Korle-Bu, Accra, Ghana
| | - Nadia Minicuci
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, Room 46, P. O. Box 4236, Korle-Bu, Accra, Ghana
- National Council Research, Institute of Neuroscience, Padova, Italy
| | - Nirmala Naidoo
- World Health Organization, Multi-Country Studies unit, Geneva, Switzerland
| | - Somnath Chatterji
- World Health Organization, Multi-Country Studies unit, Geneva, Switzerland
| | - Paul Kowal
- World Health Organization, Multi-Country Studies unit, Geneva, Switzerland
- University of Newcastle Research Centre on Gender, Health and Aging, Newcastle, Australia
| | - Richard Biritwum
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, Room 46, P. O. Box 4236, Korle-Bu, Accra, Ghana
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Peltzer K, Phaswana-Mafuya N. Fruit and vegetable intake and associated factors in older adults in South Africa. Glob Health Action 2012. [PMID: 23195518 PMCID: PMC3511777 DOI: 10.3402/gha.v5i0.18668] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Numerous studies support the protective effect of high fruit and vegetable (FV) consumption on chronic disease risk, mainly against cancer and cardiovascular diseases. Compared with younger adults, older people experience additional health, social, and environmental conditions that affect dietary intake. To identify those additional dimensions and examine them in association with FV intake, data on 3,840 participants in the Study of Global Ageing and Adults Health (SAGE) in South Africa were analyzed. METHODS We conducted a national population-based cross-sectional study in 2008 with a sample of 3,840 participants, aged 50 years or older, in South Africa. The questionnaire included questions on socio-demographic characteristics, health variables, anthropometry, and blood pressure measurements. Multivariable regression analysis was performed to assess the associations between socio-demographic factors, health variables, and inadequate FV consumption. RESULTS Overall prevalence rates of insufficient FV intake were 68.5%, 64.8% among men and 71.4% among women, with a mean intake of 4.0 servings of FV among older adults (50 years and older). In multivariable analysis, coming from the Black African or Colored population group, lower educational level and daily tobacco use were associated with inadequate FV intake. CONCLUSIONS The amount of fruit and vegetables (FVs) consumed by older South African participants was considerably lower than current recommendations (daily intake of at least five servings; 400 g). Public education and campaigns on adequate consumption of FVs should be promoted targeting lower educated and Black African and Colored population groups.
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Affiliation(s)
- Karl Peltzer
- HIV/AIDS/SIT/and TB (HAST), Human Sciences Research Council, Pretoria, South Africa.
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