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Waltsgott L, Adedeji A, Buchcik J. Ideal body image and socioeconomic factors: exploring the perceptions of Kenyan women. BMC Womens Health 2024; 24:501. [PMID: 39256736 PMCID: PMC11389067 DOI: 10.1186/s12905-024-03307-5] [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: 05/20/2024] [Accepted: 08/12/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Non-communicable diseases are an increasing threat in sub-Saharan Africa (SSA), and overweight and obesity are affecting people across all socioeconomic groups. Some studies suggest that big body sizes may be perceived as desirable among women in SSA and that high prevalence of obesity and overweight are especially present in low socioeconomic societies. This study explores the role of socioeconomic factors in the perception of the ideal body among Kenyan women and whether perceptions and beliefs about the ideal body should be considered relevant when targeting the prevention of obesity and overweight. METHOD In-depth interviews were conducted with 8 Kenyan women with varying educational backgrounds, aged between 21 and 48, using a qualitative study design. The interviews were conducted in December 2022 and January 2023 in Nairobi, audio-recorded, transcribed and analysed through qualitative content analysis and a coding system using deductive and inductive codes. RESULTS The participants reported that conclusions about a person's health and wealth status are drawn based on different body sizes. Furthermore, traditional views about the ideal body size, societal pressure, as well as the women's own experience with their body size play a role in the perception of an ideal body. CONCLUSION Small-sized women desire to gain weight as society may view them as weak and sick. Big-sized women aim to reduce weight primarily due to health complications. Nevertheless, traditionally, a big-sized woman is considered strong and wealthy, creating external pressure on women to fulfil this body image-these findings emphasise traditional aspects in designing culturally sensitive prevention and intervention methods to address overweight and obesity.
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Affiliation(s)
- Linette Waltsgott
- Faculty of Life Sciences, Department Health Sciences, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Adekunle Adedeji
- Faculty of Life Sciences, Department Health Sciences, Hamburg University of Applied Sciences, Hamburg, Germany
- Bremen International Graduate School of Social Sciences (BIGSSS), Constructor University, Bremen, Germany
- Department of Medical Psychology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna Buchcik
- Faculty of Life Sciences, Department Health Sciences, Hamburg University of Applied Sciences, Hamburg, Germany.
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2
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Keino BC, Carrel M. Multilevel factors associated with overweight and obesity in East Africa: Comparative analysis in five countries from 2003 to 2016. Health Place 2024; 89:103326. [PMID: 39067171 DOI: 10.1016/j.healthplace.2024.103326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/03/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024]
Abstract
Rising rates of overweight/obesity in sub-Saharan Africa (SSA) are a growing concern. Regional analysis of sociodemographic factors associated with overweight/obesity, as is common, may mask nationally specific associations. We examine the spatiotemporal trends of overweight/obesity in women (15-49 years) using 13 years of data (2003-2016) from Demographic and Health Surveys in five East African countries. Multivariable logistic regression reveals that urbanization and individual education, wealth, employment, marital status, and age are linked to overweight/obesity in the region, but their influence varied between nations. Variations in sociodemographic risk factors across nations underscore the need for tailored surveillance and interventions to address the increasing burden of overweight/obesity in East Africa.
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Affiliation(s)
- Barbara Chebet Keino
- Department of Geographical Sciences and Sustainability, University of Iowa, Iowa City, Iowa, USA.
| | - Margaret Carrel
- Department of Geographical Sciences and Sustainability, University of Iowa, Iowa City, Iowa, USA.
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3
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Hanson LN, Gott A, Tomsett M, Useh E, Yeadon-Caiger E, Clay R, Fan J, Hui K, Wang H, Evans EH, Cowie D, Boothroyd LG. Examining body appreciation in six countries: The impact of age and sociocultural pressure. PLoS One 2024; 19:e0306913. [PMID: 39083477 PMCID: PMC11290661 DOI: 10.1371/journal.pone.0306913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/25/2024] [Indexed: 08/02/2024] Open
Abstract
Previous research on body appreciation across the lifespan has produced conflicting results that it increases with age, decreases with age, or is generally stable with an increase in women over 50-years-old. Furthermore, most of the research has been conducted in White, Western populations. Cross-cultural research suggests that both Chinese and African women experience similar sociocultural pressures as White Western women, and that appearance ideals are shifting to resemble a more Western ideal. We cross-sectionally and cross-culturally examined body appreciation across the lifespan, recruiting White Western women (UK, USA, Canada, and Australia), Black Nigerian women, and Chinese women. 1186 women aged 18-80 completed measures of body appreciation, internalisation of thin and athletic ideals, and perceived sociocultural pressure. Body appreciation did not vary with age in women from any country. Nigerian women reported the highest body appreciation, and Western women the lowest. Higher thin/athletic ideal internalisation, and higher perceived sociocultural pressure were significantly associated with lower body appreciation in all countries and age-groups. Overall, our findings indicate that although levels of body appreciation differ drastically between ethnicities and cultures, it is generally stable across age, and shows cross-culturally robust relationships between sociocultural internalisation and pressure.
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Affiliation(s)
| | - Alexis Gott
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Megan Tomsett
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Elozino Useh
- Department of Psychology, Durham University, Durham, United Kingdom
| | | | - Rachel Clay
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Jiamin Fan
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Kennice Hui
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Hongdi Wang
- Department of Psychology, Durham University, Durham, United Kingdom
| | | | - Dorothy Cowie
- Department of Psychology, Durham University, Durham, United Kingdom
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Manyara AM, Mwaniki E, Gill JMR, Gray CM. Knowledge, perceptions and practices towards diabetes risk in sub-Saharan Africa: a mixed-methods scoping review. Public Health Nutr 2024; 27:e104. [PMID: 38533768 PMCID: PMC11010065 DOI: 10.1017/s1368980024000752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 03/03/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To synthesise current evidence on knowledge, perceptions and practices towards type 2 diabetes risk in sub-Saharan Africa. DESIGN Mixed-methods scoping review, which included 101 studies (seventy-three quantitative, twenty qualitative and eight mixed methods) from seven electronic databases. SETTING Sub-Saharan Africa, 2000-2023. PARTICIPANTS Men and women without diabetes with mean ages ranging from 20 to 63 years. RESULTS The majority of participants in most studies knew the three main diabetes modifiable risk factors - excess weight, unhealthy diet and physical inactivity. However, most people with excess weight in almost all studies underestimated their weight. Further, the self-described ideal body weight was between midpoint of normal weight and the upper limits of overweight in most quantitative studies and was described as not too skinny but not too fat in qualitative studies. In the majority of studies, participants reported low engagement in weight control, high regular sugar intake, and low regular fruit and vegetable intake but moderate to high engagement in physical activity. Barriers to reducing diabetes risk were social (e.g. societal perceptions promoting weight gain) and environmental (e.g. limited affordability of healthy foods, high accessibility of Western diets and lack of physical activity facilities). CONCLUSION There is a need for multicomponent type 2 diabetes prevention interventions that increase knowledge of identifying diabetes risk (e.g. what constitutes excess weight) and create social and physical environments that support healthy lifestyles (e.g. societal perceptions that promote healthy living, increased availability and affordability of healthy foods and physical activity facilities).
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Affiliation(s)
- Anthony Muchai Manyara
- School of Health and Wellbeing, University of
Glasgow, Glasgow, UK
- Department of Health Systems Management and Public Health,
Technical University of Kenya, Nairobi,
Kenya
- Global Health and Ageing Research Unit, Bristol Medical School,
University of Bristol, Bristol,
UK
| | - Elizabeth Mwaniki
- Department of Health Systems Management and Public Health,
Technical University of Kenya, Nairobi,
Kenya
| | - Jason MR Gill
- School of Cardiovascular and Metabolic Health, University of
Glasgow, Glasgow, UK
| | - Cindy M Gray
- School of Health and Wellbeing, University of
Glasgow, Glasgow, UK
- School of Social and Political Sciences, University of
Glasgow, Glasgow, UK
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5
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Balogun-Mwangi O, Robinson-Wood TL, DeTore NR, Edwards George JB, Rodgers RF, Sanchez W. Body image and Black African women: A comparative study of Kenya and Nigeria. Body Image 2023; 45:331-342. [PMID: 37031617 DOI: 10.1016/j.bodyim.2023.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/11/2023]
Abstract
Very few cross-national studies on body image focus on Black African women. In this study, a comparative analytical approach and sociocultural theory framework was utilized in examining measures of body image among 209 Kenyan and Nigerian women aged 18-69 (M = 34.4, SD = 7.81). We examined both weight-related and non-weight-related aspects of appearance, including hair texture, skin tone, and other racialized features. The regional samples were compared on scores of internalized Eurocentric beauty ideals, skin color satisfaction, objectified body consciousness, racialized body image satisfaction, and other demographic metrics. Kenyan and Nigerian women showed differences across multiple body image measures. Nigerian women showed thinner body ideals compared to Kenyan women and also endorsed higher skin color satisfaction, racialized body dissatisfaction, and internalized Eurocentric beauty idealization. Kenyan women showed higher levels of objectified body consciousness. An indirect effect of nationality was observed with internalized Eurocentric beauty ideals mediating differences in racialized body dissatisfaction and objectified body shame. Attention to regional variation in appearance satisfaction may deepen understandings of the particular sociocultural influences impacting body image among populations of Black African women.
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Affiliation(s)
| | - Tracy L Robinson-Wood
- Northeastern University, Department of Applied Psychology, Boston, MA 02115, United States
| | - Nicole R DeTore
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA 02114, United States; Harvard Medical School, Department of Psychiatry, Boston, MA 02114, United States
| | | | - Rachel F Rodgers
- Northeastern University, Department of Applied Psychology, Boston, MA 02115, United States; Lapeyronie University Hospital, Department of Psychiatric Emergency & Acute Care, CHRU Montpellier, France
| | - William Sanchez
- Northeastern University, Department of Applied Psychology, Boston, MA 02115, United States
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6
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Pradeilles R, Holdsworth M, Olaitan O, Irache A, Osei-Kwasi HA, Ngandu CB, Cohen E. Body size preferences for women and adolescent girls living in Africa: a mixed-methods systematic review. Public Health Nutr 2022; 25:738-759. [PMID: 33593472 PMCID: PMC9991778 DOI: 10.1017/s1368980021000768] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To synthesise evidence on body size preferences for females living in Africa and the factors influencing these. DESIGN Mixed-methods systematic review including searches on Medline, CINHAL, ASSIA, Web of Science and PsycINFO (PROSPERO CRD42015020509). A sequential-explanatory approach was used to integrate quantitative and qualitative findings. SETTING Urban and rural Africa. PARTICIPANTS Studies of both sexes providing data on body size preferences for adolescent girls and women aged ≥10 years. RESULTS Seventy-three articles from twenty-one countries were included: fifty quantitative, fifteen qualitative and eight mixed methods. Most studies reported a preference for normal or overweight body sizes. Some studies of adolescent girls/young women indicated a preference for underweight. Factors influencing preferences for large(r) body sizes included: socio-demographic (e.g. education, rural residency), health-related (e.g. current BMI, pubertal status), psycho-social (e.g. avoiding HIV stigma) and socio-cultural factors (e.g. spouse's preference, social standing, cultural norms). Factors influencing preferences for slim(mer) body sizes included: socio-demographic (e.g. higher socioeconomic status, urban residency, younger age), health-related (e.g. health knowledge, being nulliparous), psycho-social (e.g. appearance, body size perception as overweight/obese) and socio-cultural factors (e.g. peer pressure, media). CONCLUSIONS Preference for overweight (not obese) body sizes among some African females means that interventions need to account for the array of factors that maintain these preferences. The widespread preference for normal weight is positive in public health terms, but the valorisation of underweight in adolescent girls/young women may lead to an increase in body dissatisfaction. Emphasis needs to be placed on education to prevent all forms of malnutrition.
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Affiliation(s)
- Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences (SSEHS), Loughborough University, LoughboroughLE11 3TU, UK
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | | | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Christian B Ngandu
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Emmanuel Cohen
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
- UMR CNRS-MNHN 7206 « Eco-anthropologie », Musée de l’Homme, Paris, France
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Christian AK, Frempong GA. Correlates of over- or under-estimation of body size among resource-poor urban dwellers in a sub-Saharan African city. Ann Hum Biol 2020; 47:602-609. [PMID: 32988221 DOI: 10.1080/03014460.2020.1830171] [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: 10/23/2022]
Abstract
BACKGROUND Individual perception of body size has implications for lifestyle behaviours including dietary habits and weight management practices. AIM To examine factors related to respondents' estimation of their body sizes compared to their body mass index (BMI). SUBJECTS AND METHODS This cross-sectional survey comprised a sample of 917 adults in urban poor Accra, Ghana. Silhouette figure ratings were used to assess perceived body size and ideal body size at a community level. Logistic regression analysis was used to determine correlates of respondents overestimating or underestimating their body sizes. RESULTS Approximately, 69% of respondents either underestimated or overestimated their body sizes. About a quarter of respondents perceived being overweight as the preferred ideal body size in their communities. The mean BMI of females and males who underestimated their body sizes were within the overweight category and normal weight category, respectively. Gender, educational level, employment status, the community of residence, and ethnicity were associated with how respondents correctly estimated, over- or under-estimated their body sizes. There was evidence of ethnicity mediating the association between the community of residence and body size estimation. CONCLUSION Weight management interventions must be mindful of the socio-demographic and cultural proclivities of the targeted populace for optimum impact.
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Choukem SP, Tochie JN, Sibetcheu AT, Nansseu JR, Hamilton-Shield JP. Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2020; 2020:6. [PMID: 32211050 PMCID: PMC7092532 DOI: 10.1186/s13633-020-0076-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 02/13/2020] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Recently, childhood and adolescence overweight/obesity has increased disproportionately in developing countries, with estimates predicting a parallel increase in future cardiovascular disease (CVD) burden identifiable in childhood and adolescence. Identifying cardiovascular risk factors (CVRF) associated with childhood and adolescence overweight/obesity is pivotal in tailoring preventive interventions for CVD. Whilst this has been examined extensively in high-income countries, there is scant consistent or representative data from sub-Saharan Africa (SSA). OBJECTIVE This scoping review synthesises contemporary studies on CVRF associated with overweight and obesity in SSA children and adolescents to provide evidence on the current burden of overweight/obesity and CVD in this population. METHODS We searched MEDLINE and Google Scholar up to July 31, 2019 for observational and experimental studies and systematic reviews addressing childhood and adolescence overweight/obesity and CVRF in SSA without language restriction. Four investigators working in four pairs, independently selected and extracted the relevant data. The methodological quality of all included studies was assessed. RESULTS We included 88 studies with a total of 86,637children and adolescents from 20 SSA countries. The risk of bias was low in 62 (70.5%), moderate 18 (20.5%), and high in eight (9%) studies. Overweight/obesity in SSA children and adolescents is rising at an alarming rate. Its main associations include physical inactivity, unhealthy diets, high socio-economic status, gender and high maternal body mass index. Identified CVRF in overweight/obese SSA children and adolescents are mainly metabolic syndrome, hypertension, dyslipidaemia, diabetes and glucose intolerance. There is a dearth of guidelines or consensus on the management of either childhood overweight/obesity or CVRF in overweight/obese SSA children and adolescents. CONCLUSION The current findings suggest an urgent need to review current health policies in SSA countries. Health education and transforming the current obesogenic environment of the SSA child and adolescent into one which promotes physical activity and healthy dietary habits is required.
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Affiliation(s)
- Simeon-Pierre Choukem
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Diabetes and Endocrine Unit, Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Joel Noutakdie Tochie
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Aurelie T. Sibetcheu
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Jobert Richie Nansseu
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaoundé, Cameroon
| | - Julian P. Hamilton-Shield
- Bristol Biomedical Research Centre (Nutrition Theme), University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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Tuoyire DA, McNair S, Debrah SA, Duda RB. Perception of risk for hypertension and overweight/obesity in Cape Coast, Ghana. Ghana Med J 2019; 52:140-146. [PMID: 30602799 DOI: 10.4314/gmj.v52i3.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background This study examined the association between perception of risk for hypertension and overweight/obesity. Design Cross-sectional questionnaire-based survey. Setting Out-patient department of the Central Regional Hospital in Cape Coast, Ghana. Participants Adult men and women at least 18 years old. Interventions None. Main outcome measures Perception of risk for hypertension, overweight/obesity. Results About 39% of the participants (N=400) were found to be overweight/obese, with disproportionally higher rates among women (50%) than men (28%). Results of the binary logistic regression models revealed a strong positive association (OR = 2.21, 95% CI =1.23, 3.96) between perception of risk for hypertension and overweight/obesity. Increasing age, high television exposure, female gender and being in a relationship were also noted to be associated with overweight/obesity. Conclusions These findings highlight the need for the design of programmes to help individuals appreciate the reality of weight-related health risks, as well as the need to embrace lifestyles that promote healthy weight outcomes. Funding Harvard Medical School Travelling Fellowship, Scholars in Medicine Office, Harvard Medical School.
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Affiliation(s)
- Derek A Tuoyire
- Department of Community Medicine, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
| | - Sarah McNair
- Harvard Medical School, 250 Longwood Avenue, Boston, MA, USA
| | - Samuel A Debrah
- Department of Surgery, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
| | - Rosemary B Duda
- Harvard Medical School, 250 Longwood Avenue, Boston, MA, USA.,Department of Surgery, Beth Israel Deaconess Medical Centre, 330 Brookline Avenue, Boston, MA, USA
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Aladeniyi I, Adeniyi OV, Fawole O, Adeolu M, Goon DT, Ajayi AI, Owolabi EO. Pattern and correlates of obesity among public service workers in Ondo State, Nigeria: a cross-sectional study. S Afr Fam Pract (2004) 2017. [DOI: 10.1080/20786190.2017.1333784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Isaac Aladeniyi
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Oladele Vincent Adeniyi
- Department of Family Medicine, Cecilia Makiwane Hospital, Walter Sisulu University, East London, South Africa
| | - Olufunmilayo Fawole
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Mary Adeolu
- Nigeria State Health Investment Project, Akure, Nigeria
| | - Daniel Ter Goon
- Department of Health Sciences, University of Fort Hare, East London, South Africa
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Tuoyire DA, Kumi-Kyereme A, Doku DT. Socio-demographic trends in overweight and obesity among parous and nulliparous women in Ghana. BMC OBESITY 2016; 3:44. [PMID: 27826451 PMCID: PMC5093993 DOI: 10.1186/s40608-016-0124-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/18/2016] [Indexed: 12/15/2022]
Abstract
Background Overweight and obesity are among the leading threats to global health because of their association with increased risk of morbidity and mortality. Much of the research on overweight and obesity among women largely generalize without due cognisance to differences in their reproductive history. This study explored differences in trends in overweight/obesity, and associated factors between parous and nulliparous women in Ghana. Methods Anthropometric measurements from three nationally representative Ghana Demographic and Health Surveys (2003, 2008 and 2014) were analysed using descriptive statistics and multivariate binary logistic regression. Results Over all, overweight/obesity increased between 2003 and 2014, with disproportionately higher rates among parous women (from about 30 % in 2003 to about 48 % in 2014) than nulliparous women (from about 15 % in 2003 to about 24 % in 2014). Age, wealth quintile and marital status were associated with overweight/obesity similarly in both women groups. However, there were variations in the association between parous and nulliparious women by educational level, type of locality, occupation and ethnicity. Conclusion The trend of overweight/obesity in Ghana warrants urgent national level public health attention to help curb the situation. Such interventions should be tailored bearing in mind the peculiar differences in associated factors between parous and nulliparous women.
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Affiliation(s)
| | - Akwasi Kumi-Kyereme
- Department of Population & Health, University of Cape Coast, Cape Coast, Ghana
| | - David Teye Doku
- Department of Population & Health, University of Cape Coast, Cape Coast, Ghana ; School of Health Sciences, University of Tampere, Tampere, Finland
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12
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Commodore-Mensah Y, Hill M, Allen J, Cooper LA, Blumenthal R, Agyemang C, Himmelfarb CD. Sex Differences in Cardiovascular Disease Risk of Ghanaian- and Nigerian-Born West African Immigrants in the United States: The Afro-Cardiac Study. J Am Heart Assoc 2016; 5:e002385. [PMID: 26896477 PMCID: PMC4802474 DOI: 10.1161/jaha.115.002385] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 01/06/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The number of African immigrants in the United States grew 40-fold between 1960 and 2007, from 35 355 to 1.4 million, with a large majority from West Africa. This study sought to examine the prevalence of cardiovascular disease (CVD) risk factors and global CVD risk and to identify independent predictors of increased CVD risk among West African immigrants in the United States. METHODS AND RESULTS This cross-sectional study assessed West African (Ghanaian and Nigerian) immigrants aged 35-74 years in the Baltimore-Washington metropolitan area. The mean age of participants was 49.5±9.2 years, and 58% were female. The majority (95%) had ≥1 of the 6 CVD risk factors. Smoking was least prevalent, and overweight or obesity was most prevalent, with 88% having a body mass index (in kg/m(2)) ≥25; 16% had a prior diagnosis of diabetes or had fasting blood glucose levels ≥126 mg/dL. In addition, 44% were physically inactive. Among women, employment and health insurance were associated with odds of 0.09 (95% CI 0.033-0.29) and 0.25 (95% CI 0.09-0.67), respectively, of having a Pooled Cohort Equations estimate ≥7.5% in the multivariable logistic regression analysis. Among men, higher social support was associated with 0.90 (95% CI 0.83-0.98) lower odds of having ≥3 CVD risk factors but not with having a Pooled Cohort Equations estimate ≥7.5%. CONCLUSIONS The prevalence of CVD risk factors among West African immigrants was particularly high. Being employed and having health insurance were associated with lower CVD risk in women, but only higher social support was associated with lower CVD risk in men.
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Affiliation(s)
| | - Martha Hill
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - Jerilyn Allen
- Johns Hopkins University School of Nursing, Baltimore, MD
| | | | | | - Charles Agyemang
- Department of Public Health, Academic Medical Centre/University of Amsterdam, The Netherlands
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Doku DT, Neupane S. Double burden of malnutrition: increasing overweight and obesity and stall underweight trends among Ghanaian women. BMC Public Health 2015; 15:670. [PMID: 26178521 PMCID: PMC4502461 DOI: 10.1186/s12889-015-2033-6] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 07/07/2015] [Indexed: 11/24/2022] Open
Abstract
Background Overweight and obesity are among the leading causes of mortality globally, and although previously they were mostly prevalent in developed countries, recent scanty evidence suggests that overweight and obesity in developing countries have reached high levels. Trends in overweight/obesity (BMI ≥ 25 kg/m2) and underweight (BMI < 18 kg/m2) from 1993 to 2008 and associated factors were explored among 15 to 49 years old women in Ghana. Methods Nationally representative data were used from four Demographic and Health Surveys conducted in Ghana in 1993 (n = 4562), 1998 (n = 4843), 2003 (n = 5691) and 2008 (n = 4916). The data were analysed using logistic regression. Results Over all, underweight increased by 28.57 % (from 10.5 %, 95 % confidence interval (CI) = 9.61–11.39 in 1993 to 7.5 %, 95 % CI = 6.76–8.24 in 2008) and 134.85 % increase in overweight and obesity (from 13.2 %, 95 % CI = 12.22–14.18 in 1993 to 31 %, 95 % CI = 29.71–32.29 in 2008) over the fifteen year period were found. Overweight was much more common in urban women (36.8 %, 95 % CI = 35.78–37.82) compared to rural women (15.6 %, 95 % CI = 14.93–16.27). Women of urban residents were more likely of being overweight (OR = 1.43, 95 % CI = 1.25–1.63) but less likely to be underweight (odds ratio (OR) = 0.33, 95 % CI = 0.30–0.36) compared to those of rural residents. Furthermore, older age, higher education, multi-parity and being rich were associated with overweight/obesity among Ghanaian women. Conclusion Overweight and obesity are becoming a common phenomenon among Ghanaian women while underweight still remains a problem. Our study demonstrates an emerging double burden of malnutrition among Ghanaian women. Promotion of physical activity and encouraging healthy dietary habits are urgently needed to curtail obesity and overweight trends while underweight among rural women, those without higher education and those with lower wealth index can be improved through poverty reduction measures.
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Affiliation(s)
- David Teye Doku
- Department of Population and Health, University of Cape Coast, Private Mail Bag, University Post Office, Cape Coast, Ghana.
| | - Subas Neupane
- School of Health Sciences FI - 33014, University of Tampere, Tampere, Finland.
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Modesti PA, Agostoni P, Agyemang C, Basu S, Benetos A, Cappuccio FP, Ceriello A, Del Prato S, Kalyesubula R, O’Brien E, Kilama MO, Perlini S, Picano E, Reboldi G, Remuzzi G, Stuckler D, Twagirumukiza M, Van Bortel LM, Watfa G, Zhao D, Parati G. Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings. J Hypertens 2014; 32:951-60. [PMID: 24577410 PMCID: PMC3979828 DOI: 10.1097/hjh.0000000000000125] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 01/09/2014] [Accepted: 01/09/2014] [Indexed: 02/06/2023]
Abstract
The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on 'Hypertension and Cardiovascular risk in low resource settings', which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs.
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Affiliation(s)
- Pietro A. Modesti
- Department of Clinical and Experimental Medicine, University of Florence, Florence
| | | | - Charles Agyemang
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Sanjay Basu
- University of California, San Francisco, California, USA
| | - Athanase Benetos
- INSERM UMR S1116, Université de Lorraine, Vandoeuvre-les-Nancy, Nancy, France
| | - Francesco P. Cappuccio
- University of Warwick, Warwick Medical School, and University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Antonio Ceriello
- Institut d’Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain
| | - Stefano Del Prato
- Section of Metabolic Diseases and Diabetes, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Eoin O’Brien
- The Conway Institute, University College Dublin, Dublin, Ireland
| | | | | | | | | | - Giuseppe Remuzzi
- IRCCS-Istituto di Ricerche Farmacologiche ‘Mario Negri’, Bergamo, Italy
| | - David Stuckler
- Department of Sociology, University of Oxford, Oxford, UK
| | - Marc Twagirumukiza
- Faculty of Medicine and Health Sciences, Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium
| | - Luc M. Van Bortel
- Faculty of Medicine and Health Sciences, Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium
| | | | - Dong Zhao
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Gianfranco Parati
- Department of Health Sciences, University of Milano-Bicocca
- Department of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Ettarh R, Van de Vijver S, Oti S, Kyobutungi C. Overweight, obesity, and perception of body image among slum residents in Nairobi, Kenya, 2008-2009. Prev Chronic Dis 2013; 10:E212. [PMID: 24355105 PMCID: PMC3869529 DOI: 10.5888/pcd10.130198] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The increase in cardiovascular diseases in sub-Saharan Africa has been attributed in part to the changes in lifestyle, and the prevalence of risk factors for cardiovascular disease is higher among urban populations than among nonurban populations. The objective of this study was to determine the prevalence of overweight and obesity and examine perceptions of body size differentiated by sex and other determinants among slum dwellers in Nairobi, Kenya. METHODS Analysis included 4,934 adults randomly selected from the Korogocho and Viwandani slums of Nairobi. Height and weight were measured during interviews; body mass index (BMI) was calculated. Perceptions of current and ideal body image were determined by using 18 silhouette drawings of body sizes ranging from very thin to very obese. We used multivariate logistic regression analysis to determine predictors of underestimation of body weight among overweight and obese respondents. RESULTS Overall, 43.4% of women and 17.3% of men in the study population were overweight or obese. More than half (53%) of those who were overweight or obese underestimated their weight; 34.6% of women and 16.9% of men did so. In all BMI categories, more than one-third of women and men preferred body sizes classified as overweight or obese. CONCLUSION This study highlights the prevalence of overweight and obesity and the strong preference for larger body size among adults in the slums of Nairobi. Interventions to educate residents on the health risks associated with excess body weight are necessary as a part of strategies to reduce the prevalence of risk factors for cardiovascular disease in these settlements.
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Affiliation(s)
- Remare Ettarh
- Faculty of Medicine, University of British Columbia, 2775 Laurel St, Vancouver, British Columbia, Canada V5Z 1M9. E-mail:
| | | | - Sam Oti
- African Population and Health Research Center, Nairobi, Kenya
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Differential perceptions of body image and body weight among adults of different socioeconomic status in a sub-urban population. J Biosoc Sci 2013; 46:279-93. [PMID: 23721833 DOI: 10.1017/s002193201300028x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study explored the association of socioeconomic status with individuals' perception of their body image (BI) and body weight (BW) among adults in a sub-urban Nigerian population. The cross-sectional sample comprised 1521 residents (775 males and 746 females) of the town of Nnewi. Perceived BI was assessed using figural representations of different sizes for males and females. Perceived BW was determined by presenting participants with BW category options to choose from. Body mass index (BMI) was calculated from objectively measured BW and height using standardized procedures. Actual BW categories were derived from participants' BMIs using WHO criteria. Perceived BI and BW differed from actual BW among unskilled and non-tertiary males (p<0.001) and female (p<0.001 to p<0.04) in all BW categories whereas these variables differed (p<0.001) among skilled and tertiary males and females in normal weight, overweight and obese categories. Perceived BW differed (p<0.001) from actual BW among unskilled and non-tertiary males in underweight, overweight and obese categories whereas these variables differed (p<0.001) among unskilled and non-tertiary females, skilled and tertiary males and females in overweight and obese categories. Underweight 'unskilled' and 'non-tertiary' males perceived their BI to be different from their actual BW (p<0.001). Overweight and obese 'skilled' and 'unskilled', and 'tertiary' and 'non-tertiary', males and females perceived their BI and BW to be different from their actual BW (p<0.001). Significant differences in perceived BI existed between 'skilled' and 'unskilled' (p<0.001), and 'tertiary' and 'non-tertiary' (p=0.005), overweight males, and between 'skilled' and 'unskilled' (p<0.001), and 'tertiary' and 'non-tertiary' (p=0.008), normal-weight females. The 'skilled' participants had a lower risk of perceiving a larger BI (OR 0.51, 95% CI 0.41-0.64; p<0.001) and larger BW (OR 0.71, 95% CI 0.53-0.96; p=0.03) than the 'unskilled' participants. The 'tertiary' participants had a lower risk of perceiving a larger BI (OR 0.51, 95% CI 0.40-0.63; p<0.001) and larger BW (OR 0.71, 95% CI 0.53-0.95; p=0.02) than the 'non-tertiary' participants. After adjusting for possible confounders, all the risks became insignificant except for perception of BI by the 'skilled' participants (OR 0.70, 95% CI 0.50-0.99; p=0.04). Individuals in the different occupational and educational categories perceived their BI differently but their BW similarly. Given the same BMI, age, perceived ideal BI and sex, only occupation is found to be associated with perception of BI.
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Alwan H, Viswanathan B, Paccaud F, Bovet P. Is Accurate Perception of Body Image Associated with Appropriate Weight-Control Behavior among Adolescents of the Seychelles. J Obes 2011; 2011:817242. [PMID: 21603277 PMCID: PMC3092647 DOI: 10.1155/2011/817242] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 01/26/2011] [Indexed: 11/17/2022] Open
Abstract
Background. We examined body image perception and its association with reported weight-control behavior among adolescents in the Seychelles. Methods. We conducted a school-based survey of 1432 students aging 11-17 years in the Seychelles. Perception of body image was assessed using both a closed-ended question (CEQ) and Stunkard's pictorial silhouettes (SPS). Voluntary attempts to change weight were also assessed. Results. A substantial proportion of the overweight students did not consider themselves as overweight (SPS: 24%, CEQ: 34%), and a substantial proportion of the normal-weight students considered themselves as too thin (SPS: 29%, CEQ: 15%). Logistic regression analysis showed that students with an accurate weight perception were more likely to have appropriate weight-control behavior. Conclusions. We found that substantial proportions of students had an inaccurate perception of their weight and that weight perception was associated with weight-control behavior. These findings point to forces that can drive the upwards overweight trends.
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Affiliation(s)
- Heba Alwan
- Institute of Social and Preventive Medicine (IUMSP), University Hospital Centre and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Bharathi Viswanathan
- Unit for Prevention and Control of Cardiovascular Disease, Department of Public Health, Ministry of Health, Victoria, Seychelles
| | - Fred Paccaud
- Institute of Social and Preventive Medicine (IUMSP), University Hospital Centre and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Pascal Bovet
- Institute of Social and Preventive Medicine (IUMSP), University Hospital Centre and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
- Unit for Prevention and Control of Cardiovascular Disease, Department of Public Health, Ministry of Health, Victoria, Seychelles
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Alwan H, Viswanathan B, Williams J, Paccaud F, Bovet P. Association between weight perception and socioeconomic status among adults in the Seychelles. BMC Public Health 2010; 10:467. [PMID: 20696072 PMCID: PMC2924291 DOI: 10.1186/1471-2458-10-467] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 08/09/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have examined the association between weight perception and socioeconomic status (SES) in sub-Saharan Africa, and none made this association based on education, occupation and income simultaneously. METHODS Based on a population-based survey (n = 1255) in the Seychelles, weight and height were measured and self-perception of one's own body weight, education, occupation, and income were assessed by a questionnaire. Individuals were considered to have appropriate weight perception when their self-perceived weight matched their actual body weight. RESULTS The prevalence of overweight and obesity was 35% and 28%, respectively. Multivariate analysis among overweight/obese persons showed that appropriate weight perception was directly associated with actual weight, education, occupation and income, and that it was more frequent among women than among men. In a model using all three SES indicators together, only education (OR = 2.5; 95% CI: 1.3-4.8) and occupation (OR = 2.3; 95% CI: 1.2-4.5) were independently associated with appropriate perception of being overweight. The OR reached 6.9 [95% CI: 3.4-14.1] when comparing the highest vs. lowest categories of SES based on a score including all SES indicators and 6.1 [95% CI: 3.0-12.1] for a score based on education and occupation. CONCLUSIONS Appropriately perceiving one's weight as too high was associated with different SES indicators, female sex and being actually overweight. These findings suggest means and targets for clinical and population-based interventions for weight control. Further studies should examine whether these differences in weight perception underlie differences in cognitive skills, healthy weight norms, or body size ideals.
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Affiliation(s)
- Heba Alwan
- Institute of Social and Preventive Medicine IUMSP, University Hospital Centre and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
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BeLue R, Okoror TA, Iwelunmor J, Taylor KD, Degboe AN, Agyemang C, Ogedegbe G. An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective. Global Health 2009; 5:10. [PMID: 19772644 PMCID: PMC2759909 DOI: 10.1186/1744-8603-5-10] [Citation(s) in RCA: 199] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Accepted: 09/22/2009] [Indexed: 02/07/2023] Open
Abstract
Background Sub-Saharan African (SSA) countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD). This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems. Purpose The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors. Methodology We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included. Results The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and treatment efforts. Conclusion Using an African-centered cultural framework, the PEN3 model, we explore future directions and efforts to address the epidemic of CVD risk in SSA.
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Affiliation(s)
- Rhonda BeLue
- Department of Health Policy and Administration, 604 Ford Building, The Pennsylvania State University, University Park, PA, USA
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Inhibitors and enablers of physical activity in multiethnic hypertensive patients: qualitative study. J Hum Hypertens 2009; 24:280-90. [PMID: 19641519 DOI: 10.1038/jhh.2009.61] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Regular physical activity (PA) can reduce blood pressure, but hypertensive patients in ethnic minority populations are often inactive. The objective of this qualitative study was to explore inhibitors and enablers of PA from the perspective of hypertensive Ghanaian, African-Surinamese and White-Dutch patients in Amsterdam, The Netherlands. In-depth individual interviews with 46 patients were analysed for thematic content, using Maxqda software. All three groups mentioned their hypertension, the presence of other health conditions, lack of priority, lack of social support, limited financial resources or access to PA facilities as inhibitors for maintaining or increasing their level of PA. Common enablers included health-related incentives, support from physicians or family and having physically demanding work. Specific inhibitors only mentioned by Ghanaians and Surinamese included inexperience with recommended 'Western' activities (cycling), little access to their habitual forms of PA, cultural preferences for large body sizes, unfamiliarity with the host country and the pressure of social demands from the Dutch society and their own communities. Specific enablers for Ghanaians and Surinamese included access to community or church-based support groups. These patient-identified inhibitors and enablers can be a useful framework for promoting PA in hypertensive patients, particularly from immigrant groups. Physicians may build their advice on the identified enablers and tackle the inhibitors.
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Seffah JD, Kwame-Aryee RA, Adanu RMK, Munumi K, Awotwi EK. Indications for gynecologic surgery and their implications for sexual function in menopausal women. Int J Gynaecol Obstet 2008; 103:203-6. [PMID: 18812243 DOI: 10.1016/j.ijgo.2008.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Revised: 07/11/2008] [Accepted: 07/14/2008] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the indications for gynecologic surgery and the effect of surgery on dyspareunia and sexual intercourse frequency in menopausal women in Accra, Ghana. METHOD Women who had gynecologic surgery between January 2005 and December 2007 were invited for an interview about dyspareunia and frequency of intercourse before and after surgery. RESULTS Of the 93 women interviewed who underwent hysterectomy, 29 (31.1%) had dyspareunia before surgery and 13 (14.0%) after (P=0.006). Of the 65 women who had benign tumors, before surgery 26 (40%) were sexually active, while after surgery 43 (66%) were sexually active (P=0.001). However, frequency of intercourse did not change for those with malignancies. The mean frequency of intercourse before surgery was 2.11 per week, compared with 2.46 per week after surgery (P=0.50). CONCLUSION Gynecologic surgery reduced dyspareunia. More women became sexually active following surgery for benign but not malignant tumors, but the mean overall frequency of intercourse did not change significantly in the interviewed population.
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Affiliation(s)
- Joseph D Seffah
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana.
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Duda RB, Jumah NA, Hill AG, Seffah J, Biritwum R. Interest in healthy living outweighs presumed cultural norms for obesity for Ghanaian women. Health Qual Life Outcomes 2006; 4:44. [PMID: 16857048 PMCID: PMC1544332 DOI: 10.1186/1477-7525-4-44] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Accepted: 07/20/2006] [Indexed: 11/28/2022] Open
Abstract
Background Cultural norms indicate that obesity reflects increased wealth and prosperity. Yet obesity is linked to serious medical illnesses. The purpose of this study was to determine if Ghanaian women would change their body image if it meant a healthier life. Methods A questionnaire was administered to 305 Ghanaian women waiting for clinic appointments at Korle Bu Teaching Hospital, Accra Ghana. This survey included questions on current health, selection of figural stimuli, decision making on health and social determinants and 5 questions on self-perception of health from SF-36. Anthropometric measures were taken and body mass index calculated. Women were also provided with health related information at the conclusion of the interview. Results The majority of all women surveyed would reduce their current body image if it meant that they would have an overall healthier life and reduce the risks of obesity-linked illnesses and complications. Currently obese women were significantly more likely than non-obese women to reduce their body image to reduce the risk of hypertension (OR 2.03 [1.64 – 2.51],<0.001); cardiovascular accident (OR 1.96 [1.61 – 2.38],<0.001); diabetes (OR 2.00 [1.63 – 2.44],<0.001); myocardial infarction (OR 2.27 [1.80 – 2.86],<0.001); if requested by a spouse(OR 2.64 [1.98 – 3.52],<0.001); and to improve overall health (OR 1.95 [1.60 – 2.37], <0.001). There was no association with current body image and responses to SF-36. The decision to select a new body image was not influenced by education, income, marital status or parity. Age 50 years old and less was significantly associated with the body image size reduction to reduce the risk of hypertension, diabetes, and a cardiovascular accident. Conclusion The Ghanaian women interviewed in this study are interested in living a healthy life and are willing to reduce their body size to reduce the risk of obesity-linked illnesses. The target group for any interventional studies and measures to reduce obesity appears to be women age 50 and younger.
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Affiliation(s)
- Rosemary B Duda
- Department of Surgery, Beth Israel Deaconess Medical Center, RW871, 330 Brookline Ave, Boston, MA 02215, USA
| | | | - Allan G Hill
- Department of Population and International Health, Harvard School of Public Health, Huntington Ave, Boston, MA 02115, USA
| | - Joseph Seffah
- Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, University of Ghana, Accra, Ghana
| | - Richard Biritwum
- Department of Community Medicine, Korle Bu Teaching Hospital, University of Ghana, Accra, Ghana
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