Browsing School of Public Health by Subject "Obesity"
Now showing items 1-7 of 7
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Puoane, Thandi (MedPharm Publications, 2008)[more][less]
Abstract: OBJECTIVE: To estimate the prevalence of overweight and obesity, and identify factors associated with Body Mass Index (BMI) and waist circumference (WC) among adults residing in an urban township in South Africa. DESIGN: Cross-sectional study. SETTING: Khayelitsha, a large black township located in Cape Town. SUBJECTS: 107 males and 530 females, aged ≥ 18 years. METHODS: The prevalence of overweight/obesity (BMI ³ 25 kg/m2) and abdominal obesity (WC ≥ 94 cm for men and ≥ 80 cm for women), and their relationship with factors previously found to increase the risk of obesity, such as age, gender, marital status, educational level, employment status, immigrant status from rural to urban, and physical activity level, were assessed using logistic regression analyses. RESULTS: The prevalence of obesity (BMI ³ 30 kg/m2) was 53.4% and 18.7%, and that of abdominal obesity was 71.5% and 23.4%, among women and men respectively. However, more women (21.3%) than men (11.2%) reported walking more than 45 minutes per day. Female gender and being married were associated with a high BMI and large WC. Recent migration was associated with a smaller WC. The level of physical activity was not associated with BMI or WC. CONCLUSIONS: These findings suggest that physical activity may play less of a role in obesity control, or that more than 45 minutes of physical activity per day is required to reduce the risk of obesity, especially in women. At least among South African women, obesity control focused on nutritional interventions may be more beneficial than increasing the intensity or duration of physical activity. URI: http://hdl.handle.net/10566/233 Files in this item: 1
MalhotraPuoaneSAJCN2008.pdf (303.1Kb) -
Joubert, Jane; Puoane, Thandi (South African Medical Association, 2007)[more][less]
Abstract: OBJECTIVE: To estimate the burden of disease attributable to excess body weight using the body mass index (BMI), by age and sex, in South Africa in 2000. DESIGN: World Health Organization comparative risk assessment (CRA) methodology was followed. Re-analysis of the 1998 South Africa Demographic and Health Survey data provided mean BMI estimates by age and sex. Population attributable fractions were calculated and applied to revised burden of disease estimates. Monte Carlo simulation-modelling techniques were used for the uncertainty analysis. SETTING: South Africa. SUBJECTS. Adults ≥ 30 years of age. OUTCOME MEASURES. Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, ischaemic stroke, hypertensive disease, osteoarthritis, type 2 diabetes mellitus, and selected cancers. RESULTS: Overall, 87% of type 2 diabetes, 68% of hypertensive disease, 61% of endometrial cancer, 45% of ischaemic stroke, 38% of ischaemic heart disease, 31% of kidney cancer, 24% of osteoarthritis, 17% of colon cancer, and 13% of postmenopausal breast cancer were attributable to a BMI ≥ 21 kg/m2. Excess body weight is estimated to have caused 36 504 deaths (95% uncertainty interval 31 018 - 38 637) or 7% (95% uncertainty interval 6.0 - 7.4%) of all deaths in 2000, and 462 338 DALYs (95% uncertainty interval 396 512 - 478 847) or 2.9% of all DALYs (95% uncertainty interval 2.4 - 3.0%). The burden in females was approximately double that in males. CONCLUSIONS: This study shows the importance of recognising excess body weight as a major risk to health, particularly among females, highlighting the need to develop, implement and evaluate comprehensive interventions to achieve lasting change in the determinants and impact of excess body weight. URI: http://hdl.handle.net/10566/284 Files in this item: 1
PuoaneEstimating2007.pdf (412.1Kb) -
Puoane, Thandi; Hughes, Gail; Bradley, Hazel A. (Kamla-Raj Enterprises, 2005)[more][less]
Abstract: Obesity and associated non-communicable diseases such as Type 2 diabetes, hypertension, and ischaemic heart disease were previously thought to be diseases of affluent countries, but they are becoming increasingly prevalent in developing nations. Accessibility to cheap unhealthy food, global trade and market development influence nutrition transition towards diets with high fat and sugar contents. A decrease in physical activity due to urbanisation and other environmental factors such as crime and violence are thought to lead to an increased risk of obesity. Positive beliefs about body weight among black African women, together with the idea of association of thinness with HIV/AIDS virus infection are believed to fuel the obesity epidemic amongst this population This paper describes some of the contributory factors which black South African women are faced with in making choices about healthy living. A multisectoral approach will be needed to fight the epidemic of obesity and associated diseases. URI: http://hdl.handle.net/10566/243 Files in this item: 1
PuoaneObesity2005.pdf (29.48Kb) -
Kruger, Salome H; Puoane, Thandi; Senekal, Marjanne; Van Der Merwe, Theresa M (Nutrition Society, 2005)[more][less]
Abstract: OBJECTIVES: To review data on the prevalence, causes and health consequences of obesity in South Africa and propose interventions to prevent and treat obesity and related outcomes. METHODS: Data from existing literature were reviewed with an emphasis on changing eating and activity patterns, cultural factors, perceptions and beliefs, urbanisation and globalisation. Results of studies on the health consequences of obesity in South Africans are also reviewed. RESULTS: Shifts in dietary intakes and activity patterns to higher fat intakes and lower physical activity are contributing to a higher prevalence of obesity. Few overweight black women view themselves as overweight, and some associate thinness with HIV/AIDS. Glucose and lipid toxicity, associated with insulin resistance, play roles in the pathogenesis of the co-morbid diseases of obesity. Elevated free fatty acids in the black population predispose obese black patients to type 2 diabetes. CONCLUSION & RECOMMENDATIONS: Obesity prevention and treatment should be based on education, behaviour change, political support, intersectoral collaboration and community participation, local actions, wide inclusion of the population, adequately resourced programmes, infiltration of existing initiatives, evidence-based planning, and proper monitoring and evaluation. Interventions should have the following components: reasonable weight goals, healthful eating, physical activity and behavioural change. Genes and mutations affecting susceptibility to the development of co-morbidities of obesity and vulnerable periods of life for the development of obesity should be prioritised. Prevention should be managed in community services, identification of high-risk patients in primary healthcare services and treatment of co-morbid diseases in hospital services. URI: http://hdl.handle.net/10566/285 Files in this item: 1
PuoaneObesityChallenges2005.pdf (160.4Kb) -
Puoane, Thandi; Steyn, Kristela; Bradshaw, Debbie; Laubscher, Ria; Fourie, Jean; Lambert, Vicki; Mbanangwa, Nolwazi (Nature Publishing Group, 2002)[more][less]
Abstract: To ascertain the anthropometric profile and determinants of obesity in South Africans who participated in the Demographic and Health Survey in 1998. RESEARCH METHODS AND PROCEDURES: A sample of 13,089 men and women (age, _15 years) were randomly selected and then stratified by province and urban and nonurban areas. Height, weight, mid-upper arm circumference, and waist and hip circumference were measured. Body mass index (BMI) was used as an indicator of obesity, and the waist/hip ratio (WHR) was used as an indicator of abdominal obesity. Multivariate regression identified sociodemographic predictors of BMI and waist circumference in the data. RESULTS: Mean BMI values for men and women were 22.9 kg/m2 and 27.1 kg/m2, respectively. For men, 29.2% were overweight or obese (_25 kg/m2) and 9.2% had abdominal obesity (WHR _1.0), whereas 56.6% of women were overweight or obese and 42% had abdominal obesity (WHR _0.85). Underweight (BMI _18.5 kg/m2) was found in 12.2% of men and 5.6% of women. For men, 19% of the variation of BMI and 34% of the variation in waist circumference could be explained by age, level of education, population group, and area of residence. For women, these variables explained 16% of the variation of BMI and 24% of the variation in waist circumference. Obesity increased with age, and higher levels of obesity were found in urban African women. DISCUSSION: Overnutrition is prevalent among adult South Africans, particularly women. Determinants of overnutrition include age, level of education, ethnicity, and area of residence. URI: http://hdl.handle.net/10566/291 Files in this item: 1
PuoaneSurvey2002.pdf (63.15Kb) -
Puoane, Thandi; Tsolekile, Lungiswa; Steyn, Nelia (International Society on Hypertension in Blacks, 2010)[more][less]
Abstract: OBJECTIVE: To assess beliefs about body size (fatness and thinness) and body image in Black girls aged 10–18 years living in Cape Town. DESIGN: Exploratory using qualitative methods. SETTING: Cape Town, South Africa. METHOD: Participants were Black African girls (n5240), aged 10–18 years, who attended 5 primary and 6 high schools in Black townships in Cape Town. The schools and the girls were randomly selected. This paper presents qualitative data from 6 focus groups among 60 girls regarding their beliefs about thinness and fatness, and the advantages and disadvantages of being overweight or thin. RESULTS: Beliefs regarding body image indicate that two thirds of the girls perceived fatness as a sign of happiness and wealth. Socially, fatness was accepted but one third of the girls had contradictory views about its advantages. Among obese girls who believed that being obese was preferable, the dominant reasons were that being fat allowed one to engage in sport activities that need strength and also makes one look respectable. On the other hand fatness was viewed as associated with diseases such as diabetes and hypertension and with increased difficulty in finding appropriate clothing sizes. Three quarters of the girls associated thinness with ill health particularly HIV and AIDS and tuberculosis. An advantage of thinness was being less prone to develop chronic non-communicable diseases. CONCLUSION: The study shows that opinions and beliefs about body image start in adolescence. It is therefore important to consider these perceptions when designing interventions for preventing obesity and other chronic non-communicable diseases during early childhood URI: http://hdl.handle.net/10566/293 Files in this item: 1
PuoanePerceptionsCapeTown2010.pdf (178.9Kb) -
Matoti-Mvalo, Tandi; Puoane, Thandi (MedPharm Publications, 2011)[more][less]
Abstract: OBJECTIVE: To explore the perception among black South African women that people who are thin are infected with HIV or have AIDS. SETTING: Khayelitsha, an urban township in Cape Town. SUBJECTS: 513 women aged 18-65 years. METHODS: This was an exploratory study employing both quantitative and qualitative research methodology. Data were collected in two phases. The first phase involved collecting quantitative data among 513 participants. During the second phase, qualitative data were collected in a purposely selected sub-sample of 20 women. For the qualitative data collection, participants were shown eight body figures, ranging from thin to obese, and asked to choose a figure representing the ideal figure, a preferred figure and a figure thought to symbolise health. They were also invited to choose a figure that they thought represented a person infected with HIV or who had AIDS. They had the option of saying that they did not associate any of the figures with people infected with HIV or who had AIDS. Weight and height measurements were also taken. After the quantitative analysis was completed, focus group discussions explored perceptions about body image and the relation to HIV among purposely selected participants. Data were summarised by content based on questions discussed. RESULTS: Sixty-nine per cent of the participants associated a thin figure with a person infected with HIV, or who had AIDS. Only 10.2% thought the thin figure symbolised health. Fifty per cent preferred a normal-weight figure, while 34.2% thought that normal weight symbolised health. Only 2% thought that people in the normal-weight category were infected with HIV or had AIDS.Thirty-four per cent preferred to be overweight and 31% thought that being overweight symbolised health. None of the participants thought the overweight figure represented people infected with HIV or who had AIDS. Only 8% preferred the obese figure. The results of the qualitative data analysis suggested that participants preferred to be overweight and at risk of acquiring cardiovascular diseases, rather than being thin and stigmatised as a person infected with HIV or who had AIDS. CONCLUSION: This study revealed that the stigma associated with HIV and AIDS may undermine strategies for prevention of chronic noncommunicable diseases among urban black South African women. URI: http://hdl.handle.net/10566/271 Files in this item: 1
PuoanePerceptions2011.pdf (304.5Kb)
Now showing items 1-7 of 7