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Socio-economic influences on anthropometric status in urban South African adolescents: sex differences in the Birth to Twenty Plus cohort

  • Rebecca Pradeilles (a1) (a2), Paula L Griffiths (a1) (a2), Shane A Norris (a2), Alison B Feeley (a2) and Emily K Rousham (a1)...
Abstract
Objective

To investigate the associations of household and neighbourhood socio-economic position (SEP) with indicators of both under- and overnutrition in adolescents and to explore sex differences.

Design

Analysis of anthropometric, household and neighbourhood SEP data from the Birth to Twenty Plus cohort born in 1990. Anthropometric outcomes were BMI (thinness, overweight and obesity) and percentage body fat (%BF; low, high). Associations between these and the household wealth index, caregiver education and neighbourhood SEP tertile measures were examined using binary logistic regression.

Setting

Johannesburg–Soweto, South Africa.

Subjects

Adolescents aged 17–19 years (n 2019; 48·2 % men).

Results

Women had a significantly higher combined prevalence of overweight/obesity (26·2 %) than men (8·2 %) whereas men had a significantly higher prevalence of thinness than women (22·2 % v. 10·6 %, respectively). Having a low neighbourhood social support index was associated with higher odds of high %BF in women (OR=1·59; 95 % CI 1·03, 2·44). A low household wealth index was associated with lower odds of both overweight (OR=0·31; 95 % CI 0·12, 0·76) and high %BF in men (OR=0·28; 95 % CI 0·10, 0·78). A low or middle household wealth index was associated with higher odds of being thin in men (OR=1·90; 95 % CI 1·09, 3·31 and OR=1·80; 95 % CI 1·03, 3·15, respectively). For women, a low household wealth index was associated with lower odds of being thin (OR=0·49; 95 % CI 0·25, 0·96).

Conclusions

The study highlights that even within a relatively small urban area the nutrition transition manifests itself differently in men and women and across SEP indicators. Understanding the challenges for different sexes at different ages is vital in helping to plan public health services.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
* Corresponding author: Email R.Pradeilles@lboro.ac.uk
References
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1. Mamun, AA & Finlay, JE (2014) Shifting of undernutrition to overnutrition and its determinants among women of reproductive ages in the 36 low to medium income countries. Obes Res Clin Pract (Epublication ahead of print version).
2. Mendez, MA, Monteiro, CA & Popkin, BM (2005) Overweight exceeds underweight among women in most developing countries. Am J Clin Nutr 81, 714721.
3. Prentice, AM (2006) The emerging epidemic of obesity in developing countries. Int J Epidemiol 35, 9399.
4. Ziraba, AK, Fotso, JC & Ochako, R (2009) Overweight and obesity in urban Africa: a problem of the rich or the poor? BMC Public Health 9, 465.
5. Popkin, BM & Gordon-Larsen, P (2004) The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord 28, Suppl. 3, S2S9.
6. Popkin, BM (2006) Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr 84, 289298.
7. Popkin, BM, Adair, LS & Ng, SW (2012) Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 70, 321.
8. Abrahams, Z, Mchiza, Z & Steyn, NP (2011) Diet and mortality rates in Sub-Saharan Africa: stages in the nutrition transition. BMC Public Health 11, 801.
9. Ng, M, Fleming, T, Robinson, M et al. (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384, 766781.
10. Monteiro, CA, Conde, WL, Lu, B et al. (2004) Obesity and inequities in health in the developing world. Int J Obes Relat Metab Disord 28, 11811186.
11. Subramanian, SV, Perkins, JM, Ozaltin, E et al. (2011) Weight of nations: a socioeconomic analysis of women in low- to middle-income countries. Am J Clin Nutr 93, 413421.
12. Jones-Smith, JC, Gordon-Larsen, P, Siddiqi, A et al. (2011) Is the burden of overweight shifting to the poor across the globe? Time trends among women in 39 low-and middle-income countries (1991–2008). Int J Obes (Lond) 36, 11141120.
13. Jones-Smith, JC, Gordon-Larsen, P, Siddiqi, A et al. (2011) Cross-national comparisons of time trends in overweight inequality by socioeconomic status among women using repeated cross-sectional surveys from 37 developing countries, 1989–2007. Am J Epidemiol 173, 667675.
14. Monteiro, CA, Moura, EC, Conde, WL et al. (2004) Socioeconomic status and obesity in adult populations of developing countries: a review. Bull World Health Organ 82, 940946.
15. Alaba, O & Chola, L (2014) Socioeconomic inequalities in adult obesity prevalence in South Africa: a decomposition analysis. Int J Environ Res Public Health 11, 33873406.
16. Dinsa, G, Goryakin, Y, Fumagalli, E et al. (2012) Obesity and socioeconomic status in developing countries: a systematic review. Obes Rev 13, 10671079.
17. Goryakin, Y & Suhrcke, M (2013) Economic development, urbanization, technological change and overweight: what do we learn from 244 Demographic and Health Surveys? Econ Hum Biol 14, 109127.
18. Bourne, LT, Lambert, EV & Steyn, K (2002) Where does the black population of South Africa stand on the nutrition transition? Public Health Nutr 5, 157162.
19. Feeley, A, Musenge, E, Pettifor, JM et al. (2012) Changes in dietary habits and eating practices in adolescents living in urban South Africa: the Birth to Twenty cohort. Nutrition 28, e1e6.
20. Feeley, A, Pettifor, JM & Norris, SA (2009) Fast-food consumption among 17-year-olds in the Birth to Twenty cohort. S Afr J Clin Nutr 22, 118123.
21. Steyn, NP & Mchiza, ZJ (2014) Obesity and the nutrition transition in Sub-Saharan Africa. Ann N Y Acad Sci 1311, 88101.
22. Shisana, O, Labadarios, D, Rehle, T et al. (2014) South African National Health and Nutrition Examination Survey (SANHANES-1): 2014 Edition. Cape Town: HSRC Press.
23. World Obesity Federation (2014) World map of obesity. http://www.worldobesity.org/aboutobesity/world-map-obesity/ (accessed October 2014).
24. Varela-Silva, MI, Dickinson, F, Wilson, H et al. (2012) The nutritional dual-burden in developing countries – how is it assessed and what are the health implications? Coll Antropol 36, 3945.
25. Doak, CM, Adair, LS, Monteiro, C et al. (2000) Overweight and underweight coexist within households in Brazil, China and Russia. J Nutr 130, 29652971.
26. Doak, CM, Adair, LS, Bentley, M et al. (2005) The dual burden household and the nutrition transition paradox. Int J Obes (Lond) 29, 129136.
27. Caballero, B (2005) A nutrition paradox – underweight and obesity in developing countries. N Engl J Med 352, 15141516.
28. Corsi, DJ, Finlay, JE & Subramanian, S (2011) Global burden of double malnutrition: has anyone seen it? PLoS One 6, e25120.
29. Ginsburg, C, Griffiths, PL, Richter, LM et al. (2013) Residential mobility, socioeconomic context and body mass index in a cohort of urban South African adolescents. Health Place 19, 99107.
30. Allison, KW, Burton, L, Marshall, S et al. (1999) Life experiences among urban adolescents: examining the role of context. Child Dev 70, 10171029.
31. Swinburn, B, Egger, G & Raza, F (1999) Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med 29, 563570.
32. Davison, KK & Birch, LL (2001) Childhood overweight: a contextual model and recommendations for future research. Obes Rev 2, 159171.
33. Kok, G, Gottlieb, NH, Commers, M et al. (2008) The ecological approach in health promotion programs: a decade later. Am J Health Promot 22, 437442.
34. Kraak, VI, Swinburn, B, Lawrence, M et al. (2014) An accountability framework to promote healthy food environments. Public Health Nutr 17, 24672483.
35. Story, M, Kaphingst, KM, Robinson-O’Brien, R et al. (2008) Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health 29, 253272.
36. Griffiths, PL, Johnson, W, Cameron, N et al. (2013) In urban South Africa, 16 year old adolescents experience greater health equality than children. Econ Hum Biol 11, 502514.
37. United Nations Development Programme (2013) Human Development Index and its components. http://hdr.undp.org/en/content/table-1-human-development-index-and-its-components (accessed November 2014).
38. The World Bank (2014) GINI index. http://data.worldbank.org/indicator/SI.POV.GINI (accessed December 2014).
39. Beall, J, Crankshaw, O & Parnell, S (2000) Local government, poverty reduction and inequality in Johannesburg. Environ Urban 12, 107122.
40. de Wet, T, Patel, L, Korth, M et al. (2008) Johannesburg Poverty and Livelihoods Study. Johannesburg: Centre for Social Development in Africa.
41. Richter, L, Norris, S, Pettifor, J et al. (2007) Cohort profile: Mandela’s children: the 1990 Birth to Twenty study in South Africa. Int J Epidemiol 36, 504511.
42. Sheppard, ZA, Norris, SA, Pettifor, JM et al. (2010) How can we learn about community socio-economic status and poverty in a developing country urban environment? An example from Johannesburg–Soweto, South Africa. Afr Popul Stud 24, 5369.
43. Griffiths, PL, Sheppard, ZA, Johnson, W et al. (2012) Associations between household and neighbourhood socioeconomic status and systolic blood pressure among urban South African adolescents. J Biosoc Sci 44, 433458.
44. Chiolero, A, Faeh, D, Paccaud, F et al. (2008) Consequences of smoking for body weight, body fat distribution, and insulin resistance. Am J Clin Nutr 87, 801809.
45. Lohman, T, Roche, A & Martorell, R (editors) (1991) Anthropometric Standardization Reference Manual, abridged ed. Champaign, IL: Human Kinetics Books.
46. Cole, TJ, Bellizzi, MC, Flegal, KM et al. (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 12401243.
47. Cole, TJ, Flegal, KM, Nicholls, D et al. (2007) Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 335, 194.
48. World Health Organization (2000) Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. WHO Technical Report Series no. 894. Geneva: WHO.
49. Frisancho, AR (2008) Anthropometric Standards: An Interactive Nutritional Reference of Body Size and Body Composition for Children and Adults. Ann Arbor, MI: University of Michigan Press.
50. World Health Organization (1992) International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. Geneva: WHO.
51. Tanner, J (1962) Growth at Adolescence: With a General Consideration of the Effects of Hereditary and Environmental Factors Upon Growth and Maturation from the Birth to Maturity, 2nd ed. Oxford: Blackwell Scientific Publications.
52. Norris, SA & Richter, LM (2005) Usefulness and reliability of Tanner pubertal self-rating to urban black adolescents in South Africa. J Res Adolesc 15, 609624.
53. Wells, JC, Cole, TJ & ALSPAC Study Team (2002) Adjustment of fat-free mass and fat mass for height in children aged 8 y. Int J Obes Relat Metab Disord 26, 947952.
54. Muthuri, SK, Francis, CE, Wachira, LM et al. (2014) Evidence of an overweight/obesity transition among school-aged children and youth in Sub-Saharan Africa: a systematic review. PLoS One 9, e92846.
55. Griffiths, PL, Rousham, EK, Norris, SA et al. (2008) Socio-economic status and body composition outcomes in urban South African children. Arch Dis Child 93, 862867.
56. Black, JL & Macinko, J (2008) Neighborhoods and obesity. Nutr Rev 66, 220.
57. Dunton, GF, Kaplan, J, Wolch, J et al. (2009) Physical environmental correlates of childhood obesity: a systematic review. Obes Rev 10, 393402.
58. Galvez, MP, Pearl, M & Yen, IH (2010) Childhood obesity and the built environment. Curr Opin Pediatr 22, 202207.
59. Bogin, B & Varela Silva, MI (2012) The body mass index: the good, the bad, and the horrid. Bull Soc Suisse Anthropol 18, 511.
60. Subramanian, SV, Perkins, JM & Khan, KT (2009) Do burdens of underweight and overweight coexist among lower socioeconomic groups in India? Am J Clin Nutr 90, 369376.
61. Wrotniak, B, Malete, L, Maruapula, S et al. (2012) Association between socioeconomic status indicators and obesity in adolescent students in Botswana, an African country in rapid nutrition transition. Pediatric Obes 7, e9e13.
62. Bovet, P, Chiolero, A, Madeleine, G et al. (2010) Prevalence of overweight and underweight in public and private schools in the Seychelles. Int J Pediatr Obes 5, 274278.
63. West, P (1997) Health inequalities in the early years: is there equalisation in youth? Soc Sci Med 44, 833858.
64. Trogdon, JG, Nonnemaker, J & Pais, J (2008) Peer effects in adolescent overweight. J Health Econ 27, 13881399.
65. Renna, F, Grafova, IB & Thakur, N (2008) The effect of friends on adolescent body weight. Econ Hum Biol 6, 377387.
66. Puoane, T, Tsolekile, L & Steyn, N (2010) Perceptions about body image and sizes among black African girls living in Cape Town. Ethn Dis 20, 2934.
67. Voorend, CG, Norris, SA, Griffiths, PL et al. (2013) ‘We eat together; today she buys, tomorrow I will buy the food’: adolescent best friends’ food choices and dietary practices in Soweto, South Africa. Public Health Nutr 16, 559567.
68. van Vuuren, CL, Reijneveld, SA, van der Wal, MF et al. (2014) Neighborhood socioeconomic deprivation characteristics in child (0–18 years) health studies: a review. Health Place 29, 3442.
69. Pickett, KE & Pearl, M (2001) Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review. J Epidemiol Community Health 55, 111122.
70. Riva, M, Gauvin, L & Barnett, TA (2007) Toward the next generation of research into small area effects on health: a synthesis of multilevel investigations published since July 1998. J Epidemiol Community Health 61, 853861.
71. Weiss, L, Ompad, D, Galea, S et al. (2007) Defining neighborhood boundaries for urban health research. Am J Prev Med 32, 6 Suppl., S154S159.
72. Carroll-Scott, A, Gilstad-Hayden, K, Rosenthal, L et al. (2013) Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: the role of built, socioeconomic, and social environments. Soc Sci Med 95, 106114.
73. Lake, A & Townshend, T (2006) Obesogenic environments: exploring the built and food environments. J R Soc Promot Health 126, 262267.
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