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Biocultural determinants of overweight and obesity in the context of nutrition transition in Senegal: a holistic anthropological approach

Published online by Cambridge University Press:  08 October 2018

Emmanuel Cohen Open the ORCID record for Emmanuel Cohen [Opens in a new window] ,
Philippe Jean-Luc Gradidge ,
Amadou Ndao ,
Priscilla Duboz ,
Enguerran Macia ,
Lamine Gueye ,
Gilles Boëtsch ,
Patrick Pasquet ,
Michelle Holdsworth  and
Nicole Chapuis-Lucciani
Emmanuel Cohen*
Affiliation:
MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa CNRS, UMI 3189, Faculty of Medicine, UCAD, Dakar, Sénégal
Philippe Jean-Luc Gradidge
Affiliation:
Centre for Exercise Science and Sports Medicine, University of the Witwatersrand, Johannesburg, South Africa
Amadou Ndao
Affiliation:
CNRS, UMR 8177, IIAC-LAIOS, EHESS, Paris, France Goethe University Frankfurt, Frankfurt, Germany
Priscilla Duboz
Affiliation:
CNRS, UMI 3189, Faculty of Medicine, UCAD, Dakar, Sénégal
Enguerran Macia
Affiliation:
CNRS, UMI 3189, Faculty of Medicine, UCAD, Dakar, Sénégal
Lamine Gueye
Affiliation:
CNRS, UMI 3189, Faculty of Medicine, UCAD, Dakar, Sénégal
Gilles Boëtsch
Affiliation:
CNRS, UMI 3189, Faculty of Medicine, UCAD, Dakar, Sénégal
Patrick Pasquet
Affiliation:
CNRS, UMR-MNHN 7206, Musée de l’Homme, Paris, France
Michelle Holdsworth
Affiliation:
School of Health and Related Research, Public Health Section, University of Sheffield, Sheffield, UK
Nicole Chapuis-Lucciani
Affiliation:
CNRS, UMI 3189, Faculty of Medicine, UCAD, Dakar, Sénégal
*
*Corresponding author. Email: emmcohen@outlook.fr
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Abstract

Senegal is experiencing a rising obesity epidemic, due to the nutrition transition occurring in most African countries, and driven by sedentary behaviour and high-calorie dietary intake. In addition, the anthropological local drivers of the social valorization of processed high-calorie food and large body sizes could expose the population to obesity risk. This study aimed to determine the impact of these biocultural factors on the nutritional status of Senegalese adults. A mixed methods approach was used, including qualitative and quantitative studies. Between 2011 and 2013, fourteen focus group discussions (n=84) and a cross-sectional quantitative survey (n=313 women; n=284 men) of adults in three different socio-ecological areas of Senegal (rural: n=204; suburban: n=206; urban: n=187) were conducted. Dietary intake (Dietary Diversity Scores), physical activity (International Physical Activity Questionnaire), body weight norms (Body Size Scale), weight and health statuses (anthropometric measures and blood pressure) were measured. Middle-aged and older Senegalese women were found to value overweight/obesity more than younger Senegalese in all regions. In addition, young urban/suburban adults had a tendency for daily snacking whilst urban/suburban adults tended to be less physically active and had higher anthropometric means. A binary logistic regression model showed that being female, older, living in urban/suburban areas and valuing larger body size were independently associated with being overweight/obese, but not high-calorie diet. Univariate analyses showed that lower physical activity and higher socioeconomic status were associated with being overweight/obese. Finally, overweight/obesity, which is low in men, is associated with hypertension in the total sample. The nutrition transition is currently underway in Senegal’s urban/suburban areas, with older women being more affected. Since several specific biocultural factors jointly contribute to this phenomenon, the study’s findings suggest the need for local public health interventions that target women and which account for the anthropological specificities of the Senegalese population.

Keywords

EcohealthObesityPopulation Health

Information

Type
Research Article
Information
Journal of Biosocial Science , Volume 51 , Issue 4 , July 2019 , pp. 469 - 490
Copyright
© Cambridge University Press, 2018 

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References

Abrahams, Z, Mchiza, Z Steyn, NP (2011) Diet and mortality rates in sub-Saharan Africa: stages in the nutrition transition. BMC Public Health 11(1), 1.Google Scholar
Abraido-Lanza, AF, Armbrister, AN, Florez, KR Aguirre, AN (2006) Toward a theory-driven model of acculturation in public health research. American Journal of Public Health 96(8), 1342–1346.Google Scholar
Abubakari, AR, Lauder, W, Agyemang, C, Jones, M, Kirk, A Bhopal, RS (2008) Prevalence and time trends in obesity among adult West African Populations: a meta-analysis. Obesity Reviews 9, 297–311.Google Scholar
AG/GRN-GTZ (2004) Convention locale de la gestion des ressources naturelles du terroir communautaire de Taïba Niasséne. Republic of Senegal.Google Scholar
Agyemang, C, Addo, J, Bhopal, R, Ade, GA Stronks, K (2009) Cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe: a literature review. Global Health 5(7), 7.Google Scholar
Akindele, MO, Phillips, J, Igumbor, E Useh, U (2017) Body weight misperception and dissatisfaction among overweight and obese adult Nigerians. JMIR Public Health and Surveillance 3(3), e56.Google Scholar
Amougou, N, Cohen, E, Mbala, ML, Grosdidier, B, Bernard, JY, Said-Mohamed, R Pasquet, P (2016) Development and validation of two food portion photograph books to assess dietary intake among adults and children in central Africa. British Journal of Nutrition 115(5), 895–902.Google Scholar
ANSD-ICF (eds) (2015) Sénégal: Enquête Démographique et de Santé Continue. ICF International, Rockville, MD.Google Scholar
Appiah, CA, Otoo, GE Steiner-Asiedu, M (2016) Preferred body size in urban Ghanaian women: implication on the overweight/obesity problem. Pan African Medical Journal 23, 239.Google Scholar
Baller, S (2007) Être jeune, masculin et sportif: représentations urbaines de la masculinité au Sénégal. In Goerg, O (ed.) Perspectives historiques sur le genre en Afrique. L’Harmattan, Paris, pp. 167–190.Google Scholar
Besharat Pour, M, Bergstrom, A, Bottai, M, Kull, I, Wickman, M, Hakansson, N, Wolk, A Moradi, T (2014) Effect of parental migration background on childhood nutrition, physical activity, and body mass index. Journal of Obesity, 406529.Google Scholar
Blocker, DE Freudenberg, N (2001) Developing comprehensive approaches to prevention and control of obesity among low-income, urban, African-American women. Journal of the American Medical Women’s Association 56, 59–64.Google Scholar
Bosu, WK (2015) An overview of the nutrition transition in West Africa: implications for non-communicable diseases. Proceedings of the Nutrition Society 74, 466–477.Google Scholar
Brewis, AA (ed.) (2011) Obesity: Cultural and Biocultural Perspectives. Rutgers University Press, New Brunswick, NJ.Google Scholar
Bricas, N (2008) La pluralité des références identitaires des styles alimentaires urbains en Afrique. In Chiffoleau, Y, Dreyfus, F and Touzard, JM (eds) Les nouvelles figures des marchés agroalimentaires, Apports croisés de l’économie, de la sociologie et de la gestion. INRA-UMR Innovation, Paris, pp. 149–159.Google Scholar
Brown, PJ Konner, M (1987) An anthropological perspective on obesity. Annals of the New York Academy of Sciences 499, 29–46.Google Scholar
Cohen, E, Amougou, N, Ponty, A, Loinger-Beck, J, Nkuintchua, T Monteillet, N et al. (2017) Nutrition transition and biocultural determinants of obesity among cameroonian migrants in urban Cameroon and France. International Journal of Environmental Research and Public Health 14, 696.Google Scholar
Cohen, E, Bernard, JY, Ponty, A, Ndao, A, Amougou, N, Said-Mohamed, R Pasquet, P (2015) Development and validation of the body size scale for assessing body weight perception in African populations. PLoS One 10(11), 0138983.Google Scholar
Cohen, E, Boetsch, G, Palstra, FP Pasquet, P (2013) Social valorisation of stoutness as a determinant of obesity in the context of nutritional transition in Cameroon: the Bamileke case. Social Science & Medicine 96, 24–32.Google Scholar
Cohen, E, Ndao, A, Faye, B, Ndiaye, S, Ndiaye, EHM Ezan, G et al. (2018) Large body size as a socially valued factor determining excess weight and obesity in the context of the nutritional transition in Senegal. Bulletins et Mémoires de la Société d’Anthropologie de Paris 30(1–2), 59–69.Google Scholar
Cohen, E Pasquet, P (2011) Development of a new body image assessment scale in urban Cameroon: an anthropological approach. Ethnicity and Disease 21(3), 288.Google Scholar
Connor Gorber, S, Tremblay, M, Moher, D Gorber, B (2007) A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obesity Reviews 8(4), 307–326.Google Scholar
Corbeau, JP (1995) L’imaginaire du gras associé à divers types de consommation de gras et les perceptions de leurs qualités. In Valceschini, E and Nicolaïs, F (eds) Agro-alimentaire, une économie de la qualité. INRA-Economica, Paris, pp. 93–107.Google Scholar
Craig, CL, Marshall, AL, Sjoström, M, Bauman, AE, Booth, ML Ainsworth, BE et al. (2003) International physical activity questionnaire: 12-country reliability and validity. Medecine & Science in Sports & Exercise 35, 1381–1385.Google Scholar
Dapi, LN, Omoloko, C, Janlert, U, Dahlgren, L Håglin, L (2007) “I eat to be happy, to be strong, and to live.” Perceptions of rural and urban adolescents in Cameroon, Africa. Journal of Nutrition Education and Behavior 39(6), 320–326.Google Scholar
De Garine, I (1962) Usages alimentaires dans la région de Khombole (Sénégal). Cahiers d’études africaines 10, 218–265.Google Scholar
De Garine, I (1990) Adaptation biologique et bien-être psycho-culturel. Bulletins et Mémoires de la Société d’anthropologie de Paris 2(2), 151–173.Google Scholar
Delavari, M, Farrelly, A, Renzaho, A, Mellor, D Swinburn, B (2013) Experiences of migration and the determinants of obesity among recent Iranian immigrants in Victoria, Australia. Ethnicity and Health 18(1), 66–82.Google Scholar
Delavari, M, Sonderlund, AL, Mellor, D, Mohebbi, M Swinburn, B (2015) Migration, acculturation and environment: determinants of obesity among iranian migrants in Australia. International Journal of Environmental Research and Public Health 12(2), 1083–1098.Google Scholar
Delpeuch, F (2013) Globesity: A Planet out of Control? Routledge, London.Google Scholar
Doak, CM, Adair, LS, Bentley, M, Monteiro, C Popkin, BM (2005) The dual burden household and the nutrition transition paradox. International Journal of Obesity 29(1), 129–136.Google Scholar
Dop, MC, Gomis, MC, Gourdon, M Lesauvage, S (2003) Outils d’enquête alimentaire par entretien: élaboration au Sénégal. IRD éditions, Marseille.Google Scholar
Downey, G (2016) Being human in cities: phenotypic bias from urban niche construction. Current Anthropology 57(13), 52–64.Google Scholar
Drewnowski, A (2009) Obesity, diets, and social inequalities. Nutrition Reviews 67(1), 36–39.Google Scholar
Duboz, P, Macia, E, Chapuis‐Lucciani, N, Boëtsch, G Gueye, L (2012) Migration and hypertension in Dakar, Senegal. American Journal of Physical Anthropology 149(2), 250–258.Google Scholar
Duboz, P, Macia, E, Gueye, L, Boëtsch, G Chapuis-Lucciani, N (2011) Migrations internes au Sénégal. Caractéristiques socioéconomiques, démographiques et migratoires des Dakarois. Diversite urbaine 11(2), 113–135.Google Scholar
Duffey, KJ Popkin, BM (2011) Energy density, portion size, and eating occasions: contributions to increased energy intake in the United States, 1977–2006. PLoS Medicine 8(6), 1001050.Google Scholar
Dufour, DL (2006) Biocultural approaches in human biology. American Journal of Human Biology 18(1), 1–9.Google Scholar
Durnin, JVGA Womersley, JVGA (1974) Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. British Journal of Nutrition 32(1), 77–97.Google Scholar
Ebrahim, S, Pearce, N, Smeeth, L, Casas, JP, Jaffar, S Piot, P (2013) Tackling non-communicable diseases in low- and middle-income countries: is the evidence from high-income countries all we need? PLoS Medicine 10(1), 1001377.Google Scholar
FAO (eds) (2011) Guidelines for Measuring Household and Individual Dietary Diversity. FAO, Rome.Google Scholar
Fezeu, LK, Assah, FK, Balkau, B, Mbanya, DS, Kengne, AP, Awah, PK Mbanya, JCN (2008) Ten‐year changes in central obesity and BMI in rural and urban Cameroon. Obesity 16(5), 1144–1147.Google Scholar
Flynn, K Fitzgibbon, BM (1998) Body images and obesity risk among black females: a review of literature. Annals of Behavioral Medicine 20, 13–24.Google Scholar
Gning, SB, Thiam, M, Fall, F, Ba-Fall, K, Mbaye, PS Fourcade, L (2007) Le diabète sucré en Afrique subsaharienne. Aspects épidémiologiques, difficultés de prise en charge. Médecine tropicale 67(6), 607–611.Google Scholar
Guh, DP, Zhang, W, Bansback, N, Amarsi, Z, Birmingham, CL Anis, AH (2009) The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health 9(1), 88.Google Scholar
Hesse-Biber, S, Leavy, P, Quinn, CE Zoino, J (2006) The mass marketing of disordered eating and eating disorders: the social psychology of women, thinness and culture. Women’s Studies International Forum 29, 208–224.Google Scholar
Himmelgreen, DA, Pérez‐Escamilla, R, Martinez, D, Bretnall, A, Eells, B, Peng, Y Bermúdez, A (2004) The longer you stay, the bigger you get: length of time and language use in the us are associated with obesity in Puerto Rican women. American Journal of Physical Anthropology 125(1), 90–96.Google Scholar
Holdsworth, M, Delpeuch, F, Landais, E, Gartner, A, Eymard-Duvernay, S Maire, B (2006) Knowledge of dietary and behaviour-related determinants of non-communicable disease in urban Senegalese women. Public Health Nutrition 9(8), 975–981.Google Scholar
Holdsworth, M, Gartner, A, Landais, E, Maire, B Delpeuch, F (2004) Perceptions of healthy and desirable body size in urban Senegalese Women. International Journal of Obesity 28(12), 1561–1568.Google Scholar
Karimbeiki, R, Pourmasoumi, M, Feizi, A, Abbasi, B, Hadi, A, Rafie, N Safavi, SM (2018) Higher dietary diversity score is associated with obesity: a case-control study. Public Health 157, 127–134.Google Scholar
Krauss, RC, Powell, LM Wada, R (2012) Weight misperceptions and racial and ethnic disparities in adolescent female body mass index. Journal of Obesity 2012, 205393.Google Scholar
Letamo, G (2011) The prevalence of, and factors associated with, overweight and obesity in Botswana. Journal of Biosocial Science 43(1), 75–84.Google Scholar
Macia, E, Cohen, E, Gueye, L, Boetsch, G Duboz, P (2017) Prevalence of obesity and body size perceptions in urban and rural Senegal: new insight on the epidemiological transition in West Africa. Cardiovascular Journal of Africa 28(5), 324–330.Google Scholar
Macia, E, Duboz, P Gueye, L (2010) Prevalence of obesity in Dakar. Obesity Reviews 11(10), 691–694.Google Scholar
Macia, E, Gueye, L Duboz, P (2016) Hypertension and obesity in Dakar, Senegal. PloS One 11(9), 0161544.Google Scholar
Maire, B, Delpeuch, F, Cornu, A, Tchinbindat, F, Simondon, F, Massamba, JP, Salem, G Chevassus-Agnès, S (1992) Urbanisation et transition nutritionnelle en Afrique sub-saharienne: les exemples du Congo et du Sénégal. Revue d’épidémiologie et de santé publique 40(4), 252–258.Google Scholar
Mason, J (2002) Qualitative Researching. Sage Publications, London.Google Scholar
Monteiro, CA, Conde, WL, Lu, B Popkin, BM (2004) Obesity and inequities in health in the developing world. International Journal of Obesity 9, 1181–1186.Google Scholar
Morris, K (2010) UN raises priority of non-communicable diseases. The Lancet 375(9729).Google Scholar
Morris, MW, Leung, K, Ames, D Lickel, B (1999) Views from inside and outside: integrating emic and etic insights about culture and justice judgment. Academy of Management Review 24(4), 781–796.Google Scholar
Mvo, Z, Dick, J Steyn, K (1999) Perceptions of overweight African women about acceptable body size of women and children. Curationis 22(2), 27–31.Google Scholar
Ndiaye, L (2006) Les représentations sociales du corps de la femme en pays wolof sénégalais: ‘tradition et modernité’. In Ly, B (ed.) Sociétés en devenir. Presses Universitaire de Dakar, Dakar, pp. 213–234.Google Scholar
Ndoye, F Diop, A (eds) (2001) Evolution des styles alimentaires à Dakar. ENDA-GRAF/CIRAD, Dakar.Google Scholar
Neveu Kringelbach, H (2007) ‘Le poids du succès’: construction du corps, danse et carrière à Dakar. Politique africaine 107, 81–101.Google Scholar
Oldewage-Theron, WH Kruger, R (2008) Food variety and dietary diversity as indicators of the dietary adequacy and health status of an elderly population in Sharpeville, South Africa. Journal of Nutrition for the Elderly 27(1-2), 101–133.Google Scholar
Olszowy, KM, Pomer, A, Dancause, KN, Sun, C, Silverman, H Lee, G et al. (2015) Impact of modernization on adult body composition on five islands of varying economic development in Vanuatu. American Journal of Human Biology 27(6), 832–844.Google Scholar
Oyebode, O, Pape, UJ, Laverty, AA, Lee, JT, Bhan, N Millett, C (2015) Urban and migrant differences in non-communicable disease risk-factors in middle income countries: a cross-sectional study of WHO-SAGE Data. PLoS One 10(4), 0122747.Google Scholar
Parkin, DJ Ulijaszek, SJ (eds) (2007) Holistic Anthropology: Emergence and Convergence. Berghahn Books, New York.Google Scholar
Popkin, BM, Adair, LS Ng, SW (2012) Global nutrition transition and the pandemic of obesity in developing countries. Nutrition Reviews 70(1), 3–21.Google Scholar
Popkin, BM Gordon-Larsen, P (2004) The nutrition transition: worldwide obesity dynamics and their determinants. International Journal of Obesity 28, 2–9.Google Scholar
Puoane, T, Fourie, JM, Shapiro, M, Rosling, L, Tshaka, NC Oelefse, A (2005) ‘Big Is Beautiful’ – an exploration with urban black community health workers in a South African township. South African Journal of Clinical Nutrition 18(1), 6–15.Google Scholar
Renzaho, AM, McCabe, M Swinburn, B (2012) Intergenerational differences in food, physical activity, and body size perceptions among African migrants. Qualitative Health Research 22(6), 740–754.Google Scholar
Rguibi, M Belahsen, R (2006) Fattening practices among Moroccan Saharawi women. Eastern Mediterranean Health Journal 12(5), 619–624.Google Scholar
Saarloos, D, Kim, JE Timmermans, H (2009) The built environment and health: introducing individual space-time behavior. International Journal of Environmental Research and Public Health 6(6), 1724–1743.Google Scholar
Salehi-Abargouei, A, Akbari, F, Bellissimo, N Azadbakht, L (2016) Dietary Diversity Score and obesity: a systematic review and meta-analysis of observational studies. European Journal of Clinical Nutrition 70(1), 1–9.Google Scholar
Savy, M, Martin-Prével, Y, Traissac, P, Eymard-Duvernay, S Delpeuch, F (2006) Dietary Diversity Scores and nutritional status of women change during the seasonal food shortage in rural Burkina Faso. Journal of Nutrition 136(10), 2625–2632.Google Scholar
Sear, R Marlowe, FW (2009) How universal are human mate choices? Size does not matter when Hadza foragers are choosing a mate. Biology Letters 5(5), 606–609.Google Scholar
Siervo, M, Grey, P, Nyan, OA Prentice, AM (2006) A pilot study on body image, attractiveness and body size in Gambians living in an urban community. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity 11(2), 100–109.Google Scholar
Sobal, J Stunkard, AJ (1989) Socio-economic status and obesity: a review of the literature. Psychological Bulletin 105(2), 260–275.Google Scholar
Sodjinou, R, Agueh, V, Fayomi, B Delisle, H (2008) Obesity and cardio-metabolic risk factors in urban adults of Benin: relationship with socio-economic status, urbanisation, and lifestyle patterns. BMC Public Health 8(1), 84.Google Scholar
Stevens, GA, Singh, GM, Lu, Y, Danaei, G, Lin, JK, Finucane, MM Bahalim, AN (2012) National, regional, and global trends in adult overweight and obesity prevalences. Population Health Metrics 10(1), 22.Google Scholar
Stewart, D Shamdasani, P (eds) (1990) Focus Group: Theory and Practice. Sage Publications, Newbury Park.Google Scholar
Steyn, NP Mchiza, ZJ (2014) Obesity and the nutrition transition in sub‐Saharan Africa. Annals of the New York Academy of Sciences 1311(1), 88–101.Google Scholar
Sylla, A (1985) Sur l’esthétique de la femme africaine. Ethiopiques, 40–41.Google Scholar
Szabo, CP Allwood, CW (2006) Body figure preference in South African adolescent females: a cross cultural study. African Health Sciences 6, 201–206.Google Scholar
Temple, NJ Steyn, NP (2011) The cost of a healthy diet: a South African perspective. Nutrition 27(5), 505–508.Google Scholar
Ulijaszek, SJ Lofink, H (2006) Obesity in biocultural perspective. Annual Review of Anthropology 35, 337–360.Google Scholar
Warnier, JP (ed.) (2009) Régner au Cameroun: le roi-pot. Karthala Editions, Paris Google Scholar
Weiner, JS Lourie, JA (eds) (1981) Practical Human Biology. Academic Press, New York.Google Scholar
WHO (2000) Obesity: Preventing and Managing the Global Epidemic. WHO, Geneva.Google Scholar
Williamson, DA, Gleaves, DH, Watkins, PC Schlundt, DG (1993) Validation of self-ideal body size discrepancy as a measure of body dissatisfaction. Journal of Psychopathology and Behavioral Assessment 15(1), 57–68.Google Scholar
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(1), 1.Google Scholar