A qualitative research synthesis of contextual factors contributing to female overweight and obesity over the life course in sub-Saharan Africa


Autoři: Ifeoma D. Ozodiegwu aff001;  Mary Ann Littleton aff002;  Christian Nwabueze aff003;  Oluwaseun Famojuro aff003;  Megan Quinn aff003;  Richard Wallace aff004;  Hadii M. Mamudu aff005
Působiště autorů: Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America aff001;  Department of Community and Behavioral Health, East Tennessee State University, Johnson City, Tennessee, United States of America aff002;  Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, Tennessee, United States of America aff003;  Quillen College of Medicine Library, East Tennessee State University, Johnson City, Tennessee, United States of America aff004;  Department of Health Services Management and Policy, East Tennessee State University, Johnson City, Tennessee, United States of America aff005
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224612

Souhrn

Objective

Adult women are disproportionately affected by overweight and obesity in Sub-Saharan African (SSA) countries. Existing evidence on the sociocultural context remains unconsolidated. In this qualitative research synthesis, we aggregate research literature on contextual factors that potentially predispose adult women and adolescent girls to overweight and obesity to inform research, policies and programs over the life course.

Methods

PubMed, CINAHL, PsychInfo, ProQuest Central, EMBASE, and Web of Science were searched to locate qualitative research articles conducted in SSA countries beginning in the year 2000. After assessment for eligibility and critical appraisal, 17 studies were included in the synthesis. Textual data and quotes were synthesized using meta-aggregation methods proposed by the Joanna Briggs Institute.

Results

The synthesized studies were conducted in South Africa, Ghana, Kenya and Botswana. The three overarching themes across these studies were body size and shape ideals, barriers to healthy eating, and barriers to physical activity, with cultural and social factors as cross-cutting influences within the major themes. Culturally, the supposedly ideal African woman was expected to be overweight or obese, and voluptuous, and this was associated with their identity. Although being overweight or obese was not acceptable to adolescent girls, they desired to be voluptuous. Healthy food choices among women and adolescent girls were hampered by several factors including affordability of nutritious foods and peer victimization. Both adult women and adolescent girls experienced ageism as a barrier to physical activity.

Significance

This is the first qualitative research synthesis to amplify the voices of women and girls in SSA countries highlighting the challenges they face in maintaining a healthy body weight. Sociocultural, institutional and peer-related factors were powerful forces shaping body size preferences, food choices and participation in physical activity. Our study findings provide insights for the design of contextually appropriate obesity prevention interventions and lay the foundation for further research studies.

Klíčová slova:

Adolescents – Adults – African people – Food – Obesity – Physical activity – Physiological parameters – Qualitative studies


Zdroje

1. World Health Organization. Global Health Observatory Data Repository. WHO 2017. http://apps.who.int/gho/data/?theme=main.

2. Lovejoy JC, Sainsbury A, Stock Conference 2008 Working Group. Sex differences in obesity and the regulation of energy homeostasis. Obes Rev 2009;10:154–67. doi: 10.1111/j.1467-789X.2008.00529.x 19021872

3. Ouldzeidoune N, Keating J, Bertrand J, Rice J. A description of female genital mutilation and force-feeding practices in Mauritania: implications for the protection of child rights and health. PLoS One 2013;8:e60594. doi: 10.1371/journal.pone.0060594 23593257

4. Office National de la Statistique (ONS) [Mauritanie] and ORC Macro. Enquête Démographique et de Santé Mauritanie 2000–2001. Calverton, Maryland, USA: 2001.

5. World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013–2020. 2013. 978 92 4 1506236.

6. Heymsfield SB, Wadden TA. Mechanisms, Pathophysiology, and Management of Obesity. N Engl J Med 2017;376:254–66. doi: 10.1056/NEJMra1514009 28099824

7. The GBD 2015 Obesity Collaborators. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 2017;377:13–27. doi: 10.1056/NEJMoa1614362 28604169

8. Nations United. Transforming our world: The 2030 agenda for sustainable development. 2015. doi: 10.1007/s13398-014-0173-7.2

9. Simmonds M, Llewellyn A, Owen CG, Woolacott N. Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obes Rev 2016;17:95–107. doi: 10.1111/obr.12334 26696565

10. Glenton C, Colvin C, Carlsen B, Swartz A, Lewin S, Noyes J, et al. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis. In: Glenton C, editor. Cochrane Database Syst. Rev., Chichester, UK: John Wiley & Sons, Ltd; 2013. doi: 10.1002/14651858.CD010414

11. World Health Organization. WHO recommendations: optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting. Geneva, Switzerland: 2012. 23844452

12. Noyes J, Booth A, Cargo M, Flemming K, Garside R, Hannes K, et al. Cochrane Qualitative and Implementation Methods Group guidance series—paper 1: introduction. J Clin Epidemiol 2018;97:35–8. doi: 10.1016/j.jclinepi.2017.09.025 29242094

13. Sisnowski J, Street JM, Merlin T. Improving food environments and tackling obesity: A realist systematic review of the policy success of regulatory interventions targeting population nutrition. PLoS One 2017;12:e0182581. doi: 10.1371/journal.pone.0182581 28783757

14. Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: Methodological guidance for systematic reviewers utilizing meta-aggregation. Int J Evid Based Healthc 2015;13:179–87. doi: 10.1097/XEB.0000000000000062 26262565

15. WHO. Global accelerated action for the health of adolescents (‎ AA-HA!)‎: guidance to support country implementation. Geneva: 2017. Licence: CC BY-NC-SA 3.0 IGO.

16. Okop KJ, Mukumbang FC, Mathole T, Levitt N, Puoane T. Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study. BMC Public Health 2016;16:365. doi: 10.1186/s12889-016-3028-7 27129700

17. Matoti-Mvalo T, Puoane T. Perceptions of body size and its association with HIV/AIDS. South African J Clin Nutr 2011;24:40–5.

18. Bodiba P, Madu SN, Ezeokana JO, Nnedum OAU. The relationship between body mass index and self-concept among adolescent black female university students. Curationis 2008;31:77–84.

19. Draper CE, Davidowitz KJ, Goedecke JH. Perceptions relating to body size, weight loss and weight-loss interventions in black South African women: a qualitative study. Public Health Nutr 2016;19:548–56. doi: 10.1017/S1368980015001688 26006784

20. Hunter-Adams J, Rother H-A. Pregnant in a foreign city: A qualitative analysis of diet and nutrition for cross-border migrant women in Cape Town, South Africa. Appetite 2016;103:403–10. doi: 10.1016/j.appet.2016.05.004 27166078

21. Kinsman J, Norris SA, Kahn K, Twine R, Riggle K, Edin K, et al. A model for promoting physical activity among rural South African adolescent girls. Glob Health Action 2015;8:15. doi: 10.3402/gha.v8.28790 26685095

22. Muzigaba M, Kolbe-Alexander TL, Wong FN. The Perceived Role and Influencers of Physical Activity Among Pregnant Women From Low Socioeconomic Status Communities in South Africa. J Phys Act Health 2014;11:1276–83. doi: 10.1123/jpah.2012-0386 24184664

23. Phillips EA, Comeau DL, Pisa PT, Stein AD, Norris SA. Perceptions of diet, physical activity, and obesity-related health among black daughter-mother pairs in Soweto, South Africa: a qualitative study. BMC Public Health 2016;16:750. doi: 10.1186/s12889-016-3436-8 27506678

24. Puoane T, Tsolekile L, Steyn N. Perceptions about body image and sizes among Black African girls living in Cape Town. Ethn Dis 2010;20:29–34. 20178179

25. Sedibe MH, Feeley AB, Voorend C, Griffiths PL, Doak CM, Norris SA. Narratives of urban female adolescents in South Africa: dietary and physical activity practices in an obesogenic environment. South African J Clin Nutr 2014;27:114–9.

26. Sedibe HM, Kahn K, Edin K, Gitau T, Ivarsson A, Norris SA. Qualitative study exploring healthy eating practices and physical activity among adolescent girls in rural South Africa. BMC Pediatr 2014;14:211. doi: 10.1186/1471-2431-14-211 25164604

27. Voorend CGN, Norris SA, Griffiths PL, Sedibe MH, Westerman MJ, Doak CM. “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 2013;16:559–67. doi: 10.1017/S1368980012003254 23174129

28. Watson ED, Norris SA, Draper CE, Jones RA, van Poppel MN, Micklesfield LK. “Just because you’re pregnant, doesn’t mean you’re sick!” A qualitative study of beliefs regarding physical activity in black South African women. BMC Pregnancy Childbirth 2016;16:174. doi: 10.1186/s12884-016-0963-3 27435173

29. Tuoyire DA, Kumi-Kyereme A, Doku DT, Amo-Adjei J. Perceived ideal body size of Ghanaian women: “Not too skinny, but not too fat”. Women Health 2018;58:583–97. doi: 10.1080/03630242.2017.1321607 28426342

30. Tuakli-Wosornu YA, Rowan M, Gittelsohn J. Perceptions of physical activity, activity preferences and health among a group of adult women in urban Ghana: a pilot study. Ghana Med J 2014;48:3–13. 25320395

31. Brown CD. Adolescent and adult perceptions of adolescent diet, physical activity, body size, and obesity prevention in Botswana. University of Pennsylvania, 2014.

32. Mugo A. Obesity Among Women in Rural Kenya: Knowledge, Beliefs, and Perceptions. Walden University, 2016.

33. Eknoyan G. A History of Obesity, or How What Was Good Became Ugly and Then Bad. Adv Chronic Kidney Dis 2006;13:421–7. doi: 10.1053/j.ackd.2006.07.002 17045228

34. World Bank. World Bank Country and Lending Groups 2018. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups (accessed February 25, 2018).

35. Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011;378:804–14. doi: 10.1016/S0140-6736(11)60813-1 21872749

36. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity Among Adults and Youth: United States, 2015–2016. 2017. doi: 10.1017/S1368980017000088 29155689

37. Robinson SA, Webb JB, Butler-Ajibade PT. Body Image and Modifiable Weight Control Behaviors Among Black Females: A Review of the Literature. Obesity 2012;20:241–52. doi: 10.1038/oby.2011.54 21494225

38. Talleyrand RM, Gordon AD, Daquin J V., Johnson AJ. Expanding Our Understanding of Eating Practices, Body Image, and Appearance in African American Women: A Qualitative Study. J Black Psychol 2017;43:464–92. doi: 10.1177/0095798416649086

39. Pearce MJ, Boergers J, Prinstein MJ. Adolescent Obesity, Overt and Relational Peer Victimization, and Romantic Relationships. Obes Res 2002;10:386–93. doi: 10.1038/oby.2002.53 12006638

40. Puhl RM, Luedicke J, Heuer C. Weight-Based Victimization Toward Overweight Adolescents: Observations and Reactions of Peers. J Sch Health 2011;81:696–703. doi: 10.1111/j.1746-1561.2011.00646.x 21972990

41. Pont SJ, Puhl R, Cook SR, Slusser W. Stigma Experienced by Children and Adolescents With Obesity. Pediatrics 2017. doi: 10.1542/peds.2017-3034 29158228

42. Puhl RM, Heuer CA. Obesity stigma: Important considerations for public health. Am J Public Health 2010. doi: 10.2105/AJPH.2009.159491 20075322

43. Flint SW, Nobles J, Gately P, Sahota P, Association for the Study of Obesity, Obesity Empowerment Network, et al. Weight stigma and discrimination: a call to the media. Lancet Diabetes Endocrinol 2018;6:169–70. doi: 10.1016/S2213-8587(18)30041-X

44. Puhl R, Suh Y. Health Consequences of Weight Stigma: Implications for Obesity Prevention and Treatment. Curr Obes Rep 2015;4:182–90. doi: 10.1007/s13679-015-0153-z 26627213

45. Tomiyama AJ, Carr D, Granberg EM, Major B, Robinson E, Sutin AR, et al. How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Med 2018;16:123. doi: 10.1186/s12916-018-1116-5 30107800

46. Swami V. Cultural Influences on Body Size Ideals. Eur Psychol 2015;20:44–51. doi: 10.1027/1016-9040/a000150

47. Iwelunmor J, Newsome V, Airhihenbuwa CO. Framing the impact of culture on health: a systematic review of the PEN-3 cultural model and its application in public health research and interventions. Ethn Health 2014;19:20–46. doi: 10.1080/13557858.2013.857768 24266638

48. Saulsberry A, Corden ME, Taylor-Crawford K, Crawford TJ, Johnson M, Froemel J, et al. Chicago Urban Resiliency Building (CURB): An Internet-Based Depression-Prevention Intervention for Urban African-American and Latino Adolescents. J Child Fam Stud 2013;22:150–60. doi: 10.1007/s10826-012-9627-8

49. Staatz J, Hollinger F. West African Food Systems and Changing Consumer Demands 2016. https://doi.org/https://doi.org/10.1787/b165522b-en.

50. Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, et al. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet 2019;0. doi: 10.1016/S0140-6736(18)32822-8


Článek vyšel v časopise

PLOS One


2019 Číslo 11