In sub-Saharan Africa, urbanisation and food systems change contribute to rapid dietary transitions promoting obesity. It is unclear to what extent these changes are mediated by neighbourhood food environments or other factors. This paper correlates neighbourhood food provision with household consumption and poverty in Khayelitsha, South Africa and Ahodwo, Ghana. Georeferenced survey data of food consumption and provision were classified by obesity risk and protection. Outlets were mapped, and density and distribution correlated with risk classes. In Khayelitsha, 71% of households exceeded dietary obesity risk thresholds while 16% consumed protective diets. Obesogenic profiles were less (26%) and protective more prevalent (23%) in Ahodwo despite greater income poverty in Khayelitsha. Here, income-deprived households consumed significantly (p < 0.005) less obesogenic and protective diets. Small informal food outlets dominated numerically but supermarkets were key household food sources in Khayelitsha. Although density of food provision in Ahodwo was higher (76/km2), Khayelitsha outlets (61/km2) provided greater access to obesogenic (57% Khayelitsha; 39% Ahodwo) and protective (43% Khayelitsha; 16% Ahodwo) foods. Consumption and provision profiles correlate more strongly in Ahodwo than Khayelitsha (rKhayelitsha = 0.624; rAhodwo = 0.862). Higher obesogenic food consumption in Khayelitsha suggests that risky food environments and poverty together promote obesogenic diets.

Background. Accurate body weight perception is important to maintaining an ideal body weight. In Africa, a preference for a larger body size and its association with health and wellbeing has been well documented. It remains speculative if these perceptions have changed or improved and if differences exist among rural and urban dwellers. The main aim of this study was to assess the body weight and obesity perceptions among rural and urban Ghanaians. Methods. This cross-sectional study involved 565 participants. The Stunkard figure rating scale was used to assess the body weight perception of participants. Participants were to choose from the scale figures they perceived to represent their current body weight, desired body weight, ideal body weight, ideal look for a wealthy person, ideal look for a woman with children, and ideal look for a woman without children. Additionally, participants were asked to describe obesity and its threat to health in their terms. Responses of participants to the above questions are presented as frequencies. Differences between rural and urban participants as well as males and females with respect to the median figure chosen for each question were determined by Mann–Whitney U test. Results. The median age of participants was 40 (IQR 26). The prevalence of overweight and obesity observed among participants was 52.8%. The most frequently selected figure as current body image was figure 5 (23.5%). Figure 4 was most frequently chosen by both males (37.2%) and females (24.6%) as their desired body image (27.4%). Male participants (41.8%) chose figure 5 as ideal for their gender while females (27.4%) maintained figure 4 as ideal for their gender. Study participants associated overweight with wealth and childbirth, and attributed their current weights to hereditary (27%) and childbirth (27%). Most participants were not taking steps to achieve their desired body image, and only a few engaged in both dieting and exercise to lose weight. Majority of participants described obesity as the accumulation of fat (91.0%) and viewed it as a threat to health (91.0%). Differences were observed among rural and urban participants with regard to the figure chosen as ideal for a wealthy person. Conclusion. Results from this study show an improvement in obesity perception and the acknowledgment of obesity as a threat to health. There was a desire for a normal-weight figure among study participants. Attribution of current body weight to hereditary and childbirth seems to be a hindrance to the implementation of actions to achieve this normal figure weight. Public health education, screening for overweight and obesity, creation of supportive food environments, and culture-sensitive interventions are promising to curbing the obesity menace.

Purpose -Cardiovascular diseases threaten the global health system and their prevalence among the incarcerated population poses a huge economic burden to governments. The purpose of this paper is to investigate the prevalence of cardiovascular disease risk factors among prisoners.Design/methodology/approach -A systematic review was done on published studies that looked at prevalence and risk factors of cardiovascular disease among either male or female prisoners or both. PubMed, PubMed Central, Google scholar, Cochrane and Medline databases were searched from a period of 6 June 2016 to 23 June 2016. Quality assessment was done for all papers based on their methodology.Findings -Online search yielded a total of 58,587 papers of which 43 were appropriately titled, but 21 were rejected based on their abstracts. Five of the studies could not be included because full texts were not available; 17 studies that met inclusion criteria in terms of abstracts and methodology were included in the study. Majority of the studies assessed weight (64.7 per cent), height (64.7 per cent), body mass index (64.7 per cent) and blood pressure (17.6 per cent) of inmates. Two of the studies used secondary data and one collected qualitative information via focus group discussions. Overall, prevalence of obesity (23.3 per cent), smoking (53.4 per cent) and physical inactivity (57.5 per cent) reported were high among prisoners.Practical implications -Most of the studies were conducted in developed countries and this implies that there is a paucity of data in developing countries where prevalence of cardiovascular diseases is high. There is the need for more studies to be conducted in this area among developing countries.Originality/value -This paper informs stakeholders on factors that put inmates at risk of cardiovascular diseases and can initiate timely interventions to be implemented within prisons.

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Background: Good nutrition and physical activity of school-aged children are important for ensuring optimum growth and reducing obesity. This present study assessed associations between breakfast consumption, BMI-for-Age (BMI) and physical fitness in a cross-section of school-aged children attending government-owned primary schools in Kumasi, Ghana. Method: The sample consisted of 438 pupils (boys = 213; girls = 225; mean age 11.1 ± 1.1), attending 10 randomly selected schools. Weight (kg), height (cm) and Mid Upper Arm Circumference (MUAC) were measured for each participant, and BMI-for-age z-scores determined using the World Health Organisation (WHO) anthroplus software. Participants were stratified into thinness, normal weight, overweight/obese using WHO cut offs. Physical fitness was assessed using forward jump, left and right handgrips, flexibility, sit-ups and 50 metre run following standard procedures and converted to scores of 1 to 10 following Japanese standards, based on which percentiles were derived. Total fitness score for each pupil was computed by adding all scores. A questionnaire was used to assess meal intake patterns. Results: The mean BMI-for-age z-score for participants was − 0.24 ± 0.99. Thinness, normal weight and overweight/ obesity were 2.7, 86.5, and 10.5% respectively among the pupils. Overweight was higher in girls (14.2%) compared to boys (4.2%), p = 0.003. Similarly, mean MUAC was significantly (p = 0.021) higher in the girls (22.0 ± 3.2 cm) than the boys (20.7 ± 7.3 cm). For physical fitness, the girls scored higher in forward jump (p < 0.0001), 50-m run (p = 0.002) and overall fitness score than the boys (21.0 ± 6.2 versus 19.2 ± 8.3, p = 0.012). However, a larger proportion of boys performed excellently and poorly than girls (p = 0.019). A positive correlation was observed between BMI zscore and hand grip (r = 0.21, p < 0.001), while sit up (r = − 0.11, p = 0.018) showed a negative correlation with BMI z-score. No other fitness test varied by BMI. Overweight children performed best in handgrip. Majority of children said they engaged in exercise (89.9%) and consumed breakfast (78.9%). Breakfast consumption was not associated with BMI z-score (x 2 0.0359, p = 0.549) but non-breakfast consumers performed better in 50 m run compared to consumers (7.0 seconds ± 2.3 vrs 6.3 seconds ± 2.5, p = 0.022). Children who reported to exercise were physically fitter than those who did not.(Continued on next page)

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Background: Overweight and obesity have become threats to public health in all regions across the globe including sub-Saharan Africa where prevalence used to be low. Policies to regulate the food environment and promote healthy food consumption look promising to reducing the prevalence of obesity but in Ghana there is not enough data to elicit a policy response. This study assessed the association between dietary consumption, anthropometric measures, body composition and physical activity among rural and urban Ghanaian adults. Methods: This was a cross-sectional study involving 565 Ghanaian adults. Structured interviewer administered questionnaires were used to collect information on socio-demographics. Dietary consumption was assessed using household food frequency questionnaire and 24-h recall. Height, weight, BMI, waist circumference and body composition of all participants were determined. The World Health Organization's Global Physical Activity Questionnaire (GPAQ) was used to assess physical activity levels. Mann-Whitney U test was used to analyze differences in anthropometric measures, body composition and consumption among rural and urban participants. Principal component analysis was used to analyze household food frequency data and nutrient analysis template was used to analyze 24-h recall. Chi-square was used to measure differences in obesity prevalence by community and gender. Multinomial logistic regression was used to model the risk factors associated with obesity.