Africa is experiencing a rapid increase in adult obesity and associated cardiometabolic diseases (CMDs). The H3Africa AWI-Gen Collaborative Centre was established to examine genomic and environmental factors that influence body composition, body fat distribution and CMD risk, with the aim to provide insights towards effective treatment and intervention strategies. It provides a research platform of over 10 500 participants, 40–60 years old, from Burkina Faso, Ghana, Kenya and South Africa. Following a process that involved community engagement, training of project staff and participant informed consent, participants were administered detailed questionnaires, anthropometric measurements were taken and biospecimens collected. This generated a wealth of demographic, health history, environmental, behavioural and biomarker data. The H3Africa SNP array will be used for genome-wide association studies. AWI-Gen is building capacity to perform large epidemiological, genomic and epigenomic studies across several African counties and strives to become a valuable resource for research collaborations in Africa.

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Reporting of age at FMP is unreliable in women interviewed 4 years or more after the event. STRAW + 10 seems accurate in staging reproductive aging, as confirmed by the strong association of FSH and estradiol levels with the menopausal transition stage. STRAW + 10 may be appropriate for use in resource-limited settings in the absence of biomarkers. Biocultural methods may be useful in assessing the menopausal transition in culturally diverse women.

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Developing countries are disproportionately affected by hypertension, with Black women being at greater risk, possibly due to differences in body fat distribution. The objectives of this study were: (1) To examine how different measures of body composition are associated with blood pressure (BP) and incident hypertension; (2) to determine the association between baseline or change in body composition, and hypertension; and (3) to determine which body composition measure best predicts hypertension in Black South African women. The sample comprised 478 non-hypertensive women, aged 29–53 years. Body fat and BP were assessed at baseline and 8.3 years later. Body composition was assessed using dual-energy X-ray absorptiometry (DXA) (n = 273) and anthropometry. Hypertension was diagnosed based on a systolic/diastolic BP ≥140/90 mmHg, or medication use at follow-up. All body composition measures increased (p<0.0001) between baseline and follow-up. SBP and DBP increased by ≥20%, resulting in a 57.1% cumulative incidence of hypertension. Both DXA- and anthropometric-derived measures of body composition were significantly associated with BP, explaining 3–5% of the variance. Baseline BP was the most important predictor of hypertension (adjusted OR: 98–123%). Measures of central adiposity were associated with greater odds (50–65%) of hypertension than total adiposity (44–45%). Only change in anthropometric-derived central fat mass predicted hypertension (adjusted OR: 32–40%). This study highlights that body composition is not a major determinant of hypertension in the sample of black African women. DXA measures of body composition do not add to hypertension prediction beyond anthropometry, which is especially relevant for African populations globally, taking into account the severely resource limited setting found in these communities.

Background: There is a high and increasing prevalence of overweight and obesity in South Africans of all ages. Risk factors associated with overweight and obesity must be identified to provide targets for intervention. Objective: To identify the demographic, socio-economic and behavioural factors associated with body mass index (BMI) in middle-aged black South African men and women. Methods: Data on demographic and socio-economic factors were collected via questionnaire on 1027 men and 1008 women from Soweto Johannesburg, South Africa. Weight and height were measured and BMI was determined. Behavioural factors included tobacco use and consumption of alcohol, and physical activity data were collected using the Global Physical Activity Questionnaire. Menopausal status was determined for the women, and HIV status was available for 93.6% of the men and 39.9% of the women. Results: Significantly more women were overweight or obese than men (87.9 vs. 44.9%). Smoking prevalence (current or former) and minutes spent in moderate to vigorous intensity physical activity was significantly different between the sexes (both p < 0.0001). In the final hierarchical model, marital status (+ married/cohabiting), household asset score (+), current smoking (-), moderate to vigorous physical activity (-) and HIV status (- HIV infected) significantly contributed to 26% of the variance in BMI in the men. In the women, home language (Tswana-speaking compared to Zulu-speaking), marital status (+ unmarried/cohabiting), education (-), current smoking (-) and HIV status (- HIV infected) significantly contributed to 14% of the variance in BMI. Conclusions: The sex difference in BMI and the prevalence of overweight and obesity between black South African men and women from Soweto, as well as the sex-specific associations with various demographic, socio-economic and behavioural factors, highlight the need for more tailored interventions to slow down the obesity epidemic.

BackgroundThe aetiology of the metabolic syndrome and the inter-relationship between risk factors for this syndrome are poorly understood. The purpose of this investigation was to determine the risk factors for metabolic syndrome and their interactions in a cohort of women with a high prevalence of metabolic syndrome.Materials and MethodsAbdominal and whole body composition (ultrasound and dual-energy X-ray absorptiometry), blood pressure, and cardiometabolic and demographic factors were measured in a cross-sectional study of 702 black African women from Soweto, Johannesburg. Data was analysed using multivariate logistic regression.ResultsMetabolic syndrome was present in 49.6% of the study cohort. Logistic regression analysis demonstrated that adiponectin (odds ratio [95% CIs]: 0.84 [0.77, 0.92], p<0.0005) and abdominal subcutaneous fat (0.56 [0.39, 0.79], p = 0.001) reduced metabolic syndrome risk whilst insulin resistance (1.31 [1.16, 1.48], p<0.0005) and trunk fat-free soft-tissue mass (1.34 [1.10, 1.61], p = 0.002) increased risk. Within this group of risk factors, the relationship of adiponectin with metabolic syndrome risk, when analysed across adiponectin hexiles, was the least affected by adjustment for the other risk factors.ConclusionsAdiponectin has a significant protective role against metabolic syndrome and is independent of other risk factors. The protective and possible augmentive effects of abdominal subcutaneous fat and lean trunk mass, respectively on metabolic syndrome risk demonstrate the existence of novel interactions between body composition and cardiometabolic disease.

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