Factors associated with obesity and metabolic syndrome in ageing black South African women

Abstract

Background: The incidence of obesity and related metabolic diseases is high and increasing in sub-Saharan African women. Evidence on the determinants of these diseases is limited, particularly in black South African women. Objective: This PhD review attempts to understand the determinants of obesity and metabolic syndrome (MetS) in a population of ageing urban-dwelling black South African women. Methods: Drawing on the longitudinal Birth-to-Twenty-Plus cohort, data were collected in 2002/03 and 2012/13, including information on behavioural factors (smoking, sitting time, physical activity, smokeless tobacco, and alcohol consumption), body-size perception, body composition (measures of adiposity and lean mass), blood pressure, and cardiometabolic biomarkers (lipid profile, fasting insulin, fasting blood glucose, insulin resistance, leptin, and adiponectin). Results: The prevalence of obesity and related cardiovascular disease risk was high and increased significantly over the 10 year period. Despite most of the study population being physically active, sitting time was high and associated with elevated blood pressure and hypertriglyceridaemia. Two groups of people were observed, those who were happy and those who were unhappy with their body size. In logistic regression analysis, the risk of MetS was lowered by abdominal subcutaneous adipose tissue and adiponectin, and increased by age, smoking, truncal lean mass, and insulin resistance. Conclusions: Obesity was confirmed to be increasing in black South African women, despite most women being sufficiently active according to guidelines of ≥150 min activity/week. Nevertheless, the contribution of sitting time to poor health outcomes is evident in this study population and must be addressed, particularly in women who are content with being obese. The novel finding of the effects of abdominal subcutaneous tissue and truncal lean mass with MetS requires further investigation. The protective effect of adiponectin against MetS is an important finding which highlights the novel interaction between adiposity and cardiometabolic diseases in black South African women.

Smoke exposure and cardio-metabolic profile in youth with type 1 diabetes

“…Globally, over one billion people are regular smokers, and annually an estimated seven million people die as a consequence of smoking [ 30 ]. The role of smoking in cardiovascular diseases [ 31 – 34 ] and metabolic abnormalities [ 11 , 19 , 20 ] is well recognized. A dose–response relationship exists with cigarette smoking and the development of metabolic alterations in adults [ 35 ].…”

“…Indeed, smoking reduces insulin sensitivity and induces insulin resistance enhancing cardiovascular risk factors such as elevated plasma triglycerides, decreased high-density lipoprotein cholesterol and hyperglycemia [ 15 – 18 ]. Several studies show that smoking is associated with metabolic abnormalities and increases the risk of metabolic syndrome (MS) [ 11 , 19 , 20 ].…”

Addressing the problem of obesity and associated cardiometabolic risk in black South African women – time for action!

“…The thesis of Gradidge attempts to understand the determinants of obesity and metabolic syndrome (MetS) in a population of urban-dwelling black South African women [1]. This is particularly pertinent, given that black South African women have the highest prevalence of obesity (42%) within sub-Saharan Africa [2], which is associated with a high prevalence of MetS (42%) [3] and type 2 diabetes (14.7%) [4].…”

“…In his thesis, Gradidge presents an excellent conceptual framework, which positions obesity as the central risk factor for MetS, and includes the possible influence of socioeconomic status, lifestyle behaviours and body size perceptions, as key determinants of obesity [1]. Gradidge’s thesis tests this hypothesis through secondary analyses of 10-year prospective data from the caregivers of the Birth-to-Twenty longitudinal cohort study [5].…”

Assessment of the association of plant-based diets with cardiovascular disease risk profile in Africa: a systematic review and meta-analysis protocol

“…5 In South Africa, 6 overweight/obesity is 31% in men and 68% in women, with women being more susceptible to obesity in most African Open access countries. [7][8][9][10] These high prevalence rates in Africa are a cause for concern. In comparison to high-income countries, the demographic of individuals affected by cardiometabolic risk factors in Africa is slightly different to the global population.…”