Risk-factor profiles for chronic diseases of lifestyle and metabolic syndrome in an urban and rural setting in South Africa

Abstract

BackgroundChronic lifestyle diseases share similar modifiable risk factors, including hypertension, tobacco smoking, diabetes, obesity, hyperlipidaemia and physical inactivity. Metabolic syndrome refers to the cluster of risk factors that increases the risk for developing type 2 diabetes mellitus (DM) and cardiovascular disease.ObjectivesThe study aimed to assess health status and identify distinct risk-factor profiles for both chronic lifestyle diseases and metabolic syndrome in rural and urban communities in central South Africa.MethodsThe investigation formed part of the Assuring Health for All in the Free State (AHA-FS) study. During interviews by trained researchers, household socio-demographic and health information, diet, risk factors (i.e. history of hypertension and/or diabetes) and habits (e.g. smoking and inadequate physical activity levels) were determined. Adult participants underwent anthropometric evaluation, medical examination and blood sampling.ResultsThe risk-factor profile for chronic lifestyle diseases revealed that self-reported hypertension and physical inactivity were ranked the highest risk factor for the rural and urban groups respectively. The cumulative risk-factor profile showed that 40.1% of the rural and 34.4% of the urban study population had three or more risk factors for chronic lifestyle diseases. Furthermore, 52.2% of rural and 39.7% of urban participants had three or more risk factors for metabolic syndrome.ConclusionThis study confirmed that the worldwide increase in the prevalence of chronic lifestyle diseases can be attributed to a more sedentary lifestyle, especially illustrated in the urban study population, and increasing obesity. The rural study population had a higher prevalence of risk factors for metabolic syndrome.

Modifiable Coronary Heart Disease Risk Factors Trends in Urban Black South African Females and the Implications for Health Promotion Interventions

“…The increase in total serum cholesterol (from 5.6% to 23.9%) was significant and consistent with that derived from two similar studies undertaken in urban Black African females with, respectively, 15% and 20.1% of the study population presenting with hypercholesterolemia (Tibarazwa et al, 2009;Van Zyl et al, 2012). According to the literature there are two possible reasons to explain the increase in total serum cholesterol levels: first, a higher intake of fatty foods due to urbanization (Vorster et al, 2007;Richter, Baumgartner, Wentzel-Viljoen, & Smuts, 2014) and second, obesity and physical inactivity that promote elevated serum cholesterol (Normal et al, 2007;Tibarazwa et al, 2009).…”

“…1;2018 compared to 42% in 2006. The finding corroborated the findings from two urban Black female cohorts' study of which 41.1% and 55% were obese respectively (Tibazarwa et al, 2009;Van Zyl et al, 2012). These results are indicative of an increasing tendency compared to 31.8% Black females, who were obese according to the SADHS in 2003(SADHS, 2003a.…”

“…The findings of the South African Democratic Health Survey (SADHS) in 2003 supported the low levels of PA in urban versus rural populations. Other researchers indicated that 66.5% of the urban Black sample was physically inactive compared to 27.3% of the rural population (SADHS, 2003a;Van Zyl et al, 2012). In a cohort of peri-urban, mixed-race women their low physical activity levels were highlighted with nearly half not meeting the public health recommendation of 150 minutes or more of health-enhancing PA a week (Steyn, Levitt, Hoffman, Marais, Fourie, Lambert, & Lombard, 2004).…”

“…These results are indicative of an increasing tendency compared to 31.8% Black females, who were obese according to the SADHS in 2003(SADHS, 2003a. As much as researchers may want to blame urbanization for the high prevalence of obesity, the data indicate that this condition prevails in both the rural and urban areas (Vorster et al, 2007;Tibazarwa et al, 2009;Van Zyl et al, 2012). The epidemic of obesity is rather the end result of the food-marketing industry tending to promote less healthy foods (high in fat, sugar, and salt; low in potassium) in a widely accessible manner at low prices (Maseko, Majane, Milne, Norton, & Woodiwiss, 2006;Moodley, Christofides, Norris, & Achia, 2015).…”

“…In addition to this, 33.9% presented with one CHD risk factor and an alarming 59.7% with more than one such factor (Coetsee, 2007). Since then, a few researchers have reported on the modifiable CHD risk factors among urban Black South African women with varying results, mainly due to different participant ages, category groupings and cut-off points, which make comparisons difficult (Vorster et al, 2007;Tibazarwa et al, 2009;Van Zyl, Van der Merwe, Walsh, Groenewald, & Van Rooyen, 2012). In addition, the researchers did not differentiate between male and female CHD risk factors or urban or rural Black populations and most of these studies are fairly outdated as indicated earlier on.…”