Biocultural determinants of overweight and obesity in the context of nutrition transition in Senegal: a holistic anthropological approach.

Senegal is experiencing a rising obesity epidemic, due to the nutrition transition occurring in most African countries, and driven by sedentary behaviour and high-calorie dietary intake. In addition, the anthropological local drivers of the social valorization of processed high-calorie food and large body sizes could expose the population to obesity risk. This study aimed to determine the impact of these biocultural factors on the nutritional status of Senegalese adults. A mixed methods approach was used, including qualitative and quantitative studies. Between 2011 and 2013, fourteen focus group discussions (n=84) and a cross-sectional quantitative survey (n=313 women; n=284 men) of adults in three different socio-ecological areas of Senegal (rural: n=204; suburban: n=206; urban: n=187) were conducted. Dietary intake (Dietary Diversity Scores), physical activity (International Physical Activity Questionnaire), body weight norms (Body Size Scale), weight and health statuses (anthropometric measures and blood pressure) were measured. Middle-aged and older Senegalese women were found to value overweight/obesity more than younger Senegalese in all regions. In addition, young urban/suburban adults had a tendency for daily snacking whilst urban/suburban adults tended to be less physically active and had higher anthropometric means. A binary logistic regression model showed that being female, older, living in urban/suburban areas and valuing larger body size were independently associated with being overweight/obese, but not high-calorie diet. Univariate analyses showed that lower physical activity and higher socioeconomic status were associated with being overweight/obese. Finally, overweight/obesity, which is low in men, is associated with hypertension in the total sample. The nutrition transition is currently underway in Senegal's urban/suburban areas, with older women being more affected. Since several specific biocultural factors jointly contribute to this phenomenon, the study's findings suggest the need for local public health interventions that target women and which account for the anthropological specificities of the Senegalese population.

Perception of ageism and self-esteem among Lebanese elders at home and abroad.

BACKGROUND: Discrimination against old age leads to depressive symptoms and lower self-esteem. This issue is not studied in the Lebanese society where a demographic transition is taking place and the population is aging. We assess the perception of age discrimination among Lebanese and its relation to self-esteem. METHODS: We interviewed a convenience sample of 320 Lebanese elders (mean age 69.3 years +/- 6.2; 55% males) living in an urban setting (Beirut) and a rural setting (Ras-Baalbeck) a well as those who immigrated to Dakar using a preestablished questionnaire. Perception of age discrimination and socio-demographic information were collected; self-esteem was measured using the Toulouse scale. Results: More elders living in Beirut (OR = 9.7, 95% CI = 3.5-26.6) and Ras-Baalbeck (OR = 11.42, 95% CI = 3.95-33.1) perceived age-related discrimination than those living in Dakar. This perception was significantly associated to lower self-esteem (OR = 2.2, 95% CI = 1.3-3.6). CONCLUSION: Supporting emotionally vulnerable elders should be a target for policy makers in Lebanon. It is important to preserve a better quality of life for elders still playing a major role in families.

Migration and hypertension in Dakar, Senegal.

This article examines social and environmental influences on the development of hypertension in a sample of 568 adults (290 men; 278 women) aged 20 years and older from Dakar, Senegal. We test the hypothesis that more recent immigrants to the city of Dakar will have lower blood pressure and lower rates of hypertension than those who have lived there longer. Cross-sectional sociodemographic, anthropometric and blood pressure data were collected during 2009. The overall prevalence of hypertension was 27.1% (95% CI: 25.2-29.0). Hypertension rates were not significantly associated with place of birth; however, length of residence in Dakar was a significant predictor, with those living in the city for less than 10 years having reduced risks of developing hypertension (OR = 0.25; P = 0.003). Other important correlates of blood pressure and hypertension risk in this sample were age and body mass index. These findings suggest that length of exposure to the urban environment-and associated changes in lifestyle-are linked to hypertension. Public health officials should thus pay particular attention to this phenomenon, and future anthropological research should include measures of both environmental and biological characteristics to study hypertension in Senegal.

Perception of age stereotypes and self-perception of aging: a comparison of French and Moroccan populations.

The objective of this study was threefold: (1) assess the general perceptions of age stereotypes among older French and Moroccan adults, (2) analyze discourse associated with these different perceptions, and (3) compare aging self-perception scores of French and Moroccan (rural/urban) older adults and investigate the sociodemographic and health indicators likely to be associated with these self-perceptions. One-to-one structured interviews were conducted with 260 older French adults living in Marseille and 239 older Moroccans (123 living in Marrakech and 116 living in a Berber village). The same questionnaire comprising multiple-choice and short-answer questions was used in both countries. This methodology allowed us to perform quantitative and qualitative analyses. Participants averaged 73 years of age in both samples. The French and Moroccan older adults perceived positive and negative age stereotypes within their societies, but the Moroccan ones more often perceived positive stereotypes toward older adults. Moreover, almost as many Moroccan people living in Marrakech as French people perceived negative stereotypes toward older adults. The qualitative analysis allowed us to demonstrate that some notions associated with the status of older adults are shared in France and Morocco-such as respect is due to older adults-whereas other notions differ between these societies-such as the association between aging and affection/love in Morocco. Finally, this study also tended to show that the Attitudes Toward Own Aging Scale focuses mainly on the mental/physical domain of old age.

Obesity in the Lebanese elderly: prevalence, relative risks and anthropometrical measurements.

OBJECTIVE: To measure the prevalence of obesity in the Lebanese elderly population and to compare it to another sample studied 10 years ago; to investigate the best anthropometrical measurement related to obesity relative risks in this age group. DESIGN: Cross-sectional study about aging and obesity in the Lebanese society. SUBJECTS: 237 Lebanese elderly (60-85 y.o.) selected randomly from an urban and a rural community. MEASUREMENTS: Height, weight, waist and hips circumferences. RESULTS: 47% of the studied sample is obese and obesity is related to gender, educational level and age. Body mass index (BMI) is a good indicator for diabetes 2. Central obesity did not correlate with obesity relative risks. CONCLUSION: Obesity is more prevalent in 2005 than it was in 1995. Prevention programs should be installed in schools and work places in Lebanon to fight against the epidemic of obesity.