Obesity, beverage consumption and sleep patterns in rural African women in relation to advertising of these beverages.

BACKGROUND: The burden of obesity-related, non-communicable diseases in South Africa is persistent, with poor and black South African women particularly vulnerable. The purpose of the present study was to determine relationships between obesity, physical activity, sleep patterns and beverage consumption among black South African women in a rural village in the Limpopo province. METHODS: A cross-sectional study was conducted among 200 rural-dwelling African women. Data were collected on beverage consumption, sociodemographic information, sleep patterns and anthropometry using self-reported questionnaires. RESULTS: The mean body mass index (BMI) was 28.5±7.3 kg/m2, with 40% being classified as obese (BMI ≥30 kg/m2) and the mean sleep score was 4.68±2.51. Participants with very bad habitual sleeping patterns consumed significantly more sugar-sweetened beverages and alcohol than those with very good sleeping patterns. We also observed that when total coffee with sugar, fruit juice, total sugar-sweetened beverages and weight decreased the number of hours participants slept increased. CONCLUSIONS: The study identified significant associations between body weight, sleep duration and sugar-sweetened beverage consumption among rural black South African women. This underscores a need to address unhealthy lifestyle behaviours to lower incidences of non-communicable diseases in rural-dwelling women.

Relationship between Psychosocial Factors and Physical Activity among Undergraduate Students from a South African University.

Psychosocial factors such as mental health, motivation, and social support are key determinants of behavior that play a significant role in physical activity participation. Limited studies have investigated the relationship between psychosocial factors and physical activity among university students in Africa. The aim of this study was to determine the relationship between psychosocial factors and physical activity participation among undergraduate university students at a historically disadvantaged university (HDU) in South Africa. This was a cross-sectional study that used convenience sampling (n = 534, majority female, 53.6% with a mean age of 20.69). The study was conducted through an online, self-administered, and hard-copy, valid questionnaire in September 2022. Data on sociodemographic information were collected. Psychosocial factors were assessed using the Depression, Anxiety, and Stress-21 Scale for mental health, the Physical Activity and Leisure Motivation Scale for motivation, and the Perceived Social Support Scale for social support. Physical activity (calculated as MET-min/week) was assessed using the international physical activity questionnaire in short form. Results revealed that almost a third (29%) of undergraduate students were physically inactive, 31.1% were minimally active, and 39.9% were in the health-enhancing category. Physical activity was positively related to stress (r = 0.11, p < 0.05) and anxiety (r = 0.10, p < 0.05). Motivational factors were positively related to psychological condition and others' expectations (r = 0.10, p < 0.05), and depression and others' expectations (r = 0.11, p < 0.05). Results from this study highlighted that psychosocial factors were related to physical activity participation among undergraduate university students. Psychosocial factors should be considered a coping mechanism when implementing health-promoting strategies.

Strategies and Best Practices That Enhance the Physical Activity Levels of Undergraduate University Students: A Systematic Review.

Significant numbers of undergraduate university students are not meeting the physical activity guidelines recommended by the World Health Organisation. These guidelines suggest that university students should aim for 150-300 min of moderate or 75-150 min of vigorous physical activity. Strategic interventions need to be implemented to address this global public health concern. The aim of this study was to review the strategies and best practices to enhance the physical activity levels of undergraduate university students. Utilising the PRISMA guidelines, electronic databases-PubMed, Science Direct, Academic Search Complete, ERIC, Web of Science, CINAHL, SAGE, and SPORTDiscus-were searched between September 2022 and February 2023 using terms and synonyms related to physical activity, strategies, best practices, and undergraduate university students. Studies were critically assessed for their quality using an adapted version of the CASP and RE-AIM frameworks. Eleven articles met the inclusion criteria for the review. The studies reported the use of social media platforms, mobile phone applications, web-based technology, online text messages, in-person classes, and an "exergame" as methods to increase engagement in physical activity. Findings from this review indicated that validated questionnaires emerged as the predominant measurement tool. Furthermore, the frequent use of social network sites served as a best practice for implementing and promoting physical activity interventions. It is recommended that universities promote health-enhancing physical activities based on current trends and strategies, such as technology-based interventions and the use of social media, that are relevant to contemporary university students.

Sedentariness and overweight in relation to mortality in sub-Saharan Africa. A mediation analysis based on the World Health Organization-Global Health Observatory data repository.

Background: Globally, noncommunicable diseases (NCDs) have been continuously reported to be the number one leading cause of reduced life expectancy and poor life quality and have thus become a major public health concern. Objective: This study aimed to investigate the complex mediation analysis between physical inactivity and overweight in relation to mortality. Methods: The study is based on public data collected by the Global Health Observatory of the World Health Organization. Results: We showed that the median early mortality attributable to NCDs during the period 2016-2019 in both men and women was 23.2% (5th to 95th range=17.2, 35.6) while that in men alone was 25.1% (16.5, 45.7) and that of women alone was 22.0% (17.0, 27.9). When considering regional early NCDs mortality for both men and women, a systematically high median was observed in Southern Africa [28.7% (22.2, 43.8)] and a low median in Eastern Africa [21.1% (17.15, 27.3)]. The analysis of the overall relation between physical inactivity, overweight and early mortality due to NCDs revealed a statistical significance of the direct association between physical inactivity and early mortality due to NCDs. Conclusion: Our findings revealed three main epidemiological and public health concerns. First, early mortality attributable to NCDs in a range of about 20 to 30% across the sub-Saharan African regions for both sexes was observed. Second, there was a direct effect between physical inactivity and early NCDs mortality as well as the indirect effect mediated by overweight. Finally, a percentage point decrease in physical inactivity prevalence and overweight could effectively generate a reduction in mortality due to NCDs. Future studies are needed to confirm the scientific evidence observed in this study. Such studies should be based on observation of individual subjects, adopt a longitudinal design, and collect information that evaluates the complex relationship between physical inactivity and early NCDs mortality, along with the role of overweight as a possible mediator.

Strategies and best practices that enhance participation in regular physical activities among undergraduate university students: a systematic review protocol.

INTRODUCTION: Physical activity has health benefits, including lowered obesity, diabetes and hypertension levels. However, participation in regular physical activities among undergraduate students is declining and, instead, physical inactivity sets the path for sedentarism. Strategies and best practices used to enhance participation in regular physical activities among undergraduate students are beneficial for mitigating sedentariness and promoting healthy lifestyles. Therefore, this study aims to present a systematic review protocol that focuses on the strategies and best practices used to enhance participation in regular physical activities among undergraduate university students. METHODS AND ANALYSIS: Quantitative, qualitative and mixed-methods design studies will be included and appraised. The following databases will be searched: PubMed, Science Direct, Academic Search Complete, ERIC, Web of Science, SAGE, CINAHL Plus and SPORTDiscus. Database searches on physical activities among undergraduate university students will be generated to answer the following research question: What are the strategies and best practices used to enhance participation in regular physical activities among undergraduate university students? Two independent reviewers will conduct the primary screening of articles from 2011 to 2022. A third reviewer will be consulted to solve any disagreements. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and study quality will be assessed by the Johanna Biggs Institute checklist. Results from the selected articles will be extracted, summarised and categorised based on the type of study participants, study design and setting, and methodological quality. A narrative description will synthesise the findings to answer the objectives of this review. ETHICS AND DISSEMINATION: Ethics approval for this study was granted by the Humanities and Social Science Research Ethics Committee at the University of the Western Cape, reference number: HS21/10/24. The results will be disseminated through a peer-reviewed publication and conference presentation.

Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers.

BACKGROUND: Health education and self-management are among key strategies for managing diabetes and hypertension to reduce morbidity and mortality. Inappropriate self-management support can potentially worsen chronic diseases outcomes if relevant barriers are not identified and self-management solutions are not contextualised. Few studies deliberately solicit suggestions for enhancing self-management from patients and their providers. OBJECTIVE: This qualitative study aimed to unravel experiences, identify self-management barriers, and solicit solutions for enhancing self-management from patients and their healthcare providers. METHODS: Eight in-depth interviews were conducted with healthcare providers. These were followed by four focus group discussions among patients with type-2- diabetes and or hypertension receiving chronic disease care from two health facilities in a peri-urban township in Cape Town, South Africa. The Self-Management framework described by Lorig and Holman, based on work done by Corbin and Strauss was used to analyse the data. RESULTS: Patients experienced challenges across all three self-management tasks of behavioural/medical management, role management, and emotional management. Main challenges included poor patient self-control towards lifestyle modification, sub-optimal patient-provider and family partnerships, and post-diagnosis grief-reactions by patients. Barriers experienced were stigma, socio-economic and cultural influences, provider-patient communication gaps, disconnect between facility-based services and patients' lived experiences, and inadequate community care services. Patients suggested empowering community-based solutions to strengthen their disease self-management, including dedicated multidisciplinary diabetes services, counselling services; strengthened family support; patient buddies; patient-led community projects, and advocacy. Providers suggested contextualised communication using audio-visual technologies and patient-centred provider consultations. CONCLUSIONS: Community-based dedicated multidisciplinary chronic disease healthcare teams, chronic disease counselling services, patient-driven projects and advocacy are needed to improve patient self-management.

Corrigendum: Novel coronavirus and regular physical activity involvement: Opinion.

No abstract available.

Prevalence of disease complications and risk factor monitoring amongst diabetes and hypertension patients attending chronic disease management programmes in a South African Township.

BACKGROUND: South Africa established chronic disease management programmes (CDMPs) called 'clubs' to ensure quality diabetes care. However, the effectiveness of these clubs remains unclear in terms of disease risk factor monitoring and complication prevention. AIM: We assessed risk factor monitoring, prevalence and determinants of diabetes related complications amongst type-2 diabetes (T2D) and hypertension (HTN) patients attending two CDMPs. SETTING: Urban Township in Cape Town, South Africa. METHODS: Cross-sectional survey combined with a 10-year retrospective medical records analysis of adult T2D/HTN patients attending two CDMPs, using a structured survey questionnaire and an audit tool. Statistical Software for Social Sciences (SPSS) version 25 was used to analyse risk factor monitoring and calculate prevalence of complications. Potential determinants of complications were explored through logistic regression. RESULTS: There were 379 patients in the survey, 372 (97.9%) had HTN whilst 159 (41.9%) had T2D and HTN; 361 medical records were reviewed. Blood pressure (87.7%) and weight (86.6%) were the best monitored risk factors. Foot care (0.0% - 3.9%) and eye screening (0.0% - 1.1%) were least monitored. Nearly 22.0% of patients reported one complication, whilst 9.2% reported ≥ 3 complications. Medically recorded complications ranged from 11.1% (1 complication) to 4.2% with ≥ 3 complications. The most common self-reported and medically recorded complications were eye problems (33%) and peripheral neuropathy (16.4%), respectively. Complication occurrence was positively associated with age and female gender and negatively associated with perceived illness control. CONCLUSIONS: Type-2 diabetes and hypertension patients experienced diabetes related complications and inadequate risk factor monitoring despite attending CDMPs. Increased self-management support is recommended to reduce complication occurrence.

Erratum: Demographic and socio-economic predictors of physical activity among people living with HIV of low socio-economic status.

[This corrects the article DOI: 10.4102/hsag.v24i0.1127.].

Exposure of Children to Unhealthy Food and Beverage Advertisements in South Africa.

Television (TV) is a powerful medium for marketing food and beverages. Food and beverage marketers tend to use this medium to target children with the hope that children will in turn influence their families' food choices. No study has assessed the compliance of TV marketers with the South African Marketing to Children pledge since the enactment of the 2014 food advertising recommendations by the South African Department of Health and the Advertising Standards Authority. This study investigated the extent and nature of advertising of unhealthy versus healthy food and beverages to children in South African TV broadcasting channels. The date, time, type, frequency and target audience of food advertisements (ads) on four free-to-air South African TV channels were recorded and captured using a structured assessment guide. The presence of persuasive marketing techniques was also assessed. Unhealthy food and beverage advertising was recorded at a significantly higher rate compared with healthy food and beverages during the time frame when children were likely to be watching TV. Brand benefit claims, health claims and power strategies (e.g., advertising using cartoon characters and celebrated individuals) were used as persuasive strategies. These persuasive strategies were used more in unhealthy versus healthy food ads. The findings are in breach of the South African Marketing to Children pledge and suggest a failure of the industry self-regulation system. We recommend the introduction of monitored and enforced statutory regulations to ensure healthy TV food advertising space.

Novel coronavirus and regular physical activity involvement: Opinion.

The novel coronavirus (NCOVID-19) has quickly become a public health concern globally and needs urgent attention. While there is no current evidence of vaccines and specific drugs to prevent and treat the ailments emanating from NCOVID-19 infections, complementary and conventional medical treatments could prove beneficial in ameliorating some of the respiratory difficulties, especially in countries in sub-Saharan Africa. These treatments include specific breathing exercises, a diet that strengthens the immune system, as well as avoiding tobacco smoking and alcohol consumption. On the other hand, for those who have not contracted the virus, participation in indoor and within-the-yard physical activity could be beneficial in preventing unwanted weight gain as well as associated conditions such as anxiety and depression.

Body Image and the Double Burden of Nutrition among South Africans from Diverse Sociodemographic Backgrounds: SANHANES-1.

This study investigated the associations between underweight, obesity and body image (BI) among 15+ year-old South Africans with diverse socio-demographic backgrounds. A cross-sectional survey and the analyses of data for 6411 15+ year-old participants in the first South African National Health and Nutrition Examination Survey was undertaken. Body image was compared to body mass index (BMI) and socio-demography. Data were analyzed using SPSS versions 25. Results are in percentages, means, 95% confidence intervals, p-values, and odds ratios. Overall, participants who were obese of which majority: were females, earned ZAR 9601+, completed grade 6, were non-Black men, were married and resided in urban formal areas, were more likely to underestimate their BMI and desire to be lighter. Participants who were underweight of which majority: were males, had no form of income or education, were black men, were not married, resided in less urban and farm areas, were younger than 25 years, were more likely to overestimate their BMI and desire to be heavier. While underweight and obesity were strong determinants of BI, BI was differentiated by socio-demography. These findings have a public health implication that requires special attention to curb the irrepressible underweight and obesity in South Africa.

Prevalence of the risk factors for cardiometabolic disease among firefighters in the Western Cape province of South Africa.

BACKGROUND: Cardiometabolic disease (CMD) risk factors have reached epidemic proportions, with many people at risk of premature disability and death. There is insufficient data regarding the prevalence of CMD risk factors among firefighters in the Western Cape Province of South Africa. The purpose of this study was to examine the prevalence of CMD risk factors among South African firefighters in the Western Cape Province. Additional outcomes were to determine the relationship between BMI and CMD risk factors among firefighters. METHODS: A total of 219 healthy male firefighters with mean age 37.8±9.80 years volunteered to participate in the study. Anthropometric (ISAK protocol compliant) and physiological variables (ACSM protocol compliant) were assessed. Descriptive statistics, such as mean, standard deviation and percentages were used to examine the CMD risk factors prevalence among the participants. RESULTS: Based on the BMI categorization, majority (42.5%) of the participants were obese, 17.4% were overweight, 39.7% had a normal BMI, while 0.5% were underweight. The participants with systolic prehypertension were 45.7%, while 14.2% were hypertensive. Furthermore, 39.3% were prediabetic, 18.3% were diabetic, while 1.4% had blood sugar below normal level (hypoglycemic). In terms of total blood cholesterol levels, 45.7% were normal, 38.8% were borderline high, while 15.5% were high in hypercholesterolemia. The majority (51.1%) of the participants reported non-participation in regular physical activity. Between BMI and the typical risk factors, there is a significant correlation with abdominal obesity (r=0.71; P<0.001), systolic blood pressure (r=0.33; P<0.001), diastolic blood pressure (r=0.31; P<0.001), fasting blood glucose (r=0.22; P<0.01) and total cholesterol (r=0.15; P<0.05). CONCLUSIONS: There was a high prevalence of cardiometabolic disease risk factors among firefighters. Furthermore, urgent intervention focusing on the lifestyle modification and weight management is a necessity.

Demographic and socio-economic predictors of physical activity among people living with HIV of low socio-economic status.

BACKGROUND: Physical activity (PA) is beneficial for the health of people living with HIV and AIDS (PLWHA). AIM: The aim of this study was to determine if age, body weight, height, gender, waist-to-hip ratio (WHR), educational attainment, employment status, CD4+ cell count and body mass index (BMI) can predict overall PA among PLWHA of low socio-economic status (SES). SETTING: Participants in this study were HIV-infected patients on first-line antiretroviral therapy (ART) regimen offered by the South African National Department of Health, and those not on ART. Participants were conveniently sampled from a list at a community health care centre in Cape Town. METHODS: This study sample consisted of 978 HIV-infected South Africans. Physical activity data were collected using the Global Physical Activity Questionnaire. Backward multiple linear regression modelling was used to determine the relative influence of variables (age, body weight, height, gender, WHR, educational attainment, employment status, CD4+ count and BMI) on total moderate-to-vigorous PA. Alpha level was set at 0.05. RESULTS: The mean age of the participants was 38.2 (standard deviation [SD] = 8.76) years for men and 33.9 (SD = 8.53) years for women. Physical activity was significantly higher in men (480.2 [SD = 582.9] min/week) than among women (369.35 [SD = 222.53] min/week). The results of the multiple linear regression showed that educational attainment (ß = 0.127; p = 0.00), employment (ß = -0.087; p = 0.01) and gender (ß = 0.235; p = 0.00) significantly predicted total moderate-to-vigorous PA. Gender had the greatest effect, followed by educational attainment and employment status. CONCLUSION: There is a need for PA programmes that are designed to (1) target women, (2) strengthen programmes for education and promotion of PA and (3) engage the unemployed into PA for PLWHA. Physical activity interventions for this particular group should be tailored for persons of low SES.

Validity and reliability of the Setswana translation of the Short Form-8 health-related quality of life health survey in adults.

BACKGROUND: The absence of culturally relevant measures in indigenous languages could pose a challenge to epidemiological studies on health-related quality of life (HRQoL) in developing nations. AIM: To explore the feasibility and determine the validity and reliability of the Setswana translation of the HRQoL Short Form-8 (SF-8) among Setswana-speaking adults. SETTING: Potchefstroom in the North West province. METHODS: Sixty healthy men (n = 26) and women (n = 34), aged 45.5 ± 9.3 years, completed a Setswana translation of the SF-8 questionnaire and the original English version twice, with a 4-week interval between completions. RESULTS: The Setswana SF-8 presented good concurrent validity with the Spearman's correlation coefficients (ρ) of 0.72 for role physical to 0.91 for social functioning. The Cronbach's alpha coefficients for the first and second measurements were 0.87 and 0.87, respectively, for the Setswana-translated SF-8 and 0.86 and 0.89 for the original English SF-8. The reliability coefficients were moderate for the mental health (ρ = 0.60), social functioning (ρ = 0.56) and role emotional (ρ = 0.50) domains, as well as the mental component summary (ρ = 0.50) and physical component summary (ρ = 0.45), but fair for the role physical (ρ = 0.43), body pain (ρ = 0.43), general health (ρ = 0.42), physical functioning (ρ = 0.41) and vitality (ρ = 0.38) domains on the translated Setswana version of the SF-8. CONCLUSION: The Setswana SF-8 version was feasible, acceptable and had acceptable concurrent validity and fair to moderate evidence of test-retest reliability for assessing HRQoL among adult Setswana-speaking community dwellers.

Managing Noncommunicable Diseases in an African Community: Effects, Compliance, and Barriers to Participation in a 4-Week Exercise Intervention.

To determine the compliance, barriers, and effects of participation in a 4-week exercise intervention aimed at reducing risk factors for noncommunicable diseases among community-dwelling adults from a low-resourced area of South Africa. An exercise program and associated pre-posttest were performed by 76 participants (men, n = 26 and women, n = 50) aged 35 to 65 years. Baseline and end tests included height, weight, hip and waist circumference, heart rate, blood pressure, glucose, cholesterol, quality of life, and cardiorespiratory fitness measurements. The intervention consisted of 3 days/week combined aerobic and resistance exercise at an intensity of 70% heart rate reserved as determined at baseline. Compliance and barriers to participation were determined post-intervention by means of attendance registers and interviews. ANCOVA with adjustment for pretest was performed for all repeated variables. The Cronbach's alpha coefficients for exercise benefits were 0.81 and for barriers 0.84. Of the 26 men (40.8 ± 5.45 years) and 50 women (43.6 ± 7.8 years) recruited, 54 completed the intervention (71% compliance). The 4-week aerobic exercise intervention significantly reduced body mass, rate of perceived exertion, and mental components summary in men, and body mass, body mass index, VO2max, rate of perceived exertion, glucose, physical components summary, and mental components summary in women. Participants reported that the exercise milieu as a major barrier to exercise compliance while the interviews reported lack of time. A 1-month exercise intervention elucidated positive changes in risk factors for noncommunicable diseases in a low-resource community. A drop-out rate of 29% in this study is consistent with other exercise intervention trials. Exploration of the reported barriers may be useful for planning to increase compliance with future programs.