Approach to prevention of obesity of Roma population in the Region of South Bohemia with focus on selected eating behaviors.

OBJECTIVE: To survey obesity prevention methods for use in the Roma population with a focus on eating behaviors. METHODS: A semi-structured interview was used to identify potentially useful obesity prevention methods. Basic anthropometric measurements were also gathered at the same time. This study was part of the "Obesity and overweight in the Roma minority in the Region of South Bohemia" research project (grant project 280-COST-LD14114). Participants consisted of members of the Roma minority (302 respondents) as well as the majority (Czech) population for comparisons. RESULTS: Differences in eating behaviors like irregular eating schedules and excessive consumption of fast food were observed. Statistically significant differences between the Roma minority and the majority (Czech/non-Roma) population were found in this area with the help of statistical significance tests. The Chi-square characteristic of independence (χ2) was, in case of this distribution, valued at 30.815 with 5 degrees of freedom, P < 0.001. The analyses, based on the second degree of classification, identified statistically significant differences between the Roma minority and the majority population. Members of the Roma minority attended preventive health check-ups statistically less often than members of the majority population. Differences between the majority and the Roma population were also found in the degree of patient cooperation with general practitioners. CONCLUSION: The results show that the Roma population is more likely to engage in eating behaviors that can contribute to overweight and obesity than the majority population. Based on the results of a semi-structured interview and on the results of anthropometric measurements, we can say that the Roma population is at a greater health risk, relative to overweight and obesity, than the majority population.

Genetic and biochemical characteristics in the Roma minority in the South Bohemia Region.

OBJECTIVE: At present, health characteristics of Roma minority within the Czech Republic are generally unknown. Therefore we examined a Roma population for some anthropometrical, biochemical and genetic parameters. DESIGN: Groups include Roma aged above 18 years (men, women), with permanent residence in the South Bohemia Region. The Roma group (302 individuals) was selected using the snowball sampling method--the same method was used to select the non-Roma control group (78 individuals) for total cholesterol and blood sugar reference values. The main non-Roma control group was selected using the quota selection method (298 individuals). All participants completed a life style questionnaire, had their body measurements taken, were weighed, had their blood pressure and heart rates measured, had a capillary blood sample taken. RESULTS: The non-Roma population had a lower Body Mass Index (BMI) (25.86 ± 4.23 vs. 27.45 ± 6.48 kg/m², p = 0.0004). The difference in BMI and weight was found to be associated with the MC4R gene. The values of systolic and diastolic blood pressure, total cholesterol, blood sugar did not differ with regard to the tested polymorphisms. We did not find any difference in the prevalence of MC4R or TMEM18 between groups. CONCLUSION: Despite educational efforts to introduce healthier life styles into the Roma population, there has been only limited success; as a result, Roma are very likely to suffer from premature complications of atherosclerotic processes, mostly due to theirs life style. Intensive further research is needed to improve the health conditions of the Roma minority, while still respecting their cultural differences.

Evaluation of selected indicators of overweight and obesity of Roma minority in the region of South Bohemia.

OBJECTIVES: The objective of our correlation study was to compare selected indicators of overweight and obesity of Roma and non-Roma (majority) populations in the South Bohemia Region or the Czech Republic. METHODS: The following indicators were chosen for evaluation of overweight and obesity: body height and weight, waistline measurement, waist/height index, waist/hips index, BMI, total fat and blood pressure. 600 participants were examined and interviewed in total, including 302 Roma and 298 non-Roma participants. Each of the participants had a personal examination performed by a general nurse, under hygienic-epidemiological conditions. The criteria for inclusion of participants into the study were consent with examination and age greater than 18 years. RESULTS: The statistical analysis showed that, at a level of significance of p < 0.001, the following values differed between the Roma and non-Roma population of the South Bohemia Region: waist/height index, waistline, total fat, body mass index (BMI), systolic and diastolic blood pressure. Differences in the incidence of the waist/hips index were significant at p < 0.01. Correlations of incidence with indicators of overweight and obesity in Roma were registered in relation to both age and gender of participants. The results show that overweight and obesity indicators were recorded more frequently in Roma female respondents. Although the results are unique, the conclusions cannot be generalized for Roma throughout the Czech Republic. CONCLUSION: The conclusions of the above findings will be implemented in strategic materials for community planning in the South Bohemia Region. The goal will be to offer services aimed at supporting a healthy life style for Roma living in the South Bohemia Region of the Czech Republic.

Qualification of Food Intake by the Roma Population in the Region of South Bohemia.

The article presents the results of a correlation study, aimed at quantifying the food intake of the Roma population in the South Bohemian Region. To achieve the goal, we applied the method of one-day dietary recall and frequency food analysis (non-standardized). The quantification was carried out by analysis in the Nutridan program. The study involved 302 Roma persons and 298 persons in the control group. Both groups had the same representation of males and females (50:50). The age categories of both sets differed; the average age of the Roma was lower (39.2 years) (p < 0.001). The probands from the Roma population were chosen with the help of the snowball method through known respondents. The statistical analysis shows differences in nutritional estimate between the Roma population and the control sample. The Roma differ in their energy intake. Both groups showed lower intake of sugars, below 50% total energy intake (TEI) and higher intake of fats, above 30% TEI. The respondents from both groups consume little fruits and vegetables, which may be connected with their low dietary fiber intake. In addition to the differences in the nutritional estimates, we recorded statistically significant differences in body mass index (BMI; p < 0.001), in age (p < 0.001), regular alimentation (p = 0) and demanding physical activities (p = 0). In spite of the fact our groups differed in age (the Roma are younger), it can be assumed that the obesity of the Roma may be caused by unbalanced alimentation and lack of physical activities.

Cultural Features Influencing Eating, Overweight, and Obesity in the Roma People of South Bohemia.

This article describes the important cultural specifics that impact on treatment of overweight and obesity for the Roma people of South Bohemia. METHODS: Data on health and nutrition were collected using a semi-structured interview of 302 Roma adults (quantitative phase). A further 25 participants received in-depth interviews regarding their eating and lifestyle habits and perceptions about obesity and overweight (qualitative phase). Height and weight were measured with calibrated scales and stadiometer. Qualitative data were analyzed with the “grounded theory” method. RESULTS: The participants reported a relatively high consumption of high-sugar drinks and foods compared to fruits and vegetables. Lifestyle factors increasing risk of overweight identified from the qualitative interview included unemployment, socially isolating housing, poor transport, poverty, inactivity, tobacco smoking, and for women weight gain after childbirth. Also identified was the need for better health literacy. CONCLUSIONS: Effective health education may help to address risk factors for overweight and obesity in Roma peoples. Other measures include improved socioeconomic status and housing security, and improved health literacy of the Roma people.