Burden and contributing factors to overweight and obesity in young adolescents in Addis Ababa, Ethiopia.

The prevalence of overweight/obesity in adolescents has increased globally, including in low- and middle-income countries. Early adolescence provides an opportunity to develop and encourage positive health and behavioural practices, yet it is an understudied age group with limited information to guide and inform appropriate interventions. This study aims to determine the prevalence of overweight/obesity in young adolescents, aged between 10 and 14 years attending public schools in Addis Ababa, Ethiopia, and to explore the contributing factors. A cross-sectional school-based study was conducted. Adolescents completed individual questionnaires. Weight (kg) and height (m) measurements were converted to BMI-for-age and gender z-scores. Multivariate regression analysis was conducted to determine the associated factors. The overall prevalence of overweight/obesity was 8% among adolescents aged 10-14 years and it was significantly higher in females (13%) than males (2%). The diet quality for the majority of the adolescents was inadequate, putting them at risk for poor health outcomes. The contributors to overweight/obesity were different between males and females. Age and no access to a flush toilet were negatively associated with overweight/obesity in males and access to a computer, laptop or tablet was positively associated. In females, menarche was positively associated with overweight/obesity. Living with only their mother or another female adult and an increase in physical activity were negatively associated with overweight/obesity. There is a need to improve the diet quality of young adolescents in Ethiopia and understand the reasons why females are less physically active to limit the risk of poor diet-related health outcomes.

Coping through a drought: the association between child nutritional status and household food insecurity in the district of iLembe, South Africa.

OBJECTIVE: To assess and compare the association between household food insecurity and child nutritional status over two time-points taking into consideration the effects of a severe drought. DESIGN: The study used two cross-sectional household surveys during and after a severe drought, consistent with a natural experiment design. SETTING: The study took place in the district of iLembe, KwaZulu-Natal, South Africa. PARTICIPANTS: Households with children aged <5 years were invited to participate in the survey. Anthropometric measures were taken for the respective children in each of the participating households. RESULTS: The results indicated that all forms of poor nutritional status increased over the two time-points, with the most significant increases being for stunting (P < 0·016) and obesity (P < 0·001). There was evidence of an association between increasing food insecurity and stunting (P < 0·003) at the end of the drought, but not wasting, underweight or overweight. The results indicated a strong link between chronic food insecurity and chronic undernutrition. The results also showed stronger evidence of an association between food insecurity and stunting for urban households (P < 0·001) compared to their rural counterparts (P < 0·019). CONCLUSIONS: The negative effects of drought appear to contribute to increased rates of child stunting through higher levels of household food insecurity. Future research should assess this relationship through longitudinal studies. Interventions aimed at improving food security may assist in reducing child malnutrition, but policymakers should consider urban-rural differences as well as climatic and environmental events.

Father involvement, maternal depression and child nutritional outcomes in Soweto, South Africa.

Father involvement in South Africa is low, despite evidence that it can improve maternal and child health and wellbeing. Within a larger randomised controlled trial, we assessed whether father involvement during and after pregnancy increased birth weight and exclusive breastfeeding through improved maternal mental health. At 6-week postnatal, mothers completed questionnaires on birth, feeding practices, social support, father involvement and postnatal depression. Father involvement during pregnancy was measured by their attendance at antenatal care and the study intervention, whereas postnatal involvement was measured by attendance at antenatal care and type of paternal support provided. Structural equation modelling was used to identify associations between father involvement, maternal depression, low birth weight and exclusive breastfeeding. Among the 212 mother-baby pairs, father involvement was very low with only 43%, 33% and 1% of partners attending early ultrasound, antenatal care and the birth of the child, respectively. Twenty-nine percent of the mothers showed signs of depression during pregnancy, compared with 7% after birth. Eighteen percent of the infants were born low birth weight, and 57% of mothers reported exclusively breastfeeding at 6 weeks. Father involvement was directly associated with postnatal depression, but it did not directly or indirectly impact exclusive breastfeeding or low birth weight. We conclude that postnatal father involvement can improve postnatal maternal depression and that men would benefit from specific guidance on how they can support mothers during and after pregnancy.

Food Security in the District of iLembe, KwaZulu-Natal: A Comparison of Coping Strategies between Urban and Rural Households.

Food insecurity varies between urban and rural populations, as do their household characteristics and practices. The aim of the study was to compare the behaviours and practices households in rural and urban areas carry out during times of limited food in the district of iLembe, South Africa. Using a cross-sectional study design, household surveys were carried out to collect information on household characteristics, food, and coping strategies. In total, 376 households were randomly selected from low-income wards, 229 of which were rural, and 147 from urban areas. Water access was significantly better in the urban areas, as was diet diversity. The coping strategies carried out in rural households indicated better access or reliance on natural resources compared to their urban counterparts. Interventions or policies aimed at improving household food insecurity should take into account the location of the population, the natural resources available to them, and the needs of the community.