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Sociodemographic, socioeconomic, clinical and behavioural predictors of body mass index vary by sex in rural South African adults-findings from the AWI-Gen study
Wagner, R.G Crowther, N.J Gómez-Olivé, F.X Kabudula, C Kahn, K Mhembere, M Myakayaka, Z Tollman, S Wade, A.N
Wagner, R.G
Crowther, N.J
Gómez-Olivé, F.X
Kabudula, C
Kahn, K
Mhembere, M
Myakayaka, Z
Tollman, S
Wade, A.N
Abstract
Background: Despite increasing obesity in South African adults, data on the prevalence and determinants of body mass index (BMI) from rural communities, home to a significant proportion of the population, are scarce.
Objectives: To investigate overall and sex-specific determinants of BMI in a rural adult South African population undergoing rapid social and epidemiological transitions.
Methods: Baseline cross-sectional demographic, socioeconomic, anthropometric, clinical and behavioural data were collected between 2015 and 2016 from 1388 individuals aged 40-60 years and resident in the Agincourt sub-district of Mpumalanga province, a setting typical of rural northeast South Africa. A Health and Socio-Demographic Surveillance System (HDSS) underpins the sub-district and contributes to the Africa Wits-INDEPTH partnership for Genomic Studies (AWI-Gen). Linear regression was used to investigate univariate associations between log-transformed BMI and individual variables and multiple linear regression was used to investigate independent predictors of BMI overall and in sex-stratified analyses.
Results: Median BMI was significantly higher in females (28.7 kg/m2[95% CI 24.2-33.2] vs 23.0 kg/m2[95% CI 20.3-26.8];p < 0.001) with male sex associated with 17% lower BMI. In sex-stratified multiple linear regression models, compared to those never married, BMI was 7% higher in currently married males and 6% in currently married females. Current smoking in men and former smoking in women were associated with reductions in BMI of 13% and 26% respectively, compared with non-smokers. Higher educational attainment in women and higher socioeconomic status in men were both associated with higher BMI, while being HIV-positive and alcohol consumption in women were associated lower BMI.
Conclusions: Female sex strongly predicts higher BMI in this rural African population. While some predictors of higher BMI differ by sex, married individuals in both sexes had a higher BMI, suggesting that, in addition to developing sex-specific interventions to combat overweight and obesity, targeting married couples may result in reduction in population BMI.
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2018-11-30
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Taylor & Francis
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Wagner RG, Crowther NJ, Gómez-Olivé FX, Kabudula C, Kahn K, Mhembere M, Myakayaka Z, Tollman S, Wade AN; as members of AWI-Gen and the H3Africa Consortium. Sociodemographic, socioeconomic, clinical and behavioural predictors of body mass index vary by sex in rural South African adults-findings from the AWI-Gen study. Glob Health Action. 2018;11(sup2):1549436. doi: 10.1080/16549716.2018.1549436.