Lifestyle factors associated with the transition from healthy to unhealthy adiposity among black South African adults over 10 years
- PMID: 33975737
- DOI: 10.1016/j.numecd.2021.03.017
Lifestyle factors associated with the transition from healthy to unhealthy adiposity among black South African adults over 10 years
Abstract
Background and aims: Obesity is associated with an increasing prevalence of cardiovascular diseases in Africa, but some obese individuals maintain cardiometabolic health. The aims were to track metabolically healthy overweight or obesity (MHO) over 10 years in African adults and to identify factors associated with a transition to metabolically unhealthy overweight or obesity (MUO).
Methods and results: The participants were the South African cohort of the international Prospective Urban and Rural Epidemiological study. From the baseline data of 1937 adults, 649 women and 274 men were followed for 10 years. The combined overweight and obesity prevalence of men (19.2%-23.8%, p = .02) and women (58%-64.7%, p < .001), and the prevalence of the metabolic syndrome in all participants (25.4%-40.2%, p < .001) increased significantly. More than a quarter (26.2%) of the women and 10.9% of men were MHO at baseline, 11.4% of women and 5.1% of men maintained MHO over 10 years, while similar proportions (12.3% of women, 4.7% of men) transitioned to MUO. Female sex, age, and total fat intake were positively associated with a transition to MUO over 10 years, while physical activity was negatively associated with the transition. HIV positive participants were more likely to be MHO at follow-up than their HIV negative counterparts.
Conclusions: One in two black adults with BMI ≥25 kg/m2 maintained MHO over 10 years, while a similar proportion transitioned into MUO. Interventions should focus on lower fat intakes and higher physical activity to prevent the transition to MUO.
Keywords: Metabolic syndrome; Metabolically healthy obesity; South Africa; Transition.
Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of competing interest The authors report financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work as described in the attached CoI forms: Dr. HS and Dr. IM Kruger reports grants from South African National Research Foundation, grants from South Africa–Netherlands Research Programme on Alternatives in Development, grants from Population Health Research Institute, during the conduct of the study. Dr. HS Kruger reports personal fees from South African Sugar Association, personal fees from Danone Southern Africa outside the submitted work. Dr. Botha-Le Roux reports grants from South Africa–Netherlands Research Program on Alternatives in Development, grants from Population Health Research Institute, grants from South African Medical Research Council, grants from South African National Research Foundation during the conduct of the study. Dr. Schutte reports personal fees from Servier, personal fees and non-financial support from Takeda, personal fees from Novartis, personal fees from Omron, outside the submitted work. Dr Ricci, Pieters, Moss and Van Zyl have nothing to disclose.
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