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  • 1
    Online Resource
    Online Resource
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 1 ( 2021-01-05), p. 359-
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 1 ( 2021-01-05), p. 359-
    Abstract: Recent studies have suggested the common co-occurrence of hypertension and diabetes in South Africa. Given that hypertension and diabetes are known to share common socio-demographic, anthropometric and lifestyle risk factors, the aim of this study was to jointly model the shared and disease-specific geographical variation of hypertension and diabetes. The current analysis used the Study on Global Ageing and Adult Health (SAGE) South Africa Wave 2 (2014/15) data collected from 2761 participants. Of the 2761 adults (median age = 56 years), 641 (23.2%) had high blood pressure on measurement and 338 (12.3%) reported being diagnosed with diabetes. The shared component has distinct spatial patterns with higher values of odds in the eastern districts of Kwa-Zulu Natal and central Gauteng province. The shared component may represent unmeasured health behavior characteristics or the social determinants of health in our population. Our study further showed how a shared component (latent and unmeasured health behavior characteristics or the social determinants of health) is distributed across South Africa among the older adult population. Further research using similar shared joint models may focus on extending these models for multiple diseases with ecological factors and also incorporating sampling weights in the spatial analyses.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 2
    In: Social Sciences, MDPI AG, Vol. 11, No. 4 ( 2022-03-22), p. 143-
    Abstract: Women in sub-Saharan Africa report multiple impacts of menopause on daily life and have requested further information to support themselves. This study co-produced contextually relevant resources—booklets and poster—about menopause with women in Zimbabwe and South Africa. The study was conducted in four stages: interviews with women about the menopause; the development of prototype information resources; workshops with women to discuss country-specific resources; and the refinement of resources. During the interviews, women explained that they had not received or accessed much information about the menopause and thought the physical and psychological issues associated with the menopause had to be “endured”. Prototype information resources comprised booklets and a poster with contextually relevant images and information. Workshop participants suggested several changes, including the addition of more diverse images and further information about treatments. The resources were refined, translated into several African languages, and endorsed by the Ministry of Health in Zimbabwe and the South African Menopause Society in South Africa. Women will be able to access resources through healthcare clinics, community groups and churches. Working with women and other stakeholders enabled a development that was cognisant of experiences and needs. Work is now needed to improve access to treatments and support for menopause to reduce health inequities.
    Type of Medium: Online Resource
    ISSN: 2076-0760
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2663343-7
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  • 3
    Online Resource
    Online Resource
    MDPI AG ; 2020
    In:  International Journal of Environmental Research and Public Health Vol. 17, No. 17 ( 2020-08-31), p. 6325-
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 17, No. 17 ( 2020-08-31), p. 6325-
    Abstract: Little is known about physical activity (PA) levels and correlates in adults from rural settings in South Africa, where a rapid increase in the number of older people and marked disparities in wealth are evident, particularly between those living in rural and urban areas. This paper describes levels of self-reported PA in rural South African men and women and examines factors associated with meeting PA guidelines. Global Physical Activity Questionnaire (GPAQ) data from the Health and Aging in Africa: Longitudinal studies of INDEPTH communities (HAALSI) survey of 5059 adults aged over 40 years were assessed. Logistic regression analyses were used to assess socio-demographic, functional and cognitive capacity, and chronic disease measures associated with PA. In addition, 75.4% (n = 3421) of the participants with valid GPAQ data (n = 4538 of 5059) met the PA guidelines. Factors associated with not the meeting PA guidelines were being male, over the age of 80 years, being in a higher wealth category, obesity, and poorer functional capacity. These findings highlight worthwhile targets for future interventions to maintain or improve PA levels in this population and suggest that intervening earlier within this age range (from 40 years) may be crucial to prevent the ‘spiral of decline’ that characterizes the frailty syndrome.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2175195-X
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  • 4
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 8 ( 2021-04-19), p. 4310-
    Abstract: This study aimed to investigate differences in physical activity (PA) patterns and the associations between objectively measured 24-h movement behaviors and musculoskeletal measures (muscle strength, muscle mass, physical performance, and bone mineral density) in a high-income and a low-income community. This cross-sectional study recruited independent living older adults aged 60–85 years from high-income Scottish (n = 150) and low-income South African (n = 138) settings. Participants completed demographic and health questionnaires, and testing included body composition and bone mineral density (dual energy X-ray absorptiometry), physical performance (grip strength, gait speed), and PA (accelerometry). Participants accumulated similar amounts of weekly total PA, however, the Scottish cohort engaged in more moderate-to-vigorous intensity PA (MVPA) and sedentary behavior (SB), while the South African cohort spent more time sleeping and in light intensity PA (LPA). From compositional data analysis, more time spent in MVPA relative to the other movement behaviors was positively associated with higher muscle mass (p 〈 0.001) and strength (p = 0.001) in the Scottish cohort. Conversely, more time spent in MVPA was associated with faster gait speed (p 〈 0.001) and greater hip bone mineral density (p = 0.011) in the South African cohort. Our findings confirm the beneficial role of MVPA in both high- and low-income cohorts, however, the relationship MVPA had with components of musculoskeletal health in older adults differed between settings.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 5
    In: Nutrients, MDPI AG, Vol. 13, No. 12 ( 2021-12-20), p. 4558-
    Abstract: The study evaluated the association between nutrient patterns with body fat and regional adiposity in middle-aged black South African (SA) men and women and determined if this differed by sex. Body fat and regional adiposity (dual-energy x-ray absorptiometry), and dietary intake (7-day quantified food frequency questionnaire) were measured in black SA men (n = 414) and women (n = 346). Using principal component analysis, nutrient patterns were computed from 25 nutrients in the combined sample. Four nutrient patterns were extracted, explaining 67% of the variance in nutrient intake. Animal and fat, as well as the vitamin C, sugar, and potassium driven patterns, were positively associated with total adiposity. In contrast, the retinol and vitamin B12 pattern was associated with the centralisation of fat. Notably, the strength of the association between the animal-driven nutrient pattern and BMI was greater in men (1.14 kg/m2, 95% CI (0.63–1.66)) than in women (0.81 kg/m2, 95% CI (0.25–1.36)) (Pint = 0.017). In contrast, the plant-driven pattern was associated with higher abdominal subcutaneous adipose tissue (SAT) in women (44 cm2, 95% CI (22–67)) but not men (Pint = 1.54 × 10−4). These differences suggest that although men and women have similar nutrient patterns, their associations with the whole body and regional body fat are different.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2518386-2
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  • 6
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 19 ( 2022-10-06), p. 12792-
    Abstract: This study aimed to evaluate the association of longitudinal nutrient patterns with body composition in a cohort of 132 black South African middle-aged women over five years. Nutrient patterns were identified using principal component analysis at baseline and follow-up 5 years later. Associations between nutrient patterns and repeated body composition measures were evaluated using generalized estimating equations, before and after adjusting for baseline education and repeated measures of age, socio-economic status, physical activity and employment. The animal-driven nutrient pattern was associated with increases in repeated measures of visceral adipose tissue (VAT) (β coefficient, 5.79 [95% CI, 0.01–11.57] cm2), fat mass index (FMI) (0.47 [0.01–0.93] kg·m−2) and lean mass index (LMI) (0.50 [0.18–1.17] kg·m−2) (p 〈 0.05) after adjustment. Vitamin C, sugar, and potassium-driven nutrient pattern was associated with higher FMI (0.50 [0.12–0.88] kg·m−2) and LMI (0.58 [0.07–1.10] kg·m−2) before and after adjustment (p 〈 0.05). These findings suggest that dietary interventions to curb obesity in black middle-aged South African women should focus on attenuation of nutrient patterns centred on added sugar, animal fat and animal protein.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 7
    In: Nutrients, MDPI AG, Vol. 11, No. 6 ( 2019-05-31), p. 1246-
    Abstract: The dietary inflammatory index (DII®), a validated tool used to measure the inflammatory potential of the diet, has been associated with metabolic disorders in various settings, but not in African populations. The aim of this study was to investigate whether the DII is associated with markers of type 2 diabetes (T2D) risk, and if this association is mediated by adiposity and/or low-grade inflammation, in black South Africa women. Energy-adjusted-DII (E-DII) scores were calculated in 190 women (median age, 53 years) from the Birth-to-Twenty plus cohort using a validated food frequency questionnaire. Fasting glucose, insulin, HbA1c, and inflammatory cytokines were measured, and an oral glucose tolerance test performed. Basic anthropometry and dual-energy x-ray absorptiometry-derived body fat, including estimate of visceral adipose tissue (VAT) area, were measured. E-DII scores were associated with all markers of T2D risk, namely, fasting glucose and insulin, HbA1c, HOMA2-IR, two-hour glucose and Matsuda index (all p 〈 0.05). After adjusting for age, measures of adiposity, but not inflammatory cytokines, mediated the association between E-DII and markers of T2D risk (p 〈 0.05). Measures of central obesity had proportionally higher (range: 23.5–100%) mediation effects than total obesity (range: 10–60%). The E-DII is associated with T2D risk through obesity, in particular central obesity, among black middle-aged South African women.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2518386-2
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  • 8
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 8 ( 2021-04-09), p. 3973-
    Abstract: This cross-sectional study explored the differences in sociodemographics, dietary intake, and household foodways (cultural, socioeconomic practices that affect food purchase, consumption, and preferences) of food secure and food insecure older women living in a low-income urban setting in South Africa. Women (n = 122) aged 60–85 years old were recruited, a sociodemographic questionnaire was completed, and food security categories were determined. The categories were dichotomised into food secure (food secure and mild food insecurity) and food insecure (moderate and severe). A one-week quantified food frequency questionnaire was administered. Height and weight were measured to calculate body mass index (BMI, kg/m2). Most participants ( 〉 90%) were overweight/obese, unmarried/widowed, and breadwinners with a low monthly household income. Food insecure participants (36.9%) more frequently borrowed money for food (57.8% vs. 39.0%, p = 0.04), ate less so that their children could have more to eat (64.4%. vs. 27.3%, p = 0.001), and had higher housing density (1.2 vs. 1.0, p = 0.03), compared to their food-secure counterparts. Overall, 〈 30% of participants met the WHO (Geneva, Switzerland) recommended daily servings of healthy foods (fruits, vegetables, and dairy products), but 〉 60% perceived that they consumed an adequate amount of healthy foods. The overall low-quality diet of our cohort was associated with poor nutritional perceptions and choices, coupled with financial constraints.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 9
    In: Sustainability, MDPI AG, Vol. 15, No. 6 ( 2023-03-16), p. 5303-
    Abstract: The Human Mobility Transition model describes shifts in mobility dynamics and transport systems. The aspirational stage, ‘human urbanism’, is characterised by high active travel, universal public transport, low private vehicle use and equitable access to transport. We explored factors associated with travel behaviour in Africa and the Caribbean, investigating the potential to realise ‘human urbanism’ in this context. We conducted a mixed-methods systematic review of ten databases and grey literature for articles published between January 2008 and February 2019. We appraised study quality using Critical Appraisal Skills Programme checklists. We narratively synthesized qualitative and quantitative data, using meta-study principles to integrate the findings. We identified 39,404 studies through database searching, mining reviews, reference screening, and topic experts’ consultation. We included 129 studies (78 quantitative, 28 mixed-methods, 23 qualitative) and 33 grey literature documents. In marginalised groups, including the poor, people living rurally or peripheral to cities, women and girls, and the elderly, transport was poorly accessible, travel was characterised by high levels of walking and paratransit (informal public transport) use, and low private vehicle use. Poorly controlled urban growth (density) and sprawl (expansion), with associated informality, was a salient aspect of this context, resulting in long travel distances and the necessity of motorised transportation. There were existing population-level assets in relation to ‘human urbanism’ (high levels of active travel, good paratransit coverage, low private vehicle use) as well as core challenges (urban sprawl and informality, socioeconomic and gendered barriers to travel, poor transport accessibility). Ineffective mobility systems were a product of uncoordinated urban planning, unregulated land use and subsequent land use conflict. To realise ‘human urbanism’, integrated planning policies recognising the linkages between health, transport and equity are needed. A shift in priority from economic growth to a focus on broader population needs and the rights and wellbeing of ordinary people is required. Policymakers should focus attention on transport accessibility for the most vulnerable.
    Type of Medium: Online Resource
    ISSN: 2071-1050
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2518383-7
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