Risk factors for overweight and overfatness in rural South African children and adolescents.
BACKGROUND
To determine risk factors for overweight/overfatness in children and adolescents from rural KwaZulu-Natal, South Africa.


METHODS
Anthropometric data were collected from a cross-sectional sample (n = 1519, ages 7, 11 and 15 years) and linked to demographic information (n = 1310 and n = 1317 in overweight and overfat analyses, respectively). Candidate risk factors for overweight/overfatness were identified and tested for associations with overweight (BMI-for-age >+1SD, WHO reference) and overfatness (>85th centile body fatness, McCarthy reference) as outcomes. Associations were examined using simple tests of proportions (χ(2)/Mann-Whitney U tests) and multivariable logistic regression.


RESULTS
Sex was a consistent variable across both analyses; girls at significantly increased risk of overweight and overfatness (overweight: n = 180, 73.9 and 26.1% females and males, respectively (P < 0.0001); overfat: n = 187, 72.7 and 27.3% females and males, respectively (P < 0.0001)). In regression analyses, sex and age (defined by school grade) were consistent variables, with boys at lower risk of overweight (adjusted odds ratio (AOR) 0.40 (confidence interval (CI) -0.28-0.57)) and risk of overweight increasing with age (AOR 0.65 (CI- 0.44-0.96), 0.50 (CI-0.33-0.75) and 1.00 for school grades 1, 5 and 9, respectively). Results were similar for overfatness.


CONCLUSIONS
This study suggests that pre-adolescent/adolescent females may be the most appropriate targets of future interventions aimed at preventing obesity in rural South Africa.
Section of Human Nutrition, University of Glasgow, Yorkhill Hospitals, Glasgow G3 8SJ, UK Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, KwaZulu-Natal 3935, South Africa.
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Craig
School of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1QE, UK.
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JJ
Reilly
Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, KwaZulu-Natal 3935, South Africa Royal Hospital for Sick Children, University of Glasgow, Glasgow G3 8SJ, UK.
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Bland
D050154:Adiposity; D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D050177:Overweight / Q000453:epidemiology / Q000209:etiology*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012737:Sex Factors; D013019:South Africa / Q000453:epidemiology
children; obesity; social determinants