title: Factors Associated with Excessive Body Fat in Men and Women: Cross-Sectional Data from Black South Africans Living in a Rural Community and an Urban Township.
abstract: OBJECTIVE
  To determine the factors associated with excessive body fat among black African men and women living in rural and urban communities of South Africa.
  
  
  METHODS
  This is a cross-sectional analysis of data from the Prospective Urban and Rural Epidemiology (PURE) study, Cape Town, South Africa conducted in 2009/2010. The study sample included 1220 participants (77.2% women) aged 35-70 years, for whom anthropometric measurements were obtained and risk factors documented through face-to-face interviews using validated international PURE study protocols. Sex-specific logistic regression models were used to evaluate socio-demographic, lifestyle and psychological factors associated with three excessive body fat indicators, namely body mass index (BMI), waist circumference (WC) and body fat percent (BF%).
  
  
  RESULTS
  The prevalence of excessive body fat based on BF%, WC and BMI cut-offs were 96.0%, 86.1%, and 81.6% for women respectively, and 62.2%, 25.9%, and 36.0% for men respectively. The significant odds of excessive body fat among the currently married compared to unmarried were 4.1 (95% CI: 1.3-12.5) for BF% and 1.9 (95% CI: 1.3-2.9) for BMI among women; and 4.9 (95% CI: 2.6-9.6), 3.2 (95% CI: 1.6-6.4) and 3.6 (95% CI: 1.9-6.8) for BF%, WC and BMI respectively among men. Age ≤50 years (compared to age >50 years) was inversely associated with excessive BF% in men and women, and less-than-a-college education was inversely associated with excessive BMI and WC in men. Tobacco smoking was inversely associated with all three excessive adiposity indicators in women but not in men. Unemployment, depression, and stress did not predict excessive body fat in men or women.
  
  
  CONCLUSIONS
  The sex-differences in the socio-demographic and lifestyle factors associated with the high levels of excessive body fat in urban and rural women and men should be considered in packaging interventions to reduce obesity in these communities.
authors.affiliation: School of Public Health, University of the Western Cape, Bellville, South Africa; Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Kufre Joseph
authors.initials: KJ
authors.lastname: Okop
authors.affiliation: Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa; Division of Endocrinology and Diabetes, Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Naomi
authors.initials: N
authors.lastname: Levitt
authors.affiliation: School of Public Health, University of the Western Cape, Bellville, South Africa; Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Thandi
authors.initials: T
authors.lastname: Puoane
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D050154:Adiposity; D000328:Adult; D000368:Aged; D044383:Black People; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000473:pathology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population; D013019:South Africa; D014505:Urban Population