A qualitative research synthesis of contextual factors contributing to female overweight and obesity over the life course in sub-Saharan Africa

English version

Autoři: Ifeoma D. Ozodiegwu ^aff001; Mary Ann Littleton ^aff002; Christian Nwabueze ^aff003; Oluwaseun Famojuro ^aff003; Megan Quinn ^aff003; Richard Wallace ^aff004; Hadii M. Mamudu ^aff005
Působiště autorů: Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America ^aff001; Department of Community and Behavioral Health, East Tennessee State University, Johnson City, Tennessee, United States of America ^aff002; Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, Tennessee, United States of America ^aff003; Quillen College of Medicine Library, East Tennessee State University, Johnson City, Tennessee, United States of America ^aff004; Department of Health Services Management and Policy, East Tennessee State University, Johnson City, Tennessee, United States of America ^aff005
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0224612

Souhrn

Objective

Adult women are disproportionately affected by overweight and obesity in Sub-Saharan African (SSA) countries. Existing evidence on the sociocultural context remains unconsolidated. In this qualitative research synthesis, we aggregate research literature on contextual factors that potentially predispose adult women and adolescent girls to overweight and obesity to inform research, policies and programs over the life course.

Methods

PubMed, CINAHL, PsychInfo, ProQuest Central, EMBASE, and Web of Science were searched to locate qualitative research articles conducted in SSA countries beginning in the year 2000. After assessment for eligibility and critical appraisal, 17 studies were included in the synthesis. Textual data and quotes were synthesized using meta-aggregation methods proposed by the Joanna Briggs Institute.

Results

The synthesized studies were conducted in South Africa, Ghana, Kenya and Botswana. The three overarching themes across these studies were body size and shape ideals, barriers to healthy eating, and barriers to physical activity, with cultural and social factors as cross-cutting influences within the major themes. Culturally, the supposedly ideal African woman was expected to be overweight or obese, and voluptuous, and this was associated with their identity. Although being overweight or obese was not acceptable to adolescent girls, they desired to be voluptuous. Healthy food choices among women and adolescent girls were hampered by several factors including affordability of nutritious foods and peer victimization. Both adult women and adolescent girls experienced ageism as a barrier to physical activity.

Significance

This is the first qualitative research synthesis to amplify the voices of women and girls in SSA countries highlighting the challenges they face in maintaining a healthy body weight. Sociocultural, institutional and peer-related factors were powerful forces shaping body size preferences, food choices and participation in physical activity. Our study findings provide insights for the design of contextually appropriate obesity prevention interventions and lay the foundation for further research studies.

Klíčová slova:

Physiological parameters – Food – Physical activity – Qualitative studies – Obesity – Adolescents – African people – Adults

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