| Institution: | 1. Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa;2. Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, South Africa;3. Pediatric Epidemiology, Department of Pediatrics, Leipzig University, Germany;4. Hypertension in Africa Research Team, North-West University, Potchefstroom, South Africa;5. Physical Activity, Sport Science and Recreation, North-West University, Potchefstroom, South Africa;6. African Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa;7. School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, Australia |
| Abstract: | Background and aimsObesity 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 resultsThe 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.ConclusionsOne 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. |
