Obesity in urban women - Is too much food intake the only causing factor?

With studies showing that 62% of black urban South African women are overweight and obese, compared to 53% of urban white women - a lot has to be done to overcome this issue, writes MZINGISI MGWALI.

Research into the health behaviour of urban South African women and their daughters, conducted by Zandile Mciza of the MRC/UCT Exercise Science and Sports Medicine Research Unit, has proved that social environment contribute to women's obesity.

Zandile's study established that factors such as socio-economic status, culture, environment and family, in addition to biological factors, do play a big role in the development of obesity in women.

The study included 333 primary schoolgirls aged 9-12 years and their mothers from the Cape Town area. Research subjects were interviewed to get information about their demographics, cultural identity and body image. Also, their weight, height and skin-fold thickness were measured.

The aim of Zandile's research was to validate questionnaires concerning body image perception, body size dissatisfaction, weight-related beliefs and attitudes of multi-ethnic South African mothers and their daughters. She is the first South African to validate such questionnaires.

Questionnaire validation is a process of finding reliability in questionnaires. 'You do this to make sure that the items/questions in the questionnaire are giving you the information that you want or intend to get. To prove that my instruments were valid, I had to compare them against a golden standard or another tool,' Zandile explains. They also had to be user-friendly, age-appropriate and culturally sensitive.

The results highlighted that all urban women from different ethnic groups are not happy with their body sizes, whereas black pre-adolescent girls are found to have less body size dissatisfaction when compared to their white counterparts.

'When participants where asked to choose their ideal body type from the sketches provided, black mothers and their daughters were similar in that they preferred bigger body sizes when compared to white mothers and their daughters, who preferred thinner bodies,' Zandile said, adding that the study confirmed that black women saw bigger bodies as attractive. Also, women with bigger bodies are considered as HIV/AIDS-free in black communities, she added.

It was also found that less pressure from the social environment, such as friends and family, is exerted on young black girls to adopt thinner bodies than on white girls.

Zandile's study
Zandile, now a full-time PhD student in the Nutrition and Dietetics Unit at the University of Cape Town (UCT), was born in Durban but she later moved to King William's Town in the Eastern Cape. She says growing up in an environment where black people's participation in health services was very low is what motivated her to go into science.

'I went into science in an effort to learn more about health problems, such as the chronic diseases of lifestyles (diabetes mellitus, hypertension and heart disease) which my community was facing and to also try to find solutions,' Zandile says.

After finishing her tertiary studies doing a dietician course at the University of the Western Cape (UWC), she joined the Sports Science Institute of South Africa based at UCT. While there, Zandile was introduced to the obesity topic and its link to the chronic diseases of lifestyle. She saw this as an opportunity to fulfill her goal. 'The experience I had working in hospital and community settings and the literature I reviewed taught me that the best way to reach my goal of trying to uncover health troubles facing my community was to properly understand the causes of obesity,' says Zandile.

Zandile obtained a sponsorship from the MRC, UCT and the Nestlé foundation to kick-start her research career. But she soon learnt that there was a lack of information in South Africa regarding obesity and a need for culturally sensitive and age-appropriate instruments to explore those issues. She started her research by adapting all the available tools and later modified them to suit the cultural diversity of SA women. She also designed new instruments.

Late last year, Zandile won the prestigious 2005 Women in Science Fellowship award in the category of Gender Responsive Research.

The fellowship came with R100 000 prize money, which can only be used for research support such as international traveling and study expenses. She plans to conduct a nationwide study on obesity as soon as she's completed her PhD.

Zandile advises women who think they might be overweight and obese to seek help from a professional who is well informed about this subject, such as a dietician, in order to avoid using incorrect information.

'Obesity is a killer disease, as identified by the World Health Organisation. It might not affect you there and then, but may increase the risk of developing chronic diseases of lifestyle later in life, she concluded.