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Changes in body mass index, dietary intake and physical activity of South African immigrants in Hobart, Australia

Stanton, Marcile (2011-12)

Thesis (MNutr)--Stellenbosch University, 2011.


ENGLISH ABSTRACT: INTRODUCTION: Immigration, especially to countries with a higher prevalence of overweight and obesity, has been found to exacerbate these conditions in immigrants. This study investigated the change in dietary intake, physical activity and body mass index (BMI) of South African immigrants in Hobart, Australia. OBJECTIVES: The objectives were to determine the change in BMI, the current and usual dietary intakes and perceived dietary changes and the current physical activity levels and perceived changes in physical activity since immigration of South African immigrants residing in the Greater Hobart Area. DESIGN: This study had descriptive, cross-sectional as well as analytical components. SAMPLING: Forty seven participants were recruited by contacting known immigrants, postings in newspapers, contacting immigrant social groups, contacting the Department of Economic Development as well as using the social networking program, “Facebook”. All participants had to be between the ages of 20 and 50 and have lived in Australia for longer than six months, but shorter than five years. Thirty participants completed the study with a mean age of 37.17 years. METHODS: Participants were required to complete a self-administered sociodemographic questionnaire, a 3-day diet record, physical activity questionnaire and quantified food frequency questionnaire (QFFQ). The investigator administered a weight change questionnaire. Anthropometric measurements included weight, height and waist circumference measurements. RESULTS: There was no significant difference between the BMIs of participants preand post-immigration (p=0.06), but the percentage of overweight female participants increased from 24% (n=4) to 29% (n=5) and the percentage of overweight male participants increased from 46% (n=6) to 69% (n=9). The percentage of obese female participants increased from 6% (n=1) to 12% (n=2) post-immigration with the male participants showing no increased prevalence of obesity. Participants appeared aware of their weight classifications with 60% (n=18) reporting that they considered themselves overweight. Mean waist circumference values of male and female participants were classified as action level 1. Forty one percent (n=7) of female participants and 31% (n=4) of male participants had waist circumference values classified as action level 2. Carbohydrate intakes were below the Nutrient Reference Values (NRV) recommendations for 84% (n=25) and 62% (n=19) of participants as indicated by the QFFQ and diet records respectively and the mean carbohydrate intake values of male and female participants (QFFQ and diet records) were below the NRV recommendations as well. Fibre intakes were below the NRV recommendations for 76% (n=23) and 82% (n=25) of participants as indicated by the QFFQ and food records respectively. Saturated fat and sodium intakes were high. Folate, calcium and potassium were consumed in lower than recommended amounts by a large proportion of participants. Sixty seven percent (n=20) of participants reported an increase in physical activity post-immigration and 70% (n=21) of participants anticipated a future increase in physical activity levels. CONCLUSION: The study population experienced an increase in weight. A number of other risk factors for cardiovascular and other chronic diseases were also identified including high waist circumference values, high saturated fat and sodium intakes and low fibre, folate, calcium and potassium intakes. Interventions aimed at decreasing the risk of South African immigrants in Hobart becoming overweight/obese and developing chronic diseases should probably be aimed at lower saturated and total fat intake, higher carbohydrate and fibre intake and plenty of dietary variation and should further encourage physical activity, but this needs to be confirmed by larger prospective studies.

AFRIKAANSE OPSOMMING: INLEIDING: Daar is gevind dat immigrasie, veral na lande met ‘n hoër prevalensie van oorgewig en vetsugtigheid, hierdie toestande in immigrante kan vererger. Hierdie studie het die veranderinge in dieetinname, fisiese aktiwiteit en liggaamsmassa-indeks (LMI) van Suid-Afrikaanse immigrante in Hobart, Australië ondersoek. DOELWITTE: Die doelwitte was om die verandering in LMI na immigrasie, die huidige en gewoontelike dieetinname en gerapporteerde dieet veranderinge na immigrasie asook die huidige fisiese aktiwiteit en gerapporteerde fisiese aktiwiteit veranderinge van Suid-Afrikaanse immigrante, wat in die groter Hobart area woon, te ondersoek. ONTWERP: Die studie het beskrywende asook analitiese komponente gehad. STEEKPROEFTREKKING: Respondente is gewerf deur alle bekende immigrante te kontak, koerant boodskappe te plaas, sosiale groepe vir immigrante te kontak, die Department van Ekonomiese Ontwikkeling te kontak asook deur die sosiale netwerk program, “Facebook”, te gebruik. Alle respondente moes tussen die ouderdomme van 20 en 50 wees en moes langer as ses maande, maar korter as vyf jaar in Australië woon. METODES: Respondente het ‘n sosio-demografiese vraelys asook ‘n drie dag voedselrekord, ‘n voedselfrekwensie vraelys en ‘n fisiese aktiwiteit vraelys voltooi. Die navorser het ‘n gewigsverandering vraelys afgeneem. Antropometriese metings het gewig, lengte en middelomtrek ingesluit. RESULTATE: Daar was nie ‘n betekenisvolle verskil tussen die LMI waardes van respondente voor en na immigrasie nie (p=0.06), maar die persentasie oorgewig vroulike respondente het toegeneem van 24% (n=4) na 29% (n=5) en die persentasie oorgewig manlike respondente het toegeneem van 46% (n=6) na 69% (n=9). Die persentasie vetsugtige vroulike respondente het toegeneem van 6% (n=1) na 12% (n=2) na immigrasie en die manlike respondente het geen toename in vetsugtigheid getoon nie. Dit het voorgekom asof respondente bewus was van hulle gewigsklassifikasies met 60% (n=18) wat gerapporteer het dat hulle hulself as oorgewig beskou. Die gemiddelde middelomtrek waardes van die manlike en vroulike respondente was geklassifiseer as aksie vlak 1. Een en veertig persent (n=7) van die vroulike respondente en 31% (n=4) van die manlike respondente het middelomtrek waardes getoon wat as aksie vlak 2 geklassifiseer was. Koolhidraat inname was laer as the nutrient verwysingswaardes vir 84% (n=25) en 62% (n=19) van die respondente soos aangedui deur die voedselfrekwensie lys en 3-dag voedselrekord. Vesel inname was laer as the nutrient verwysingswaardes vir 76% (n=23) en 82% (n=25) van die respondente soos aangedui deur die voedselfrekwensie lys en 3-dag voedselrekord. Die gemiddelde waardes vir koolhidraat en vesel inname vir manlike en vroulike respondente (voedselfrekwensie lys en 3-dag voedselrekord) was laer as die nutrient verwysingswaardes. Versadigde vet en natrium innames was hoog. Folaat, kalsium en kalium innames van ‘n groot proporsie respondente was laer as die aanbevelings. Sewe en sestig persent (n=20) van die respondente het gerapporteer dat hulle fisiese aktiwiteitsvlakke toegeneem het na immigrasie en 70% (n=21) van die respondente het verwag dat hulle fisiese aktiwiteitsvlakke sou verhoog. AANBEVELINGS: Die studie populase het ‘n toename in gewig en LMI ondervind. ‘n Aantal verdere risikofaktore vir kroniese en kardiovaskulêre siektes was geïdentifiseer, byvoorbeeld hoë middelomtrek waardes, hoë versadigde vet en natrium innames en lae vesel, folaat, kalsium en kalium innames. Programme wat fokus op die voorkoming van oorgewig/vetsug in Suid-Afrikaanse immigrante in Hobart, Australië moet moontlik gemik wees op laer totale en versadigde vet inname, hoër vesel en koolhidraat inname asook variasie in diet en fisiese aktiwiteit moet ook verder aangemoedig word. Sodanige aanbevelings moet egter bevestig word deur groter prospektiewe studies.

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