Cultivating meaningful relationships with young people
How do we best engage young people in decision-making about their health?
A scoping review of deliberative priority setting methods
This scoping review’s objectives are to identify deliberative prioritysetting techniques and investigate their suitability for involving young people in the formulation of healthcare and health policy.
Using Medical Subject Headings (MeSH) and free text terms, seven databases were systematically searched for articles published in English before July 2021 that discussed the use of deliberative priority-setting approaches for health decision-making with young people. A team of six independent reviewers looked over all titles, abstracts, and full-text papers.
According to this review, it is best to spend time cultivating meaningful relationships with young people and making sure they are fairly compensated for their time and contributions if you want to engage them in decision-making about their health. This paper also contends that while there are strategies for power-sharing with young people, organisations and international institutions that decide on global health policy have not yet adopted them.
In addition, this review identified deliberative priority-setting methods that may not be appropriate for all young people. Digital engagement, for example, may not be as effective for young people in low-resource settings and the global south, where access to internet connections and reliable and consistent digital technology is limited.
According to the authors, World Health Organisation (WHO), United Nations Children’s Fund (UNICEF), and other global organizations that want to engage young people in setting priorities for healthcare and health policy may benefit from designing their interactions with young people around key features of deliberative priority setting processes. https://doi.org/10.1186/s12939-022-01794-2
The authors note the importance of safeguarding mental health and helping healthcare professionals. If neglected, poor mental health can interfere with daily activities and have a negative impact on patient care. https://doi.org/10.3390/ijerph20032365
Daniella Watson
The relationship between physical activity & body mass index
Physical Activity and Its Association With Body Mass Index: A Cross-Sectional Analysis in Middle-Aged Adults from 4 Sub-Saharan African Countries
Monica Muti
The purpose of this study was to investigate the relationship between self-reported physical activity (PA) domains (i.e., work, leisure, and transport-related PA) and body mass index (BMI) in 9388 men and women aged 29-82 years. These participants were recruited across five sites in Africa as part of the Africa-Wits-INDEPTH partnership for Genomic (AWI-Gen) study. Face-to-face interviews were conducted at study sites in various countries to collect data on PA and demographic variables.
The study also found regional and sex-specific variations in patterns of PA when assessing activity in work, travel, and leisure domains, as well as their association with BMI, across five communities in four African countries. Although the prevalence of meeting PA recommendations was high (above 80%) in both men and women, it was higher in men (83.9% vs 80.5%). Work and transportation-related PA contributed the most to total moderate to vigorous physical activities (MVPA), with leisure time PA contributing very little at these sites. These findings correspond to those previously reported in low-income settings.
A comparison of domain-specific PA patterns in 104 countries revealed that low-income countries had more work and transportation-related PA than high-income countries. In Africa, for example, work frequently involves manual labour, which may result in higher work and transportation-related PA. It’s also possible that a sizable proportion of the participants will find transportation costs prohibitively expensive. As a result, they choose to walk or take other nonmotorized transportation to work, which is consistent with findings from an earlier study in Nairobi, where walking or taking other nonmotorized transportation was the primary mode of transportation.
Results indicate that BMI differs greatly between locations and between sexes and that PA may not be enough to lower BMI on its own. Therefore, the paper contends, there is a requirement for more context-specific PA recommendations. https://doi.org/10.1123/jpah.2022-0539
Dietary habits and overall adiposity in black South African adolescents and adults
Nutrient Patterns and Body Mass Index: A Comparative Longitudinal Analysis in Urban Black South African Adolescents and Adults
The purpose of this study was to assess the relationship between dietary habits and overall adiposity in black South African adolescents and adults and to ascertain if the relationships are longitudinally sustained over a 24-month period.
The research was carried out at the Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto’s SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU).
The nutritional patterns of 750 participants—250 teenagers between the ages of 13 and 17 and 500 adults between the ages of 27 and 45—were determined using principal component analysis (PCA).
According to the author’s knowledge, no research has examined the relationship between dietary habits and BMI over time in black South African adolescents and adults.
The authors found that the dietary habits of adults and adolescents were similar throughout time, however, their correlations with BMI were different. Only the “plant-driven nutrition pattern” was significantly and positively linked to an increase in adolescents’ BMI. The “plant-driven nutrient pattern” and the “fat-driven nutrient pattern” were both significantly and positively associated with an increase in BMI in adults.
Furthermore, the findings that adults mostly consumed plant-based nutrients are consistent with those reported by Ratshikombo et al. and Makura-Kankwende et al. among middle-aged Black South Africans. In contrast, the findings that both genders of urban adolescents consume a diet that is primarily plant-based contradicts previous findings by Pisa et al., in which the authors reported that adolescents in rural areas consumed the most “animal-derived nutrients” (e.g., dairy products, fish, eggs etc,). The discrepancies between the current findings and those of Pisa et al. among adolescents might be explained by a rapid change in nutrition transition occurring in rural regions. This change is characterised by higher intakes of animal protein, fat, and added sugar, indicating a shift to a more “Western” diet. This transition is often accompanied by reduced levels of physical activity, particularly among teenage girls.
These findings suggest that adolescents’ eating habits are influenced by their geographic location (for example, urban versus rural) and socioeconomic status. Therefore, programs aimed at encouraging youth to eat healthier diets should take these factors into account before being implemented.
In conclusion, while there are changes in age and gender in the connection of nutrient patterns with BMI, their stability across time suggests that dietary interventions aiming at improving health outcomes can start earlier, in adolescence. The findings have implications for future attempts to promote preconception health through nutrition as they emphasize the importance of taking gender variations into consideration and addressing both girls’ and boys’ health-related behaviors.
https://doi.org/10.3390/nu15051075
Gudani Mukoma
Publications
1. Kim, A. W., Said Mohamed, R., Norris, S. A., Richter, L. M., & Kuzawa, C. W. (2023). Psychological legacies of intergenerational trauma under South African apartheid: Prenatal stress predicts greater vulnerability to the psychological impacts of future stress exposure during late adolescence and early adulthood in Soweto, South Africa. Journal of Child Psychology and Psychiatry, 64(1), 110–124.
https://doi.org/10.1111/jcpp.13672
2. Strauss-Kruger, M., Wentzel-Viljoen, E., Ware, L. J., Van Zyl, T., Charlton, K., Ellis, S., & Schutte, A. E. (2023). Early evidence for the effectiveness of South Africa’s legislation on salt restriction in foods: The African-PREDICT study. Journal of Human Hypertension, 37(1), 42–49.
https://doi.org/10.1038/s41371-021-00653-x
3. Poveda, N. E., Adair, L. S., Martorell, R., Patel, S. A., Ramirez-Zea, M., Bhargava, S. K., Bechayda, S. A., Carba, D. B., Kroker-Lobos, M. F., Horta, B. L., Lima, N. P., Mazariegos, M., Menezes, A. M. B., Norris, S. A., Nyati, L. H., Richter, L. M., Sachdev, H., Wehrmeister, F. C., & Stein, A. D. (2023). Growth patterns in childhood and adolescence and adult body composition: A pooled analysis of birth cohort studies from five low and middle-income countries (COHORTS collaboration). BMJ Open, 13(3), e068427. https://doi.org/10.1136/bmjopen-2022-068427
4. Nyamwanza, A., Jacobs, P., & Nyezi, K. (2023). Advancing a transformative human development approach to climate resilience through local innovation in South Africa. Development Southern Africa, 1–14. https://doi.org/10.1080/0376835X.2023.2171365
CoE-HUMAN • NEWSLETTER • March 2023
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