Socio-economic status and urbanization are linked to snacks and obesity in adolescents in Botswana

Segametsi D. Maruapula, Jose C. Jackson, Joanna Holsten, Sheila Shaibu, Leapetswe Malete, Brian Wrotniak, Sarah J. Ratcliffe, George G. Mokone, Nicolas Stettler, Charlene Compher

Research output: Contribution to journalReview articlepeer-review

42 Citations (Scopus)

Abstract

Objective To describe patterns of food consumption associated with overweight/ obesity (OW/OB) and their links to socio-economic status (SES) and urbanization. Design A nationwide cross-sectional survey. Setting Secondary schools in cities, towns and villages in Botswana, Africa. Subjects A total of 746 adolescent schoolchildren. Results OW/OB is associated with greater SES, city residence and a snack-food diet pattern. Students belonging to higher SES compared with those from a lower SES background reported significantly (P < 0·01) more daily servings of snack foods (1·55 v. 0·76) and fewer servings of traditional diet foods (0·99 v. 1·68) and also reported that they ate meals outside the home more often (90 % v. 72 %). Students in cities ate significantly (P < 0·01) more servings of snacks (1·69 v. 1·05 v. 0·51) and fewer servings of traditional foods (0·67 v. 1·52 v. 1·61) compared with those in urban and rural villages. The odds of OW/OB were increased 1·16-fold with a snack-food diet, a result that was diminished when controlled for SES. Conclusions These data suggest that nutritional transition occurs at different rates across urbanization and SES levels in Botswana. In cities, increasing the availability of fruit while reducing access to or portion sizes of snack items is important. Emphasis on continued intake of traditional foods may also be helpful as rural areas undergo economic and infrastructural development.

Original languageEnglish
Pages (from-to)2260-2267
Number of pages8
JournalPublic Health Nutrition
Volume14
Issue number12
DOIs
Publication statusPublished - Dec 2011
Externally publishedYes

Keywords

  • Food patterns
  • Nutrition transition
  • Snacks
  • Traditional diet

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