Yiga Peter, Seghers Jan, Ogwok Patrick, Matthys Christophe
Nutrition and Obesity Unit, Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Aging, Katholieke Universiteit Leuven, Leuven, Belgium.
Department of Food Technology, Kyambogo University, Kampala, Uganda.
Br J Nutr. 2020 Oct 28;124(8):761-772. doi: 10.1017/S0007114520001828. Epub 2020 May 28.
Urban sub-Saharan Africa is in a nutrition transition shifting towards consumption of energy-dense nutrient-poor diets and decreasing physical activity. Determinants of nutrition transition in sub-Saharan Africa are presently not well understood. The objective of this review was to synthesise available data on determinants of dietary and physical activity behaviours among women of reproductive age in urban sub-Saharan Africa according to the socio-ecological framework. We searched MEDLINE, Embase, Scopus, Web of Science and bibliographies of included articles for qualitative, observational and randomised controlled studies published in English from January 2000 to September 2018. Studies conducted within general populations of women aged 18-49 years were included. Searches were according to a predefined protocol published on PROSPERO (ID = CRD42018108532). Two reviewers independently screened identified studies. From a total of 9853 unique references, twenty-three studies were retained and were mainly from South and West Africa. No rigorous designed quantitative study was identified. Hence, data synthesis was narrative. Notable determinants of dietary behaviour included: convenience, finances, social network, food skills and knowledge gaps, food deserts and culture. Cultural beliefs include strong relationship between high social status and weight gain, energy-dense confectionery, salt or fat-rich foods. Physical activity is influenced by the fast-changing transport environment and cultural beliefs which instigate unfavourable gender stereotypes. Studies with rigorous qualitative and quantitative designs are required to validate and develop the proposed frameworks further, especially within East Africa. Nevertheless, available insights suggest a need for comprehensive skill-based interventions focusing on socio-cultural misconceptions and financial limitations.
撒哈拉以南非洲城市地区正处于营养转型期，人们的饮食正转向高能量、低营养的食物，身体活动也在减少。目前，人们对撒哈拉以南非洲营养转型的决定因素还不太了解。本综述的目的是根据社会生态框架，综合撒哈拉以南非洲城市地区育龄妇女饮食和身体活动行为决定因素的现有数据。我们检索了MEDLINE、Embase、Scopus、科学引文索引以及纳入文章的参考文献，以查找2000年1月至2018年9月以英文发表的定性、观察性和随机对照研究。纳入了针对18至49岁女性总体人群开展的研究。检索按照在国际系统评价前瞻性注册库（PROSPERO，ID = CRD42018108532）上发布的预定义方案进行。两名评审员独立筛选已识别的研究。在总共9853篇独特参考文献中，保留了23项研究，这些研究主要来自南部和西部非洲。未发现严格设计的定量研究。因此，数据综合采用叙述性方式。饮食行为的显著决定因素包括：便利性、财务状况、社交网络、食品技能和知识差距、食物荒漠和文化。文化观念包括高社会地位与体重增加、高能量糖果、高盐或高脂肪食物之间的紧密联系。身体活动受到快速变化的交通环境和文化观念的影响，这些观念引发了不利的性别刻板印象。需要开展具有严格定性和定量设计的研究，以进一步验证和完善所提出的框架，特别是在东非地区。尽管如此，现有见解表明需要开展基于技能的综合干预措施，重点关注社会文化误解和财务限制。
