Suid-Afrikaanse tieners is kwesbaar vir diabetes en hartsiekte
’n Groot middelomtrek en hoë bloeddruk was die mees algemene risikofaktore vir metaboliese sindroom onder die Kaapse tieners in die studie. Foto: Andres Ayrton/PexelsDie tienerjare word dikwels beskou as ’n tyd van krag en lewenskrag, wanneer lewenslange gewoontes vir goeie gesondheid begin vorm aanneem. Maar nuwe navorsing deur die Universiteit van die Wes-Kaap (UWK) dui daarop dat hierdie prentjie besig is om te verander, met ’n kommerwekkende getal adolessente in Kaapstad wat vroeë tekens van metaboliese sindroom (’n kluster onderling verwante toestande wat die risiko van hartsiekte en tipe 2-diabetes in die latere lewe verhoog) toon. Hierdie navorsing kom saam met die wêreldwye gedenking van Wêreldvetsugdag op 4 Maart.
Metaboliese sindroom, of MetS, sluit toestande soos maagvetsug, hoë bloeddruk, verhoogde bloedsuiker en abnormale cholesterolvlakke in. Hoewel daar heelwat navorsing oor hierdie toestand onder volwassenes is, is daar minder bekend oor die prevalensie daarvan onder tieners in Afrika suid van die Sahara.
Om hierdie leemte aan te vul, het navorsers, onder leiding van PhD-student, Annalie Wentzel, van die Skool vir Openbare Gesondheid, ongeveer 500 tieners tussen die ouderdom van 13 en 18, en hoofsaaklik uit laer- tot middelinkomsteskole en huishoudings in Kaapstad, geassesseer.
Prof Zandile Mchiza en dr Kim Anh Nguyen van die Suid-Afrikaanse Mediese Navorsingsraad, prof Naomi Levitt van die Chroniese Siekte-inisiatief aan die Universiteit van Kaapstad, en dr Peter von Philipsborn, voorsitter van Openbare Gesondheidsvoeding aan die Universiteit van Bayreuth in Duitsland, is mede-outeurs van die studie.
Navorsers het die prevalensie van MetS onder adolessente met behulp van vyf internasionale riglyne geassesseer en vergelyk tot hoe ’n mate hierdie riglyne met mekaar strook. Hulle het faktore soos bloeddruk en vastende bloedsuiker gemeet, en ook leefstylgewoontes, met inbegrip van fisiese aktiwiteit en skermtyd, in ag geneem.
Die resultate toon dat vier van die riglyne baie soortgelyke bevindings gelewer het, met die bevinding dat tussen 4.7% en 5.7% van adolessente aan metaboliese sindroom ly. Die een riglyn, De Ferranti, het egter uitgestaan, deur ’n baie hoër koers van amper 18% aan te dui.
Annalie Wentzel, PhD-student aan die UWK. Foto voorsienOngeag die riglyne wat gebruik is, is ’n groot middelomtrek en hoë bloeddruk as die mees algemene risikofaktore vir metaboliese sindroom uitgewys. Die studie het bevind dat meisies, veral swart Afrikane, ingevolge die meeste diagnostiese kriteria meer waarskynlik aan metaboliese sindroom sou ly as seuns.
Hierdie hoër risiko onder vroue word hoofsaaklik verbind met groter maagvetsug, hoër liggaamsmassa-indeks en verhoogde bloeddruk. Hierdie verhoogde risiko in meisies word gevorm deur ’n mengsel van biologiese, gedrags- en sosiale faktore, waaronder die vroeë aanvang van puberteit in meisies, wat verband hou met ’n natuurlike toename in liggaamsvet en veranderinge in cholesterolvlakke tydens adolessensie.
“Kulturele norms in talle Suid-Afrikaanse opsette wat ’n groter vroulike liggaam verkies, of gewigstoename as ’n teken van gesondheid of volwassenheid beskou, kan die aanvaarding van hoër vetvlakke versterk en oorgewig normaliseer,” meld die navorsers.
Leefomstandighede en skoolagtergrond speel ’n rol, met adolessente wat in informele behuising woon wat ’n beduidend hoër koers van metaboliese sindroom toon as dié wat in baksteenhuise woon – wat dui op ’n verband tussen informele behuising en metaboliese versteurings.
Voorts word daar genoem dat die hoë vlakke van verhoogde bloeddruk, maagvetsug en ongesonde cholesterolvlakke, veral onder meisies, die dringende behoefte aan vroeë en geteikende gesondheidsingrypings uitlig. Die bevindings beklemtoon ook die belangrikheid van die gebruik van gepaste gesondheidsiftingswerktuie wat die verskille tussen seuns en meisies, en oor bevolkings heen, in ag neem.
ABantwana abaFikisayo baseMzantsi Afrika basebuNgozini bokuFumana iSifo seSwekile neSifo seNtliziyo
Isihloko: Ubukhulu bomlinganiso wesinqe noxinzelelo lwegazi oluphezulu zibe zezona zinto zixhaphakileyo ezibangela umngcipheko wokuba neempawu zokuba namafutha neswekile eninzi emzimbeni phakathi kwabantwana abafikisayo baseKapa kolu phononongo. Umfanekiso: Andres Ayrton/PexelsIminyaka yobudala ephakathi kwelishumi nengamashumi amabini amaxesha amaninzi ibonwa njengexesha lokuba namandla nodlamko nalapho imikhwa yobomi bonke yokuba sempilweni ithi iqalise. Kodwa uphando olutsha olusuka kwiYunivesithi yaseNtshona Koloni (iUWC) lubonakalisa ukuba oku kusenokuba kuyatshintsha, nalapho inani elixhalabisayo labantwana abafikisayo eKapa libonakalisa iimpawu zamsinya zokuba namafutha neswekile eninzi emzimbeni, iqela leemeko zezempilo ezinxulumeneyo ezandisa umngcipheko wokuba nesifo sentliziyo nohlobo 2 lwesifo seswekile ekuhambeni kwexesha ebomini. Oku kufika nanjengoko kukhunjulwa uSuku lokuTyeba kaKhulu lweHlabathi kwihlabathi jikelele namhlanje.
Iimpawu zokuba namafutha neswekile eninzi emzimbeni, okanye iMetS, ziquka iimeko ezifana nokutyeba ngendlela engaqhelekanga, uxinzelelo lwegazi oluphezulu, ukunyuka kweqondo leswekile egazini namaqondo angaqhelekanga amafutha emzimbeni. Nangona le meko iphononongwa kakuhle ebantwini abadala, kuncinci okwaziwayo malunga nokuxhaphaka kwayo kubantwana abafikisayo kwiAfrika ekumazantsi eSahara. Ukukhawulelana nesi sikhewu, abaphandi abakhokelwe ngumfundi wezifundo zePhD uAnnalie Wentzel osuka kwiSikolo sezeMpilo yoLuntu luye lwavavanya abantwana abafikisayo abamalunga nama500, abaneminyaka eli13 ukuya kweli18 ubudala, nalapho uninzi lwabo lusuka kwizikolo namakhaya abo banemivuzo emincinci ukuya kwabo banemivuzo ephakathi eKapa.
Abanye ababhali kolu phononongo baquka uNjing Zandile Mchiza noGqr Kim Anh Nguyen abasuka kwiBhunga loPhando lwezeMpilo laseMzantsi Afrika, uNjing Naomi Levitt osuka kwiPhulo leZifo eziNganyangekiyo laseAfrika (Chronic Disease Initiative for Africa) kwiYunivesithi yaseKapa, noGqr Peter von Philipsborn, uSihlalo wezeSondlo kwiMpilo yoLuntu kwiYunivesithi yaseBayreuth eJamani.
Abaphandi baye bavavanya ukuxhaphaka kweMetS phakathi kwabantwana abafikisayo besebenzisa izikhokelo zakwihlabathi jikelele ezihlanu baza bathelekisa indlela ezingqamana ngokusondeleneyo ngayo ezi zikhokelo. Baye bathatha imilinganiso yezinto ezifana noxinzelelo lwegazi novavanyo lobungakanani beswekile egazini, ngelixa bethathela ingqalelo imikhwa yeendlela zokuphila, kuquka imisebenzi esebenzisa umzimba nexesha lokubukela umabonakude, ukucofa ikhompyutha okanye ifowuni.
Isihloko: Annalie Wentzel, umfundi wePhD eUWC. Umfanekiso/UbonelelweIziphumo ziye zabonakalisa ukuba ezine kwezo zikhokelo ziye zavelisa okuyelelene kakhulu, nalapho abantwana abafikisayo abenza i4.7% nabenza i5.7% baye bafumaniseka beneempawu zokuba namafutha neswekile eninzi emzimbeni. Nangona kunjalo, isikhokelo esinye esibizwa ngokuba yi-de Ferranti, siye sabalasela, nalapho siye sachonga izinga eliphezulu nangakumbi kakhulu eliphantse lifikelele kwi18%. Umlinganiso wesinqe omkhulu noxinzelelo lwegazi oluphezulu zibe zezona zinto zixhaphake kakhulu ezibangela umngcipheko weempawu zokuba namafutha neswekile eninzi emzimbeni, ngokungakhathalisekanga ukuba zeziphi izikhokelo ezisetyenzisiweyo. Olu phononongo luye lwafumanisa ukuba amantombazana, ingakumbi angamaAfrika amnyama, asethubeni elikhulu kunamakhwenkwe lokuba neempawu zokuba namafutha neswekile eninzi emzimbeni phantsi kweekhrayitheriya zofunyaniso ezininzi.
Lo mngcipheko uphezulu kumanina uye wanxulunyaniswa ngokuphambili nokutyeba kakhulu kwesisu, ubunzimba bomzimba obuphezulu, nokuba phezulu kwamaqondo oxinzelelo lwegazi. Oku kwanda komngcipheko emantombazaneni kubangelwa yingxubevange yezinto ezingokwebhayoloji, ezingokokuziphatha nezingokwentlalo, kuquka nokuqalisa msinya ukufikisa emantombazaneni, nto leyo inxulunyaniswa nokwanda ngokwendalo kwamafutha omzimba nokutshintsha kwamaqondo amafutha asemzimbeni ngexesha lokufikisa.
“Izinto eziqhelekileyo ngokweenkcubeko kwiimeko ezininzi eMzantsi Afrika ezixhasa ukuba amabhinqa abe nemizimba emikhulu, okanye ukubona ukuba mkhulu ngokomzimba njengophawu lokuba sempilweni okanye lokuqola, zingakuqinisa nangakumbi ukwamkelwa kwamaqondo okutyeba aphezulu kwaye zikwenze kube yinto eqhelekileyo ukutyeba ngokugqithisileyo,” baqaphele oko abaphandi.
Iimeko ekuphilwa phantsi kwazo neemvelaphi ngokwezikolo ziye zadlala indima, nalapho abantwana abafikisayo abahlala kwizindlu ezingamiselekanga bathi babe namaqondo aphezulu eempawu zokuba namafutha neswekile eninzi emizimbeni kunabo bahlala kwizindlu zezitena - nto leyo ibonakalisa unxulumano phakathi kwezindlu ezingamiselekanga neengxeki zasemzimbeni.
Ngaphezu koko, baye baqaphela ukuba amaqondo okuba noxinzelelo lwegazi oluphezulu, ukutyeba kwezisu namaqondo amafutha emzimbeni angenampilo, ingakumbi phakathi kwamantombazana, agqamisa imfuneko engxamisekileyo yeenkqubo zongenelelo lwezempilo lwamsinya nolujolisiweyo. Okufunyanisiweyo kukwagxininisa ukubaluleka kokusetyenziswa kwezixhobo ezifanelekileyo zohluzo lwezempilo ezicacisa umahluko phakathi kwamakhwenkwe namantombazana kuluntu jikelele.
Large waistline and high blood pressure were the most common risk factors for metabolic syndrome among Cape Town teenagers in the study. Image: Andres Ayrton/PexelsTeenage years are often seen as a time of strength and vitality when lifelong habits for good health begin to take shape. But new research from the University of the Western Cape (UWC) suggests this picture may be shifting, with a worrying number of adolescents in Cape Town showing early signs of metabolic syndrome, a cluster of interrelated conditions that increases the risk of heart disease and type 2 diabetes later in life. This comes as World Obesity Day is being commemorated across the globe today.
Metabolic syndrome, or MetS, includes conditions such as abdominal obesity, high blood pressure, raised blood sugar and abnormal cholesterol levels. While this condition is well studied in adults, less is known about its prevalence among teenagers in sub-Saharan Africa. To address this gap, researchers led by PhD student Annalie Wentzel from the School of Public Health assessed about 500 teenagers, aged 13 to 18, mostly from lower to middle-income schools and households in Cape Town.
Other authors on the study include Prof Zandile Mchiza and Dr Kim Anh Nguyen from the South African Medical Research Council, Prof Naomi Levitt from the Chronic Disease Initiative for Africa at the University of Cape Town, and Dr Peter von Philipsborn, Chair of Public Health Nutrition at the University of Bayreuth in Germany.
Researchers assessed the prevalence of MetS among adolescents using five international guidelines and compared how closely these guidelines aligned with one another. They measured factors such as blood pressure and fasting blood sugar, while considering lifestyle habits, including physical activity and screen time.
The results showed that four of the guidelines produced very similar findings, with between 4.7% and 5.7% of adolescents found to have metabolic syndrome. However, one guideline called de Ferranti, stood out, identifying a much higher rate of almost 18%. Large waistline and high blood pressure were the most common risk factors for metabolic syndrome, irrespective of the guidelines used. The study found that girls, particularly black African, were more likely than boys to have metabolic syndrome under most diagnostic criteria.
Annalie Wentzel, PhD student at UWC. Image/SuppliedThis higher risk among females was mainly associated with greater abdominal obesity, higher body mass index, and elevated blood pressure. This increased risk in girls is shaped by a mix of biological, behavioural and social factors, including the early onset of puberty in girls, which is associated with natural increases in body fat and changes in cholesterol levels during adolescence.
“Cultural norms in many South African settings that favour a larger female body size, or view weight gain as a sign of health or maturity, may reinforce acceptance of higher adiposity levels and normalise overweight,” researchers noted.
Living conditions and school backgrounds played a role, with adolescents living in informal housing having significantly higher rates of metabolic syndrome than those living in brick houses - suggesting a link between informal housing and metabolic disorders.
Furthermore, they have noted that the high levels of elevated blood pressure, abdominal obesity and unhealthy cholesterol levels, especially among girls, highlight the urgent need for early and targeted health interventions.
The findings also stress the importance of using appropriate health screening tools that account for differences between boys and girls and across populations.
