The impact of body fat and its distribution on risk factors for cardiovascular disease in black South African women

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dc.contributor.advisorGoedecke, Juliaen_ZA
dc.contributor.advisorCollins, Malcolmen_ZA
dc.contributor.authorJennings, Courtney Len_ZA
dc.date.accessioned2014-07-28T18:16:53Z
dc.date.available2014-07-28T18:16:53Z
dc.date.issued2008en_ZA
dc.descriptionIncludes abstract.
dc.descriptionIncludes bibliographical references (p. 183-214).
dc.description.abstractObesity and obesity-related diseases are a large global problem in both developed and developing nations. In South Africa, a country currently undergoing epidemiological transition, the prevalence of obesity is high, particularly in urban black women. Early detection of overweight and obese individuals is essential for the management of obesity and its related co-morbidities; however, there is no ethnic-specific field measure of body fat percent validated for use in black South African women. Further, despite high levels of adiposity, these women have an atypical presentation of cardiovascular disease (CVD) risk factors, presenting with relatively low levels of visceral adipose tissue (VAT) and a favourable lipid profile compared to white women. As a result of this atypical presentation of CVD risk factors, a high prevalence of “healthy obesity” has been reported, although the determinants of this phenotype have not been systematically investigated. In addition, the applicability of commonly used diagnostic criteria for the determination of insulin resistance, which include enlarged waist circumference and dyslipidemia as components, has not been investigated in this population. Therefore, the overall aim of this thesis was to investigate the impact of body fat and its distribution on the presentation and identification of CVD risk factors in relatively young black South African women, prior to the onset of CVD. More specifically, the objectives were; i) to determine if near infrared interactance (NIR) is a valid field measure of body fat percent in South African women; ii) to determine the agreement between International Diabetes Federation (IDF) and National Cholesterol Education Program (Adult treatment panel III) (ATP III) metabolic syndrome criteria and the degree to which these criteria can predict insulin resistance, and explore the extent to which these phenomena can be explained by body fat and its distribution; iii) to identify determinants of the “metabolically healthy obese” (MHO) and “metabolically obese normal weight” (MONW) phenotypes; and iv) to complete a preliminary investigation of the association between polymorphisms within genes that encode for proteins involved in tissue-specific glucocorticoid metabolism and obesity, body fat distribution and CVD risk factors in black South African women. As obesity is associated with increased risk of cardiovascular disease, accurate quantification of body fatness is particularly important in health risk appraisal. However, in developing countries, “gold standard” measures of body fat percent such as underwater weighing and dual energy x-ray absorptiometry (DXA) are not always practical, as access to facilities and resources are limited. Therefore, a valid field measure of body fat percent is needed for the purpose of health risk appraisal. NIR is a potentially useful field measure of body fat percent that is currently used in South Africa for this purpose. However, NIR cannot be used with confidence in South Africa until it has been validated in different ethnic populations. Therefore, the first study in this thesis examined the validity of singlesite NIR (Futrex-6100 A/ZL) as a measure of body fat percent compared to the criterion method of DXA in black and white South African women.en_ZA
dc.identifier.apacitationJennings, C. L. (2008). <i>The impact of body fat and its distribution on risk factors for cardiovascular disease in black South African women</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology. Retrieved from http://hdl.handle.net/11427/3252en_ZA
dc.identifier.chicagocitationJennings, Courtney L. <i>"The impact of body fat and its distribution on risk factors for cardiovascular disease in black South African women."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology, 2008. http://hdl.handle.net/11427/3252en_ZA
dc.identifier.citationJennings, C. 2008. The impact of body fat and its distribution on risk factors for cardiovascular disease in black South African women. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Jennings, Courtney L AB - Obesity and obesity-related diseases are a large global problem in both developed and developing nations. In South Africa, a country currently undergoing epidemiological transition, the prevalence of obesity is high, particularly in urban black women. Early detection of overweight and obese individuals is essential for the management of obesity and its related co-morbidities; however, there is no ethnic-specific field measure of body fat percent validated for use in black South African women. Further, despite high levels of adiposity, these women have an atypical presentation of cardiovascular disease (CVD) risk factors, presenting with relatively low levels of visceral adipose tissue (VAT) and a favourable lipid profile compared to white women. As a result of this atypical presentation of CVD risk factors, a high prevalence of “healthy obesity” has been reported, although the determinants of this phenotype have not been systematically investigated. In addition, the applicability of commonly used diagnostic criteria for the determination of insulin resistance, which include enlarged waist circumference and dyslipidemia as components, has not been investigated in this population. Therefore, the overall aim of this thesis was to investigate the impact of body fat and its distribution on the presentation and identification of CVD risk factors in relatively young black South African women, prior to the onset of CVD. More specifically, the objectives were; i) to determine if near infrared interactance (NIR) is a valid field measure of body fat percent in South African women; ii) to determine the agreement between International Diabetes Federation (IDF) and National Cholesterol Education Program (Adult treatment panel III) (ATP III) metabolic syndrome criteria and the degree to which these criteria can predict insulin resistance, and explore the extent to which these phenomena can be explained by body fat and its distribution; iii) to identify determinants of the “metabolically healthy obese” (MHO) and “metabolically obese normal weight” (MONW) phenotypes; and iv) to complete a preliminary investigation of the association between polymorphisms within genes that encode for proteins involved in tissue-specific glucocorticoid metabolism and obesity, body fat distribution and CVD risk factors in black South African women. As obesity is associated with increased risk of cardiovascular disease, accurate quantification of body fatness is particularly important in health risk appraisal. However, in developing countries, “gold standard” measures of body fat percent such as underwater weighing and dual energy x-ray absorptiometry (DXA) are not always practical, as access to facilities and resources are limited. Therefore, a valid field measure of body fat percent is needed for the purpose of health risk appraisal. NIR is a potentially useful field measure of body fat percent that is currently used in South Africa for this purpose. However, NIR cannot be used with confidence in South Africa until it has been validated in different ethnic populations. Therefore, the first study in this thesis examined the validity of singlesite NIR (Futrex-6100 A/ZL) as a measure of body fat percent compared to the criterion method of DXA in black and white South African women. DA - 2008 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2008 T1 - The impact of body fat and its distribution on risk factors for cardiovascular disease in black South African women TI - The impact of body fat and its distribution on risk factors for cardiovascular disease in black South African women UR - http://hdl.handle.net/11427/3252 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/3252
dc.identifier.vancouvercitationJennings CL. The impact of body fat and its distribution on risk factors for cardiovascular disease in black South African women. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology, 2008 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/3252en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Human Biologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherHuman Biologyen_ZA
dc.titleThe impact of body fat and its distribution on risk factors for cardiovascular disease in black South African womenen_ZA
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
dc.type.qualificationnamePhDen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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