Maternal perceptions of infant's body weight and childhood obesity in South Africa: A qualitative study in Soweto
Corresponding Author
Emmanuel Cohen
SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
CNRS, UMR 7206 “Eco-anthropologie”, Musée de l'Homme, Museum National d'Histoire Naturelle, Paris, France
Correspondence
Emmanuel Cohen, SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
Email: [email protected]
Search for more papers by this authorWiedaad Slemming
Division of Community Paediatrics, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Search for more papers by this authorStephanie V. Wrottesley
SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Search for more papers by this authorAlessandra Prioreschi
SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Search for more papers by this authorShane A. Norris
SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Search for more papers by this authorCorresponding Author
Emmanuel Cohen
SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
CNRS, UMR 7206 “Eco-anthropologie”, Musée de l'Homme, Museum National d'Histoire Naturelle, Paris, France
Correspondence
Emmanuel Cohen, SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
Email: [email protected]
Search for more papers by this authorWiedaad Slemming
Division of Community Paediatrics, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Search for more papers by this authorStephanie V. Wrottesley
SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Search for more papers by this authorAlessandra Prioreschi
SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Search for more papers by this authorShane A. Norris
SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Search for more papers by this authorAbstract
From a socio-anthropological study focusing on maternal body weight perceptions and dietary practices towards infants living in Soweto (South Africa), we studied how lay sociocultural traits may lead to early childhood obesity. Most mothers tended to socially value and normalize fatness. This propensity led mothers, particularly older women at home, to adopt high-calorie feeding practices towards infants, although some mothers tended to question these lay norms. Further works must consider how lay (emic) sociocultural norms in African townships can contradict biomedical (etic) messages, conveying for the community thinness as the acceptable standard, and may expose infants to early obesity.
CONFLICT OF INTEREST STATEMENT
All authors have no conflict of interest to declare.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Supporting Information
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chso12689-sup-0001-TableS1.docxWord 2007 document , 13 KB |
Table S1. |
chso12689-sup-0002-TableS2.xlsxExcel 2007 spreadsheet , 11.1 KB |
Table S2. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- Appiah, C. A., Otoo, G. E., & Steiner-Asiedu, M. (2016). Preferred body size in urban Ghanaian women: Implication on the overweight/obesity problem. The Pan African Medical Journal, 23, 239.
- Ashforth, A. (2002). An epidemic of witchcraft? The implications of AIDS for the post-apartheid state. African Studies, 61(1), 121–143.
10.1080/00020180220140109 Google Scholar
- Boëtsch, G. (2006). Les variations historiques et culturelles de la morphologie corporelle. Médecine et nutrition, 42(1), 29–35.
10.1051/mnut/2006421029 Google Scholar
- Bondaz, J., & Bonhomme, J. (2014). Gift, sacrifice, and sorcery: The moral economy of alms in Senegal. Annales. Histoire, Sciences Sociales: English Edition, 69(2), 341–375.
10.1017/S2398568200000790 Google Scholar
- Bosire, E. N., Cele, L., Potelwa, X., Cho, A., & Mendenhall, E. (2021). God, church water and spirituality: Perspectives on health and healing in Soweto, South Africa. Global Public Health.
- Bosire, E. N., Cohen, E., Erzse, A., Goldstein, S. J., Hofman, K. J., & Norris, S. A. (2020). ‘I'd say I'm fat, I'm not obese’: Obesity normalisation in urban-poor South Africa. Public Health Nutrition, 23(9), 1515–1526.
- Brewis, A. A., Wutich, A., Falletta-Cowden, A., & Rodriguez-Soto, I. (2011). Body norms and fat stigma in global perspective. Current Anthropology, 52(2), 269–276.
- Brown, P. J., & Konner, M. (1987). An anthropological perspective on obesity. Annals of the New York Academy of Sciences, 499, 29–46.
- Cassidy, C. M. (1991). The good body: When big is better. Medical Anthropology, 13(3), 181–213.
- Cohen, E., Bernard, J. Y., Ponty, A., Ndao, A., Amougou, N., Said-Mohamed, R., & Pasquet, P. (2015). Development and validation of the body size scale for assessing body weight perception in African populations. PLoS ONE, 10(11), 0138983.
- Cohen, E., Boëtsch, G., Palstra, F. P., & Pasquet, P. (2013). Social valorisation of stoutness as a determinant of obesity in the context of nutritional transition in Cameroon: The Bamileke case. Social Science & Medicine, 96, 24–32.
- Cohen, E., Gradidge, P. J. L., Micklesfield, L. K., & Norris, S. A. (2019). Relationship between BMI and body image disturbances amongst south African mothers and their daughters living in Soweto, Johannesburg. Family & Community Health, 42(2), 140–149.
- Cohen, E., Gradidge, P. J. L., Ndao, A., Duboz, P., Macia, E., Gueye, L., Boëtsch, G., Pasquet, P., Holdsworth, M., & Chapuis-Lucciani, N. (2019). Biocultural determinants of overweight and obesity in the context of nutrition transition in Senegal: A holistic anthropological approach. Journal of Biosocial Science, 51(4), 469–490.
- Cohen, E. (2020). Des corps pour paraître. La corpulence et ses perceptions au Sénégal.
- Colvin, C. J., Smith, H. J., Swartz, A., Ahs, J. W., de Heer, J., Opiyo, N., Kim, J. C., Marraccini, T., & George, A. (2013). Understanding careseeking for child illness in sub-Saharan Africa: A systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, pneumonia and malaria. Social Science & Medicine, 86, 66–78.
- Copans, J. (2008). L'enquête et ses méthodes: L'enquête ethnologique de terrain. Armand Colin.
- Corbin, J. M., & Strauss, A. (1990). Grounded theory research: Procedures, canons, and evaluative criteria. Qualitative Sociology, 13(1), 3–21.
- Dapi, L. N., Omoloko, C., Janlert, U., Dahlgren, L., & Håglin, L. (2007). “I eat to be happy, to be strong, and to live.” Perceptions of rural and urban adolescents in Cameroon, Africa. Journal of Nutrition Education and Behavior, 39(6), 320–326.
- de Garine, I. (1990). Adaptation biologique et bien-être psycho-culturel. Bulletins et Mémoires de la Société d'Anthropologie de Paris, 2(2), 151–173.
- de Garine, I., & Pollock, N. J. (1995). Social aspects of obesity. Gordon and Breach Publishers.
- de Lame, D. (2007). Entre le dualisme et son double, les écueils de la construction de soi. Politique Africaine, 107, 9–22.
10.3917/polaf.107.0009 Google Scholar
- De Wet, T. (1998). Muti Wenyoni: Commodification of an African folk medicine. South African Journal of Ethnology, 21(4), 165–172.
- Fottrell, E., Tollman, S., Byass, P., Golooba-Mutebi, F., & Kahn, K. (2012). The epidemiology of ‘bewitchment'as a lay-reported cause of death in rural South Africa. Journal of Epidemiology and Community Health, 66(8), 704–709.
- Foucault, M. (1976). Histoire de la sexualité—La volonté de savoir (Vol. 1). Gallimard Paris.
- Gitau, T. M., Micklesfield, L. K., Pettifor, J. M., & Norris, S. A. (2014a). Changes in eating attitudes, body esteem and weight control behaviours during adolescence in a south African cohort. PLoS ONE, 9(10), 109709.
- Gitau, T. M., Micklesfield, L. K., Pettifor, J. M., & Norris, S. A. (2014b). Ethnic differences in eating attitudes, body image and self-esteem among adolescent females living in urban. South African Journal of Psychiatry, 17, 468–474.
- Gradidge, P. J.-L., Golele, P., & Cohen, E. (2020). Body weight perceptions and obesity amongst university employed south African women. Women & Health, 60(8), 851–862.
- Green, E. C. (1996). Purity, pollution and the invisible snake in southern Africa. Medical Anthropology, 17(1), 83–100.
- Greenhalgh, S. (2012). Weighty subjects: The biopolitics of the US war on fat. American Ethnologist, 39(3), 471–487.
- Gremillion, H. (2005). The cultural politics of body size. Annual Review of Anthropology, 34, 13–32.
- Holten, L. (2013). Mothers, medicine and morality in rural Mali: An ethnographic study of therapy management of pregnancy and children's illness episodes (Vol. 6). LIT Verlag Münster.
- Hundt, G. L., Stuttaford, M., Ngoma, B., & SASPI Team. (2004). The social diagnostics of stroke-like symptoms: Healers, doctors and prophets in Agincourt, Limpopo Province, South Africa. Journal of Biosocial Science, 36(4), 433–443.
- Le Breton, D. (2011). Anthropologie du corps et modernité. PUF.
- Liddell, C., Barrett, L., & Bydawell, M. (2005). Indigenous representations of illness and AIDS in sub-Saharan Africa. Social Science & Medicine, 60(4), 691–700.
- Luque, M. N., Del Carmen García Fernández, M., & Tejada, A. J. R. (2006). Acculturation strategies and attitudes of African immigrants in the south of Spain: Between reality and hope. Cross-Cultural Research, 40(4), 331–351.
- Marenko, B. (2014). Neo-animism and design: A new paradigm in object theory. Design and Culture, 6(2), 219–241.
- Mason, J. (2002). Qualitative researching. Sage.
- McFarlane, C. (2015). South Africa: The rise of traditional medicine. Insight on Africa, 7(1), 60–70.
10.1177/0975087814554070 Google Scholar
- Mchiza, Z. J., Goedecke, J. H., & Lambert, E. V. (2011). Intra-familial and ethnic effects on attitudinal and perceptual body image: A cohort of south African mother-daughter dyads. BMC Public Health, 11(1), 433.
- Mchiza, Z. J., & Maunder, E. M. W. (2013). Fighting childhood obesity. South African Journal of Clinical Nutrition, 26(3), 100–102.
- Mendenhall, E., Seligman, R. A., Fernandez, A., & Jacobs, E. A. (2010). Speaking through diabetes: Rethinking the significance of lay discourses on diabetes. Medical Anthropology Quarterly, 24(2), 220–239.
- Micklesfield, L. K., Lambert, E. V., Hume, D. J., Chantler, S., Pienaar, P. R., Dickie, K., Goedecke, J. H., & Puoane, T. (2013). Socio-cultural, environmental and behavioural determinants of obesity in black south African women: Review articles. Cardiovascular Journal of Africa, 24(9), 369–375.
- Morris, P. F., & Szabo, C. P. (2013). Meanings of thinness and dysfunctional eating in black south African females-a qualitative study: Original. African Journal of Psychiatry, 16(5), 338–342.
- Mvo, Z., Dick, J., & Steyn, K. (1999). Perceptions of overweight African women about acceptable body size of women and children. Curationis, 22(2), 27–31.
- Ndoye, F. (2001). Evolution des styles alimentaires à Dakar. ENDA-GRAF/CIRAD.
- Nyaaba, G. N., Masana, L., Aikins, A. D. G., Stronks, K., & Agyemang, C. (2018). Lay community perceptions and treatment options for hypertension in rural northern Ghana: A qualitative analysis. BMJ Open, 8(11), e023451.
- Okop, K. J., Mukumbang, F. C., Mathole, T., Levitt, N., & Puoane, T. (2016). Perceptions of body size, obesity threat and the willingness to lose weight among black south African adults: A qualitative study. BMC Public Health, 16(1), 365.
- Onebunne, J. I., & Obasi, P. (2019). The Africanity of African literature and orality of African orature in a world of change. Journal of African Studies and Sustainable Development, 1(2), 1–16.
- Orobator, A. E. (2021). Religion and faith in Africa: Confessions of an animist. Orbis Books.
- Owolabi, E. O., Goon, D. T., Adeniyi, O. V., Adedokun, A. O., & Seekoe, E. (2017). Prevalence and associated factors of obesity among south African adults: A cross-sectional study. Online Journal of Health and Allied Science, 16(2), 1–7.
- Pelto, P. J., & Pelto, G. H. (1997). Studying knowledge, culture, and behavior in applied medical anthropology. Medical Anthropology Quarterly, 11(2), 147–163.
- Phetla, M. C., & Skaal, L. (2017). Perceptions of healthcare professionals regarding their own body weight in selected public hospitals in Mpumalanga Province, South Africa. South African Medical Journal, 107(4), 338–341.
- Popkin, B. M., Adair, L. S., & Ng, S. W. (2012). Global nutrition transition and the pandemic of obesity in developing countries. Nutrition Reviews, 70(1), 3–21.
- Pradeilles, R., Holdsworth, M., Olaitan, O., Irache, A., Osei-Kwasi, H. A., Ngandu, C. B., & Cohen, E. (2021). Body size preferences for women and adolescent girls living in Africa: A mixed-methods systematic review. Public Health Nutrition, 25(3), 738–759.
- Prioreschi, A., Wrottesley, S. V., Slemming, W., Cohen, E., & Norris, S. A. (2020). A qualitative study reporting maternal perceptions of the importance of play for healthy growth and development in the first two years of life. BMC Pediatrics, 20(1), 1–11.
- Rispel, L. C., Cloete, A., & Metcalf, C. A. (2015). “We keep her status to ourselves”: Experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine. SAHARA: Journal of Social Aspects of HIV/AIDS Research Alliance, 12(1), 10–17.
- Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: Causes and consequences. Journal of Family Medicine and Primary Care, 4(2), 187–192.
- Scheper-Hughes, N., & Lock, M. M. (1987). The mindful body: A prolegomenon to future work in medical anthropology. Medical Anthropology Quarterly, 1(1), 6–41.
10.1525/maq.1987.1.1.02a00020 Google Scholar
- Scherz, C. (2018). Stuck in the clinic: Vernacular healing and medical anthropology in contemporary sub-Saharan Africa. Medical Anthropology Quarterly, 32(4), 539–555.
- Schierenbeck, I., Johansson, P., Andersson, L. M., Krantz, G., & Ntaganira, J. (2016). Collaboration or renunciation? The role of traditional medicine in mental health care in Rwanda and eastern Cape Province, South Africa. Global Public Health, 13(2), 159–172.
- Sikstrom, L. (2014). “Without the grandparents, life is difficult”: Social hierarchy and therapeutic trajectories for children living with HIV in rural Northern Malawi. Children and Youth Services Review, 45, 47–54.
- Thomas, M., & DeCaro, J. A. (2018). Body image models among low-income African American mothers and daughters in the Southeast United States. Medical Anthropology Quarterly, 32(2), 293–310.
- Tratnik, P. (2017). Conquest of body: Biopower with biotechnology (Vol. 2017). Springer.
10.1007/978-3-319-57324-3 Google Scholar
- Warnier, J.-P. (2009). Régner au Cameroun: Le roi-pot. Karthala Editions.
10.3917/kart.warni.2009.01 Google Scholar
- Wrottesley, S. V., Prioreschi, A., Slemming, W., Cohen, E., Dennis, C.-L., & Norris, S. A. (2021). Maternal perspectives on infant feeding practices in Soweto, South Africa. Public Health Nutrition, 24(12), 3602–3614.
- Zempleni, A. (1988). Between “sickness” and “illness”: From socialization to individualization of the “disease”. Social Science & Medicine, 27(11), 1171–1182.