Overweight, obesity and associated risk factors in the South African Air Force, Bloemfontein
The prevalence of overweight and obesity has grown to epidemic proportions during recent decades, while this increase does not seem to be slowing down. Various factors influence the development of overweight and obesity, including socio-demographic factors, dietary intake and behaviour such as sleep deprivation, alcohol intake and energy expenditure. A strong link between overweight and obesity and the development of numerous chronic conditions has also been clearly demonstrated in the literature. These conditions include cardiovascular disease, hypertension, Type 2 diabetes mellitus, malignancies, obstructive sleep apnoea and osteoarthritis. In this study, the prevalence of overweight and obesity, as well as the association between the above-mentioned risk factors and health consequences of overweight and obesity, was investigated at Air Force Base Bloemspruit, Bloemfontein (AFB Bspt). A cross-sectional descriptive study, conducted on 166 (136 male and 30 female) uniformed volunteers from AFB Bspt, aged 23 to 59 years, took place at the various units situated at AFB Bspt, including Base Head Quarters, 506 Protection Squadron, 87 Helicopter Flying School, 16 Squadron and 6 Air Support Unit. Participants completed a self-administered questionnaire which reported on socio-demographic-, behavioural-, and dietary factors as well as physical activity. Physical activity was determined by means of the self-administered International Physical Activity Questionnaire (IPAQ) Short Form. Standard measuring techniques were used to determine weight, height and waist circumference. Waist circumference was evaluated by means of the World Health Organization (WHO) gender-specific cut-off points for the evaluation of metabolic complications. Body Mass Index (BMI) was calculated using weight and height and classified, using the WHO BMI cut-off points, as either underweight or normal weight, overweight or obese. The prevalence of both overweight and obesity was high in the current study, which is in line with national and global trends. As expected, a statistically significant relationship was identified between waist circumference and the different BMI categories. Literature supports a relationship between overweight and obesity and ageing. Although not significant, the median age of participants showed a slight increase from normal weight to overweight and obesity. Socio-demographic factors investigated in this study included gender, ethnicity, rank, marital status and educational attainment. Although the relationship between these factors and overweight and obesity is clearly described in the literature, no statistically significant differences were identified in the current study. Also, no significant differences were identified regarding reported health conditions across BMI categories. Dietary factors including high intakes of fat and sugar, low intake of fruits and vegetables, meal frequency and number of meals consumed outside the home have been associated with overweight and obesity, however, in the current study, no significant associations were identified. It is concerning that the majority of participants do not consume the recommended amount of fruit and vegetables daily. Behavioural aspects including perceived stress, sleeping patterns and tobacco and alcohol use were also investigated. Almost two-fifths of participants identified themselves as moderately stressed, while almost half of the participants identified themselves as highly stressed individuals. Approximately 80% of participants reported more than seven hours of sleep per night. Most respondents were non-smokers. No statistically significant differences were identified between behavioural aspects investigated across BMI categories. High levels of physical activity were reported. Obese individuals had the highest median for moderate physical activity, while all BMI categories had the same median for vigorous physical activity. The maximum number of hours spent on moderate and vigorous physical activity for one individual was observed in the overweight category, where 42 hours per week was reported for each. No statistically significant differences were identified for physical activity with regard to BMI categories. Future studies should aim to include a larger number of participants, from different military bases in other geographic areas in South Africa. A more detailed evaluation of anthropometric status, including waist-hip ratio and body composition assessment, should be considered. Questionnaires should be completed through structured, individual interviews by qualified researchers to allow for more in-depth assessment and to ensure that questions are well understood. This study provides valuable information regarding the high prevalence of overweight and obesity in the study sample, as well as low fruit and vegetable intakes that should be addressed in order to improve the health and wellbeing of the military community at AFB Bspt.