Biocultural determinants of body weight among Cameroonian and Senegalese populations experiencing the nutrition transition: a holistic anthropological proposal – ANTHROPOLISTIC

The urbanisation process around the world, which started in High-Income countries, favours obesogenic environmental conditions. The development of transport and tertiary sector, as well as processed energy-dense food, associated with sociocultural factors, such as urban stress, together participate in the creation of living spaces exposing individuals to obesity-related cardiometabolic diseases. This is known as the nutrition transition. Most Low- and Middle-Income Countries in Africa are experiencing a faster nutrition transition leading to an epidemic explosion of obesity. If African populations are faced with a globalized urban environment presenting some uniform physical obesogenic characteristics, their respective evolutionary and cultural history in different socio-ecosystems might determine their adaptive trajectory within urban environments. Yet, most programs aiming to reduce obesity use a uni-disciplinary approach to understand its aetiology. This could explain the current failure of health institutions to prevent obesity. Furthermore, the biocultural background of populations is insufficiently considered to assess their particular adaptive capacity to evolve in new urban environments, and minimize their exposure to obesity. Although the generic determinants of obesity are well identified, their respective effect as well as systemic interactions in body weight regulation remain poorly understood. Our original project, ANTHROPOLISTIC, will develop a novel holistic understanding of body weight regulation, by considering together sociocultural and biological factors, in two anthropologically different African populations (Senegalese and Cameroonians) experiencing the nutrition transition. To do so, ANTHROPOLISTIC will consist of a cross-sectional integrative interdisciplinary study reuniting the two major branches of anthropology (sociocultural and biological) to explore holistically the main biocultural drivers of body weight in both Cameroonian and Senegalese populations in the context of the nutrition transition. Hence, a mixed-methods biocultural anthropological study, collecting qualitative and quantitative data on body weight drivers in 4 rural-urban Senegalese and Cameroonian groups, will be conducted. For the quantitative study, eligible participants will complete a series of questionnaires and measurements to (1) collect their main socio-demographic characteristics, (2) administer validated wellbeing, body image, physical activity and food questionnaires, (3) undertake a complete anthropometric protocol (height, weight, fat mass, etc.), and (4) objectively assess daily pattern of physical activity and metabolic regulations, as well as (5) indicators of the metabolic syndrome (i.e. fasting glucose, blood lipids, WC, blood pressure) of participants. We will also (6) extract DNA to determine the genetic factors associated with body shape. For the qualitative study, we will conduct (1) focus groups discussions to identify the daily social norms, perceptions and practices (orally declared) on body weight, diet and physical activity; (2) individual in-depth semi-structured interviews to explore idiosyncratic postures towards these norms and all aspects of participants’ wellbeing (e.g. poor material conditions, social isolation, social pressures, stress); (3) a photovoice approach based on a self-description by participants of their living environment characteristics associated with these dimensions, and (4) a participant observation phase based on visual data collection and informal unstructured interviews to rigorously characterize practices related to sociocultural perceptions collected. Because this unique interdisciplinary project around a systemic anthropological approach will improve our understanding of the etiology of obesity in Africa, the scientific, medical, cultural and economic benefits of ANTHROPOLISTIC will be major, and disseminate at local, national and international scales.