Prevalence of Overweight and Obesity among Primary School Children Aged 8-13 Years in Dar es Salaam City, Tanzania

Background. The understanding of obesity as a growing health problem in Africa and Tanzania in particular is hampered by lack of data as well as sociocultural beliefs in which overweight and obesity are revered. This study sought to determine the prevalence of overweight and obesity among primary school children aged 8-13 years in Dar es Salaam, Tanzania. Method. A cross-sectional analytical research design was used to study overweight and obesity in primary schools in Dar es Salaam, Tanzania. The target population was 150,000 children aged 8-13 years. Stratified random sampling was used to select 1781 children. Weight and height were taken and WHO standards for children were used to determine weight status. Results. Findings showed that the prevalence of overweight and obesity was 15.9% and 6.7%, respectively ( = 1781). However, 6.2% of the children were underweight. There were significant differences in mean BMI between children in private and public schools ( = 0.021), between male and female ( < 0.001), and across age groups of 8-10 and 11-13 years ( < 0.001). Conclusion. The prevalence of overweight and obesity among primary school children is significant and requires management and prevention strategies

Evidence of negative energy balance using doubly labelled water in elite Kenyan endurance runners prior to competition

Previous studies have found Kenyan endurance runners to be in negative energy balance during training and prior to competition. The aim of the present study was to assess energy balance in nine elite Kenyan endurance runners during heavy training. Energy intake and expenditure were determined over 7d using weighed dietary intake and doubly labelled water, respectively. Athletes were on average in negative energy balance (mean energy intake 13 241 (SD 1330) kJ/d v. mean energy expenditure 14 611 (SD 1043) kJ/d; P=0·046), although there was no loss in body mass (mean 56·0 (SD 3·4) kg v. 55·7 (SD 3·6) kg; P=0·285). The calculation of underreporting was 13; (range −24 to +9%) and almost entirely accounted for by undereating (9% (range −55 to +39%)) as opposed to a lack of significant underrecording (i.e. total water intake was no different from water loss (mean 4·2 (SD 0·6) l/d v. 4·5 (SD 0·8) l/d; P=0·496)). Fluid intake was modest and consisted mainly of water (0·9 (SD 0·5) l/d) and milky tea (0·9 (SD 0·3) l/d). The diet was high in carbohydrate (67·3 (SD 7·8) %) and sufficient in protein (15·3 (SD 4·0) %) and fat (17·4 (SD 3·9) %). These results confirm previous observations that Kenyan runners are in negative energy balance during periods of intense training. A negative energy balance would result in a reduction in body mass, which, when combined with a high carbohydrate diet, would have the potential in the short term to enhance endurance running performance by reducing the energy cost of runnin

Physical activity energy expenditure and cardiometabolic health in three rural Kenyan populations.

OBJECTIVES: Physical activity is beneficial for metabolic health but the extent to which this may differ by ethnicity is still unclear. Here, the objective was to characterize the association between physical activity energy expenditure (PAEE) and cardiometabolic risk among the Luo, Kamba, and Maasai ethnic groups of rural Kenya. METHODS: In a cross-sectional study of 1084 rural Kenyans, free-living PAEE was objectively measured using individually-calibrated heart rate and movement sensing. A clustered metabolic syndrome risk score (zMS) was developed by averaging the sex-specific z-scores of five risk components measuring central adiposity, blood pressure, lipid levels, glucose tolerance, and insulin resistance. RESULTS: zMS was 0.08 (-0.09; -0.06) SD lower for every 10 kJ/kg/day difference in PAEE after adjustment for age and sex; this association was modified by ethnicity (interaction with PAEE P < 0.05). When adjusted for adiposity, each 10 kJ/kg/day difference in PAEE was predicted to lower zMS by 0.04 (-0.05, -0.03) SD, without evidence of interaction by ethnicity. The Maasai were predicted to have higher cardiometabolic risk than the Kamba and Luo at every quintile of PAEE, with a strong dose-dependent decreasing trend among all ethnicities. CONCLUSION: Free-living PAEE is strongly inversely associated with cardiometabolic risk in rural Kenyans. Differences between ethnic groups in this association were observed but were explained by differences in central adiposity. Therefore, targeted interventions to increase PAEE are more likely to be effective in subgroups with high central adiposity, such as Maasai with low levels of PAEE.This research was supported by DANIDA (J. no. 104.DAN.8-871, RUF project no. 91202), the Welcome Trust, the Medical Research Council Epidemiology Unit (MC_UU_12015/3), the NIHR Biomedical Research Centre Cambridge [IS-BRC-1215-20014], the Gates Cambridge Trust, Cluster of International Health (University of Copenhagen), Steno Diabetes Centre, Beckett Foundation, Dagmar Marshall Foundation, Dr Thorvald Madsen’s Grant, Kong Christian den Tiende’s Foundation, and Brdr Hartmann Foundation. We thank all participants, local chiefs, councils, politicians, and research teams responsible for data generation. We also thank Rosemarie Bell and Angela Wood (Department of Public Health and Primary Care, Cambridge, UK) for logistical assistance and guidance on statistical methods, respectively. Special thanks go to Professor Knut Borch-Johnsen, Copenhagen University Hospital (Holbaek, Denmark) for his invaluable contribution to the Kenya Diabetes Study in general. We acknowledge the permission by the Director of KEMRI to publish this manuscript

Elite Kenyan endurance runners are hydrated day-to-day with ad libitum fluid intake

Previous studies of elite Kenyan endurance runners reported that athletes did not consume liquids before or during training and infrequently consumed modest amounts of liquids after training that contributed to low daily fluid intake. Purpose: To assess hydration status of elite Kenyan endurance runners during an important training period. Methods: Hydration status was monitored in fourteen elite Kenyan endurance runners over a 5-d training period 1 wk prior to the Kenyan national trials for the 2005 IAAF Athletics World Championships by measuring body mass, urine osmolality, total body water, and daily fluid intake. Dietary sodium (Na) intake was estimated using a 5-d nutritional diary and biochemical analysis, whilst [Na] was determined in urine and sweat. Intestinal temperature was monitored continuously during training sessions. Results: Daily fluid intake was consistent with previous observations. There was a significant body mass loss during the morning, interval, and afternoon training sessions (P &#60; 0.05). Nevertheless, mean total body water and pretraining body mass were well maintained day-to-day throughout the 5-d recording period (P = 0.194 and P = 0.302, respectively). Furthermore, there was no significant difference between the osmolality of the morning urine sample and the evening sample (P = 0.685). Mean Na intake was not significantly different to Na loss in sweat and urine (P = 0.975). No athlete showed signs or symptoms of heat strain at any time. Conclusions: These results demonstrate that elite Kenyan endurance runners remain well hydrated day-to-day with an ad libitum fluid intake; a pattern and volume of fluid intake that is consistent with previous observations of elite Kenyan endurance runner