Development and Tracking of Body Mass Index from Preschool Age into Adolescence in Rural South African Children: Ellisras Longitudinal Growth and Health Study

The purpose of this observational prospective cohort study was to investigate the development and tracking of body mass index (BMI) of Ellisras rural children from preschool age into late adolescence from the Ellisras Longitudinal Growth and Health Study. Heights and weights of children were measured according to the standard procedures recommended by the International Society for the Advancement of Kinanthropometry twice a year from 1996 to 2003. In total, 2,225 children—550 preschool and 1,675 primary school—aged 3-10 years (birth cohorts 1993 to 1986) were enrolled at baseline in 1996 and followed through out the eight-year periodic surveys. In 2003, 1,771 children—489 preschool and 1,282 primary school—were still in the study. The prevalence of overweight was significantly higher among girls (range 1.6-15.5%) compared to boys (range 0.3-4.9%) from age 9.1 years to 14.9 years. The prevalence of thinness (severe, moderate, and mild) ranged from 7.1% to 53.7% for preschool children and from 8.0% to 47.6% for primary school children. Both preschool and primary school children showed a significant association between the first measurements of BMI and the subsequent measurement which ranged from B=0.2 (95% confidence interval [CI] 0.1-0.4) to B=0.8 (95% CI 0.6-0.9) for preschool and B=0.2 (95% CI 0.1-0.3) to B=0.7 (95% CI 0.6-0.8) for primary children. A significant tracking of BMI during 4-12 years of life was more consistent for preschool children (B=0.6 (95% CI 0.6-0.7) and for primary school children (B=0.6 (95%CI 0.5-0.6). Investigation of nutritional intake and physical activity patterns will shed light on how healthy these children are and their lifestyle

The IUCN red list for ecosystems: how does it compare to South Africa's approach to listing threatened ecosystems?

The publication of the International Union for Conservation of Nature (IUCN) Red List of Ecosystems (RLE) standards is an important development that has received broad acceptance globally. More than 100 countries across the globe including South Africa and Myanmar have adopted the IUCN RLE standards as their national framework for assessing the risk of ecosystem collapse. The strongest motivations for the alignment include: (i) elimination of confusion and reducing the administrative burden for maintaining multiple lists of threatened ecosystems, (ii) increased legitimacy of the ecosystem threat status assessment by basing them on a body of sound scientific literature, (iii) comparable assessments across different environments and countries across the globe, (iv) for the threatened national ecosystems to be recorded under the IUCN RLE registry. Furthermore, the IUCN Red List makes it easier for countries to secure funding from international donors to achieve national biodiversity conservation objectives, and address knowledge and data gaps through focused research. The IUCN RLE standards only became available after many countries including South Africa and Australia each independently tailor-developed national indicators or standards for assessing threats to ecosystems. The Ecosystem Threat statuses (ETS) standards are developed to aid biodiversity monitoring efforts, and many have progressed into the legislated national list of the threatened ecosystems. In South Africa, the gazetted list of threatened ecosystems is ratified to inform policy development and land-use planning tools that mainstream biodiversity considerations into economic development activities. Considering the strong links between the gazetted list of threatened ecosystems and many of the policy and spatial planning tools, the change and/or update to the IUCN RLE standards may disrupt conservation and land-use plans. In addition, South Africa has limited data on ecosystem integrity with to apply the full range of the IUCN RLE functional criteria which may lead to the risk of ecosystem collapse being underestimated. However, the country has comprehensive data on threatened plant species which in many cases contain detailed information on drivers of environmental degradation and biotic disruptions. In addition, extensive efforts have been made to link threatened species and the ecosystem types in which they occur. Such efforts enable the country to look at degradation through species lenses to better understand the degree of underestimation of ecosystem risk. Nonetheless, there is a need to interrogate and holistically understand the implications that may emanate from this shift, hence the importance of this study. This thesis was focused on assessing the origins and history of the IUCN and South Africa's approach to assessing threats to ecosystems. In chapter 1, I reviewed the key concepts including the scientific basis and criteria to understand the purpose and philosophy of the South Africa (SA) ETS and IUCN RLE frameworks. In Chapter 2, I compared and contrasted the SA ETS and IUCN RLE assessment outcomes of ecosystems susceptible to only spatial threats. Finally, in Chapter 3, I tested whether the IUCN RLE is a good proxy for the distribution of threatened species in South Africa. The results revealed that the IUCN RLE and SA ETS standards have overarching similarities (e.g. spatial and functional criteria) as they both share the common ancestry (IUCN Red List of Threatened Species). Equally, there are key differences (e.g. decision thresholds) that explain the misalignments in the ecosystem threat status between the two systems. Meanwhile, the quantitative results alluded that the proportions of matching assessment outcomes are high when the risk categories (Critically Endangered: CR and Endangered: EN versus Vulnerable: VU and Least Concern: LC) are split in accordance with their policy uptake (i.e. National Environmental Management Act (NEMA) EIA regulations) but relatively low per individual risk category. Furthermore, the results suggest that not all ecosystem types undergoing spatial declines entirely reflect the status of threatened plant species they contain. Many of these threatened plant species overlap with ecosystems at immediate risk of collapse (CR and EN). Such species will indirectly benefit from broad-scale conservation interventions that are informed by the list of threatened ecosystems. However, the majority of plant species threatened by either habitat loss and/or land degradation occur within the least threatened ecosystems. These species will not benefit from conservation responses informed by the gazetted national list of threatened because spatial declines within these ecosystems are considered to either be minimal or stable to trigger conservation response. Encouragingly, there are existing legal conservation tools such as stewardship programmes, Key Biodiversity Areas, and Critical Biodiversity Areas that allow threatened and unprotected ecological features including species to be strategically targeted for conservation responses. However, there is a need for South Africa to intensify efforts that ensure that these legal tools are implemented correctly and successfully to maximise conservation impacts and arrest biodiversity loss

The relationship between body composition and physical fitness in 14 year old adolescents residing within the Tlokwe local municipality, South Africa: The PAHL study

<p>Abstract</p> <p>Background</p> <p>Little is known about the relationship between body composition and physical fitness in 14 year-old high school adolescents of South Africa. Baseline data from a longitudinal study on physical activity and health (PAHLS) may provide valuable information for future studies, hence to inform public health policy makers. The objectives of this study are to determine the prevalence of underweight, normal weight and overweight among adolescents aged 14 years in the Tlokwe Local Municipality of the North West Province of South Africa, and to assess the association between physical fitness and body composition separately for boys and girls, adjusted for race and locality.</p> <p>Methods</p> <p>Body weight, height and triceps, and subscapular skinfolds of 256 adolescents (100 boys and 156 girls) aged 14 years were measured, and percentage body fat and body mass index (BMI) were calculated. BMI was used to determine underweight, normal weight and overweight based on the standard criterion. Physical fitness was assessed by standing broad jump, bent arm hang and sit-ups according to the EUROFIT fitness standard procedures. Multinomial logistic regression analyses stratified for gender and adjusted for race (black or white), and the locality (urban or township) of the schools were used to analyze the data.</p> <p>Results</p> <p>In the total group 35.9% were underweight and 13.7% overweight. Boys were more underweight (44%) than girls (30.7%). The prevalence of overweight was 8% in boys and 17.3% in girls. BMI was strongly (p = 0.01) related with percentage body fat. Strong and significant positive associations between physical fitness and BMI for the underweight girls with high physical fitness scores (OR, 10.69 [95%CI: 2.81-40.73], and overweight girls with high physical fitness scores (OR, 0.11 [95%CI: 0.03-0.50]) were found. Non-significant weaker positive relationship between physical fitness and BMI for the underweight boys with high physical fitness scores (OR, 1.80 [95%CI: 0.63-5.09]), and the overweight boys with high physical fitness scores (OR, 0.18 [95%CI: 0.02-1.78]) were found.</p> <p>Conclusion</p> <p>Both underweight and overweight among boys and girls in Tlokwe Local Municipality exist, and their effects on physical fitness performances were also noticed. As such, strategic physical activity, interventions or follow-up studies recognizing this relationship particularly in the overweight adolescents are needed. In addition, authorities in health and education departments dealing with adolescents should make use of this evidence base information in policies development.</p

Development and tracking of central patterns of subcutaneous fat of rural South African youth: Ellisras longitudinal study

<p>Abstract</p> <p>Background</p> <p>Individuals grow and accumulate central patterns of body fat into the diseases they will suffer from as older adults. The need to elicit the development and tracking of central patterns of body fat from younger age into adolescent remains to be explored.</p> <p>Method</p> <p>Skinfolds measurements were done according to the standard procedures in the Ellisras Longitudinal Growth and Health Study. In total, 2,225 children--550 preschool and 1,675 primary school--aged 3-10 years (birth cohorts 1993 to 1986) were enrolled at baseline in 1996 and followed through out the eight-year periodic surveys. In 2003, 1,771 children--489 preschool and 1,282 primary school--were still in the study.</p> <p>Results</p> <p>The development of triceps, biceps, suprailiac and suscapular skinfolds of Ellisras girls were significantly higher (p < 0.001 to 0.05) compared to boys over time. The tracking coefficient between the initial measurements and the subsequent measurements was higher for skinfolds (r about 0.63) than for skinfold ratios (r about 0.43). Longitudinal tracking coefficient measuring the association between the initial measurements and all the follow up measurements simultaneously was about 0.57.</p> <p>Conclusion</p> <p>The accumulation of central patterns of body fat of Ellisras children starts in childhood and adolescence spurt with Ellisras girls acquiring more than boys over time. High significant tracking of skinfold thickness while the skinfold ratios show low and insignificant tracking over time. The magnitude of central patterns of body fat accumulation over time requires further investigation to clarify their association with risk factors for cardiovascular diseases.</p

Development and Tracking of Body Mass Index from Preschool Age into Adolescence in Rural South African Children: Ellisras Longitudinal Growth and Health Study

The purpose of this observational prospective cohort study was to investigate the development and tracking of body mass index (BMI) of Ellisras rural children from preschool age into late adolescence from the Ellisras Longitudinal Growth and Health Study. Heights and weights of children were measured according to the standard procedures recommended by the International Society for the Advancement of Kinanthropometry twice a year from 1996 to 2003. In total, 2,225 children-550 preschool and 1,675 primary school-aged 3-10 years (birth cohorts 1993 to 1986) were enrolled at baseline in 1996 and followed through out the eight-year periodic surveys. In 2003, 1,771 children-489 preschool and 1,282 pri- mary school-were still in the study. The prevalence of overweight was significantly higher among girls (range 1.6-15.5%) compared to boys (range 0.3-4.9%) from age 9.1 years to 14.9 years. The prevalence of thinness (severe, moderate, and mild) ranged from 7.1% to 53.7% for preschool children and from 8.0% to 47.6% for primary school children. Both preschool and primary school children showed a significant association between the first measurements of BMI and the subsequent measurement which ranged from B=0.2 (95% confidence interval [CI] 0.1-0.4) to B=0.8 (95% CI 0.6-0.9) for preschool and B=0.2 (95% CI 0.1-0.3) to B=0.7 (95% CI 0.6-0.8) for primary children. A significant tracking of BMI during 4-12 years of life was more consistent for preschool children (B=0.6 (95% CI 0.6-0.7) and for primary school children (B=0.6 (95%CI 0.5-0.6). Investigation of nutritional intake and physical activity patterns will shed light on how healthy these children are and their lifestyle

Investigating the use of psychological assessment in South African schools.

The field of psychological assessment in South African schools faces many challenges at present. To be able to meaningfully respond to these challenges, it was important to gain an understanding of how psychological assessment is being perceived by educators, whether as being necessary (or not), in their workplace. The study aimed to gather information and generate knowledge in order to provide some pointers about the educators’ perceived use of psychological assessment measures. Thereafter, analyse their perceptions in terms of these assessments. It was a mixed study using both quantitative and qualitative research methods. The proposed sample was seventy-five (n = 75) educators from former model-c and township schools. Data was collected through the use of a self-response questionnaire (quantitative) and then used to identify themes. The identified themes were then used for discussion in focus group interviews (qualitative). Descriptive and thematic content analysis were used for the interpretation of the research data and triangulation thereof

Current smoking behaviour among rural South African children: Ellisras Longitudinal Study

<p>Abstract</p> <p>Background</p> <p>The use of tobacco products is the major cause of chronic diseases morbidity and mortality. Most smokers start the smoking habits from childhood and adolescent stages.</p> <p>Method</p> <p>This was a cross-sectional study. A total of 1654 subjects (854 boys and 800 girls), aged 11 to 18 years, who were part of the Ellisras Longitudinal Study completed the questionnaire. Association between tobacco products use and habits, attitudes and beliefs were explored in this study. Logistic regression was used to estimate the association.</p> <p>Results</p> <p>The prevalence of tobacco product use increases with increasing (4.9 to 17.1%) age among boys whereas girls do not smoke cigarette but only considerable number (1.0 to 4.1%) use home made tobacco products (pipe and snuff) among the Ellisras rural children. Parents and grand parents play a significant (about 50%) role in influencing smoking behaviour among the Ellisras rural children. Seeing actors smoking on TV shows was positively associated (p < 0.05) with smoking (OR = 2.3 95%CI (1.3-4.1 and OR = 2.3 95%CI 1.3-4.1 after adjusting for age and gender). However, women who smoke cigarette were significantly (p < 0.001) associated with success and success and wealth (OR = 2.8, 95% CI 1.5-5.2) even after adjusting for age and gender (OR = 2.9 95% CI 1.5-5.4).</p> <p>Conclusion</p> <p>The usage of tobacco products was high among older boys. Girls did not smoke cigarette. This tobacco use behaviour mirrors the cultural norms and adult behaviour. The association of this tobacco used products with biological parameters will shed more light on the health of these children over time.</p

Health Status and Permanent Loss to Follow up of Ellisras Longitudinal Study Subjects: Rural South African Context

Noncommunicable diseases (NCDs) are responsible for two out of three deaths worldwide with their profile changing from one country to another. But evidence to sustained these changes are still very limited in rural South African population. The well-characterized Ellisras Longitudinal Study (ELS) provides a unique opportunity of mapping some of these changes in vulnerable adolescent and young adults. The objective is we determined the extent of NCD risk factors derived from anthropometric and blood pressure measurements affected Ellisras Longitudinal Study (ELS) subjects over time for those who died or permanently lost to follow-up. A total of 2238 subjects aged 3–10 years (born between 1994 and 1986) were randomly selected to take part of the Ellisras Longitudinal Study (ELS) in November 1996. The attrition rate of ELS subjects based on death ranges between 0.71 and 3.73% for boys and 0.75 and 4.89% for girls. The prevalence of sever undernutrition ranges from 3.2 to 53%, moderate undernutrition ranges from 9.7 to 28.8%, while mild undernutrition ranges from 17.9 to 59.1% for both males and females. The prevalence of undernutrition was high while hypertension, obesity, and overweight were low in the population. The identification of appropriate NCD indicators for mortality in rural South African population needs more consideration and evaluation

Results from South Africa's 2016 report card on physical activity for children and youth

Background: We present results of the 2016 Healthy Active Kids South Africa (HAKSA) Report Card on the current status of physical activity (PA) and nutrition in South African youth. The context in which we interpret the findings is that participation in PA is a fundamental human right, along with the right to "attainment of the highest standard of health." Methods: The HAKSA 2016 Writing Group was comprised of 33 authorities in physical education, exercise science, nutrition, public health, and journalism. The search strategy was based on peer-reviewed manuscripts, dissertations, and 'gray' literature. The core PA indicators are Overall Physical Activity Level; Organized Sport Participation; Active and Outdoor Play; Active Transportation; Sedentary Behaviors; Family and Peer Influences; School; Community and the Built Environment; and National Government Policy, Strategies, and Investment. In addition, we reported on Physical Fitness and Motor Proficiency separately. We also reported on nutrition indicators including Overweight and Under-nutrition along with certain key behaviors such as Fruit and Vegetable Intake, and policies and programs including School Nutrition Programs and Tuck Shops. Data were extracted and grades assigned after consensus was reached. Grades were assigned to each indicator ranging from an A, succeeding with a large majority of children and youth (81% to 100%); B, succeeding with well over half of children and youth (61% to 80%); C, succeeding with about half of children and youth (41% to 60%); D, succeeding with less than half but some children and youth (21% to 40%); and F, succeeding with very few children and youth (0% to 20%); INC is inconclusive. Results: Overall PA levels received a C grade, as we are succeeding with more than 50% of children meeting recommendations. Organized Sports Participation also received a C, and Government Policies remain promising, receiving a B. Screen time and sedentary behavior were a major concern. Under-and over-weight were highlighted and, as overweight is on the rise, received a D grade. Conclusion: In particular, issues of food security, obesogenic environments, and access to activity-supportive environments should guide social mobilization downstream and policy upstream. There is an urgent need for practice-based evidence based on evaluation of existing, scaled up interventions.Scopu