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

Inter Arm Blood Pressure and Cardiovascular Risk in Young Adults at Ellisras

Cardiovascular disease is a notable cause of death globally. When undetected, varying measurements of BP between arms can lead to inaccuracies in the interpretation and management of blood pressure consequently putting individuals in an avoidable risk through sub-optimal blood pressure control. The aim of the study was to determine the difference in blood pressure between the arms and its association to cardiovascular risk in young adults at Ellisras. A total of 624 young adults aged 18 to 29 years old participated in the study. Blood pressure measurements and blood analysis were done according to standard procedures. Multivariate logistic regression was used to determine the association between interarm blood pressure and cardiovascular risk factors. There was significant (p ≤ 0.05) mean difference of diastolic blood pressure of the <10 mmHg and ≥ 10 mmHg groups. There was a positive significant association between systolic inter arm blood pressure difference and hypertension (B = 5.331; 95%CI = 12.260–23.183; P = 0.026) while no significant association was found between diastolic blood pressure and interarm diastolic differences in diastolic blood pressure (B = 1.081; 95%CI = 1.032–1.131; P = 0.920). The current study showed positive associations between inter arm differences and a few cardiovascular risk factors including BMI and gender. Detection of an interarm BP difference should motivate the need for a thorough cardiovascular/health assessment

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

The association between dyslipidemia and anthropometric indicators in black and white adolescents residing in Tlokwe Municipality, North-West Province, South Africa: the PAHL study

Background: The dyslipidemia associated with excess weight is a risk for cardiovascular disease. Worldwide and in South Africa adolescent obesity has been reported.Objectives: To determine the association between dyslipidemia and anthropometric indices in black and white adolescents.Methods: The study involved 129 black and 69 white adolescents aged 12 to 16 years. Data collected included height, weight, waist circumference (WC) and skinfolds, blood pressure and blood for glucose, insulin, total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (Trig) and C - reactive protein (CRP).Results: WC correlated negatively with HDL in both blacks (p=0.042) and whites (p=0.008) and in whites it correlated positively with LDL (p=0.006); TC/HDL (p=&lt;0.001) and LDL/HDL ratio (p&lt;0.0001). WC/Hgt correlated negatively with HDL (p=0.028) and positively with LDL/HDL (p=0.026 and p&lt;0.0001) in both races. In whites positive correlations were between WC/Hgt and TC (p=0.049); LDL (p=0.003) and TC/HDL (p&lt;0.0001). BAZ correlated positively with TC/HDL ratio (p=0.004) and LDL/HDL ratio (p=0.002). The most common abnormalities were HDL and LDL.Conclusion: Whites exhibited more associations between dyslipidemia and anthropometric indicators as compared to Blacks, suggesting that there might be differences in the lipid metabolism or even susceptibility to risk factors in adolescents.Key words: dyslipidemia, anthropometry, adolescent

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

Body composition in stunted, compared to non-stunted, black South African children, from two rural communities

Background: The objective was to compare the body composition of black stunted, and non-stunted, children, from two rural communities in South Africa, and investigate whether increased total and central adiposity is found in stunted children. The design was a cross-sectional study. The setting was two study populations of children in rural South Africa. The subjects were 351 children aged 10-15 years old [Transition and Health during Urbanisation of South Africans (THUSA BANA) study], and 1 760 children aged 6-13 years old [Ellisras Longitudinal Growth and Health Study (ELS)].Method: The body mass index (BMI), BMI for age z-score, sum of triceps and subscapular skin folds (SSF), waist circumference (WC), waist:height ratio (WHtR) of stunted, and non-stunted, children, were compared.Results: Almost 10% (n = 203) of children were stunted, and 34% had a BMI for age z-score below -2. After adjustment for age, non-stunted children had significantly higher values for BMI and WC, in both boys and girls. SSF was similar in stunted and non-stunted boys, but tended to be greater in non-stunted, rather than stunted girls. In the ELS, stunted boys and girls had significantly higher WHtR than non-stunted children, while similar results were found in the THUSA BANA study, although the difference was not significant in the girls. All stunted groups had a WHtR greater than 0.41, proposed as a cut-off point due to its association with increased risk for high blood pressure in children.Conclusion: More research needs to be carried out on anthropometric indices for the distribution of body fat, independent of age, race, gender, and sexual maturation, in children and adolescents. This study showed inconsistent results, and highlights the complexity of using various adiposity measures in stunted and non-stunted children

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