Measurement of physical activity in urban and rural South African adults: a comparison of two self-report methods

Abstract Background Due to the large mortality from inactivity-related non-communicable diseases in low- and middle- income countries, accurate assessment of physical activity is important for surveillance, monitoring and understanding of physical (in)activity epidemiology in many of these countries. Research on relative performance of self-report physical activity instruments commonly used for epidemiological research in Africa have rarely been reported. The present study compared estimates of physical activity measured with the International Physical Activity Questionnaire – Short Form (IPAQ-SF) and the Baecke Physical Activity Questionnaire (BPAQ) among urban and rural black South African adults. Methods Self-reported physical activity data using the IPAQ-SF and BPAQ were collected from a representative sample of 910 urban and rural black South African adults (age = 59.2 ± 9.5 years, 69.7 % women) participating in the 2015 wave of the Prospective Urban and Rural Epidemiological (PURE) study in the North West Province of South Africa. Between-method relationships (pearson correlations [r] and intraclass correlation coefficients [ICCs]) and agreements (Bland-Altman mean difference with 95 % limits of agreement and Kappa coefficient [k]) of IPAQ-SF and BPAQ variables were estimated. Sensitivity and specificity of the BPAQ relative to the IPAQ-SF to classify individuals according to the international guidelines for sufficient physical activity were calculated using chi-square statistics. Results Correlations between IPAQ-SF scores and BPAQ indices were small (r = 0.08–0.18; ICCs = 0.09–0.18) for BPAQ leisure and sport indices, moderate-to-large for work index (r = 0.42–0.59; ICCs = 0.40–0.62) and total physical activity index (r = 0.52–0.60; ICCs = 0.36–0.51). Between methods mean difference for total physical activity was large (1.85 unit), and agreement in physical activity classifications was poor to moderate (k = 0.16–0.44). The sensitivity of the BPAQ to identify sufficiently active people from the IPAQ-SF was very good (98 %), but its specificity to correctly classify insufficiently active people was weak (23 %). Conclusion Notable disparities in physical activity estimates between methods suggest that utilization of IPAQ-SF and BPAQ for surveillance and epidemiology studies in Africa should depend on research questions and population to be studied. Future studies with objective measures are needed to confirm the relative validity between the two instruments

Comparison of several prediction equations using skinfold thickness for estimating percentage body fat vs. body fat percentage determined by BIA in 6-8-year-old South African children : The BC-IT Study

Body composition measurement is useful for assessing percentage body fat (%BF) and medical diagnosis, monitoring disease progression and response to treatment, and is essential in assessing nutritional status, especially in children. However, finding accurate and precise techniques remains a challenge. The study compares %BF determined by bioelectrical impedance analysis (BIA) and calculated from available prediction equations based on skinfolds in young South African children. A cross-sectional study performed on 202 children (83 boys and 119 girls) aged 6–8 years. Height and weight, triceps and subscapular skinfolds were determined according to standard procedures. %BF was determined with BIA and three relevant available equations. SPSS analyzed the data using paired samples tests, linear regression, and Bland–Altman plots. Significant paired mean differences were found for BIA and Slaughter (t 201 = 33.896, p < 0.001), Wickramasinghe (t 201 = 4.217, p < 0.001), and Dezenberg (t 201 = 19.910, p < 0.001). For all of the equations, the standards for evaluating prediction errors (SEE) were above 5. The Bland–Altman plots show relatively large positive and negative deviations from the mean difference lines and trends of systematic under- and over-estimation of %BF across the %BF spectrum. All three equations demonstrated a smaller %BF than the %BF measured by BIA, but the difference was smallest with the Wickramasinghe equation. In comparison, a poor SEE was found in the three %BF predicted equations and %BF derived from BIA. As such, an age-specific %BF equation incorporating criterion methods of deuterium dilution techniques or ‘gold-standard’ methods is needed to refute these findings. However, in the absence of developed %BF equations or 'gold-standard' methods, the available prediction equations are still desirable

Anthropometrically determined nutritional status of urban primary schoolchildren in Makurdi, Nigeria

<p>Abstract</p> <p>Background</p> <p>No information exists on the nutritional status of primary school children residing in Makurdi, Nigeria. It is envisaged that the data could serve as baseline data for future studies, as well as inform public health policy. The aim of this study was to assess the prevalence of malnutrition among urban school children in Makurdi, Nigeria.</p> <p>Methods</p> <p>Height and weight of 2015 (979 boys and 1036 girls), aged 9-12 years, attending public primary school in Makurdi were measured and the body mass index (BMI) calculated. Anthropometric indices of weight-for-age (WA) and height-for-age (HA) were used to estimate the children's nutritional status. The BMI thinness classification was also calculated.</p> <p>Results</p> <p>Underweight (WAZ < -2) and stunting (HAZ < -2) occurred in 43.4% and 52.7%, respectively. WAZ and HAZ mean scores of the children were -0.91(SD = 0.43) and -0.83 (SD = 0.54), respectively. Boys were more underweight (48.8%) than girls (38.5%), and the difference was statistically significant (p = 0.024; p < 0.05). Conversely, girls tend to be more stunted (56.8%) compared to boys (48.4%) (p = 0.004; p < 0.05). Normal WAZ and HAZ occurred in 54.6% and 44.2% of the children, respectively. Using the 2007 World Health Organisation BMI thinness classification, majority of the children exhibited Grade 1 thinness (77.3%), which was predominant at all ages (9-12 years) in both boys and girls. Gender wise, 79.8% boys and 75.0% girls fall within the Grade I thinness category. Based on the WHO classification, severe malnutrition occurred in 31.3% of the children.</p> <p>Conclusions</p> <p>There is severe malnutrition among the school children living in Makurdi. Most of the children are underweight, stunted and thinned. As such, providing community education on environmental sanitation and personal hygienic practices, proper child rearing, breast-feeding and weaning practices would possibly reverse the trends.</p

Birth weight and body composition as determined isotopic dilution with deuterium oxide in 6- to 8-year-old South African children

Low and high birth weight (BW) are associated with obesity later in life; however, this association has not been extensively studied in African countries. This study determines the association between BW and body composition derived from deuterium oxide (D2O) dilution in 6- to 8-year-old South African children (n = 91; 40 boys, 51 girls). BW was recorded retrospectively from the children’s Road-to-Health cards. Weight and height were measured using standard procedures, and D2O dilution was used to determine total body water and, subsequently, to determine body fat. Fatness was classified using the McCarthy centiles, set at 2nd, 85th, and 95th (underfat, overfat and obese). BW correlated with body composition measures, such as body weight (r = 0.23, p = 0.03), height (r = 0.33, p < 0.001), and fat free mass (FFM; r = 0.27, p = 0.01). When multiple regression analysis was employed, BW significantly and positively associated with FFM (β = 0.24, p = 0.013; 95% CI: 0.032; 0.441) and fat mass (β = 0.21, p = 0.02, 95%CI: 0.001; 0.412) in girls and boys combined. A total of 13% of the children had a low BW, with 21% being overweight and 17% obese. More girls than boys were overweight and obese. Intervention strategies that promote healthy uterine growth for optimal BW are needed in order to curb the global obesity pandemic

Level of agreement between objectively determined body composition and perceived body image in 6- To 8-year-old South African children- To Body Composition-Isotope Technique study

To assess the level of agreement between body size self-perception and actual body size determined by body mass index (BMI) z-score and body fatness measured by the deuterium dilution method (DDM) in South African children aged 6-8 years. A cross-sectional sample of 202 children (83 boys and 119 girls) aged 6-8 years from the Body Composition-Isotope Technique study (BC-IT) was taken. Subjective measures of body image (silhouettes) were compared with the objective measures of BMI z-score and body fatness measured by the DDM. The World Health Organization BMI z-scores were used to classify the children as underweight, normal, overweight, or obese. DDM-measured fatness was classified based on the McCarthy centile curves set at 2nd, 85th and 95th in conjunction with fatness cut-off points of 25% in boys and 30% in girls. Data were analyzed using SPSS v26. Of 202 children, 32.2%, 55.1%, 8.8%, and 2.4% perceived their body size as underweight, normal, overweight, and obese, respectively. Based on BMI z-score, 18.8%, 72.8%, 6.9%, and 1.5% were classified as underweight, normal, overweight, and obese, respectively. Body fatness measurement showed that 2.5%, 48.0%, 21.8%, and 29.7% were underweight, normal weight, overweight, and obese, respectively

Objectively determined habitual physical activity in South African adolescents: the PAHL study

BACKGROUND: There is limited data on objectively determined habitual physical activity (PA) in 16-year old South African adolescents. The purpose of this study was to objectively determine the habitual PA of adolescents from the North West Province of South Africa by race and gender. METHODS: Adolescents (137 girls, 89 boys) from the ongoing Physical Activity and Health Longitudinal Study (PAHL study), participated in the present study. Habitual PA was objectively recorded by means of the Actiheart(®) over a period of 7 days. Time spent in moderate-to-vigorous intensity physical activity (MVPA) was assessed. RESULTS: Average MVPA for the study sample was 50.9 ± 40.3 minutes/day. Girls were significantly more active than boys expending more time in MVPA (61.13 ± 52.2 minutes/day; p < 0.05) than boys (35.0 ± 32.9 minutes/day). Although white adolescents spent more time in MVPA than black adolescents, there was no significant difference in MVPA between black (47.87 ± 39.6 minutes/day; p = 0.58) and white adolescents (59.5 ± 41.8 minutes/day). CONCLUSION: Physical activity varies by both gender and race in adolescents from the North West Province of South Africa. Objectively determined data from our study indicates that girls habitually spend more time in MVPA per day than boys, and that white adolescents habitually engage in more MVPA than black adolescents. Seeing as the average MVPA per day for the entire study sample falls below the recommended daily average of 60minutes/day, adolescents should be the foremost targets of interventions aimed at enhancing habitual PA

Relationship between body image and socio-economic status in South African adolescents: PAHL-Study

The aim of this study was to determine the body image (BI) and its relationship with socio-economic status  (SES) among adolescents. The 15-year-old adolescents (N=287), consisting of 111 boys and 176 girls, were  grouped according to SES. They completed the Body-Image Ideals Questionnaire (BIQ) to assess any  discrepancy between ideal and perceived body image on a 4-point Likert-type scale. Cross products for each question were calculated, as well as a mean summarised body-image value for the BIQ. No significant   differences for BIQ were found between boys and girls, but significant differences were found for body imagebetween high and low SES with respect to weight, muscle tone, chest size and body proportion. A more  pronounced discrepancy in body image was noted for higher SES than for low SES. In conclusion, adolescents of low and high SES perceived their body image significantly differently with regard to physical appearance. Future interventions aimed to facilitate changes in body composition should takecognisance of these perceptions.Key words: Body image; Adolescents; Socio-economic status