Protocol for validating simple measures of body fatness and physical activity of children in twelve African countries: The ROUND-IT Africa Study

Body fatness and physical activity (PA) among children should be measured accurately to address the pandemics of obesity and physical inactivity. Limited accurate PA data exist in the African region, and crude proxy measures of body composition (such as body mass index: BMI) and physical activity (such as questionnaires) may have limited most surveys and studies from the region. A stable isotope technique (deuterium dilution) and accelerometry provide ‘gold standards’ for validating measures of body fatness and PA, respectively. The consortium on “Reducing Obesity Using Nuclear Techniques to Design Interventions in Africa (ROUND-IT)” Study, therefore aimed to validate the accuracy of, 1) World Health Organisation’s (WHO) BMI-for-age as a means of assessing excessive body fatness; 2) the Physical Activity Questionnaire for Children (PAQ-C) as a means of measuring PA, and 3) to describe accelerometer-measured PA in a large African multi-country sample of children 6 – 11 years of age (n=2050). ROUND-IT Africa is a cross-sectional multi-centre study conducted in 12 countries (Benin, Ghana, Kenya, Mali, Mauritius, Morocco, Namibia, Senegal, Tunisia, Uganda, the United Republic of Tanzania and South Africa). Data collection began in April 2014 and was completed at the end of 2018. Height, body weight and waist circumference were measured using standard methods. Obesity was defined based on WHO’s BMI-for-age criteria. Body fatness was measured using total body water, and excess fatness determined using the criterion-referenced thresholds of >25% (boys) and >30% (girls). PA and sedentary behavior were assessed for 7 days in randomly assigned subsamples by accelerometry. The study was approved by local ethics committees in each participating country. Findings of the research, which will add to the existing body of scientific knowledge on African children, will be disseminated through journal publications, technical reports, conferences, and contacts with relevant non-governmental organisations, particularly the WHO.Keywords: Children, obesity, overweight, body composition, physical activity

Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity-GoPA! 2015 and 2020 Surveys.

Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world's population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world's population live in countries where PA promotion capacity should be significantly improved. Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion