Prevalence and correlates of compliance with 24-h movement guidelines among children from urban and rural Kenya—The Kenya-LINX project

BackgroundLike many countries in sub-Saharan Africa, Kenya has experienced rapid urbanization in recent years. Despite the distinct socioeconomic and environmental differences, few studies have examined the adherence to movement guidelines in urban and rural areas. This cross-sectional study aimed at examining compliance to the 24-hour movement guidelines and their correlates among children from urban and rural Kenya.MethodChildren (n = 539) aged 11.1 ± 0.8 years (52% female) were recruited from 8 urban and 8 rural private and public schools in Kenya. Physical activity (PA) and sleep duration were estimated using 24-h raw data from wrist-worn accelerometers. Screen time (ST) and potential correlates were self- reported. Multi-level logistic regression was applied to identify correlates of adherence to combined and individual movement guidelines.ResultsCompliance with the combined movement guidelines was low overall (7%), and higher among rural (10%) than urban (5%) children. Seventy-six percent of rural children met the individual PA guidelines compared to 60% urban children while more rural children also met sleep guidelines (27% vs 14%). The odds of meeting the combined movement guidelines reduced with age (OR = 0.55, 95% CI = 0.35–0.87, p = 0.01), was greater among those who could swim (OR = 3.27, 95% CI = 1.09–9.83, p = 0.04), and among those who did not engage in ST before school (OR = 4.40, 95% CI = 1.81–10.68, p<0.01). The odds of meeting PA guidelines increased with the number of weekly physical education sessions provided at school (OR = 2.1, 95% CI = 1.36–3.21, p<0.01) and was greater among children who spent their lunch break walking (OR = 2.52, 95% CI = 1.15–5.55, p = 0.02) or running relative to those who spent it sitting (OR = 2.33, 95% CI = 1.27–4.27, p = 0.01).ConclusionsPrevalence of meeting movement guidelines among Kenyan children is low and of greatest concern in urban areas. Several correlates were identified, particularly influential were features of the school day, School is thus a significant setting to promote a healthy balance between sleep, sedentary time, and PA

Combining diaries and accelerometers to explain change in physical activity during a lifestyle intervention for adults with pre-diabetes: A PREVIEW sub-study

Self-report and device-based measures of physical activity (PA) both have unique strengths and limitations; combining these measures should provide complementary and comprehensive insights to PA behaviours. Therefore, we aim to 1) identify PA clusters and clusters of change in PA based on self-reported daily activities and 2) assess differences in device-based PA between clusters in a lifestyle intervention, the PREVIEW diabetes prevention study. In total, 232 participants with overweight and prediabetes (147 women; 55.9 ± 9.5yrs; BMI ≥25 kg·m-2; impaired fasting glucose and/or impaired glucose tolerance) were clustered using a partitioning around medoids algorithm based on self-reported daily activities before a lifestyle intervention and their changes after 6 and 12 months. Device-assessed PA levels (PAL), sedentary time (SED), light PA (LPA), and moderate-to-vigorous PA (MVPA) were assessed using ActiSleep+ accelerometers and compared between clusters using (multivariate) analyses of covariance. At baseline, the self-reported “walking and housework” cluster had significantly higher PAL, MVPA and LPA, and less SED than the “inactive” cluster. LPA was higher only among the “cycling” cluster. There was no difference in the device-based measures between the “social-sports” and “inactive” clusters. Looking at the changes after 6 months, the “increased walking” cluster showed the greatest increase in PAL while the “increased cycling” cluster accumulated the highest amount of LPA. The “increased housework” and “increased supervised sports” reported least favourable changes in device-based PA. After 12 months, there was only minor change in activities between the “increased walking and cycling”, “no change” and “increased supervised sports” clusters, with no significant differences in device-based measures. Combining self-report and device-based measures provides better insights into the behaviours that change during an intervention. Walking and cycling may be suitable activities to increase PA in adults with prediabetes

Forming new health behavior habits during weight loss maintenance—The PREVIEW study.

Changing lifestyle habits to achieve and maintain weight loss can be effective in prevention of type 2 diabetes. Ability to resist temptations is considered one of the key factors in behaviour change. This study examined how both habit-strength, motivation, and temptations for an energy-dense diet developed during the maintenance stage of a behaviour modification intervention tool. Participants with prediabetes and overweight/obesity were recruited in the two-phase trial PREVIEW with the aim to achieve ≥8% body weight loss over 2 months, and maintain weight loss over a subsequent 34-month period. The four-stage intervention (PREMIT) supported participants in weight-maintenance. Uni- and multivariate analyses were completed from the beginning of the PREMIT maintenance stage (week 26 of the PREVIEW trial) with 962 individuals who completed the trial. Habit-strength and ability to resist temptations increased during the early PREMIT adherence stage (weeks 26 to 52) before plateauing during middle (weeks 52 to 104) and late (weeks 104 to 156) PREMIT adherence stages. Higher habit-strength for energy dense diet was significantly associated with larger weight-regain (p ≤ .007). No changes in motivation or interaction with PREMIT attendance were observed. Changing diet habits is a complex, multifactorial process with participants struggling at least with some aspects of weight maintenance. Habits against consuming energy dense, sweet and fatty, food appeared effective in protecting against weight re-gain. The observed effect sizes were small reflecting the complexity of breaking old habits and forming new ones to support long term maintenance of weight loss

Wealth and Sedentary Time Are Associated With Dietary Patterns Among Preadolescents in Nairobi City, Kenya

Objective: The study aimed to compare dietary patterns in preadolescents in urban areas with different physical activity and socioeconomic profiles in Nairobi, Kenya.Design: Cross-sectional.Participants: Preadolescents aged 9−14 years (n = 149) living in low- or middle-income areas in Nairobi.Variables Measured: Sociodemographic characteristics were collected using a validated questionnaire. Weight and height were measured. Diet was assessed using a food frequency questionnaire and physical activity by accelerometer.Analysis: Dietary patterns (DP) were formed through principal component analysis. Associations of age, sex, parental education, wealth, body mass index, physical activity, and sedentary time with DPs were analyzed with linear regression.Results: Three DPs explained 36% of the total variance in food consumption: (1) snacks, fast food, andmeat; (2) dairy products and plant protein; and (3) vegetables and refined grains. Higher wealth was associated with higher scores of the first DP (P < 0.05).Conclusions and Implications: Consumption of foods often deemed unhealthy (eg, snacks and fast food) was more frequent among preadolescents whose families were wealthier. Interventions that seek ways to promote healthy lifestyles among families residing in urban areas of Kenya are warranted