Investigation of the Seasonal Variation in Fat Patterning of Ellisras Rural Children and Adolescents, in the Limpopo Province, South Africa

An increase in childhood obesity has become a global concern since childhood obesity often leads to adulthood obesity. This study aimed to investigate whether there is seasonal variation in fat patterning, and whether fat patterning is associated with seasons among the Ellisras population aged 5-15 years. A total of 1986 children and adolescents (1034 boys and 952 girls) aged 5-15 enrolled in this cross-sectional study. Skinfold measurements were obtained using standard procedures. Obesity prevalence was determined using frequency analysis. The correlation between obesity and two seasons was tested using multinomial regression analysis. The results showed that girls aged 11-15 years had significantly (p ≤ 0.03) larger median fat variables (triceps, biceps, and suprailiac) in spring compared to autumn. The prevalence of obesity ranged from 3-11% with boys being more obese (4-11%) than girls (3-7%) aged 5-15. Regression analysis showed a negative significant (p ≤ 0.001) correlation between autumn and obesity by the subscapular/(subscapular+triceps) (SST) ratio, both unadjusted -2.991 (95%CI -3.233:-2.803) and adjusted -2.897 (95% CI -4.331:-1.629). The findings of the study showed that there was seasonal variation in fat patterning among boys and girls in the Ellisras population and that fat patterning is associated with seasons.

Hypertension Prevalence and Determinants among Black South African Adults in Semi-Urban and Rural Areas

The burden of hypertension is reported to be on the rise in developing countries, such as South Africa, despite increased efforts to address it. Using a cross-sectional study design, we assessed and compared the prevalence of and risk factors associated with hypertension amongst adults aged ≥18 years in semi-urban and rural communities (1187 semi-urban and 1106 rural). Trained community health workers administered the INTERHEART Risk Score tool and performed blood pressure assessments using the MEDIC Pharmacists Choice Blood Pressure Monitor. Hypertension was defined to be a systolic blood pressure (BP) ≥ 140 mmHg and diastolic BP ≥ 90 mmHg. A multivariate logistic regression model was used to identify factors and determine their relationship with hypertension. The prevalence of hypertension amongst semi-urban and rural communities was 21% with no gender difference. In the semi-urban area, physical activity, family history, fruit intake, salty food, and eating meat were significantly associated with the odds of hypertension among women, whereas only the waist-to-hip ratio (WHR), diabetic status, and salty food were the predictors for rural women. Factors such as fried food and low fruit intake were significantly associated with the odds of hypertension among men in the semi-urban area, whereas only the WHR was significant among men in the rural area. Hypertension was found to be prevalent among semi-urban and rural adults in Limpopo Province, South Africa.

The value of community outreach for a University: a synthesis of trends in higher education The case of the University of Limpopo (ELS 45)

BACKGROUND

The South African National Development Plan (SANDP) vision for 2030 highlights key recommendations for reducing the prevalence of non-communicable diseases (NCDs) by 28% by 2030. These are mirrored by the World Heart Federation, although it focuses on reducing the NCD prevalence by 25% by 2025. The targeted diseases include, among others, cardiovascular diseases, diabetes, cancer and chronic respiratory diseases.

OBJECTIVES

The aim was to contribute to discussion on the social responsibility, public good and community development functions of a university in South Africa, as derived from the Higher Education Act 101 of 1997 (as amended).

METHODS

The researcher's ontology links with this notion of the existence of multiple realities that exist among universities in South Africa, and provides the basis for a social construction epistemology. Different realities exist for the University of Limpopo.

RESULTS

The Dikgale Health and Demographic Surveillance System and the Ellisras Longitudinal Study, which both started in 1996 within the University of Limpopo, provide ample bush university outreach models on social responsibility, public good and community development. Community participation was central to the dissemination of research results.

CONCLUSIONS

Social responsibility, public good and community development are core functions for a university, which should be treated as stand-alone roles, such as teaching, learning and research. The University of Limpopo has distinguished itself by being true to its vision of 'being a leading African university focused on the developmental needs of its communities and epitomising academic excellence and innovativeness'.

Ellisras Longitudinal Study conference 2017: The relationship between dietary intake and body mass index among young rural adults in South Africa aged 18 to 30 years (ELS 18)

AIM

To assess the relationship between dietary intake and adiposity in young rural South African adults.

METHODS

A total of 728 young adults participated and dietary intake was assessed using the 24-hour recall method. Linear regression models were used to determine the association between dietary intake and body mass index (BMI) before and after adjustment for age and gender.

RESULTS

Females showed higher mean BMI values than males in all age groups. An age group of 27- to 30-year-old females had a mean value of 28.1 kg/m² while males had a mean value of 21.9 kg/m². The distribution of BMI categories (underweight, normal weight, overweight, obese) was 20.5, 61.7, 9.3 and 3.1% in males, and 8.6, 42.5, 23.1 and 25.8% in females (p ≤ 0.05). Cholesterol intake was significantly (p ≤ 0.05) associated with BMI (beta = 0.002, 95% CI: 0.00-0.004) as well as overweight and obesity (odds ratio = 1.734; 95% CI: -1.09-2.75) after adjustment for age and gender.

CONCLUSIONS

There was a high prevalence of overweight and obesity among rural Ellisras females. Moreover, increasing cholesterol intake was associated with overweight and obesityin the overall sample.

Ellisras Longitudinal Study 2017: The relationship between waist circumference, waist-to-hip ratio, skinfolds and blood pressure among young adults in Ellisras, South Africa (ELS 14)

BACKGROUND

Obesity and hypertension are major risk factors for non-communicable diseases in the world today. The relationship between indicators of obesity and blood pressure needs attention in the rural South African population.

AIM

This study examined the relationship between anthropometric parameters and blood pressure (BP) among young adults in the Ellisras rural area of South Africa.

METHODS

A total of 742 (365 females and 377 males) young adults aged 22 to 30 years, who were part of the Ellisras Longitudinal Study (ELS), participated in the research. Anthropometric and BP measurements were taken using the protocol of the International Society for the Advancement of Kinanthropometry (ISAK). Linear regression was used to determine the relationship between anthropometric parameters and BP. The risk of developing hypertension among young Elisras adults was evaluated using logistic regression.

RESULTS

The results indicted a higher but on-significant prevalence of hypertension in men (2.7%) than women (2.4%). Linear regression showed a significant positive (p < 0.05) association between waist circumference and systolic BP (β = 0.273, 95% CI: 0.160-0.386), even after being adjusted for age and gender (β = 253, 95% CI: 0.127-0.343). The risk for developing hypertension was significant ( p < 0.05) for waist circumference (OR = 2.091, 95% CI: 1.129-3.871) after adjustment for age and gender.

CONCLUSIONS

Of all anthropometric parameters, waist circumference was most significantly associated with BP ( p < 0.05). Anthropometric indicators of obesity were strong predictors of hypertension among young adults in the Ellisras rural area.

The risk of metabolic syndrome as a result of lifestyle among Ellisras rural young adults

The study aimed to investigate the association between metabolic syndrome (MetS) and lifestyle risk factors among Ellisras adults. A cross-sectional study was conducted on 624 adults (306 males and 318 females). MetS was defined according to the criteria of the International Diabetes Federation. The prevalence of MetS was 23.1% (8.6% males and 36.8 % females). Females appeared to have higher mean values for waist circumference (WC), fasting blood glucose (FBG), total cholesterol (TCHOL) and low-density lipoprotein cholesterol (LDL-C), while males had high mean values for high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP). No significant age and gender differences were observed for dietary intake. Significantly more females (51.9%) presented with increased WC than males (4.6%). Participants who had a high dietary energy intake were significantly less likely to present with larger WC (OR: 0.250 95% CI [0.161; 0.389]), low HDL-C (OR: 0.306 95% CI [0.220; 0.425]) and high LDL-C (OR: 0.583 95% CI [0.418; 0.812]) but more likely to present with elevated FBG (OR: 1.01 95% CI [0.735; 1.386]), high TCHOL (OR: 1.039 95% CI [0.575; 1.337]), high TG (OR: 1.186 95% CI [0.695; 2.023]) and hypertension (OR: 5.205 95% CI [3.156; 8.585]). After adjusting for age, gender, smoking, and alcohol status, high energy intake was more than two times likely to predict MetS in adults with a large WC (OR: 2.766 95% CI [0.863; 3.477] and elevated FBG (OR: 2.227 95% CI [1.051; 3.328]). Therefore, identifying groups that are at an increased risk and those that are in their early stages of MetS will help improve and prevent the increase of the MetS in the future.

Dietary Fiber Intake and Metabolic Syndrome Risk Factors among Young South African Adults

This study attempts to bridge the research gap regarding the importance of dietary fiber in reducing metabolic syndrome (MetS) risk factors in young rural South Africans. A total of 627 individuals (309 males and 318 females) aged 18–30 years participated in the study. Dietary intake was measured using a validated 24-h recall method. The consumption of different types of dietary fiber (total, soluble, and insoluble) was calculated and presented as grams. Anthropometrics, blood pressure, fasting blood glucose, and lipid profiles were measured according to standard protocols. According to the definition of the International Diabetes Federation (IDF), the prevalence of MetS was 23.1%. Overall, the total median [interquartile range (IQR)] values for total, insoluble, and soluble fiber consumed were 4.6 g [0.0–48.9], 0.0 g [0.0–18.0], and 0.0 g [0.0–15.0], respectively. Females had a higher median [IQR] intake of total (5.1 g [0.0–48.9] vs. 4.3 g [0.0–43.9]), insoluble (0.0 g [0.0–18.0] vs. 0.0 g [0.0–12.0]), and soluble fiber (0.0 g [0.0–14.9] vs. 0.0 g [0.0–7.3]) than males, respectively. The mean values for waist circumference, fasting blood glucose, and total cholesterol were higher in females than males (82.20 cm vs. 75.07 cm; 5.59 mmol/L vs. 5.44 mmol/L; and 4.26 mmol/L vs. 4.03 mmol/L, respectively), with significant differences observed for waist circumference and total cholesterol (p < 0.001 and p = 0.005, respectively). More than 97% of participants had fiber intakes below the recommended levels. After adjusting for all potential confounders (age, gender, and energy), log total fiber was inversely associated with fasting blood glucose (β = −0.019, 95% CI [−0.042 to 0.003], p < 0.05), systolic blood pressure (β = −0.002, 95% CI [−0.050 to 0.002], p < 0.05) and high-density lipoprotein cholesterol (β = −0.085, 95% CI [−0.173 to 0.002], p = 0.051) This study may be of public health relevance, providing a potential link between less dietary fiber intake and fasting blood glucose (FBG) and both systolic and diastolic blood pressure. Therefore, this observational data encourages public health policy measures to increase the consumption of dietary fiber in rural communities in order to lower the burden of MetS and its associated risk factors.

The relationship between sitting height, sitting height to height ratio with blood pressure among Polokwane private school children aged 6-13 years

BACKGROUND

It is notable that sitting height (SH) correlates with blood pressure (BP) in children and adolescents of developed countries. However, little is known about the relationships between SH and SH to height ratio (SH/H) with BP in South African children from middle and upper socio-economic groups. The purpose of this study was to compare SH and SH/H of private school attending children in the Polokwane area with National Health and Nutrition Examination Survey III (NHANES III) reference population and to determine the relationship between SH, SH/H with BP among private school attending children.

METHODS

A total of 1665 children (846 boys and 819 girls) aged between 6 and 13 years attending three private schools in Polokwane, underwent anthropometric and BP measurements using standard procedures. Linear regression was used to determine the relationship between height, SH, SH/H with BP among these children.

RESULTS

Polokwane private school attending boys from age 7 to 13 years displayed a lower mean SH compared to the NHANES III whereas NHANHES III girls from age 10 to 13 years had a higher mean SH compared to those in private school. In the simple regression analysis, SH was positively associated with SBP (β =1.318; 95% CI = 1.217-1.418) and DBP (β = 0.641; 95% Cl = 0.555-0.727). The findings remains statistically significant only for SH with both SBP (β = 1.025; 95% Cl = 0.844-1.201) and DBP (β = 0.585; 95% Cl 0.434-0.736) after adjusting for age, gender and BMI among these children.

CONCLUSION

In South African children, SH and SH/H were lower compared to the NHANES III children. There was a significant positive association between DBP and SBP together with the components of height among Polokwane private school children.

Performance of blood pressure to height ratio as a screening tool for elevated blood pressure in rural children: Ellisras Longitudinal Study

There are complications in diagnosing hypertension in children and adolescents due to variation of blood pressure (BP) values to age, gender and height. This study was aimed at assessing whether the performance of BP-to-height ratio (BPHR) can be an effective tool for screening prehypertension and hypertension in Ellisras Longitudinal Study (ELS) children aged between 6 and 17 years. A number of the 9002 children aged 6-17 years who were part of the ELS underwent height and BP measurements using standard procedures. Receiver-operating characteristic curve was used to assess the accuracy of BPHR to screen children with prehypertension and hypertension. The optimal systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) cut-off points for hypertension were determined. Sensitivity/specificity, positive predictive values and negative predictive values were calculated. The optimal thresholds for defining prehypertension was 0.77 in children aged 6-10 years and 0.73 in adolescents aged between 11 and 17 years for systolic BPHR and 0.55 in children and 0.53 in adolescents for diastolic BPHR, respectively. The corresponding values for hypertension stage 1 were 0.76 and 0.73 for SBPHR and 0.50 and 0.58 for DBPHR, respectively. BPHR can be used as an effective tool for screening both prehypertension and hypertension in ELS children aged 6-17 years.

The Relationship Between Strength Measurements and Anthropometric Indicators (BMI and Skinfold Thickness) in Ellisras Rural Adolescents Aged 9–15 Years: Ellisras Longitudinal Study

Purpose. Handgrip strength and arm hang have been recognized as predictors of muscle strength and presented as biomarkers for important health outcomes and overall fitness of an individual. The aim of the study was to investigate the relationship between arm hang and handgrip strength with BMI and skinfold thickness.

Method. The total of 769 children (391 boys and 378 girls) aged 9-15 years underwent a series of anthropometric and strength measurements with the use of standard procedures. Linear regression was applied to assess the relationship of arm hang and handgrip strengths with body mass index and skinfold thickness.

Results. The prevalence of undernutrition and low strength measurements was high (1.7-85%) while the prevalence of overweight and obesity was low (1.5-4.2%) in the Ellisras children aged 9-15 years. Boys showed a significantly higher (p < 0.05) mean arm hang (9.6-13.1 kg) than girls (4.0-5.1 kg) aged 11-15 years. There was a significant (p < 0.05) association between low strength and underweight among Ellisras rural children when unadjusted (OR = 0.650; 95% CI = 0.487-0.867) and adjusted (OR = 0.650; 95% CI = 0.489-0.868) for age and gender.

Conclusions. The prevalence of undernutrition and poor strength was high. An association was observed between arm hang and anthropometric indicators while handgrip showed no significant association with anthropometric indicators. Further studies are needed to investigate the association between strength and undernutrition over time.

Exposure to Agrochemicals and Cardiovascular Disease: A Review

Introduction: In the agricultural world there is a continuous loss of food, fiber and other commodities due to pests, disease and weeds before harvesting time. These losses had create lots of financial burden to the farm owners that might lead to shutting down of their daily business. Worldwide, there is an overall very high loss of agricultural products due to weeds growth alone. To counteract this problem most farmers resort to the use of agrochemicals to increase their production but compromising the health of their farmworkers. The purpose of the study will be to assess the relationship between the agrochemical particles and cardiovascular diseases among farmworkers. Method: Non-systematic review was used to collect data. The following database were use: Medline, EBSCO, and Science Direct to search for the existing journal articles. Results: This study addresses the relationship between agrochemicals particles and cardiovascular diseases in the farming industries using literature review. Discussion: Other researchers had already done an extensive research on the pathway of potential mechanisms linking the ultrafine particulate matter to cardiovascular diseases. The outcomes of those investigations were the clinical results of events that might lead to the development of myocardial infarction, congestive heart failure (CHF), stroke, arrhythmia and sudden death. Xenobiotic compounds that maybe implicated in the pathophysiology of human cardiovascular diseases, will be examined and included in this study. There is compelling evidence suggesting that toxic free radicals of pesticides play an important role in human health. Conclusion: There is a close relationship between agrochemicals particle and cardiovascular diseases.

The relationship between BMI and dietary intake of primary school children from a rural area of South Africa: The Ellisras longitudinal study

OBJECTIVES

To investigate the relationship between dietary intake and BMI of primary school children from a rural area of South Africa cross-sectionally. Both under and over nutrition remain major health problems in South Africa. In rural areas, where especially undernutrition leads to child morbidity and mortality, determinants should be detected.

METHODS

Data was used from 825 children (421 boys, 404 girls), aged 6-12 years, participating in the Ellisras Longitudinal Growth study. Height and weight were measured in accordance with the protocol of the International Society for the Advancement of Kinanthropometry. Internationally recommended cut-off points for body mass index (BMI) were used. Dietary intake was measured using the 24 h recall method. In general, boys and girls from Ellisras had dietary intake levels lower than or according to dietary guidelines.

RESULTS

A singular linear regression model showed a significant association between monounsaturated fat and BMI. The multiple model demonstrated that total fat (B = 0.05, CI: 0.019-0.082), monounsaturated fat (B = -0.093, CI: -0.160 to -0.026) and polyunsaturated fat (B = 0.056, CI: 0.09-0.02) predict BMI.

CONCLUSION

This study supports previous findings about BMI and dietary trends in rural areas of South Africa. Despite low fat intake of the subjects, this macronutrient appeared to predict BMI most strongly. More research is needed; however, to further examine how healthy their lifestyle is nowadays with respect to diet and into what extent the nutrition transition has reached this area.

Advertisement and knowledge of tobacco products among Ellisras rural children aged 11 to 18 years: Ellisras Longitudinal study

Background

Tobacco products use is the leading cause of chronic diseases morbidity and mortality. This study explores an exposure to tobacco advertisements factors and knowledge, an association with snuff/pipe usage and cigarette smoking among Ellisras rural children aged between 11 to 18 years.

Methods

A total of 1654 subjects (854 boys and 800 girls) who were part of the Ellisras Longitudinal Study completed the questionnaire.

Results

A significant (p < 0.05) number of boys (11.7%) compared to girls (8.8%) received free cigarettes from the members of the community. Bill boards were successful in advertising tobacco products among the Ellisras rural boys (17% boys and 12.8% for girls, p < 0.022). Multivariate analyses found significant association between cigarette smoking (OR = 1.7 95%CI 1.1-2.7 and Model 2 OR 1.6 95%CI 1.0-2.6 adjusted for age and gender) and advertisements of tobacco products on the TV screens, videos or movies.

Conclusions

Exposure to tobacco products advertisements was high among Ellisras rural children. Though tobacco products legislation exists in South Africa, efforts should be taken by the health professionals to emphasize the danger of using tobacco products even among the illiterate. Teachers and parents should refrain from advertising tobacco products at schools and at homes.

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

BACKGROUND

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.

METHOD

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.

RESULTS

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).

CONCLUSION

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.

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

Background

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.

Method

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.

Results

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.

Conclusion

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.

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.

Somatotype and blood pressure of rural South African children aged 6-13 years: Ellisras longitudinal growth and health study

BACKGROUND

Physique has been useful in assessing the outcome of underlying growth and maturity processes, which leads to a better understanding of variation in child and adult health. However, a high endomorphy rating has been associated with hypertension in adults, posing a serious threat to their health status, while receiving little attention in children.

AIM

The study examined the association between somatotypes, body mass index (BMI) and blood pressure (BP) in 6-13-year-old rural children, in Ellisras, South Africa.

SUBJECTS

A total of 1902 subjects (980 boys and 922 girls) aged 6-13 years were studied as part of the Ellisras Longitudinal Study. Height, weight, four skinfold sites, two breadths, and two girths were measured according to the International Society for the Advancement of Kinanthropometry (ISAK). The Heath-Carter method of somatotyping was used, together with internationally recommended cut-off points for BMI in children. Hypertension, defined as the average of three separate BP readings, where the systolic or diastolic BP is greater than or equal to the 95th percentile for age and sex, was determined.

RESULTS

The prevalence of hypertension ranges from 1 to 5.8% in boys and 3.4-11.4% in girls. The prevalence of overweight ranges from 1.1 to 2.9% in boys and 0.6-4.6% in girls. Systolic BP and BMI showed a significant positive correlation at age 6 years (r = 0.436) and 10-13 years (r = 0.180-0.246 in boys and r = 0.221-0.271 in girls). Diastolic BP showed an insignificant correlation with the BMI and somatotype components in boys and girls.

CONCLUSION

A significant association exists between BP and BMI, and ectomorphy components even after being adjusted for age, gender and height. The need to manage hypertensive individuals is evident in this sample to combat this chronic disease from an early age. Follow-up studies should investigate the relationship between BP and the dietary intake of these children.

The association of fat patterning with blood pressure in rural South African children: the Ellisras Longitudinal Growth and Health Study

BACKGROUND

Hypertension is one of the major causes of death in developed and underdeveloped nations. Essential hypertension and obesity may have their inception in childhood, with little data in African children to support these findings. Objectives were to determine the prevalence of overweight and hypertension in rural children in South Africa. Additionally, the association between fat-patterning ratios and blood pressure (BP) was investigated.

METHODS

Data were collected from 1884 subjects (967 boys and 917 girls), aged 6-13 years, participating in the Ellisras Longitudinal Study. Height; weight; and triceps, biceps, subscapular, and suprailiac skinfolds were measured according to the protocol of the International Society for the Advancement of Kinanthropometry. Skinfold ratio was used as an indicator of the central pattern of body fat. Internationally recommended cut-off points for body mass index (BMI) were used. Hypertension, defined as the average of three separate BP readings where the systolic BP or diastolic BP is >or=95th percentile for age and sex, was determined.

RESULTS

The prevalence of hypertension ranged from 1 to 5.8% for boys and 3.1 to 11.4% for girls, and that of overweight from 1.1 to 2.9% for boys and 0.6 to 4.6% for girls. The association between high systolic BP and high BMI was -3.0, while that for high diastolic BP and high BMI was -0.68.

CONCLUSIONS

The prevalence of hypertension is evident from the age 6 years for girls, while that of overweight was low. Overweight became evident from the age 10 to 13 years for both sexes. A significant association between high diastolic BP and high BMI was noted, while children with low BMIs were less likely to be hypertensive. Investigating habitual physical activity, fitness and dietary patterns will shed more light on the association of fat patterning and BP in this population.

Body composition and physical fitness of undernourished South African rural primary school children

OBJECTIVE

The purpose of this study was to determine the relationships between the body composition characteristics, body mass index (BMI), sum of skinfolds (SSF), % body fat (%BF), fat-free mass (FFM) and waist-to-hip ratio (WHR), and nine physical fitness items in undernourished rural primary school children in Ellisras, South Africa.

DESIGN

A cross-sectional study.

SETTING

The study consisted of 462 boys and 393 girls who were aged 7-14 y.

MEASUREMENTS

Five body composition measures were assessed: BMI, SSF, %BF, FFM and WHR. Nine physical fitness test items were assessed: standing long jump, bent arm hang, sit-ups, 10 x 5 m shuttle run, 50 m sprint, 1600 m run, flamingo balance, sit and reach, plate tapping.

RESULTS

BMI was highly correlated with FFM (r = 0.7, P < 0.001). In line with findings from Western countries, regression coefficients (B) showed that children with higher BMI or SSF performed worse in bent arm hang (girls, B = -0.84, P < 0.001, and B = -0.06, P = 0.02, respectively) and in 1600m run (B = 6.68, P < 0.001). BMI was significantly associated with flamingo balance (B = 0.26, P = 0.04). WHR was positively associated with bent arm hang (B = 9.37, P = 0.03), and inversely with sit and reach (B = -7.48, P = 0.01). In contrast, significant relationships were found between BMI and standing long jump (B = 0.74, P = 0.04), sit and reach (B = 0.51, P < 0.001), flamingo balance (B = 0.26, P = 0.04) and plate tapping (B = -19, P = 0.01). SSF was significantly associated with sit and reach (B = 0.04, P = 0.03). Significant inverse associations were found between FFM and bent arm hang (girls, B = -0.06, P = 0.05), 1600 m run (girls, B = -2.33, P = 0.003) and 50 m run (boys, B = -0.11, P = 0.006). FFM was significantly associated with standing long jump (boys, B = 0.99, P < 0.001; girls, B = 0.73, P < 0.001), flamingo balance (B = 0.17, P < 0.001), and with sit and reach (boys, B = 0.59, P = 0.03).

CONCLUSION

In the present study in undernourished children, body composition was significantly related to physical fitness, but not always in the expected direction. It is therefore important to note that in this population, BMI should not be interpreted as a measure of fatness/overweight, but rather as an indicator of muscle mass.

Nutrition related knowledge and practices of hypertensive adults attending hypertensive clinics at Day Hospitals in the Cape Metropole

The aim of this study was to determine nutrition knowledge and dietary practices of hypertensive adults attending hypertensive clinics at Day Hospitals in the Cape Metropole. Ten Day Hospitals were randomly selected from a total of 31 Day Hospitals and the first participants attending the hypertension clinics per day were recruited. A total of 85 participants were evaluated. The weight, height, waist and hip circumference of each participant was measured, as well as their blood pressure. Knowledge of dietary intake was obtained by completing a questionnaire, during an interview with the patient. Knowledge regarding salt usage indicated that a large percentage (34.1%) of participants believed that flavour enhancers like Aromat or Fondor could safely be used instead of table salt. Furthermore, 23.5% reported that tinned and smoked meat or fish have a low sodium (salt) content. Fruit and vegetables were perceived as having a positive effect on hypertension by 74.1% of participants. However, only 15% of the group knew that the recommendation for their usage was five or more servings per day. Only 12.9% of participants in this study had a normal weight (body mass index (BMI) < 25), 25.9% were overweight (BMI 25 - 29.9) and 61.2% were obese (BMI > or =30); 84.7% recognized the association between obesity and hypertension. A large waist circumference (> 88 cm in women; 102 cm in men) was found in 61.2% of participants, however, only 18.2% of black men had such a measurement. Uncontrolled blood pressure readings (> 140/90 mm Hg) were found in 61.2% of these patients at the hypertension clinics.

Stability of somatotypes in 4 to 10 year-old rural South African girls

In 1996, a mixed Ellisras longitudinal study (ELS) was initiated to assess the stability of somatotypes in 408 girls who comprised 99 pre-school and 309 primary school children in Ellisras rural area in the Northern Province of South Africa. The children's somatotype was assessed using the Heath-Carter anthropometric method. Anthropometric dimensions were taken according to the protocol of the International Society for the Advancement of Kinanthropometry (ISAK). The most stable pre-school and primary school girl had migratory distances (MDs) of 2.6 and 3.4, respectively, while the least stable pre-school and primary school girl had MDs of 17.9 and 24.4, respectively. The mean somatotype of the pre-school children was mesomorph-ectomorph throughout the complete age range, while the mean somatotype of primary school girls was mesomorph-ectomorph for all the age groups except for the 9.5 years group at which it was in the balanced ectomorph. The inter-age partial correlations for endomorphy and ectomorphy were high and significant, but insignificant with regard to mesomorphy.

Obesity: does it occur in African children in a rural community in South Africa?

BACKGROUND

Total body fatness and a centripetal fat patterning are recognized as risk indicators of cardiovascular disease in adulthood. In this study, the development of these risk factors in rural South African children during the preschool years and first years of formal schooling is explored.

METHOD

The initial cross-sectional data from the Ellisras Longitudinal Investigations in Rural Community Children Project, ongoing since 1996, were used, involving 684 boys and 652 girls, aged 3-10 years, in the Ellisras rural community. Overweight was measured using the body mass index (BMI) (kg/m2). Overfatness was based on the sum of the triceps and subscapular skinfold thicknesses. A centripetal fat patterning was measured by the sum of trunk skinfolds relative to limb skinfolds and the ratio of the subscapular to triceps skinfold. Further, the ratio of the subscapular to supraspinale skinfold was used as an indicator of lower body fat patterning. The 85th percentiles of the NHANES III were used as cutoff values for overweight, overfatness and a centripetal fat patterning.

RESULTS

At ages 7 and 8 years, mean BMI was statistically significantly higher in males compared to females (P < 0.05). The log transformed supraspinale skinfold thickness was larger in females compared to males at ages 4-7 years; the log transformed subscapular skinfold was larger in girls compared to boys aged 7-10 years. Less clear patterns were found for the extremity skinfolds and the skinfold ratios. Very few children (0-2.5% in males and 0-4.3% in females) had BMI values above the NHANES III 85th percentiles, indicating a very low prevalence of overweight children in the area. About 15% of the males showed overfatness at ages 3-4 years, while low prevalence was found at older ages.

CONCLUSION

Few Ellisras rural children had above normal values for BMI, indicating a low prevalence of obesity in this population. In the 3- and 4-year-old group more subjects were found to have excessive fat, as indicated by the sum of the triceps and subscapular skinfold thicknesses.