Background: To investigate the mediation effects of physical activity (PA) on the relationship between the perceived neighborhood aesthetic environment and overweight/obesity in free-living South Africans. Methods: A cross-sectional study of 671 adults aged ≥ 35 years was analyzed. PA was assessed using the validated International Physical Activity Questionnaire. Perceived neighborhood aesthetics was assessed using the Neighborhood Environment Walkability Scale Questionnaire. Results: Of 671 participants, 76.0% were women, 34.1% aged 45–54 years, and 69.2% were overweight or obese. In adjusted logistic regression models, overweight/obesity was significantly associated with neighborhood aesthetics [odds ratio (OR) = 0.68; 95% confidence interval (CI), 0.50–0.93] and PA (OR = 0.65; 95% CI, 0.65–0.90). In expanded multivariable models, overweight/obesity was associated with age 45–55 years (OR = 1.59; 95% CI, 1.05–2.40), female gender (OR = 6.24; 95% CI, 3.95–9.86), tertiary education (OR = 4.05; 95% CI, 1.19–13.86), and urban residence (OR = 2.46; 95% CI, 1.66–3.65). Conclusion: Aesthetics was positively associated with PA; both aesthetics and PA were negatively associated with overweight and obesity. There was no evidence to support a significant mediating effect of PA on the relationship between aesthetics and overweight/obesity. Future studies should consider objective assessment of aesthetics and PA. In addition, future studies should consider using longitudinal design to evaluate food-related environments, which are related to overweight or obesity.
Pasmore Malambo, Andre P. Kengne, Estelle V. Lambert, Anniza De Villiers and Thandi Puoane
Catherine Draper, Susan Basset, Anniza de Villiers, Estelle V. Lambert and the HAKSA Writing Group
There is current concern for the health and well-being of children and youth in South Africa, including habits of physical activity (PA) and sedentary behavior. The 2014 Healthy Active Kids South Africa Report Card evaluates the current activity status of children and youth.
The Research Working Group was comprised of 23 experts in physical education, nutrition, sport science, public health and journalism. The search was based on a systematic review of peer-reviewed literature (previous 5 years), dissertations, and nonpeer-reviewed reports (‘gray’ literature) dealing with the PA and nutritional status of South African children and youth 6−18 years of age. Key indicators were identified and data extracted. Grades for each indicator were discussed and assigned.
Overall PA levels received a D grade, as roughly 50% or more of children and youth were not meeting recommended levels. Organized sports participation fared better with a C, and government policies were promising, receiving a B. Screen time and sedentary behavior were a major concern and received a grade of F. Under- and over-weight were highlighted, but overweight is on the rise and this indicator was assigned a D grade. Most of the other indicators in South Africa remained the same or became worse so that grades declined from C- to D. In particular, sedentary behavior, soft-drink and fast food consumption, and an ineffectual regulatory environment to control advertising to children were a concern. There is need to engage parents and communities for advocacy and social mobilization.
Monika Uys, Catherine Elizabeth Draper, Sharief Hendricks, Anniza de Villiers, Jean Fourie, Nelia Steyn and Estelle Victoria Lambert
The purpose of this study was to assess factors that influence physical activity (PA) levels during break-times in South African primary school children.
The System for Observing Play and Leisure Activities in Youth (SOPLAY) was used to observe PA levels during break-times at low-income schools (4 intervention, 4 control). The intervention was based on action-planning including: school environment, curriculum, and family involvement. Categories of observed activity included Sedentary, Eating, Walking, or Vigorous PA. Contextual factors assessed included teacher supervision, equipment, and crowding. Chi-square tests were used to determine associations between PA levels and contextual factors.
In the 970 observations made, 31% of learners were sedentary, 14% were eating, 29% were walking, and 26% were engaged in vigorous PA. There were no differences in break-time PA between intervention and control groups (NS). With supervision, children were more likely to eat and less likely to do vigorous PA (P = .035). Playground crowding was associated with lower levels of vigorous activity and more sedentary behavior (P = .000).
PA during break-time was adversely affected by over-crowding and lower with supervision. The results suggest that interventions may be targeted at the school policy environment to reduce these barriers to PA.
Monika Uys, Susan Bassett, Catherine E. Draper, Lisa Micklesfield, Andries Monyeki, Anniza de Villiers, Estelle V. Lambert and the HAKSA 2016 Writing Group
We present results of the 2016 Healthy Active Kids South Africa (HAKSA) Report Card on the current status of physical activity (PA) and nutrition in South African youth. The context in which we interpret the findings is that participation in PA is a fundamental human right, along with the right to “attainment of the highest standard of health.”
The HAKSA 2016 Writing Group was comprised of 33 authorities in physical education, exercise science, nutrition, public health, and journalism. The search strategy was based on peer-reviewed manuscripts, dissertations, and ‘gray’ literature. The core PA indicators are Overall Physical Activity Level; Organized Sport Participation; Active and Outdoor Play; Active Transportation; Sedentary Behaviors; Family and Peer Influences; School; Community and the Built Environment; and National Government Policy, Strategies, and Investment. In addition, we reported on Physical Fitness and Motor Proficiency separately. We also reported on nutrition indicators including Overweight and Under-nutrition along with certain key behaviors such as Fruit and Vegetable Intake, and policies and programs including School Nutrition Programs and Tuck Shops. Data were extracted and grades assigned after consensus was reached. Grades were assigned to each indicator ranging from an A, succeeding with a large majority of children and youth (81% to 100%); B, succeeding with well over half of children and youth (61% to 80%); C, succeeding with about half of children and youth (41% to 60%); D, succeeding with less than half but some children and youth (21% to 40%); and F, succeeding with very few children and youth (0% to 20%); INC is inconclusive.
Overall PA levels received a C grade, as we are succeeding with more than 50% of children meeting recommendations. Organized Sports Participation also received a C, and Government Policies remain promising, receiving a B. Screen time and sedentary behavior were a major concern. Under- and over-weight were highlighted and, as overweight is on the rise, received a D grade.
In particular, issues of food security, obesogenic environments, and access to activity-supportive environments should guide social mobilization downstream and policy upstream. There is an urgent need for practice-based evidence based on evaluation of existing, scaled up interventions.