Physical Activity, Screen-Based Sedentary Behaviour, Dietary Habits and Adiposity Of 9 to 11 Year Old School Children in Nairobi County, Kenya
Wachira, Lucy Joy Muthoni
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Lifestyle related chronic diseases in adulthood are potential health consequences of failing to regulate body weight issues and lifestyle behaviors such as physical activity (PA), sedentariness, and dietary intake in childhood. The purpose of the study was to assess the PA, diet, sedentarism (screen-time - ST) and adiposity of 9 to 11 year-old primary school children in Nairobi County. The study used a cross-sectional analytical design and engaged a total of 563 children from primary schools in Nairobi County. PA levels and patterns were objectively measured using an Actigraph GT3X+ accelerometer for 7 consecutive days. Sedentary ST and dietary habits were assessed by self-report using a questionnaire. Adiposity of the children was classified using BMI (WHO Standards) and percent body fat. Data were analyzed using SPSS, Version 17.0. Independent T-tests and one way ANOVA were used to compare differences in the means of variables. Chi-square test and binary logistic regression was used to establish the relationship between categorical variables. Multinomial logistic regression was used to identify the predictors of adiposity. A p-value of <0.05 was considered significant. Most of the respondents (73%) were of normal body weight and there were significant differences in adiposity by SES (p < 0.001). About 14.3% were sufficiently active with more males (20.2%) meeting the WHO recommended PA levels than females (9.3%). A higher percentage of participants from public schools (26.5%) met the recommended PA levels than those from private schools (0.8%) and were found to be 42.6 times more likely to be sufficiently active than private school participants (p=0.001). Participants from private schools were 5.1 times more likely to be overweight/obese (OR=5.1; 95% CI: 3.14 - 8.145; p <0.001) than those from public schools. Majority (95.5%) of the overweight, and all the overfat and obese respondents were 9.8 times more likely to be insufficiently active than those who were not (OR=9.8; 95% CI: 2.357 - 40.674; p=0.002). Most of the participants that achieved the set PA guidelines were from low SES. Overall, 15.5% of the participants had high ST and spent 4.25 hours in screen-based sedentary activities on a weekend day (higher than the CSEP recommendation of not more than 2 hours of ST daily). ST was significantly associated to adiposity status (χ 2 = 18.057, p = 0.035). The most frequently consumed foods on a weekly basis were vegetables (5.3) and fruits (5.1). Those who consumed cakes/pastries (χ2=14.679, p=0.023), potato crisps (χ2=21.626, p=0.003) and fast foods (χ2=13.462, p=0.036) more frequently were significantly less likely to be overweight/obese. The strongest predictors of adiposity status were PA and type of school attended (p<0.001 for both). All the null hypotheses were rejected. The study recommends that further studies and intervention plans should focus on those who are overweight/obese, those with insufficient PA and high ST levels. More focus should also be directed towards factors identified to greatly influence lifestyle behaviours and adiposity (type of school and PA). Policies should also be formulated to promote and further enhance the current efforts on healthy active living among children.