Correlates of objectively measured overweight/obesity and physical activity in Kenyan school children: results from ISCOLE-Kenya

Abstract

BackgroundChildhood overweight/obesity and inadequate physical activity burden Western countries, and now, pose a growing threat to the health of children in low and middle income countries. Behavioural transitions toward more sedentary lifestyles coupled with increased consumption of high calorie foods has resulted in rising proportions of overweight/obesity and decreasing levels of physical activity in school-aged children. The objective of this study was to determine the prevalence and to investigate factors associated with overweight/obesity and physical activity in Kenyan children aged 9 to 11 years.MethodsBody composition and physical activity measures of participating children were accomplished by anthropometric assessment, accelerometry, and administration of questionnaires related to diet and lifestyle, and the school and neighbourhood environments. Data collection was conducted in the city of Nairobi as part of a larger International Study of Childhood Obesity, Lifestyle and Environment.ResultsA total of 563 participants (46.5% boys, 53.5% girls) were included in the analyses. Of these, 3.7% were underweight, 14.4% were overweight, and 6.4% were obese based on WHO cut-points. Mean daily sedentary time was 398 minutes, time spent in light physical activity was 463 minutes, and time spent in moderate-to-vigorous physical activity was 36 minutes based on activity cut-points developed by Treuth et al. Only 12.6% of participating children were meeting the recommendation of ≥ 60 minutes of daily moderate-to-vigorous physical activity, and 45.7% of participants used active transportation to/from school. Increasing parental education level, total annual household income, and attending a private rather than public school were associated positively with being overweight/obese and negatively with meeting physical activity guidelines.ConclusionsThis study provided the evidence for an existing prevalence of childhood overweight/obesity in Nairobi. Children were spending a considerable amount of time in sedentary and light intensity physical activity, with few meeting physical activity guidelines. Higher socioeconomic status and parental education attainment were associated with a higher likelihood of children being overweight/obese and a lower likelihood of children meeting the physical activity recommendations. Interventions and strategies should be attentive to the potential health consequences of lifestyle transitions resulting from urbanisation and economic prosperity.

Results From Kenya’s 2016 Report Card on Physical Activity for Children and Youth

“…The ISCOLE-Kenya study found that only one-half of the participating schools offered organized soccer, volleyball, track and field, and swimming to the children and youth. 20 Although Kenya is a sporting nation having achieved considerable success in athletics and rugby, only about half of schools studied offered organized sports that allow children's participation. 20 Provision of sufficient sports facilities both in school and at the community level is key as facilities normally attract children and youth to participate in PA.…”

“…20 Although Kenya is a sporting nation having achieved considerable success in athletics and rugby, only about half of schools studied offered organized sports that allow children's participation. 20 Provision of sufficient sports facilities both in school and at the community level is key as facilities normally attract children and youth to participate in PA. There are different factors that motivate Kenyans to participate in organized sports and physically active children and youth have better academic performance, body image, leadership qualities, and an element of team spirit than those who do not participate in sports.…”

“…There are different factors that motivate Kenyans to participate in organized sports and physically active children and youth have better academic performance, body image, leadership qualities, and an element of team spirit than those who do not participate in sports. 20,21 Participation in sports also develops the spirit of give and take and hence inculcating the spirit of fair play. The grade is based on paucity of data and the best available evidence.…”

Results from Kenya’s 2014 Report Card on the Physical Activity and Body Weight of Children and Youth

“…Only 3 studies estimated proportions of children meeting global PA guidelines. 11,13,15 Based on a weighting of these findings, it was estimated that about one-half of Kenyan children and adolescents met the global PA guideline. Accelerometry data also show that urban children and adolescents had significantly lower MVPA than rural peers.…”

“…ISCOLE-Kenya showed that maternal and paternal education level and total annual household income were associated with meeting recommended PA guidelines, 15 with a decreasing trend in the number of children who met the guidelines with increasing maternal/paternal educational attainment and increasing household SES. A study on a pastoralist community 17 noted gender differences in the encouragement and acceptability of, or participation in PA. Certain sociocultural beliefs do exist in some Kenyan communities whereby female children are discouraged from being physically active-a trait deemed unfeminine.…”