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Selected Papers from the 2nd Ellisras Longitudinal Study and Other Non-Communicable Diseases Studies International Conference 3–5 December 2019

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 July 2020) | Viewed by 17980

Special Issue Editor

Division of Cancer Control and Population Sciences, Behavioral Research Program, National Cancer Institute, 9609 Medical Center Drive MSC 7344, Bethesda, MD 20892, USA
Interests: cancer prevention; built environment; physical activity; obesity; energy balance; natural experiments; transportation and health; acculturation; geospatial approaches to cancer control; childhood obesity
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Special Issue Information

The Ellisras Longitudinal Study and Other Non-Communicable Disease Studies International Conference organizing committee takes pleasure in inviting papers presented at this conference on 3–5 December 2019 held at University of Limpopo and Ellisras/Lephalale, to be submitted on or before 30 March 2020. The major sub-themes for the conference include (1) lifestyle risk factors for non-communicable diseases: tobacco and alcohol consumption; (2) nutrition, dietary intake, and physical activity; (3) biological risk factors for non-communicable diseases: biochemical parameters, hypertension, genetics, lipid profiles, diabetes; (4) growth, maturation, and ageing; and (5) child health and health education. The conference provided a unique inclusive platform for discussion by ordinary members of the Ellisras/Lephalale community, expert scholars, students, and experienced professionals from all over the world, offering a truly special international networking experience, as well as a comprehensive and interactive program in which participants can cultivate their cross-cultural and communication skills while highlighting different topics related to poverty and cardiovascular diseases.

Keynote speakers for the conference included Prof. Han C.G. Kemper, Pediatric Exercise Physiologist and Epidemiologist, Principal Investigator of the Amsterdam Growth and Health Longitudinal Study, Amsterdam UMC, Amsterdam Public Health Research Institute, The Netherlands; Prof. Andre Kengne, Director, Non-Communicable Diseases Research Unit South African Medical Research Council, Cape Town, South Africa; Dr. Geofrey Musinguzi, Principal Investigator and International Manager for Scaling Up Packages of Interventions for Cardiovascular Disease Prevention in selected sites in Europe and sub-Saharan Africa, University of Antwerp, Belgium; and Prof. TM Mothiba Research Professor, Faculty of Health Sciences, University of Limpopo, South Africa.

Poverty and cardiovascular diseases are a double burden in rural South African populations. Non-communicable diseases (NCDs) are responsible for two out of three deaths worldwide, with their profile changing from one country to the other. Africa is expected to experience the largest increase in NCD-related mortality, globally accounting for 46% of all expected mortalities attributable to NCDs by 2030. Exposure to known risk factors account for about two-thirds of premature NCDs deaths, with an estimated half of NCD deaths attributed to weak health systems and poverty in sub-Saharan Africa. While low-cost solutions and high-impact essential NCD interventions, delivered through primary healthcare approaches, have been shown to have an impact on the population level, existing literature shows that the changing profile of NCDs has been inadequate and fragmented. A well formulated cohort study in Africa could answer major questions relating to the changing magnitude of NCD risk factor profiles in Africa.

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Keywords

  • Non-communicable diseases
  • Poverty
  • Child health
  • Lifestyle factors
  • Cardiovascular diseases
  • Growth
  • Genetics
  • Maturation
  • Physical activity
  • Lipids

Published Papers (6 papers)

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Research

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13 pages, 708 KiB  
Article
Body Roundness Index, A Body Shape Index, Conicity Index, and Their Association with Nutritional Status and Cardiovascular Risk Factors in South African Rural Young Adults
by Mbelege Rosina Nkwana, Kotsedi Daniel Monyeki and Sogolo Lucky Lebelo
Int. J. Environ. Res. Public Health 2021, 18(1), 281; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010281 - 01 Jan 2021
Cited by 23 | Viewed by 4011
Abstract
Background: The study aimed to investigate the association of Body Roundness Index (BRI), A Body Shape Index (ABSI), and Conicity Index with nutritional status and cardiovascular risk factors in South African rural young adults. Methods: The study included a total of 624 young [...] Read more.
Background: The study aimed to investigate the association of Body Roundness Index (BRI), A Body Shape Index (ABSI), and Conicity Index with nutritional status and cardiovascular risk factors in South African rural young adults. Methods: The study included a total of 624 young adults aged 21–30 years from the Ellisras rural area. Anthropometric indices, blood pressure (BP), and biochemical measurements were measured. Results: BRI was significantly correlated with insulin (0.252 males, females 0.255), homeostatic model assessment (HOMA)-β (0.250 males, females 0.245), and TG (0.310 males, females 0.216). Conicity Index was significantly associated with pulse rate (PR) (β 0.099, 95% confidence interval (CI) 0.017, 0.143, p < 0.013; β 0.081, 95% CI 0.000 0.130, p < 0.048), insulin (β 0.149, 95% CI 0.286 0.908, p < 0.001; β 0.110, 95% CI 0.123 0.757, p < 0.007). Conicity Index is associated with insulin resistance (IR) (odds ratio (OR) 7.761, 95% CI 5.783 96.442, p < 0.001; OR 4.646, 95% CI 2.792 74.331, p < 0.007), underweight (OR 0.023, 95% CI 0.251 0.433, p < 0.001; OR 0.031, 95% CI 0.411 0.612, p < 0.001), and obesity (OR 1.058, 95% CI 271.5 4.119, p < 0.001; OR 1.271, 95% CI 0.672 1.099, p < 0.001). Conclusion: Conicity Index was positively associated with insulin resistance, hypertension and dyslipidaemia. Further investigation of these indices and their association with nutritional status and cardiovascular diseases (CVDs) could assist in efforts to prevent CVD in the rural South African population. Full article
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9 pages, 294 KiB  
Article
The Relationship between Low 25-Hydroxyvitamin D and Cardio-Metabolic Risk Factors among Ellisras Young Adults
by Betty Sebati, Kotsedi Monyeki and Susan Monyeki
Int. J. Environ. Res. Public Health 2020, 17(20), 7626; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207626 - 19 Oct 2020
Cited by 3 | Viewed by 1575
Abstract
Introduction: 25-hydroxyvitamin D (25(OH)D) is found in circulating blood and is regarded as an estimate of vitamin D status. Low circulating 25(OH)D levels are associated with a high body mass index (BMI), increased weight and the increased development of adipose tissue. This study [...] Read more.
Introduction: 25-hydroxyvitamin D (25(OH)D) is found in circulating blood and is regarded as an estimate of vitamin D status. Low circulating 25(OH)D levels are associated with a high body mass index (BMI), increased weight and the increased development of adipose tissue. This study aimed to determine the relationship between low 25(OH)D and cardio-metabolic risk factors among Ellisras young adults. Materials and methods: This is a cross-sectional study that took place in a rural area at Ellisras in Limpopo Province South Africa. The study included 631 young adults (327 females and 304 males) aged between 20 and 29 years. Anthropometric measurements including height, weight and waist circumference were measured following standard procedures. Blood pressure, pulse pressure and blood parameters including fasting plasma glucose, total cholesterol and triglycerides were also measured. Correlations and linear regression were performed to determine the relationship between low 25(OH)D and cardio-metabolic risk factors. Results: Descriptive statistics showed significant (p < 0.05) mean difference of LDL, HDL and blood pressure between males and females. There was a significant association between low 25(OH)D and WC (p = 0.010) based on Spearman correlation. There was no association found between low 25(OH)D and HDL in all models (B ranges from 0.072 to 0.075). There was also no association found between low 25(OH)D and systolic blood pressure (SBP) in all models (B ranges from −0.009 to −0.024). Conclusion: Low 25(OH)D was correlated with WC, and therefore with adiposity. Knowledge of the associations between 25(OH)D deficiency and cardio-metabolic risk before the development of the disease is therefore important to establish whether 25(OH)D supplementation can be used for the prevention of these conditions. Educational programmes should be implemented to educate the communities and the nation at large on how to prevent 25(OH)D deficiency. Full article
15 pages, 348 KiB  
Article
Persistent Malnutrition and Associated Factors among Children under Five Years Attending Primary Health Care Facilities in Limpopo Province, South Africa
by Perpetua Modjadji and Josephine Mashishi
Int. J. Environ. Res. Public Health 2020, 17(20), 7580; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207580 - 19 Oct 2020
Cited by 16 | Viewed by 4164
Abstract
Despite years of interventions intended to reduce child malnutrition in South Africa, its negative effects, stunting in particular, persist mainly among children under five years old living in under-resourced regions. A cross-sectional study was conducted to determine the prevalence of malnutrition and associated [...] Read more.
Despite years of interventions intended to reduce child malnutrition in South Africa, its negative effects, stunting in particular, persist mainly among children under five years old living in under-resourced regions. A cross-sectional study was conducted to determine the prevalence of malnutrition and associated factors among 404 children under age five attending childcare services with their mothers in selected healthcare facilities of Limpopo Province, South Africa. Anthropometry, socio-demographics and obstetric history were collected. Height-for-age, weight-for-age and body mass index-for-age Z-scores were used to determine stunting, underweight and thinness among children, respectively. Logistic regression analyses were performed to generate the factors associated with malnutrition. Stunting (45.3%) was the prevalent form of malnutrition among children under age five, affecting boys (51.7%) more than girls (38.8%) and children aged 12–23 months (62.4%) more than those <11 months old (40.1%), in addition to the overall prevalence of underweight (29.0%) and thinness (12.6%). Boys had increased odds of stunting (adjusted odds ratio, AOR = 2.07, 95% CI: 1.26–3.41, p = 0.004) and underweight (AOR = 2.17, 95% CI: 1.32–3.57, p = 0.002) than girls. Children aged 12–23 months were more likely to be stunted (AOR = 4.79, 95% CI: 2.36–9.75, p ≤ 0.0001) than children aged ≤11 months. Delayed introduction of solid foods increased the odds of stunting (AOR = 5.77, 95% CI: 2.63–12.64, p ≤ 0.0001) and underweight (AOR = 2.05, 95% CI: 1.08–3.89, p = 0.028). Children with normal birth weight were less likely to be thin (AOR = 0.42, 95% CI: 0.19–0.92, p = 0.029) and underweight (AOR = 0.34, 95% CI: 0.17–0.68, p = 0.003) than children who had low birth weight. Children whose mothers had obtained secondary school education (AOR = 0.39, 95% CI: 0.16–0.97, p = 0.044), and Grade 12 or post-Grade 12 education (AOR = 0.32, 95% CI: 0.12–0.83, p = 0.020) were less likely to be stunted than were children of mothers who had only primary school education. Suboptimal complementary feeding predisposed children to stunting and underweight. National nutrition programs should be context-specific to improve the introduction of complementary foods among children, especially in the remote and poor areas. Full article
11 pages, 309 KiB  
Article
The Relationship between Binge Drinking and Metabolic Syndrome Components amongst Young Adults Aged 21 to 31 Years: Ellisras Longitudinal Study
by Kotsedi Daniel Monyeki, Hlengani James Siweya, Han C. G. Kemper, Andre P. Kengne, Geofrey Musinguzi, Mbelegem Rosina Nkwana, Tebogo Mothiba, Tumiso Malatji, Shisana M.-A. Baloyi, Rambelani Malema, Lloyd Leach, Moloko Matshipi, Ramakgahlela Betty Sebati, Mohlago Ablonia Seloka, Eliot Sibuyi and Suzan Mafoloa Monyeki
Int. J. Environ. Res. Public Health 2020, 17(20), 7484; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207484 - 15 Oct 2020
Cited by 3 | Viewed by 2126
Abstract
Background: Evidence is lacking on the effects of binge alcohol consumption on metabolic syndrome in the rural South African population. The purpose of this study was to investigate the association between binge drinking and components of metabolic syndrome (MetS) amongst Ellisras rural young [...] Read more.
Background: Evidence is lacking on the effects of binge alcohol consumption on metabolic syndrome in the rural South African population. The purpose of this study was to investigate the association between binge drinking and components of metabolic syndrome (MetS) amongst Ellisras rural young adults aged 21 to 31 years who are part of the Ellisras Longitudinal Study. Methods: Logistic regression analysis was applied to a total of 624 participants (306 males and 318 females) aged 21 to 31 years who took part in the Ellisras Longitudinal Study (ELS). The model was adjusted for covariates, including smoking, age, and gender. Binge alcohol consumption was assessed using a standardised questionnaire that was validated for the Ellisras rural community. A standardised method of determining the components MetS was used after fasting blood samples were collected from all the participants. Results: Binge drinking remained significantly associated with low levels of high-density lipoprotein cholesterol (HDL-C) (OR = 2.64, 95% CI = 1.23–5.65), after being adjusted for smoking, age, and gender. Other MetS components were not predicted. Instead, gender remained significantly associated with all MetS components, except triglycerides, at multivariate analysis. Age retained significance at multivariate analysis with waist girth (OR = 2.13, 95% CI = 1.37–3.34), triglycerides (OR = 2.30, 95% CI = 1.05–5.02), and the MetS composite (OR = 1.65, 95% CI = 1.12–2.41). Conclusion: Binge drinking was significantly associated with lower levels of HDL-C. Future studies should investigate the relationship between alcohol abuse and the components of incident MetS in this population. Full article
7 pages, 269 KiB  
Article
Association of Carboxyhemoglobin Levels with Peripheral Arterial Disease in Chronic Smokers Managed at Dr George Mukhari Academic Hospital
by Mashudu Nemukula, Motetelo Alfred Mogale, Honey Bridget Mkhondo and Lizette Bekker
Int. J. Environ. Res. Public Health 2020, 17(15), 5581; https://doi.org/10.3390/ijerph17155581 - 02 Aug 2020
Cited by 2 | Viewed by 2419
Abstract
Chronic cigarette smokers (CCS) are known to have elevated levels of carboxyhemoglobin (COHb). However, it is not known whether increased levels of COHb are associated with endothelial dysfunction (ED), and therefore the development of peripheral arterial disease (PAD). The aim of the study [...] Read more.
Chronic cigarette smokers (CCS) are known to have elevated levels of carboxyhemoglobin (COHb). However, it is not known whether increased levels of COHb are associated with endothelial dysfunction (ED), and therefore the development of peripheral arterial disease (PAD). The aim of the study was to investigate the association of blood COHb and plasma nitric oxide (NO) levels, and whether it is an independent risk factor in the development of PAD among CCS at Dr George Mukhari Academic Hospital (DGMAH). A sample of 120 CCS with PAD and a convenience sample of 100 CCS without PAD were recruited into the study. Blood COHb levels were measured using the ABL 90 FLEX CO-oximeter automated spectroscopy. Plasma nitric oxide (NO) levels were measure using ELISA. Logistic regression analysis was used to investigate the association of blood COHb and plasma NO with PAD. Blood COHb levels of CCS with PAD were significantly higher than those of CCS without PAD, and the NO levels of CCS with PAD were significantly lower than those of CCS without PAD. Although both the blood COHb and plasma NO in CCS were significantly associated with PAD in bivariate logistic analysis, only plasma NO was independently associated with PAD in multivariate logistic analysis. This finding is consistent with the hypothesis that COHb is a cause of arterial damage in PAD, leading to reduced NO, and therefore reduced arterial dilation. Full article

Review

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11 pages, 4014 KiB  
Review
Change in the Mindset of a Paediatric Exercise Physiologist: A Review of Fifty Years Research
by Han C. G. Kemper
Int. J. Environ. Res. Public Health 2020, 17(8), 2888; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17082888 - 22 Apr 2020
Cited by 3 | Viewed by 3006
Abstract
In this review, the career of a pediatric exercise physiologist (HCGK) is given over a period of almost 50 years. His research was concentrated on the relationship of physical activity (physical education, sport, and daily physical activity) with health and fitness in teenagers [...] Read more.
In this review, the career of a pediatric exercise physiologist (HCGK) is given over a period of almost 50 years. His research was concentrated on the relationship of physical activity (physical education, sport, and daily physical activity) with health and fitness in teenagers in secondary schools. (1) His first experiment was an exercise test on a bicycle ergometer to measure aerobic fitness by estimating physical work capacity at a heart rate of 170 beats/minute (PWC170). (2) Secondly, a randomized control trial (RCT) was performed with an intervention of more intensive physical education (PE) with circuit interval training during three lessons per week over a period of six weeks. (3) Thereafter, a second RCT was performed with an intervention of two extra PE lessons per week over a whole school year. The results of these two RCTs appeared to be small or nonsignificant, probably because the effects were confounded by differences in maturation and the habitual physical activity of these teenagers. (4) Therefore, the scope of the research was changed into the direction of a long-term longitudinal study (the Amsterdam Growth And Health Longitudinal Study). This study included male and female teenagers that were followed over many years to get insight into the individual changes in biological factors (growth, fitness, obesity, hypercholesterolemia, and hypertension) and lifestyle parameters such as nutrition, smoking, alcohol usage, and daily physical activity. With the help of new advanced statistical methods (generalized estimating equations, random coefficient analysis, and autoregression analysis) suitable for longitudinal data, research questions regarding repeated measurements, tracking, or stability were answered. New measurement techniques such as mineral bone density by means of dual-energy X-ray absorptiometry (DEXA) showed that bone can also be influenced by short bursts of mechanical load. This changed his mind: In children and adolescents, not only can daily aerobic exercise of at least 30 to 60 min duration increase the aerobic power of muscles, but very short highly intensive bursts of less than one minute per day can also increase the strength of their bones. Full article
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