PHYSICAL ACTIVITY AND WEIGHT STATUS OF ADULTS IN IKWUANO LGA, ABIA STATE

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ABSTRACT

This study assessed the physical activity and weight status (BMI) of adults in rural communities of lkwuano LGA, Abia state. This cross sectional study used a simple random sampling technique to select 429 adult from selected communities in the LGA. A structured and validated questionnaire was used to collect information on socio demographic characteristics and GPAQ was used  to assess the physical activity of the participants, while anthropometry was assessed using standard procedures. Descriptive (mean, standard deviation, frequencies), correlation statistics were used to analyse the data collected. A p- value of less than 0.05 was accepted as statistically significant. Results revealed that 15.5% and 23.5% were obese and overweight, respectively. Majority (71.8%) of the participants were physically inactive and did not meet WHO recommendation of physical activity (≥600 minute/week). There was no significant positive correlation between the physical activity met and weight status (BMI) of the participants (r= -0.030; p< 0.05). The amount of activity that people undertake as part of their daily life is decreasing and participation in leisure time activity is therefore necessary to ensure that the recommended levels of physical activity are met.



TABLE OF CONTENTS

TITLE PAGE i
CERTIFICATION             ii
DEDICATION            iii
ACKNOWLEDGEMENT            iv
TABLE OF CONTENTS v
LIST OF TABLES            ix
ABSTRACT x

CHAPTER 1
INTRODUCTION
Statement of problem 3
Objectives                                                                                         5 
Significance of the study 5

CHAPTER 2
LITERATURE REVIEW 7
2.0 Adult 7
2.1 Physical activity 8
2.2 Types of physical activity 9
2.2.1 Physical activity at work             9
2.2.2 Physical activity at leisure time             9
2.3 Methods of measuring physical activity                       10
2.3.1 Physiological measures of physical activity           10
2.3.2 Objective methods of assessment     11
2.3.2.1 Pedometers     11
2.3.2.3 Accelerometers     12
2.2.3 Physical activity questionnaire     12
2.4 WHO recommended physical activity for adults     13
2.5 Classification of physical activity                 14
2.5.1Sedentary activity     14
2.5.2 Moderate-intensity activity     14
2.5.3 vigorous –intensity activity     15
2.6 Physical activity in adulthood       15
 2.7 Barriers to physical activity     16
2.8 Risk associated with physical activity                             17
2.9 Interventions to promote physical activity     18
2.10 Classification of physical activity      19
2.10.1 Overweight and obesity      19
2.11 Anthropometric measurement      20
2.11.1 Body mass index      21
2.11.2 Height measurement      21
2.11.3 Weight measurement                                                                    22
2.11.4 Waist circumference      22
2.11.5 Mid-upper arm circumference      22
2.12 Role of Physical activity      23

CHAPTER 3                                                                               
MATERIALS AND METHOD 25
3.1 Study design 25
3.2 Area of study 25
3.3 Population of study 25
3.4 Sample size determination 26
3.4 .1Sampling size determination    26
3.4.2 Sampling procedure 27
3.5 Preliminary activities 27
3.5.1 Preliminary visit 27
3.5.2 Informed consent 27
3.5.3 Training of research assistants 27
3.5.4 Ethical Approval 28
3.6 Data collection 28
3.6.1 Questionnaire Administration 28
3.6.2 Interview 28
3.6.3 Anthropometry 28
3.6.3.1 Weight measurement 28
3.6.3.2 Height measurement 28
3.6.3.3 Waist circumference 29
3.6.3.4 Hip circumference 29
3.7 Physical Activity Assessment 30
3.8 Classification of physical Activity 30
3.9 Data analysis 31
3.10 Statistical analysis 31

CHAPTER 4
RESULTS AND DISCUSSION 32
4.1 Socio demographic characteristics 32
4.1b Socio demographic                            35
4.2.1 Anthropometric characteristics of the participants 36
4.3 Physical activity status of the participants 39
4.5 Relationship between physical activity and weight status     41

CHAPTER 5
CONCLUSION
5.1 Conclusion 45
 5.2 Recommendation 46
REFERENCE 47
Appendix I 55
Appendix II 67            
 




LIST OF TABLES

Table 3.1 Classification of waist circumference 29

Table 3.2 The classification of waist-hip ratio 29  
   
Table 3.3 The International classification of adult underweight, 
Overweight and Obesity according to BMI 30

Table 3.4 The classification of physical activity 32

Table 4.1 socio-demographic characteristics of the participants 33

Table 4.1b socio-demographic characteristics of the participants
 continued

Table 4.2 Anthropometric indices of the participants  38

Table 4.3Physical activity characteristics of participants 40

Table 4.4 Relationship between physical activity and weight status 44
                                              




CHAPTER 1
INTRODUCTION

Physical activity is an important determinant of health and it is associated with reduced risk of chronic diseases such as cardiovascular disease (CVD), diabetes, obesity and certain forms of cancers (WHO, 2002). About two million deaths per year are attributable to physical inactivity worldwide, and more than 80% of deaths from chronic diseases occur in developing countries (Olayinka et al., 2004). The nutritional lifestyle and socioeconomic transitions occurring in many developing countries have significantly increased the burden of chronic non communicable disease in the region including in Nigeria and other African countries (Abegunde, 2007). In addition, rapid urbanization and it's attendant unhealthy dietary habits and reduced physical activity have been linked to the epidemiologic transition from infectious communicable diseases to chronic non communicable disease in Africa (Guthold et al., 2011). 

According to National Institute of Health (NIH), excess body weight has been associated with an increase in health-related diseases such as heart disease, diabetes, certain forms of cancer, musculoskeletal disorders, and other related problems (Sherwood et al., 2000). The morbidity and mortality of increased weight conditions have resulted in an increase in the associated health-care cost of these conditions (Abegunde, 2007). One of the lifestyle intervention opportunities that has been shown to be active is physical activity, due to it’s importance in body-weight regulation and it’s independent effect on related health outcomes (Bergman et al., 2008). The interest in physical activity as a lifestyle strategy  to combat the increasing prevalence of overweight and obesity stems from the fact that it is the one method that can be consistently used to increase energy expenditure (Stein et al., 2004). 

Studies have reported an inverse relationship between physical and body weight; that is, those who were physically inactive weighed more (Lee et al., 2000). Reviews such as Saris (2003), noted that physical activity is an important factor in the prevention of overweight or obesity. Furthermore, Groot et al., (2006), indicated that once an individual becomes obese or overweight, physical activity decreases, setting up a vicious cycle of increasing body weight and even less physical activity.

Overweight and obesity, was defined by the World Health Organization as body-mass index ≥ 25kg/m2 and ≥ 30kg/m2 respectively, are associated with several diseases including cardiovascular disease, diabetes and several types of cancer (Lim et al., 2010). Physical inactivity is also a global health problem responsible for the risk increment of non-communicable diseases (Lee et al., 2012). When physical activity disappears, the life expectancy of human would rise by 0.68 years (Blair et al., 2012). In addition, the World Health Organization and the American College of Sports Medicine have recommended that obese and overweight individuals engage in moderate-intensity aerobic physical activity for atleast 30minutes for 5days per week, or vigorous-intensity aerobic physical activity for atleast 20minutes for 3days per week (Haskel et al., 2007). However, obese individuals have usually physical, social and psychological barriers to perform the recommended level of physical activity (Hills et al., 2010). It is quite difficult to resolve these two major health problems worldwide; obesity and physical inactivity pandemic (Hills et al., 2010).

Physical activity has been shown to have a modest effect on body weight that is typically <3% of initial body weight, but has an additive effect when combined with dietary restriction (Jakicic and Winters, 1999). Moreover, physical activity has been shown to be an important behavioral factor for enhancing long-term weight loss and minimizing weight regain; however, this may require relatively high doses of physical activity that approach 300 minutes per week (WHO, 2018). Physical activity may concurrently reduce abdominal adiposity, and which may serve as a pathway by which there is also an improvement in health-related risk factors for various chronic diseases (Lear et al., 2007).
 
Physical activity is a key to understanding obesity aetiology and is therefore an important component in any obesity prevention and treatment strategies (Wing, 2002). Regular physical activity also appears to be critical specifically for the reduction of obesity related and other chronic diseases (Sherwood et al., 2000). However the interrelationship that exists between overweight, obesity, physical activity, and other determinates of obesity needs to be clarified. This study, is therefore aimed to access the physical activity and weight status of adults in Ikwuano LGA. 

1.1 STATEMENT OF PROBLEM 
During the last 30 years, the prevalence of obesity has increased worldwide however, there is an increase in overweight than those who are underweight (Finucane et al., 2011; Caballero, 2007). The developing countries are still battling with this non communicable diseases. This is as a result of the nutrition transition, reduced physical activity and economic development (River et al., 2005). 

Modernization have introduced physically inactive life in Africa because of white collar and paid jobs where people sit in offices or remain in shops all day. Urbanization may have further compounded the problem by increasing the population of physically inactive people. One of the few reports from Nigeria indicated that 25-27% of Nigerians were physically inactive (Abubakari et al., 2008). Another reported that 68.6% of adults in a Nigerian cities were physically inactive (Oyeyemi et al., 2013). Physical inactivity is one of the 10 leading risk factors for global mortality (WHO, 2014). People who are physically inactive have a 20% to 30% increased risk of all-cause mortality compared to those who engage in at least 150 minutes of moderate intensity physical activity per week or equivalent as recommended by WHO (WHO, 2018). The environment people live tends to have influence on their readiness to participate in physical activities as revealed by other studies (Li et al., 2005; Bolívar et al., 2010; Ding et al., 201 ). Concisely, these reports indicated that crime, fear of violence, traffic density, road pavement, walkways, congestion, parks and enjoyable scenery influence engagement in physical activity. The reports also showed that friendliness of neighbours, sporting arena or recreational facilities also influence engagement in physical activities particularly leisure (Li et al., 2005; Bolívar et al., 2010; Ding et al., 201 ). Also according to Koski (2002), modern technology has replaced physical activity at home, at work, and in transportation. Watching television, playing video games and using the computer contribute most to physical inactivity (Faith et al., 2001). The more time people spend in these sedentary activities, the more likely they are to be overweight (Hi et al., 2003). People may not be obese because they eat too much, but because they move too little. However reducing their food intake would further affect health or cause nutrient deficiencies (Campbell et al., 2007). Physical activity is a necessary component of nutritional health. Therefore to prevent weight gain, the Dietary Reference Intake (DRI) suggests an accumulation of 60mintes of moderately intense physical activities every day in addition to less intense activity of daily living (WHO, 2009).                                                   
There is need to promote further development of public policies in other to improve physical activity (Browner, 1995). It is clear that physically active people have a lower disease risk than sedentary individuals but the components of activity which determine particular health gains is not well understood. Thus  the factors responsible  for  physical  activity  are  the  subject  of  interest. However, this will be the same for different health outcomes and this is why further study of associated mechanisms is important.

This study is therefore aimed to assess the relationship between physical activity and weight status of adults in Ikwuano L.G.A, Abia State. 

1.2 GENERAL OBJECTIVE 
The general objective is to  determine  the  relationship   between physical  activity  level and weight  status of adults in Ikwuano  Local  Government  Area  of  Abia  State.

1.3 SPECIFIC OBJECTIVES
The specific objectives are to:

i.   assess socio-demographic characteristics of the adults. 

ii.   determine the physical activity level of the subjects using GPAQ  

iii.   determine the weight status of the subjects using anthropometry

iv.   assess the relationship between physical activity and weight status of subjects. 

1.4 SIGNIFICANCE OF THE STUDY
This study will create an impact to the body of knowledge on overweight and obesity in Nigeria, thereby increasing awareness to the health practitioners and the general public about the dangers or health implications of being obese, as well as how their weight could be controlled. Furthermore, results from this research would also help them to identify the importance of consuming adequate diets and carrying out physical exercise, which would improve their health condition.        
                                                       

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