ABSTRACT
Physical activity (PA) is a key requirement for maintaining good health and one of the nine global targets to improve the prevention and treatment of non-communicable diseases. This study was aimed to assess the physical activity and anthropometric status of adults in Amaoba, Ikwuano LGA, Abia state. Questionnaires which included socio-demographic characteristics, physical activity and anthropometric measurements were administered to 429 adults in 5 randomly selected villages in Amaoba. Data was analyzed using Descriptive statistics and Pearson correlation. Significance was judged at p<0.05 using the Statistical Package for Socials Sciences, SPSS version 21. The result showed more males (57.7%) than females (42.3%) participated in the study. More (59.2%) were between 20 – 30 yearsof age, some (21.9%) between 31 – 40 years and few (6.5%, 5.6%, 3.7%, 3.0%) are between 41 - 50 years, 51 - 60 years, 61 - 70 years and 71 years and above respectively. Many (57.8%) were single and some (42.2%) were married. Some (47.1% and 44.1%) had tertiary and secondary educational status respectively while few 3.5% and 5.4% had primary and no formal educational status respectively. Artisans and traders were 34.3% and 27.3% respectively, 17.2% were students, leading to many (65.5%) earning less than ₦30,000 monthly incomes. Prevalence of underweight, overweight and obesity were 3.7%, 23.8% and 15.9% respectively. Some (24.3% and 15.8%) of the females were overweight and obese respectively, while 23.3% and 9.2% of the males were overweight and obese respectively. Some (44.3%) had low risk of cardiovascular disease, 20.7% moderately at risk while 35% had a high risk. The prevalence of inactivity was 71.8% while sufficient physical activity was 28.2%. By gender differences, 65.3%and 34.7% males and females respectively were physically active while 48.1% and 51.9% of males and females did not meet the recommendation. There was significant correlation (P<0.05) between the time spent on sedentary behavior and physical activity MET minutes. Therefore, there is need for time spent on sedentary behaviors to be reduced among adults as it affects the physical activity status.
TABLE OF CONTENTS
Title page i
Certification ii
Dedication iii
Acknowledgements iv
Table of Contents v
List of Tables viii
Abstract ix
CHAPTER 1: INTRODUCTION
1.1 Background of study 1
1.2 Statement of problem 3
1.3 Objectives of the study 5
1.3.1 General objective of the study 5
1.2.2 Specific objectives of the study 5
1.4 Significance of the study 6
CHAPTER 2: LITERATURE REVIEW
2.1 Physical activity and exercise 7
2.2 Types of physical activity and exercise 8
2.2.1 Activities of daily living 8
2.2.2 Aerobic exercise 8
2.2.3 Anaerobic exercise 9
2.2.4 Balance training 9
2.2.5 endurance exercise (endurance training) 10
2.3 Health benefits of physical activity 10
2.4 Physical inactivity 12
2.5 Prevalence of physical inactivity among adults 13
2.6 Physical activity and anthropometric status of adults 15
2.7 Assessments of physical activity 16
2.8 Anthropometric assessments of adults 18
2.8.1 Height 19
2.8.2 Weight 20
2.8.3 Body mass index (BMI) 21
2.8.4 Abdominal/waist circumference 22
2.8.5 Hip circumference (HC) 23
2.8.6 Waist-hip circumference ratio 24
2.8.7 Skinfold thickness 24
2.8.8 Triceps skin fold measurement 25
2.8.9 Mid-upper Arm Circumference (MUAC) 25
2.9 Relationship between physical activity and anthropometric status 28
CHAPTER 3: MATERIALS AND METHOD
3.1 Study Design 30
3.2 Area of Study 30
3.3 Population of Study 31
3.4 Sampling and Sampling Techniques 31
3.4.1 Sample size determination 31
3.4.2 Sampling procedure 32
3.5 Preliminary Activities 32
3.5.1 Preliminary visits 32
3.5.2 Training of research assistants 32
3.5.3 Ethical approval 33
3.5.4 Informed consent 33
3.6 Data Collection 33
3.6.1 Questionnaire administration 33
3.6.2 Anthropometric measurements 34
3.6.2.1 Weight measurement 34
3.6.2.2 Height measurement 34
3.6.2.3 Waist circumference (WC) 34
3.6.2.4 Hip circumference (HC) 35
3.7 Data analysis 35
3.7.1 Body mass index (BMI) 35
3.7.2 Waist circumference 36
3.7.3 Waist hip ration (WHR) 37
3.7.4 Classification of physical activity 37
3.8 Statistical Analysis 38
CHAPTER 4: RESULTS AND DISCUSSION
4.1 Demographic and Socio-Economic Characteristics of the Respondents 39
4.3 Anthropometric Characteristics of the Respondents 45
4.5 Prevalence of Physical Activity and Inactivity Overall, by Respondents
Socio-Demographic Characteristics 48
4.6 Relationship between Physical Activity, Time Spent on Sedentary
Behavior and Anthropometric Status of the Respondents 50
CHAPTER 5: CONCLUSION AND RECOMMENDATIONS
5.1 Conclusion 52
5.2 Recommendations 52
REFERENCE
APPENDIX I
APPENDIX II
APPENDIX III
APPENDIX IV
LIST OF TABLES
2.1 BMI standard 22
2.2 Country-specific MUAC cutoffs 27
3.1 The International classification of adult underweight, overweight and obesity according to BMI 36
3.2 Waist-hip ratio 37
4.1 Background/demographic information of the respondents 41
4.2 Socio-economic characteristics of the respondents 43
4.3 Mean anthropometric measurement of the respondents 46
4.4 Anthropometric distribution of the respondents 47
4.5 Physical activity characteristics of the respondents 49
4.6 The relationship between the Time spent on sedentary behaviour, anthropometric Status and Physical activity MET minutes of the Respondents using Pearson correlation 51
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Universally, the contribution of different risk factors for disease burden has changed substantially, with successful conquest of communicable infections leading to a shift away from factors associated with high prevalence of communicable diseases which were particularly prevalent in children, towards those for non-communicable diseases that predominate in adulthood (Lim et al., 2012). A large percentage of these non-communicable diseases are preventable through the reduction of the four main modifiable behavioural risk factors; unhealthy diet, physical inactivity, harmful use of tobacco and excessive alcohol consumption and reducing obesity (Mwagi et al., 2017).
Eating healthy breakfast, maintaining proper weight, not snacking in between meals, never smoking cigarettes, regular physical activity, moderate or no use of alcohol and getting adequate and regular 7-8 hours of sleep have been associated with better health and are referred to as the “Alameda seven.”(Grosse-Tebbe and Figueras, 2014; Mwagi et al., 2017). Physical activity (PA) is a key requirement for maintaining good health (Iwuala et al., 2019). It is linked with lower rates of all-cause mortality, and reduced risk for developing chronic diseases such as hypertension, diabetes, stroke, osteoporosis, cancer, and depression (Schnohr et al., 2003; Knight, 2012). In recognition of this strong link between physical activity and major non-communicable diseases, member states of WHO agreed to a 10% relative reduction in the prevalence of insufficient physical activity by 2025, as one of the nine global targets to improve the prevention and treatment of non-communicable diseases (WHO, 2013).
Opportunities for people to be physically active exist in the four major domains of their day-to-day lives: at work (especially if the job involves manual labour); for transport (for example, walking or cycling to work); in domestic duties (for example, housework or gathering fuel); or in leisure time (for example, participating in sports or recreational activities) (WHO, 2002).
World Health Organization (2014) recommends that all persons aged 18 to 64 years should engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity activity weekly, in order to improve cardiorespiratory and muscular fitness, bone health and reduce the risk of NCDs and depression adults should engage in at least 150 min of moderate intensity physical activity (PA) or its equivalent per week.
Body composition and anthropometric assessment have been used for evaluating the impact of physical activity on individuals (Dominics et al., 2018). Anthropometry is a common method of assessing the nutritional status of an individual. It is also the measurement of humans and establishing norms and sex, age, weight, height, etc. reflecting both health and nutritional status and predicts performance, health and survival (Wardlaw and Kessel, 2002; Joshi, 2004). Anthropometry can be used to provide the single most portable, universally applicable, inexpensive and non-invasive technique for assessing the size, proportions and composition of the human body (WHO, 2019).
1.2 STATEMENT OF THE PROBLEM
The world population was at 7, 243, 700 billion people in 2014 (FAO, 2014; Memela, 2017). Majority (74.37%) of the world population is made up of ‘adults’ (age 15 years and older (Central Intelligence Agency, CIA, 2015). Amongst all the countries in Africa, Nigeria is the most populated and the sixth largest country in the world (Desa, 2015).
Globally, in 2016 the age-standardised prevalence of insufficient physical activity was 27·5%, with a difference between sexes of more than 8 percentage points (23·4%, in men vs 31·7%, in women) (WHO, 2018). Between 2001, and 2016, levels of insufficient activity were although not significance (28·5%, in 2001). The highest levels in 2016, were in women in Latin America and the Caribbean (43·7%), south Asia (43·0%), and high-income Western countries (42·3%), whereas the lowest levels were in men from Oceania (12·3%), East and Southeast Asia (17·6%), and sub-Saharan Africa (17·9%). Prevalence in 2016 was more than twice as high in high-income countries (36·8%) as in low-income countries (16·2%), and insufficient activity has increased in high-income countries over time (31·6%, in 2001) (WHO, 2018). In 2014, physical inactivity-related non-communicable diseases (NCDs) were responsible for about 3 million deaths in sub-Saharan Africa (WHO, 2014; Oyeyemi et al., 2018). Also, in Nigeria, NCDs already account for at least one quarter and one third of all deaths in males and females, respectively (WHO, 2015).
The two basic forces spreading this malady are the increase in consumption of high calorie-low fiber fast food and the decrease in physical activity due to mechanized transportations and sedentary form of leisure time activities (Saklayen, 2018). According to Iwuala et al. (2015) the result of a 2008 systematic review put the prevalence of physical inactivity at 25–27% among Nigerians (Abubakari and Bhopal, 2008). And of recent the prevalence of physical activity among Nigerian adults was 78% with 76% amongst females and 79% amongst males (Adewale et al., 2018).
The environments people live have also been found to have influence on people’s readiness to participate in physical activities as studies from different parts of the world have shown (Piro et al., 2006; Shibata et al., 2009; Bolívar et al., 2010; Ding et al., 2011; Giehl et al., 2012; Oyeyemi et al., 2012; Solomon et al., 2013; Moran et al., 2014; Oyeyemi et al., 2014; Ejechi and Ogege, 2015). Bixby et al. (2019) in a longitudinal study showed that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. Urbanization and adoption of Western lifestyle have been hypothesized as factors contributing to increasing obesity and overweight in developing countries, especially with rural to urban migrants (Umuerri et al., 2017).
Although the prevalence of obesity and overweight is more in urban than rural settings worldwide, the difference is narrow in developed countries and previous studies in Nigeria have shown a rise in the incidence of overweight and obesity, as well as the metabolic syndrome due to the adoption of Western dietary and lifestyle patterns (Bakari and Onyemelukwe, 2005; Popkin, 2006; Anyanwu et al., 2011; Iloh et al., 2011; Amira et al., 2011; Chukwuonye et al., 2013). About 3 million deaths resulting from physical inactivity are expected to increase up to 80% by 2020 if urgent actions are not taken (Agbegunde et al., 2007; WHO, 2013; 2014; Adewale et al., 2018). However, fewer studies exist to provide evidence for the relationship between physical activity and anthropometric status of Nigerian adults. Therefore, this study aimed to assess physical activity and anthropometric status of adults in Amaoba Ikwuano LGA of Abia state.
1.3 OBJECTIVES OF THE STUDY
1.3.1 General objective
The general objective of this study is to assess physical activity and anthropometric status of adults in Amaoba Ikwuano Local Government Area.
1.3.2 Specific objectives
The specific objectives of the study include to:
i. determine the socio-demographic status of the adults in Amaoba Ikwuano Local Government Area.
ii. assess the anthropometric status of the adults
iii. assess the prevalence of physical inactivity among the adults
iv. assess the relationship between physical activity and anthropometric status.
1.4 SIGNIFICANCE OF THE STUDY
The World Health Organization recommends the reduction in the level of inactivity as a key priority intervention for preventing the increasing chronic diseases” mortality and morbidity occurring in Africa, therefore, for effective country specific interventions against NCDs in Nigeria, it is important to first establish the status of surveillance system, national policy and research capacity on physical activity. There is a need to develop bold initiatives and implement policies that will increase physical activity across all sectors including transportation, urban planning, sports and recreation and workplaces and schools. Therefore, tracking the physical activity profile of this country through research is relevant to national, regional and international public health actions. Evaluating the physical activity profile of Nigeria could help identify research, surveillance and policy gaps and provide information on data needed for effective public health programme planning and action in the country.
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