The association between anthropometric measures and physical performance in black adults of the North West Province, South Africa

Abstract

South Africa, like many low and upper middle income countries, is undergoing urbanisation with a rapid socio-economic and nutrition transition that may affect the body composition and physical activity patterns of individuals. Obesity has become a major health problem causing an increase in the incidence and prevalence of various non-communicable diseases. Physical activity has been shown to be associated with a lower fat mass and an increase in muscular strength and function and has also been recognised as a key lifestyle factor to prevent and delay muscle loss and obesity during ageing. Maintaining or increasing physical activity levels may decrease the decline of age-associated physical performance. There is a paucity of data on the association between anthropometric measures and the physical performance of black adults in Southern Africa. The aim of this longitudinal study was to examine the association between anthropometric measures and the physical performance of rural and urban black South African adults in the North West Province, South Africa. Stratified random sampling was used to select participants from four communities to participate in the PURE-SA study in 2005. Follow-up visits were done in 2010 and 2015. Anthropometric measurements, demographic information and information concerning physical activity were collected. Physical performance tests were added in 2015. Participants who were HIV positive, whose data were incomplete and pregnant women were excluded in 2005. Data of 1 428 participants were available. In 2015, 926 individuals returned for a follow up and 774 participants remained after the participants were excluded who were HIV positive. The combined overweight/obesity prevalence of both men (p=0.02) and women (p<0.001) increased significantly over time. Physical activity decreased gradually in both men and women (p<0.0001). Statistically significant differences in handgrip strength between the tertile groups of calf circumference were found in men (p=0.002) and women (p<0.0001). Calf circumference was positively associated with handgrip strength and walk speed performance even after adjustments were made for potential confounders. This mini-dissertation has shown that the prevalence of being overweight or obese among black South African adults is increasing, particularly in women in the North West Province. Calf circumference may be a useful predictor of physical performance in black men and to a more limited extent in women.