Angela de Silva

Sedentary Behaviour and Physical Activity in South Asian Women: Time to Review Current Recommendations?

Objective Our aims were to describe activity and sedentary behaviours in urban Asian women, with dysglycaemia (diagnosed at recruitment), and without dysglycaemia and examine the relative contribution of these parameters to their glycaemic status. Methods 2800 urban women (30–45 years) were selected by random cluster sampling and screened for dysglycaemia for a final sample of 272 newly diagnosed, drug naive dysglycaemic and 345 normoglycaemic women. Physical activity and sedentary behaviours were assessed by the International Physical Activity Questionnaire (IPAQ). Demographic data, diet and anthropometry were recorded. Logistic regression analysis assessed contribution of all parameters to dysglycaemia and exposure attributable fractions were calculated. Results The mean energy expenditure on walking (2648.5±1023.7 MET-min/week) and on moderate and vigorous physical activity (4342.3±1768.1 MET-min/week) for normoglycemic women and dysglycaemic women (walking;1046.4±728.4 MET-min/week, moderate and vigorous physical activity; 1086.7±1184.4 MET-min/week) was above the recommended amount of physical activity per week. 94.3% of women spent >1000 MET-minutes/week on activity. Mean sitting and TV time for normoglycaemic and dysglycaemic women were 154.3±62.8, 38.4±31.9, 312.6±116.7 and 140.2±56.5 minutes per day respectively. Physical activity and sedentary behaviour contributed to dysglycaemia after adjustment for family history, diet, systolic blood pressure and Body Mass Index. Exposure attributable fractions for dysglycaemia were; lower physical activity: 78%, higher waist circumference: 94%, and TV viewing time: 85%. Conclusions Urban South Asian women are at risk of dysglycaemia at lower levels of sedentary behaviour and greater physical activity than western populations, indicating the need for re-visiting current physical activity guidelines for South Asians.

Body fat assessment in Sri Lankan adolescent girls; development of a simple field tool

Background: Development of accurate, simple measures of body fat is essential in developing countries due to the rising prevalence of overweight and obesity. Application of skin-fold thickness (SFT) to body fat prediction equations is an inexpensive method suitable for field settings. Aim: To determine percentage fat mass (%FM) of Sri Lankan adolescent girls using Fourier Transform Infrared spectrometry (FTIR) as a reference method and develop a SFT-prediction equation to estimate %FM. Methods: Weight, height and SFT were measured and %FM determined by FTIR in 131 adolescent, post-menarcheal girls (15–19 years). SFT-measurements were applied to available body composition equations for validation in the population. A new equation for %FM was derived and validated. Results: Mean %FM (FTIR) was 19.13 ± 8.2.Selected body composition prediction equations over-estimated %FM. The multiple regression procedure yielded a final equation consisting of two anthropometric and one demographic variable, %FM = 9.701 − (0.460)* age+(0.640)*TricepsSFT+(0.583)*Supra-iliacSFT. Conclusions: Existing SFT prediction-equations are unsuitable for predicting %FM in this population. The new equation utilizing one peripheral and one truncal skin-fold, is appropriate for prediction of %FM in this population and may be applicable to other South Asian/Asian-Indian adolescents following validation.

Effects of dehydration on cricket specific skill performance in hot and humid conditions

The aim of the current study was to assess the effects of dehydration on cricket specific motor skill performance among fast-bowlers, fielders, and batsmen playing in a hot and humid environment. 10 fast-bowlers, 12 fielders and 8 batsmen participated in two field trials conducted 7 days apart: a fluid provision trial (FP) and a fluid restriction trial (FR). Each trial consisted of a 2-hr standardized training session and pretraining and posttraining skill performance assessments. Bowling speed and accuracy (line and length), throwing speed and accuracy (overarm, sidearm and underarm) and timed running between wickets (1, 2, and 3 runs) was assessed pre to posttraining in each trial. Mass loss was 0.6 ± 0.3 kg (0.9 ± 0.5%) in FP, and 2.6 ± 0.5kg (3.7 ± 0.8%) in FR trials. Maintaining mass within 1% of initial values did not cause any significant skill performance decline. However, the dehydration on the FR trial induced a significant time and trial effect for bowling speed by 1.0 ± 0.8% reduction (0.3 ± 0.8% reduction in FP trial; p < .01) and 19.8 ± 17.3% reduction in bowling accuracy for line (3.6 ± 14.2% reduction in FP trial; p < .01), but no effect on bowling length. A significant decline was noted in the FR trial for throwing speed for overarm (6.6 ± 4.1%; p < .01; 1.6 ± 3.4% reduction in FP trial) and sidearm (4.1 ± 2.3%; p < .01; 0.6 ± 4.7% increase in FP trial) techniques, and for throwing accuracy for overarm (14.2 ± 16.3%; p < .01; 0.8 ± 24.2% increase in FP trial) and sidearm (22.3 ± 13.3%; p < .05; 3.2 ± 34.9% reduction in FP trial) techniques. Batsmen demonstrated significant performance drop in making three runs (0.8 ± 1.2% increase in time in FP trial and 2.2 ± 1.7% increase in time in FR trial; p < .01). Moderate-severe dehydration of 3.7% body mass loss significantly impairs motor skill performance among cricketers, particularly bowlers and fielders, playing in hot and humid conditions. Fluid ingestion strategies maintaining mass loss within 1% prevented a decline in skill performance.

Knowledge, Attitudes, and Practices on Lifestyle and Cardiovascular Risk Factors Among Metabolic Syndrome Patients in an Urban Tertiary Care Institute in Sri Lanka:

Metabolic syndrome (MetS) is a significant predictor of cardiovascular diseases (CVDs). A pretested questionnaire was used to assess knowledge, attitudes, and practice (KAP) of CVD and its risks among Sri Lankan urban adults (35-55 years) with MetS. KAP scores were predefined as high, moderate, and low. Of the participants (n = 423), 13% were males and 87% were females. Attitudes scores were high among this population, though their knowledge and practices scores on CVD risk factors were moderate. Participants with high mean knowledge scores had significantly lower waist circumference (WC) and showed a trend toward reduced fasting blood glucose levels. Participants with high practice scores had significantly lower BMI and WC, which signify that better knowledge and practices are associated with decrease in CVD risk markers in these patients. The study reveals that urban MetS patients have a moderate knowledge and practice score, though their attitude score is high regarding CVD risk factors.

Lifestyle patterns and dysglycaemic risk in urban Sri Lankan women.

Specific dietary patterns are associated with the risk of chronic disease. An in-depth understanding more reflective of lifestyle would be possible when assessing the synergistic effects of both diet and physical activity in pattern analysis. In the present study, we examined the biochemical markers of dysglycaemia and cardiometabolic risk in relation to lifestyle patterns using principal component analysis (PCA). Urban women (n 2800) aged 30-45 years were screened for dysglycaemia using cluster sampling from the Colombo Municipal Council area. All the 272 dysglycaemic women detected through screening and 345 randomly selected normoglycaemic women were enrolled. The International Physical Activity Questionnaire and a quantitative FFQ were used to assess physical activity and diet, respectively. Anthropometric measurements, bioelectrical impedance analysis and biochemical estimations were carried out. Lifestyle patterns were identified based on dietary and physical activity data using exploratory factor analysis. PCA was used for the extraction of factors. A total of three lifestyle patterns were identified. Women who were predominantly physically inactive and consumed snacks and dairy products had the greatest cardiometabolic risk, with a higher likelihood of having unfavourable obesity indices (increased waist circumference, fat mass percentage and BMI and decreased fat-free mass percentage), glycaemic indices (increased glycosylated Hb (HbA1c) and fasting blood sugar concentrations) and lipid profile (increased total cholesterol/TAG and decreased HDL-cholesterol concentrations) and increased high-sensitivity C-reactive protein concentrations. For the first time, we report lifestyle patterns and demonstrate the synergistic effects of physical activity/inactivity and diet and their relative association with cardiometabolic risk in urban women. Lifestyle pattern analysis greatly increases our understanding of high-risk behaviours occurring within real-life complexities.

Body composition in urban South Asian women; development of a bioelectrical impedance analysis prediction equation.

Abstract Background: Assessment of body composition plays a significant role in combating chronic disease among South Asians. Accurate assessment of body composition by bioelectrical impedance analysis (BIA) requires population-specific equations which are currently unavailable for urban South Asian women. Aim: To assess validity of direct BIA assessment and selected equations for prediction of total body water (TBW), against Deuterium (2H2O) dilution and develop and validate a population-specific TBW equation for urban South Asian women. Subjects and method: Data of 80 urban Sri Lankan women (30–45 years) were used for this analysis. Body composition was assessed by 2H2O dilution (reference) and BIA. Available BIA equations were assessed for validity. A new TBW equation was generated and validated. Results: Direct BIA measurements and other equations did not meet validation criteria in predicting TBW. TBW by the new equation (TBW = 3.443 + 0.342 × (height2/impedance) + 0.176 × weight) correlated (p < 0.001) with TBW by reference method. TBW using the new equation was not significantly different (25.30 ± 2.4 kg) from the reference (25.32 ± 2.7 kg). Conclusion: Direct use of TBW by instrument and existing equations are less suitable for this population. The new TBW equation is suitable for body composition assessment in urban South Asian women.

Urbanisation, dietary patterns and body composition changes in adolescent girls: a descriptive cross sectional study

BackgroundUrbanisation has been reported to have negative effects on lifestyle and possibly on body composition. The aim of this study was to assess the effect of urbanization on dietary patterns and measures of body composition in Sri Lankan adolescent girls.MethodsBody Mass Index was calculated in 552 adolescent school dropouts. Percentage body fat was calculated using a population specific skin fold thickness equation. Dietary patterns were identified based on information obtained from a food frequency questionnaire. Extraction of factors of the dietary patterns was by principal component analysis. The sum of hours / week spent on physical activity was calculated. Focus group discussions were held to gather supportive qualitative data on food related behaviors. Multivariate linear regression models were used to assess the association between independent variables and dietary patterns.ResultsTwo dietary patterns were identified; a convenience-based dietary pattern with higher factor loadings for starchy foods other than rice, animal foods, dairy products, fruits, sweetened food and fried food, and a traditional pattern with higher factor loadings for rice, tubers and potatoes, vegetables and dark green leafy vegetables. An urban girl had greater than three times the risk of having a higher percentage body-fat than a rural girl (P = 0.01, OR = 3.2). Time spent on physical activity was significantly (P = 0.003) higher among the rural girls. Focus group discussions indicate that urban girls preferred food from vendors due to convenience while rural girls preferred home cooked meals.ConclusionsUrban adolescents in this study followed a convenience based dietary pattern and this dietary pattern and lower physical activity was associated with overweight and higher body fat.