Clustered cardiovascular risk in South African primary schoolchildren
Physical activity, cardiorespiratory fitness and clustered cardiovascular risk in South African primary schoolchildren from disadvantaged communities: a cross-sectional study
The coexistence of multiple cardiovascular risk factors has been reported in school-aged children from the age of nine years, but most evidence stems from high-income countries. This cross-sectional study aimed at describing the cardiovascular health risk, physical activity (PA) behavior and cardiorespiratory fitness (CRF) levels of even younger South African primary schoolchildren, and at examining the associations between PA/CRF and a composite measure of cardiovascular risk.
This paper draws on cross-sectional baseline data of the KaziAfya study, a cluster randomized controlled trial with a 2 × 2 factorial design. The aim of the KaziAfya study was to assess the effect of a PA and multimicronutrient supplementation intervention on children’s growth, health and wellbeing in three African countries. For the South African component of the study, our intention was to recruit approximately 1320 school-aged children attending grades 1–4. Cross-sectional data from 832 primary schoolchildren (grade 1–4) were analyzed. Total cholesterol/HDL ratio, triglycerides, systolic/diastolic blood pressure, body fat, and glycated hemoglobin were assessed as cardiovascular risk markers. Overall, 24.2% of the participants did not meet current PA standards. Higher CRF/PA were associated with lower body fat and lower clustered cardiovascular risk (p < 0.05). When categorizing children into CRF/PA quartiles, a lower clustered cardiovascular risk gradient was found in children with higher CRF (p < 0.05) or PA (p < 0.05). Our data shows that higher CRF/PA is associated with lower clustered cardiovascular risk already from a young age.
Given that clustered cardiovascular risk present during childhood can track into adulthood, we advocate for PA participation and a healthy weight from a young age onwards. This study was funded by the Fondation Botnar.
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