Doctoral Degrees (Exercise, Sport and Lifestyle Medicine)

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Browsing Doctoral Degrees (Exercise, Sport and Lifestyle Medicine) by Author "Dickie, Kasha Elizabeth"

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    Behavioural lifestyle factors, physical health-related fitness and cardiometabolic disease risk in women from a low socio-economic urban community in Stellenbosch (Western Cape)
    (Stellenbosch : Stellenbosch University, 2020-03) Dickie, Kasha Elizabeth; Terblanche, Elmarie; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Sport Science.
    ENGLISH ABSTRACT: Non-communicable diseases (NCDs), such as cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), represent an ever-rising threat to the effective management of national health in South Africa. This especially among low versus high socio-economic urban communities as evidenced almost a decade ago. The results of which are likely to lead to an even higher demand for chronic public health care provision, and thus put immediate economic strain on the imminent South African (SA) National Health Insurance fund soon to be launched in 2026. However, one could argue that the evidence needed to reformulate the existing SA health policies, especially those directed at NCD-risk management and inclusive of modifiable behavioural/lifestyle factors, is either: i) not implemented and no action is taken; or ii) implemented, yet ineffective; or iii) limited and thus unable to detect a clinically significant effect to date. Thus, the primary aim of this study was to characterise behavioural/lifestyle factors namely physical activity (PA) and sedentary behaviour, as well as physical health-related fitness and cardiometabolic disease risk profiles for CVD and T2DM in a group of urban women from an under-resourced Western Cape community. In addition, to determine whether physical inactivity, sedentarism and poor health-related fitness levels are important predictors of obesity and other cardiometabolic disease risk outcomes associated with CVD and T2DM. Fifty-one (N=51) apparently healthy women (42 ± 13 yrs) underwent the following measurements: physical activity (PA) and sedentary time (ST), anthropometric, cardiovascular and physical-health related fitness (cardiorespiratory fitness [CRF] and muscular strength). Results from the study showed that less than a third of the women met the World Health Organisation (WHO) Global Health Recommendations for moderate to vigorous-intensity PA (MVPA) using accelerometry. Although overweight, women who accumulated ≥ 30-min of MVPA per day presented with more favourable body composition and regional body fat measures, compared to those who did not. In addition, women who were sufficiently active presented with reduced cardiometabolic disease risk. Although the associations between PA (intensities and volume) and CRF were not statistically significant, all were positive and showed clinically important associations. Independent of steps/day, higher CRF was associated with women who were younger and with reduced measures of total and central adiposity (p < 0.001). Whereas higher physical health-related fitness as opposed to ST and MVPA, was independently associated with reduced cardiometabolic risk but potentially mediated by adiposity. In an attempt to combat cardiometabolic disease risk for CVD and T2DM among low socio-economic community urban-dwelling women, public health interventions should target domains in which time is already spent physically active. Such as walking briskly for travel- and/or occupational-related activities, while also aiming to increase public awareness of the health-enhancing benefits associated with meeting MVPA recommendations. Furthermore, intervention strategies also aimed at reducing cardiometabolic risk should target physical health-related fitness while also reducing ST especially among women who are already sarcopenic. Although the success of which will only be met once we understand the community’s specific barriers to PA and healthy dietary habits.