Association of accelerometry-based and self-reported physical activity with cardiovascular risk in South African children

Patricia Arnaiz; Felix Guntlisbergen; Denis Infanger; Markus Gerber; Larissa Adams; Danielle Dolley; Nandi Joubert; Madeleine Nienaber; Siphesihle Nqweniso; Rosa du Randt; Peter Steinmann; Jürg Utzinger; Cheryl Walter; Uwe Pühse; Ivan Müller

doi:10.17159/sajs.2023/15494

Authors

Patricia Arnaiz Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland https://orcid.org/0000-0001-5626-3510
Felix Guntlisbergen Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
Denis Infanger Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland https://orcid.org/0000-0001-9028-7110
Markus Gerber Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland https://orcid.org/0000-0001-6140-8948
Larissa Adams Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa https://orcid.org/0000-0003-1459-1916
Danielle Dolley Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa https://orcid.org/0000-0002-7374-9034
Nandi Joubert 1.Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland; 2.Swiss Tropical and Public Health Institute, Allschwil, Switzerland; 3.University of Basel, Basel, Switzerland https://orcid.org/0000-0002-6920-981X
Madeleine Nienaber Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa https://orcid.org/0000-0001-8183-1065
Siphesihle Nqweniso Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa https://orcid.org/0000-0001-8793-9624
Rosa du Randt Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa https://orcid.org/0000-0003-1033-9908
Peter Steinmann 1.Swiss Tropical and Public Health Institute, Allschwil, Switzerland; 2.University of Basel, Basel, Switzerland https://orcid.org/0000-0003-1033-9908
Jürg Utzinger 1.Swiss Tropical and Public Health Institute, Allschwil, Switzerland; 2.University of Basel, Basel, Switzerland https://orcid.org/0000-0001-6885-0798
Cheryl Walter Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa https://orcid.org/0000-0001-8422-4105
Uwe Pühse Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland https://orcid.org/0000-0003-1228-316X
Ivan Müller Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland https://orcid.org/0000-0002-6397-9979

DOI:

https://doi.org/10.17159/sajs.2023/15494

Keywords:

physical activity, accelerometry, self-report, cardiovascular health, children, South Africa

Abstract

The burden of non-communicable diseases is increasing, with risk factors emerging early in life. Physical activity reduces cardiovascular risk, but limited evidence exists for children from lower-income countries and mostly relies on self-reported methods that might be inaccurate and biased. We aimed to compare self-reported and accelerometer-measured physical activity in relation to cardiovascular risk markers in children from underserved communities in South Africa. We analysed cross-sectional data from 594 children aged 8 to 13. Physical activity was measured via accelerometry and the Physical Activity Questionnaire for Older Children (PAQ-C). Correlation analyses and linear regression models examined the relationship between accelerometer-measured and self-reported physical activity and their association with cardiovascular risk markers (body mass index, blood pressure, blood lipid profile and glycated haemoglobin). Results show a positive but weak correlation between PAQ-C scores and accelerometer-measured moderate-to-vigorous physical activity (MVPA). MVPA was inversely associated with body mass index, whilst sedentary behaviour correlated positively with lipid levels. PAQ-C scores were inversely associated with systolic blood pressure. The comparison of self-reported and accelerometer-measured physical activity in children from Gqeberha, South Africa, revealed inconsistencies in their correlation and association with cardiovascular risk markers. Accelerometry provided a more accurate cardiovascular risk estimation than PAQ-C, although associations were weak. Further, longitudinal studies should investigate the predictive power of both methodologies. These findings inform researchers and public health practitioners in the choice of method for physical activity appraisal beyond practical considerations, especially when combined with cardiovascular risk and in lower-income settings.

Significance:

We explore two widely used methods to assess physical activity levels in children. By comparing both methods, we expose inconsistencies in their correlation and association with cardiovascular risk markers. These data can guide researchers and public health practitioners in the use of one method beyond practical considerations. Whilst this work focuses on children from marginalised areas of South Africa, the issues explored are of relevance to other lower-income settings.

Open data set: https://doi.org/10.5281/zenodo.7217145