Meeting physical activity guidelines is associated with reduced risk for cardiovascular disease in black South African women; a 5.5-year follow-up study.

Kasha Dickie,Estelle V Lambert,Sarah Chantler,Julia H Goedecke,Lisa K Micklesfield

doi:10.1186/1471-2458-14-498

Abstract

BackgroundLow levels of physical activity (PA) have been associated with increased risk for cardiovascular disease (CVD) and type 2 diabetes (T2D), but few studies have examined whether meeting international PA guidelines is associated with reduced risk in a black South African (SA) population. The aims of this study were to compare body composition and cardio-metabolic risk factors for CVD and T2D between active and inactive groups (part 1, cross-sectional analysis) and, to determine whether PA level predicts changes in body composition and cardio-metabolic risk factors for CVD and T2D at follow-up after 5.5-years (part 2, longitudinal analysis).MethodsPart 1 included a sample of 240 apparently healthy black SA women (26 ± 7 years) who underwent the following measurements at baseline: PA (Global Physical Activity Questionnaire (GPAQ)), body composition and regional fat distribution (dual-energy x-ray absorptiometry and computerised tomography), blood pressure, fasting glucose, insulin and lipid concentrations. For part 2, a sub-sample of women (n = 57) underwent the same measurements after a 5.5-year period.ResultsAt baseline, 61% of women were classified as meeting the guidelines for moderate- to vigorous-intensity physical activity (MVPA) according to GPAQ. Women who were active had significantly lower body weight (p < 0.001), body fat (BMI, fat mass, % body fat, waist circumference, central and appendicular fat mass, all p < 0.001), and measures of insulin resistance (fasting serum insulin and HOMA-IR, both p = 0.01), and higher high-density lipoprotein cholesterol (p = 0.041), compared to the inactive group. At follow-up, all body fat measures increased significantly in both groups and diastolic blood pressure decreased significantly in those who were active at baseline, but did not change in those who were inactive.ConclusionsMeeting PA guidelines was associated with decreased risk for CVD and T2D in black SA women, but did not prevent the increase in body fat over time. Interventions promoting physical activity to specifically address obesity in this high-risk group are recommended.

Highlights

Low levels of physical activity (PA) have been associated with increased risk for cardiovascular disease (CVD) and type 2 diabetes (T2D), but few studies have examined whether meeting international PA guidelines is associated with reduced risk in a black South African (SA) population
The main findings of this study were that 61% of apparently healthy urban dwelling, black SA women in this cohort were classified as sufficiently active according to current Global Physical Activity Questionnaire (GPAQ) criteria, which are based on international physical activity recommendations for health [3]
Being active at baseline did not attenuate the increase in weight that occurred over a 5.5-year follow-up period, but was associated with a significant decrease in diastolic blood pressure (DBP)

Summary

Introduction

Low levels of physical activity (PA) have been associated with increased risk for cardiovascular disease (CVD) and type 2 diabetes (T2D), but few studies have examined whether meeting international PA guidelines is associated with reduced risk in a black South African (SA) population. Results from the most recent South African Demographic Health Survey (SADHS) [7] show that only 14% of women were sufficiently active, the majority of PA was achieved during leisure-time (53.9%), with a 13.1% difference shown between black African urban (49.8%) and rural (62.9%) groups. Smaller studies in SA have shown black rural women accumulate more activity than black women living in urban settings [8,9,10]

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