BackgroundCommunities in low-to-middle income countries undergoing rapid urbanisation as well as nutrition transition are particularly at risk for associated health issues such as overweight and obesity. South Africa has a double-burden of both under- and over-nutrition, creating some uncertainty as to where to direct healthcare interventions. Therefore, providing anthropometric data in vulnerable populations, such as in early childhood, is much needed.MethodsThis observational study assessed height, weight, head circumference and age-adjusted BMI in 1785 Grade 4 (9.5 ± 0.7 years old) learners from 12 schools in two different areas in South Africa.ResultsOverall, the results of this study found a higher prevalence of overnutrition (>95th percentile for age-adjusted BMI) than undernutrition (<15th percentile for age-adjusted BMI), 27.3% versus 12.4% respectively. Although the boys were significantly older and taller than the girls in this sample, there were no significant sex differences between boys and girls for BMI (19.9 kg/m2 ± 6.0 vs 20 kg/m2 ± 5.8, p = 0.59). Significant differences were found between peri-urban and urban areas for undernutrition (16.1% versus 9.5%, p < 0.001) and overnutrition (9.7% versus 41.2%, p < 0.001).ConclusionSouth African children living in urban areas are particularly vulnerable to high rates of overweight and obesity. Therefore, interventions that are area and context specific are needed to address the issues of malnutrition in South Africa.

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Background: Sufficient physical activity (PA) lowers poor health outcomes, with data showing these protective effects in populations under varying levels of lockdown during the COVID-19 pandemic. The advent of online PA programmes has created novel opportunities to offset the deleterious effects of inactivity. However, data are limited and the readiness and acceptance of such technology is unknown. These authors nevertheless noted an opportunity to investigate this approach based on promising emerging data at the time of the hard lockdown in South Africa. Objective: This exploratory study investigated the engagement and perceptions of a smartphone application to promote health and fitness in a sample of employees at a South African university. Methods: Employed members of staff (n=15) of the University of the Witwatersrand were recruited through email invitation during the hard Level 5 COVID-19 lockdown in 2020. Individualised home-based PA programmes were prescribed through a mobile application for a period of eight weeks. Researchers qualified in Biokinetics provided online supervision of the exercise sessions during the intervention. Participants were asked to complete a self-reported questionnaire about their use of the application. Thematic analysis was used to understand these responses. Results: Lack of motivation was perceived to have a negative effect on participation in the online PA programme. Only one participant reported using the mobile application consistently during the study period, while half of the participants reported having trouble with the usage of the application. The participants frequently mentioned the need for technical support and further engagement from the clinicians supervising the PA programme to ensure use and progression. Staff identified issues with connectivity and already having too many phone applications (apps) amongst the reasons for the technical difficulties. Conclusion: This study demonstrates the challenges and potential for the uptake of online PA interventions during COVID-19 and, despite its small sample size, the data provide important lessons learned that will be used as information in further investigations.

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