Energy expenditure in young adult urban informal settlement dwellers in South Africa

Abstract

Obesity prevalences are increasing in industrialized and developing countries. As a pilot for a comparative study of physical activity and weight change, we assessed energy expenditure (EE) in young black South African adults living in an urban informal settlement. Total EE (TEE) was assessed using doubly labeled water, activity EE (AEE) and activity patterns by accelerometry and body composition by isotope dilution. Twenty young women and eight men were enrolled. Over 50% of the women and no men were obese (mean BMI 31.0 and 21.6 kg/m 2 , respectively). Women had significantly lower TEE and AEE after adjustment for body size, as well as lower levels of moderate and vigorous activity. Neither TEE nor AEE was associated with BMI or percent body fat, whereas percent time in vigorous activity was modestly negatively associated with adiposity. These data add to the small literature on EE and activity among populations undergoing epidemiologic transitions. ( The prevalence of obesity, coupled with rising rates of type II diabetes and cardiovascular diseases, is increasing dramatically in many developing countries (Zimmet, 2003;Popkin and Gordon-Larsen 2004). These trends mirror a number of environmental changes associated with increased globalization of economies and societal behaviors; quantitative data on even the most basic aspects of these changes are limited. European Journal of Clinical NutritionAt a superficial level, overweight is caused by chronic energy imbalance, that is, this has been attributed to both population-level declines in habitual physical activity and dietary changes and increases in consumption of energy dense foods (Popkin and Gordon-Larsen, 2004). There are, however, relatively few data on total energy expenditure (TEE) and physical activity patterns from developing country populations.We present EE data from black South African young adults residing in an urban informal settlement, collected using the doubly labeled water (DLW) method and accelerometry.These pilot data were collected as part of an international comparative study on EE and weight change.Twenty women and eight men were recruited from Khayelitsha, an urban informal settlement, located in Cape Town, South Africa, in 2006. All participants were healthy by self-report, not taking medications and free of conditions, which might impede activity. The study was approved by the Research and Ethics Committees of the University of Cape Town and the Institutional Review Board of Loyola University Chicago. All participants gave written informed consent.Participants had TEE measured using the DLW two-point method, described earlier (Schoeller and van Santen, 1982). Resting EE (REE) was estimated from fat-free mass (FFM) (Cunningham, 1991). Activity EE (AEE) was calculated: AEE ¼ (0.9*TEE)ÀREE, the term '(0.9*TEE)' represents the estimated 10% of TEE expended as the thermic effect of food. Body composition was measured using the isotope dilution method (Schoeller et al., 1985). Accelerometry was used in a subset of the participants (thirtee...

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