Temporal Trends and Correlates of Physical Activity, Sedentary Behaviour, and Physical Fitness among School-Aged Children in Sub-Saharan Africa: A Systematic Review

Abstract

Recent physical activity (PA) and fitness transitions, identified as behavioural shifts from traditionally active lifestyles to more industralised and sedentary lifestyles, have been observed among school-aged children. There is a wealth of supporting evidence of such behavioural transitions in high income countries; however, a paucity of data on lower income countries exists. These transitions pose a particular threat to the welfare of children by accelerating the onset of chronic diseases. This systematic review investigated the evidence for a PA and fitness transition among Sub-Saharan Africa’s school-aged children. Temporal trends and correlates of PA, SB, and fitness were examined. Studies were identified by searching the MEDLINE, Embase, Africa Index Medicus, Global Health, Geobase, and EPPI-Centre electronic databases, and were included if they measured outcomes of interest in apparently healthy samples of children (5‒17 years). A total of 71 articles met the inclusion criteria (40 informed PA, 17 informed SB, and 37 informed fitness). Vast heterogeneity in study methodology complicated analysis of transitions over time and no temporal trends were immediately discernible. However, higher socioeconomic status, urban living, and female children were found to engage in lower levels of PA, higher SB, and performed worse on aerobic fitness measures compared to lower socioeconomic status, rural living, and male children. Data revealed that urbanization was associated with a trend towards decreased PA, increased SB, and decreased aerobic fitness over time. Representative, temporally sequenced data examining a PA and fitness transition are lacking in this region (PROSPERO Registration Number: CRD42013004399).

Physical Activity of Children: A Global Matrix of Grades Comparing 15 Countries

“…40 The review did find adverse associations between PA, sedentary behaviors, and fitness, and urban living and higher socioeconomic status, suggesting that traditional economic development may paradoxically be related to reduced healthy active lifestyles and fitness. 40 Organized Sport Participation. Most countries had sufficient evidence to grade the Organized Sport Participation indicator.…”

Global Matrix 2.0: Report Card Grades on the Physical Activity of Children and Youth Comparing 38 Countries

“…17 These findings are consistent with observations of the epidemiological, nutrition, and physical activity transitions. [18][19][20] Furthermore, country-level factors, such as per capita income, income inequality, and Human Development Index (HDI, http://hdr.undp.org/en/content/human-development-indexhdi) have been shown to be related to levels of childhood physical activity in different ways in different countries. 7,21,22 With escalating interest in global solutions to current childhood inactivity and obesity levels, 4,6,10 it is responsible and pragmatic to reflect on the universality of proposed solutions and shared experiences to such pandemics.…”

Relationships between active school transport and adiposity indicators in school-age children from low-, middle- and high-income countries

“…1 Unfortunately, the data for time trends in physical activity (PA) and sedentary behaviors among children and adolescents from LMIC are extremely sparse. 4,5 Nonetheless, in some HIC, PA levels among school-age children are decreasing, whereas time spent in sedentary behaviors is increasing. 4 Within the context of the nutrition and PA transition, 6 in which PA patterns are often the result of environmental and societal changes, it is important to understand the role of activities that can be incorporated into everyday life, including active school transport (AST).The prevalence of AST, unfortunately, has declined in several HIC including Canada, 7 the United States, 8 Australia 9 and Switzerland.…”