Obesity is affecting an increasingly larger proportion of adolescents in the world, and this can be attributed to low resting metabolic rate (RMR) as well as reduced physical activity (PA) levels. Little is known about objectively determined habitual PA and RMR in 16 year old African adolescents. The purpose of this study is twofold. Firstly, to determine the objectively measured PA status of adolescents and secondly, to determine the relationship that exists between RMR and PA in 16 year old adolescents. Two hundred and twenty six (226) adolescents aged sixteen (16) wore the Actiheart® monitor, combined accelerometry and heart rate for seven (7) consecutive days. Six high schools were recruited to take part in the study: two from town (high socio-economic status) and four from the township (low socio-economic status) of the Potchefstroom area of the North West Province of South Africa. Times spent in moderate to vigorous physical activity, physical activity counts per minute (CPM), total energy expenditure (TEE), active energy expenditure (AEE) and physical activity levels (PAL) were assessed using the Actiheart®. The participants’ RMR was measured by indirect calorimetry using the Fitmate Pro (Cosmed, Italy). All data analyses were performed with the SPSS Version 20 software (IBM SPSS, II). The descriptive statistics (mean and standard deviations) as well as independent t-tests and Mann-Whitney U test were performed to determine differences between ethnicity and genders and to calculate practical significance. A Type I error rate of p ≤ 0.05 was used for statistical significance. To investigate the relationship between RMR and physical activity regression analysis was performed with adjustment for gender, race and fat free mass. Results: Significantly higher PAL (1.57 ± 0.15) were determined in girls compared to boys (PAL = 1.41 ± 0.10). Black adolescents indicated significant higher PAL (1.53 ± 0.14) compared to white adolescents (1.45 ± 0.16). On average, regardless of race or gender, the participants were more active on weekdays than weekends. The current study shows that girls spent more minutes/day in moderate to vigorous physical activity (MVPA) than the boys. The results show that 16.4% of the study sample was either overweight or obese. After adjustment for gender, ethnicity and FFM, linear regression between RMR and moderate-to-vigorous PA yielded an r2 = 0.46 (p ˂ 0.05.) Conclusion: Objectively determined PA of adolescents in South Africa indicates that only one third of adolescents are meeting the recommended 60 minutes of daily MVPA. Gender and race specific interventions are needed to increase habitual physical activity levels in adolescents. Given the fact that the studied sample did not meet recommended daily physical activity and the adverse effect of inactivity and chronic diseases of life style, urgent strategies to inculcate the culture of regular physical activity as a preventative measure of chronic diseases of life style are needed. Behaviour that is carried on into adulthood is established during adolescence. Civic health efforts should focus on encouraging adolescent involvement in regular moderate-to-vigorous PA, which will subsequently increase RMR and lower the risk of the development of non-communicable chronic diseases such as obesity. Further local research is needed to confirm the association between RMR and PA in the local population. / Thesis (MSc (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

Obesity is affecting an increasingly larger proportion of adolescents in the world, and this can be attributed to low resting metabolic rate (RMR) as well as reduced physical activity (PA) levels. Little is known about objectively determined habitual PA and RMR in 16 year old African adolescents. The purpose of this study is twofold. Firstly, to determine the objectively measured PA status of adolescents and secondly, to determine the relationship that exists between RMR and PA in 16 year old adolescents. Two hundred and twenty six (226) adolescents aged sixteen (16) wore the Actiheart® monitor, combined accelerometry and heart rate for seven (7) consecutive days. Six high schools were recruited to take part in the study: two from town (high socio-economic status) and four from the township (low socio-economic status) of the Potchefstroom area of the North West Province of South Africa. Times spent in moderate to vigorous physical activity, physical activity counts per minute (CPM), total energy expenditure (TEE), active energy expenditure (AEE) and physical activity levels (PAL) were assessed using the Actiheart®. The participants’ RMR was measured by indirect calorimetry using the Fitmate Pro (Cosmed, Italy). All data analyses were performed with the SPSS Version 20 software (IBM SPSS, II). The descriptive statistics (mean and standard deviations) as well as independent t-tests and Mann-Whitney U test were performed to determine differences between ethnicity and genders and to calculate practical significance. A Type I error rate of p ≤ 0.05 was used for statistical significance. To investigate the relationship between RMR and physical activity regression analysis was performed with adjustment for gender, race and fat free mass. Results: Significantly higher PAL (1.57 ± 0.15) were determined in girls compared to boys (PAL = 1.41 ± 0.10). Black adolescents indicated significant higher PAL (1.53 ± 0.14) compared to white adolescents (1.45 ± 0.16). On average, regardless of race or gender, the participants were more active on weekdays than weekends. The current study shows that girls spent more minutes/day in moderate to vigorous physical activity (MVPA) than the boys. The results show that 16.4% of the study sample was either overweight or obese. After adjustment for gender, ethnicity and FFM, linear regression between RMR and moderate-to-vigorous PA yielded an r2 = 0.46 (p ˂ 0.05.) Conclusion: Objectively determined PA of adolescents in South Africa indicates that only one third of adolescents are meeting the recommended 60 minutes of daily MVPA. Gender and race specific interventions are needed to increase habitual physical activity levels in adolescents. Given the fact that the studied sample did not meet recommended daily physical activity and the adverse effect of inactivity and chronic diseases of life style, urgent strategies to inculcate the culture of regular physical activity as a preventative measure of chronic diseases of life style are needed. Behaviour that is carried on into adulthood is established during adolescence. Civic health efforts should focus on encouraging adolescent involvement in regular moderate-to-vigorous PA, which will subsequently increase RMR and lower the risk of the development of non-communicable chronic diseases such as obesity. Further local research is needed to confirm the association between RMR and PA in the local population. / Thesis (MSc (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

Studies in both children and adults indicate that waist circumference (WC), a measure of abdominal obesity is closely related to cardiovascular risk factors. The accurate identification of abdominally obese children in health screening programmes for early intervention is of importance. There are, however, concerns about using international definitions for screening purposes because in most instances these have been derived from Western populations and, therefore, may have limited usefulness to children in other parts of the world. When these cut–off points are used in developing countries, they ignore the fact that the growth patterns of children and burdens of disease vary between countries. Due to lack of population specific cut–off points for children in the developing world it may be tempting and convenient to use the same cut–off points as for children in developed countries, but such a practice runs the risk of exporting failure. Ideally, a screening tool should have both high sensitivity and specificity, and these are important considerations in choosing the definition for the detection of childhood abdominal obesity. High sensitivity is necessary to avoid failure of identifying obese children and high specificity of the screening tool ensures that non–obese children are not misclassified as obese, which may otherwise lead to unnecessary treatment and psychosocial implications of stigmatisation. Failure to identify the abdominally obese child may have more serious consequences than misclassification, since it results in an increase in adult morbidity and mortality. Therefore, the main aim of this thesis was to examine fat distribution patterns of black South African (SA) children in relation to health risk. The specific objectives were to: compare the body composition of black stunted and non–stunted children from two rural communities in South Africa; to describe and compare the age and sex specific WC percentile distribution for black SA children from different study populations and compare the WC percentile distribution with those for African–American (A–A) children and to assess the diagnostic accuracy of waist–to–height ratio (WHtR) as a marker for high blood pressure, a cardiovascular risk factor in SA children. Findings of this study demonstrated increased total adiposity in non–stunted children, but trends of increased central adiposity, measured as WHtR in stunted children. This warrants further investigation on this relationship among children older than 13 years in the African context where many children are stunted. The differences observed between the different data sets and between SA and A–A children suggest that nationally representative data should be used to develop age, sex and ethnic specific WC percentiles for this population. The results indicate clearly that the median WC of children from SA studies is smaller than those of A–A children, with a medium to large effect size for the difference. Results also suggest concern with respect to high WC values (> 80 cm) among some children. The recommended universal WHtR cut–off value of 0.5 for assessment of cardiovascular risk is not suitable for black SA children because it had low sensitivity in predicting high blood pressure. The absence of locally developed cut–off values for WC and WHtR for children warrants research due to the associations between being overweight and obese and disease outcomes. It is fundamental to detect risk at an early stage so that appropriate intervention can be initiated timeously. / Thesis (Ph.D. (Nutrition))--North-West University, Potchefstroom Campus, 2011.

Studies in both children and adults indicate that waist circumference (WC), a measure of abdominal obesity is closely related to cardiovascular risk factors. The accurate identification of abdominally obese children in health screening programmes for early intervention is of importance. There are, however, concerns about using international definitions for screening purposes because in most instances these have been derived from Western populations and, therefore, may have limited usefulness to children in other parts of the world. When these cut–off points are used in developing countries, they ignore the fact that the growth patterns of children and burdens of disease vary between countries. Due to lack of population specific cut–off points for children in the developing world it may be tempting and convenient to use the same cut–off points as for children in developed countries, but such a practice runs the risk of exporting failure. Ideally, a screening tool should have both high sensitivity and specificity, and these are important considerations in choosing the definition for the detection of childhood abdominal obesity. High sensitivity is necessary to avoid failure of identifying obese children and high specificity of the screening tool ensures that non–obese children are not misclassified as obese, which may otherwise lead to unnecessary treatment and psychosocial implications of stigmatisation. Failure to identify the abdominally obese child may have more serious consequences than misclassification, since it results in an increase in adult morbidity and mortality. Therefore, the main aim of this thesis was to examine fat distribution patterns of black South African (SA) children in relation to health risk. The specific objectives were to: compare the body composition of black stunted and non–stunted children from two rural communities in South Africa; to describe and compare the age and sex specific WC percentile distribution for black SA children from different study populations and compare the WC percentile distribution with those for African–American (A–A) children and to assess the diagnostic accuracy of waist–to–height ratio (WHtR) as a marker for high blood pressure, a cardiovascular risk factor in SA children. Findings of this study demonstrated increased total adiposity in non–stunted children, but trends of increased central adiposity, measured as WHtR in stunted children. This warrants further investigation on this relationship among children older than 13 years in the African context where many children are stunted. The differences observed between the different data sets and between SA and A–A children suggest that nationally representative data should be used to develop age, sex and ethnic specific WC percentiles for this population. The results indicate clearly that the median WC of children from SA studies is smaller than those of A–A children, with a medium to large effect size for the difference. Results also suggest concern with respect to high WC values (> 80 cm) among some children. The recommended universal WHtR cut–off value of 0.5 for assessment of cardiovascular risk is not suitable for black SA children because it had low sensitivity in predicting high blood pressure. The absence of locally developed cut–off values for WC and WHtR for children warrants research due to the associations between being overweight and obese and disease outcomes. It is fundamental to detect risk at an early stage so that appropriate intervention can be initiated timeously. / Thesis (Ph.D. (Nutrition))--North-West University, Potchefstroom Campus, 2011.

Motivation: C-reactive protein (hs-CRP) and other risk factors such as cortisol and obesity in the diagnosis of cardiovascular dysfunction (CVD) in African and Caucasian women has become increasingly imperative when one considers the escalation of hypertension among these groups. Recent studies have explored some aspects of these risk factors and the roles that they play within hypertension and possible future risk for cardiovascular disease. Hs-CRP has been associated with the increased prevalence of hypertension and obesity. Cortisol per se has also been linked with the development of both hypertension and the hypothalamic-pituitary adrenal cortex (HPA) response. Nevertheless, the exact mechanism remains rather uncertain due to conflicting outcomes of research within different ethnic groups. Several recent investigations have, however, linked hypocortisolism with both urbanisation and a subsequent increased likelihood of hypertension within African women as they have presented increased vascular blood pressure responses. Conversely, Caucasian women have displayed an increased central cardiac reactivity. The lack of data regarding the relationship between the above-mentioned parameters within both African and Caucasian women serves as the motivation for conducting this study. Objective: To investigate hs-CRP, cortisol and hypertension as contributors to the increased likelihood of cardiovascular dysfunction in both African and Caucasian women within South Africa. hs-CRP use this through whole document please Methodology: The manuscript presented in Chapter 2 has been compiled using data obtained from the POWIRS (Profiles of Obese Women with Insulin Resistance Syndrome) study. Apparently healthy African (N=102) and Caucasian (N=115) women, matched for age and body mass index, were recruited from the North-West Province of South Africa for participation within this study. Subjects were divided into normotensive (NT) and hypertensive (HT) groups according to the mean resting cardiovascular values that were taken using a Finometer device. High-sensitivity C-reactive protein (hs-CRP) and cortisol blood serum values were determined by immunochemistry and ELISA analyses. Significant differences within each ethnic group and between each of the groups (NT and HT) were determined by analysis of covariance (ANCOVA), for anthropometric, cardiovascular, hs-CRP and cortisol variables, while adjusting for cardiovascular covariates (age, smoking and alcohol consumption). Partial correlations analyses were used to examine the relationship between hs-CRP, cortisol, anthropometric and cardiovascular parameters adjusting for cardiovascular covariates. Logistic regression analyses was used within each ethnic group to determine the relationship between anthropometric, cardiovascular, hs-CRP and cortisol as independent variables and hypertension as dependent variable. This study was approved by the Ethics Committee of the North-West University and all subjects gave informed consent in writing. For a more detailed description of the subjects, study design and analytical procedures please refer to the Materials and Methods section within Chapter 2 of this dissertation. Results and Conclusion: Both ethnic groups presented higher hs-CRP and lower cortisol levels compared to normal values. Lower waist circumference (WC) and cortisol as well as higher blood pressure (BP) and vascular values were evident in Africans compared to Caucasians. Both HT ethnic groups were older and more visceral obese compared to their NT counterparts. HT Caucasians indicated higher central adrenergic responses whilst HT Africans showed vascular adrenergicresponses. Only NT Africans had lower cortisol values than NT Caucasians but the Africans (NT and HT) responded with higher diastolic blood pressure responses compared to their Caucasian counterparts. Moreover, hs-CRP within African women significantly correlated with all BP and obesity variables whilst hs-CRP only associated with stroke volume (SV) and compliance (Cw) within HT Caucasian women. Cortisol in both ethnic groups was strongly associated with vascular BP responses. Only BP contributed to the higher prevalence of HT in both ethnic groups. In conclusion, these results suggest the possible diverse roles of HPA axis dysregulation associated with higher inflammatory responses. This happens in conjunction with cardiac and vascular responses within more obese Caucasian and especially African women, respectively. / MSc (Physiology), North-West University, Potchefstroom Campus, 2009

Motivation: C-reactive protein (hs-CRP) and other risk factors such as cortisol and obesity in the diagnosis of cardiovascular dysfunction (CVD) in African and Caucasian women has become increasingly imperative when one considers the escalation of hypertension among these groups. Recent studies have explored some aspects of these risk factors and the roles that they play within hypertension and possible future risk for cardiovascular disease. Hs-CRP has been associated with the increased prevalence of hypertension and obesity. Cortisol per se has also been linked with the development of both hypertension and the hypothalamic-pituitary adrenal cortex (HPA) response. Nevertheless, the exact mechanism remains rather uncertain due to conflicting outcomes of research within different ethnic groups. Several recent investigations have, however, linked hypocortisolism with both urbanisation and a subsequent increased likelihood of hypertension within African women as they have presented increased vascular blood pressure responses. Conversely, Caucasian women have displayed an increased central cardiac reactivity. The lack of data regarding the relationship between the above-mentioned parameters within both African and Caucasian women serves as the motivation for conducting this study. Objective: To investigate hs-CRP, cortisol and hypertension as contributors to the increased likelihood of cardiovascular dysfunction in both African and Caucasian women within South Africa. hs-CRP use this through whole document please Methodology: The manuscript presented in Chapter 2 has been compiled using data obtained from the POWIRS (Profiles of Obese Women with Insulin Resistance Syndrome) study. Apparently healthy African (N=102) and Caucasian (N=115) women, matched for age and body mass index, were recruited from the North-West Province of South Africa for participation within this study. Subjects were divided into normotensive (NT) and hypertensive (HT) groups according to the mean resting cardiovascular values that were taken using a Finometer device. High-sensitivity C-reactive protein (hs-CRP) and cortisol blood serum values were determined by immunochemistry and ELISA analyses. Significant differences within each ethnic group and between each of the groups (NT and HT) were determined by analysis of covariance (ANCOVA), for anthropometric, cardiovascular, hs-CRP and cortisol variables, while adjusting for cardiovascular covariates (age, smoking and alcohol consumption). Partial correlations analyses were used to examine the relationship between hs-CRP, cortisol, anthropometric and cardiovascular parameters adjusting for cardiovascular covariates. Logistic regression analyses was used within each ethnic group to determine the relationship between anthropometric, cardiovascular, hs-CRP and cortisol as independent variables and hypertension as dependent variable. This study was approved by the Ethics Committee of the North-West University and all subjects gave informed consent in writing. For a more detailed description of the subjects, study design and analytical procedures please refer to the Materials and Methods section within Chapter 2 of this dissertation. Results and Conclusion: Both ethnic groups presented higher hs-CRP and lower cortisol levels compared to normal values. Lower waist circumference (WC) and cortisol as well as higher blood pressure (BP) and vascular values were evident in Africans compared to Caucasians. Both HT ethnic groups were older and more visceral obese compared to their NT counterparts. HT Caucasians indicated higher central adrenergic responses whilst HT Africans showed vascular adrenergicresponses. Only NT Africans had lower cortisol values than NT Caucasians but the Africans (NT and HT) responded with higher diastolic blood pressure responses compared to their Caucasian counterparts. Moreover, hs-CRP within African women significantly correlated with all BP and obesity variables whilst hs-CRP only associated with stroke volume (SV) and compliance (Cw) within HT Caucasian women. Cortisol in both ethnic groups was strongly associated with vascular BP responses. Only BP contributed to the higher prevalence of HT in both ethnic groups. In conclusion, these results suggest the possible diverse roles of HPA axis dysregulation associated with higher inflammatory responses. This happens in conjunction with cardiac and vascular responses within more obese Caucasian and especially African women, respectively. / MSc (Physiology), North-West University, Potchefstroom Campus, 2009

Background: In South Africa, as in many other developing countries, iron deficiency (the most common micronutrient deficiency) still remains unresolved; while obesity has emerged as a public health challenge causing increases in the incidence and prevalence of cardiovascular diseases (CVDs). Research has shown that certain iron indices are associated with both anthropometric and biological markers of CVDs. Adiposity is thought to modulate the pathway linking iron status to CVDs. Objective: To examine the associations between iron indices, anthropometric and biological markers of CVDs in an African population undergoing transition. Methods: This thesis was based on secondary analysis of data generated during the Transition and Health during Urbanisation of South Africans (THUSA) study; and primary and secondary analysis of the baseline Prospective Urban and Rural Epidemiological (PURE) study. Both studies were cross–sectional in design and were conducted between 1996–1998 and in 2005 respectively in the North West Province of South Africa. The 1854 men and women participants in the THUSA study (>15years) and 1262 women participants in the PURE study (>35years) were included in the analysis. The relationship between iron and anthropometric indicators of CVD risk was examined in the THUSA study while that of iron status, anthropometric and biological markers of CVD risk was examined in the PURE study. Results: In the THUSA study, ferritin was positively associated with body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), body fat and subscapular skinfold (r=0.141, 0.359, 0.396, 0.308, 0.141 respectively for men and 0.126, 0.232, 0.319, 0.126, 0.105 respectively for women; p<0.01). Only the women showed decreased serum iron concentration with increasing BMI (p<0.05). WC and WHR increased with increasing serum ferritin concentration for both genders (p<0.05). As for the PURE study, associations between iron status parameters and CVD risk factors were generally weak (r<0.3, p<0.01) and were not retained after adjusting for valid confounders. WC and WHR increased with increasing ferritin concentration (p<0.05). Conclusion: Although these results do not indicate any significant association between iron indices and biological markers of CVD, its association with anthropometric indices gives an indication of the possible contribution of iron in the aetiology of CVDs. Thus, it may be necessary to exercise caution on the emphasis placed on iron as a nutrient and iron intervention programmes because of the suggestive role of iron in CVD development. / Thesis (Ph.D. (Nutrition))--North-West University, Potchefstroom Campus, 2011.

The increasing prevalence of childhood obesity worldwide is viewed as a global epidemic (World Health Organization, 2010). It is associated with a variety of health problems as well as physical– (cardio–respiratory endurance, flexibility, muscular strength, muscular endurance, and body composition), and motor proficiency (fine manual control, manual coordination, body coordination, and strength–and–agility) (Asayama et al., 2003:644; Okely et al., 2004:242; Tokmakidis et al., 2006:870). As far as the South African context is concerned, there is little research examining these relationships and the effect of physical intervention there upon, in nine– to 12–year old children. The first and second objectives of this study were to determine whether obesity would influence the physical– and/or the motor proficiency of nine– to 12–year–old South African children. The third and fourth objectives of this study were to determine the effect of a multidisciplinary intervention on the physical– and the motor proficiency of nine– to 12–year–old obese children. For objectives one and two, a cross–sectional study was performed on 280 children (128 boys and 152 girls), with an average age of 10.6 years (±1.05). Anthropometric–, physical– and motor measurements were obtained by the 'Fitnessgram' (Meredith & Welk, 1999) and the 'Bruininks–Oseretsky Test of Motor Proficiency–II' (Bruininks & Bruininks, 2005). Body mass index (BMI) cut–off points were used to classify the children as normal, overweight, or obese (Cole et al., 2000). The data was analysed with regard to the above–mentioned objectives with the Statistica computer program, by means of descriptive statistics, Spearman rank correlations, and variance analyses. The results show that the physical fitness variables, cardio–respiratory endurance and muscular strength, particularly leg muscular strength, showed significant decreases with an increase in BMI. A progressive, but insignificant, decrease was found in muscular endurance with an increase in BMI, while flexibility showed the weakest relationship to BMI. The motor variables strength–and–agility weakened significantly with an increase in BMI, while fine manual control, manual coordination, and body coordination showed the weakest relationships to BMI. Variance analysis showed further significant relationships among BMI, cardio–respiratory endurance, muscular strength, and running speed–and–agility (p<0.05). It can be concluded that health–promoting physical fitness and the motor proficiency of young South African children are negatively influenced by obesity and intervention strategies are recommended to promote the quality of life of such children. For objectives three and four, an availability random sample of 37 experimental subjects, with an average age of 11 years (±0.99) was taken, where 20 subjects (seven boys and 13 girls) took part in a multidisciplinary intervention programme, and 17 subjects (six boys and 11 girls) formed part of a control group. Body composition, physical–, and motor proficiency were analysed by the 'Fitnessgram' (Meredith & Welk, 1999) and the 'Bruininks–Oseretsky Test of Motor Proficiency–II' (Bruininks & Bruininks, 2005) during baseline measurements, on completion of the intervention programme, and after a follow–up period of three months. The results, which were analysed with a repeated–measures analysis, Bonferroni–post–hoc analysis, and dependent and independent t–tests, show that the intervention programme brought about a significant change in all the body composition variables, excluding body height. Flexibility, muscular strength, and abdominal muscular endurance, as well as one of the four fine manual control test items (folding paper), two of the 12 body coordination test items (tapping feet and fingers - opposite sides synchronised, and standing on one leg on a line - eyes closed), and six of the seven strength and agility test items (shuttle run, stepping sideways over a balance beam, one–legged stationary hops, one–legged side hops, two–legged side hops, and sit–ups), showed significant differences from the control group on completion of the intervention programme. The results indicate that the intervention brought about differences in body composition and physical– and motor proficiency and also showed a sustainable effect over a period of three months on body fat percentage, subscapular skinfold and leg muscular strength. From this, it can be deduced that young obese children need sustained guidance to be able to maintain the lifestyle adaptations that are required by obesity interventions. It can be concluded that the physical– and motor proficiency of children is negatively influenced by obesity, that a multidisciplinary intervention programme improves the body composition profile of obese children and has a positive effect on the physical– and the motor proficiency of obese nine– to 12–year old South African children, although the effect is not sustainable without ongoing, controlled intervention. / Thesis (Ph.D. (Kinderkinetics))--North-West University, Potchefstroom Campus, 2012.

Obesity in children and adolescents is on the rise and is a major risk factor for chronic disease, thus posing one of the greatest public health challenges for the 21st century. Although adolescent obesity is increasing in all ethnic groups, its prevalence is higher in non–Caucasian populations. A possible explanation for ethnic differences in the development of obesity could be ethnic differences in resting metabolic rate (RMR). A low RMR would pre–dispose an ethnic group to obesity. In South Africa limited research has been published with regards to body composition (BC) and RMR in adolescents and the possible association of RMR with BC. The first aim of this study, therefore, was to determine differences in BC and RMR between 14 year old black and Caucasian South African adolescents from the Tlokwe municipality of the North West Province, South– Africa. The second aim was to investigate whether significant relationships between the body composition characteristics body mass index (BMI), percentage body fat (%BF), fat free mass (FFM) and RMR exist in this group. The baseline data of participants in the Physical Activity and Health Longitudinal Study (PAHLS) was used. Anthropometric measurements included stature, body mass, triceps and subscapular skinfolds, and waist girth to determine BMI, %BF, FFM and waist–to–height ratio (WHTR). RMR was measured by the FitMate Pro Indirect Calorimetry (Cosmed). An independent t–test was used to compare the two groups (black vs. Caucasian, boys and girls respectively) with regards to body composition and RMR. Pearson correlation coefficients (adjusted for gender and ethnicity) were calculated, to study the relationship between RMR and body composition. Significant difference levels were set at p<0.05. The present cross–sectional results revealed significant differences in BC and RMR in black and Caucasian adolescents of the Tlokwe municipality, with Caucasian adolescents of both genders having a higher RMR and FFM compared to their counterpart black adolescents. The results further indicated that Caucasian adolescents were significantly (p<0.05) taller, heavier and had a higher %BF, WHTR, FFM and RMR than the black adolescents of both genders. Boys of both ethnicities had a higher RMR than the girls, with black girls having the lowest RMR. Both underweight and overweight/obesity were present in both ethnic groups and genders emphasizing the double burden of disease prevalent in South Africa. The overweight/obese group of both ethnicities had a higher FFM and RMR than the normal and underweight group. After adjusting for gender and ethnicity a high non–significant negative relationship was observed between RMR and FFM in the overweight group. The reasons for these persistent differences in ethnic groups for RMR in adolescents are not clear. A positive association between anthropometric indicators of BC and RMR influenced by gender and ethnicity was indicated. Whether the observed ethnic differences in RMR predict future weight gain and obesity awaits the results of longitudinal analyses. It is suggested that intervention programmes be implemented focusing on the prevention of obesity in adolescents, but especially black adolescent girls, as they are indicated to be the group more prone to obesity. These results supported the literature findings and identified the need for longitudinal data regarding RMR and BC in adolescents. The PAHL–Study will continue to follow–up these adolescents over a period of time as some of the conclusions made will further be cleared, including whether the observed ethnic differences in RMR predict future weight gain and obesity. / Thesis (M.Sc. (Biokinetics))--North-West University, Potchefstroom Campus, 2012.

Background: In South Africa, as in many other developing countries, iron deficiency (the most common micronutrient deficiency) still remains unresolved; while obesity has emerged as a public health challenge causing increases in the incidence and prevalence of cardiovascular diseases (CVDs). Research has shown that certain iron indices are associated with both anthropometric and biological markers of CVDs. Adiposity is thought to modulate the pathway linking iron status to CVDs. Objective: To examine the associations between iron indices, anthropometric and biological markers of CVDs in an African population undergoing transition. Methods: This thesis was based on secondary analysis of data generated during the Transition and Health during Urbanisation of South Africans (THUSA) study; and primary and secondary analysis of the baseline Prospective Urban and Rural Epidemiological (PURE) study. Both studies were cross–sectional in design and were conducted between 1996–1998 and in 2005 respectively in the North West Province of South Africa. The 1854 men and women participants in the THUSA study (>15years) and 1262 women participants in the PURE study (>35years) were included in the analysis. The relationship between iron and anthropometric indicators of CVD risk was examined in the THUSA study while that of iron status, anthropometric and biological markers of CVD risk was examined in the PURE study. Results: In the THUSA study, ferritin was positively associated with body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), body fat and subscapular skinfold (r=0.141, 0.359, 0.396, 0.308, 0.141 respectively for men and 0.126, 0.232, 0.319, 0.126, 0.105 respectively for women; p<0.01). Only the women showed decreased serum iron concentration with increasing BMI (p<0.05). WC and WHR increased with increasing serum ferritin concentration for both genders (p<0.05). As for the PURE study, associations between iron status parameters and CVD risk factors were generally weak (r<0.3, p<0.01) and were not retained after adjusting for valid confounders. WC and WHR increased with increasing ferritin concentration (p<0.05). Conclusion: Although these results do not indicate any significant association between iron indices and biological markers of CVD, its association with anthropometric indices gives an indication of the possible contribution of iron in the aetiology of CVDs. Thus, it may be necessary to exercise caution on the emphasis placed on iron as a nutrient and iron intervention programmes because of the suggestive role of iron in CVD development. / Thesis (Ph.D. (Nutrition))--North-West University, Potchefstroom Campus, 2011.