Clustered cardiovascular disease risk among children aged 8-13 years from lower socioeconomic schools in Gqeberha, South Africa

Danielle Dolley; Cheryl Walter; Rosa du Randt; Uwe Pühse; Jacob Bosma; Ann Aerts; Larissa Adams; Patricia Arnaiz; Jan Degen; Stefanie Gall; Nandi Joubert; Ivan Müller; Madeleine Nienaber; Felicitas Nqweniso; Harald Seelig; Peter Steinmann; Jürg Utzinger; Markus Gerber

doi:10.1136/bmjsem-2022-001336

Clustered cardiovascular disease risk among children aged 8-13 years from lower socioeconomic schools in Gqeberha, South Africa

BMJ Open Sport Exerc Med. 2022 Jun 23;8(2):e001336. doi: 10.1136/bmjsem-2022-001336. eCollection 2022.

Authors

Danielle Dolley¹, Cheryl Walter¹, Rosa du Randt¹, Uwe Pühse², Jacob Bosma³, Ann Aerts⁴, Larissa Adams¹, Patricia Arnaiz², Jan Degen², Stefanie Gall², Nandi Joubert^{5

6}, Ivan Müller², Madeleine Nienaber¹, Felicitas Nqweniso¹, Harald Seelig², Peter Steinmann⁶, Jürg Utzinger⁶, Markus Gerber²

Affiliations

¹ Department of Human Movement Science, Nelson Mandela University, Gqeberha, Eastern Cape, South Africa.
² Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
³ Nelson Mandela University, Gqeberha, South Africa.
⁴ Novartis Foundation, Basel, Switzerland.
⁵ University of Basel, Basel, Switzerland.
⁶ Swiss Tropical and Public Health Institute, Basel, Switzerland.

Abstract

Objectives: To determine the prevalence of individual cardiovascular disease (CVD) risk factors and clustered CVD risk among children attending schools in periurban areas of Gqeberha and to investigate the independent association between clustered CVD risk, moderate to vigorous physical activity (MVPA) and cardiorespiratory fitness (CRF).

Methods: Baseline data were collected in a cross-sectional analysis of 975 children aged 8-13 years. We measured the height, weight, waist circumference, blood pressure, fasting glucose, full lipid panel, 20 m shuttle run performance and accelerometry. The prevalence of individual risk factors was determined, and a clustered risk score (CRS) was constructed using principal component analysis. Children with an elevated CRS of 1 SD above the average CRS were considered 'at-risk'.

Results: We found 424 children (43.3%) having at least one elevated CVD risk factor: 27.7% elevated triglycerides, 20.7% depressed high-density lipoprotein cholesterol and 15.9% elevated total cholesterol. An elevated clustered risk was identified in 17% (n=104) of the sample; girls exhibited a significantly higher CRS >1 SD than boys (p=0.036). The estimated odds of an elevated clustered risk are doubled every 2 mL/kg/min decrease in VO₂max (95% CI 1.66 to 3.12) or every 49 min reduction in MVPA (95% CI 27 to 224).

Conclusion: A relatively high prevalence of elevated individual and clustered CVD risk was identified. Our results have also confirmed the independent inverse association of the clustered CVD risk with physical activity and CRF. These indicate that increased levels of CRF or MVPA may aid in the prevention and reduction of elevated clustered CVD risk.

Keywords: Cardiology prevention; Children; Children's health and exercise; Non-communicable disease.