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Runners from East Africa including Kenya, Ethiopia and Uganda have dominated middle- and long-distance running events, for almost six decades. This narrative review examines and updates current understanding of the factors explaining the dominance of East Africans in distance running from a holistic perspective. The dominance of East African distance runners has puzzled researchers, with various factors proposed to explain their unparalleled success. Four key elements emerge: 1) biomechanical and physiological attributes, 2) training characteristics, 3) psychological motivations, and 4) African diet. Runners from East Africa often exhibit ectomorphic somatotypes, characterized by lean body compositions which lead them to an extraordinary biomechanical and metabolic efficiency. Their sociocultural lifestyle, training regimens beginning at a young age with aerobic activities, seem crucial, as well as moderate volume, high-intensity workouts at altitudes ranging from 2,000 to 3,000 m. Psychological factors, including a strong motivation to succeed driven by aspirations for socioeconomic improvement and a rich tradition of running excellence, also contribute significantly. A multifactorial explanation considering these factors, without a clear genetic influence, is nowadays the strongest argument to explain the East African phenomenon. To unravel the mystery behind the supremacy of East African runners, it is imperative to consider these multifaceted factors. The predominantly rural lifestyle of the East African population underscores the importance of aligning modern lifestyles with the evolutionary past of Homo sapiens, where physical activity was integral to daily life. Further research is required to explain this phenomenon, with a focus on genetics. [ABSTRACT FROM AUTHOR]

PurposeThe development of valid measures of built environments relevant for physical activity is an important step toward controlling the global epidemic of physical inactivity-related noncommunicable diseases and deaths. This study assessed the construct validity of a self-report neighborhood environment walkability scale adapted for Africa (NEWS-Africa), by examining relationships with self-reported walking for transportation and recreation using pooled data from six sub-Saharan African countries.MethodsNEWS was systematically adapted to assess urban, periurban, and rural environments in sub-Saharan Africa. Adults (n = 469, 18-85 yr, 49.7% women) from Cameroon, Ghana, Mozambique, Nigeria, South Africa, and Uganda were purposively recruited from neighborhoods varying in walkability and socioeconomic status, with some from villages. Participants completed the 76-item (13 subscales) NEWS-Africa by structured interview and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire.ResultsThe overall "walkability" index had a positive relationship with both walking for transportation (η = 0.020, P = 0.005) and recreation (η = 0.013, P = 0.028) in the pooled analyses. The mixed-use access and stranger danger scales were positively related with transport walking (η = 0.020, P = 0.006 and η = 0.021, P = 0.040, respectively). Proximity of recreational facilities (η = 0.016, P = 0.015), road/path connectivity (η = 0.025, P = 0.002), path infrastructure (η = 0.021, P = 0.005), and overall places for walking and cycling (η = 0.012, P = 0.029) scales were positively related to recreational walking. Country-specific results were mostly nonsignificant except for South Africa and Uganda.ConclusionsOf 14 NEWS-Africa scales, 7 were significantly related to walking behavior in pooled analyses, providing partial support for the construct validity of NEWS-Africa. However, effect sizes appeared to be lower than those from other continents. Further study with larger and more diverse samples is needed to determine whether the instrument performs well in each country.

BackgroundBuilt environment and policy interventions are effective strategies for controlling the growing worldwide deaths from physical inactivity-related non-communicable diseases. To improve built environment research and develop African specific evidence, it is important to first tailor built environment measures to African contexts and assess their psychometric properties across African countries. This study reports on the adaptation and test-retest reliability of the Neighborhood Environment Walkability Scale in seven sub-Saharan African countries (NEWS-Africa).MethodsThe original NEWS comprising 8 subscales measuring reported physical and social attributes of neighborhood environments was systematically adapted for Africa through extensive input from physical activity and public health researchers, built environment professionals, and residents in seven African countries: Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa and Uganda. Cognitive testing of NEWS-Africa was conducted among diverse residents (N = 109, 50 youth [12 - 17 years] and 59 adults [22 - 67 years], 69 % from low socioeconomic status [SES] neighborhoods). NEWS-Africa was translated into local languages and evaluated for 2-week test-retest reliability in adult participants (N = 301; female = 50.2 %; age = 32.3 ± 12.9 years) purposively recruited from neighborhoods varying in walkability (high and low walkable) and SES (high and low income) and from villages in six of seven participating countries.ResultsThe original 67 NEWS items was expanded to 89 scores (76 individual NEWS items and 13 computed scales). Several modifications were made to individual items, and some new items were added to capture important attributes in the African environment. A new scale on personal safety was created, and the aesthetics scale was enlarged to reflect African specific characteristics. Over 95 % of all NEWS-Africa scores (items plus computed scales) demonstrated evidence of "excellent" (ICCs > .75 %) or "good" (ICCs = 0.60 to 0.74) reliability. Seven (53.8 %) of the 13 computed NEWS scales demonstrated "excellent" agreement and the other six had "good" agreement. No items or scales demonstrated "poor" reliability (ICCs

Background: To determine if children's moderate to vigorous physical activity (MVPA) and sedentary time varied across levels of household income in countries at different levels of Human Development Index (HDI), consistent with the theory of epidemiological transition. Methods: Data from 6548 children (55% girls) aged 9--11 years from 12 countries at different HDI levels are used in this analysis to assess MVPA and sedentary time (measured using ActiGraph accelerometers) across levels of household income. Least-square means are estimated separately for boys and girls at the estimated 10th, 50th, and 90th percentiles of HDI for the sample. Results: For boys, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (both P < .002). For girls, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (all P < .01) and positively related with income at the 90th percentile (P = .04). Sedentary time is positively associated with income at the 10th percentile of HDI for boys (P = .03), but not for girls. Conclusions: Results support the possibility of an epidemiological transition in physical activity, with lower levels of MVPA observed at opposite levels of income depending on the HDI percentile. This phenomenon was not observed for sedentary time. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the relationship between outdoor time and physical activity (PA), sedentary time (SED), and body mass index z scores among children from 12 lower-middle-income, upper-middle-income, and high-income countries. Methods: In total, 6478 children (54.4% girls) aged 9–11 years participated. Outdoor time was self-reported, PA and SED were assessed with ActiGraph GT3X+ accelerometers, and height and weight were measured. Data on parental education, neighborhood collective efficacy, and accessibility to neighborhood recreation facilities were collected from parent questionnaires. Country latitude and climate statistics were collected through national weather data sources. Gender-stratified multilevel models with parental education, climate, and neighborhood variables as covariates were used to examine the relationship between outdoor time, accelerometry measures, and body mass index z scores. Results: Each additional hour per day spent outdoors was associated with higher moderate- to vigorous-intensity PA (boys: +2.8 min/d; girls: +1.4 min/d), higher light-intensity PA (boys: +2.0 min/d; girls: +2.3 min/d), and lower SED (boys: −6.3 min/d; girls: −5.1 min/d). Effect sizes were generally weaker in lower-middle-income countries. Outdoor time was not associated with body mass index z scores. Conclusions: Outdoor time was associated with higher PA and lower SED independent of climate, parental education, and neighborhood variables, but effect sizes were small. However, more research is needed in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

The Active Healthy Kids Global Alliance organized the concurrent preparation of Report Cards on the physical activity of children and youth in 38 countries from 6 continents (representing 60% of the world's population). Nine common indicators were used (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and the Built Environment, and Government Strategies and Investments), and all Report Cards were generated through a harmonized development process and a standardized grading framework (from A = excellent, to F = failing). The 38 Report Cards were presented at the International Congress on Physical Activity and Public Health in Bangkok, Thailand on November 16, 2016. The consolidated findings are summarized in the form of a Global Matrix demonstrating substantial variation in grades both within and across countries. Countries that lead in certain indicators often lag in others. Average grades for both Overall Physical Activity and Sedentary Behavior around the world are D (low/poor). In contrast, the average grade for indicators related to supports for physical activity was C. Lower-income countries generally had better grades on Overall Physical Activity, Active Transportation, and Sedentary Behaviors compared with higher-income countries, yet worse grades for supports from Family and Peers, Community and the Built Environment, and Government Strategies and Investments. Average grades for all indicators combined were highest (best) in Denmark, Slovenia, and the Netherlands. Many surveillance and research gaps were apparent, especially for the Active Play and Family and Peers indicators. International cooperation and cross-fertilization is encouraged to address existing challenges, understand underlying determinants, conceive innovative solutions, and mitigate the global childhood inactivity crisis. The paradox of higher physical activity and lower sedentary behavior in countries reporting poorer infrastructure, and lower physical activity and higher sedentary behavior in countries reporting better infrastructure, suggests that autonomy to play, travel, or chore requirements and/or fewer attractive sedentary pursuits, rather than infrastructure and structured activities, may facilitate higher levels of physical activity. [ABSTRACT FROM AUTHOR]

Background: Kenya's 2016 report card aimed to highlight the health and well-being of Kenyan children and youth using the best available evidence on the physical activity of Kenyan children and youth. The report pointed at areas where Kenya was succeeding and areas where more action is required. Methods: Inclusive analyses of available data sources on the core indicators related to physical activity and body weights of Kenyan children and youth (5 to 17 years) were conducted. These were assigned grades based on a set of specific criteria. Results: Results show that Active Play, Active Transportation, Overweight and Obesity, and Sedentary Behavior were favorable with a grade of B. Overall Physical Activity, Organized Sport Participation, and School (infrastructure, policies, and programs) each received a grade of C, while Family and Peers, Government and Nongovernment organizations, as well as the Community and the Built Environment were assigned grade D. Conclusions: Over 72% of Kenyan children and youth use active transportation to and from school and in their daily lives. Although majority of the children and youth have normal body weight, there is need to ensure that they meet and maintain the physical activity levels recommended by the World Health Organization. More needs to be done especially in relation to the governmental and nongovernmental organizations, organized sports participation, as well as involvement of family and peers in promoting healthy active lifestyles among Kenyan children and youth. More representative data for all indicators are required in Kenya. [ABSTRACT FROM AUTHOR]

Sub-Saharan African countries are undergoing rapid urbanization resulting in vast changes in dietary habits. Dietary practices involving excess energy intake have been associated with overweight/obesity. We assessed the dietary behaviour of children and their relationships with weight status. Data was collected in Kenya, as part of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). The study recruited 563 children aged 9–11 years from 29 schools in Nairobi. A seven-day food frequency questionnaire was used to assess dietary intake. Dietary behaviours such as consumption of breakfast, school lunch, meals prepared/eaten away from home, emotional eating and snacking while watching television were also assessed. Body mass index (BMI-for-age and sex) was used as the indicator of weight status. Of the sample, 53.5% were girls; 20.8% were classified as overweight/obese; 72.9% ate meals out of home regularly; 55.2% ate lunch provided by the school; and only 76% had breakfast on all weekdays. Eating more when happy, eating fried foods while watching television, and consumption of vegetables were positively associated with BMI. Majority of overweight children were female (56.6%) and the type of school attended predicted BMI, F(6, 536) = 18.371, p < 0.0001, R2 = 0.171. BMI was negatively associated with consumption of cakes/pastries (χ2 = 14.7, V = 0.165, p = 0.023), potato crisps (χ2 = 21.6, V = 0.197, p = 0.003), and fast foods (χ2 = 13.5, p = 0.036). ANOVA results revealed no significant differences in the consumption of foods with BMI except for vegetables (p = 0.003). Children have healthy diets rich in fruits and vegetables and low in energy-dense foods. Also, less healthy diets were observed in children with lower BMI. There is need for interventions targeting the overweight/obese children, particularly those of higher SES. [ABSTRACT FROM AUTHOR]

Background: A physical activity transition to declining activity levels, even among children, now poses a serious public health concern because of its contribution to a rising prevalence of noncommunicable diseases. Childhood physical activity levels are associated with parental perceptions of the neighborhood; however, these relationships have not been explored in sub-Saharan Africa (SSA). The objective was to investigate relationships between parental perceptions of the neighborhood and physical activity indicators among Kenyan children. Methods: Data were collected from children 9 to 11 years old in Nairobi as part of the International Study of Childhood Obesity, Lifestyle and Environment. Child physical activity was assessed by accelerometry, and information on obtaining sufficient physical activity, active transport, and parental perceptions of the neighborhood collected using questionnaires. Results: Of 563 participating children, 45.7%, 12.6%, and 11.4% used active school transportation, met physical activity guidelines, and were sufficiently active, respectively. Parental perception of positive neighborhood social cohesion, positive environs and connectivity, and negative child safety concerns, were associated with child physical activity outcomes. Conclusions: Aspects of parental perceptions of the neighborhood were associated with child physical activity outcomes and should be further explored to appropriately inform policy and practice in curbing declining physical activity levels among children in SSA. [ABSTRACT FROM AUTHOR]