Browsing by Author "Mukoma, Gudani Goodman"

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    Accelerometer use to assess physical activity in pregnancy - A validation study
    (2019) Mukoma, Gudani Goodman
    Background Little is known about physical activity (PA) patterns in pregnancy. Previous epidemiological research suggests that most women do not participate in regular PA during pregnancy. However, these estimates are often based on the use of crude measures that are not validated and may be prone to error. Furthermore, given the limited research using objective, comprehensive and validated methods, there is currently no commonly accepted measurement tool used to assess PA during pregnancy. Aim The aim of this study was to assess the validity of accelerometer devices in measuring physical activity energy expenditure (PAEE) during pregnancy. Methods Pregnant women (n = 22) in their first trimester (<14 weeks, longitudinal) between the ages of 18- 40, were invited to participate. In addition, women in their 2nd and 3rd trimesters were invited for a once off testing (cross-sectional). All participants completed a 60-minutes submaximal walking protocol with different intensities, each having a 5-min duration. Participants wore one ActiGraph, Axivity and GENEActiv on the left wrist, and one ActiGraph on the waist. Energy expenditure was measured using the Oxycon. Physical activity for pregnant and nonpregnant women, at each stage of the walking protocol, was compared using the Wilcoxon ranksum test. The relationships between accelerometers, placement positions, and criterion validity were assessed using Pairwise correlation. Results Significant differences in energy expenditure estimates were observed when using the hip-worn ActiGraph (p=0.03) and GENEActiv (p=0.05) accelerometers between the pregnant and nonpregnant participants. In the pregnant participants, moderate significant correlations were found between the Axivity and GENEActiv accelerometers (r =0.43) at 15 minutes rest, and the ActiGraph-wrist and GENEActiv accelerometers (r =0.39) at 5km/h. When comparing placement position for the pregnant sample, significant relationships were observed between the ActiGraph worn on the hip versus the waist, but only during rest (r =0.56), 3km/hr (r =0.41) and 5km/hr (r =0.76). None of the accelerometers showed consistent correlation with the Oxycon for measuring energy expenditure during this protocol. Conclusion Although there were some relationships found between the pregnant and non-pregnant participants when measuring PA using ActiGraph-hip and GENEActiv accelerometers during the walking test protocol, and when comparing placement position of the hip versus the waist using ActiGraph accelerometers, in general, these accelerometers did not provide consistent correlations between each other or the Oxycon for both the pregnant and non-pregnant participants. As a result a clear pattern for measuring EE during PA was not observed, and further research is needed to confirm this data and provide an accurate tool for measuring PA during pregnancy
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    From the onset: Impact of Nutrition and Lifestyle during the Preconception period in Urban South African Young Adults
    (University of the Witwatersrand, Johannesburg, 2023-03) Mukoma, Gudani Goodman; Norris, Shane A.
    Background: In South Africa, 22% of adolescents are overweight or obese, the onset of tobacco smoking is shown to peak between the ages of 15 and 22, 1 in 3 adolescents watch more than 3 hours of television per day, and nearly half of all adults are insufficiently active. Physical inactivity, poor diet, risky alcohol use, illicit drug use are among the behavioural risk factors associated with obesity and mental health problems, all of which have morbidity and mortality implications for adult health. Risks in later life include premature death, long-term disability, childbirth complications, gestational diabetes, diabetes and cardiovascular diseases. However, there is data paucity showing the personal, social, and environmental factors that are determinants of health, especially diet, physical activity (PA), obesity, and associated NCDs in South African adolescents and young adults. Aim: To investigate the individual, household, and environmental factors that influence adolescents' dietary and physical activity habits and to identify ways in which these factors can be leveraged for interventions to better ensure the health of future generations, especially during the crucial preconception years. Methods: This thesis was purposely designed to use a sequential mixed-methods approach that integrates quantitative (Chapter 3 paper 1: cross-sectional and Chapter 6 paper 4: longitudinal) and qualitative (Chapter 4 paper 2: longitudinal and Chapter 5 paper 3: cross-sectional) analyses in order to meet the four specific objectives of my research. The methods selected for this series of investigations were primarily influenced by the substantive research questions that arose, as opposed to methodological and epistemological concerns alone. I utilized three pre-existing data sources, including the "Birth-to-Twenty Cohort," the "Determinants of Type 2 Diabetes Mellitus (T2D)" study, and the "Soweto household enumeration survey." I have gathered new prospective data that is quantitatively and qualitatively longitudinal and cross-sectional. Results: The findings of this thesis in the context of Soweto show that the relationship between dietary patterns and nutritional status (BMI) is independent of socioeconomic status (SES). Adolescents and young adults face a variety of intersecting barriers resulting from personal preferences and their living conditions, which influence their dietary and physical activity habits while occurring at the time; this is important to consider when designing interventions to promote healthy behaviour change. Unexpected stressors, such as the outbreak of the COVID-19 pandemic, contributed to exacerbating adolescents' and young adults' poor health conditions, and as a result, the prevalence of poor nutrition intake, a lack of physical activity, and mental health issues increased. Although the nutrient patterns of adolescents and adults were comparable over time, their associations with BMI were not. The associations with BMI of the "plant-driven nutrient pattern," "fat-driven nutrient pattern," and "animal-driven nutrient pattern" revealed sex differences. Conclusion: Adolescent diet and lifestyle continue to be important research areas in the intent to enhance preconception health and reducing maternal and infant mortality.