Quality of life, physical activity and cardiorespiratory fitness in black African women: B-Healthy project
- 29 Downloads
To study the associations between physical activity (PA), cardiorespiratory fitness (CRF), and health-related quality of life (HRQoL) in black African women from a low socioeconomic community in South Africa.
Black African women (n = 146) aged 35–75 years from a low socioeconomic community in South Africa participated in this study. We measured PA levels via ActiHeart® accelerometers, and CRF by measuring peak oxygen consumption (V̇O2 peak). HRQoL was assessed once with the SF-8 Health Survey (SF-8). Participants were classified into groups based on age, moderate to vigorous PA (MVPA), and V̇O2 peak. Logistic regressions were used to compare the odds of having total HRQoL component scores above reported norms across PA and fitness groups. Two multiple linear regression models were developed using physical component summary (PCS) and mental component summary (MCS) as response variables respectively.
V̇O2 peak and MVPA varied considerably across the sample and declined with increasing age. Participants in higher quartiles of MVPA and CRF showed trends to higher PCS scores. For CRF these trends were statistically significant, and persisted after adjustment for age and other possible confounders (p = 0.036). PCS was significantly associated with age, relative V̇O2 peak, and income (all p < 0.05), while MCS was associated with income (p = 0.028).
CRF is the most significant predictor, together with age and income, on the PCS of the HRQoL among black African women. We recommend that when seeking improvements in HRQoL, interventions should focus on improving CRF, particularly V̇O2 peak.
KeywordsQuality of life Physical activity Cardiorespiratory fitness Female
We are grateful to the participants for their willingness to take part in this research. Also, we thank the staff of the Primary Health Care Clinics from Ikageng and for their help and support. The study was funded by PhASRec (Potchefstroom Campus) and the North-West University (South Africa).
Dr. Nauris Tamulevicious was funded by the Fulbright Core Scholar Award from the United States Department of State Bureau of Educational and Cultural Affairs.
Compliance with ethical standards
Conflict of interest
No competing financial interests exist.
- 1.World Health Organization. (2014). Global status report on noncommunicable diseases 2014. Geneva: World Health Organization. Retrieved from http://www.who.int/nmh/publications/ncd-status-report-2014/en/. Accessed 15 Dec 2018
- 2.Clennin, M. N., Payne, J. P. W., Rienzi, E. G., Lavie, C. J., Blair, S. N., Pate, R. R., et al. (2015). Association between cardiorespiratory fitness and health-related quality of life among patients at risk for cardiovascular disease in Uruguay. PLoS ONE,10(4), e0123989. https://doi.org/10.1371/journal.pone.0123989.CrossRefPubMedPubMedCentralGoogle Scholar
- 3.Forouzanfar, M. H., Afshin, A., Alexander, L. T., Anderson, H. R., Bhutta, Z. A., Biryukov, S.,…, Murray, C. J. L. (2016). Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: A systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388, 1659–1724. https://doi.org/10.1016/s0140-6736(16)31679-8 CrossRefGoogle Scholar
- 4.World Health Organization. (2010). Global recommendations on physical activity for health. Geneva: WHO Library Cataloguing-in-Publication Data. Geneva, Switzerland. Retrieved from http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Recomendaciones+Mundiales+Sobre+Actividad+Física+Para+La+Salud#2. Accessed 10 Nov 2018
- 5.Lee, I. M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., Katzmarzyk, P. T.,…, Wells, J. C. (2012). Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. The Lancet, 380(9838), 219–229. https://doi.org/10.1016/s0140-6736(12)61031-9 CrossRefGoogle Scholar
- 6.Pisa, P. T., Behanan, R., Vorster, H. H., & Kruger, A. (2012). Social drift of cardiovascular disease risk factors in Africans from the North West Province of South Africa: The PURE study. Cardiovascular journal of Africa,23(7), 371–378. https://doi.org/10.5830/CVJA-2012-018.CrossRefPubMedPubMedCentralGoogle Scholar
- 7.Vorster, H. H., Venter, C. S., Kruger, H. S., Kruger, A., Malan, N. T., Wissing, M. P.,…, MacIntyre, U. (2000). The impact of urbanization on physical, physiological and mental health of Africans in the North West Province of South Africa: The THUSA study. South African Journal of Science, 96(9), 505–514Google Scholar
- 9.Joubert, J., Norman, R., Bradshaw, D., Goedecke, J. H., Steyn, N. P., & Puoane, T. (2007). Estimating the burden of disease attributable to excess body weight in South Africa in 2000. South African Medical Journal,97(8), 683–690. https://doi.org/10.1016/0277-9536(95)00436-X.CrossRefPubMedGoogle Scholar
- 10.Ross, R., Blair, S. N., Arena, R., Church, T. S., Després, J.-P., Franklin, B. A.,…, Wisløff, U. (2016). Importance of assessing cardiorespiratory fitness in clinical practice: A case for fitness as a clinical vital sign: A scientific statement from the American Heart Association. Circulation, 134(24), e653–699. https://doi.org/10.1161/cir.0000000000000461
- 11.Häkkinen, A., Rinne, M., Vasankari, T., Santtila, M., Häkkinen, K., & Kyröläinen, H. (2010). Association of physical fitness with health-related quality of life in Finnish young men. Health and Quality of Life Outcomes,8(8), 15. https://doi.org/10.1186/1477-7525-8-15.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Irwin, D. E., Atwood, C. A., Hays, R. D., Spritzer, K., Liu, H., Donohue, J. F.,…, DeWalt, D. A. (2015). Correlation of PROMIS scales and clinical measures among chronic obstructive pulmonary disease patients with and without exacerbations. Quality of Life Research, 24(4), 999–1009. https://doi.org/10.1007/s11136-014-0818-1 CrossRefGoogle Scholar
- 16.World Health Organization. (2007). Prevention of cardiovascular disease: Guidelines for assessment and management of cardiovascular risk. Geneva: World Health Organization.Google Scholar
- 18.World Health Organization. (2000). Obesity: Preventing and managing the global epidemic. World Health Organization. Geneva: World Health Organization.Google Scholar
- 19.Marfell-Jones, M. J., Stewart, A. D., & de Ridder, J. H. (2012). International standards for anthropometric assessment. Wellington: International Society for the Advancement of Kinanthropometry.Google Scholar
- 21.Matthews, C. E., Hagströmer, M., Pober, D. M., & Bowles, H. R. (2012). Best practices for using physical activity monitors in population-based research. Medicine and Science in Sports and Exercise,44(1 Suppl 1), S68–S76. https://doi.org/10.1249/MSS.0b013e3182399e5b.CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Tudor-Locke, C., Camhi, S. M., & Troiano, R. P. (2012). A catalog of rules, variables, and definitions applied to accelerometer data in the National Health and Nutrition Examination Survey, 2003–2006. Preventing Chronic Disease,9, E113. https://doi.org/10.5888/pcd9.110332.CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Ware, J. E., Kosinski, M., Dewey, J. E., & Gandek, B. (2001). How to score and interpret single-item health status measures: A manual for users of the sf-8 health survey. Lincoln RI: QualityMetric Incorporated.Google Scholar
- 27.National Department of Health, Statistics South Africa, South African Medical Research Council, & ICF. (2017). South Africa demographic and health survey 2016: key indicators. Pretoria.Google Scholar
- 28.Gradidge, P. J. L., Crowther, N. J., Chirwa, E. D., Norris, S. A., & Micklesfield, L. K. (2014). Patterns, levels and correlates of self-reported physical activity in urban black Soweto women. BMC Public Health,14(1), 934. https://doi.org/10.1186/1471-2458-14-934.CrossRefPubMedPubMedCentralGoogle Scholar
- 29.Guthold, R., Louazani, S. A., Riley, L. M., Cowan, M. J., Bovet, P., Damasceno, A.,…, Armstrong, T. P. (2011). Physical activity in 22 African countries: Results from the world health organization STEPwise approach to chronic disease risk factor surveillance. American Journal of Preventive Medicine, 41(1), 52–60. https://doi.org/10.1016/j.amepre.2011.03.008 CrossRefGoogle Scholar
- 30.Crombie, I. K., Irvine, L., Williams, B., McGinnis, A. R., Slane, P. W., Alder, E. M., et al. (2004). Why older people do not participate in leisure time physical activity: A survey of activity levels, beliefs and deterrents. Age and Ageing,33(3), 287–292. https://doi.org/10.1093/ageing/afh089.CrossRefPubMedGoogle Scholar
- 31.Werneck, A. O., Oyeyemi, A. L., Gerage, A. M., Cyrino, E. S., Szwarcwald, C. L., Sardinha, L. B., et al. (2018). Does leisure-time physical activity attenuate or eliminate the positive association between obesity and high blood pressure? The Journal of Clinical Hypertension,20(5), 959–966. https://doi.org/10.1111/jch.13292.CrossRefPubMedGoogle Scholar
- 35.Shisana, O., Labadarios, D., Rehle, T., Simbayi, L., Zuma, K., Dhansay, A.,…, SANHANES-1 Team. (2013). South African national health and nutrition examination survey (SANHANES-1). Cape Town: HSRC Press.Google Scholar
- 36.Engberg, E., Tikkanen, H. O., Koponen, A., Hägglund, H., Kukkonen-Harjula, K., Tiitinen, A.,…, Pöyhönen-Alho, M. (2018). Cardiorespiratory fitness and health-related quality of life in women at risk for gestational diabetes. Scandinavian Journal of Medicine & Science in Sports, 28(1), 203–211. https://doi.org/10.1111/sms.12896 CrossRefGoogle Scholar
- 39.van Klaveren, M., Tijdens, K., Hughie-Williams, M., & Ramos-Martin, N. (2009). An overview of women’s work and employment in South Africa. Amsterdam.Google Scholar
- 41.World Health Organization. (2019). Global tuberculosis report 2019. Geneva. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/329368/9789241565714-eng.pdf?ua=1. Accessed 1 Nov 2019
- 43.Kaplan, G. A., Goldberg, D. E., Everson, S. A., Cohen, R. D., Salonen, R., Tuomilehto, J., et al. (1996). Perceived health status and morbidity and mortality: Evidence from the Kuopio ischaemic heart disease risk factor study. International Journal of Epidemiology,25(2), 259–265. https://doi.org/10.1093/ije/25.2.259.CrossRefPubMedGoogle Scholar
- 44.Ferraro, K. F., & Kelley-Moore, J. A. (2001). Self-rated health and mortality among black and white adults: Examining the dynamic evaluation thesis. Journals of Gerontology: Series B Psychological Sciences and Social Sciences,56(4), S195–S205. https://doi.org/10.1093/geronb/56.4.S195.CrossRefGoogle Scholar
- 46.Rejeski, W. J., Lang, W., Neiberg, R. H., Van Dorsten, B., Foster, G. D., Maciejewski, M. L.,…, Williamson, D. F. (2006). Correlates of health-related quality of life in overweight and obese adults with type 2 diabetes. Obesity, 14(5), 870–883. https://doi.org/10.1038/oby.2006.101 CrossRefGoogle Scholar
- 50.Wood, L., Shannon, T., Bulsara, M., Pikora, T., McCormack, G., & Giles-Corti, B. (2008). The anatomy of the safe and social suburb: An exploratory study of the built environment, social capital and residents’ perceptions of safety. Health and Place,14(1), 15–31. https://doi.org/10.1016/j.healthplace.2007.04.004.CrossRefPubMedGoogle Scholar
- 51.Lindström, M., Hanson, B. S., & Östergren, P. O. (2001). Socioeconomic differences in leisure-time physical activity: The role of social participation and social capital in shaping health related behaviour. Social Science and Medicine,52(3), 441–451. https://doi.org/10.1016/S0277-9536(00)00153-2.CrossRefPubMedGoogle Scholar
- 53.van den Berg, L., & Grobler, W. C. J. (2014). The influence of access to facilities on the physical activity level of high school pupils in Bophelong, a semi-urban area of South Africa. Mediterranean Journal of Social Sciences,5(23), 905–913. https://doi.org/10.5901/mjss.2014.v5n23p905.CrossRefGoogle Scholar