Screen-based sedentary behaviour and adiposity among school children: Results from International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) - Kenya.

BACKGROUND: High levels of sedentary behaviours have been independently associated with several negative health indicators, including obesity. Screen time (ST) is often used as a contributing measure of sedentary time. It is recommended that children spend no more than 2 hours on recreational sedentary screen-based activities daily. We describe screen-based sedentary time of urban school children and examine the associations between body mass index (BMI) and percent Body Fat (%BF) with ST levels. METHODS: Data were collected from 563 children aged 9 to 11 years attending 29 non-boarding primary schools in Nairobi, Kenya, as part of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Data were analysed to test for associations between ST and sex, type of school attended (public verses private), Socioeconomic status, adiposity, and access to electronic devices. We also assessed participants' ST on school and weekend days. RESULTS: Of the participants recruited, 15.5% had high ST levels, 67.9% spent no more than 2 hours in recreational screen activities on school days while 74.2% did not meet the guidelines on weekend days. Participants sex was associated with daily ST (t = 3.5, p<0.001), ST on the weekend (t = 3.9, p <0.001) and total ST per week (t = 3.5, p<0.001) with males having higher ST than females. ST was associated with type of school for daily ST (t = 3.6, p <0.001), ST on the weekend (t = 4.5, p<0.001) and total ST per week (t = 3.6, p<0.001) where private schools pupils had higher ST. ST was not associated with BMI. ST was not associated with %BF except on weekend days (p = 0.038) where those classified as overfat/obese (fat) had higher ST. CONCLUSIONS: A large proportion of children spend more time than recommended on screen activities particularly on weekend days. Strategies to improve healthy living should focus on the reduction of sedentary ST for school-aged children.

The relationship between agricultural biodiversity, dietary diversity, household food security, and stunting of children in rural Kenya.

The study was to determine the role of Dietary diversity (DD), household food security (HFS), and agricultural biodiversity (AB) on stunted growth in children. Two cross-sectional studies were undertaken 6 months apart. Interviews were done with mothers/caregivers and anthropometric measurements of children 24-59 months old. HFS was assessed by household food insecurity access scale (HFIAS). A repeated 24-h recall was used to calculate a dietary diversity score (DDS). Agricultural biodiversity (AB) was calculated by counting the number of edible plants and animals. The study was undertaken in resource-poor households in two rural areas in Kenya. Mothers/Care givers and household with children of 24-59 months of age were the main subjects. The prevalence of underweight [WAZ <-2SD] ranged between 16.7% and 21.6% and stunting [HAZ <-2SD] from 26.3% to 34.7%. Mean DDS ranged from 2.9 to 3.7 and HFIAS ranged from 9.3 to 16.2. AB was between 6.6 and 7.2 items. Households with and without children with stunted growth were significantly different in DDS (P = 0.047) after the rainy season and HFIAS (P = 0.009) in the dry season, but not with AB score (P = 0.486). The mean AB for households with children with stunted growth were lower at 6.8, compared to 7.0 for those with normal growth, however, the difference was insignificant. Data indicate that households with children with stunted growth and those without are significantly different in DDS and HFIAS but not with AB. This suggests some potential in using DDS and HFIAS as proxy measures for stunting.

Impact of counselling on exclusive breast-feeding practices in a poor urban setting in Kenya: a randomized controlled trial.

OBJECTIVE: To determine the impact of facility-based semi-intensive and home-based intensive counselling in improving exclusive breast-feeding (EBF) in a low-resource urban setting in Kenya. DESIGN: A cluster randomized controlled trial in which nine villages were assigned on a 1:1:1 ratio, by computer, to two intervention groups and a control group. The home-based intensive counselling group (HBICG) received seven counselling sessions at home by trained peers, one prenatally and six postnatally. The facility-based semi-intensive counselling group (FBSICG) received only one counselling session prenatally. The control group (CG) received no counselling from the research team. Information on infant feeding practices was collected monthly for 6 months after delivery. The data-gathering team was blinded to the intervention allocation. The outcome was EBF prevalence at 6 months. SETTING: Kibera slum, Nairobi. SUBJECTS: A total of 360 HIV-negative women, 34-36 weeks pregnant, were selected from an antenatal clinic in Kibera; 120 per study group. RESULTS: Of the 360 women enrolled, 265 completed the study and were included in the analysis (CG n 89; FBSICG n 87; HBICG n 89). Analysis was by intention to treat. The prevalence of EBF at 6 months was 23.6% in HBICG, 9.2% in FBSICG and 5.6% in CG. HBICG mothers had four times increased likelihood to practise EBF compared with those in the CG (adjusted relative risk = 4.01; 95% CI 2.30, 7.01; P=0.001). There was no significant difference between EBF rates in FBSICG and CG. CONCLUSIONS: EBF can be promoted in low socio-economic conditions using home-based intensive counselling. One session of facility-based counselling is not sufficient to sustain EBF.