Relationships between moderate vigorous physical activity, motor- and health-related fitness and motor skills in children.

BACKGROUND:  Childhood is an important transitional period for the development of healthy physical activity (PA) behaviours, so it is important to understand its impact on a healthy lifestyle. AIM:  This study aimed to determine the influences of sex, socioeconomic status (SES) and body composition (BC) on the relationships between PA, motor skills, motor- and health-related physical fitness in 5-8-year-olds. SETTING:  Participants were a subsample consisting of 299 children (150 boys, 149 girls, mean age 6.83 ± 0.96 years) from the Exercise, Arterial Modulation and Nutrition in Youth South Africa study (ExAMIN Youth SA). METHODS:  Anthropometric measures, health-related physical fitness (HRPF), motor-related physical fitness (MRPF), objectively measured PA and demographic information were determined. RESULTS:  Only 66% achieved the recommended 60 min of daily moderate vigorous physical activity (MVPA) with 19% classified as having unhealthy body composition (11% overweight, 8% obese). Fat-free mass and SES revealed small-to-moderate influences on the relationship between MVPA, standing broad jump (SBJ; r = 0.32), predicted VO2max (r = 0.28) and beep levels (r = 0.22). For MRPF, the quality of running (r = 0.12) and balancing were associated with MVPA. Adjusting for sex, BC and SES in the relationship between PA with HRPF and MRPF, reductions in most correlations were observed. CONCLUSION:  Moderate vigorous physical activity levels were positively associated with HRPF, MRPF and some motor skills in 5-8-year-olds. Socioeconomic status (lower parental income, employment and education negatively influenced the association between MVPA and fitness [beeps, SBJ, O2max]).Contribution: This study provides knowledge with regard to the use of accelerometer for baseline data for PA, MRPF, HRPF as well as motor skills in South African children.

Sustainable effects of a motor skill programme on physical activity levels in 7-8 years old children, in the Eastern Cape Province of South Africa.

BACKGROUND: Deteriorating global physical activity (PA) levels among children warrants new and sustainable approaches to increase PA levels. This study aimed to determine the immediate and sustainable influences of a 9-week movement program on the PA levels in 7 to 8-year-old school children in the Raymond Mhlaba Municipality in the Eastern Cape Province of South Africa. METHODS: A randomized control trial including two groups (control group (CG) and intervention group (IG)), pre-post-retest (after six months of no intervention) design was used. Seventy school children, mean age 7.12 years (± 0.71) (n = 35 IG; n = 35 CG) participated in the study. A 9-week movement program was followed twice a week for 30 min during school hours. PA was measured for 7 consecutive days using a hip-mounted wGT3X-BT Actigraph accelerometer. The Test of Gross Motor Development-Third Edition (TGMD-3) was used to assess motor skills. Hierarchical Linear Modelling (HLM) was applied to analyze the data with time, sex, and group as predictors. Effect sizes were computed using Cohen's d-cut points to assess the practical significance of changes over time. Estimated regression coefficients were also computed to determine the strength of the relationship between moderate-to-vigorous physical activity (MVPA) and fundamental movement skills (FMS). RESULTS: Before the intervention, 60% of the IG met the 60 min of daily MVPA guideline, while light physical activity (LPA) per day was also higher than sedentary behavior (SB) in both groups. No immediate (p < 0.01) or sustainable (p < 0.01) increases in MVPA levels were found and no positive associations emerged between FMS and MVPA levels. CONCLUSIONS: This intervention had little to no effect on children's MVPA. More understanding of the activity behavior and interests of children is needed to improve their PA behavior through the content of movement programs. Strategies are also needed to communicate clear messages at a personalized but also parental level, focusing on enhancing health through regular PA, especially to promote PA in young children.

Longitudinal pathways of associations between motor proficiency and physical fitness during earlier and later childhood: The NW-CHILD study.

Understanding the relationships between motor proficiency (MP) and physical fitness (PF) is important for the future health of children, although longitudinal findings of this nature are limited. This study explored the association between MP and PF during earlier childhood (6 and 9 years old) and later childhood (12 years old) in boys and girls. A stratified and randomized research design including a baseline and two follow-up time-point measures (2010, 2013, and 2016) were used. Primary school children (N = 374, boys = 178; girls = 196) were tested with the Bruininks-Oseretsky Test of Motor-Proficiency-2, Short Form, and the Test of Gross Motor Development- 2, at ages 6 and 9 years, and with the Progressive Aerobic Cardiovascular Endurance Run test at age 12. Spearman Rank Order Correlations and stepwise regression analyses were used to analyze the data. Although of a low magnitude, proof of a dynamic longitudinal, but a stable relationship between MP and PF were found and with different gender-specific relationships in this pathway of association. A small but significant percentage of variation in PF at 12 years could be explained by overall motor competence (MC) and object control skills (OCS) at the ages of 6 and 9 years. Among girls, the association with PF at 12 years was influenced by both OCS, and MC, although only MC contributed to the variation found in boys. Socio-economic status made an insignificant contribution at 6 years to later PF in boys, but not in girls. MC, including OCS during early and middle childhood can be considered as possible triggers of physical activity which again, can increase PF during later childhood. Obtaining early competence in these developmental areas is therefore important to promote positive and sustainable trajectories of health with long-term health outcomes.

The Influence of a 9-Week Movement Program on the Body Composition of 7- to 8-Year-Old Schoolchildren in the Eastern Cape of South Africa.

Pediatric obesity has become a growing global epidemic which has negative health consequences, including for South African children. This study aimed to determine the immediate and sustainable influences of a 9-week movement program on the body composition of 7 to 8-year-old school children in a rural area of South Africa. A two group, pre-test, post-test and re-test after six months experimental design was used to compare anthropometric measurements of the intervention group (IG) and control group (CG). Ninety-three schoolchildren (IG = 57; CG = 36) participated in the study. A 9-week movement program was followed twice a week for 30 min during school hours with an emphasis on improving BMI. Hierarchical Linear Modelling (HLM) was used to analyze the data with time, sex and group as predictors. Effect sizes was computed based on the Cohen's d to assess the practical significance of findings. The intervention positively changed the waist circumference. The subscapular skinfold and BMI showed statistical and practically significant sustainable changes because of the intervention, although gender influenced these effects. School based movement interventions, focusing on improving fundamental movement skills (FMS), have the potential to contribute to a healthier BMI, skinfold thickness and circumferences among young children.

Age and Sex Differences in the State and Relationships between Process and Product Assessments of Fundamental-Motor Skills in Five to Eight-Year-Olds: The ExAMIN Youth SA Study.

Adequate development of Fundamental Motor Skills (FMS) at a young age benefit holistic development and positive health outcomes. This study determined age and sex developmental differences in the state and the relationships between process and product assessments of four fundamental-motor skills (FMS) in five to eight-year-olds. An availability sample of 636 children; 291 boys, 345 girls, mean age of 6.8 ± 0.97 years in the North West Province of South Africa participated in the study. Spearman rank order correlations analyzed relationships between assessments, while sex and age differences were examined using independent t-testing and one-way ANOVA. Age showed significant developmental trajectories in all FMS. Older children were found to be more at risk for not learning FMS to mastery, while unique developmental patterns were also established compared to international trends. Strong to moderate significant practical associations (p < 0.05) emerged between process and product assessments in catching (r = 0.79), jumping (r = 0.40) running (r = −0.33) and kicking (r = 0.20), while also confirming that the strength of the associations varies depending upon the skill type. Associations strengthened with increasing age, were higher in girls in all FMS, while associations between behavioral criteria in all FMS also differed between FMS and sexes. These strong associations, need to be taken into consideration during the development of FMS towards obtaining full mastery.

The Value of a Motor Intervention for 3 to 6-Year-Old Children Infected with and Affected by HIV.

Human immunodeficiency virus (HIV)/Aquired Immune Deficiency Syndrome (AIDS) is a large threat to human health and is challenging to address. This study aims to determine if motor intervention is a possibility for promoting the life expectancy and quality of life of children with HIV. The group consisted of 22 participants: 11 HIV-infected (51.73 months, SD 10.15) and 11 HIV-affected children (44.45 months, SD 10.76). A two-group (intervention and control group) pre-test−post-test research design was followed. The HIV-infected and affected children were randomly matched and grouped into an intervention and control group. The intervention group participated in a 12-week motor intervention of 60 min per session, twice per week. The effect of the program was analyzed with regard to motor skills, as established by the PDMS-2 and two strength capabilities. An ANCOVA adjusted for pre-test differences (p < 0.05) indicated statistically significant improvement (p < 0.05) with large practical significance (d > 0.8) in locomotor, fine motor and overall motor skills. The infected children also showed better improvement compared to the affected children. Motor intervention is recommended in the health care path of children affected and infected with HIV, although modifications for improvement of the program are suggested, based on the results attained.

A demographic approach to assess elevated blood pressure and obesity in prepubescent children: the ExAMIN Youth South Africa study.

BACKGROUND: Obesity and hypertension prevalence among children are a concern, with limited evidence available on sex and ethnic differences in childhood blood pressure. We aimed to determine the number of children with hypertension and obesity to identify unique adiposity and blood pressure characteristics by sex and ethnicity, and to estimate the odds of having elevated blood pressure with increasing adiposity. METHODS: We included 1062 healthy children (5-9 years of age) in an observational school-based study in South Africa. Pediatric validated automated devices were used to measure brachial blood pressure and performed pulse wave analysis to assess central hemodynamics. Standard anthropometry was carried out to determine body composition and demographic questionnaires were completed. RESULTS: Almost 20% of children were overweight/obese and 14.1% had elevated blood pressure or hypertension (22.8%). Ethnic differences included greater adiposity in white compared with black children (all P < 0.0001), but higher DBP and total vascular resistance in black compared with white children (both P < 0.05). DBP and total vascular resistance were also higher in girls than boys (both P < 0.01). A 51-60% increased risk of developing elevated blood pressure was observed for 1SD (standard deviation) increase of sex-specific BMI [1.60 (1.4-1.8); P < 0.0001] and waist/height ratio [1.51 (1.3-1.7); P < 0.0001]. CONCLUSION: Unique sex and ethnic differences in body composition and blood pressure exist in prepubescent children, with overweight/obesity increasing the risk of elevated blood pressure. Our findings support primary prevention strategies to combat the growing burden of hypertension and obesity-related diseases in youth. TRIAL REGISTRATION: The study is registered on ClinicalTrials.gov (NCT04056377).

Long-Term Influences of Stunting, Being Underweight, and Thinness on the Academic Performance of Primary School Girls: The NW-CHILD Study.

Poor socio-economic status contributes to undernutrition which, in turn, can increase the risk of academic underachievement. This study wants to determine if stunting, being underweight, and thinness show long term relations with academic performance in primary school girls aged 6 to 13 in the North West province of South Africa. A randomized and stratified longitudinal research design including a baseline and two time-point measurements over seven school years was used. The sample included girls aged 6 to 13 years (N = 198) in the North West province of South Africa. Academic performance in the June school assessments and national and provincial assessments in grades 1, 4, and 7 were used to determine academic performance. Independent t-testing was used to determine differences between thinness, underweight and stunted girls as opposed to a reference group with no undernutrition indices. A repeated measures ANOVA and post hoc Bonferroni adjustment analyzed relations over time. Normal weight girls significantly outperformed stunted girls academically (p < 0.05) over time. Stunting had prolonged and significant negative influences on language, mathematics, and grade point average (p < 0.05). Early identification of undernutrition, especially stunting, is important for intervention and the implementation of timely prevention strategies, especially during early childhood years.

Influences of Differing Menarche Status on Motor Capabilities of Girls, 13 To 16 Years: A Two-Year Follow-Up Study.

Puberty and the onset of menarche influences the motor performance of girls. However, the magnitude of these influences during varying maturity status, is not clear. This longitudinal study over two years aimed to investigate differences in motor fitness between early and late developing girls based on pre- and post-menarche status. A convenience sample (n = 58) of girls aged 13.51 ± 3.51, divided by means of the Status Quo method into pre (n = 13) and post-menarche (n = 45) groups, was used. Motor fitness was tested once annually by standardized protocols. Basic statistics, independent t-testing and a repeated measures ANOVA with a post hoc Bonferonni correction were used (p < 0.05 = statistical significance). Effect sizes were determined by Cohen's d-values. Only explosive upper body strength differed significantly between groups during baseline, favoring post-menarche girls. Initially, post-menarche girls showed advantages in hand-eye coordination and speed (p > 0.05) with pre-menarche girls performing better in agility and explosive leg strength (p > 0.05). At 15.51 years, no significant, between-group differences were found. Pre-menarche girls surpassed post-menarche girls in hand-eye coordination and 0-40 m speed and post-menarche girls displayed higher explosive leg and upper body strength scores (p > 0.05). Our data show that the potential to excel in sport based on motor capabilities can only be accurately estimated 1-2 years after reaching menarche.

Effect of the Growth Spurt on Training of Strength and Power During Mid-Adolescence in Boys.

ABSTRACT: Badenhorst, J, Pienaar, AE, and Gerber, BP. The effect of the growth spurt on training of strength and power during mid-adolescence in boys. J Strength Cond Res 35(8): 2193-2204, 2021-This study determined if the growth spurt will influence the training of strength and power in boys (N = 86) of differing maturity levels. Based on a 2-group, pretest posttest design within a 2 school-year follow-up period, including 4 time point measurements, an experimental group (EG), who participated in different school sports were subjected to an additional 6 months, strength and power training program, twice a week for 45 minutes over 2 consecutive years (n = 47, 13.67 ± 0.26 years). They were compared with boys (n = 39, 13.68 ± 0.16 years) serving as a control group (CG) for normal growth who did not compete in any sports or training programs. Both EG and CG were subdivided into 3 maturity groups, late developers (LD), early developers, and typical developers (TD) based on a linear growth rate. Assessments were performed every 6 months for changes in height, body mass, strength, and power. Differences within and between the EG, CG, and maturity groups were analyzed using repeated measures analysis of variance and hierarchical linear modeling, whereas significance of practical differences were determined by effect sizes (d). Early developers presented with training effects, whereas TD and LD showed conditioning and adaptation responses to training. Customized training to leverage the different maturation levels in a way to optimize strength and power advancement is important for the preparation of boys for sports participation during mid-adolescence because it can positively affect adaptation and responsiveness to training in boys of different maturity levels.

Influences of persistent overweight on perceptual-motor proficiency of primary school children: the North-West CHILD longitudinal study : Persistent overweight and perceptual-motor proficiency in children.

BACKGROUND: Overweight can be a precursor of poor motor execution, negatively impacting the overall development of school-aged children on various levels. This study determined the long-term influences of overweight on perceptual-motor proficiency (PMP) of primary school children in the North-West Province of South Africa. METHODS: The study, which included 381 participants, formed part of the NW-CHILD longitudinal study from Grade 1 (6.86 years, ± 0.39) in 2010 to Grade 7 (12.9 years, ± 0.38) in 2016. Socioeconomic categories, called quintiles, were used to compare high and low socioeconomic status groups. Overweight was identified when BMI values fell above the 85th percentile, using age- and gender-specific cut-off points. The group was categorised into 4 BMI groups (never overweight, persistent overweight, overweight-to-normal and normal-to-overweight). The Bruininks Oseretsky Test of Motor Proficiency-2 (BOT-2) Short Form and selected composites measuring strength, balance, and running speed and agility were used to assess PMP. RESULTS: A repeated measures ANOVA analysis indicated specific PMP differences between different BMI groups, but not total motor proficiency (BOT-2 Short Form total) differences. Practical significant group differences (Cohen's d-values) were found in running speed and agility, strength, balance and the BOT-2 total, over seven primary school years. The persistent overweight group showed the poorest performance over time, but also showed deteriorating skills and a gradual widening in perceptual-motor skills performance, compared to the other groups. BMI-related differences in perceptual-motor coordination were also more pronounced in older age groups. CONCLUSIONS: Persistent overweight negatively impacts specific motor-proficiency components, while improving weight status can counter these effects, which highlights the importance of timeous intervention to combat obesity at a young age.

Competency in Object Control Skills at an Early Age Benefit Future Movement Application: Longitudinal Data from the NW-CHILD Study.

The level of competency in object control skills (OCSs) during early childhood is considered to be a possible determinant of the successful generalization of these skills during later childhood. This study aimed to determine if an association exists between competency in object control skills during early childhood (6-9 years) and the application of these skills during later childhood (12 years). The NW-CHILD longitudinal study (2010-2016), included a baseline and two time-point follow-up measures in grades 1, 4, and 7 of South African children. A total of 374 participants (boys = 178, 47.59% and girls = 196, 52.41%) completed testing at all three time-points and were analyzed. The Test of Gross Motor Development, Second Edition, and the Canadian Agility and Movement Skill Assessment were used to determine associations between object control skill competency during early and later childhood by using descriptive statistics, Spearman rank order correlations, and stepwise regression analysis. The level of object control skill competency at 6 and 9 years, significantly influences the application of these skills at 12 years. A high overall and significant contribution of OCS (4.6%, p < 0.01) to the variance in the skills and time scores at 12 years; p < 0.05 were found. Competence in object control skills at an early age can provide a baseline from where opportunities for progression or transfer of skills can result in more advanced skillful executions which consequently can be considered to be a cornerstone of improved future physical activity and healthier lifestyles.

The mediating effect of physical fitness on long term influences of overweight in primary school girls' academic performance.

BACKGROUND: Overweight and obesity contribute to multiple health risks in children, while also impacting negatively on educational performance. Physical fitness can impact outcomes beyond health related measures therefore it can play a mediating role in combating the negative effects of being overweight. METHODS: One hundred and seventy-two primary school girls aged 6-13 years old from the North West Province of South Africa formed part of this random stratified longitudinal research design in which three follow-up measurements took place over seven years. Body Mass Index was used to compile obesity profiles, while the progressive aerobic cardiovascular endurance run (PACER) was used to determine cardiovascular fitness. Academic school achievements for grades 1, grade 4 and grade 7, as well as national and provincial values were correlated with academic performance. Data were analyzed by a repeated measure over time ANOVA as well using a latent growth curve model from the structural equation modelling framework (SEM). RESULTS: No differences (P>0.05) were found in the academic performance of obese and normal weight girls, although obese girls showed poorer physical fitness values (P<0.05). The SEM model was a good fit for all requirements (RMSEA, 0.60; CMIN DF, 2.837; CFI, 0.966). VO2max had a standardized indirect mediation effect (-132) while body composition showing a standardized direct effect (0.183) with academic achievement. Physical fitness showed a mediation effect with regard to obesity and academic achievement in grade 7 girls. CONCLUSIONS: Although the academic performance of obese girls did not show impairment before the age of 12 years, physical fitness had a reversible effect on relationships between obesity and academic achievement. This substantial influence of physical fitness should be used strategically in preventive intervention programs necessary to enhance cognitive functioning, academic performance and brain health among overweight children.

Comparison of Body Mass Index and fat percentage criteria classification of 7-13 year-old rural boys in South Africa.

BACKGROUND: The aim of this paper was to investigate whether BMI and fat percentage classification criteria, would classify a sample of 7-13 year old boys from a rural background in similar nutritional categories. METHODS: A cross-sectional study with a stratified random sampling included 601 rural boys (7-13 years old). Fat percentage criteria classification and BMI were calculated and compared. Maturity status, and age at peak height velocity (PHV) were indirectly determined. Statistical techniques included descriptive statistics, Pearson product correlation coefficients, the Kappa agreement test and the McNemar's test. The level of statistical significance was set at p ≤ 0.05. RESULTS: All age groups presented with statistically significant high correlations between BMI and fat percentage, and low to medium correlations between fat percentage and maturity age (MA). Measurement of agreement between BMI and fat percentage classifications showed poor to fair agreements for all age groups, with the exception of the eight-year old group which presented a moderate agreement. CONCLUSIONS: Classifications based on BMI and fat percentage, results in different classifications for the same population. Until further research has been done to determine the best classification for nutritional status, it is recommended that both classification methods be used for more accurate classification of nutritional status.

The Exercise, Arterial Modulation and Nutrition in Youth South Africa Study (ExAMIN Youth SA).

Background: The impact of a sedentary and unhealthy lifestyle on cardiovascular health is well-documented, however the current obesity and hypertension trends among children is concerning. The ExAMIN Youth SA study aims to investigate the impact of lifestyle behaviors (physical fitness/activity, dietary intake and psychosocial factors) involved in early vascular aging among South African children. Methods: This study is an analytical, multidisciplinary, observational cohort study in a school-based setting. We aim to phenotype a cohort of ~1,000 primary school children (black and white boys and girls between ages 5-9 years) based on current clinical childhood conditions including hypertension and obesity. The primary phenotype is large artery stiffness and retinal microvascular diameters, both biomarkers of early vascular aging. The risk factors and mediators of early vascular aging and also responsible for the clinical conditions include physical inactivity, unhealthy diet, and life stress. Additionally, urinalysis and salivary analyses will be performed to identify biomarkers related to the pathophysiology of early vascular aging. Discussion: In line with the growing prevalence of obesity and hypertension responsible for the development of early vascular aging from childhood to adulthood, this study will address the critical areas in which we observe unfavorable arterial modulation related to dietary behaviors, physical inactivity, and early life stress. Implementation of novel biological markers may further contribute to our understanding of early cardiovascular adaptations in childhood, and aid in the development of primary prevention programs. Trial registration: The study was retrospectively registered on ClinicalTrials.gov on 15 August 2019 (NCT04056377).

The South African 24-Hour Movement Guidelines for Birth to 5 Years: An Integration of Physical Activity, Sitting Behavior, Screen Time, and Sleep.

BACKGROUND: In December 2018, the South African 24-hour movement guidelines for birth to 5 years were released. This article describes the process used to develop these guidelines. METHODS: The Grading of Recommendations Assessment, Development, and Evaluation-ADOLOPMENT approach was followed, with some pragmatic adaptions, using the Australian guidelines for the early years as a starting point. A consensus panel, including stakeholders in early childhood development and academics, was formed to assist with the development process. RESULTS: At a face-to-face meeting of the panel, global and local literatures were considered. Following this meeting, a first draft of the guidelines (including a preamble) was formulated. Further reviews of these drafts by the panel were done via e-mail, and a working draft was sent out for stakeholder consultation. The guidelines and preamble were amended based on stakeholder input, and an infographic was designed. Practical "tips" documents were also developed for caregivers of birth to 5-year-olds and early childhood development practitioners. The guidelines (and accompanying documents) were released at a launch event and disseminated through various media channels. CONCLUSIONS: These are the first movement guidelines for South African and the first such guidelines for this age group from a low- and middle-income country.

The association between under-nutrition, school performance and perceptual motor functioning in first-grade South African learners: The North-West Child Health Integrated with Learning and Development study.

BACKGROUND: Early childhood is characterised by an immense spurt of growing and learning where under-nutrition can have adverse effects on the neuro-developmental health and school performance of children. A full understanding of the relationship between school performance and motor functioning skills and malnourishment in school beginners is still lacking. AIM: To determine the association between indices of under-nutrition and how it relates to school performance and motor functioning skills of first-grade learners. SETTING: North West province (NWP) of South Africa (SA). METHOD: The baseline data of the stratified, randomised North-West Child Health Integrated with Learning and Development (NW-CHILD) longitudinal study were used. Grade 1 learners (N = 816, 420 boys, 396 girls, mean age 6.78+ years) from four school districts in the NWP of SA took part in the study. Indices of under-nutrition were determined by Z-scores (-2 standard deviation [s.d.]) for stunting (height-for-age [HAZ]) and wasting and underweight (Z-score for body mass index) using the 2007 World Health Organization reference sample. The Bruininks-Oseretsky Test of Motor Proficiency Short Form and the Visual Motor Integration fourth edition were used to assess different aspects of motor functioning, while school performance in mathematics, reading and writing was assessed by teachers according to the National South African standards of assessments. RESULTS: Both HAZ and Z-score for weight-for-age correlated significantly with school performance and motor functioning skills (r > 2.0, p < 0.05), while visual perception was moderately associated (r < 0.30) with mathematics in HAZ and Z-score for weight-for-height (WHZ) children. Motor functioning of HAZ and WHZ children was significantly poorer (p < 0.05) compared to typical children, while underweight was not associated with any outcome variables. CONCLUSION: Moderate forms of stunting and wasting influence school performance and motor functioning of school beginners negatively, while an association between visual perceptual abilities and inferior mathematics, reading and writing suggests a close link with inferior cognitive information processing in stunted and wasted children. These barriers should be addressed as poor scholastic success in Grade 1 may influence future school performance and the subsequent well-being of children.

The association between under-nutrition, school performance and perceptual motor functioning in first-grade South African learners: The North-West Child Health Integrated with Learning and Development study

Background: Early childhood is characterised by an immense spurt of growing and learning where under-nutrition can have adverse effects on the neuro-developmental health and school performance of children. A full understanding of the relationship between school performance and motor functioning skills and malnourishment in school beginners is still lacking. Aim: To determine the association between indices of under-nutrition and how it relates to school performance and motor functioning skills of first-grade learners. Setting: North West province (NWP) of South Africa (SA). Method: The baseline data of the stratified, randomised North-West Child Health Integrated with Learning and Development (NW-CHILD) longitudinal study were used. Grade 1 learners (N= 816, 420 boys, 396 girls, mean age 6.78+ years) from four school districts in the NWP of SA took part in the study. Indices of under-nutrition were determined by Z-scores (−2standard deviation [s.d.]) for stunting (height-for-age [HAZ]) and wasting and underweight (Z-score for body mass index) using the 2007 World Health Organization reference sample. The Bruininks­Oseretsky Test of Motor Proficiency Short Form and the Visual Motor Integration fourth edition were used to assess different aspects of motor functioning, while school performance in mathematics, reading and writing was assessed by teachers according to the National South African standards of assessments. Results: Both HAZ and Z-score for weight-for-age correlated significantly with school performance and motor functioning skills (r> 2.0, p< 0.05), while visual perception was moderately associated (r< 0.30) with mathematics in HAZ and Z-score for weight-for-height (WHZ) children. Motor functioning of HAZ and WHZ children was significantly poorer (p<0.05) compared to typical children, while underweight was not associated with any outcome variables.Conclusion: Moderate forms of stunting and wasting influence school performance and motor functioning of school beginners negatively, while an association between visual perceptual abilities and inferior mathematics, reading and writing suggests a close link with inferior cognitive information processing in stunted and wasted children. These barriers should be addressed as poor scholastic success in Grade 1 may influence future school performance and the subsequent well-being of children

Influence of Different Visual Perceptual Constructs on Academic Achievement Among Learners in the NW-CHILD Study.

Visual perception plays an important and integrating role in the development of cognitive abilities and perceptual-motor skills. Visual perception comprises different independent constructs that may function in an integrative manner. This study aimed to determine whether (and the extent to which) various visual-perceptual constructs influence the academic achievement of 12-year-old school children. In a cross-sectional analysis, we extracted only 2016 data from 581 learners (mean age = 12.92 years, SD = 0.42) who were participants in the North-West Child Health, Integrated with Learning and Development longitudinal study (2010-2016). We used the Test of Visual Perceptual Skills, Third Edition, the North-West Provincial Assessment and mid-year school examination reports to determine visual perceptual abilities and academic achievement of this participant group. We calculated correlations between visual perceptual constructs and academic performance using Spearman rank order correlations and separately analyzed the influence of gender and socioeconomic status with independent T tests. Different visual perceptual constructs did have significant influences on specific areas of academic learning and on academic achievement generally ( r = .26 to r = .41). Spatial relationships showed slightly greater correlations with academic achievement ( r = .15 to r = .33) than did other basic visual perceptual constructs, possibly because spatial relationships are not completely developed at age 12. Complex and basic visual perceptual skills had medium significant retrospective correlations with grade point average ( r = .40 and r = .41) and first additional language ( r = .30 and r = .33). We concluded that basic and complex visual perceptual constructs remain important for academic achievement in this age-group, while gender and socioeconomic status influence both visual perceptual abilities and academic achievement.

Prevalence of overweight and obesity among primary school children in a developing country: NW-CHILD longitudinal data of 6-9-yr-old children in South Africa.

BACKGROUND: Widespread trends of increasing child obesity are reported in developing countries. This longitudinal NW-CHILD study investigated changes in overweight and obesity over a three year period among 574 children between the ages 6 and 9 (282 boys, 292 girls; 407 black, 143 white) in South Africa (SA), taking into consideration sex, race and school type. Stratified random sampling was used to identify 20 schools, across 5 school SES levels (quintiles), in 4 educational districts of the North West Province of SA. Standard anthropometric techniques and international age adjusted BMI cut-off points for children were used to determine overweight and obesity, 3-years apart. Mixed models were used to analyse the effects of sex, race and socio-economic status (SES) of the school. RESULTS: Overall obesity increased over 3-years by 4% from 12.5% at baseline to 16.7% during follow-up. Obesity increased significantly in both white (4.2%) and black (2.0%) children, although overall prevalence in the final year was double (27.3%) in white children compared to black children (13.3%). Prevalence in obesity increased more in boys (3.2%) compared to girls (2.4%), although girls showed a higher overall prevalence (18.5%). SES effects were significant where children in schools associated with higher SES, had the highest rate of increase and the highest prevalence of obesity. A significant change towards an unhealthy BMI was found in 9.2% of the group over the 3-year period, although a small percentage (3.0%) also transitioned towards a healthier BMI. CONCLUSIONS: Overall obesity prevalence rose significantly from 6-9-years. Obesity, compared to overweight, increased more during this period. Prevalence and rate of increase differed markedly in different sexes, race and SES, masking the extent of the problem. Shifting towards an unhealthy BMI was more common than obtaining a healthier BMI over the 3-year period. It also demonstrated the difficulty of breaking the cycle of obesity, once it had started. Early prevention strategies are needed based on the trends established in this study, with special attention to white children living in high SES regions, and black children in economic transition.