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The aetiology of the metabolic syndrome and the inter-relationship between risk factors for this syndrome are poorly understood. The purpose of this investigation was to determine the risk factors for metabolic syndrome and their interactions in a cohort of women with a high prevalence of metabolic syndrome. Abdominal and whole body composition (ultrasound and dual-energy X-ray absorptiometry), blood pressure, and cardiometabolic and demographic factors were measured in a cross-sectional study of 702 black African women from Soweto, Johannesburg. Data was analysed using multivariate logistic regression. Metabolic syndrome was present in 49.6% of the study cohort. Logistic regression analysis demonstrated that adiponectin (odds ratio [95% CIs]: 0.84 [0.77, 0.92], p<0.0005) and abdominal subcutaneous fat (0.56 [0.39, 0.79], p = 0.001) reduced metabolic syndrome risk whilst insulin resistance (1.31 [1.16, 1.48], p<0.0005) and trunk fat-free soft-tissue mass (1.34 [1.10, 1.61], p = 0.002) increased risk. Within this group of risk factors, the relationship of adiponectin with metabolic syndrome risk, when analysed across adiponectin hexiles, was the least affected by adjustment for the other risk factors. Adiponectin has a significant protective role against metabolic syndrome and is independent of other risk factors. The protective and possible augmentive effects of abdominal subcutaneous fat and lean trunk mass, respectively on metabolic syndrome risk demonstrate the existence of novel interactions between body composition and cardiometabolic disease.

Background The increasing sedentary behaviour and burden of non-communicable diseases among office workers raise significant concerns. Height-adjustable sit-to-stand desks offer a potential solution, yet uptake remains challenging, limiting their effectiveness and long-term adoption. The experiences of office workers who withdrew from a height-adjustable sit-to-stand desk intervention need to be explored to inform program refinement. Methods A qualitative approach was used, with pre-identified themes guiding data collection, while subthemes emerged inductively from transcripts and field notes. Twelve participants with a mean age of 46.0 years were conveniently sampled. These office workers withdrew from a height-adjustable standing desk randomised controlled trial and did not form any part of other studies. One-on-one semi-structured interviews guided data collection about the participants’ experiences and reasons for early withdrawal from the intervention. Data were thematically analysed using Atlas.ti 23. Results Most participants were female ( n  = 10, 83.3%). All participants completed high school, while 41.7% completed a postgraduate degree from a university and credit bureau company. Despite the participants’ understanding of the benefits of height-adjustable sit-to-stand workstations, most of the participants discontinued the intervention due to perceived barriers that aligned with the themes: “discomforts and dislikes”, “applicability and practicality”, “people’s perception—i.e., what other people will say” and “transitioning to electronic sit-to-stand desks”. Conclusions The findings of this study may assist in formulating a policy to improve compliance with height-adjustable sit-to-stand workstations in the workplace. Future studies should consider individual preferences, design, functionality, knowledge, and motivation to ensure effective implementation, utilisation, and compliance with height-adjustable sit-to-stand workstations.

The growing prevalence of non-communicable diseases (NCDs) in South African workers has been shown to be associated with absenteeism and increased risk of morbidity. Low-income workers living in urban settings are particularly vulnerable. Consultation with workers is crucial for understanding risks and identifying opportunities for intervention to promote health in the workplace. The purpose of this study was to examine South African pharmaceutical manufacturing workers' perspectives of health risk factors and absenteeism, and to identify how they perceived a role for the organisation to initiate interventions to improve their health. Five focus groups were conducted to capture 27 employees' perspectives. The semi-structured focus group discussions were recorded and analysed using a thematic content analysis approach. Participants indicated that they were aware of behavioural health risks such as prolonged sitting. They showed insight into strategies to prevent injuries and stay healthy, but also expressed dissatisfaction about the lack of organisational support, leading to stress and consequently absenteeism. Participants emphasized the responsibility of the organisation to support a range of health promoting strategies. The findings of this study are important for cultivating a tailored workplace intervention to reduce NCD risk factors in the pharmaceutical manufacturing workforce. It is vital that these be supported by leadership of the company through the provision of funding and the development of internal healthcare services.

Background The prevalence of sedentary behaviour has concurrently risen with multiple cardiometabolic risk markers independent of physical activity levels. Office-based workers accumulate the highest levels of sitting time during occupational times. This study aims to investigate the short-term effects of using height-adjustable sit-to-stand workstations on cardiometabolic risk markers of office-based workers in South Africa. Results Sixty-two office-based workers were randomized into intervention (n = 44), and the control group (n = 18). Small improvements were observed in BMI, blood pressure, and cholesterol levels in this cohort. Conclusion This preliminary investigation confirms that short-term height-adjustable sit-stand interventions are effective in reducing workplace sitting time and selected health outcomes. South Africa has been attributed with the highest burden of obesity in Sub-Saharan Africa, as a result, there is a need to implement long-term workplace intervention to reverse these implications. Trial registration Pan African Clinical Trial Registry, PACTR201911656014962 on the 12th of November 2019.

Introduction Cirrhosis is the main cause of morbidity and mortality globally, accounting for approximately 1.2 million deaths annually. Impaired aerobic capacity, muscle wasting and reduced muscle strength are significant complications in patients with cirrhosis. Preoperative exercise intervention “prehabilitation” has been recognised as a potential approach to optimise muscle strength, aerobic capacity and body composition as well as quality of life in patients awaiting abdominal surgery. However, there is little evidence on the effects of preoperative exercise on older adults with cirrhosis and awaiting liver transplant. Thus, the primary objective of this systematic review and meta-analysis will be to assess the effects of exercise interventions in improving aerobic capacity, muscle strength and body composition of older adults with cirrhosis and awaiting liver transplant. Methods and analysis This systematic review and metaanalysis protocol was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This systematic review will include all peer-reviewed randomised controlled trials (RCTs), including cluster RCTs, controlled (non-controlled), complex clinical trials (CCTs) or cluster trials, cohort, observational studies published in English from inception until July 2024. The following electronic databases will be searched: MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO) and Scopus (Elsevier) and supplemented by a secondary screening of the reference lists of all included articles. Searches will involve studies with both male and female participants aged ≥ 18 years with cirrhosis and awaiting liver transplant. Primary outcomes will include muscle strength, and aerobic capacity. The secondary outcomes include body composition (e.g. body mass index, and thigh circumference). The Cochrane Collaboration Risk of Bias Tool will be used to evaluate quality of the studies and Review Manager (RevMan) V.5.3 (Copenhagen, Denmark: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). Effect sizes will be expressed as a standardised mean difference, and their 95% confidence intervals will be calculated and presented as a forest plot. The standard χ 2 and I 2 tests will be used to test heterogeneity. Conclusion This systematic review and meta-analysis is anticipated to provide meaningful and contemporary evidence on the effects of preoperative exercise in older adults living with cirrhosis and awaiting liver transplant. In addition, the findings will help clinicians with developing safe and effective preoperative exercise regimens for these patients.

Background Physical inactivity is a growing public health challenge in low- and middle-income countries (LMICs), yet evidence on scalable, community-based interventions remains limited. We evaluated the effectiveness of a Female Community Health Volunteers (FCHVs)-led, home-based educational programme in promoting physical activity in semi-urban Nepal. Methods We conducted a six-month, open-label, cluster-randomised controlled trial among adults in 14 wards of Pokhara, Nepal, with seven clusters each assigned to intervention or control. Trained FCHVs made three home visits, one per month, delivering two-hour sessions promoting physical activity, using materials co-designed with guidance from the Theory of Planned Behaviour. The main outcome was the change in daily device-measured moderate-to-vigorous physical activity (MVPA) from baseline to follow-up. Results Among 264 participants (132 in the intervention arm and 132 in the control arm; mean age 49.6 years; 67.5% women) in intention-to-treat analysis, device-measured MVPA declined over six months. However, compared with the control group, the intervention group had a 9.80 min/day smaller decline in non-bout MVPA (95% CI: 0.41–19.18; p  = 0.041) and a 4.53 min/day smaller decline in MVPA accumulated in ≥ 10-min bouts (95% CI: 0.29–8.77; p  = 0.036). Positive effects were observed in between-group average acceleration (+ 1.84 mg, p  = 0.035). Conclusions Although MVPA declined in both groups over six months, the FCHV-led, home-based educational intervention attenuated this decline compared to usual care. These findings suggest that existing health volunteer-led education may contribute to maintaining physical activity levels in semi-urban populations. Trial registration Trial registration clinicaltrials.gov Identifier: NCT06386692.

Background As a consequence of ‘Western’ acculturation, eating disorders and body image disturbances, such as fatness phobia and body dysmorphic disorders towards musculature and body shape, are emerging in Africa, with young people the most affected. It is therefore important to accurately assess perceptions of body shape. However, the existing body image assessment scales lack sufficient accuracy and validity testing to compare body shape perception across different African populations. The purpose of this study was to develop and validate the Body Shape Scale (BOSHAS) to evaluate body shape perceptions related body image disorders in African populations. Methods To develop the BOSHAS, anthropometric measures of 80 Cameroonians and 81 Senegalese (both sexes included; 40.1% females overall) were taken for three body shape criteria: somatotype components, body mass index (BMI) and waist-to-hip ratio. Subjects were selected to cover a wide variability in body shape and were photographed in full face and profile positions. To validate the BOSHAS, the scale was administered twice (2 weeks apart) to 106 participants (aged 31.2 ± 12.6 years) to assess its reliability. In addition, a questionnaire measuring different aspects of body shape (e.g. musculature) was also administered ( n  = 597; aged 36.7 ± 15.6 years) to assess its convergent validity. Results The BOSHAS includes two sex-specific subscales of 10 photographs each. Most participants were able to repeat their BOSHAS preference order. Test-retest reliability was also consistent in estimating Current Body Shape (CBS), Desired Body Shape and Ideal Body Shape for participants and their partners. CBS was correlated with BMI, and different BOSHAS indices were consistent with declarations obtained by questionnaire. Conclusions The BOSHAS is the first sex-specific scale of real African models photographed in face and profile, including large body shape variability. The validation protocol showed good validity and reliability for evaluating body shape perceptions and dissatisfaction of Africans.

Objective The public health message ‘move for health’ is relevant given the high prevalence of insufficient physical activity, particularly in African countries. The call for behaviour modification including limiting unhealthy dietary patterns in these settings is therefore critical; however, there is limited knowledge on the adoption of health promotion strategies in the workplace. This study aimed to investigate workers’ perceptions of physical activity and healthy eating. Results Five focus groups were conducted with 28 participants employed in a South African pharmaceutical manufacturing company to explore perceptions of physical activity and healthy eating. Results showed that two categories emerged: physical activity and unhealthy behaviours. Participants recognised the importance of obtaining sufficient physical activity in various domains, however believed that contemporary lifestyle limited opportunities for movement. Likewise, participants viewed healthy eating as unrealistic due to financial constraints. There was however agreement that total physical activity time could be increased during recreational pursuits outside of vocational time and may include intermittent walking for travel. These findings are important for workplace interventions and provide a more robust understanding of workers’ perceptions of physical activity and healthy eating.

This study aimed to determine whether lifestyle and psycho-social factors determine changes in body composition over 10 years in a population of black African females with a high prevalence of obesity. Data were collected from 430 women at baseline and 10-year follow-up. Dual energy x-ray absorptiometry-derived body fat mass and fat free soft tissue mass, and simple anthropometric measures were taken at both time points. Data on physical activity (PA), diet, smoking, and alcohol intake were collected at baseline. Body size dissatisfaction and body size discrepancy were determined at baseline using the feel minus ideal (FID) index and the perceived minus actual weight status discrepancy score (PAD), respectively. All body composition measurements increased over 10 years (p<0.0005). Two distinct groups of overweight/obese females were identified using PAD and FID: one that was content with their body size and one that wished to be leaner. Vigorous PA at baseline was inversely associated with absolute changes in all measures of adiposity. In subjects who underestimated their body size at baseline (74.0% of the study population) changes in total and peripheral levels of body fat were less than in subjects who correctly identified their body size. In the group that underestimated body size, more women wanted to be leaner than in the group who knew their body size (60.1% vs 47.5%, p<0.05). Underestimation of body size is common and is associated with a lower gain in total body adiposity and a prevalent desire to lose weight.

Objective: The aim of this comparative study was to determine the gender differences in cardiac morphology and performance in adolescent black South African footballers. Methods: Anthropometry, electrocardiography and echocardiography data were measured in 167 (85 males and 82 females) adolescent black South African footballers (mean age: 14.8 ± 1.3 years). Vertical jump height was used as a performance measure of explosive lower-limb power. Results: The males had less body fat compared with the females (12.1 ± 3.6 vs 16.8 ± 4.1%, p < 0.05), while females had higher left ventricular end-diastolic diameters compared with males (48.7 ± 3.7 vs 40.7 ± 8.1, p < 0.05). Vertical jump height was higher in males (37.2 ± 10.3) compared with females (31.2 ± 8) and was inversely associated with body fat (β = –0.2, p < 0.05) and positively associated with lean mass (β = 0.5, p < 0.05). Conclusion: The findings showed that adolescent black South African male footballers had a performance advantage over females for explosive lower-limb power, which was explained by differences in body composition and not cardiac morphology.