Browsing by Author "Gerber, Markus"

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Association between physical activity, nutritional status and cognitive performance among school children in southern Tanzania
(Frontiers, 2025-06-10) Mwakalebela, Fahad; Minja, Elihaika; Mwalugelo, Yohana; Killel, Erick; Rajab, Rehema; Mollel, Getrud; Mponzi, Winifrida; Masanja, Honorati; Okumu, Fredros; Lang, Christin; Gerber, Markus; Utzinger, Jürg; Long, Kurt; Kosia, Efraim; Elisaria, Ester; Finda, Marceline
Background: Physical activity is pivotal in promoting overall health and wellbeing, improving brain function and cognitive performance, and reducing risk of excessive weight and non-communicable diseases. Despite these benefits, physical inactivity among children and adolescents remains a global concern, particularly in low- and middle-income countries (LMICs). Only few studies have explored the association between physical activity, nutritional status, and cognitive performance in LMICs like Tanzania. This study assessed these associations among school children in a rural setting in southern Tanzania. Methods: Physical activity was assessed using an actigraphy device that assessed 7-day average of physical activity among school children aged 6–13 years. Cognitive performance was assessed via the Flanker task, which assessed the executive domain of cognitive functions, specifically information processing and inhibitory control. Weight was determined using Tanita digital scale, and height was measured using measuring board. A multinomial logistic regression model and a gamma generalized linear model with a log link function were used to examine the association between physical activity, nutritional status, and cognitive performance. Results: Among 678 children who participated in the baseline assessment, 77.9% had normal weight, 14.3% were underweight, 5.5% were overweight, and 2.4% were obese. Most (92.6%) of the children engaged in at least 60 min per day of moderate-to-vigorous physical activity (MVPA) as per WHO recommendations. Children who did not meet the recommended MVPA level were nearly three times more likely to be obese compared to those who did. No statistically significant associations were found between physical activity and cognitive performance, or between nutritional status and cognitive performance. Conclusion: This study highlights a high prevalence of normal weight and adherence to WHO-recommended MVPA levels among school children in southern Tanzania. However, children not meeting MVPA criteria were more likely to be obese, indicating the importance of physical activity in maintaining a healthy weight. The lack of association between physical activity or nutritional status and cognitive performance, indicates that there may be additional factors that influence cognitive outcomes. Further research is needed to explore these interactions, particularly in rural LMIC settings.
Dietary diversity among households living in Kilombero district, in Morogoro region, South-Eastern Tanzania
(Elsevier B.V., 2021-06-11) Minja, Elihaika; Swai, Johnson; Mponzi, Winifrida; Ngowo, Halfan; Okumu, Fredros; Gerber, Markus; Pühse, Uwe; Long, Kurt; Utzinger, Jürg; Lang, Christin; Beckmann, Johanna; Finda, Marceline
Background: Adequate nutrition is essential for good health and active life. However, diets in most low and middle-income households lack diversity, especially in settings where people eat predominantly starchy foods. In this study, we assessed the associations between socio-economic status and household dietary diversity in families living in South-eastern Tanzania. Method: A cross-sectional questionnaire was administered to 925 parents of school children in four wards in South-eastern Tanzania, as part of a trial; assessing the effects of physical activity and micronutrient supplementation on overall growth, health and well-being of school children. The dietary intake was assessed by 24-h dietary recall and dietary diversity score (DDS) was calculated. Socio-economic status was derived from a weighted score using principal component analysis (PCA). Multinomial logistic regression was used to investigate the association between dietary diversity and socio-economic status. This baseline data assessment was completed in July and August 2019. Results: Cereals, oils and fats were the most consumed food groups, legumes were the most common source of protein and fish was the most common animal protein. More than three quarters of the households had medium dietary diversity (MDD). Higher household education and large farm size were the only factors significantly associated with having high dietary diversity. Conclusion: A majority of the households in South-eastern Tanzania have medium dietary diversity, comprised of cereal, fats and oils and proteins. Having high dietary diversity was associated with higher education and large farm sizes. Improving community members’ knowledge and awareness of nutritional benefits could improve the dietary diversity at household level.
Effect of a School-Based Physical Activity and Multi-Micronutrient Supplementation Intervention on Cognitive Function and Academic Achievement Among Schoolchildren in Tanzania: Secondary Outcome from the KaziAfya Cluster-Randomized Controlled Trial
(MDPI, 2025-08-27) Minja, Elihaika; Mrimi, Emmanuel; Mponzi, Winfrida; Beckmann, Johanna; Finda, Marceline; Okumu, Fredros; Long, Kurt; Lang, Christin; Utzinger, Jürg; Gerber, Markus
Background: Physical activity (PA) and adequate micronutrient intake are essential for brain development and may influence cognitive function and academic achievement. However, few large-scale studies have assessed the combined effects of PA and multi-micronutrient supplementation (MMNS) in school-age children. Methods: A cluster-randomized placebocontrolled trial in four peri-urban Tanzanian schools assigned children to one of four groups: (i) PA alone; (ii) MMNS alone; (iii) PA plus MMNS; or (iv) placebo. Children were followed over two school years with assessments at baseline, 14 months, and 26 months. Cognitive function was assessed using computerized Flanker tasks. Academic achievement was evaluated through end-of-year exams in mathematics and Kiswahili subject scores. Anthropometric measures determined nutritional status. Data were analyzed using generalized estimated equations (GEE). Results: Complete data from 559 children (326 girls, 233 boys) aged 6–12 years showed differing characteristics across groups, particularly age and body mass index. No significant intervention effects on cognitive function were found. MMNS groups (alone or combined with PA) showed significantly higher Kiswahili scores, while PA alone had the lowest performance compared to placebo. No intervention effect was found in mathematics. Sex, hemoglobin level, and baseline measures were key predictors for cognition or academic performance. Conclusions: PA and MMNS interventions showed no significant cognitive or academic improvements versus placebo. Further research should optimize school-based nutrition and PA programs for improved learning outcomes.
Prevalence and Determinants of Undernutrition in Schoolchildren in the Kilombero District, South-Eastern Tanzania
(MDPI, 2024-04-25) Minja, Elihaika; Mrimi, Emmanuel; Mponzi, Winfrida; Mollel, Getrud; Lang, Christin; Beckmann, Johanna; Gerber, Markus; Pühse, Uwe; Long, Kurt; Masanja, Honorat; Okumu, Fredros; Finda, Marceline; Utzinger, Jürg
Childhood undernutrition is a major issue in low- and middle-income countries, affecting the health, well-being, and educational outcomes of schoolchildren. This study aimed to assess the prevalence and associated factors of stunting, wasting, and underweight among schoolchildren in peri-urban areas in the south-eastern part of Tanzania. A cross-sectional study was conducted involving 930 children aged 6–12 years from four primary schools from July to August 2019. The WHO Anthro Survey Analyzer was employed to estimate the prevalence of stunting, wasting, and underweight, while logistic regression analyses examined sociodemographic background, malaria infection, anaemia, anthropometric measures, and dietary diversity score as potential factors. The prevalence of stunting, wasting, underweight, overweight, and obesity was 11.8%, 4.3%, 3.9%, 11.1%, and 2.0%, respectively. Overall, 1.5% of the children had malaria, as determined by rapid diagnostic tests, and 0.4% had severe anaemia. Univariate analysis indicated higher odds of undernutrition among children aged 9–12 compared to their younger peers. Stunting was more common among children with low and medium dietary diversity. Anaemia was found in 11.2% of schoolchildren, and severe anaemia was associated with wasting. Multivariate analysis revealed that age and low dietary diversity were significantly associated with undernutrition. These findings emphasise the need for school-based health and nutrition programmes targeting children beyond the age of 5 to improve their nutritional status and mitigate potential adverse effects on health, cognition, and academic achievement. Regular assessment of the nutritional status of schoolchildren is warranted.