Browsing by Author "Killel, Erick"

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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.
The relationship between feeding practices and stunting among children under two years in Tanzania mainland: a mixed-method approach
(Springer Nature, 2024-10-28) Mandara, Faith; Festo, Charles; Killel, Erick; Lwambura, Samwel; Mrema, Jackline; Katunzi, Farida; Martin, Haikael; Elisaria, Ester
Background Proper infant and young child feeding practices have gained attention over the years as one of the interventions to reduce childhood stunting. However, there is still a gap in research to determine these relationships in children under two years and the reasons for improper feeding. Objective This study aimed to assess the relationship between feeding practices, stunting and barriers among children under two years. Methodology Utilizing a mixed-method approach, the study involved secondary analysis of 1806 records of children aged 6–23 month, from the Next Generation Nutrition Program conducted in Tanzania (2015–2019). Both quantitative and qualitative data analyses were employed. Frequency distribution tables were utilized to describe study participants stratified by their stunting status. Subsequently, modified Poisson regression models identified predictors of stunting. Qualitative analysis encompassed deductive and inductive approaches, to extract themes that address the behaviors contributing to inappropriate feeding practices. Results Stunting prevalence was 28.8% among children aged 6–23 months, with the majority (65%) of stunted children aged 1 year or older. Dietary diversity was low: 88.3% and 86.3% of stunted and non-stunted children, respectively, consumed less than 5 food groups. Surprisingly, early initiation of breastfeeding, time of stopping breastfeeding, and minimum dietary diversification were not significantly associated with child stunting (p-value > 0.05). Barriers to proper feeding practices identified were inadequate knowledge of feeding, maternal condition, economic hardship, cultural issues, and seasonality. Conclusion Early breastfeeding and minimum dietary diversity were not significant predictors of stunting. However, the mother’s age and height > 150 cm reduced stunting risk while child sex, age, birth weight, marital status, and place of delivery also influenced stunting risk. It is crucial for initiatives to emphasize good feeding practices while addressing the complex factors that may hinder optimal feeding practices in this age group to reduce childhood stunting effectively.