Browsing by Author "Mrimi, Emmanuel."

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    Effect of physical activity and multi‑micronutrient supplementation on body composition among Tanzanian schoolchildren: secondary outcomes from the KaziAfya cluster‑randomized controlled trial
    (BMC Public Health, 2025-07-03) Minja, Elihaika.; Mrimi, Emmanuel.; Mponzi, Winfrida .
    Childhood obesity is a growing public health concern [1]. The World Health Organization (WHO) estimated that in 2022, approximately 390 million children and adolescents aged 5–19 years were overweight or obese, with the prevalence more than doubling from 8% in 1990 to 20% in 2022 [2]. Although undernutrition has historically been the main concern in low- and middle-income countries (LMICs), a rising trend in childhood overweight and obesity is now evident, driven by rapid transitions in lifestyle and diet [3, 4]. In some African countries such as South Africa, Ghana and Tunisia, the prevalence of overweight and obesity has surpassed 20% [5–7]. In Tanzania, national studies reported rates between 9 and 23% depending on the region [8–12]. These figures highlight a growing burden alongside persistent infectious diseases [13]. Overweight in childhood often persists in adulthood, increasing the risk of non-communicable diseases like type 2 diabetes and cardiovascular disease [14, 15]. Psychosocial consequences, including low self-esteem and stigma, are also common. However, cultural perceptions in parts of sub-Saharan Africa may view larger body sizes positively, which complicates health messaging [16, 17]. Nonetheless, rising obesity remains a concern due to its link with urbanization, reduced physical activity and poor dietary habits [4, 18]. Additionally, children recovering from malnutrition may gain disproportionate fat mass (FM) during catch-up growth, which enhances the long-term risk of obesity [19, 20]. Micronutrient deficiencies are common in this age group and may contribute to excess fat accumulation and poor metabolic outcomes [21–25]. Evidence from animal and human studies suggests that adequate micronutrient intake may support lean mass development and fat metabolism [26, 27]. School-based interventions targeting physical activity (PA) and multi-micronutrient supplementation (MMNS) have been proposed as effective strategies to address body composition in children [28, 29]. For instance, the KaziAfya study in South Africa reported improved fa tfree mass (FFM) and reduced fat mass (FM) following PA and MMNS interventions [28]. Similarly, the Disease, Activity and Schoolchildren’s Health (DASH) project found reduced obesity and hypertension risk with increased PA in under-resourced schools [30]. The current study assessed the effect of PA and MMNS interventions on body composition among children in Tanzania who were longitudinally enrolled in a school based cluster-randomized controlled trial as part of the KaziAfya study. The research specifically examined whether the individual and combined PA and MMNS interventions were associated with changes in overall and truncal estimates of FM and FFM among participants. These effects were also evaluated separately by sex to determine whether boys and girls respond differently to the interventions. It is important to investigate these body composition measures in parallel to determine how interventions may alter their relative balance, and hence, reduce the risk of obesity. The results can inform the development of more effective community specific interventions that have the potential to reduce the burden of childhood obesity and long-term metabolic diseases in sub-Saharan countries that are undergoing rapid urbanization.