ASSESSMENT OF THE INFLUENCE OF BRISK WALKING ON ANTHROPOMETRIC AND BODY STRUCTURE INDICES OF OBESE FEMALE ADULTS IN KADUNA CITY, NIGERIA
This study was conducted to assess the effect of brisk walking on anthropometric and body composition indices of obese female adults in Kaduna metropolis, Nigeria. To achieve this purpose repeated measure research design was used for this study. The population for the research was obese female adults of Kaduna metropolis. Using purposive sampling, 17 obese female adults with body mass index between 30.0 and 39.9 kg/m2 and ages of 40 – 50 years who met the inclusion and exclusion criteria were selected for this study. There were 3 attritions leaving 14 participants in the group. The training group was subjected to, brisk walking for 30-50 minutes with 10 and 5 minutes of warm up and cool down activities respectively. The exercise programme was conducted on 3 alternate days per week for 12 weeks. Body weight, height, waist and hip circumferences, visceral adipose fat, percent body fat and lean muscle mass were measured at base-line, immediately after the 6th and 12th week of training period. The descriptive statistics of mean, standard deviation and standard error of means were used to analyze the data of the physical characteristics of the participants. Repeated-measures ANOVA was used to assess the effect of training on all the assessed variables while post hoc Bonferroni Multiple comparison was used to evaluate the effect of the training on the variables. The null hypotheses raised for this study were tested at 0.05 alpha levels. The results of this study revealed that brisk walking significantly reduced the total body weight F (2, 26) = 80.010, P = 0.005, body mass index F (2, 26) = 57.576, P = 0.005, waist circumference F (2, 26) = 50.982, P = 0.005, percent body fat F (2, 26) = 18.120 P = 0.005 and significant increase in lean muscle mass F (2, 26) = 12.025, P = 0.005 of the participants. However, 12 week of brisk walking did not significantly reduce waist-hip-ratio F(2, 26) = .085, P=0.005 and visceral fat F(2, 26) = .127, P=0.005 of the participants. It was concluded that brisk walking significantly reduced the total body weight, body mass index, waist circumference, percent body fat as well as lean muscle mass but did not significantly reduce waist-hip-ratio and visceral fat of obese female adults. Although there were significant changes in the total body weight, body mass index and the %body fat due to brisk walking, the participants were still obese. It was therefore recommended that brisk walking should not only be prescribed for the modification of anthropometric and body composition indices, it should be made a lifestyle practice for optimal weight management benefit. Brisk walking may also be used to assist individuals with obesity problem.
1.1 Background of the Study
Life-style is generally considered a personal issue. However, World Health Organization (WHO) (2016b), reported a strong correlation between mortality rate and lifestyle practices globally. One of such lifestyle practices is physical inactivity or sedentary living which was highlighted as one of the causes of obesity, leading to metabolic and cardiovascular diseases and other related problems (Ding, Rogers, Van der Ploeg, Stamatakis &, Bauman, 2015; WHO, 2016b). Experts in nutrition stressed that obesity is difficult to define qualitatively; but it is generally accepted that anyone who has a body mass index (BMI) equal to or greater than 30kg/m2 is obese (Kent, 2005; WHO, 2016b). It generally results from a chronic imbalance between energy intake and expenditure resulting in weight gain mostly as fat (Ahima, 2010). Globally, there has been an increased intake of energy-dense foods that are high in fat; and an increase in physical inactivity due to the increasing sedentary nature of many forms of work, changing modes of transportation and increasing urbanization (WHO, 2016b). Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environmental, food processing, distribution and marketing as well as education (WHO, 2016b). Physical inactivity and unhealthy diet have been linked with obesity and obesity has been found to contribute to approximately 55% of type 2 diabetes mellitus (T2DM) (Rother, 2007). The incidence of T2DM doubles with every 20% of excess weight and this figure applies to the young as well as the older diabetic persons (Makama, 2010). Similarly, physical inactivity is the fourth leading risk factor for mortality (WHO, 2017). Physical activity is a vital part of a comprehensive weight loss and weight control programme and it can increase cardiorespiratory fitness and also lead to weight loss in overweight and obese adults (Melam, Alhusaimi, Buragadda, Kaur & Khan, 2016)
Anthropometric measurements are set of noninvasive and quantitative techniques for determining an individual‟s body fat patterns by measuring, recording and analyzing specific dimensions of the body, such as height, weight and body circumferences at the hip and waist (Kaur, Kaur & Puri, 2016). They are used to determine the relationship between various body measurements for epidemiological and medical outcomes. Body mass index (BMI) is a person’s weight in kilograms divided by the square of height in meters; weight (kg) / height
(m2) (National Institute of Health, 2012; Centre for Disease Control, 2015a; WHO, 2016b). Body mass index is the most commonly used and simple measure of body size (generalized obesity), especially for estimating the frequency of obesity in large epidemiological studies (Farzad, Fatemeh, Salehi & Nojomi, 2012). However, BMI does not consider the distribution of body fat, resulting in variability in different individuals and populations (Liu, Tong, Tong, Lu & Qin, 2011). In the assessment of obesity, the central distribution of body fat cannot be overlooked; hence the use of other anthropometric indices such as waist circumference (WC), hip circumference and waist – hip – ratio (WHR) as measures of adiposity (Sanya, Ogwumike, Ige & Ayanniyi, 2009).
Waist circumference has been recommended as a simple and practical measure for identifying overweight and obese individual. It is particularly useful for individuals and population groups with different body builds. Similarly, WHR has also been shown to be a better and simpler indicator of both intra- abdominal fat and coronary artery disease than BMI. Waist circumference and waist hip ratio are used to predict the risk of obesity as they account for regional abdominal adiposity (Liu et al., 2011). A meta-regression analysis of prospective studies by De Koning, Merchant, Pogue & Anand, (2007) showed that WHR and WC measurements were strongly associated with incidence of coronary heart disease, independent of BMI. Furthermore, a study conducted among 359,387 participants from nine countries in Europe showed that both general and abdominal adiposity are associated with the risk of death and support the use of WC, WHR and BMI in assessing the risk of premature death (Pischon, Boeing, Hoffmann, Bergmann, Schulze & Overvad, et al. (2008).
Body composition is a component of health – related fitness used to describe the percentage of fat, bone, water and muscle in the body expressed as percent body mass, visceral fat and lean muscle mass. Excessive body fat is associated with increased metabolic risk and its measurement is important in implementing curative and preventive health measures (Ranasinghe, Gamage, Katulanda, Andraweera, Thilakarathne & Tharanga, 2013). Many studies have shown an association between increased abdominal or visceral adipose tissue and conditions such as hyper-insulinemia, hypertension and dyslipidemia, independent of general obesity or fatness. A greater risk of chronic disease mortality and morbidity has been shown with an increased level of abdominal adiposity, rather than gluteal or femoral adiposity (Warren, Schreiner & Terrry, 2005).
American College of Sports Medicine, (2015) reported that aerobic training has the potential of altering anthropometric and body composition of adults. People who are insufficiently physically active have a 20 – 30% increased risk of all causes of mortality compared to those who engage in at least 30 minutes of moderate intensity physical activity on most days of the week (WHO, 2010; ACSM, 2015; CDC, 2015b). Administration of such exercise leads to significant health benefits. A study conducted by Gary Hunter, an exercise physiologist and his team, in the University of Alabama at Birmingham (UAB) Department of Human Studies found that as little as 80 minutes a week of aerobic or resistance training helped not only to prevent weight gain, but also to inhibit a regain of harmful visceral fat one year after weight loss (Hunter, Brock, Byrne, Chandler-Laney, Corraat, & Gower 2010). The American College of Sports Medicine, (2015) recommends that adults should get at least 150 minutes of moderate intensity exercise per week. The exercise recommendation can be met through 30-60 minutes of moderate intensity exercise (three to five days per week) (ACSM, 2018).
Aerobic exercise is believed by many exercise scientists to be the single best predictor of weight maintenance. Aerobic exercise reduces weight and improved cardiopulmonary fitness in obese subjects better than anaerobic exercise (Al Saif & Alsenany, 2015). Aerobic exercise includes any rhythmic activity involving large muscle groups that elevate the heart rate for a sustained period (Rogers, 2015). These include walking, running, swimming, jumping, cycling, rowing, rope skipping and many such activities. Though the principles of aerobic exercise are the same for everyone, someone who is obese may find certain forms of aerobic exercise unrealistic (Rogers, 2015). For instance, high-impact activities, such as running and jumping may be uncomfortable or stressful to the joints of obese adults, while walking, swimming, cycling or using an elliptical trainer might be better choices for starting regular exercise for this group of persons (Rogers, 2015).
Walking is an excellent, low-intensity activity with little risk of injury. It does not require special facilities and minimum amount of attention is necessary, so socializing is easy and convenient (Ehrman, Gordon, Visich & Keteyian, 2013). Walking is an enjoyable, free, easy, social and great exercise. A walking program is flexible and boosts high success rates because people can stick to it. It is easy for walking to become a regular and satisfying part of life (American Heart Association, 2016). People of almost any fitness level can find a comfortable walking pace to participate in this low-impact aerobic activity. Walking at a pace of 5.7km/h, Borg scale of perceived exertion 11 – 14 is considered brisk walking which is a popular and convenient form of exercise that plays an important role in weight management and it is often recommended for obese individual because it increases energy expenditure (Melam et al., 2016).
This study, therefore, was conducted to assess the effect of brisk walking on anthropometric and body composition indices of obese female adult in Kaduna metropolis, Nigeria.
1.2 Statement of the Problem
There is an increasing trend of overweight and obesity among adults in developing countries of the world which makes it a major health problem. This is because obesity is the most pervasive and chronic disease in need of new strategies for medical treatment, management and prevention.
The prevalence of obesity has risen steadily over the past decades in adults and children to become a global epidemic and represents a major public health challenge (Melam et al., 2016). In 2014, more than 1.9 billion (39 %) adults age 18 years and above were overweight and over 600 million (13%) were obese. Of this obese figure, 11% were men, 15% women and 41 million children under the age of 5 were also estimated to be overweight or obese in
2014 (WHO, 2016b). Globally, the prevalence of obesity in women exceeds that in men (Kaur & Walia, 2007; WHO, 2010; 2016b).
Obesity is no longer just a concern for developed countries, but it is becoming an increasing problem in many developing countries. Data from the World Health Organization shows that the prevalence of overweight and obesity increased by 20% between 2002 and 2010 in
Nigeria (Akarolo-Anthony, Willett, Spiegelman & Adebamowo, 2014). The prevalence of obese individuals in Nigeria is of epidemic proportions and there is a need to pay closer attention to combating this health disorder (Chukwuonye, Chuku, John, Ohagwu, Imoh, Isa, Ogah & Oviasu 2013). According to the WHO, 2010 survey data on Nigeria, the prevalence of overweight was 26% and 37% in men and women respectively, while the prevalence of obesity was 3% and 8.1% in men and women respectively. World Bank Gender Statistics
(2015) also, reported increased statistics of obese women from 13.4% in 2010 to 16.3% in 2014 in Nigeria. Other studies have also shown higher incidence of obesity among females than males in Nigeria (Wahab, Sani,Yusuf, Gbadamosi., Gbadamosi, & Yandutse, 2011; Banwat, Chingle, Lar, Damib & Zoakah, 2012; Adebayo, Balogun, Adedoyin, Obas horoJohn, Bisiriyu & Abiodun, 2014; Fadupin, Adeoye, & Ariyo, 2014). Reports from various population sub-groups in Nigeria as described by Iloh, Amadi, Nwankwo, Ugwu and (2011) in Imo State, Wahab et al. (2011) in Katsina State, Adebayo et al. (2014) among adults in Osun State, Akarolo-Anthony et al. (2014), of a government worksite in Abuja and Banwat et al. (2015) in Jos, showed obesity predominance among adult aged 40 years and above with class 1 obesity as the most prevalent followed by class 2 obesity.
Although several research studies have been reported on the prevalence of obesity in Kaduna, there is paucity of information on its management (Adaramaja & Olanrewaju, 2008; Shehu,
Abdullahi & Adekeye, 2010; Oladimeji, Fawole, Nguku & Nsubuga, 2012; Dahiru & Ejembi, 2013). A study conducted among civil servants in Kaduna State reported 27% prevalence of obesity with women four times more obese than the men (Oladimeji et al., 2012). Lack of regular exercise has been identified as a major cause of obesity in Kaduna State (Adaramaja & Olanrewaju, 2008; Shehu et al., 2010). Increasing use of motorized transport and sedentary types of occupation such as office work, accompanied by high risk dietary and lifestyle/behaviors were associated to the prevalence of obesity in Kaduna City. Physical inactivity was the most prevalent behavioral factor, 91%, followed by unhealthy diet 90%, and cigarette smoking 6% (Oladimeji et al., 2012). Dahiruna & Ejembi, (2013) conducted a research in Dakaci, a semi-urban settlement near Zaria, Kaduna State to assess clustering of cardiovascular disease risk-factors (hypertension, physical inactivity, cholesterol, T2DM and obesity), the result shows that only 20% of the population had no risk factor, while more females than males had various risk-factors. In addition, the proportion of subjects with riskfactors increased with increasing BMI, particularly high blood pressure.
The medical risk of obesity is highly associated with the distribution of body fat, and abdominal fat is considered at least as an important medical risk as the total amount of body fat. BMI, waist circumference (WC), and waist-to-hip ratio (WHR) are used to classify obesity and the risks of abdominal fat accumulation (Vazquez, Duval, Jacobs, & Silventoinen, 2007; Kavak, Pilmane & Kazoka, 2014). Generally, researchers have linked high BMI, WC, WHR, visceral fat and percent body fat with chronic diseases such as hypertention, dyslipidamia, T2DM and coronary heart disease (Dehghan & Merchant, 2008;
Oda, 2008; Zhang, Rexrode, Van Dan, Li, & Hu, 2008; Srikanthan, Seeman & Karlamangla, 2009).
Walking at a pace of 5.7 km/h, Borg scale of perceived exertion 11 – 14 is considered brisk walking, and it is a popular and convenient form of exercise that plays an important role in weight management and it is often recommended for obese individual because it increases energy expenditure (Melam et al., 2016). Report on the association of brisk walking and obese adult women of Kaduna State is limited and there are no published perspective data on the association.
In view of the epidemic state of obesity in Nigeria, especially in Kaduna State, and the advocacy to promote healthy living and reduce diseases associated with increasing inactivity such as obesity, this study, was conducted to assess the efficacy of brisk walking on selected anthropometric and body composition indices of obese female adult in Kaduna metropolis, Nigeria.
1.3 Research Question
This study was conducted to answer the following research questions:
Can brisk walking modify:
- total body weight (TBW) of obese female adults in Kaduna metropolis, Nigeria? ii. body mass index (BMI) of obese female adults in Kaduna metropolis, Nigeria? iii. waist circumference (WC) of obese female adults in Kaduna metropolis, Nigeria? iv. waist – hip – ratio (WHR) of obese female adults in Kaduna metropolis, Nigeria?
- visceral fat of obese female adults in Kaduna metropolis?
- percent body fat of obese female adults in Kaduna metropolis, Nigeria? vii. lean muscle mass of obese female adults in Kaduna metropolis, Nigeria?
1.4 Purpose of the Study
The purpose of this study was to determine the effects of brisk walking on:
- TBW of obese female adults in Kaduna metropolis, Nigeria ii. BMI of obese female adult of Kaduna metropolis, Nigeria. iii. WC of obese female adult of Kaduna metropolis, Nigeria. iv. WHR of obese female adult of Kaduna metropolis, Nigeria.
- Visceral fat of obese female adult of Kaduna metropolis, Nigeria.
- Percent body fat of obese female adult of Kaduna metropolis, Nigeria. vii. Lean muscle mass of obese female adult of Kaduna metropolis, Nigeria.
1.5 Basic Assumptions
Based on the available research evidence, the following assumptions were made for this study:
- Aerobic exercise like brisk walking is effective for improving metabolism and fat utilization among obese persons.
- Metabolic response to brisk walking can be assessed
- Walking is a natural form of exercise, so obese individuals can easily adapt to it with less injuries.
- Brisk walking can influence anthropometric indices of obese women.
- Brisk walking can modify body composition indices of obese women.
Based on the research questions and the purpose of this study, the following hypotheses were raised for this study:
1.6.1 Major Hypothesis
There is no significant effect of brisk walking on selected anthropometric and body composition indices of obese female adults in Kaduna metropolis, Nigeria.
1.6.2 Sub – Hypotheses
- There is no significant effect of brisk walking on total body weight of obese female adults in Kaduna metropolis, Nigeria
- There is no significant effect of brisk walking on body mass index of obese female adults in Kaduna metropolis, Nigeria. iii. There is no significant effect of brisk walking on waist circumference of obese female adults in Kaduna metropolis, Nigeria. iv. There is no significant effect of brisk walking on waist- hip- ratio of obese female adults in Kaduna metropolis, Nigeria. .
- There is no significant effect of brisk walking on visceral fat of obese female adults in
Kaduna metropolis, Nigeria. .
- There is no significant effect of brisk walking on percent body fat of obese female adults in Kaduna metropolis, Nigeria. vii. There is no significant effect of brisk walking on lean muscle mass of obese female adults in Kaduna metropolis, Nigeria.
1.7. Significance of the Study
Excessive body fat is associated with increased metabolic risk and its measurement is important in implementing curative and preventive health measures (Ranasinghe, Gamage, Katulanda, Andraweera, Thilakarathne and Tharanga, 2013). Lack of regular exercise training as been identified as among the major risk factors affecting normal body composition and anthropometric indices of an obese individual; (Adaramaja and Olarenwaju, 2008; Shehu et al., 2010; WHO 2010). The risk of obesity co-morbidities increases with increasing BMI (Iloh et al., 2011). The results of this study was to show if brisk walking as an exercise mode could be used to modify the total body weight as well as the BMI of obese female adult in
Kaduna metropolis, Kaduna State, Nigeria.
Evidence-based guidelines on the management of obesity promote the use of waist circumference as a measure of abdominal obesity for predicting excess relative risk of disease in overweight and class I obese persons. This investigation was to prove whether brisk walking could be prescribed for the modification of waist circumference in obese female
The Nurses‟ Health Study also found that waist circumference and waist-to-hip ratio are equally effective at predicting who was at risk of death from heart disease, cancer, or any cause (Zhang et al., 2008). The result of this study was also to show if brisk walking could be used to modify the waist-hip-ratio of obese female adults of Kaduna metropolis. Excess abdominal fat (also known as visceral, central or upper-body fat) is associated with an increased risk of cardio-metabolic disease (Despres, 2007). That explains why increasing attention has been paid to abdominal adiposity and its association with increased mortality over the last several years, (Vissers, Hen, Taeymans, Baeyens, Poortmans & Gaal, 2013). This investigation would show if brisk walking could be effective in improving metabolism and abdominal fat utilization of obese female adults. Increased percent body fat is strongly associated with the risk of chronic diseases such as hypertension, dyslipidemia, diabetes mellitus, and coronary heart disease (Dehghan & Merchant, 2008). The results of this study could be helpful in accepting or rejecting the beneficial effect of brisk walking on percent body fat as reported by previous researchers. Habibzadeh and Dneshmandi (2010), showed significant effect of brisk walking on lean muscle mass of obese young women suffering from bulimia nervosa, the results of this study could be used to modify the lean muscle mass of obese female adults of Kaduna metropolis, Nigeria.
The findings of this study would indicate if brisk walking could be prescribed to assist individuals with health related problems associated with obesity.Results of this study would contribute to the existing literature on the effect of brisk walking on the anthropometric and body composition indices of obese female adults. The result of this study could provide baseline data on the current status of women with regards to the effect of brisk walking on the anthropometric and body composition indices of obese female adults of Kaduna metropolis, Nigeria.
This study could highlight areas for further research on the brisk walking in the control and management of obesity, which may be investigated in the future.
1.8 Delimitation of the Study This study was delimited to:
i. obese women with BMI between 30.0 and 39.9 kg/m2 and age 40 to 50 years ii. brisk walking as the mode of exercise iii. body weight, height, waist and hip circumferences (anthropometric variables) iv. visceral fat, percent body fat and lean muscle mass (body composition variables)
ASSESSMENT OF THE INFLUENCE OF BRISK WALKING ON ANTHROPOMETRIC AND BODY STRUCTURE INDICES OF OBESE FEMALE ADULTS IN KADUNA CITY, NIGERIA