Browsing by Author "Lambert, E V"

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    Open Access
    Energy balance and energy expenditure in obesity: Is obesity a disease of inactivity?
    (2003) Lambert, E V; Goedecke, J H
    The aim of this clinical review was to examine the problem of obesity in the context of energy balance, and specifically to examine the role of increased physical activity in altering energy balance in obese individuals. The control of obesity depends on a regulatory axis involving feedback control between: food intake, nutrient turnover, energy expenditure, and body fat stores. Physical activity impacts on this regulatory axis at all levels. There are four major conclusions regarding physical activity in the management of obesity: (/) a combination of physical activity and restriction of energy intake is more effective for weight loss than exercise or dieting, independently; (/'/) physical activity may help to offset the loss of fat-free mass and attenuate the decline in metabolic rate that occurs with food energy restriction while dieting; (Hi) exercise may be most beneficial for the prevention of weight regain after weight loss; and (/V) the impact of physical activity on body composition and body weight occurs in a dose-dependent manner. There is consensus that moderate intensity activity of approximately 45 - 60 min/day is required to prevent the transition to overweight or obesity. However, in order to lower the overall risk of chronic diseases of lifestyle, minimising co-morbidities of obesity and increasing adherence, the Centers for Disease Control and American College of Sports Medicine guidelines provide an evidence-based recommendation that 'every adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably, all days of the week'.
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    Evaluation of a school-based nutrition and physical activity programme for Grade 4 learners in the Western Cape province
    (South African Academy of Family Practice, 2013) Jacobs, K L; Mash, B; Draper, C E; Forbes, J; Lambert, E V
    Objective: This study aimed to evaluate the effectiveness of the Making the Difference programme (MTDP), an education-and activity-based intervention for Grade 4 learners at primary schools in the Western Cape. Design: This was a cross-sectional, post-intervention survey of an existing programme, using control schools as a comparator. Setting and subjects: The study involved Western Cape primary schools in the 2009 school year. Schools were randomly sampled from two regions. Four intervention (active in the MTDP) and five control (non-participating) schools (n = 325 learners) were selected. Outcome measures: The following outcome measures were assessed using an administered questionnaire to learners: learners' knowledge of, attitudes towards, and behaviour in relation to nutrition and physical activity. Results: A small but significant improvement (eating vegetables and taking lunch boxes to school) was demonstrated with regard to self-reported behaviour in relation to nutrition in the intervention group. However, this behaviour was not explained by differences in barriers to healthy eating, self-efficacy or knowledge, which were not different between the groups, or by perceived social support, which was actually significantly increased in the control group. Groups displayed no differences in physical activity or sedentary behaviour. However, the results showed a significant difference between the groups in terms of a reduction in perceived barriers to physical activity and increased physical activity self-efficacy in the active group. Conclusion: While the MTDP only had a modest effect on the self-reported nutrition and physical activity behaviour of the learners, results regarding lower perceived barriers to physical activity and increased physical activity self-efficacy were promising.
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    Healthy lifestyle interventions in general practice: Part 14: Lifestyle and obesity
    (South African Academy of Family Physicians, 2011) Derman, E W; Whitesman, S; Dreyer, M; Patel, D N; Nossel, C J; Lambert, E V; Schwellnus, M P
    Obesity is defined as an excessive amount of body fat or adiposity. It can be measured using the body mass index (BMI), and according to established criteria for adult men and women, overweight is defined as a BMI between 25-30 kg/m2, and obesity as a BMI > 30 kg/m2. Obesity is clinically associated with many serious co-morbidities, and is widely recognised as one of the leading health threats in most countries around the world. Weight loss is recommended for patients with a BMI > 25 kg/m2. The goals of weight loss therapy are to reduce obesity-related co-morbidities and decrease the risk of future obesity-related medical complications. The management of obesity is multifactorial, and involves the use of combined lifestyle interventions, including regular physical activity and dietary and psychosocial intervention. Practical clinical advice regarding interventions in these important areas is provided in this article.
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    Obesity and overweight in South African primary school children - the Health of the Nation Study
    (2006) Armstrong, M E G; Lambert, M I; Sharwood, K A; Lambert, E V
    Objectives. To determine the prevalence of overweight and obesity in a sample of South African children aged 6 - 13 years. Design. Random sampling of schools within each provincial and socio-economic category. Setting. Primary school children from 5 South African provinces. Subjects. 10 195 (5 611 male and 4 584 female) primary school children. Outcome measure. Height and weight were measured and body mass index (BMI) (weight (kg)/height (m)2 ) was calculated for each grouping (age x gender x ethnic group). Cut-off points for BMI defining obese and overweight for gender and age (6 - 13 years) were calculated in accordance with international standards. Results. There were significant differences in height and mass between the different ethnic groups and genders. This trend was not evident for the BMI values. The prevalence of obesity within the sample was 3.2% for boys and 4.9% for girls, whereas overweight prevalence was 14.0% for boys and 17.9% for girls. When the contribution of each ethnic group was adjusted to the demographics of South Africa these values were only slightly different. The prevalence of obesity and overweight among boys was 2.4% and 10.9% respectively, while obese and overweight girls comprised 4.8% and 17.5%, respectively. Conclusions. South African children show trends of obesity and overweight, similar to values in developed countries about 10 years ago. Intervention strategies to combat an increasingly sedentary lifestyle may need to be developed for the South African context.