Van Gent, M.Van Niekerk, R.L.Mvula, Sisanda2026-07-212026-07-212025Mvula, S. (2026) Body composition, physiological risk factors and physical activity among adolescents at risk for non-communicable diseases in the Eastern Cape, South Africa. Master's dissertation. University of Fort Hare.http://hdl.handle.net/20.500.11837/4107Master's dissertationAdolescence is a critical period of transition into adulthood, during which unhealthy behaviors are often initiated and can persist into later stages of life, contributing to the rising prevalence of noncommunicable diseases (NCDs). In South Africa (SA), NCDs accounted for 51% of total deaths in 2016, with heart disease being a major contributor. The studies revealed that over 20% of adolescents were classified as overweight or obese, with a higher prevalence observed in females compared to males. A significant number of adolescents showed elevated blood pressure and abnormal cholesterol levels, indicating a concerning trend to ward cardiovascular risk among adolescents. Approximately only 50% of adolescents met the recommended guidelines for physical activity, with gender differences including 25% of boys and 16% of girls meeting the recommended physical activity levels. The Healthy Active Kids South Africa (HAKSA)Report Card has shown some improvement, upgrading the overall physical activity to a B-grade in 2022, with 60% to 73% of children meeting the recommended physical activity levels. This study investigated body composition, physiological risk factors, and physical activity among adolescents at risk for NCDs in the Eastern Cape, South Africa. Body composition was assessed using skinfold measurements, BMI, and waist-to-hip ratio, while physiological measurements included random blood glucose, cholesterol, and blood pressure. Additionally, physical activity was measured indirectly using the International Physical Activity Questionnaires (IPAQ) long form. The statistical analyses were executed using SPSS (IBM, Version 27) package software. Data analysis involved various methods, including descriptive statistics, independent samples t-tests, chi-square analysis, logistic regression, and Pearson correlation. Adolescents presenting with one or more metabolic risk factors were classified as “at risk”, whereas those without any metabolic risk factor were classified as not at risk. Healthy and unhealthy body fat percentages were classified based on specific thresholds: <25% for boys and <30% for girls were considered healthy, while ≥25% for boys and ≥35% for girls were classified as unhealthy. The criteria for classifying adolescents into the unhealthy and healthy waist-to-hip ratios were based on the cut-off score, including 0.9 for males, which was considered healthy, and >0.9 was unhealthy. In contrast, 0.85 for females was considered healthy, and >0.85 was considered unhealthy. Among 257 participants, 131 (50.9%) were classified as at risk for NCDs, and those classified as at risk were categorized as overweight. The study also highlighted that both groups (at risk and not at risk) met the minimum WHO requirements of 300 minutes per week of physical activity. Additionally, the study revealed a higher proportion of females (74.0%) at risk for metabolic risk compared to males (26.0%). Of the boys showing higher levels of unhealthy body fat, 83% were classified within the at-risk group. Similarly, 100% of the girls displayed unhealthy fat and were in the at-risk group. The sum of 4 skinfolds (p = 0.000), with an odds ratio of 1.12, indicated that adolescents who presented with a high sum of 4 skinfolds were 1.12 times more likely to develop metabolic risk diseases. Total physical activity demonstrated an odds ratio of 0.99 (p=0.039), suggesting that adolescents were 0.99 times less likely to develop metabolic risk for each additional minute of physical activity. Most adolescents who participated in the study were from quintiles 1-3 (43% males and 58% females). A significant association (p=0.001) was identified between gender and physical activity levels, with 30.3% of males and 69.7 % of females not meeting the recommended physical activity levels. The analysis further revealed a significant association (p=0.000) between metabolic risk and sex, with a much larger proportion of females (74%) having metabolic risk than males (26%). A significant association (p=0.053) was identified among urban participants, where a greater percentage (61.0%) engaged in sufficient physical activity compared to those who did not (39.0%). Similarly, another significant association (p=0.053) was observed in rural areas, revealing that a higher proportion of participants (51.7%) did not meet the recommended levels of physical activity, while those who were active constituted 48.3%. The study observes the weak correlations between different body composition variables and physical activity among adolescents. A significant negative, weakm correlation was observed between the age and body fat percentage of the participants (r = -0.143, p = 0.024). A significant positive weak correlation was found between age and total physical activity (r = 0.180, p = 0.003), as well as with school-related physical activity (r = 0.155, p = 0.011) and housework-related physical activity (r = 0.198, p = 0.00. Body fat had a significant negative weak correlation with waist-to-hip ratio (r=-0.233, p=0.000) and transportrelated physical activity (r=-0.137, p=0.031). The sum of 4 skinfolds presented a significant negative, weak correlation with transport-related (r=-0.134, p=0.037). While body fat is a significant risk factor, physical activity is not the primary contributor to metabolic risk in this population. This study underscores the importance of implementing targeted public health initiatives that support active transportation, particularly among adolescents with higher body fat percentages. Implementing strategies that encourage healthy behaviors is crucial for reducing metabolic risks associated with NCDs in this population. The findings stress the need for community and school initiatives to promote active lifestyles and address differences in physical activity between urban and rural adolescents.enChronic diseasesHuman body--CompositionExerciseTeenagersSouth AfricaThesis