The Exercise, Arterial Modulation and Nutrition in Youth South Africa Study (ExAMIN Youth SA)

Ruan Kruger, Makama Andries Monyeki, Aletta Elisabeth Schutte, Wayne Smith, Catharina Martha Cornelia Mels, Herculina Salomé Kruger, Anita Elizabeth Pienaar, Lebo Francina Gafane-Matemane, Yolandi Breet, Leandi Lammertyn, Gontse Gratitude Mokwatsi, Ankebé Kruger, Elmari Deacon, Henner Hanssen, Ruan Kruger, Makama Andries Monyeki, Aletta Elisabeth Schutte, Wayne Smith, Catharina Martha Cornelia Mels, Herculina Salomé Kruger, Anita Elizabeth Pienaar, Lebo Francina Gafane-Matemane, Yolandi Breet, Leandi Lammertyn, Gontse Gratitude Mokwatsi, Ankebé Kruger, Elmari Deacon, Henner Hanssen

Abstract

Background: The impact of a sedentary and unhealthy lifestyle on cardiovascular health is well-documented, however the current obesity and hypertension trends among children is concerning. The ExAMIN Youth SA study aims to investigate the impact of lifestyle behaviors (physical fitness/activity, dietary intake and psychosocial factors) involved in early vascular aging among South African children. Methods: This study is an analytical, multidisciplinary, observational cohort study in a school-based setting. We aim to phenotype a cohort of ~1,000 primary school children (black and white boys and girls between ages 5-9 years) based on current clinical childhood conditions including hypertension and obesity. The primary phenotype is large artery stiffness and retinal microvascular diameters, both biomarkers of early vascular aging. The risk factors and mediators of early vascular aging and also responsible for the clinical conditions include physical inactivity, unhealthy diet, and life stress. Additionally, urinalysis and salivary analyses will be performed to identify biomarkers related to the pathophysiology of early vascular aging. Discussion: In line with the growing prevalence of obesity and hypertension responsible for the development of early vascular aging from childhood to adulthood, this study will address the critical areas in which we observe unfavorable arterial modulation related to dietary behaviors, physical inactivity, and early life stress. Implementation of novel biological markers may further contribute to our understanding of early cardiovascular adaptations in childhood, and aid in the development of primary prevention programs. Trial registration: The study was retrospectively registered on ClinicalTrials.gov on 15 August 2019 (NCT04056377).

Keywords: arterial stiffness; blood pressure; child health; nutrition; obesity; physical activity; psychosocial behavior; retinal vessel diameters.

Copyright © 2020 Kruger, Monyeki, Schutte, Smith, Mels, Kruger, Pienaar, Gafane-Matemane, Breet, Lammertyn, Mokwatsi, Kruger, Deacon and Hanssen.

Figures

Figure 1
Figure 1
Flow diagram of the three phases of the baseline study population and data collection. (A) The pre-screening phase including the planning, organization, permission and recruitment; (B) The screening phase which involved participant assent and consent, and baseline data collection; and (C) The post-screening phase comprises of a multifaceted feedback process and data analysis.
Figure 2
Figure 2
Data and sample collection for the ExAMIN Youth SA study took place in Potchefstroom and surrounding areas as well as in Klerksdorp, both located in the Southern district of the North-West province of South Africa. The outline of the South African map was purchased from yourfreetemplates.com with the Creative Commons' license, which is Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0).

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