Browsing by Author "Hills, A.P."

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Creating a pro-active health care system to combat chronic diseases in Sri Lanka: the central role of preventive medicine and healthy lifestyle behaviors
(Taylor and Francis Group, 2016) Sagner, M.; Arena, R.; McNeil, A.; Brahmam, G.N.; Hills, A.P.; de Silva, H.J.; Karunapema, R.P.; Wijeyaratne, C.N.; Arambepola, C.; Puska, P.
INTRODUCTION: The current burden and future escalating threat of chronic diseases, constitutes the major global public health challenge. In SriLanka, cardiovascular diseases account for the majority of annual deaths. Data from Sri Lanka also indicate a high incidence and prevalence of pre-diabetes and diabetes; 1 in 5 adults have elevated blood sugar in Sri Lanka. It is well established that chronic diseases share four primary behavioral risk factors: 1) tobacco use; 2) unhealthy diet; 3) physical inactivity; and 4) harmful use of alcohol. AREAS COVERED: Evidence has convincingly shown that replacing these behavioral risk factors with the converse, healthy lifestylecharacteristics, decrease the risk of poor outcomes associated with chronic disease by 60 to 80%. In essence, prevention or reversal of these behavioral risk factors with effective healthy lifestyle programing and interventions is the solution to the current chronic disease crisis. Expert Commentary: Healthy lifestyle is medicine with global applicability, including Sri Lanka and the rest of the South Asia region. This policy statement will discuss the chronic disease crisis in Sri Lanka, its current policies and action implemented to promote healthy lifestyles, and further recommendations on preventive medicine and healthy lifestyle initiatives that are needed to move forward.
Prediction equation for physical activity energy expenditure in 11-13-year-old Sri Lankan children
(MDPI Publishing, 2023) Dabare, P.; Wickramasinghe, P.; Waidyatilaka, I.; Devi, S.; Kurpad, A.V.; Samaranayake, D.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Hills, A.P.; Lanerolle, P.
This study aimed to develop a regression equation to predict physical activity energy expenditure (PAEE) using accelerometry. Children aged 11-13 years were recruited and randomly assigned to validation (n = 54) and cross-validation (n = 25) groups. The doubly labelled water (DLW) technique was used to assess energy expenditure and accelerometers were worn by participants across the same period. A preliminary equation was developed using stepwise multiple regression analysis with sex, height, weight, body mass index, fat-free mass, fat mass and counts per minute (CPM) as independent variables. Goodness-of-fit statistics were used to select the best prediction variables. The PRESS (predicted residual error sum of squares) statistical method was used to validate the final prediction equation. The preliminary equation was cross-validated on an independent group and no significant (p > 0.05) difference was observed in the PAEE estimated from the two methods. Independent variables of the final prediction equation (PAEE = [0.001CPM] - 0.112) accounted for 70.6% of the variance. The new equation developed to predict PAEE from accelerometry was found to be valid for use in Sri Lankan children.
Relationship between physical activity, sedentary behaviour and body composition among 11-13 year-old adolescent girls in Colombo
(Sri Lanka Medical Association, 2018) Dabare, H. P. M.; Waidyatilaka, P.H.I.U.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Jayawardena, R.; Hills, A.P.; Lanerolle, P.; Wickremasinghe, V.P.
INTRODUCTION AND OBJECTIVES: Physical activity (PA) is essential in reducing the risk of obesity. This study aimed to identify the relationship between the intensity of PA and body composition among 11-13 year-old adolescent girls from Colombo, Sri Lanka. METHODS: This is part of a larger study. A purposive sample of 46 adolescent school girls were recruited from the Colombo Municipal Council area. Time spent on light (LPA), moderate (MPA), vigorous (VPA), moderate-to• vigorous (MVPA) PA and sedentary behaviour were determined by waist-worn accelerometers (Actigraph• WGT3X-BT). Deuterium dilution (gold standard) was used with Fourier Transform Infrared (Agilent 4500®) spectroscopy to assess fat mass (FM) and fat-free mass. The% FM cut-off of 33.7% for Sri Lankan children was used to categorize the sample into high fat (HF) and normal fat (NF) groups. RESULTS: The mean age was 12.3 ± 1 year. %FM was significantly correlated with sedentary behaviour (r = 0.65, p < 0.001) and negatively correlated with'Mvf'A duration (r = -0.4, p < 0.01). Time spent on VPA (15.8 ± 6.7 min/day vs. 7.6 ± 3.2 min/day) and MVPA (33.9 ± 13.3 min/da vs. 15.5 ± 7.5 min/day) were significantly (p <0.01) higher among the NF group compared to the HF group. The NF group had significantly (p < 0.01) lower sedentary behaviour (379.7 ± 135 min/day vs. 622.7 ± 105.3 min/day) compared to the HF group. CONCLUSION: %FM was higher among the adolescent girls who spent more time in sedentary behaviours and among those who spent less time engaged in MVPA
Relationship between objectively measured physical activity, sedentary behaviour and body mass index among 11-13 year-old adolescents in Colombo
(Sri Lanka Medical Association., 2019) Dabare, H.P.M.; Waidyatilaka, P.H.I.U.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Jayawardena, R.; Hills, A.P.; Lanerolle, P.; Wickramasinghe, V.P.
INTRODUCTION & OBJECTIVES: Inadequate physical activity (PA) and sedentary behaviour (SB) are attributed to the high prevalence of adolescent obesity in the world. This study aimed to identify the relationship between PA intensity, SB and body mass index (BMI) among I I -13 year-old adolescents in Colombo, Sri Lanka. METHODS: A purposive sample of 95 adolescent school girls and boys were recruited from the Colombo Municipal Council Area. Time spent on moderate-to-vigorous PA (MVPA) and SB were determined by accelerometers (Actigraph-WGT3X-BT) worn on the waist for 10 consecutive days. Height and weight were measured using the standard methodology and BMI was calculated. RESULTS: The sample consisted of 51.6 % of boys (n=49). Mean BMI of the boys was 17.2 ± 3.2 kgm-2 and girls was 17.2 ± 3.2 kgm-2. A significantly (p< 0.05) lower SB (487.4 ± 101.4 min/day vs. 596.4 ± 83.8 min/day) and a significantly higher time spent on MVPA (31.8 ± 15.1 min/day vs. 15 ± 6.7 min/day) were observed among normal weight (NW) girls compared to overweight (OW) girls. Similarly, compared to the OW boys, NW boys had a significantly (p< 0.05) lower SB (578.5 ± 94.1 min/day vs. 696.4 ± 87.4 min/day) and a significantly higher time spent in MVPA (52.9 ± 19.3 min/day vs. 23.4 ± 6.3 min/day). CONCLUSION: Effective strategies should be implemented to reduce SB and increase PA in order to correct the obsogenic behaviour among the adolescents.
Validation of accelerometer-based energy expenditure equations using doubly-labelled water technique in 11-13 year-old Sri Lankan children
(Sri Lanka College of Paediatricians, 2021) Dabare, P.M.; Wickramasinghe, P.; Waidyatilaka, I.; Devi, S.; Kurpad, A.V.; Samaranayake, D.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Hills, A.P.; Lanerolle, P.
INTRODUCTION: Accelerometer based prediction equations are used to calculate physical activity energy expenditure (PAEE) among children. Currently, accelerometer-derived PAEE prediction equations validated against a criterion method do not exist for Sri Lankan children. Objective: To assess the validity of published prediction equations to estimate PAEE in Sri Lankan children against the doubly labelled water (DLW) technique. Method: Ninety-six children aged 11-13 years from an urban area of Sri Lanka were included in the study. Energy expenditure was assessed using the DLW technique over 10 days and participants wore ActiGraph accelerometers during the same period. Correlation between the measured and predicted PAEE was assessed by the Pearson correlation coefficient. Validity of equations was assessed by the paired t-test and the level of agreement using the Bland Altman analysis. Results: Predicted PAEE values were significantly (p<0.05) correlated with the measured PAEE except for the equations of Treuth and Schmitz. Prediction equations of Ekelund, Freedson, Mattock and Zhu significantly overestimated measured PAEE (p<0.05) whereas, Trost and Puyau equations significantly underestimated PAEE. A wide limit of agreement with a large mean bias was observed in all estimated PAEE, except for the equation of Zhu. Conclusions: Existing accelerometer-based PAEE equations have low accuracy in predicting PAEE in Sri Lankan children.