Browsing by Author "Waidyatilaka, I."

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Association between early weight gain and later adiposity in Sri Lankan adolescents
(Cambridge University Press., 2021) Samaranayake, D.; Lanerolle, P.; Waidyatilaka, I.; de Lanerolle-Dias, M.; Hills, A. P.; Wickremasinghe, A.R.; Wickramasinghe, V.P.
ABSTRACT: Early growth pattern is increasingly recognized as a determinant of later obesity. This study aimed to identify the association between weight gain in early life and anthropometry, adiposity, leptin, and fasting insulin levels in adolescence. A cross-sectional study was conducted in 366 school children aged 11-13 years. Weight, height, and waist circumference (WC) were measured. Fat mass (FM) was assessed using bioelectrical impedance analysis. Blood was drawn after a 12-h fast for insulin and leptin assay. Birth weight and weight at 6 months and at 18 months were extracted from Child Health Development Records. An increase in weight SD score (SDS) by ≥0.67 was defined as accelerated weight gain. Linear mixed-effects modeling was used to predict anthropometry, adiposity, and metabolic outcomes using sex, pubertal status, accelerated weight gain as fixed factors; age, birth weight, and family income as fixed covariates, and school as a random factor. Children with accelerated weight gain between birth and 18 months had significantly higher body mass index (BMI) SDS, WC SDS, height SDS, %FM, fat mass index (FMI), fat free mass index (FFMI), and serum leptin levels in adolescence. Accelerated weight gain between 6 and 18 months was associated with higher BMI SDS, WC SDS, %FM, and FMI, but not with height SDS or FFMI. Accelerated weight gain at 0-6 months, in children with low birth weight, was associated with higher height SDS, BMI SDS, WC SDS, %FM, and FMI; in children with normal birth weight, it was associated with BMI SDS, WC SDS, height SDS, and FFMI, but not with %FM or FMI. Effects of accelerated weight gain in early life on anthropometry and adiposity in adolescence varied in different growth windows. Accelerated weight gain during 6-18 months was associated with higher FM rather than linear growth. Effects of accelerated weight gain between 0 and 6 months varied with birth weight. KEYWORDS: Early accelerated growth; adiposity; adolescence; birth weight; insulin; leptin; obesity.
Develepment and validation of a BIA prediction equation for 11-13 year old Sri Lankan girls
(Sri Lanka Medical Association, 2018) Samaranayake, D.; Dabare, H. P. M.; de Lanerolle-Dias, M.; Waidyatilaka, I.; Jayawardena, R.; Hills, A. P.; Wickremasinghe, A.R.; Lanerolle, P.; Wickramasinghe, V.P.
INTRODUCTION AND OBJECTIVES: Population-specific measures of body composition are important in management of childhood obesity. This study aimed to develop and validate a bioelectrical impedance analysis (BIA) equation to assess total body water (TBW) and fat mass (FM) in Sri Lankan girls aged 11-13 years. METHODS: Forty-six 11-13 year-old healthy school girls were purposively selected and randomly divided into model development (n=30) and model validation (n=l6) sub-samples. Weight, height and impedance using BIA were measured. TBW was determined and FM was derived through the criterion Deuterium-dilution technique. Prediction equations for TBW and FM were developed using impedance index (heightvimpedance; cm2/Q), weight and height as independent variables. Final equations were developed combining the two sub-samples. Validity was assessed using correlation coefficients, paired-samples T-test and Bland-Altman plots. RESULTS: In the validation sample, predicted TBW and FM showed significant correlations and did not significantly differ from reference values, Final prediction equation for TBW had a R2 of 92.3% and RMSE of l.035 while FM prediction equation had a R2 of 94.3% and RMSE of 1.38. TBW predicted from new equation (19.48± 3.45kg) was not significantly different from reference TBW (19.52±3.65kg) and the two measures were significantly correlated (r=0.975, p<0.001). Similarly, predicted FM (10.41±4.39kg) was not significantly different from reference FM (10.38±4.74kg) and predicted and reference values were significantly correlated (r=0.974, p<0.001). In both prediction equations, the majority ofresiduals were within mean± l.96SD. CONCLUSION: Newly developed prediction equations for BIA assessment of TBW and FM show high validity compared to reference technique.
Lifestyle patterns and dysglycaemic risk in urban Sri Lankan women
(Cambridge University Press, 2014) Waidyatilaka, I.; de Silva, A.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Atukorala, S.; Somasundaram, N.; Lanerolle, P.
Specific dietary patterns are associated with the risk of chronic disease. An in-depth understanding more reflective of lifestyle would be possible when assessing the synergistic effects of both diet and physical activity in pattern analysis. In the present study, we examined the biochemical markers of dysglycaemia and cardiometabolic risk in relation to lifestyle patterns using principal component analysis (PCA). Urban women (n 2800) aged 30-45 years were screened for dysglycaemia using cluster sampling from the Colombo Municipal Council area. All the 272 dysglycaemic women detected through screening and 345 randomly selected normoglycaemic women were enrolled. The International Physical Activity Questionnaire and a quantitative FFQ were used to assess physical activity and diet, respectively. Anthropometric measurements, bioelectrical impedance analysis and biochemical estimations were carried out. Lifestyle patterns were identified based on dietary and physical activity data using exploratory factor analysis. PCA was used for the extraction of factors. A total of three lifestyle patterns were identified. Women who were predominantly physically inactive and consumed snacks and dairy products had the greatest cardiometabolic risk, with a higher likelihood of having unfavourable obesity indices (increased waist circumference, fat mass percentage and BMI and decreased fat-free mass percentage), glycaemic indices (increased glycosylated Hb (HbA1c) and fasting blood sugar concentrations) and lipid profile (increased total cholesterol/TAG and decreased HDL-cholesterol concentrations) and increased high-sensitivity C-reactive protein concentrations. For the first time, we report lifestyle patterns and demonstrate the synergistic effects of physical activity/inactivity and diet and their relative association with cardiometabolic risk in urban women. Lifestyle pattern analysis greatly increases our understanding of high-risk behaviours occurring within real-life complexities. © The Authors 2014
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.
School-based physical activity intervention in 11-13-year-olds: study protocol for cluster randomized controlled trial
(Medip Academy, 2019) Prasangi, M.; Dabare; Waidyatilaka, I.; Jayawardena, R.; Wickremasinghe, R.; Andrew, P.; Hills; Wickramasinghe, P.; Lanerolle, P.
Background: Targeted strategies to enhance regular physical activity appear to be promising to promote health and well-being of adolescents. This article reports the design of a cluster randomised controlled trial to evaluate the effectiveness of a school-based physical activity programme on the rate and duration of moderate-to-vigorous physical activity, sitting time including screen time, and health-related physical fitness parameters among 11-13 year-old adolescents. Methods: This is a cluster randomized controlled trial conducted in 360 adolescents from government schools in the Colombo Municipal Council area, Sri Lanka. An individual school was considered as a unit of randomization and the 12 selected schools were randomly assigned to one of two groups: control (six schools) and intervention groups (six schools). The intervention group follows a physical activity programme for 30 minutes on three school days per week, for three consecutive months in addition to the standard practice. The primary outcomes are moderate-to-vigorous physical activity rate and duration and sitting time including screen time. Secondary outcomes are the health-related physical fitness parameters: cardiovascular fitness, muscle fitness and flexibility, and body composition. All the outcomes are measured at baseline and three-months following the intervention. Discussion: The outcomes of this study will be an evidence-based intervention programme with the potential to be incorporated into the national education system thus promoting health and well-being of adolescents in Sri Lanka. Trial Registration: Registered at the Sri Lanka Clinical Trials Registry (SLCTR/2018/028). Keywords: Physical activity, Adolescents, Physical fitness, Moderate-to-vigorous physical activity
Sedentary behaviour and physical activity in South Asian women: time to review current recommendations?
(Public Library of Science, 2013) Waidyatilaka, I.; Lanerolle, P.; Wickremasinghe, R.; Atukorala, S.; Somasundaram, N.; de Silva, A.
OBJECTIVE: Our aims were to describe activity and sedentary behaviours in urban Asian women, with dysglycaemia (diagnosed at recruitment), and without dysglycaemia and examine the relative contribution of these parameters to their glycaemic status. METHODS: 2800 urban women (30-45 years) were selected by random cluster sampling and screened for dysglycaemia for a final sample of 272 newly diagnosed, drug naive dysglycaemic and 345 normoglycaemic women. Physical activity and sedentary behaviours were assessed by the International Physical Activity Questionnaire (IPAQ). Demographic data, diet and anthropometry were recorded. Logistic regression analysis assessed contribution of all parameters to dysglycaemia and exposure attributable fractions were calculated. RESULTS: The mean energy expenditure on walking (2648.5±1023.7 MET-min/week) and on moderate and vigorous physical activity(4342.3±1768.1 MET-min/week) for normoglycemic women and dysglycaemic women (walking;1046.4±728.4 MET-min/week, moderate and vigorous physical activity; 1086.7±1184.4 MET-min/week) was above the recommended amount of physical activity per week. 94.3% ofwomen spent >1000 MET-minutes/week on activity. Mean sitting and TV time for normoglycaemic and dysglycaemic women were 154.3±62.8, 38.4±31.9, 312.6±116.7 and 140.2±56.5 minutes per day respectively. Physical activity and sedentary behaviour contributed to dysglycaemia after adjustment for family history, diet, systolic blood pressure and Body Mass Index. Exposure attributable fractions for dysglycaemia were; lower physical activity: 78%, higher waist circumference: 94%, and TV viewing time: 85%.CONCLUSIONS: Urban South Asian women are at risk of dysglycaemia at lower levels of sedentary behaviour and greater physical activitythan western populations, indicating the need for re-visiting current physical activity guidelines for South Asians
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.
Validity of BIA prediction equations in determining the fat mass of 11-13 year old Sri Lankan girls
(Sri Lanka Medical Association, 2018) Samaranayake, D.; Dabare, H. P. M.; de Lanerolle-Dias, M.; Waidyatilaka, I.; Jayawardena, R.; Hills, A. P.; Wickremasinghe, A.R.; Wickramasinghe, V.P.; Lanerolle, P.
INTRODUCTION AND OBJECTIVES: Bioelectrical impedance analysis (BIA) is a simple body composition assessment method, based on use of prediction equations. Validation of equations for the specific populations is important for accurate assessment. This study aimed to determine the validity of available BIA equations in assessing the fat mass (FM) in Sri Lankan girls aged 11-13 years. METHODS: Forty-six 11-13 year-old healthy school girls were purposively selected. Weight, height and impedance using BIA were measured. Total body water was determined and FM was derived through the criterion Deuterium dilution technique. Twelve BIA prediction equations applicable to the age and sex were identified from literature. Predicted FM calculated according to each equation was compared with reference FM (assessed through isotope dilution), and validity was assessed using correlation coefficients, paired samples T-test and Bland-Altman plots. RESULTS: FM predicted by all twelve equations was significantly correlated (r>0.93, p<0.05) with reference FM. Mean (±SD) bias of predicted FM ranged from -5.32 (±1.79) kg to 5.8 (±2.1 l) kg. Only four equations predicted mean FM values that were not significantly different from the mean reference FM values, the mean bias (±SD) ranging from -0.21 (±2.23) kg to 0.06 (±l.72) kg. Of these four prediction equations, only one had a symmetric, uniform distribution of error within the ±l .96 SD limits in the Bland-Altman analysis. CONCLUSION: Most available BIA prediction equations are unsatisfactory for use in the local context. Cross validation of existing prediction equations before use or development of BIA prediction equations to suit the local populations is recommended.