Hakeem R, Thomas J, Badruddin S H.
Urbanisation and activity pattern of south Asian children.
J Pak Med Assoc Jan ;52(9):402-7.

OBJECTIVE: To compare the physical activity level and total energy expenditure of 10-12 year old school children living at different levels of urbanization. METHOD: All the participating children kept a three-day record of their activities, for every fifteen-minutes, in specially designed diaries. Activities were grouped according to intensity that was determined on the basis of Physical Activity Ratio (PAR). After calculating the average time spent in a day, in activities of varying intensity, overall Physical Activity Level (PAL) of each subject was calculated by factorization method. After measuring bodyweight using a standard equation Basal Metabolic Rate (BMR) of the subjects was calculated. Total Energy Expenditure (TEE) was assessed on the basis of PAL and BMR of each child. SUBJECTS: Physical activity level of six groups of 10-12 year old children, representing various urbanization categories, was studied. Three groups of children were recruited from Punjab, Pakistan: rural, middle income urban and high income urban, and they were assigned urbanization rank (UR) 1, 2 and 3. Another three groups of children were recruited from Slough, UK: British Pakistani, British Indian, and British Caucasian and they were assigned urbanization rank 4, 5 and 6 respectively. RESULTS: Physical activity level decreased significantly with the urbanization rank only among girls of Pakistani origin (UR 1-4). Pattern of gender differences in activity level was different in rural and urban children. Rural girls were slightly more active than rural boys, whereas in urban areas boys were significantly more active than girls. Because of lower bodyweight the less urbanized children in spite of having higher PAL had a lower mean TEE as compared to the more urbanized groups. CONCLUSION: The activity level of rural children having access to formal education and television could not be expected to be very different from their urban counterparts. Inactivity of urban girls needs particular attention. Because of lower caloric requirements, on similar diets, less urbanized groups may succumb to overweight more easily than the urbanized groups. Participation in active games may present a substitute to decreased involvement in moderately active work and play activities.

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