title: Descriptive epidemiology of ambulatory activity in rural, black South Africans.
abstract: OBJECTIVE
  We investigated the distribution of objectively measured ambulation levels and the association of ambulation levels to adiposity levels in a convenience sample of adolescent and adult, rural black South Africans.
  
  
  METHODS
  We analyzed 7-d pedometry data, collected over a period of nine consecutive days, in 789 subjects (women, n = 516; men, n = 273). Adiposity measures included body mass index (BMI) and waist circumference (WC). Obesity was defined as BMI > or = 30 kg x m(-2) or WC > or = 102 cm for men and WC > or = 88 cm for women.
  
  
  RESULTS
  The average age- and BMI-adjusted 7-d ambulation level was 12,471 steps per day (95% confidence interval (CI) = 12,107-12,834). Ambulation levels differed between sexes (P = 0.0012), and weekday ambulation differed from weekend ambulation (P = 0.0277). Prevalences, age adjusted to the world population, for sedentarism (SED; <5000 steps per day), low active-somewhat active (5000-9999 steps per day), and active-very active (ACT; > or =10,000 steps per day) were 8.0%, 25.5%, and 66.6%, respectively. In contrast, published self-reported national prevalences for physical inactivity, insufficient physical activity, and physically active have been estimated to be 43%-49%, 20%-27%, and 25%-37%, respectively. After adjusting for sex and age, adiposity measures remained significantly associated with steps per day (BMI, r = -0.08; WC, r = -0.12; P < 0.03). Adjusting for sex, age, village, and season, SED increased the risk of obesity by more than twofold compared with ACT (P < 0.05). Achieving <10,000 steps per day compared with ACT was associated with an increased multivariate-adjusted obesity risk of 86%-89% (P < 0.001).
  
  
  CONCLUSIONS
  Ambulation levels were high for this rural African sample, and prevalences for SED and ACT differed from published self-reported estimates.
authors.affiliation: Physical Activity Epidemiology Laboratory, University of Limpopo, Turfloop Campus, Polokwane, South Africa. ianc@ul.ac.za
authors.forename: Ian
authors.initials: I
authors.lastname: Cook
authors.forename: Marianne
authors.initials: M
authors.lastname: Alberts
authors.forename: Johanna S
authors.initials: JS
authors.lastname: Brits
authors.forename: Solomon R
authors.initials: SR
authors.lastname: Choma
authors.forename: Sthembiso S
authors.initials: SS
authors.lastname: Mkhonto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012424:Rural Population; D057185:Sedentary Behavior; D017678:Sex Distribution; D013019:South Africa / Q000453:epidemiology; D016138:Walking / Q000706:statistics & numerical data*; D055815:Young Adult