CC BY
100
DOI: 10.14526/2070-4798-2019-14-2-116-125
Influence of body composition on health status of civil servants in Efon local government of Ekiti State, Nigeria
DOMINIC Olufunmilola Leah1*, ABOLARIN Joseph1, SEIDINA Iliasu Yakubu1, ATIKUMI Nathaniel2, AHMED Mulkah Adebisi3
department of Human Kinetics Education, Faculty of Education, University of Ilorin, Nigeria department of Health, Physical Education and Recreation, Faculty of Science and Technology
Education, University of Cape Coast, Ghana 3Department of Science Education, Faculty of Education, University of Ilorin, Nigeria
lolafunmidom@gmail.com*
Annotation: Unhealthy body composition (BC) is largely responsible for metabolic syndrome (MS) and emergence of cardiovascular diseases (CVDs) leading to tragic events such as slumping, diabetes, increase morbidity and mortality that have become frequent among civil servants. The study was conducted to determine influence of body composition on health status of Civil Servants in Efon Local Government of Ekiti State, Nigeria. Research Methods. Descriptive research design with simple random sampling technique was used to select 150 participants (n female 93, n male 57) from ministries/commissions in the local government. Standardized instruments were used to measure height, weight, waist and hip circumferences, Body Mass Index (BMI) and percentage body fat (BF%). Demographic data were analysed using percentage; hypotheses were tested with regression analysis p< 0.05. Results. Findings revealed more females 62 (66.7%) than males 36 (63.4%) had high BMI; majority of the civil servants had healthy %BF for healthy living n males 39 (67.7%), n females 69 (73.7%). Waist-to-hip ratio (WHR) revealed bad and unhealthy status n male 51 (83.9%) and n females 88 (94.7%), and a good indicator of CVDs and MS risk factor. BC variables were significant determinants of health status R=.747, R2=.558, SEE=.531, p=.000; BMI was the most significant P=.500, p=.008. Conclusion. BC assessment could be reliably used for monitoring health status of civil servants. BMI and WHR have higher predictive ability for risk of MS and CVDs. Interventions of medical screening and health promotion campaigns towards behaviour modification and healthy lifestyle among the civil servants is recommended.
Keywords: BMI, Health Risks, Physical Activity, WHR.
For citation: DOMINIC Olufunmilola Leah, ABOLARIN Joseph, SEIDINA Iliasu Yakubu, ATIKUMI Nathaniel, AHMED Mulkah Adebisi. Influence of body composition on health status of civil servants in Efon local government of Ekiti State, Nigeria. The Russian Journal of Physical Education and Sport. 2019; 14(2): 98-106. DOI: 10.14526/2070-4798-2019-14-2-116-125
INTRODUCTION
Daily consumption of staple food especially carbohydrates, and fatty foods without the proportional burn-out of such foods, inactivity and long-time sitting create way for accumulation of body fat. Meanwhile, the increase in body size, otherwise called fatness that was mostly misconstrued as sign of good diet, good living and pride in the late 18th and 19th centuries among in most communities have become an alarming risk factor of diseases, health challenges and premature death today (Dominic, Onifade and Lajide, 2010; Engeda, Dachew, Woreta, Kelkay, and Ashenafie, 2016). Advancement and innovations had lured more people to become lazy and sedentary (Omonu, 2015). Sedentary life styles (lack of or inadequate exercises, sitting for long time
in office or work place and on computer), lead to series of diseases (cardiovascular diseases, allergies, headaches) and expose individuals to many physical, social, emotional and psychological challenges, that trigger body ailment increasingly (Nascente, Jardim, Peixoto, et al., 2016; Dominic et al., 2018). These problems are often compounded due to economic hardships and increase in the number of people taking up unhealthy lifestyle behaviours like overeating, lack of medical check-ups, high consumption of sugar, alcohol, salt, smoking, eating of contaminated foods, excessive seasonings in diets and poor sleep patterns. These unhealthy lifestyle behaviours are the most common preventable cause of unhealthy body composition (Dominic et al., 2018, World Health Organization [WHO], 2010).
Therefore, a desirable lifestyle is the one that has healthy body composition and healthful potentials through diet of low fat and high in fibre, adequate physical activity and avoidance of unhealthy habit and practices.
Body composition is a health-related component of physical fitness which includes the relative amount of muscle, fat, bones and other vital parts of the body. It is the ratio of fat to muscle where the minimum fat and maximum lean mass is a sign of fit and healthy body. The human body is composed of water, protein, minerals and fat which encompass the proportion of fat and fat-free mass that are germane determinant of functional ability, health, wellness and living status of an individual (Akindele, Philips and Igunmbor, 2016). Adebayo (2015) observed that in order prevent cardio-vascular diseases, individuals must develop and maintain healthy body composition through dictated adequate nutrition, healthy lifestyles, healthful living habits and safe environment.
Bad body composition leads to metabolic syndrome and emergence of cardiovascular diseases (CVD) (American Heart Association [AHA], 2015), which was responsible for about 17.3 million global mortality in 2013, and may rise to 23 billion by the year 2030. About 470,000 Africans die yearly of heart disease (HD). For example, in 2014, 356,500 people had cardiac attack (CA) because of poor body composition and involvement in unhealthy habits like smoking. In 2010, smoking affected 6.2 million people while diabetes affected 285 million people worldwide which may increase to 439 million people by the year 2030. Twenty five percent of deaths due to non-communicable diseases from CVD affect people below the age of 60 years, mostly working class (Nascente et al., 2016; Liberato, Marple-Brown, Bressan and Hills, 2013; Okafor, Anyaehie and Ofoegbu, 2014).
Considering total body weight of human beings, studies have shown (Janssens, Goedecke, de Bree, Aderibigbe, Akande and Mesnard, 2106; Vipene and Ogunleye, 2013) that body fat of adults constitutes 14 - 17% of the total weight of men and 21 - 24% of total weight in women. Body fat percentage (BF%) classification according to health status and gender, indicate that essential fat is 10-13% (females) and
2-5% (males); athletes 14-20% (females) and 6-13% males; fitness 21-24% (females) and 14-17% males; acceptable (healthy) 25-31% (females) and 18-25% males; obese >32% (females) and >25% males (United States Department of Health and Human Services, 1994). Women require higher amounts of body fat than men because of the sex-characteristics that are necessary for childbearing functions. When these ranges of body fat are exceeded in both men and women, disease risk threshold becomes overstretched with increased risk of becoming overweight and obese. Researches have shown that on average, being overweight is liable to reduced attention, working memory and increases the risk of early onset of dementia (cognitive and intellectual deterioration) (Ogunmola, Olaifa, Oladapo and Babatunde, 2013; Shuval et al., 2014). In addition, too much body fat results to health problems like hypertension, elevated blood lipids (fats and cholesterol), diabetes mellitus, cardiovascular disease, respiratory dysfunction, gall bladder disease, insulin resistance, cancer (colon, prostate, oesophagus, ovaries, endometrium, breast, and cervix), arthritis, gout, back pain, osteoporosis, complications during pregnancy, menstrual abnormalities, sleep, apnea and impaired immune functions (Vipene and Ogunleye, 2013; Chinedu et al., 2013; Pescatello, Arenea, Riebe and Thompson, 2014).
Essential body fat serves enormous functions to the body (Figley, Asem, Levenbaum and Courtney, 2016; Oke, and Agwubike, 2015). These include improved metabolism, improved strength, improved appearance, improved brain functions and increased daily movement. In addition, the maintenance of healthy skin and hair, maintenance of the right body temperature, storehouse for energy in the body, smooth functioning of cells, cushioning effects on organs and tissues, bone marrows, lungs, liver, spleen, kidneys, intestines, cardiac muscles, lipid-rich tissues throughout the central nervous system and skeletal muscles fuelling. In addition, essential fat serves as acting as shock absorber for bones (Office of Disease Prevention and Health Promotion [ODPHP], 2014), and helps to absorb many vital vitamins like A, E, D and K and acts as immunity boosters to protect the body from
R
ailments (Ukegbu and Nwaegbute, 2012; Juraschek et al., 2014).
Body mass index (BMI) is the index that expresses adult weight in relation to height. It is the most common method of measuring obesity or determining body weight and it is calculated by dividing the body weight (in kilograms) by height (in metres) squared. BMIs of individuals are classified as healthy/normal (BMI 18.5-24.9); overweight (BMI 25.0-29.9); obesity I (BMI 30.034.9); obesity II (BMI 35.0-39.9); obesity III (BMI 40.0-49.9); obesity IV (BMI 50.0-59.9) and obesity V (BMI D60.0) (WHO, 2010). Another way of determining body composition and health or fitness of an individual is the use of waist-to-hip-ratio (WHR). WHR classification differs in men and women for determining health (WHO, 2010). The ratios of >9.0 in males and >8.5 in females is one of the decisive benchmarks for metabolic syndrome. Research confirmed that waist-to-hip ratio is the superior clinical measurement for predicting the all cause cardiovascular diseases mortality and that hip circumference indicates a lower risk for body fat accumulation (Odo, Ezeanyika and Uchendu, 2015; Talabi, 2016).
Many epidemiological studies suggest that socioeconomic status is related to body composition in which low educational attainment, income and social status are strongly associated with perceived poor health awareness and poor health status (Figley, 2016; Talabi, 2016). It has been observed that in most cases busy schedules of the elites and working class influence their nutritional behaviours. For many of them it is normal to skip breakfast and eat junk foods like pastries, fries and carbonated drinks during lunch break. These foods, which are high in sodium and calories but low in nutrients are often misconstrued as denoting high class or high taste. Unfortunately, they increase the opportunity for excess accumulation of body fat and increases the risk of unhealthy body composition among civil servants (Omonu, 2016; Dominic et al., 2016 WHO, 2010; Soenen and Chapman, 2013).
Another potential risk factor for unhealthy body composition, obesity and chronic diseases among civil servants is that most of them have sedentary job, which is known to induce low or outright
negligence of physical activity during leisure time. Sedentariness is an independent risk factor for unhealthy body composition, chronic diseases and all-cause mortality (Omonu, 2015; Ojiambo, 2013). Meanwhile, breaking sedentariness by increasing physical activity is the cheapest means to reverse unhealthy body composition and control its challenges such as back pain, stress, obesity, diabetes and coronary heart disease, cardiovascular diseases and improving quality of life (Dominic et al., 2016; Talabi, 2016; Ojiambo, 2013; Soenen and Chapman, 2013). Regular exercise and adequate physical activity have been proved to induce improvement of energy balance, stressful conditions, sleep, fatigue and healthy weight.
STATEMENT OF THE PROBLEM
It appeared most civil servants were not aware of the consequences of unhealthy behaviours and/ or unacceptable high level of negligence among those who were purportedly aware. As such the accumulated effect of unhealthy behaviours among civil servants in Nigeria was suspected to be related with high incidences of chronic diseases that occur among civil servants during active service or immediately after retirement, leading to obesity, slumping, stroke, diabetes, high morbidity and mortality rates. The current economic recession in Nigeria might even accelerate the rate of unhealthy behaviours among civil servants. Hence, this study was timely to investigate the influence of body composition on the health status of Civil servants in Effon Local Government who might adopt risky measures to cope with their new economic challenges.
Hypothesis. Body composition is not a significant predictor of health status of Civil Servants in Effon Local Government of Ekiti State.
Objective of Study. The objective of this study was to:
1. Examine the influence of body composition rating on health status of Civil Servants in Effon Local Government of Ekiti State.
2. Determine the extent to which body composition predict health status of Civil Servants in Effon Local Government of Ekiti State.
METHODOLOGY
Descriptive research design was used for this study. The population consisted of all the Civil Servants in Efon-Alaye Local Government in Ekiti State, Nigeria. Randomisation was done to select the sample of 150 workers out of 248. The bio data of the participants revealed that 14 were within the age bracket of 22-31years (9.33%); 47 (31.33%) within 32-41years; 72 (48%) between 42-51years and 17(11.33%) were within the age range of 52years and above. Ninety-three (62%) were males as 57 (38%) were females. The measured body components were BMI, %BF, and WHR. Portable height scale was used for height measurement. Two birds non-elastic tape rule was used for waist and hip circumference measurement while Body fat/ hydration monitor scale (model number 703249CE) was used for body weight measurement. All the equipment was standardized, and reliably calibrated for body composition measurement. However, the
to confirm its functionality as well as familiarize with the operation. Body composition was categorized as follows: BMI was based on underweight <18.5, healthy 18.5-24.9, overweight 25.0-29.9, and obesity >30.0. Body fat was based on %BF categories as: below <3% and <10%; essential <5% and <10%; athlete <13% and < 20%; fitness <17% and <24%; acceptable/healthy <25% and <31% and >25% and >33% all for males and females respectfully while WHR was based on unhealthy >9.0 and >8.5 for males and for females respectively.
Proper enlightenment was given and the participants filled and signed informed consent form before the study. Percentage was used to describe the demographic data and body composition of the respondents. Multiple regression was used to analyse the relationship between body composition and health status with 0.05 alpha level to determine statistical significance. IBM SPSS version-20.0 application software was used for the data analysis.
Results
Table 1 - Analysis of Body Composition of Civil Servants in Efon Local Government
researcher conducted a pilot test prior to the study ody
Yariabiei C audi hin üb .411 Ciril Serrant! Male FetnaLE Rar ba?
N(4fc)
EMI UiKfeirvâ ¡si.: ¿(3.3) 2(22) 3 (53) P-Mtf
Hsatthy 45(32) 32 (34.4) ie (25.1) EKC-îLLir.t
OUUHL^Ë 70 (4Î.7) 35 (41 31 (544-. Poor
Obs-sity 1 24 (16-C ) 23(21.5) 4 (7.0) POM
Obs-sityl 3 p 0) — 3 (5 3) Very Rkm
Total 150 (10 0) 93(100) ST (100)
EFQ.j Bdow 1 — 1 Poor
Suuuilid 4(2.7) — 4 (7.0)
AlMete 14 13 ( 14.0) 1 (1.5) Good
Hühss 34(22.7) 24 (25 .£) 10 (17 S) Good
Aoc^ptabb H-5«Uhry 53 (35.3) 26(2S.-5) 27 (47.4) Excédait
Obs-3e 44(293) 30(322) 14 (24.6) Very Rm
Total 150 <100) 93 (100.0) SJ (10 0.0)
1VHR Unite dlfhy 132 (335 7Ï(Ï3 9) 54 (94.7) Poor
Hi.dttiiy 1B< 12;. 15(1 S. 1) 3(5.3) Gööi
Total IHK 100) 9,3(100) 57(10-0)
Table 1 shows analysis of the participants' body composition variables. Three variables were measured, body mass index (BMI), body fat percentage (BF %) and waist-to-hip ratio (WHR). These variables were used to rate the participants' health and risk of metabolic and cardiovascular diseases. The analysis revealed that for BMI, 41.9% male and 54.4% female were overweight; 34.4% males and 28.1% females healthy; 2.2% males and 5.3% females underweight and 21.5% males and 12.3% females obese indicating that most of the Civil Servants are at health risk. By implication, the Civil
Servants do not have healthy BMI (72.0% females have poor BMI while 65.6% males equally possess poor BMI). BF% reveal that more females 73.7% were healthy than males 39.8%. The breakdown of this indicates 1.8% females have very poor, 32.2% males and 24.6% females have very poor body fat% while 39.8% males and 26.3% females have good BF%, 28.0% of male and 47.4% of f have excellent BF%. For WHR, 83.9% of male and 94.7 were within unhealthy category while just 16.1% of male and 5.3% of female were in healthy status.
Table 2a - Model Summary of Multiple Regression Analysis for Determinants of Health Status
R-
Adjmted R"
SEE
Si?
.747
.553
549
.531
.000
p < 0.05
The result in table 2a shows there was a high positive multiple correlation between body composition and health status; R (multiple correlation) = .747, their BMI, BF% and WHR account for 55.8% variance in their health status of the participants R2 = .558, and could account for 54.9% of the entire population of the civil servants R2 = .549. Furthermore, the result revealed that
Table 2b - Coefficients of Regression Analysis for the
the model combining BMI, BF% and WHR was significantly suitable for predicting health status of the civil servants in Effon Local Government; p = .000. In addition, SEE (standard error of the estimate) = .531 indicates that there was high degree of accuracy in predicting health status of the civil servants with these body composition variables.
Predictors of Health Status
Model
Unit and aide ed C c = 3ï: i ria rt
BtandardÉ Ed Coefficients
3td. Error
(Cforettfrt) EBi EMI WHR
1.808 .14j .436 .951
309 .055 .■374 .D4
.500 .391
.002 .003 .000
p < 0.05
The coefficients of regression in table 2b, revealed that all the body composition variables were significant in determining health status of the participants. Considering the strength of relationship which explains the unique contribution of each variable of body composition to health status, BMI proved to be more effective determinant of health status P (standardised coefficient) = .500, p = .008; WHR was next P = .392, p = .000 and BF% was the lowest P = .198, p = .002. This implies that civil servants must consider these variables as important indicators for monitoring their health status and ensure they maintain a healthy range to be healthy.
DISCUSSION
In this study, analysis of body composition was conducted and used to determine health status of 150 male and female civil servants in Effon Local Government of Ekiti State, Nigeria. The identified BMI conditions were: underweight, overweight, obesity 1, obesity 2 and healthy. Participants who had underweight, overweight, and obesity 1 conditions
were rated as having poor health status; those with obesity 2 condition were rated as having very poor health status and others who had healthy were rated as having excellent health condition. It was revealed that majority 65.1% of the civil servants had poor BMIs, 3.3% of this were underweight which can be attributed to under nourishment (Ojiambo, 2013; Soenen and Chapman, 2013). Civil servants in this category are susceptible to increased risk of health conditions like fatigue, lethargy, low peripheral and respiratory muscle strength, impaired immune system, depression and anxiety (Ojiambo, 2013). The obese 2 were all females, rated very poor and constituted 5.3% of the female participants. More females (66.6%) than males (63.4%) have higher BMI than required, which means considering their BMI assessment of health status, females were at higher risk of metabolic syndrome than males (Shuval et al., 2014). Based on world BMI statistics, larger number of women are obese than men as such females are more susceptible to cardiovascular diseases, cognitive deterioration and reduced working memory and dementia;
allergies, headaches, physical, social, emotional and psychological challenges and other body ailments (WHO, 2010; American Heart Association, 2015). Findings of this study however showed that the difference in the proportion of obese male and female was not as high as previous studies (Dominic et al., 2010, WHO, 2010). Rating of BF% of the participants revealed a different information about the health status of the participants as majority of them 70% had favourable condition comprising of essential, athlete, acceptable healthy body conditions. Considering their BF% by gender, the females 73.7% had better rating than the male 67.8%. This is contrary to previous studies which have rated BF% of females to be lower than males (Dominic et al., 2018, WHO, 2010; Adebayo, 2015; Figley et al., 2016, Hoeger and Hoeger, 2011), but similar to the revelation when we used BMI. This implies a need for further investigation of civil servants to ascertain the extent to which their lifestyle especially their job affects their health status. It might also be that the current economic situation influenced the health status of more male participants than female since they were more populated in this sample and more of them were bread winners of their families than the females who may have the support of their husbands or other members of their families.
Considering WHR majority of the participants were unhealthy. In this case, more females 94.7% had unhealthy WHR rating than males 83.9%. Again, this rating indicates a high risk of chronic disease, metabolic disorder, cardiovascular diseases and mortality among the civil servants in Effon Local Government. This finding confirms the opinions of previous studies that civil servants possess unhealthy body fat that could endanger their health (Talabi, 2016). Accumulation of fat mass around the abdominal and hip region increases the risk of diseases like high blood pressure, abdominal obesity, certain types of cancer and osteoporosis (Akindele et al., 2016, Figley et al., 2016) since there is high possibility of impairment to the organs located around this region of the body (Dominic et al., 2010). For this reason, Talabi (2016) concluded that WHR should be considered as a superior clinical measurement for predicting the all-cause cardiovascular diseases mortality. This high rate
of unhealthy body composition among these civil servants call for urgent action to avert imminent health consequences which could increase the occurrences of slumping, stroke, heart failure and sudden death. Therefore, awareness education of the implication of unhealthy body composition through lifestyle habits and its antecedent morbidity and mortality is a critical intervention strategy for inculcating healthy behaviour among civil servants in Effon Local Government and by extension, the entire Nigeria.
Although other factors contributed to health status of the civil servant in Effon Local Government, the model that was designed for this study using multiple regression analysis revealed that body composition (BF%, WHR and BMI) significantly determined 55.8% of health status of the civil servants, which is in line with the opinion that %BF and BMI are vital variables of body composition for determining individual's health and dictates quality of life (Adebayo, 2015; American Heart Foundation, 2015; Janssens et al., 2016, Vipene and Ogunleye, 2013). The level of contribution revealed that when using body composition to assess overall health status of the participants BMI is the most important factor to be given consideration. In addition, the significant contributions of the WHR and BF% to determination of the participants' health status implied that abdominal adiposity as indicated by WHR was more important than BF% in health assessment since it provides information about fat mass around the organs in the abdominal region (Dominic et al., 2010). Finally, the ratings of body composition parameters considered in this study suggests the necessity to engage in regular sufficient physical activity in order to reverse the health risk of developing hypokinetic diseases which might have long term effect on their productivity. In addition, social and economic problems and premature mortality are associated with sedentary jobs that are typical of most civil servants' jobs. This is corroborated by several studies that poor body composition which may be caused by sedentariness (sitting for long, inadequate or no physical activity); risky habits (sleeping habit, smoking and alcoholism); and nutrition (junk food, too much carbohydrate, carbonated and fatty food)
(Engeda et al., 2016, Omonu, 2015, Dominic et al., 2018; Soenen and Chapman, 2013) culminating into excess fat accumulation, increased WHR and high BMI account for predominance of CVD that lead to some health challenges (Shuval et al., 2014).
Conclusion
Based on the findings of this study we concluded that:
Majority of the status civil servants in Effon Local Government had high risk of metabolic and cardiovascular diseases. This was mostly indicated by their BMI which was used to assess the overall distribution fat and fat-free mass.
BMI, WHR and %BF were useful determinants of health status and can be used to predict health status. BMI which considers the proportionality of ones' height to body was the best predictive factor among the tree indicators.
WHR which has link with abdominal adiposity is the second important factor. It can be used to predicting overall health status since abdominal adiposity has close relationship with functioning of the organs around the abdominal region.
RECOMMENDATION
Due to the high health and mortality risk associated with unhealthy body composition, we recommended that an urgent medical screening of the civil servant should be conducted to determine those who already have clinical condition(s) that might require treatment. There is also a need for health promotion campaigns for behaviour modification and healthy lifestyle among the civil servants with specific attention to nutrition, physical activity, sleep and stress management.
REFERENCES
1. Adebayo, D (2015). Watch out, prolong sitting kills. Available at http://wwwpunchng.
2. Akindele, M. O., Philips, J. S., Igunmbor, E. U. The Relationship Between Body Fat Percentage and Body Mass Index in Overweight and Obese Individuals in An Urban African Setting. Journal of Public Health in Africa. 2016, no 7(1), pp. 1 - 5.
3. American Heart Association (2015). Heart Disease and Stroke Statistics - 2016 Update: A Report from the American Heart Association,"
Circulation. Available at http://circ.ahajournals. org/content/early/2015/CIR.ooooooooooooo. citation.
4. Chinedu, S. N., Ogunlana, O. O., Azuh, D. E. et al. Correlation between Body Mass and Waist Circumference in Nigerian Adults: Implication as Indicator of Health Status. Journal of Public Health Research. 2013, no 2(16), pp. 93 - 98.
5. Dominic, O. L, Seidina, I. Y., Williams, D. F., Oyerinde, O. O., Olaitan, L., Onifade, O. A. ICT Use Implications for Exercise Participation and Health in the Nigerian University Community. Journal of Physical Education and Health-Social Perspective. 2oi8, no 7(11), pp. 5 -14.
6. Dominic, O. L. Onifade, O. A., Lajide, E. O. Body Mass Index and Waist/Hip Ratio among Female Workers in Ilorin University, Nigeria. Medicina Sportiva. 2010, no 6(4), pp. 1467-1472.
7. Engeda, E. H., Dachew, B. A., Woreta, H. K., Kelkay, M. M., Ashenafie, T. D. Health Seeking Behaviour and Associated Factors among Pulmonary Tuberculosis Suspects in Lary Armachiho District, North-west Ethiopia. A Country-Based Study. Tuberculosis Research and Treatment. 2016, no 4, pp. 1 - 7.
8. Figley, C. R., Asem, J. S., Levenbaum, E. L., Courtney, S. M. Effect of body mass index and body fat percentage on default mode, exercise control and Salience network structure and functions. Frontiers in Neuroscience. 2016, no 10(234), pp. 1 - 23.
9. Hoeger, W.W. K., Hoeger, S. A. Fitness and wellness. 2o11, (9th e.d.). USA: Wadsworth.
10. Janssens, W., Goedecke, J., de Bree, G. J., Aderibigbe, S. A., Akande, T. M., Mesnard, A. The Financial Burden of Non-communicable Chronic Diseases in Rural Nigeria: Wealth and Gender Heterogeneity in Health Care Utilization and Health Expenditures. 2016, PLOS-ONE no 11(11), pp. 1 -
19.
11. Juraschek, S., Blaha, M. J., Whelton, S. P. et al. Physical Fitness and Hypertension in a Population at Risk for Cardiovascular Disease. Project. Journal of the American Heart Association. 2014, no 3(6), pp. 1 - 11.
12. Liberato, S. C., Marple-Brown, L., Bressan, J., Hills, A. P. The relationship between body composition and cardiovascular risk factors in
young Australian men. Nutrition Journal. 2013, no 12(108), pp. 1 - 10.
13. Nascente, F. M. N., Jardim, T. V., Peixoto, M. R. G. et al. Sedentary Lifestyle and Its Associated Factors among Adolescents from Public and Private Schools in Brazilian State Capital. BioMedCentral Public Health. 2016, no 16(1177), pp. 1 - 8.
14. Odo, I., Ezeanyika U., Uchendu, N. The Relationship among Body Composition and Body Mass Index in Population of Adolescents in Enugu State, Nigeria. International Journal of Current Microbiology and Applied Sciences. 2015, no 4(1), pp. 884 - 897.
15. Office of Disease Prevention and Health Promotion (ODPHP). (2014). Health-related Quality of Life and Well-being. Available at https:// www.healthypeople.gov/ 2020/about/foundation-health-measures/Health-Related-Quality-of-Life-and-Well-Being.
16. Ogunmola, O. J., Olaifa, A. O., Oladapo, O. O., Babatunde, O. A. Prevalence of Cardiovascular Risk Factors among Adults without Obvious Cardiovascular Diseases in Rural Community in Ekiti State, South West, Nigeria. BioMedCentral Cardiovascular Disorder. 2013, 13(89), pp. 1 - 8.
17. Ojiambo, R. M. Physical activity and wellbeing: A Review of Health Benefits of Physical Activity on health outcomes. Journal of Applied Medical Sciences. 2013, no 2(2), pp. 69 - 78.
18. Okafor, C. I., Anyaehie, U. S. B., Ofoegbu, E. N. The Magnitude of Obesity and Its Relationship to Blood Pressure among the Residents of Enugu Metropolis in South-East Nigeria. Annals of Medical and Health Science Research. 2014, no 4(4), pp. 624 - 629.
19. Oke, K., Agwubike, E. O. Body composition and pulmonary functional correlates in Nigerian male Amateur boxer. Journal of Romanian Sports Medicine Society. 2015, no 42, pp. 884 - 897.
20. Omonu, J. B. Reducing Overweight and Obesity among Adult Men and Women through
Exercise Participation. European Scientific Journal. 2015, no 11(14), pp. 329 - 336.
21. Pescatello, L. S., Arena, R. Riebe, D., Thompson, P. D. American College of Sports Medicine (ACSM)'s Guidelines for Exercise Testing and Prescription. 2014, (9th e.d.). USA: Philadelphia.
22. Shuval, K., Finley, C. E., Barlow, C. E., Gabriel, K., Leonard, P. D., Kohl, H. W. I. Sedentary Behaviour, Cardiorespiratory Fitness, Physical Activity and Cardio-metabolic Risk in Men: The Cooper Centre Longitudinal Study. Mayo Clinic Proceedings. 2014, no 89(8), pp. 1052 - 1062.
23. Soenen, S., Chapman, I. M. Body Weight, Anorexia and Under Nutrition in Older People. Journal of American Medical Directors Association. 2013, no 14(9), pp. 642 - 648.
24. Talabi, A. E. (2016). Heaven is Far - Only the Fit Can Make It. Available at http://www.unilorin. ng.
25. Ukegbu, P., Nwaegbute, A. Body Composition Changes among Lactating Mothers in Abia State, Nigeria. American Journal of Food and Nutrition. 2012, no 2(1), pp. 21 - 25.
26. United States Department of Health and Human Services. Bioelectrical Impedance Analysis in Body Composition Measurement: National Institutes of Health Technology Assessment Conference Statement. American Journal of Clinical Nutrition. 1994, no 64(3 Suppl), pp. 524S - 532S.
27. Vipene, J. B, Ogunleye, A. V. Anthropometric study of body composition variables in selected male and female athletes in River State, Nigeria. Journal of Social Sciences and Humanities 2013. no 2(4), pp. 281 - 287.
28. World Health Organization (WHO) (2010). 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Non-communicable Diseases. Available at http://www.who.int/nmh/ publications/9789241597418.
Author's information:
DOMINIC Olufunmilola Leah - PhD., Department of Human Kinetics Education, Faculty of
Education, University of Ilorin, Nigeria, e-mail: lolafunmidom@gmail.com
ABOLARIN, Joseph - M.Ed., Department of Human Kinetics Education, Faculty of Education, University of Ilorin, Nigeria
SEIDINA, Iliasu Yakubu - M.Ed, Department of Human Kinetics Education, Faculty of Education, University of Ilorin, Nigeria
ATIKUMI, Nathaniel - M.Ed, Department of Health, Physical Education and Recreation, Faculty of Science and Technology Education, University of Cape Coast, Ghana
AHMED, Mulkah Adebisi - PhD., Department of Science Education, Faculty of Education, University of Ilorin, Nigeria
