PhD defence: Physical activity levels, cardiorespiratory fitness, and diabetes

among People living with HIV and HIV-uninfected adults in Tanzania

Brenda Wilfred Kitilya

PhD thesis

Diabetes mellitus is becoming a growing public health concern among Tanzania's adult population, including people living with HIV (PLWH). Physical activity and high cardiorespiratory fitness reduces the risk of diabetes. Yet adults in Sub-Saharan Africa (SSA), particularly PLWH, have significant levels of physical inactivity and poor cardiorespiratory fitness, which raises concerns about a high risk of diabetes and mortality.

This doctoral dissertation examines the levels and correlates of physical activity in adults, changes in physical activity among PLWH following the start of antiretroviral therapy (ART), and also assessed the relationships between physical activity and cardiorespiratory fitness and beta-cell dysfunction, insulin resistance, and diabetes mellitus. The thesis further explored social and cultural elements that affect physical activity in more detail.

We found that physical activity levels and capacity vary by HIV status, and that PLWH have poor levels of both due to HIV-related health problems, as opposed to HIV-uninfected individuals, whose poor levels of both were associated with anemia and obesity.

Running, walking, and rope skipping, house chores were found to be the most popular forms of physical activity and, that these practices were deeply ingrained in the gender roles and stereotypes that were already prevalent in the community. PLWHs also believe that physical activity is good for their health, regardless of how much or what kind of physical activity they engage in. Also, we discovered that physical activity improves beta-cell function and lowers the risk of insulin resistance and diabetes mellitus.

These findings are novel in that they will help guide the development of contextually based physical activity programs that will encourage physical activity and lower the risk of diabetes mellitus in adults, especially PLWH in Tanzania however, further research is needed to assess these associations of physical activity and diabetes mellitus and explore social and cultural aspects in detail among PLWH and adult population as whole.

Download Table of contents; English summary; Danish summary; List of papers.

2023, 309 pages.

Time

16 June 2023, 09:00

Place

Catholic University of Health and Allied Sciences, Tanzania and online.

Opponents 

Professor Christian Mølgaard (Chair), Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Denmark.

Professor Domenica Morona, CUHAS, Tanzania.

Associate professor Bruno Fokas Sunguya, School of Public Health and Social Sciences, MUHAS, Tanzania.

Main supervisor

Associate Professor Mette Frahm Olsen, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Denmark.

Former main supervisor: Professor Henrik Friis, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Denmark.

Co-supervisor

Professor Robert Peck MD, MS, PhD, Associate Professor of Medicine and Pediatrics, Catholic University of Health and Allied Sciences, Tanzania.

Dr George PrayGod, MD, PhD, Principal Research Scientist, National Institute for Medical Research, Tanzania.

The thesis is available for inspection at the library, Nørre Allé 51, DK-2200 Copenhagen N.