Effect of physical activity and multi-micronutrient supplementation on body composition among Tanzanian schoolchildren: secondary outcomes from the KaziAfya cluster-randomized controlled trial.

Johanna Beckmann, Christin Lang, Jürg Utzinger, Kurt Z Long, Markus Gerber, Elihaika G Minja, Emmanuel C Mrimi, Winfrida P Mponzi, Marceline F Finda, Fredros O Okumu

Journal: BMC public health 2025;25(1):2356

PMID: 40611032

Free Full Text on BioMed Central View on PubMed

Abstract

BACKGROUND

Childhood overweight and obesity are increasing in low- and middle-income countries, including Tanzania, due to changing lifestyles and diets. This study evaluated the effect of a school-based physical activity (PA) programme and multi-micronutrient supplementation (MMNS) on body composition among primary schoolchildren in the Kilombero district, Tanzania.

METHODS

In a cluster-randomized design, children aged 6-12 years were assigned to one of four groups: PA, MMNS, both interventions combined (PA + MMNS), or control. Body composition was assessed at baseline and after 14 months (T2) and 26 months (T3).

RESULTS

Among 745 children (396 girls, 349 boys) from 16 clusters assessed at T3, no statistically significant differences in overall body composition (primary outcome) were observed across intervention groups compared to control. However, sex-stratified analyses revealed important differential responses: girls in the PA arm showed significant decreases in both fat mass (FM) and fat-free mass (FFM), while girls in the PA + MMNS arm exhibited significant decreases in FFM and truncal fat-free mass (TrFFM). In contrast, boys in the MMNS arm demonstrated significant increases in FFM and TrFFM, while boys in the PA + MMNS arm showed significant increases in FFM and TrFFM alongside a significant decrease in truncal fat mass (TrFM).

CONCLUSION

The interventions showed gender-specific effects on body composition. Further research is warranted to understand why boys and girls respond differently to similar interventions.

TRIAL REGISTRATION

The study was registered on 9 August 2018, with ISRCTN. https://doi.org/10.1186/ISRCTN29534081 .

Address: Environmental Health and Ecological Sciences, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania. [email protected].; Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland. [email protected].; University of Basel, Petersplatz 1, CH-4003, Basel, Switzerland. [email protected].; Environmental Health and Ecological Sciences, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania.; Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.; University of Basel, Petersplatz 1, CH-4003, Basel, Switzerland.; Environmental Health and Ecological Sciences, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania.; Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052, Basel, Switzerland.; Environmental Health and Ecological Sciences, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania.; School of Life Science and Bioengineering, Nelson Mandela African Institution of Science & Technology, P.O. Box 447, Arusha, Tanzania.; Environmental Health and Ecological Sciences, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania.; School of Life Science and Bioengineering, Nelson Mandela African Institution of Science & Technology, P.O. Box 447, Arusha, Tanzania.; School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, G12 8QQ, UK.; Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.; University of Basel, Petersplatz 1, CH-4003, Basel, Switzerland.

DOI: 10.1186/s12889-025-23457-x

Link outs

Free resources

Full Text Sources:

Medical:

MeSH Terms: Humans, Tanzania, Female, Male, Child, Body Composition, Exercise, Dietary Supplements, Micronutrients