Kretschmer, Luke David Willem; (2024) Cross-Cultural Comparisons of Physical Activity; Observations from High-Income Countries and a Hunter-Gatherer Population. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Physical activity's impact on health throughout the life course is well-established, but low rates of activity, especially in childhood, persist. While previous studies have explored how activity correlates within and between populations, research on the full distribution of activity and its cross-cultural differences are limited. This thesis aims to integrate data and methods from epidemiology and biological anthropology to investigate the distribution of activity in high-income nations and a hunter-gatherer population. Differences in the distribution of individuals was observed in the objective accelerometery data in the International Childrens Accelerometry Database (ICAD). In this dataset boys were more active on average, undertaking a greater average amount of moderate-to-vigorous physical activity (MVPA). However, the greater variation also observed for boys may imply that differences in average activity levels are not caused by all boys undertaking more activity, but a larger subset undertaking additional activity beyond ‘day-to-day’ activities. Between the contributing studies, more active populations were not necessarily more variable, but a study that was variable in one threshold of activity was likely to be variable in others. Amongst the BaYaka hunter-gatherers, volumes of activity were over three times higher than World Health Organisation recommendations. Volumes of activity peaked in early adulthood but were high across the life course. Men were marginally more active, but differences did not appear to be driven by women’s reproductive status or due to proximity to markets. Compared to the American National Health And Nutrition Examination Survey (NHANES) and British Millennium Cohort Study (MCS) datasets, activity increased with age across childhood, with boys and girls sharing similar activity levels. While BaYaka children appeared to show a regular pattern of activity across the day, they varied more between days than American school children. This thesis provides new evidence to further an understanding of the socio-cultural determinants of health. It emphasises the role highly active hunter-gatherer societies can play in contrasting sedentary modern cultures. While gender and aged based differences in activity were the norm in the included high-income populations, the BaYaka differed notably, with high levels of activity that increased equitably with age for boy and girls. This thesis also demonstrates the value of developing a nuanced understanding of the full distribution of activity. Amongst the ICAD studies, statistically examining the variability and skewness furthered an understanding built solely on the mean.

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