ABSTRACT
BACKGROUND: Childhood overweight and obesity is a health
hazard and is an emerging public health problem.
OBJECTIVE: The objective of this study is to determine the
pattern of overweight and obesity and influencing factors among secondary
school students in Ekwulobia town in Anambra state of Nigeria.
METHODS: This was a descriptive cross-sectional study. Subjects
were selected randomly using multistage sampling technique. 250 students aged
12-19 years from three schools were studied. Calibrated mechanical weighing
scale was used to measure their weights. Heights were measured with rigid meter
rule. A semi-structured, self-administered questionnaire was used to collect
data on their physical activities, dietary habits and parent’s occupation.
RESULTS: Mean age of the students was 15.6 years ± 1.75.
Overall prevalence of overweight and obesity among them were 5.6 percent and
3.2 percent respectively. Females were more overweight than males (7.8% and
3.3% respectively), and also more obese (4.6% and 1.7% respectively).
Prevalence of obesity was highest in the 18- 20 year age group (5.6%).
Prevalence of overweight and obesity (combined) was higher in private school
(10.7%) than in public schools (6.0%). Frequent consumption of soft drinks,
meat pie, biscuit, sweet; and frequent television watching promoted obesity
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CONCLUSION/RECOMMENDENTIONS: Gradual increase in the
prevalence of overweight and obesity was found. However these are still much
lower than in developed countries. Faulty dietary eating habits and sedentary
activities are major culprits. This constitutes a major public health
challenge. I therefore recommend the following:
Health education in schools, and media campaigns are
needed. Policy makers, Health professionals, School authorities, Non
Governmental Organizations (NGOs) and National Agency
for Food and Drug Administration and Control (NAFDAC) should be involved in
primary preventive actions against childhood overweight and obesity.
CHAPTER ONE
INTRODUCTION
Obesity is the most
common nutritional disorder in affluent societies. Obesity may be defined as a condition in which there is excessive amount of body fat 1.
It is an abnormal growth of the adipose tissue due to an enlargement of the fat
cells (hypertrophic obesity) or an increase in the number of the fat cells (hyperplastic obesity) or a
combination of both 2. Excess fat accumulates because there is
imbalance between energy intake and expenditure.
The significance of obesity requires constant emphasis
because it is associated with increased morbidity and mortality. It predisposes
to the development of important diseases and diminishes the efficiency and
happiness of those affected. Obesity is a chronic disease, prevalent in both
developed and developing countries, and affecting children as well as adults.
Obesity is now so
common that it is replacing the more traditional public health concerns including
Undernutrition 2. It is now a global phenomenon.
It is extremely difficult to assess the size of the problem
and to compare the prevalence rates in different countries as no exact figures
are available and also because the definitions of obesity are not standardized.
However it has been estimated to affect 10 to 20 percent of children and adolescents in
developed countries 3.
Overweight may be
defined as an excess of bodyweight but not necessarily body fat; a body mass index (BMI) of 25 –
29.9 4. Body Mass Index (BMI) is acceptable for determining obesity
for children two years
and older 5. Although the BMI number is calculated the same way for
children and
adults, the criteria used to interpret the meaning of the BMI number for
children and teens are different from
those used for adults. BMI age- and sex- specific percentiles are used 6.
The Centers for Disease Control (CDC), has published tables for determining
this in children 7.Overweight
(but not obese) is a BMI between the cut-off values for overweight and obesity,
and obese is a BMI
greater than the cut-off value for obesity7. For normal weight, the
BMI is lower than the cut-off
value for overweight7.
STATEMENT OF THE
PROBLEM
Obesity is a health
hazard and a detriment to well-being which is reflected in the increased morbidity and
mortality 2. It is a key risk factor in the natural history of other
chronic and non communicable diseases. Due to the rising prevalence of obesity
in children and its many adverse health effects, it
is now being recognized as a serious public health concern 8.
The incidence of
chronic diseases is escalating much more rapidly in developing countries than
in industrialized countries. There is strong evidence that childhood obesity is
also becoming increasingly
prevalent in low-and middle-income countries 9,10. Malnutrition and
obesity co-exist in many developing
countries 11.
Obesity has many
health complications. The first problems to occur in these obese children are usually emotional
or psychological 12. Childhood obesity can also lead to serious
conditions such as diabetes
mellitus, high blood pressure, heart disease, sleep problems and cancer 13.
Other disorders include liver disease, early puberty or menarche, eating
disorders such as anorexia, skin infections, asthma
and other respiratory problems 14. Studies have shown that
overweight
children are more
likely to grow up to be overweight adults 13. Obesity during
adolescence has been found to
increase mortality rates during adulthood15. In schools, obese
students often suffer from teasing, harassment and ridicule from their peers 16.
At home they may also suffer harassment, discrimination and name-calling from
their own family members and neighbours.
These may lead to
anxiety, depression 17, low self esteem, frustration and even
withdrawal. A study18 has shown that college obesity is
increasing, and that physical inactivity, disordered eating perceptions, and
disordered behaviours are associated with increased rates of overweight and
obesity. A 2008 study has found that children who are obese have carotid
arteries which have prematurely aged by as much as thirty years, as well as
abnormal levels of cholesterol. A 15 year old obese child will have the carotid artery of a 45 year
old person 19. According to World Health Organization estimates, by
the year 2020, non communicable diseases will account for approximately three quarters of all deaths in the developing
world 20, and adolescent obesity will likely be a major risk factor
contributing to this. This emerging public health issue of increasing incidence
of childhood obesity in developing countries will likely create an enormous
socio-economic and public health burden for poorer nations in the
near future 21. Nigeria is a poor developing nation.
JUSTIFICATION FOR
THE STUDY
Since it has been
shown that interventions are not usually successful once overweight and obesity have occurred 22, it becomes important to
generate and provide research information for policy makers, health care
providers, parents and the general population, so that the problem could be
identified in childhood and appropriate attention given at that early age. The
developing trends in the factors that
influence childhood overweight and obesity among our students are definite health risks that
require definite studies and data for planning interventions.
In Nigeria (as also in other developing countries) little is
known about the prevalence of childhood overweight and obesity because of the
limited number of studies available, particularly in the South Eastern States
of Nigeria.
Nigeria needs more studies and data for reliable assessment
of the problem of childhood overweight and obesity in Nigeria and for
comparison of its prevalence with those of other regions of the world. Studies
such as this research project are therefore necessary to further reveal this
apparently hidden but important public health problem. The prevalence of
childhood overweight and obesity and their association with chronic diseases in
adulthood are still under appreciated in Nigeria because of inadequate studies,
data and publicity. The college years are highly influential in shaping adult
behaviours, particularly with regard to diet, physical activity, and other
lifestyle habits. Interventions aimed at the college population may help reduce
overweight and obesity during the transition from adolescence to adulthood and
thereby prevent some of the long-term health consequences of obesity, which
include coronary heart disease, hypertension, type 2 diabetes, and dyslipidemia 18.
Identification of, and a clearer understanding of these risk factors may prove
useful in the treatment of adolescent obesity by helping in the development of
multifaceted interventions that not only address weight loss but also target
the associated
disordered behaviours 18.
Up to now, most national public health programs and
policies, as well as national level research on children and adolescents in
Nigeria appear to have focused mainly on under nutrition and its effects on
survival, mortality, and development, in mothers and children. Since childhood overweight and
obesity and their co-morbidities will continue to increase the impact of a
number of risk factors for
adult diseases, it is reasonable and important to increase knowledge and awareness about the
prevalence of these disorders in Nigeria, which is still grappling with the public health
effects of malnutrition and micronutrient deficiencies. This study will be an additional stimulus
and contribution to these efforts.
In this period of Health Sector Reform, this study can equip
stakeholders to make policies that will recognize and address the emerging
challenges of childhood overweight and obesity in Nigeria in general. In
particular, seminars could be organized with evidence of this research data in
Ekwulobia town, for students and parents to initiate and stir up voluntary
preventive health measures for themselves against these emerging childhood
problems.
AIM OF THE STUDY
To determine the pattern of overweight and obesity among
secondary school students in Ekwulobia town, in Anambra state of Nigeria.
SPECIFIC OBJECTIVES
1.
To determine the prevalence of
overweight and obesity among the secondary school students in Ekwulobia town.
2.
To determine the age and gender
differentials in the prevalence of overweight and obesity among these secondary
school students in Ekwulobia town.
3.
To identify factors influencing
childhood overweight and obesity among these students.
4. To suggest ways of preventing overweight and obesity
among the students.
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Item Type: Project Material | Size: 73 pages | Chapters: 1-5
Format: MS Word | Delivery: Within 30Mins.
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