ABSTRACT
The study assessed the prevalence of overweight and obesity of children aged 6 -12 years living in rural communities of Umuahia South Local Government Area of Abia State, Nigeria. A random sampling technique was used in selecting 5 schools and 180 children used for the study. One hundred and eighty subjects each were selected randomly from the rural schools, respectively. This was done by picking 36 subjects comprising of boys and girls within the ages 6-12 years from each of the 5 schools, by way of balloting without replacement. A structured questionnaire was used to collect information on the personal data, family background, parents’ socio-demographic status, physical activity pattern of the family and monthly income range of the parents. Anthropometric measurements of weight, height and triceps were done in the rural schools, respectively. Statistical Package for Social Sciences (SPSS) version 15 was used to analyze the data. Information from the questionnaires, weight was analyzed using frequencies and percentages and categorized using World Health Organization (WHO) anthro software. Comparison was done using chi square test for categorized variables while ANOVA was used to analyze continuous variables. Anthropometric result showed that prevalence of childhood stunting, wasting, overweight and obesity among the primary school children studied Umuahia South Local Government Area Abia State was 42.8%, 6.7%, 23.9% and 15.0% respectively. Obesity was more among the female children (13.5%) than in the males (16.5%) and overweight was more among the male children (17.5%) relative to the females (6.4%). Children whose parents monthly income was N50,000 and above showed higher prevalence of overweight and obesity than those whose parents monthly income was less than N18,000 respectively. A lower number of rural children (1.7%) view television for more than two hours per day.The body mass index (BMI) distribution of the children showed15.0% were obese and 23.9% were overweight. Conclusive evidence has shown that socio economic, nutrition status of children had a negative impact on the obese children in terms of weight loss.
TABLE OF CONTENTS
Title page i
Declaration ii
Certification iii
Dedication iv
Acknowledgements v
Table of contents vi
List of Tables ix
Abstract x
CHAPTER 1: INTRODUCTION
1.1 Background information 1
1.2 Statement of the problem 3
1.3 Objectives of the study 5
1.4 Significance of the study 6
CHAPTER 2: LITERATURE REVIEW
2.1 Origin of childhood obesity 7
2.2 Prevalence of childhood obesity 7
2.3 Definition of childhood obesity 15
2.3.1 Classification of Obesity in Children 16
2.4 Measurement of obesity 19
2.4.1 Weighing Methods 20
2.4.2 Human Anthropometric Method 20
2.4.3 Modern Machine Method 21
2.5 Predisposing and causative factors of
childhood obesity 22
2.5.1 Genetic factors 22
2.5.2 Dietary factors 25
2.5.3 Level of physical Activity 27
2.5.4 Medical factors 28
2.5.5 Environmental factors 29
2.5.6 Psychological factors 29
2.5.7 Socio- economic factors 30
2.6 Complication/problems of childhood obesity 31
2.6.1 Health Problems 31
2.6.2 Economic Problems 34
2.6.3 Social and Psychological Problems 35
2.7 Dietary management of childhood obesity 35
2.8 Prevention of childhood obesity 37
2.8.1 Parent nutrition education 38
2.8.2 Dietary consideration 38
2.8.3 Physical activity 39
CHAPTER 3:
MATERIALS AND METHOD
3.1 Study design 40
3.2 Area of study 40
3.3 Population of the study 40
3.4 Sampling and sampling techniques 41
3.5 Preliminary activities 42
3.6 Sampling selection 44
3.7 Data collection 44
3.8 Data analysis 46
3.9 Statistical analysis 46
CHAPTER 4: RESULTS AND DISCUSSIONS
4.1 Personal characteristics of caregivers of
children 48
4.2 Socio-economic
characteristics of parents 50
4.3 Food consumption pattern of primary
school children 53
4.4 Lifestyle and activity pattern of primary
school children 59
4.5 Anthropometric status of primary school
children 62
4.6 Effect of socio-economic characteristics,
lifestyle, and physical activity on nutritional status of primary school
children 69
CHAPTER 5: CONCLUSION AND
RECOMMENDATION
5.1 Conclusion 75
5.2 Recommendation 76
References 77
LIST OF
TABLES
Table 4.1: Personal Data of caregivers of the
children 49
Table
4.2: Socio-economic characteristics
of parents 51
Table 4.3: Pattern of food consumption of primary
school children 55
Table 4.4: Frequency of consumption of some foods
from various food groups 58
Table 4.5: lifestyle and activity pattern of primary
school children 60
Table 4.6a: Anthropometric characteristics of primary
school children. 63
Table 4.6b: Anthropometric status of
primary school children by gender. 66
Table 4.6c: Anthropometric status of primary school
children by age 68
Table 4.7: Effect of socio-economic status,
lifestyle and physical activity
on
weight-for-age status of primary school children 70
Table 4.7b: Effect of socio-economic status, lifestyle
and physical activity on height-for-age status of primary school children 72
Table 4.7c: Effect of socio-economic status,
lifestyle and physical activity on BMI-for-age status of primary school
children 74
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND INFORMATION
The
past few decades have brought marked lifestyle changes throughout the world,
which have resulted in a physical inactivity (sedentary lifestyle), and an
increase in caloric intake (Miller et al.,
2004). There is scientific evidence that changes in diet have both positive and
negative influences in health throughout life (Veneman, 2006). Changes in diet
have mostly contributed to pediatric obesity (Miller et al., 2004).Overweight and obesity is becoming increasingly
prevalent in low income countries where improvements in socio-economic
conditions and rapid urbanization are causing a nutrition transition
characterized by a rapid shift in the composition of diet (higher fat and low
carbohydrate), reduced activity patterns and
subsequent shift in body composition (Drake et al., 2002).
Obesity has become a pandemic, with more
than a billion people affected worldwide (Kimm and Obarsanck, 2002). It is
characterized by excess accumulation of body fat accompanied by minimal
physical work or exercise and is a danger to the good health and wellbeing of
most persons. The prevalence of overweight and obesity is increasing at an
alarming rate with populations living in both developed and developing
countries (Nyaruhucha et al., 2003).
Moreover, the problem appears to be increasing more rapidly among children compared
to adults, implying that the health consequences will become fully apparent in
the future (Nyaruhucha et al., 2003).
Data from the International Obesity Task force (IOTF)
indicated that 22million of the world’s children under five years of age are
overweight or obese (Dietel, 2002). Over the past 30 years, the frequency of
overweight children (defined as a body mass index (BMI) greater than the 85thpercentile
for age and sex) had tripped leading to more than 30% of children in the United
State being overweight (Miller et al.,
2004). Consequently, an alarming number of children who are overweight or obese
are developing diseases that are seen normally in adulthood (Oduwole et al., 2007).
Barness
et al. (2007) highlighted the risk of
obese children growing up to become obese adults with all of the associated
health risks such as cardiovascular disease, hypertension, dyslipidemia, type 2
diabetes mellitus, among others. More so, researchers have documented health
risks during childhood linked to obesity such as rising incidence of type 2
diabetes among youths (Hannon et al.,
2005), asthma and sleep apnea (Deane and Thomson, 2006) and hypertension and
dyslipidemia (Chien-Chan et al.,
2009).
However,
from the information available, the prevalence of childhood obesity remains
very low in Africa, although it appears to be rising in several countries
(Lobstein et al., 2004). A Nigerian survey
in 2007 estimated some 17% of pre-school children to be overweight, of which 5%
were obese (Senbajo and Adejuyigbe, 2007).A decade earlier, the figure had been
below 4% for overweight and obesity combined, using weight-for-height criteria
(Blossner and Deonsis, 2000). Obesity among adolescents in Nigeria was
relatively low but with markedly differing levels in urban area (3.3%) and 0.2%
in rural areas (Oduwole et al., 2007).
Findings
further suggested that the mechanisms of obesity development are fully not understood
and it is believed to be a disorder with multiple causes (Dehgtan et al., 2005). Environmental factors,
lifestyle preferences and cultural environment play vital role in the rising
prevalence of obesity worldwide (Dehgan et
al., 2005). This study supports the importance of early intervention as a
panacea to prevent the persistence of early overweight into adolescence and
adulthood.
1.2 STATEMENT OF THE PROBLEM
Obesity
is a major threat to children’s health today. The prevalence of obesity has
been steadily increasing, over the past 25 years, and the number of obese
children has nearly tripled (Ogden et al.,
2002; Hedley et al., 2004 and Nader et al., 2006). By body mass index (BMI)
criteria(>+2SD for age and sex), approximately 15% of children 6-19 years
old are obese (Krebs and Jacobson, 2003).In the long run, significant health problems
associated with obesity, such as cardiovascular disease, type 2 diabetes, and hypertension,
usually will appear in adulthood (Gordon, 2007). An increase in these
health-related complications has been noted in children. About 40% of obese
children (and about 80% of obese adolescents) become obese adults (Gordon,
2007). Many factors have been identified as the causative agent of obesity.
They include hormones, heredity, defective metabolism, large fat cell, lack of
physical exercise and over eating (Nyaruhucha et al., 2003). However, the most common and main cause is consumption
of calories in excess of the normal body requirements (Nyaruhucha et al., 2003).
In
developed countries, obesity has been concentrated among the poor for decades,
but in developing countries, obesity has traditionally been associated with wealth
until now (Lobstein, 2003). Overweight and obesity are becoming problems of the
poor (Lobstein, 2003). Trends in obesity have been documented in only a few
African countires (Nyaruhucha et al.,
2003).
World
Health Organization (2011) figures classified over a third of adult Nigerians
as overweight (29%) or clinically obese (7%) with the prevalence increasing
with time. Moreover, the problem appears to be increasing more rapidly among
children compared to adults, implying that the health consequences will become
apparent in the future (Nyaruhucha et al.,
2003).
In
recent time, a lot of attention has been given to chronic disease, which is
escalating much more rapidly in developing countries than in industrialized
countries (Gordon, 2007). A potential emerging public health issue may be the
increasing incidence of childhood obesity in developing countries and the
resulting socio-economic health burden these countries may face in the near
future (Roya, 2007). Children in Abia State, Nigeria, like every other part of
the developing countries are not exempted. In this regard, a potential emerging
public health issue for developing countries may be the increasing incidence of
childhood obesity which is a key factor for many chronic non-communicable
diseases and may result in the reduction of effective productive individuals,
creating an enormous, social-economic and public health burden for the nation.
Although,
there is a growing body of data on obesity and overweight in this age group,
few data are available on the true extent of overweight among school-age
children in low-income countries (Moreira, 2002).Consequently, there is need to
investigate the prevalence of overweight and obesity among primary school
children (6-12years) in Umuahia South Local government area of Abia State,
Nigeria.This is because managing obesity at childhood is more effective, as
management at adulthood has proved to be a facture due to lack ofdiscipline.
However, if the incidence of childhood obesity can be ceased among growing
children, then the various health, social and psychological complication of
obesity may be addressed. This in turn helps to protect the source of obesity
related complications.
1.3 OBJECTIVES OF THE STUDY
The
general objectives of this study is to determine the prevalence of childhood
overweight and obesity among primary school children (6-12 years) in Umuahia
South Local government area of Abia state, Nigeria.
The
specific objectives were:
1.
To determine the
socio-economic characteristics of the study population.
2.
To investigate the food
consumption pattern of the study population.
3.
To evaluate the lifestyle
and activity pattern of the studied subjects.
4.
To identify factors that affect
food consumption and activity pattern.
5.
To assess anthropometric
status using different growth indicators.
6.
To ascertain the effect
of socio-economic status, food consumption pattern, lifestyle and activity
pattern on nutritional status of the study population.
1.4 SIGNIFICANCE OF THE STUDY
-
Information obtained from this
study will be relevant in creating awareness among primary school children
about the risk factors and long life effect of obesity.
- The
findings of this study will motivate caregivers to establish a healthy
lifestyle and adequate feeding habit of their children thereby improving
parental care.
- The
Ministry of Health, health practitioners (Dietitians Nutritionists, Doctors)
will harness the findings from this study in the fight against the major killer
diseases.
- The
outcome of this study will be beneficial to the government as a tool for health
policy formulation.
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