1
|
Adeomi AA, Lawal NOO. Overweight and obesity among female adolescents in Nigeria; an emerging, but under-reported epidemic. BMC Womens Health 2024; 24:302. [PMID: 38773434 PMCID: PMC11106934 DOI: 10.1186/s12905-024-03146-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/15/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Overweight and obesity are increasing at epidemic levels in all ages globally, but there is little nationally representative data on female adolescents in Nigeria. The focus on female adolescents is important because of the negative implications of overweight and obesity on their health and survival, and that of their unborn children. AIM To estimate the prevalence and identify the determinants of overweight and obesity among female adolescents in Nigeria. METHODS Cross-sectional study using data from the Nigeria demographic and health survey, 2018. A total of 2,721 female adolescents aged 15-19 years were selected using cluster sampling technique. Overweight and obesity were determined using BMI-for-age reference values of World Health Organization and different explanatory variables at the individual, household and community levels were included. Binary logistic regression analysis was used to identify the determinants of overweight/obesity using five models. RESULTS The mean age of the respondents was 16.8 ± 1.4 years. The prevalence rate of overweight/obesity was 10.2%, but with a large variation in the geographical and socio-economic distribution. At the crude/unadjusted rate, nearly all the explanatory variables showed a statistically significant association with overweight and obesity, but at the full model which controlled for all the explanatory variables, only the household wealth index retained its statistically significant association, such that female adolescents who were from richer and richest households had about 3 times higher odds of being obese compared to those from the poorest households. (OR: 2.7; p = 0.018; CI: 1.18-6.18), (OR: 2.8; p = 0.027; CI: 1.13-7.06) respectively. CONCLUSION The prevalence of overweight/obesity among female adolescents in Nigeria was 10.2%. The household wealth index remained the only factor with a statistically significant association with overweight and obesity after controlling for confounders. Efforts at addressing overweight and obesity among female adolescents in Nigeria should target those from the richer/richest households.
Collapse
Affiliation(s)
- Adeleye Abiodun Adeomi
- Department of Community Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
| | | |
Collapse
|
2
|
van Zwieten A, Dai J, Blyth FM, Wong G, Khalatbari-Soltani S. Overadjustment bias in systematic reviews and meta-analyses of socio-economic inequalities in health: a meta-research scoping review. Int J Epidemiol 2024; 53:dyad177. [PMID: 38129958 PMCID: PMC10859162 DOI: 10.1093/ije/dyad177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Overadjustment bias occurs when researchers adjust for an explanatory variable on the causal pathway from exposure to outcome, which leads to biased estimates of the causal effect of the exposure. This meta-research review aimed to examine how previous systematic reviews and meta-analyses of socio-economic inequalities in health have managed overadjustment bias. METHODS We searched Medline and Embase until 16 April 2021 for systematic reviews and meta-analyses of observational studies on associations between individual-level socio-economic position and health outcomes in any population. A set of criteria were developed to examine methodological approaches to overadjustment bias adopted by included reviews (rated Yes/No/Somewhat/Unclear). RESULTS Eighty-four reviews were eligible (47 systematic reviews, 37 meta-analyses). Regarding approaches to overadjustment, whereas 73% of the 84 reviews were rated as Yes for clearly defining exposures and outcomes, all other approaches were rated as Yes for <55% of reviews; for instance, 5% clearly defined confounders and mediators, 2% constructed causal diagrams and 35% reported adjusted variables for included studies. Whereas only 2% included overadjustment in risk of bias assessment, 54% included confounding. Of the 37 meta-analyses, 16% conducted sensitivity analyses related to overadjustment. CONCLUSIONS Our findings suggest that overadjustment bias has received insufficient consideration in systematic reviews and meta-analyses of socio-economic inequalities in health. This is a critical issue given that overadjustment bias is likely to result in biased estimates of health inequalities and accurate estimates are needed to inform public health interventions. There is a need to highlight overadjustment bias in review guidelines.
Collapse
Affiliation(s)
- Anita van Zwieten
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Jiahui Dai
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
| | - Germaine Wong
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
- Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
| | - Saman Khalatbari-Soltani
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
3
|
Bertrand-Protat S, Chen J, Jonquoy A, Frayon S, Thu Win Tin S, Ravuvu A, Caillaud C, Galy O. Prevalence, causes and contexts of childhood overweight and obesity in the Pacific region: a scoping review. OPEN RESEARCH EUROPE 2023; 3:52. [PMID: 38031554 PMCID: PMC10685071 DOI: 10.12688/openreseurope.15361.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
Background Non-communicable diseases (NCDs) are a major threat to health and development and account for 75% of deaths in the Pacific Islands Countries and Territories (PICTs). Childhood obesity has been identified as a main risk factor for NCDs later in life. This review compiled overweight and obesity (OWOB) prevalence (anthropometric data) for children aged six to 12 years old living in the Pacific region and identified possible related causes. Methods We conducted a systematic search using PubMed, Google Scholar and ScienceDirect for articles published between January 1980 and August 2022. We also searched for technical reports from Ministries of Health. Guided by the eligibility criteria, two authors independently read the selected articles and reports to extract and summarise relevant information related to overweight and obesity. Results We selected 25 articles, two worldwide analyses of population-based studies and four national reports. Information revealed that childhood OWOB prevalence reached 55% in some PICTs. This review also indicated that age, gender and ethnicity were linked to children's weight status, while dietary practices, sleep time and level of physical activity played a role in OWOB development, as well as the living environment (socio-economic status and food availability), parenting practices and education level. Conclusion This review highlighted that anthropometric data are limited and that comparisons are difficult due to the paucity of surveys and non-standardized methodology. Main causes of overweight and obesity are attributed to individual characteristics of children and behavioural patterns, children's socio-economic environment, parenting practices and educational level. Reinforcement of surveillance with standardised tools and metrics adapted to the Pacific region is crucial and further research is warranted to better understand root causes of childhood OWOB in the Pacific islands. More robust and standardized anthropometric data would enable improvements in national strategies, multisectoral responses and innovative interventions to prevent and control NCDs.
Collapse
Affiliation(s)
- Solene Bertrand-Protat
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Juliana Chen
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Aurélie Jonquoy
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Stéphane Frayon
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Si Thu Win Tin
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Amerita Ravuvu
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Corinne Caillaud
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Olivier Galy
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
4
|
Biadgilign S, Mgutshini T, Gebremichael B, Berhanu L, Cook C, Deribew A, Gebre B, Memiah P. Association between dietary Intake, eating behavior, and childhood obesity among children and adolescents in Ethiopia. BMJ Nutr Prev Health 2023; 6:203-211. [PMID: 38618527 PMCID: PMC11009522 DOI: 10.1136/bmjnph-2021-000415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/19/2023] [Indexed: 04/16/2024] Open
Abstract
Introduction The upsurge of overweight/obesity (OW/OB) among children and adolescents is as a result of complex interactions between lifestyle behaviours and socioeconomic factors. The objective of this study was to determine socioeconomic and sociodemographic factors, dietary intake and eating behaviours of children and adolescents in Ethiopia and their association with OW/OB. Methods A cross-sectional study was conducted among 632 children and adolescents-parent dyads. To identify overweight/obese among children and adolescents, body mass index-for-age Z-scores by sex and age relative to WHO 2007 reference was calculated using WHO AnthroPlus software. A multivariable logistic regression model fitted to determine the adjusted associations between the outcome and the predictors selected from the bivariate analyses. Data analysis was carried out using STATA V.15.0. Results The proportion of participants with low, medium and high dietary diversity scores was 7.28%, 22.5%, and 70.2%, respectively. Participants aged 13-18 years were less likely to be overweight or obese [adjusted OR (aOR) = 0.40; 95%CI: 0.26, 0.64] to those aged 5-12 years. Children in a family with the richest or highest socioeconomic status (SES) were more likely to be overweight or obese than those in families with the poorest or lowest status. Children and adolescents who consumed soft drinks (sugar-sweetened beverages) four or more times per week [aOR = 3.24; 95%CI: 1.13, 7.95] were more likely to be overweight or obese to those who did not consume soft drinks. Conclusions The study identified factors such as younger age (<12 years), high SES and consumption of soft drinks as key contributors to overweight and obesity among children and adolescents. Therefore, interventions targeting behavioural prevention and reduction of overweight and obesity among children and adolescents should be cognizant of the above factors during implementation in order to achieve desired outcomes, further guided by exploratory qualitative studies to identify public perceptions and attitudes affecting dietary practices.
Collapse
Affiliation(s)
- Sibhatu Biadgilign
- Department of Health Studies, College of Human Sciences, University of South Africa, Addis Ababa, Ethiopia
| | | | - Bereket Gebremichael
- Pediatrics and Child Health, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Lioul Berhanu
- Nutrition Unit, Save the Children International, Addis Ababa, Ethiopia
| | - Courtney Cook
- Department of Nursing, Fortis Institute - Pensacola, Pensacola, Florida, USA
| | - Amare Deribew
- School of Public Health, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Nutrition International, Addis Ababa, Ethiopia
| | - Betemariam Gebre
- Public Health Unit, International Medical Corps, Khartoum, Sudan
| | - Peter Memiah
- Graduate School, University of Maryland, Baltimore, Maryland, USA
| |
Collapse
|
5
|
Malovic P, Vrevic E, Bacovic D, Bojanic D, Ljubojevic M. The Relationship between Certain Parental/Household Socio-Economic Characteristics and Female Adolescent Obesity in Montenegro. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050820. [PMID: 37238368 DOI: 10.3390/children10050820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Considering that obesity is characterized today as a public health challenge and an epidemic in many countries in the world and that one of the main predictors for obesity is socio-economic status (SES), the aim of this paper was to assess the relationship between the SES of parents/guardians and female adolescent obesity in Montenegro. METHODS A stratified random probability sample method was used, and the number of participants in this study was 596, aged 15.8 ± 0.58, from all three regions in Montenegro. As SES was a factor in this research, specific SES parameters such as household wealth and parental educational level were collected for parent/guardian of each child. The following anthropometric indices were utilized to evaluate nutritional status: body mass index (BMI) and waist to height ratio (WHtR). RESULTS Regarding nutritional status, it can be said that no statistically significant difference between female adolescents according to the regions of Montenegro was found. Of all the adolescents in the study, 15.4% of them were above the normal nutrition level as measured by BMI, while 12.2% were classified as obese by the WHtR. Furthermore, the study found a significant negative relationship between a mother's level of education and obesity in female adolescents, with odds ratios of 0.31 (p = 0.035) and 0.19 (p = 0.009) for secondary and high level education, respectively. This suggests that daughters of mothers with higher levels of education are less likely to be obese. CONCLUSIONS In regard to the nutritional status of the respondents in this study, their values fell within the normal range compared to the European average. However, the results regarding the relationship between certain SES characteristics and obesity suggest a similarity to developed countries.
Collapse
Affiliation(s)
- Pavle Malovic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
| | - Erol Vrevic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
| | - Dragan Bacovic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
| | - Danilo Bojanic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
| | - Milovan Ljubojevic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
| |
Collapse
|
6
|
Nwosu E, Fismen AS, Helleve A, Hongoro C, Sewpaul R, Reddy P, Alaba O, Harbron J. Trends in prevalence of overweight and obesity among South African and European adolescents: a comparative outlook. BMC Public Health 2022; 22:2287. [PMID: 36474229 PMCID: PMC9727950 DOI: 10.1186/s12889-022-14724-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND South Africa has several national surveys with body weight-related data, but they are not conducted regularly. Hence, data on longitudinal trends and the recent prevalence of adolescent obesity are not readily available for both national and international reporting and use. This study collectively analysed nationally representative surveys over nearly 2 decades to investigate trends in prevalence of adolescent obesity in South Africa. Furthermore, it compared these data with similar continental report for 45 countries across Europe and North America including United Kingdom, Norway, Netherland, Sweden, Azerbaijan, etc. to identify at-risk sub-population for overweight and obesity among adolescents. METHODS: The study included primary data of adolescents (15 - 19 years) from South African national surveys (N = 27, 884; girls = 51.42%) conducted between 1998 and 2016. Adolescents' data extracted include measured weight, height, sex, parent employment status, monthly allowance received, and family socioeconomic-related variables. Data were statistically analysed and visualized using chi-square of trends, Wald statistics, odds ratio and trend plots, and compared to findings from European survey report (N = 71, 942; girls = 51.23%). South African adolescents' obesity and overweight data were categorized based on World Health Organization (WHO)'s growth chart and compared by sex to European cohort and by family socioeconomic status. RESULTS By 2016, 21.56% of South African adolescents were either obese or overweight, similar to the 21% prevalence reported in 2018 among European adolescents. Girls in South Africa showed higher trends for obesity and overweight compared to boys, different from Europe where, higher trends were reported among boys. South African Adolescents from upper socioeconomic families showed greater trends in prevalence of overweight and obesity than adolescents from medium and lower socioeconomic families. Mothers' employment status was significantly associated with adolescents' overweight and obesity. CONCLUSIONS Our study shows that by 2016, the prevalence of adolescent obesity was high in South Africa - more than 1 in 5 adolescents - which is nearly similar to that in Europe, yet South African girls may be at a greater odd for overweight and obesity in contrast to Europe, as well as adolescents from high earning families. South African local and contextual factors may be driving higher prevalence in specific sub-population. Our study also shows the need for frequent health-related data collection and tracking of adolescents' health in South Africa.
Collapse
Affiliation(s)
- Emmanuel Nwosu
- grid.7836.a0000 0004 1937 1151Research Centre for Health Through Physical Activity, Lifestyle and Sport (HPALS), Division of Physiological Sciences, Human Biology Department, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7935 South Africa
| | - Anne-Siri Fismen
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Arnfinn Helleve
- grid.418193.60000 0001 1541 4204Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Charles Hongoro
- grid.417715.10000 0001 0071 1142Developmental, Capable and Ethical State Division, Human Sciences Research Council (HSRC), Pretoria, 0001 Gauteng Province South Africa
| | - Ronel Sewpaul
- grid.417715.10000 0001 0071 1142Health & Wellbeing, Human & Social Capabilities Division (HSC), Human Sciences Research Council (HSRC), Private Bag X9182, Cape Town, 8000, 116 - 118 Merchant House, Buitengracht Street, 8001 Cape Town, South Africa
| | - Priscilla Reddy
- grid.16463.360000 0001 0723 4123School of Education, University of KwaZulu-Natal, Durban, South Africa
| | - Olufunke Alaba
- grid.7836.a0000 0004 1937 1151Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Janetta Harbron
- grid.7836.a0000 0004 1937 1151Research Centre for Health Through Physical Activity, Lifestyle and Sport (HPALS), Division of Physiological Sciences, Human Biology Department, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7935 South Africa
| |
Collapse
|
7
|
Liu H, Zhang M, Fu P, Chen Y, Zhou C. Dual Burden of Malnutrition Among Adolescents With Hunger Aged 12-15 Years in 41 Countries: Findings From the Global School-Based Student Health Survey. Front Med (Lausanne) 2022; 8:771313. [PMID: 35083236 PMCID: PMC8784550 DOI: 10.3389/fmed.2021.771313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/15/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Hunger is a pandemic among adolescents, resulting in both underweight and obesity, and posing a substantial health challenge. Objective: To estimate the dual burden of malnutrition among adolescents with hunger. Design: Data were from the Global school-based Student Health Survey (GSHS). In total, data from 26,986 adolescents with hunger across 5 regions and 41 countries between 2010 and 2015 were analyzed in this study. Weighted prevalence and mean estimates of underweight, overweight, and obesity were calculated by gender, age, and country. Prevalence and 95% confidence intervals (CI) were calculated for regional and country-level income. Results: The total prevalence of underweight, overweight and obesity among young adolescents with hunger was 6.2% (95% CI: 4.4–8.0%), 25.1% (95% CI: 20.3–29.9%) and 8.9% (95% CI: 6.5–11.3%), respectively. Southeast Asia had the highest prevalence of underweight (17.2%; 95% CI: 7.3–27.0%). America had the highest regional prevalence of obesity (11.1%; 95% CI: 7.2–15.1%) and overweight (28.9%; 95% CI: 21.9–35.9%). Low income countries had relatively high prevalence of underweight (11.5%; 95% CI: 3.2–19.9%). High income countries had the highest prevalence of obesity (17.4%; 95% CI: 14.9–19.9%) and overweight (38.7%; 95% CI: 32.0–45.4%). The co-existence of underweight and overweight among adolescents with hunger was highest in the Eastern Mediterranean region, and in upper-middle and high-income countries. Conclusions: There is a dual burden of underweight and obesity among adolescents with hunger aged 12–15 years, which differs between geographical regions. The integration of targeted interventions and policies is required to simultaneously address both underweight and increasing rates of obesity among adolescents with hunger in different regions.
Collapse
Affiliation(s)
- Huaqing Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,School of Public Health, Bengbu Medical College, Bengbu, China
| | - Min Zhang
- School of Health Management, Bengbu Medical College, Bengbu, China
| | - Peipei Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yan Chen
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| |
Collapse
|
8
|
Clark SN, Bennett JE, Arku RE, Hill AG, Fink G, Adanu RM, Biritwum RB, Darko R, Bawah A, Duda RB, Ezzati M. Small area variations and factors associated with blood pressure and body-mass index in adult women in Accra, Ghana: Bayesian spatial analysis of a representative population survey and census data. PLoS Med 2021; 18:e1003850. [PMID: 34762663 PMCID: PMC8584976 DOI: 10.1371/journal.pmed.1003850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/14/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Body-mass index (BMI) and blood pressure (BP) levels are rising in sub-Saharan African cities, particularly among women. However, there is very limited information on how much they vary within cities, which could inform targeted and equitable health policies. Our study aimed to analyse spatial variations in BMI and BP for adult women at the small area level in the city of Accra, Ghana. METHODS AND FINDINGS We combined a representative survey of adult women's health in Accra, Ghana (2008 to 2009) with a 10% random sample of the national census (2010). We applied a hierarchical model with a spatial term to estimate the associations of BMI and systolic blood pressure (SBP) and diastolic blood pressure (DBP) with demographic, socioeconomic, behavioural, and environmental factors. We then used the model to estimate BMI and BP for all women in the census in Accra and calculated mean BMI, SBP, and DBP for each enumeration area (EA). BMI and/or BP were positively associated with age, ethnicity (Ga), being currently married, and religion (Muslim) as their 95% credible intervals (95% CrIs) did not include zero, while BP was also negatively associated with literacy and physical activity. BMI and BP had opposite associations with socioeconomic status (SES) and alcohol consumption. In 2010, 26% of women aged 18 and older had obesity (BMI ≥ 30 kg/m2), and 21% had uncontrolled hypertension (SBP ≥ 140 and/or DBP ≥ 90 mm Hg). The differences in mean BMI and BP between EAs at the 10th and 90th percentiles were 2.7 kg/m2 (BMI) and in BP 7.9 mm Hg (SBP) and 4.8 mm Hg (DBP). BMI was generally higher in the more affluent eastern parts of Accra, and BP was higher in the western part of the city. A limitation of our study was that the 2010 census dataset used for predicting small area variations is potentially outdated; the results should be updated when the next census data are available, to the contemporary population, and changes over time should be evaluated. CONCLUSIONS We observed that variation of BMI and BP across neighbourhoods within Accra was almost as large as variation across countries among women globally. Localised measures are needed to address this unequal public health challenge in Accra.
Collapse
Affiliation(s)
- Sierra N. Clark
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, United Kingdom
| | - James E. Bennett
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, United Kingdom
| | - Raphael E. Arku
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, United States of America
| | - Allan G. Hill
- Department of Social Statistics and Demography, University of Southampton, Southampton, United Kingdom
| | - Günther Fink
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
| | - Richard M. Adanu
- Department of Population, Family, and Reproductive Health, University of Ghana, Accra, Ghana
| | | | - Rudolph Darko
- School of Medicine, University of Ghana, Accra, Ghana
| | - Ayaga Bawah
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - Rosemary B. Duda
- Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, United Kingdom
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
- Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, United Kingdom
| |
Collapse
|
9
|
Sserwanja Q, Mutisya LM, Olal E, Musaba MW, Mukunya D. Factors associated with childhood overweight and obesity in Uganda: a national survey. BMC Public Health 2021; 21:1494. [PMID: 34344336 PMCID: PMC8330108 DOI: 10.1186/s12889-021-11567-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/29/2021] [Indexed: 01/19/2023] Open
Abstract
Background Childhood obesity is an emerging public health problem globally. Although previously a problem of high-income countries, overweight and obesity is on the rise in low- and middle-income countries. This paper explores the factors associated with childhood obesity and overweight in Uganda using data from the Uganda Demographic and Health Survey (UDHS) of 2016. Methods We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4338 children less than 5 years. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Overweight and obesity were combined as the primary outcome. Children whose BMI z score was over two were considered as overweight while those with a BMI z score greater than three were considered as obese. We used multivariable logistic regression to determine factors associated with obesity and overweight among children under 5 years of age in Uganda. Results The prevalence of overweight and obesity was 5.0% (217/4338) (95% CI: 4.3–5.6), with overweight at 3.9% (168/4338: 95% CI: 3.2–4.3) and obesity at 1.1% (49/4338: 95% CI: 0.8–1.5). Mother’s nutritional status, sex of the child, and child’s age were associated with childhood obesity and overweight. Boys were more likely to be overweight or obese (aOR = 1.81; 95% CI 1.24 to 2.64) compared to girls. Children who were younger (36 months and below) and those with mothers who were overweight or obese were more likely to have obesity or overweight compared to those aged 49–59 months and those with underweight mothers respectively. Children from the western region were more likely to be overweight or obese compared to those that were from the North. Conclusion The present study showed male sex, older age of the children, nutritional status of the mothers and region of residence were associated with obesity and overweight among children under 5 years of age.
Collapse
Affiliation(s)
- Quraish Sserwanja
- Programs Department, GOAL, Arkaweet Block 65 House No, 227, Khartoum, Sudan.
| | - Linet M Mutisya
- Maternal and Child Health Project, Swedish Organization for Global Health, Mayuge, Uganda
| | | | - Milton W Musaba
- Department of Obstetrics and Gynaecology, Busitema University, Mbale, Uganda
| | - David Mukunya
- Department of Community and Public Health, Busitema University, Mbale, Uganda.,Sanyu Africa Research Institute, Mbale, Uganda
| |
Collapse
|
10
|
Muhsen K, Na’amnih W, Goldsmith R, Maya M, Zeidan N, Kassem E, Ornoy A. Associations of Feeding Practices in Early Life and Dietary Intake at School Age with Obesity in 10- to 12-Year-Old Arab Children. Nutrients 2021; 13:2106. [PMID: 34205416 PMCID: PMC8234619 DOI: 10.3390/nu13062106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/13/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022] Open
Abstract
Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10-12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10-12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10-12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity.
Collapse
Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (W.N.); (M.M.)
| | - Wasef Na’amnih
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (W.N.); (M.M.)
| | | | - Maayan Maya
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (W.N.); (M.M.)
| | - Nuha Zeidan
- Clalit Health Service, Diet and Nutrition Unit, P.O. Box 789, Arara 30026, Israel;
| | - Eias Kassem
- Department of Pediatrics, Hillel Yaffe Medical Center, Hadera 38100, Israel;
| | - Asher Ornoy
- Laboratory of Teratology, Department of Medical Neurobiology, The Hebrew University Hadassah Medical School, Jerusalem 9112002, Israel
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| |
Collapse
|
11
|
Ferreira CS, Andrade FBD. [Socioeconomic inequalities in the prevalence of excess weight and sedentary behavior among Brazilian adolescents]. CIENCIA & SAUDE COLETIVA 2021; 26:1095-1104. [PMID: 33729362 DOI: 10.1590/1413-81232021263.09022019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/03/2019] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to estimate the prevalence of excess weight and a sedentary lifestyle among Brazilian students between 13 and 17 years of age and investigate the magnitude of the socioeconomic inequalities related to these outcomes. A cross-sectional study was carried out based on data from the National School Health Survey (PeNSE) conducted in 2015. Inequalities were evaluated using the Absolute and Relative Index of Inequality. The prevalence of excess weight in Brazil was 24.2%, ranging from 20.7% in the Northeast Region to 27.8% in the Southern Region. The prevalence of a sedentary lifestyle in Brazil was 67.8%, ranging from 61.8 % in the North Region to 70.3% in the Southeast Region. The direct and positive association between better socioeconomic conditions and the prevalence of excess weight and a sedentary lifestyle indicate health inequities in Brazil. The results of this study point to the need to restructure and reinforce public policies directed at adolescents, which should have as guidelines the promotion of a healthy lifestyle and the reduction of health inequities.
Collapse
Affiliation(s)
- Carolina Souza Ferreira
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz (Fiocruz). Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | - Fabíola Bof de Andrade
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz (Fiocruz). Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| |
Collapse
|
12
|
Ramon-Krauel M, Leal-Witt MJ, Osorio-Conles Ó, Amat-Bou M, Lerin C, Selva DM. Relationship between adiponectin, TNFα, and SHBG in prepubertal children with obesity. Mol Cell Pediatr 2021; 8:3. [PMID: 33689083 PMCID: PMC7947057 DOI: 10.1186/s40348-021-00113-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/01/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Sex hormone-binding globulin (SHBG) levels are low in adult subjects with obesity when compared to normal-weight individuals. Obesity is associated with higher tumor necrosis factor alpha (TNFα) plasma levels and lower adiponectin levels. Moreover, we have recently elucidated the molecular mechanisms by which TNFα and adiponectin regulate hepatic SHBG production. AIM The main objective of this study was to assess if the adult associations between TNFα, adiponectin, and SHBG are present in prepubertal children. METHODS We determined several morphometric and biochemical parameters in normal-weight (n=15) and obese prepubertal (n=51) children, as well as quantified plasma SHBG, TNFα receptor 1 (TNFα-R1), and adiponectin levels. RESULTS Our results showed that prepubertal children with obesity had decreased plasma SHBG levels compared to normal-weight controls (67 nmol/L vs 172 nmol/L). Importantly, SHBG plasma levels correlated significantly (P < 0.05) with TNFα (negatively, ßstd= - 0.31) and adiponectin (positively, ßstd= 0.58) suggesting an important role of these two cytokines in determining plasma SHBG levels in prepubertal children. CONCLUSIONS Our results suggest that plasma adiponectin levels may play a more important role than TNFα in influencing plasma SHBG levels in our prepubertal population with obesity.
Collapse
Affiliation(s)
- Marta Ramon-Krauel
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
| | - María Jesús Leal-Witt
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
| | - Óscar Osorio-Conles
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
| | - Montse Amat-Bou
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
| | - Carles Lerin
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08950, Barcelona, Spain.
| | - David M Selva
- Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Pg Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| |
Collapse
|
13
|
do Carmo AS, Mendes LL, Pessoa MC, Meireles AL, da Silva AAM, Dos Santos LC. Family characteristics, perceived environment for physical activity, and childhood obesity: An approach with structural equation models. Am J Hum Biol 2020; 33:e23560. [PMID: 33377256 DOI: 10.1002/ajhb.23560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To evaluate the direct and indirect effects of family characteristics and the perceived neighborhood environment on obesity risks among schoolchildren. METHODS Through phone contact with the child's mothers/guardians, the perceptions about the aspects of the neighborhood that could limit or promote health. Physical activity, socioeconomic data, self-reported weight and height, and ultra-processed consumption of the respondents were evaluated, in addition to the screen time of both mothers and children. A hybrid model of structural equations was used to test the direct and indirect effects of family and environmental variables on childhood obesity. SETTING Belo Horizonte, Minas Gerais, Brazil. SUBJECTS A total of 322 children from 9 to 10 years old from municipal schools and their respective mothers/guardians. RESULTS Childhood obesity was positively associated with obesity among mothers/guardians and with the latent variable "socioeconomic status (SES)." It was observed that the child's guardians positively influenced childhood obesity through their own habits, such as screen time and consumption of ultra-processed products, with obesity of mothers/guardians as mediators of both associations. There were no direct and indirect effects of the latent variables of the perceived environment in childhood obesity. CONCLUSION Family characteristics are important determinants of childhood obesity and should be considered when designing prevention strategies. Parental perceptions of neighborhood characteristics did not have an influence on childhood obesity.
Collapse
Affiliation(s)
- Ariene Silva do Carmo
- Programa de Pós-Graduação em Ciências da Saúde - Saúde da Criança e do Adolescente, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Loures Mendes
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Milene Cristine Pessoa
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Adriana Lucia Meireles
- Departamento de Nutrição Clínica e Social, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | - Luana Caroline Dos Santos
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
14
|
Al Shaikh A, Farahat F, Abaalkhail B, Kaddam I, Aseri K, Al Saleh Y, Al Qarni A, Al Shuaibi A, Tamimi W. Prevalence of Obesity and Overweight among School-Aged Children in Saudi Arabia and Its Association with Vitamin D Status. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020133. [PMID: 33525269 PMCID: PMC7927516 DOI: 10.23750/abm.v91i4.10266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Childhood obesity is a significant global public health problem. Worldwide data showed an increasing trend over the years. We aimed to explore the prevalence of obesity, and its association with vitamin D status. METHODS This cross-sectional study was conducted during the period from 2016 to 2017. The study included 3613 schoolchildren aged 6-19 years in the western, central, and eastern regions in Saudi Arabia. Anthropometric data including age, sex and body mass index (BMI) was collected and the serum 25OH- vitamin D (25OHD) was measured. Age-sex standardized BMI Z-scores using the 2007 World Health Organization growth standards were applied. RESULTS Data from 3613 school-aged children (females = 51.8%), with equal percentage of participants from each region were analyzed. Prevalence of obesity and overweight was estimated at 7.1% and 14.4% respectively. An increasing trend was detected with age (p: 0.006). Obesity started to increase at the age of 10 years and continued to increase until 19 years. Most of the obese children (64.2%) had deficient vitamin D levels, compared to 33.7% of them with suboptimal levels and only 2.0% with optimal levels (p: <0.001). CONCLUSIONS This large cohort study revealed a high prevalence (21.5%) of obesity and overweight in school children aged between 6-19 years with increasing trend with age. Children with high BMI showed extremely high prevalence of VDD and VDI. These findings are alarming and point to the need for effective national interventions that include improving and encouraging access to physical activity and exposure to sunlight, educational activities for students, parents, and schoolteachers and possible enrichment of staple food with vitamin D.
Collapse
Affiliation(s)
- Adnan Al Shaikh
- King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | | | | | | | | | - Yousef Al Saleh
- King Saud bin Abdulaziz University for Health Sciences - Riyadh.
| | - Ali Al Qarni
- Al Imam Abdulrahman Bin Faisal Hospital, MNGHA - Dammam.
| | | | | |
Collapse
|
15
|
Danquah FI, Ansu-Mensah M, Bawontuo V, Yeboah M, Kuupiel D. Prevalence, incidence, and trends of childhood overweight/obesity in Sub-Saharan Africa: a systematic scoping review. Arch Public Health 2020; 78:109. [PMID: 33292679 PMCID: PMC7599109 DOI: 10.1186/s13690-020-00491-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/20/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The growing burden of non-communicable diseases (NDC), particularly in low-and middle-income countries, poses a significant threat to global health. Obesity and overweight constitute major risk factors of NCDs such as heart diseases, diabetes, and kidney disease, and as a result, contribute significantly to the development of chronic morbidities, reduced quality of life, and increased risk of premature death. This study described evidence on the prevalence, incidence, and trends of childhood overweight and obesity in sub-Sahara Africa (SSA). METHODS We conducted a systematic scoping review employing the Arksey and O'Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. To obtain relevant published articles for this review, we performed a comprehensive keywords search in PubMed, Google Scholar, Web of Science, and CINAHL via EBSCOhost platform for studies published between 2009 and June 2019. Guided by the eligibility criteria, title and abstracts, as well as the full-text articles were independently screened in parallel by two investigators. All relevant data were independently extracted by two investigators using a piloted form designed in Microsoft and thematic analysis conducted. RESULTS Of the 81 included studies obtained from 250,148 potentially eligible articles, the majority (25) conducted in South Africa followed by 18 in Nigeria. Six studies were conducted in Ethiopia (6), Tanzania (5), Kenya (4), Cameroon (4), Ghana (3), Uganda (2), Mozambique (2), and Sudan (2). One study each was conducted in Botswana, Gambia, Lesotho, Mauritius, Seychelles, Togo, and Zimbabwe. The remaining three articles were multi-country studies. Most (81.5%) of the included studies were cross-sectional surveys and the majority (79) focused on both male and female participants. The majority (80/81) of the included studies reported on the prevalence of childhood overweight/obesity, 8 on the trends of childhood overweight/obesity, and one presented evidence on the incidence of childhood overweight and obesity in SSA. CONCLUSION This review demonstrates limited studies on childhood overweight/obesity in most SSA countries although the included studies suggest an increasing burden. Considering the consequences of childhood obesity, there is a need for more primary researches to inform policies decision and implementation to halt the rise of childhood obesity/overweight in SSA.
Collapse
Affiliation(s)
- Frederick Inkum Danquah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Monica Ansu-Mensah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Vitalis Bawontuo
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
- Research for Sustainable Development Consult, Sunyani, Ghana
| | - Matilda Yeboah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Desmond Kuupiel
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
- Research for Sustainable Development Consult, Sunyani, Ghana
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001 South Africa
| |
Collapse
|
16
|
Danquah FI, Ansu-Mensah M, Bawontuo V, Yeboah M, Udoh RH, Tahiru M, Kuupiel D. Risk factors and morbidities associated with childhood obesity in sub-Saharan Africa: a systematic scoping review. BMC Nutr 2020; 6:37. [PMID: 32884829 PMCID: PMC7460801 DOI: 10.1186/s40795-020-00364-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/24/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA. METHODS Guided by the Arksey and O'Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted. RESULTS A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region. CONCLUSION This review findings suggest a paucity of literature on the risk factors of childhood obesity and morbidities in most SSA countries. Hence, there is the need to intensify research efforts, especially experimental study designs using innovative strategies to promote healthy lifestyle choices that will prevent or minimize the risks and health consequences of childhood obesity in SSA.
Collapse
Affiliation(s)
- Frederick Inkum Danquah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Monica Ansu-Mensah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Vitalis Bawontuo
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
- Research for Sustainable Development Consult, Sunyani, Ghana
| | - Matilda Yeboah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Roseline H. Udoh
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Mohammed Tahiru
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Desmond Kuupiel
- Research for Sustainable Development Consult, Sunyani, Ghana
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Durban, 4001 South Africa
| |
Collapse
|
17
|
Taklual W, Baye S, Mekie M, Andualem T. Double Burden of Malnutrition among Female Adolescent Students in Bahir Dar City, Amhara, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6249524. [PMID: 32879884 PMCID: PMC7448125 DOI: 10.1155/2020/6249524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 07/20/2020] [Accepted: 07/29/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Globally, nearly a third of the population suffers from at least one form of malnutrition. Both over- and undernutrition are a growing concern in developing countries particularly among female adolescents. This study was aimed at assessing nutritional status and associated factors among female adolescents in secondary schools of Bahir Dar City, Amhara, Ethiopia, 2019. METHODS A school-based cross-sectional study was conducted in secondary schools of Bahir Dar City among 682 female adolescent students in 2019. A simple random sampling technique with proportional allocation was used to select study participants. Data were collected using a self-administered questionnaire. Data were entered into Epi Info version 7.1 and analyzed by SPSS version 21. Underweight and overweight statuses of the participants were determined by using the WHO cutoff point. Bivariable and multivariable logistic regressions were used to identify the significance of association at a 95% confidence interval. P value < 0.05 was used to declare statistical significance. RESULTS In this study, the prevalence of underweight, overweight, and obesity was 15%, 8.4%, and 4.7%, respectively. Female adolescents found between age groups of 14-16.5 years old (AOR: 1.7, 95% CI: 1.03-2.69), family size ≥ 4 (AOR: 2.8, 95% CI: 1.05-4.99), participants who did not eat meat once per week (AOR: 1.6, 95% CI: 1.90-2.82), and no onset of menarche (AOR: 4.4, 95% CI: 1.21-15.75) were found to be more likely underweight. In addition, adolescents with family monthly income above 6500 Ethiopian birr (AOR: 12.7, 95% CI: 2.47-65.62), who ate meat two times and more per week (AOR: 2.07, 95% CI: 1.47-9.14), and who ate fruit at least once a week (AOR: 0.20, 95% CI: 0.05-0.78) were more likely to be overweight compared with counterparts. Conclusion and Recommendation. The prevalence of underweight and overweight was found to be high. Design evidence-based adolescent nutritional intervention shall be emphasized by the government and other concerned bodies to avert the dual burden of malnutrition.
Collapse
Affiliation(s)
- Wubet Taklual
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sewunet Baye
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Maru Mekie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tesfaye Andualem
- Department of Medical Laboratory, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| |
Collapse
|
18
|
Choukem SP, Tochie JN, Sibetcheu AT, Nansseu JR, Hamilton-Shield JP. Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2020; 2020:6. [PMID: 32211050 PMCID: PMC7092532 DOI: 10.1186/s13633-020-0076-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 02/13/2020] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Recently, childhood and adolescence overweight/obesity has increased disproportionately in developing countries, with estimates predicting a parallel increase in future cardiovascular disease (CVD) burden identifiable in childhood and adolescence. Identifying cardiovascular risk factors (CVRF) associated with childhood and adolescence overweight/obesity is pivotal in tailoring preventive interventions for CVD. Whilst this has been examined extensively in high-income countries, there is scant consistent or representative data from sub-Saharan Africa (SSA). OBJECTIVE This scoping review synthesises contemporary studies on CVRF associated with overweight and obesity in SSA children and adolescents to provide evidence on the current burden of overweight/obesity and CVD in this population. METHODS We searched MEDLINE and Google Scholar up to July 31, 2019 for observational and experimental studies and systematic reviews addressing childhood and adolescence overweight/obesity and CVRF in SSA without language restriction. Four investigators working in four pairs, independently selected and extracted the relevant data. The methodological quality of all included studies was assessed. RESULTS We included 88 studies with a total of 86,637children and adolescents from 20 SSA countries. The risk of bias was low in 62 (70.5%), moderate 18 (20.5%), and high in eight (9%) studies. Overweight/obesity in SSA children and adolescents is rising at an alarming rate. Its main associations include physical inactivity, unhealthy diets, high socio-economic status, gender and high maternal body mass index. Identified CVRF in overweight/obese SSA children and adolescents are mainly metabolic syndrome, hypertension, dyslipidaemia, diabetes and glucose intolerance. There is a dearth of guidelines or consensus on the management of either childhood overweight/obesity or CVRF in overweight/obese SSA children and adolescents. CONCLUSION The current findings suggest an urgent need to review current health policies in SSA countries. Health education and transforming the current obesogenic environment of the SSA child and adolescent into one which promotes physical activity and healthy dietary habits is required.
Collapse
Affiliation(s)
- Simeon-Pierre Choukem
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Diabetes and Endocrine Unit, Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Joel Noutakdie Tochie
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Aurelie T. Sibetcheu
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Jobert Richie Nansseu
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaoundé, Cameroon
| | - Julian P. Hamilton-Shield
- Bristol Biomedical Research Centre (Nutrition Theme), University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| |
Collapse
|
19
|
Gao L, Ma L, Xue H, Min J, Wang H, Wang Y. A 3-year longitudinal study of effects of parental perception of children's ideal body image on child weight change: The Childhood Obesity Study in China mega-cities. Prev Med 2020; 132:105971. [PMID: 31899255 PMCID: PMC7024657 DOI: 10.1016/j.ypmed.2019.105971] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/06/2019] [Accepted: 12/27/2019] [Indexed: 12/24/2022]
Abstract
This study examined prevalence of childhood overweight and obesity (ov/ob) and central obesity in five mega-cities across China (Beijing, Shanghai, Xi'an, Nanjing and Chengdu); described parental perceptions of children's ideal body image (IBI); and prospectively examined associations between parental perception of child IBI and child weight changes over 3 years. In this NIH-funded, open cohort study, data were collected from students and their parents in 2015, 2016 and 2017 (n = 3298, in 3 waves). Cross-sectional analysis included all 3298 children; longitudinal data analysis used mixed effects models and included 1691 children aged 6-17 years with ≥two body mass index (BMI) measurements during 2015-2017. Ov/ob prevalence based on Chinese age-sex-specific BMI cut-points was 30.0%. Based on waist-to-height ratio (WHtR), the abdominal obesity rate was 19.8%. Parents reported different preferred IBI for boys vs girls, being about 3 times more likely to select ov/ob as ideal for boys than for girls (4.5% vs 1.5%, respectively, P < .001). In longitudinal analysis, children whose parents selected ov/ob as ideal had higher BMI Z-scores and WHtR increase over time than those whose parents selected an average body image (β [SE] = 0.042 [0.011], and β [SE] = 0.010 [0.004], respectively, all P < .05). Ov/ob rates were high among children in major cities in China. Chinese parents preferred a heavier ideal body image for their boys. Health promotion programs should help empower parents and their children to develop appropriate body images and maintain healthy body weight.
Collapse
Affiliation(s)
- Liwang Gao
- Global Health Institute, Xi'an Jiaotong University Health Science Center, China; School of Public Health, Xi'an Jiaotong University Health Science Center, China
| | - Lu Ma
- Global Health Institute, Xi'an Jiaotong University Health Science Center, China; School of Public Health, Xi'an Jiaotong University Health Science Center, China
| | - Hong Xue
- Department of Health Behavior and Policy, Virginia Commonwealth University, USA
| | - Jungwon Min
- Healthcare Analytics Unit, Children's Hospital of Philadelphia, USA; Fisher Institute of Health and Well-Being, Department of Nutrition and Health Science, College of Health, Ball State University, USA
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, China
| | - Youfa Wang
- Global Health Institute, Xi'an Jiaotong University Health Science Center, China; School of Public Health, Xi'an Jiaotong University Health Science Center, China; Fisher Institute of Health and Well-Being, Department of Nutrition and Health Science, College of Health, Ball State University, USA.
| |
Collapse
|
20
|
Adom T, Kengne AP, De Villiers A, Puoane T. Prevalence of overweight and obesity among African primary school learners: a systematic review and meta-analysis. Obes Sci Pract 2019; 5:487-502. [PMID: 31687173 PMCID: PMC6819980 DOI: 10.1002/osp4.355] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 06/05/2019] [Accepted: 06/11/2019] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION The increasing trend in the global prevalence of childhood overweight and obesity presents a major public health challenge. This study reports the results of a systematic review and meta-analysis to estimate the prevalence of overweight and obesity among primary school learners residing in Africa according to the different body mass index criteria and population level characteristics. METHODS A search of multiple databases was conducted to identify relevant research articles published between January 1980 and February 2017. Random effects models were used to pool prevalence data within and across population level characteristics after variance stabilization through arcsine transformation (PROSPERO registration number CRD42016035248). RESULTS Data from 45 studies across 15 African countries, and comprising 92,379 and 89,468 participants for overweight and obesity estimates were included. Estimated overweight and obesity prevalence differed significantly across criteria: 10.5% [95% confidence interval, CI: 7.1-14.3] and 6.1% [3.4-9.7] by World Health Organization; 9.5% [6.5-13.0] and 4.0% [2.5-5.9] by International Obesity Task Force; and 11.5% [9.6-13.4] and 6.9% [5.0-9.0] by Centre for Diseases Control, respectively (p = 0.0027 for overweight; p < 0.0001 for obesity). Estimates were mostly higher in urban, and private schools, but generally similar by gender, major geographic regions, publication year and sample size. Substantial heterogeneity in the estimates across and within criteria were not always explained by major study characteristics. CONCLUSION Overweight and obesity are prevalent among African primary school learners, particularly those attending urban, and private schools. The results from this meta-analysis could be helpful in making informed decisions on childhood obesity prevention efforts in African countries.
Collapse
Affiliation(s)
- T. Adom
- School of Public Health, Faculty of Community and Health SciencesUniversity of Western CapeCape TownSouth Africa
- Nutrition Research CentreRadiological and Medical Sciences Research Institute, Ghana Atomic Energy CommissionAccraGhana
| | - A. P. Kengne
- Non‐communicable Disease Research UnitSouth African Medical Research CouncilCape TownSouth Africa
| | - A. De Villiers
- Division of Research Capacity DevelopmentSouth African Medical Research CouncilCape TownSouth Africa
| | - T. Puoane
- School of Public Health, Faculty of Community and Health SciencesUniversity of Western CapeCape TownSouth Africa
| |
Collapse
|
21
|
Adom T, Kengne AP, De Villiers A, Puoane T. Association between school-level attributes and weight status of Ghanaian primary school children. BMC Public Health 2019; 19:577. [PMID: 31092232 PMCID: PMC6521351 DOI: 10.1186/s12889-019-6937-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/02/2019] [Indexed: 11/25/2022] Open
Abstract
Background Little is known about the impact of the school environmental context on the emerging trend of childhood obesity in Africa. We examined the association of the schools’ contextual factors with body mass index (BMI), abdominal obesity and overweight (including obesity) in urban Ghana. Method Using cross-sectional data from 543 school children aged 8–11 years attending 14 primary schools, we applied multilevel logistic regressions and linear regression models to investigate the association of child- and school level attributes with overweight, abdominal obesity, and BMI. Results We observed significant variance of the random effects of schools in BMI (2.65, p < 0.05), abdominal obesity (0.85, p < 0.05), and overweight (1.41, p < 0.05), with school contextual levels accounting for 19.7, 20.6, and 30.0% of the total variability observed in BMI, abdominal obesity and overweight respectively. Attending high socioeconomic (SES) level school, private school and school with increased after-school recreational facilities were associated with higher BMI. Children were more likely to be overweight if they attended a high SES level school, had access to healthful foods at school, and after-school recreational facilities. With regards to abdominal obesity, attending a school with increased physical activity facilities decreased the odds of abdominal obesity; however the odds increased if they attended a school with access to after-school recreational facilities. Conclusion A number of school-level factors were associated with BMI, overweight and abdominal obesity of children in the present study. Our results provide support for improved school environment to reduce overweight.
Collapse
Affiliation(s)
- Theodosia Adom
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa. .,Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana.
| | - André Pascal Kengne
- Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Anniza De Villiers
- Division of Research Capacity Development, South African Medical Research Council, Cape Town, South Africa
| | - Thandi Puoane
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| |
Collapse
|
22
|
Childhood Obesity Prevention in Africa: A Systematic Review of Intervention Effectiveness and Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071212. [PMID: 30987335 PMCID: PMC6480149 DOI: 10.3390/ijerph16071212] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/23/2019] [Accepted: 03/27/2019] [Indexed: 01/22/2023]
Abstract
Childhood obesity is of increasing concern in many parts of Africa. We conducted a systematic search and review of published literature on behavioural childhood obesity prevention interventions. A literature search identified peer-reviewed literature from seven databases, and unindexed African journals, including experimental studies targeting children age 2–18 years in African countries, published in any language since 1990. All experimental designs were eligible; outcomes of interest were both behavioural (physical activity, dietary behaviours) and anthropometric (weight, body mass index, body composition). We also searched for process evaluations or other implementation observations. Methodological quality was assessed; evidence was synthesised narratively as a meta-analysis was not possible. Seventeen articles describing 14 interventions in three countries (South Africa, Tunisia and Uganda) were included. Effect scores indicated no overall effect on dietary behaviours, with some beneficial effects on physical activity and anthropometric outcomes. The quality of evidence was predominantly weak. We identified barriers and facilitators to successful interventions, and these were largely resource-related. Our systematic review highlights research gaps in targeting alternative settings to schools, and younger age groups, and a need for more rigorous designs for evaluating effectiveness. We also recommend process evaluations being used more widely.
Collapse
|
23
|
Adom T, De Villiers A, Puoane T, Kengne AP. Prevalence and correlates of overweight and obesity among school children in an urban district in Ghana. BMC OBESITY 2019; 6:14. [PMID: 30984407 PMCID: PMC6442428 DOI: 10.1186/s40608-019-0234-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 02/21/2019] [Indexed: 02/08/2023]
Abstract
Background There is limited data on risk factors associated with childhood overweight and obesity in Ghanaian school children. Therefore, the aim of this study was to assess the prevalence of overweight and obesity and associated risk factors in Ghanaian school children. Methods Data for this study were obtained from a cross-sectional survey of 543 children aged 8 and 11 years, attending private and public primary schools in the Adentan Municipality of Greater Accra Region, Ghana. Anthropometric, dietary, physical activity, sedentary behaviours, sleep duration and socio-demographic data were collected. BMI-for-age Z-scores were used to classify children as overweight/obesity. Multivariable logistic regressions were used to assess the determinants of overweight and obesity. Results The overall prevalence of overweight/obesity was 16.4%. Children living in middle (OR = 1.88; 95% CI = 1.01–3.50) and high socioeconomic status (SES) households (2.58; 1.41–4.70) had increased odds of being overweight or obese compared to those living in low SES household. Attending private school (2.44; 1.39–4.29) and watching television for more than 2 h each day (1.72; 1.05–2.82) were significantly associated with increased likelihood of overweight and obesity. Children who slept for more than 9 h a night (0.53; 0.31–0.88) and walked or cycled to school (0.51; 0.31–0.82) had lower odds of being overweight or obese. Conclusions A number of modifiable risk factors were associated with overweight and obesity in this study. Public health strategies to prevent childhood obesity should target reduction in television watching time, promoting active transport to and from school, and increasing sleep duration.
Collapse
Affiliation(s)
- Theodosia Adom
- 1Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana.,2School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Anniza De Villiers
- 3Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Thandi Puoane
- 2School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - André Pascal Kengne
- 3Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| |
Collapse
|
24
|
Challenges and opportunities to tackle the rising prevalence of diet-related non-communicable diseases in Africa. Proc Nutr Soc 2019; 78:506-512. [PMID: 30732666 DOI: 10.1017/s0029665118002823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Africa is experiencing a sharp rise in non-communicable diseases (NCD) related to rapid globalisation and urbanisation leading to shifts in dietary and lifestyle patterns characterised by increased energy intake and physical inactivity. However, unlike more resource-endowed regions, Africa has a double burden of disease: NCD co-exist with infectious diseases including lower respiratory tract infections, HIV/AIDS and diarrhoeal diseases. The African economy is also relatively weaker, making it difficult to cope with this burden. It is postulated that NCD will soon overtake infectious diseases as the number one cause of death in the African region. The recognition of NCD as diseases and obesity as a related risk factor is weak in Africa, compounded by stigma associated with wasting in HIV/AIDS and obesity being perceived as a sign of wealth, achievement and care. There is also a dearth of data on overweight and obesity in the region and little knowledge that infant feeding practices, such as breast-feeding, are linked to reduced risk of NCD in both children and mothers. While complex multi-sectoral approaches to address this NCD menace are needed, Africa may benefit from taking simple initial steps to address NCD risk factors including: (1) behaviour change communication to challenge perceptions on NCD; (2) promoting and protecting breast-feeding; (3) formulating policies and regulations limiting wide availability of unhealthy foods; (4) mainstream nutrition education in school curricula and (5) collection of accurate data based on indicators that can reflect the double burden of disease and malnutrition; and fostering multi-sectoral actions against NCD.
Collapse
|
25
|
Adeniyi OF, Fagbenro GT, Olatona FA. Overweight and Obesity Among School-aged Children and Maternal Preventive Practices against Childhood Obesity in Select Local Government Areas of Lagos, Southwest, Nigeria. Int J MCH AIDS 2019; 8:70-83. [PMID: 31321148 PMCID: PMC6630490 DOI: 10.21106/ijma.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Childhood obesity is an emerging epidemic in the developing countries, particularly in the urban settings. This study examines the prevalence of overweight and obesity among school-aged children and the maternal preventive practices against childhood obesity. METHODS This is a cross-sectional study of school-aged children aged 6-13 years and mothers from two Local Government Areas of Lagos State, Southwest Nigeria. Multi-stage sampling technique was used to select study areas and participants, while data were collected using an interviewer administered questionnaire. The Body Mass Index (BMI) of children were determined using the World Health Organisation (WHO) 2007 reference charts. Chi-square test was used to analyze categorical variables and logistic regression analyses were conducted to determine the factors associated with the nutritional status and maternal childhood obesity preventive practices. All analyses were conducted using the Statistical Package for Social Sciences (SPSS) 21. RESULTS In all, 440 children comprising of 232 boys (52.7%) and 208 girls (42.3%) were studied. Of these, 29 of the participants (6.6%) were overweight, while 39 of them (8.9%) were obese. Most of the children (71.2%) consumed root/tubers and processed cereals while 9 (0.02%) and (17) 0.04% consumed fruits and vegetables. BMI was only significantly related to child age and sex. In all, 243 mothers (55.2%) had good practices against childhood obesity. Levels of maternal preventive practices were not significantly associated with child BMI. CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS Overweight/obesity among school-aged children in Lagos is high. Only half of the mothers were involved in preventive practices against childhood obesity. There is need for continuous education and advocacy concerning healthy diet and other preventive strategies against childhood obesity in Lagos, and potentially other parts of the developing world.
Collapse
Affiliation(s)
- Oluwafunmilayo Funke Adeniyi
- Department of Pediatrics, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | | | - Foluke A. Olatona
- Department of Community Health, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| |
Collapse
|
26
|
Li LW, Wong HM, Gandhi A, McGrath CP. Caries-related risk factors of obesity among 18-year-old adolescents in Hong Kong: a cross-sectional study nested in a cohort study. BMC Oral Health 2018; 18:188. [PMID: 30458813 PMCID: PMC6247777 DOI: 10.1186/s12903-018-0657-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Socio-economic status, health awareness, and dietary habits have been reported as common risk factors of dental caries and obesity. The present study aimed to explore shared mediators between caries and obesity and to estimate the effects of caries-related factors on adiposity. METHODS This was a cross-sectional study among adolescents aged 18 years. The study was nested in a population-representative cohort of Chinese in Hong Kong. The number of decayed, missing, and filled permanent teeth (DMFT) was recorded during the oral examinations. Body Mass Index (BMI), Waist Circumference (WC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), and Triceps Skinfold Thickness (TRSKF) were used as adiposity indices. Data on socio-economic status, oral health behavior (tooth brushing habit, use of fluoride toothpaste, dental flossing habit, and mouth rinse habit), and dietary record (frequency and amount of different food) were collected through self-completed questionnaires. Chi-square tests and binary logistic regressions were used for analysis. RESULTS Three hundred eighty-three participants were included. The mean (standard deviation, SD) of BMI, WC, WHR, WHtR, TRSKF, and DMFT were 21.26 (3.72), 69.11 (9.25), 0.77 (0.06), 0.42 (0.05), 15.72 (6.33), and 2.06 (2.43), respectively. Males were more likely to be overweight/obese than females. Various factors including gender, parental employment status, mouth rinse habit, frequency and amount of meat intake, frequency of oil intake, use of fluoride toothpaste, and DMFT were found significant (p < 0.05) in different final models of adiposity status. CONCLUSIONS More mediators should be included in future research to elucidate mechanism of the association between caries and obesity.
Collapse
Affiliation(s)
- Ling-Wei Li
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, 2/F Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
| | - Hai Ming Wong
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, 2/F Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
| | - Akanksha Gandhi
- Food and Nutritional Science, School of Biological Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Colman Patrick McGrath
- Periodontology & Public health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
27
|
Jung SH, Kim MH, Ryu JI. Inequalities in oral health among adolescents in Gangneung, South Korea. BMC Oral Health 2018; 18:68. [PMID: 29699545 PMCID: PMC5921975 DOI: 10.1186/s12903-018-0533-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/17/2018] [Indexed: 11/30/2022] Open
Abstract
Background This study aims to evaluate inequality in oral health among adolescents and to explain the mechanisms of such inequalities in Gangneung, South Korea. Methods One thousand two hundred sixty-seven students in their first year from four vocational and three general schools participated in the baseline survey of 2011, and 84.7% of them were surveyed again in 2013. Oral examinations by the same dentist and a self-administered questionnaire were repeated during both waves. Outcome measure for oral health was the existence of untreated dental caries (DT). As socioeconomic position (SEP) indicators, school type (general vs. vocational), father’s and mother’s education, perceived economic status, and Family Affluence Scale (FAS) were measured. Variables measuring oral health related behaviours included tooth brushing frequency, frequency of eating snacks and drinking sodas, smoking, and annual visits to dental clinics. Chi-square tests and panel logistic regression were adopted to examine the associations between dental caries and SEP indicators by STATA version 15.1. Results Having a less educated father and attending a vocational school were significant predictors for untreated caries after controlling for SEP indicators. However, students from general schools, higher SEP by father’s education, perceived economic status, or FAS, or having non-smoking experience or annual visits to dental clinics were more likely to stay caries-free. Conclusions There were socioeconomic inequalities in oral health on an adolescent panel. Given that oral health status during adolescents can persist throughout the course of a person’s life, intervention to tackle such inequalities and school environments are required. Electronic supplementary material The online version of this article (10.1186/s12903-018-0533-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Se-Hwan Jung
- Department of Preventive Dentistry, College of Dentistry, Gangneung-Wonju University, 120 Gangneungdaehag-ro, Gangneung City, Gangwon Province, 25457, South Korea
| | - Myoung-Hee Kim
- Center for Health Equity Research, People's Health Institute, 36 Sadangro 13-gil, 2nd floor, Dongjak-gu, Seoul, 07004, South Korea
| | - Jae-In Ryu
- Department of Preventive and Social Dentistry, College of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
| |
Collapse
|
28
|
Ahmed MH, Ali YA, Awadalla H, Elmadhoun WM, Noor SK, Almobarak AO. Prevalence and trends of obesity among adult Sudanese individuals: Population based study. Diabetes Metab Syndr 2017; 11 Suppl 2:S963-S967. [PMID: 28736258 DOI: 10.1016/j.dsx.2017.07.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
Abstract
AIM The prevalence of obesity has increased across the globe in particular in Africa. The aim of this study was to determine the prevalence of obesity in Sudan. MATERIAL AND METHODS Descriptive, cross sectional study recruited 7239 individuals. Demographic and clinical data were collected by an interview using a pretested standardised questionnaire. Anthropometric measurements including body weight, height and waist circumference have been taken using standardized techniques and calibrated equipment. Body mass index (BMI) has been calculated. RESULTS Total of 7239 persons completed the questionnaires; the results showed that prevalence of obesity was found to be 21.2%, with a higher rate of obesity in females than males (26.3% versus 13.8%). The prevalence of central obesity was also higher in women (36.7%) than men (17.6%).The prevalence of overweight was 34.9%. The overall prevalence of overweight/obesity was 56.1%. Obesity determined by BMI was associated with hypertension and diabetes. While central obesity was associated with an increase in age, female, diabetes and hypertension. CONCLUSION The prevalence of obesity was 21.2%. Obesity and central obesity have a higher prevalence among Sudanese women. Obesity and central obesity were associated with diabetes and hypertension.
Collapse
Affiliation(s)
- Mohamed H Ahmed
- Department of Medicine and HIV Metabolic clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK.
| | - Yasmeen A Ali
- Public and Tropical Health Program, University of Medical Sciences and Technology, Khartoum, Sudan.
| | - Heitham Awadalla
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
| | - Wadie M Elmadhoun
- Department of Pathology, Faculty of Medicine and Health Sciences, Nile Valley University, Sudan,.
| | - Sufian K Noor
- Department of Medicine, Faculty of Medicine and Health Sciences, Nile Valley University, Atabra, Sudan.
| | - Ahmed O Almobarak
- Department of Pathology, Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan.
| |
Collapse
|
29
|
Jésus P, Guerchet M, Pilleron S, Fayemendy P, Maxime Mouanga A, Mbelesso P, Preux PM, Desport JC. Undernutrition and obesity among elderly people living in two cities of developing countries: Prevalence and associated factors in the EDAC study. Clin Nutr ESPEN 2017; 21:40-50. [PMID: 30014868 DOI: 10.1016/j.clnesp.2017.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/24/2017] [Accepted: 05/30/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND Nutritional status among elderly people living in Sub-Saharan Africa is poorly studied, even though undernutrition and obesity are known to cause many complications and are risk factors for progression and death in several diseases. The aims of this study were to assess the nutritional status of the elderly in Central Africa and to study the factors associated with nutritional disorders (undernutrition and obesity). METHODS Two cross-sectional population-based studies were carried out in the capitals of Central African Republic (CAR) and Republic of Congo (ROC) between 2008 and 2009. Participants were aged ≥65 years old and underwent nutritional assessment including the following measurements: weight, height, body mass index (BMI), waist circumference (WC). Diet was also investigated. Nutritional status was defined according to the WHO BMI classification (<18.5 = undernutrition; ≥30 = obesity). Multinomial regression analysis was performed in order to identify factors associated with nutritional status. RESULTS 990 elderly people underwent nutritional assessment (482 in CAR and 508 in ROC). Mean BMI was 22.7 ± 4.8 kg/m2. The prevalence of undernutrition was 19.2% and was lower in ROC than in CAR (9.5% vs. 29.5%; p < 0.0001). The prevalence of obesity was 8.8% and was higher in ROC than in CAR (14.6% vs. 2.7%; p < 0.0001). The mean WC was 85.3 ± 28.4 cm. Adjusted on study site, increasing age (OR = 1.6 [95% CI: 1.1-2.3] for 75-84 years, OR = 2.6 [95% CI: 1.4-4.8] for 85+ years), occupation as farmer/breeder (OR = 2.2 [95% CI: 1.1-4.2]), smoking (OR = 1.71 [95% CI: 1.14-2.56]) and low sugar consumption (OR = 1.7 [95% CI: 1.1-2.7]) were positively associated with undernutrition whereas only female sex was positively associated with obesity (OR = 5.0 [95% CI: 2.2-11.0]). CONCLUSIONS The prevalence of undernutrition is high in the elderly population of these countries, in contrast to obesity. Undernutrition and obesity are associated with different socio-economic factors and food consumption. Simple nutritional advice could contribute to improving the nutritional status of elderly people in Central Africa.
Collapse
Affiliation(s)
- Pierre Jésus
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France.
| | - Maëlenn Guerchet
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; King's College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, UK
| | - Sophie Pilleron
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
| | - Philippe Fayemendy
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France
| | - Alain Maxime Mouanga
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Psychiatry Department, University Hospital of Brazzaville, Brazzaville, Congo
| | - Pascal Mbelesso
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Neurology Department, Amitié Hospital, Bangui, Central African Republic
| | - Pierre Marie Preux
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Medical Information & Evaluation, Clinical Research and Biostatistics Unit, University Hospital of Limoges, Limoges, France
| | - Jean Claude Desport
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France
| |
Collapse
|
30
|
Prediabetes: the cat is out! Int J Diabetes Dev Ctries 2016. [DOI: 10.1007/s13410-016-0513-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|