|Year : 2013 | Volume
| Issue : 2 | Page : 62-66
Weight status among young males in Upper Egypt
Sameh Zaytoun1, Mohammed Al-Ateeq2, Hesham Ayoub3, Mohamed Alsenbesy1, Hanan Nomeir4
1 Department of Community Medicine and Public Health; Department of Internal Medicine, South Valley University, Egypt
2 Department of Family Medicine, National Guard Medical Affairs, Saudi Arabia
3 Department of Internal Medicine, Military Medical Academy, Egypt
4 Department of Medical Biochemistry, Alexandria University, Egypt
|Date of Web Publication||12-Mar-2014|
Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh
Source of Support: None, Conflict of Interest: None
Background: Obesity is a common health problem, with increasing prevalence world-wide. The metabolic changes of obesity can induce serious health problems and increase the risk for many diseases. Aim of the Work: The aim of this study to determine the body weight disorders, socio-demographic profile and associated medical conditions among young male adults in the Upper Egypt. Subjects and Methods: A cross-sectional study was carried out in Qena University Hospital from 1 st August 2011 to 31 st August 2012, with a total number of 500 male subjects ranging from 18 to 30 years old. All individuals participating in the study were submitted to the followings: Filling a predesigned data collection sheet including: Demographic and socioeconomic data, family history of obesity, full clinical examination and laboratory investigations: Fasting glucose level for all participants and post-prandial serum glucose level for subjects with history of diabetes mellitus (DM) or have a risk factor of DM. Results: About 6% of subjects found to be obese with body mass index above 30. Middle social class was found to comprise most individuals with normal weight (69.6%). On the other hand, more than half of the underweights (57.9%) and 41.9% of obese subjects were from low social class. Most of youth of high social class were either normal (46.7%) or over weight and none of them were underweight (P < 0.001). About 3% and 6.5% of obese persons were found to be diabetics and hypertensive respectively. There was a significant association between obesity and the presence of family history of obesity (P = 0.012). Conclusion: The prevalence of obesity was similar among young males from different places in the Upper Egypt with being more prevalent among low social classes.
Keywords: Male youth, obesity, Upper Egypt
|How to cite this article:|
Zaytoun S, Al-Ateeq M, Ayoub H, Alsenbesy M, Nomeir H. Weight status among young males in Upper Egypt. Saudi J Obesity 2013;1:62-6
| Introduction|| |
Obesity is defined as excessive accumulation of body fat, whereas overweight refers to increased body weight over the ideal weight in weight tables, this means that all obese are overweight and not necessary the vice is viscera. 
Obesity is a common health problem among all ages including young adults world-wide and it is almost the foremost cause of non-communicable chronic disease globally. Unfortunately, prevalence of obesity is increasing in both developed and undeveloped countries. Reasons for the rising prevalence include urbanization of the world's population, increased availability of food supplies and reduction of physical activity. 
Many theories had been formulated to explain how and why obesity occurs, they include genetic factors, energy imbalance, fat cell theory, behavioral factors and central regulation theory. ,,,
The excess weight of the enlarged adipose tissue mass together with the metabolic changes of obesity can induce serious health problems and increase the risk for many diseases  and conditions including hypertension,  dyslipidemia,  DM,  sleep apnea and obesity hypoventilation syndrome,  Orthopedic complications,  Skin disorders,  gallbladder, breast, uterine, cervical, and ovarian cancers,  and psychological disorders. 
| Aim of The Work|| |
The aim of this work is to study the body weight status, socio-demographic profile and associated medical conditions among young male adults in the Upper Egypt.
| Subjects and Methods|| |
A cross-sectional study was carried out from August 2011 to August 2012 in Qena University Hospital, Egypt. All the examinations and investigations were performed at out-patient clinic.
The present study comprised a total number of 500 male subjects ranging from 18 to 30 years old, attending the Out-patient Clinics in Qena University Hospital for different reasons. No sampling was done; all the visitors to the out-patient clinics during the study period who meet the criteria were taken. Excluding criteria includes: any female patient, any male patient outside the age range and any patient with a history of secondary obesity or mentally incompetent. A written consent was taken from all enrolled participants after approval of the study by the Ethical Committee at Qena Faculty of Medicine.
All individuals of the present study were submitted to the followings:
Filling a predesigned data collection sheet that includes
- Personal and demographic data (e.g. age and residence).
- Socio-economic data (e.g. marital status, educational level and occupation). The social status was assessed using a scoring system developed by Fahmy and El-Sherbini.  This scoring system was originally published in 1983. It includes seven domains with a total score of 84, with a higher score indicating better socio-economic status: Education and cultural, Occupation, Family, Family possessions, Economic, Home sanitation, Health care. 
- Information about family history of obesity.
- Weight and height: taken by trained nurses using calibrated manual weighing scale.
- Calculation of body mass index (BMI) using the Quettlet's formula:
BMI = Weight (Kg)/Height (m) 2 .
The obtained results were interpreted according to classification of body weight disorders: the subject was considered underweight if BMI was less than 18.5, normal if BMI was between 18.6 and 24.9, overweight if BMI was between 25 and 29.9 and obese if BMI was more than 30.
A total volume of 5 ml of blood was drawn under aseptic conditions using disposable syringes fitted with 20-gauge needle from each individual while being fasting over-night (8-12 h). The blood sample was evacuated slowly on the inner wall of a coded tube and allowed to clot at room temperature. After complete clotting, each tube was centrifuged at 4000 rpm for 20 min to get a clear yellow serum for estimation of fasting glucose level. This was achieved by Roche/Hitachi 911 analyzer with Roch-Glu Kits (enzymatic colorimetric assay method based on the work of Trinder).  The intensity is directly proportional to glucose concentration that measured photometrically. Those with history of DM or had a risk factor of DM were prone to post-prandial serum glucose level. They drank 75 g glucose in 300 ml water within 5 min then another blood samples (2 ml of each individual) were taken after 2 h and measured as mentioned before. DM was considered when the value of fasting blood glucose exceeds 126 mg/dl and above 200 mg/dl for the post-prandial level. 
The collected data were tabulated and analyzed through computer facilities using the Statistical Package for Social Science (SPSS) version 10. ANOVA F test was applied for comparison of the mean of the age between the different studied groups. The association between categorical variables was tested by the Chi-square "×2" test and the level of significance was < 0.05. Simple bivariate analyses were achieved to assess the influence of family history of obesity (risk factor) on the presence of obesity; this has been done using the crude odds ratio (OR) with 95% confidence interval (CI).
| Results|| |
The present study included 500 male youth, attending the out-patient clinics for different causes, 250 from Qena (50%), 200 from Luxor (40%) and 50 from Al bahr Al ahmar (10%) Governorates. Their mean age was 25 ± 4.55 years.
[Table 1] gives information about the socio-demographic characteristics of the studied population. The great majority were single (98.2%) with no statistically significant difference between the three groups. Most of those resided in Luxor and Al bahr Al ahmar governorates were coming from rural areas (88.4% and 78.0% respectively) as compared with only 8.5% from Qena (P < 0.0001).
As regard to occupation, 50.6% of the total studied population were higher school graduates, while manual working was recorded among 45% and those without job were 4.4% (P = 0.0005).
Overall, about two thirds of the studied populations belong to middle social class (66.4%). Low Social class was reported among 19.0% of Qena group as compared with 33.2% and 34.0% of Luxor and Al bahr Al ahmar groups respectively (P = 0.0088).
More than half (52%) of Al bahr Al ahmar group had less than 9 years of education while only 28% and 27.6% of Qena and Luxor groups respectively had this low level of education with statistically significant difference between them (P = 0.0019).
The overall prevalence of underweight, overweight and obesity was (%3.8), (9.8%) and (6.2%) among participants respectively. [Table 2] describes body weight disorders in relation to both medical problems and different social classes of the studied youth.
|Table 2: Association between body weight, some medical problems and social classes|
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It was found that 3.2% of obese persons were diabetics and 6.5% of them were hypertensive. The prevalence of DM and hypertension (HTN) among normal weight individuals was much less (0.2%) for both conditions and that difference was statistically significant (P < 0.001).
As regards to the relation of social class on BMI; it was noted that moderate social class comprised most individuals with normal weight (69.6%). Furthermore, 63% of overweight, 45% of obese and 42.1% of underweight subjects were from middle social class. On the other hand, more than half (57.9%) of the underweights and 41.9% of obese were from low social class. Most of youth of high social class were either normal (46.7%) or over weight and none of them was underweight P < 0.001.
It was found that subjects with obesity have positive family history of obesity (P = 0.012). Young adults with a family history of obesity were at more than 5 times higher risk of being obese than those without a family history of obesity (OR = 5.72, 95% CI: 1.05-32.43).
| Discussion|| |
The present work revealed that 6.2% of the studied male youth had obesity. Bakr  stated in his research that 12.5% of 317 students of Ain Shams University in Egypt of both sexes and age of 20-24 years were obese. Farahat and Abou-El Fath  found that 13.4% of 500 students from Menoufia University, Egypt were obese. Similarly, Al Isa  found that the prevalence of obesity was 13.7% among 842 Kuwait university students of age 18-25 years. With subtraction of both age and sex factors, the prevalence of obesity in the present study was less than national and international results. This may be explained by the fact that most of the study population of the present study are from the middle social class who may be more educated and practicing healthy life-style that result in less prevalence of obesity compared to low social classes.
The present work had compared the prevalence of obesity among the three involved governorates and declared that the highest prevalence was recorded in those from Qena (6.8%) followed by Luxor (6.0%) and Al bahr Al ahmar group was the least (4.0%). However, this difference was not statistically significant. Near to this study, Shaheen et al. (2002)  on his survey on 36,000 individuals of both sex and different age groups starting from 2 up to 70 years old from eight governorates, found that 20.6% of the total sample were obese and the highest prevalence was in Cairo (27.2%) and the lowest in El-Wady El-Gadid (11.1%) and this difference was explained on the basis of the varied level of urbanization between the governorates. Similar results with 31.2% prevalence of overweight and 22.1% prevalence for obesity were obtained from the work of Al-Nuaim et al. who studied the prevalence of obesity among adult Saudi population and concluded that obesity was lower in those living in the desert and rural areas with traditional life-style than those in more urbanized environment, which offered foods with lack of physical activity. 
The present work through lights on the relation between obesity and social class; where obesity was more prevalent in low class (41.9%) than in high class (12.9%). In parallel, Lissner et al.  in their study on 208 obese individuals, found that 37% of them were of low class while 14.6% were of high class. The difference in prevalence of obesity between different social classes was also reported by Tawfik et al. and explained on the basis that socio-economic factors are the major influences on both energy intake and energy expenditure; where unhealthy diet and insufficient physical activity were the main contributing factors for obesity in low social class.
A significant association between obesity and DM as well as hypertension was revealed in the present study; where 3.2% and 6.5% of obese persons were diabetics and hypertensive respectively as compared with lower percentages among the normal weight individuals with statistically significant difference (P < 0.001). This relationship was well-documented in other studies. Sanada et al.  found that high BMI is an independent and dose-dependent risk factor for type 2diabetes in overweight Japanese patients. Ogden et al.  reported that the risk of developing hypertension is 3 times greater in obese individuals. Furthermore, a community based study achieved by Herman et al.  mentioned that obese individuals had more than double risk to develop DM.
The role of family history in development of obesity was evaluated in this work. There is a significant association between obesity and the presence of family history of obesity (P < 0.05). Young adults with family history of obesity were at more than 5 times increased risk of being obese than those without a family history of obesity (OR = 5.66, 95% CI: 1.05-32.43). Several studies supported this result, which was attributed to either hereditary or environmental factors. ,
However, the reporting of family history of obesity among study subjects was based on self-reporting and this is may be affected by recall bias and may result in poor reliability.
| Conclusion|| |
The prevalence of obesity was similar among young males from different places in the Upper Egypt with being more prevalent among the low social classes.
| Recommendations|| |
- Young males from low social classes should be targeted by health program for obesity prevention and management.
- Further studies needed for estimation and comparison with different areas in Egypt.
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[Table 1], [Table 2]