|Year : 2017 | Volume
| Issue : 1 | Page : 3-7
Adolescents’ overweight and obesity among Alabnaa schools in Tabuk, Saudi Arabia
Salem K Al Dahi1, Mansour A Rofayda1, Gashgary Y.A Eman1, Mahmoud A.A Rami1, Hassan E Sanna1, Mohamed E Malak1, Abdualrzg A Fatma2
1 Preventive Medicine Department, King Salman Armed Forces Hospital North Western Region, Tabuk University, Tabuk, Kingdom of Saudi Arabia
2 Department of Public Health, Tabuk University, Tabuk, Kingdom of Saudi Arabia
|Date of Web Publication||13-Jul-2017|
Mansour A Rofayda
Preventive Medicine Department, King Salman Armed Forces Hospital North Western Region, P.O. Box 100, Tabuk
Kingdom of Saudi Arabia
Source of Support: None, Conflict of Interest: None
Background: Obesity is a major risk factor for illness and death. It is associated with diabetes, hypertension, hyperlipidemia, obstructive sleep apnea, and osteoarthritis. With the increase in life expectancy, obesity is causing more years of disability. Hence, the increased cost of obesity and its sequelae will put a strain on the resources of governments and individuals. Saudi Arabia is one of the fastest growing economies of the world. Consequently, obesity is increasing in the Kingdom at an alarming rate.
Objectives: To determine the prevalence of adolescents overweight and obesity and to study some contributing factors regarding obesity among Alabnaa schools students in Tabuk, Saudi Arabia.
Materials and Methods: This cross-sectional study was conducted among the students of Alabnaa school, Tabuk, KSA in 2015–2016. Self-administered questionnaire was constructed by the investigators in Arabic language, it included gender, age, some relevant factors regarding obesity. Weight, height were measured, and body mass index was calculated. Childhood growth chart was used to classify the degree of overweight and obesity. Data was managed using SPSS version 21.
Results: Prevalence of overweight and obesity among students were 11.4% and 14.9% respectively. Prevalence of obesity among male students was 12.5% compared to 16.9% among female students (statistically significant). Students whose mothers were highly educated, with family history of (obesity and diabetes), intaking soft drinks were more obese than their counterparts.
Conclusion: This study revealed that the prevalence of overweight and obesity are high among adolescents in Tabuk region particularly among those with family history of obesity, diabetes and those intake soft drink frequently. Screening for obesity at school entry and providing health education sessions for students about diet and exercise are highly recommended.
Keywords: Adolescent, obesity, overweight, risk factors
|How to cite this article:|
Al Dahi SK, Rofayda MA, Eman GY, Rami MA, Sanna HE, Malak ME, Fatma AA. Adolescents’ overweight and obesity among Alabnaa schools in Tabuk, Saudi Arabia. Saudi J Obesity 2017;5:3-7
|How to cite this URL:|
Al Dahi SK, Rofayda MA, Eman GY, Rami MA, Sanna HE, Malak ME, Fatma AA. Adolescents’ overweight and obesity among Alabnaa schools in Tabuk, Saudi Arabia. Saudi J Obesity [serial online] 2017 [cited 2018 Mar 23];5:3-7. Available from: http://www.saudijobesity.com/text.asp?2017/5/1/3/210584
| Introduction|| |
Currently, one of the most common problems related to lifestyle is being overweight. Severe overweight or obesity is a key risk factor for the development of many chronic diseases such as heart and respiratory diseases, non-insulin-dependent type-2 Diabetes Mellitus, hypertension, and some cancers, as well as premature death.
Overweight is defined as body mass index (BMI) between 85–94th percentile while obesity is defined as BMI equals or greater than 95th percentile for the same age and gender.
Obese youth are more likely to have risk factors for cardiovascular diseases such as high cholesterol or high blood pressure. Obese adolescents are more likely to have prediabetes. Children and adolescents who are obese are at a greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem.
In Saudi Arabia, it has been documented that the prevalence of obesity among adolescents increased significantly from 1988 to 2005.
Evidence shows that there are significant difficulties associated with managing obesity once it has been established. It is also acknowledged that obese children and adolescents may develop adulthood obesity, making the conditions very complex to manage. Due to seriousness of health impacts of obesity, management of early obesity has been identified as a public health priority.
The objectives of this study were to measure the prevalence of obesity and its some contributing factors among students in Alabnaa school in Tabuk region, KSA.
MATERIALS AND METHODS
This cross-sectional study was conducted in 2015–2016 among students of Alabnaa schools in Tabuk city, KSA. The study population included students of males and females intermediate and secondary schools. The total students of all schools was 5749 students (2675 males and 3074 females). Out of them, 1850 students were selected by using simple randomization method.
Data collection and ethical consideration
The study was approved by the ethical committee of King Salman Armed Forces Hospital, Tabuk city. Permission from the educational authorities in Tabuk was obtained; written consent was obtained from each school Headmaster; verbal consent was given by the students who participated, and responses were kept strictly confidential.
Data were collected through a self-administered questionnaire. The questionnaire included the following items; age, gender, family history of obesity, family history of diabetes mellitus, history of thyroid diseases, performing physical activity, watching television, intake fast food, and intake soft drink. Weight and height of each student were measured while BMI was calculated by well trained personnel using growth chart published World Health Organization.
Data entry and analysis
Data were entered and analyzed by using Statistical Package for the Social Sciences (SPSS) version 21. Chi-Square and Student-t test were used accordingly and P-values were considered statistically significant if less than 0.05.
| Results|| |
Out of the 1850 self-administered questionnaires distributed to the students, 1832 questionnaires returned, giving a response rate of 99.6%.
[Table 1] presents the sociodemographic characteristics of the students who participated in the study. Their age ranged between 11 and 19 years. More than half of them were females (53.5%).
Overall, the prevalence of overweight and obesity among adolescent students were 11.4% and 14.9% respectively.
The prevalence of overweight and obesity among female students were found to be significantly higher than that among male students [Table 2].
Regarding association between mothers’ educational level and obesity, it was found that students whose mothers with high educational qualification suffered from obesity comparing with their counterparts [Table 3].
|Table 3: Association between weight status of students and their mothers’ education level|
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Studying the association between some variables and obesity among students revealed that family history of obesity and family history of DM were statistically significant (P values less than 0.05).
[Table 4] shows relationship between weight status of students and some of their life-styles such as physical activities, watching TV, eating fast food and drinking soft drinks. There was no significant association between overweight/obesity among students and practicing physical exercise, watching TV, or eating fast. However, students who intake soft drink were more likely to be obese/overweight compared to those who do not drink such juices (P=0.04).
|Table 4: Association between weight status of students and some of their daily lifestyles|
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| Discussion|| |
The prevalence of overweight and obesity among children and adolescents has increased worldwide. In the past thirty years, rate of obesity among children and adolescents increased by 2–4 folds in different developing countries including Saudi Arabia.
In the present study, the rates of overweight among male students and female students were 9.9% and 12.6% respectively while the rates f obesity were 12.5% among male students and 16.9% among female students. In one study conducted in Riyadh, the prevalence rates of overweight and obesity among adolescents were 13.8% and 20.5% respectively. There is significant difference as females students suffer from overweight and obesity more than male students. This difference could be due to cultural and geographical reasons as reported earlier.
Parents educational level can play some roles regarding risk factor of obesity among children. In this study, it was found that children of mothers with high education level have high rate of obesity and overweight. This association could be due to that their mothers are working outside, do not prepare food at their houses and depend on ready made meals and fast food from outside. In this regard, Nazarov found in his study that children of mothers with less education were at low risk of developing obesity.
Thyroid gland has important roles in weight control and obesity. Slight elevation of serum thyroid stimulating hormone levels were found to be associated with obesity s occurrence., In this study, no association was found between the history of thyroid dysfunction and obesity. This finding could be due to few number of participants (8 children) have history of thyroid diseases.
Research found that incidence of type-2 diabetes was high among children and adolescents suffering from obesity Childhood obesity., In this study, eight children were found having type-1 diabetes, and six out of them were having normal body mass index.
This study found that children with family history of obesity have high rate of obesity. This association could be due to types of food utilized by all members of family,, sharing of common life styles in addition to genetic factors. Despite the underlying cause, Saudi family should be educated to prepare and to choose well balanced diet to control obesity in KSA.
US surveys including the Behavioral Risk Factor Surveillance System and the National Health and Nutrition Examination Survey revealed that inner-city residents were more overweight, less physically active, and less healthy overall than the general population. The studies on sprawl and public health have found that the increased levels of sprawl were associated with increased obesity as well as decreased physical activity. Our study result showed no significant relationship between obesity and watching TV. In one American study, it was found that fast food consumption by children and adolescents increased by 5-folds from 1977 to 1995 and fast food comprised of 12% of daily caloric intake and almost one-third of all youths now eat at fast food restaurants on any given day. In this study we found that more than than 70% of participants eat fast food either as part of their daily meals which is considered as serious indicator that young Saudi generation depends on unhealthy food which will lead to more chronic diseases epidemic that will be difficult to control in the near future.
The consumption of soft drinks and its association with obesity have been highlighted in a number of recent research articles. The term soft drinks is used to include carbonated drinks and sugar-sweetened drinks. Results of this study revealed that at least 2/3 of participants intake soft drink either daily or at least once per week. However, weak association was found regarding intake of soft drink and overweight/obesity (P=0.04).
| Conclusion|| |
This study revealed that the prevalence of overweight and obesity among students of intermediate and secondary schools in Tabuk region were high. Many sedentary life styles and bad dietary habits such as physical inactivities, eating and drinking unhealthy food and drinks were identified.
Based on this study, the following recommendations are suggested:
- In order to identify students with obesity screening program for student at school entry should be implemented.
- In order to improve knowledge, attitude and the practice of students regarding obesity and its associated health problems, intensive health education on healthy diet and lifestyles should be conducted at all schools.
- Further studies are suggested to explore the impact of health education programs on knowledge, attitude and practice of students on their weight and lifestyles.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
World Heath Organisation. Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series, No. 854; 1995.
Hu F. Measurements of adiposity and body composition. In: Hu F, editors. Obesity Epidemiology. New York City: Oxford University Press; 2008. p. 53-83.
Flegal KM, Ogden CL. Childhood obesity. Adv Nutr J 2016;6.
Raj M, Kumar RK. Obesity in children & adolescents. Indian J Med Res 2010;132:598-607.
] [Full text]
Peplow P, Adams J, Young T. Cardiovascular and Metabolic Disease: Scientific Discoveries and New Therapies ; 2015. p. 35.
Story M. School-based approaches for preventing and treating obesity. Int J Obes Relat Metab Disorders 1999; 23.
Lobstein T, Frelut ML. Prevalence of overweight among children in Europe. Obes Rev 2003;4:195-200.
Al Dhaifallah A, Mwanri L, Aljoudi A. Childhood obesity in Saudi Arabia: Opportunities and challenges. Saudi J Obes 2015;3:2-7.
Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. World Health Organ. Tech Rep. Ser.; 2000. p. 100-42. [Back to cited text no. 4].
Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: Public-health crisis, common sense cure. Lancet 2002;360:473-82.
Sameera Karnik and Amar Kanekar Childhood obesity: A global public health crisis. Int J Prev Med 2012;3:1-7.
Nazarov Z, Rendall MS. Differences by mother’s education in the effect of childcare on child obesity. Econ Lett 2014;124:286-9.
de Moraes AC, Fadoni RP, Ricardi LM, Souza TC, Rosaneli CF, Nakashima AT et al.
Prevalence of abdominal obesity in adolescents: A systematic review. Obes Rev 2011;12:69-77.
Laurberg P, Knudsen N, Andersen S, Carlé A, Pedersen IB, Karmisholt J. Thyroid function and obesity. Eur Thyroid J 2012;1:159-67.
Knudsen N, Laurberg P, Rasmussen LB, Bülow I, Perrild H, Ovesen L et al.
Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metabol 2005;90:4019-24.
Zeitler P. Approach to the obese adolescent with new-onset diabetes. J Clin Endocrinol Metab 2010;95:5163-70.
Rosenbloom AL, Joe JR, Young RS, Winter WE. Emerging epidemic of type 2 diabetes in youth. Diabetes Care 1999;22:345-54.
Puhl RM, Latner JD. Stigma, obesity, and the health of the nation’s children. Psychol Bull 2007;133:557-80.
Sargeant LA, Wareham NJ, Khaw K-T. Family history of diabetes identifies a group at increased risk for the metabolic consequences of obesity and physical inactivity in EPIC-Norfolk: A population-based study. The European Prospective Investigation into Cancer. Int J Obes Relat Metab Disord 2000;24:1333-9.
Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B et al.
Evidence based physical activity for school-age youth. J Paediatr 2005;146:732-7.
Eberhardt MS, Pamuk ER. The importance of place of residence: Examining health in rural and nonrural areas. Am J Public Health 2004;94:1682-6.
Lopez RP, Hynes HP. Obesity, physical activity, and the urban environment: Public health research needs. Environ Health 2006;5:25.
Davis B, Carpenter C. Proximity of fast-food restaurants to schools and adolescent obesity. Am J Public Health 2009;99:505-10.
James J, Kerr D. Prevention of childhood obesity by reducing soft drinks. Int J Obes 2005;29:S54-7.
[Table 1], [Table 2], [Table 3], [Table 4]