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ORIGINAL ARTICLE
Year : 2019  |  Volume : 63  |  Issue : 4  |  Page : 330-333  

Overweight and obesity among the boys of primary public schools of Baish City in Jazan Province, Saudi Arabia: A cross-sectional study


1 Lecturer, Department of Health Education and Promotion, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
2 Assistant Professor, Department of Health Education and Promotion, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
3 Health Education Intern, Department of Health Education and Promotion, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia

Date of Web Publication18-Dec-2019

Correspondence Address:
Dr. Mohd Shanawaz
Department of Health Education and Promotion, Jazan University
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.IJPH_355_18

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   Abstract 


Background: Overweight and obesity are important modifiable risk factors for various noncommunicable diseases. The link between obesity, poor health outcomes, and all-cause mortality is well established. Overweight and obesity during childhood increases the likelihood of diabetes, hypertension, coronary heart disease, stroke, certain cancers, obstructive sleep apnea, and osteoarthritis more early in younger age groups. Objectives: The aim of the study was to estimate the prevalence and some correlates of overweight and obesity in the study population. Methods: The present study was a cross-sectional study conducted during October 2017 among 300 boys of primary public schools from Baish City of Jazan Province, Saudi Arabia. A semi-structured questionnaire was used for data collection. Weight and height were measured using standard tools. The WHO Z-score reference values of body mass index-for-age were used for the screening of overweight and obesity. Analysis was done using the Statistical Package for the Social Sciences (SPSS version 19.0). Results: The prevalence of overweight and obesity was 10.1% and 12.4%, respectively, among the study participants. There was a significant difference in the overweight and obesity between urban and rural study population. Overweight and obesity was found higher among children who took frequently junk food. Conclusions: Overweight and obesity was substantially prevalent among primary schoolboys with a significant rural–urban difference.

Keywords: Body mass index for age, obesity, overweight, WHO Z-score


How to cite this article:
Fakeeh MI, Shanawaz M, Azeez FK, Arar IA. Overweight and obesity among the boys of primary public schools of Baish City in Jazan Province, Saudi Arabia: A cross-sectional study. Indian J Public Health 2019;63:330-3

How to cite this URL:
Fakeeh MI, Shanawaz M, Azeez FK, Arar IA. Overweight and obesity among the boys of primary public schools of Baish City in Jazan Province, Saudi Arabia: A cross-sectional study. Indian J Public Health [serial online] 2019 [cited 2020 Jul 10];63:330-3. Available from: http://www.ijph.in/text.asp?2019/63/4/330/273358




   Introduction Top


Obesity can be defined simply as a disease in which excess body fat has accumulated to such an extent that health may be adversely affected. However, the amount of excess fat, its distribution within the body, and the associated health consequences vary considerably between obese individuals.[1] One of the most common problems related to lifestyle today is being overweight. Severe overweight or obesity is a key risk factor in the development of many chronic diseases such as heart and respiratory diseases, noninsulin-dependent diabetes mellitus, hypertension, and some cancers, as well as early death. The health consequences range from increased risk of premature death to serious chronic conditions that reduce the overall quality of life. Special concern is the increasing incidence of child obesity among the Middle East countries.[2],[3],[4],[5],[6],[7] The national data revealed that the rates of overweight and obesity among school-age children have reached 23% and 9.3%, respectively.[8]

Obesity, in general, is a major risk factor for noncommunicable diseases (NCDs), and it is estimated that by the year 2020, three-quarter of all deaths in developing countries will be attributed to NCDs. Many diseases and health-related abnormalities are associated with obesity such as metabolic, cardiovascular, and musculoskeletal disorders.[9] Obese children are more prone to develop such diseases and abnormalities.[8] Among children aged 2–19 in the USA, 31.7% were overweight and 16.9% were obese.[10] The prevalence of overweight was estimated to be 21.5% and obesity was estimated to be 13.7% among children aged 5–17 years in a national surveillance in the UAE.[11] Children aged between 6 and 8 years had the prevalence of overweight and obesity 25.5% and 6.5%, respectively, in Lebanon.[12] This study aimed to provide an estimate of prevalence and determinants of overweight and obesity among primary public schoolboys of Baish City in Jazan Province, Saudi Arabia.


   Materials and Methods Top


A cross-sectional, observational study was conducted among primary public schoolboys (1st to 6th standard) aged from 6 to 13 years in Baish City of Jazan Province, Saudi Arabia, during October 2017. Baish City is one of the major cites of Jazan Province, which is located in the southwestern region of Saudi Arabia, on the tropical Red Sea coast. The area was selected randomly. The area and study population represent the Jazan population.[13],[14]

By using the prevalence of obesity among primary schoolchildren and using the formula, the sample size was calculated.[15],[16] Considering the prevalence of obesity to be 23%, the minimum sample required was 237 students, but to correct nonresponse, refusal of some students, and for analysis convenience, an overall sample of 300 students was selected.

After getting a list of all schools from the Ministry of Education, five schools each from urban and rural areas were selected randomly. Hence, a total of ten schools were selected for the study purpose. Then, from each school, classes grading from 1st to 6th standard were used for the sample selection. Every third child from each class was selected systematically from the attendance register till a sample of five students was obtained from each class and a total of 30 students from a school.

Each student was weighed on an electronic weighing scale (CAMRY EF601 Max 150 kg/330lb) and the weight was recorded to a nearest of 100 g. Height was measured using a measuring scale (HM200P PortStad Portable Stadiometer). The age was recorded from the birth certificate or the register from the school.

The WHO Z-score reference values of the body mass index (BMI) for the age were used for the screening of overweight and obesity among the study population.[17]

The reference lines on the growth charts are called Z-score lines because they are based on Z-scores, also known as standard deviation (SD) scores. Z-scores or SD scores are used to describe how far a measurement is from the median (average). These scores are calculated differently for measurements that are distributed normally and nonnormally in the reference population. Children who are more than 3 SD for reference medium (>3 Z-score) are considered as obese and those children whose BMI for age is over 2 SD are considered as overweight.

The study used age, area, and the frequency of junk foods intake as the subvariables.

A semi-structured questionnaire was developed and pilot tested before the data collection. The collected data were analyzed for different variables such as age, occupation, birth order, family size, children dietary intake, physical activity patterns, and sleeping time. The analysis was done using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, version 19 (IBM Corp., Armonk, N.Y., USA). Chi-square test and Kruskal–Wallis H-test were used for the analysis at 5% level of significance.

Ethics

The study was approved by the Research Committee at the faculty of public health and tropical medicine, Jazan University, on November 27, 2017, using a reference number HE/2017/4. All the participants in the study had given their written consent declaration. The procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000.


   Results Top


The present study focused on the distribution of overweight and obesity among primary school-going male children. The collected data were tabulated according to the age, geographical area, and the frequency of junk food intake in various public schools of Jazan Province, Saudi Arabia. A total of 300 children were studied; however, the data of 298 participants could be analyzed.

The overall prevalence of overweight and obesity among the study participants was found to be 10.1% (30/298) and 12.4% (37/298), respectively. Overweight and obesity was more among children of higher age groups (above 10–11 years), compared to the lower age groups; no significant relationship between age and BMI was found using Kruskal–Wallis test with 24 degree of freedom [Table 1].
Table 1: Distribution of the study subjects according to the body mass index categories and age

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The prevalence of overweight and obesity in urban areas was 12.9% and 12.3%, respectively, and in rural areas, it was 7.3% and 12.6%, respectively [Table 2]. The combined prevalence of overweight and obesity in urban areas (25.2%) was much higher than in rural areas (19.9%). It was found to be statistically significant using Chi-square test.
Table 2: Distribution of the body mass index categories of the participants according to the area of residence

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The study found a high percentage distribution of overweight (10.4%) and obesity (11.8%) among the study participants who always consumed junk foods when compared to those who are rarely or never eating junk foods. However, there was no relationship between the frequency of junk-food intake to overweight and obesity using Kruskal–Wallis test with 12 degree of freedom [Table 3].
Table 3: Distribution of the body mass index categories of the participants according to their frequency of junk-food intake

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   Discussion Top


The findings of this study are consistent with the findings of a previous study conducted in Saudi Arabia in the year 2013 where it was found that there was a high prevalence of overweight and obesity among school-age children.[8]

The present study found a higher prevalence of overweight and obesity in urban areas when compared to rural. It could be due to the reasons such as availability and accessibility of widespread fast-food restaurants, mostly sedentary lifestyle in urban areas, working mothers, and less outdoor activities when compared to rural areas here in Saudi Arabia. In a similar study, conducted in the UAE, it was found that the overweight and obesity is more in urban areas when compared to rural.[11]

Another factor that has been studied as a possible contributing factor of childhood obesity is the consumption of junk foods. Junk foods include foods such as chips, baked goods, and candy. While snacking has been shown to increase overall caloric intake, no link was reported between snacking and overweight, which is consistent with our findings.[18]

The nutrition transition is mainly affecting urban localities that have gradually abandoned their traditional eating habits for more imported and processed foods including fast foods and carbonated fizzy drinks. Increased fast-food consumption has been linked with obesity in the recent years.[19] Many families, especially those with two parents working outside the home, opt for these places as they are often favored by their children and are both convenient and inexpensive. Foods served at fast-food restaurants tend to contain a high number of calories with low nutritional values.[20]

The present study gives us an opportunity to find the prevalence of overweight and obesity in private schools along with comparisons between males and females in the near future.


   Conclusion Top


Overweight and obesity is still substantially prevalent among primary schoolboys in Baish city, significantly being higher in urban areas. It is recommended that more health education campaigns, physical education, healthy eating habits, and behavior activities of children are to be taught at the school level, especially in urban areas.

Acknowledgment

We would like to thank our Dean Dr. Mohammed J. Al-Malki, Vice Dean Dr. Yahya Al-Amir, Faculty of Public Health and Tropical Medicine, Jazan University, study participants, and our reviewers for the support provided to us in this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

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Jazan City Profile TSN. Available from: http://www.the-saudi.net/saudi-arabia/jizan/Jizan%20City%20-%20Saudi%20Arabia.htm. [Last accessed on 2017 Oct 30].  Back to cited text no. 13
    
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Statistics GA. Jazan General Population and Housing Census; 2010. Available from: https://www.stats.gov.sa/sites/default/files/en-jazan-population-by-gender-govnernorate-nationality_2.pdf. [Last accessed on 2017 Oct 04].  Back to cited text no. 14
    
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Shanawaz AN, Sunder S, Khan M, Rani S, Padmanabha B. An evaluation of nutritional status of children in Anganwadi Centres of Hyderabad district of Andhra Pradesh state using WHO z score technique. Global J Med Pub Health 2013;2:1-6.  Back to cited text no. 15
    
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Connolly MA. Communicable Disease Control in Emergencies: Afield Manual: World Health Organization; 2005.  Back to cited text no. 16
    
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World Health Organization. WHO Child Growth Standards: Training Course on Child Growth Assessment. World Health Organization; 2008.  Back to cited text no. 17
    
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Anderson PM, Butcher KF. Childhood obesity: Trends and potential causes. Future Child 2006;16:19-45.  Back to cited text no. 18
    
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Prentice AM, Jebb SA. Fast foods, energy density and obesity: A possible mechanistic link. Obes Rev 2003;4:187-94.  Back to cited text no. 19
    
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Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: Causes and consequences. J Family Med Prim Care 2015;4:187-92.  Back to cited text no. 20
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