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Sitaula D, Dhakal A, Lageju N, Silwal A, Basnet SK, Shrestha N, Anup Bikram BC, Phoju N. Prevalence and Associated Factors of Adolescent Obesity among Rural School Adolescents in Nepal: A Cross-Sectional Study. Glob Health Epidemiol Genom 2023; 2023:2957278. [PMID: 37808524 PMCID: PMC10558264 DOI: 10.1155/2023/2957278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/28/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023] Open
Abstract
Background Overweight and obesity are major risk factors for chronic diseases and are the leading cause of mortality worldwide. Obesity during adolescence is strongly associated with adulthood obesity leading to increased morbidities and mortality. As a developing country undergoing rapid urbanization, Nepal is in a transitional phase where undernutrition coexists with obesity; however, there is a dearth of literature on the status of adolescent obesity in the rural section of Nepal. The aim of this study was to determine the prevalence of adolescent obesity in a rural district of Nepal and find out its associated factors. Methods An institution-based cross-sectional study was conducted among the adolescent students studying in classes 8, 9, and 10 in four secondary schools of Gosaikunda rural municipality of Rasuwa district, Nepal. Total enumerative sampling was used, and Global School-based Health Survey (GSHS) standard questionnaires were used in collecting the information. Height and weight measurements were taken, and the body mass index was classified according to Asia-Pacific criteria. The collected data were analyzed using "SPSS" version 22. Logistic regression analysis was used to evaluate the associated factors, and a p value of ≤0.05 was considered statistically significant. Results Out of 267 adolescents, 14.6% were obese and 14.6% were overweight. Of the female participants, 39.6% were either obese or overweight, while 12.6% of the male adolescents were overweight/obese. Among the total participants, 16.5% were underweight, including 14.0% females and 20.4% males. Female adolescents were about five times (AOR: 5.2, 95% CI (2.5-10.9), p < 0.01) more likely of being overweight/obese than male adolescents. Conclusions More than one-quarter of the adolescents were found to be obese/overweight, and the prevalence was significantly more among female adolescents. It emphasizes the necessity of school-based programs promoting a healthy lifestyle among students to maintain healthy weight status.
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Affiliation(s)
| | - Aarati Dhakal
- Department of Community Programs, Dhulikhel Hospital, Kathmandu University, Kavre, Nepal
| | - Nimesh Lageju
- Rasuwa Hospital, Dhunche, Rasuwa, Bagmati Province, Nepal
| | - Amisha Silwal
- Department of Medical Oncology, Nepal Cancer Hospital and Research Center, Lalitpur, Nepal
| | | | - Niki Shrestha
- Department of Community Medicine, Chitwan Medical College, Chitwan, Nepal
| | - B. C. Anup Bikram
- NCD and Mental Health Section, Epidemiology and Disease Control Division, Kathmandu, Nepal
| | - Niraj Phoju
- Rasuwa Hospital, Dhunche, Rasuwa, Bagmati Province, Nepal
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Hamann SA, Thorup L, Patsche CB, Hohwü L, Hjortdal VE, Gyawali B, Neupane D, Kallestrup P. Association between nutritional status and socio-economic status among school children aged 9-17 years in a semi-urban area of Nepal. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:53. [PMID: 37291650 DOI: 10.1186/s41043-023-00392-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND In many low-and middle-income countries (LMICs), childhood overweight is increasing, while underweight remains a problem. This study aimed to investigate the association between socio-economic status (SES) and nutritional status among Nepalese school children. METHODS This cross-sectional study used a multistage random cluster sampling method and included 868 students aged 9-17 years from both public and private schools located in a semi-urban area of Pokhara Metropolitan City, Nepal. SES was determined based on a self-reported questionnaire. Body weight and height were measured by health professionals and body mass index (BMI) was categorized based on the World Health Organization BMI-for-age cut-offs. The association between Lower and Upper SES and BMI was assessed using mixed-effects logistic regression model estimating the adjusted odds ratio (aOR) with a corresponding 95% confidence interval (CI) and compared to Middle SES. RESULTS The proportion of obesity, overweight, underweight, and stunting among school children was 4%, 12%, 7%, and 17%, respectively. More girls were overweight/obese compared with boys (20% vs. 13%). The mixed-effects logistic regression model showed that both participants from Lower SES households and Upper SES households had a higher tendency to be overweight compared to participants from Middle SES; aOR = 1.4; 95% CI 0.7-3.1 and aOR = 1.1; 95% CI 0.6-2.1, respectively. Furthermore, stunting and overweight occurred simultaneously. CONCLUSIONS This study found that about one out of four children and adolescents in the study setting was malnourished. There was a tendency that both participants from Lower SES and Upper SES had higher odds of being overweight compared to participants from Middle SES. Furthermore, both stunting and overweight were present simultaneously in some individuals. This emphasizes the complexity and importance of awareness of childhood malnutrition in LMICs like Nepal.
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Affiliation(s)
- Sophie Amalie Hamann
- Department of Public Health, Center for Global Health (GloHAU), Aarhus University, Aarhus, Denmark
| | - Lene Thorup
- Department of Public Health, Center for Global Health (GloHAU), Aarhus University, Aarhus, Denmark.
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | | | - Lena Hohwü
- The Research Center for Health and Welfare Technology, VIA University College Aarhus, Aarhus, Denmark
| | - Vibeke Elisabeth Hjortdal
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Bishal Gyawali
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
- Nepal Development Society, Bharatpur-05, Chitwan, Nepal
| | - Per Kallestrup
- Department of Public Health, Center for Global Health (GloHAU), Aarhus University, Aarhus, Denmark
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Overweight/Obesity Prevalence among Under-Five Children and Risk Factors in India: A Cross-Sectional Study Using the National Family Health Survey (2015–2016). Nutrients 2022; 14:nu14173621. [PMID: 36079879 PMCID: PMC9460849 DOI: 10.3390/nu14173621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
The occurrence of overweight and obesity has increased in recent years in India. In this study, we investigate the prevalence and associated risk factors of overweight/obesity among children aged 0–59 months in India. Using data from the 2015–2016 National Family Health Survey-4 (NFHS-4), the research sample included 176,255 children aged 0 to 59 months. Bivariate and multivariate techniques were used to analyze children’s risk factors for overweight/obesity. We identified that the prevalence of overweight/obesity among children aged 0–59 was 2.6% in India. The study findings reveal that factors such as child sex, age, birth weight, birth rank, maternal education, number of children, age at marriage, mother’s BMI, media exposure, social group, and dietary diversity score were most significantly correlated with childhood overweight and obesity in India. Furthermore, we found that male children (ARR: 1.08) aged between 0 and 11 months (ARR: 3.77) with low birth rank (ARR: 1.24), obese (ARR: 1.81) children whose mothers married after the age of 18 (ARR: 1.15), children who belong to a scheduled tribe family (ARR: 1.46), and children who consumed 7–9 food items (ARR: 1.22) were at highest risk of being overweight and obese. However, breastfeeding (ARR: 0.85) and Muslim families (ARR: 0.87) appeared to be protective factors with respect to childhood overweight and obesity in India. Pertinent public health programs, clinical follow-up, and awareness about sedentary lifestyles can help to reduce overweight/obesity risks in children.
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Le GB, Dinh DX. Prevalence and associated factors of overweight and obesity among primary school children: a cross-sectional study in Thanhhoa City, Vietnam. BMJ Open 2022; 12:e058504. [PMID: 35459674 PMCID: PMC9036463 DOI: 10.1136/bmjopen-2021-058504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To determine the prevalence and associated factors of overweight and obesity among primary school children (6-11 years old) in Thanhhoa city in 2021. DESIGN Cross-sectional study. SETTING Seven primary schools in Thanhhoa city, Vietnam. PARTICIPANTS 782 children (and their parents). PRIMARY AND SECONDARY OUTCOME MEASURES Two-stage cluster random sampling was used for selecting children and data were collected from January to February 2021. A self-administrated questionnaire was designed for children and their parents. Children's height and weight were measured and body mass index (BMI)-for-age z-scores were computed using the WHO Anthro software V.1.0.4. Data were analysed using R software V.4.1.2. The associations between potential factors and childhood overweight/obesity were analysed through univariate and multivariate logistic regression analyses. Variables were selected using the Bayesian Model Averaging method. RESULTS The prevalence of overweight/obesity among primary school children in Thanhhoa city was 35.93% (overweight 21.61% and obesity 14.32%). The proportion of overweight girls was nearly equal to that of boys (20.78% and 22.52%, respectively, p=0.6152) while the proportion of boys with obesity was four times as many as that of girls (23.86% and 5.62%, respectively, p<0.0001). Child's sex was the factor significantly associated with childhood overweight/obesity. Boys had double the risk of being overweight/obese than girls (adjusted OR: aOR=2.48, p<0.0001). Other potential factors which may be associated with childhood overweight/obesity included mode of transport to school, the people living with the child, mother's occupation, father's education, eating confectionery, the total time of doing sports, and sedentary activities. CONCLUSION One in every three primary school children in Thanhhoa city were either overweight or obese. Parents, teachers and policy-makers can implement interventions in the aforementioned factors to reduce the rate of childhood obesity. In forthcoming years, longitudinal studies should be conducted to determine the causal relationships between potential factors and childhood overweight/obesity.
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Affiliation(s)
- Giang Ba Le
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Dai Xuan Dinh
- Department of Pharmaceutical Management and Pharmacoeconomics, Hanoi University of Pharmacy, Hanoi, Viet Nam
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The association of sleep problem, dietary habits and physical activity with weight status of adolescents in Nepal. BMC Public Health 2021; 21:938. [PMID: 34001092 PMCID: PMC8130305 DOI: 10.1186/s12889-021-10985-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 05/05/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Overweight/obesity among adolescents is an emerging public health issue worldwide. However, the evidence on the determinants of body weight status and lifestyle behaviors among Nepalese adolescents is limited. This study aims to explore the sleep characteristics, dietary habits, and physical activity and its association with body mass index (BMI) among Nepalese adolescents. METHODS A cross-sectional study was conducted between July and November 2019 among 627 randomly selected adolescents from eight schools located in Kathmandu Metropolitan City, Nepal. A self-administrated structure questionnaire was used to collect the data. Anthropometric measurements (adolescent's BMI), sleep characteristics, dietary habits, and physical activity were assessed using validated tools. Multinomial logistic regression analyses assessed the association between covariates and BMI categories. The statistical significance was considered at p-value < 0.05 and 95% confidence intervals (CIs). RESULTS The overall prevalence of underweight and overweight/obesity among adolescents was 9.1% (95% CI: 7.1-11.6) and 23.7% (95% CI: 20.6-27.7) respectively. In multinomial logistic regression, adolescents who reported sleep problem compared to those with no such problem (Relative risk ratio (RRR) = 13.37, 95% CI: 7.14-25.05), adolescents who had obstructive sleep apnea (OSA) symptoms (RRR = 3.21, 95% CI:1.31-7.86), who consumed soft drink ≥1 time/day in past 1 months (RRR = 5.44, 95% CI: 2.93-10.10), consumed high-fat dietary ≥2 times/day (RRR = 2.17, 95% CI: 1.18-3.99), and had a habit of junk food consumptions (RRR = 5.71, 95% CI:2.55-12.82), adolescents who had 5-6 h/day sedentary behavior (RRR = 3.21, 95% CI: 1.14-9.09), adolescents from Terai/Madhesi castes (RRR = 2.81, 95% CI: 1.19-6.64) and adolescents whose father was employed (RRR = 2.04, 95% CI: 1.04-3.98) were at increased risk of being overweight/obesity. In contrast, adolescents aged 14-16 years had 71% lower (RRR = 0.29, 95% CI: 0.16-0.52), and adolescents who consumed less than five food groups had 45% lower (RRR = 0.55, 95% CI: 0.31-0.97) risk of being overweight/obesity compared to 12-14 years age groups and consumed more than five food groups respectively. CONCLUSIONS The findings of this study warrant immediate interventions to improve the lifestyle to reduce overweight/obesity among Nepalese adolescents. Creating a conducive environment, both at school and home is essential to encourage adolescents for the adoption of healthy lifestyle behaviors.
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Schwinger C, Chandyo RK, Ulak M, Hysing M, Shrestha M, Ranjitkar S, Strand TA. Prevalence of Underweight, Overweight, and Obesity in Adults in Bhaktapur, Nepal in 2015-2017. Front Nutr 2020; 7:567164. [PMID: 33072798 PMCID: PMC7536337 DOI: 10.3389/fnut.2020.567164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/18/2020] [Indexed: 01/13/2023] Open
Abstract
Introduction: There is an increase in the double burden of malnutrition globally, with a particular rise documented in Asia. In Nepal, undernutrition has been prevalent for decades. Today, however, the incidence of overweight and obesity (OWOB) in the country has increased substantially. There is a need to conduct local studies reporting on the concurrent burden of both underweight and OWOB across adult populations. This study addresses this need by describing the distribution of body mass index (BMI) in a defined population of adults living in the peri-urban community of Bhaktapur, Nepal. Material and methods: For this cross-sectional analysis, we used data that were available from 600 women and 445 men whose children were enrolled in an individually randomized, double-blind, placebo-controlled trial assessing the effect of daily vitamin B12 supplementation. Upon enrolment of their 6–11-month old children, mothers and fathers were interviewed about their socio-demographic details. In addition, their weight and height were measured by trained field workers. Each parent's BMI was calculated as the ratio of body weight (in kg) and height squared (in m), expressed as kg/m2, and categorized according to the WHO recommendation. We used linear and multinomial logistic regression models to assess associations between the BMI of the mothers and fathers, and their baseline characteristics. Results: The mean BMI was 23.7 kg/m2 for both the mothers and fathers with a standard deviation (SD) of 3.6 and 3.7, respectively. The proportion categorized as underweight, overweight, and obese was also similar in the two groups with around 5% being underweight, 30% being overweight and 5% being obese. Age was positively associated with BMI in both groups. Those categorized as daily wage earner had a lower mean BMI than those in other occupational groups. Conclusion: Our results contribute to documenting the burden of both under- and overnutrition in a selected group of young adults living in a peri-urban community in Nepal. As Nepal is undergoing an improvement in its economic situation, as well as a nutrition transition, it is important to provide sufficient information to enable timely action, and evidence-based decision-making to prevent a further increase in Nepal's growing double burden of malnutrition.
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Affiliation(s)
- Catherine Schwinger
- Department of Global Public Health and Primary Care, Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway
| | - Ram K Chandyo
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Manjeswori Ulak
- Department of Global Public Health and Primary Care, Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway.,Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Merina Shrestha
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Suman Ranjitkar
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Tor A Strand
- Department of Global Public Health and Primary Care, Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway.,Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
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Overweight, obesity, weight-related behaviors, and health-related quality of life among high-school students in Turkey. Eat Weight Disord 2020; 25:1295-1302. [PMID: 31463887 DOI: 10.1007/s40519-019-00762-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 07/26/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the prevalence of overweight and obesity, and associated socio-demographic and lifestyle behaviors among a sample of high-school students in Turkey. This study also examined the effect of overweight and obesity on health-related quality of life in students. METHODS A cross-sectional survey of 1216 adolescents aged 14-18 years old was conducted from 2018 to 2019 in Turkey, using questionnaire forms and anthropometric measurements. Classification of BMI was based on the WHO reference weight categories. Factors linked to adolescent obesity were identified using the binary logistic regression model and the degree of association was revealed by determining the odds ratio, at a confidence interval (CI) of 95%. RESULTS The prevalence of overweight was 26.1%, while that of obese students was 12.8%. Factors associated with being obese included being in the 14-15 age group, being male, having dysfunctional family relationships, spending more than 3 h/day on screen time, and performing physical activity (≥ 60 min) two times or less per week. Obese adolescents reported significantly lower scores in physical and mental health. CONCLUSIONS In this study, more than one-third of the students were either overweight or obese. Obesity was associated with screen time, physical activity, and family relationship. Obesity in children had a negative impact on their quality of life. Therefore, increasing physical activity, lowering screen time, and having a healthy parent-adolescent relationship could contribute to reducing the prevalence of obesity in overweight/obese students. LEVEL OF EVIDENCE Level V, descriptive (cross-sectional) study.
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Nationally representative surveys show gradual shifting of overweight and obesity towards poor and less-educated women of reproductive age in Nepal. J Biosoc Sci 2020; 53:214-232. [PMID: 32216862 DOI: 10.1017/s0021932020000152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Overweight and obesity are considered major public health concerns all over the world. They have the potential to increase the risk of developing non-communicable diseases in reproductive age women, increasing their risk of pregnancy related complications and adverse birth outcome. This study was carried out to identify the trend of prevalence of overweight and obesity, along with their determinants, among reproductive age women (15-49 years) in Nepal. Data were taken from the nationally representative 2006, 2011 and 2016 Nepal Demographic and Health Surveys (NDHSs). Women were considered to be overweight or obese when their BMI was 23.0-27.5 kg/m2 or ≥27.5 kg/m2, respectively. Univariate, bivariate and multivariate analyses were performed, with significance taken at p<0.05. The prevalences of overweight and obesity both showed rising trends in women of reproductive age in Nepal from 2006 to 2016, particularly among those with no education, only primary education and poor women. The presence of overweight and obesity was found to be significantly associated with the sample women's age, educational status, wealth index, place of residence, ecological zone, developmental region, number of household members, marital status and ethnicity. In 2016 one in every three women of reproductive age in Nepal was either overweight or obese. As overweight and obesity have detrimental effects on women's health, the Government of Nepal, in collaboration with other government and non-government organizations, should take action to halt the rising trends in overweight and obesity in the country.
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Khanal P, Nielsen MO. Is Foetal Programming by Mismatched Pre- and Postnatal Nutrition Contributing to the Prevalence of Obesity in Nepal? Prev Nutr Food Sci 2019; 24:235-244. [PMID: 31608248 PMCID: PMC6779080 DOI: 10.3746/pnf.2019.24.3.235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 04/27/2019] [Indexed: 12/16/2022] Open
Abstract
Nepal and many developing countries are currently suffering from increased prevalence of obesity, type 2 diabetes, and other metabolic disorders. Unhealthy dietary habits and physical inactivity are traditionally considered as responsible factors for these disorders. The relatively new concept of foetal programming suggests that development of metabolic diseases later in life may be associated with poor nutritional status in utero, and such phenomenon could be amplified by subsequent exposure to unhealthy diets after birth. We suggest that foetal programming and mismatched nutritional situations during foetal and postnatal life are important causative factors for increased prevalence of obesity and metabolic disorders in Nepal. Issues highlighted in this paper may also be relevant to other developing countries with similar socioeconomic status. Undernutrition in foetal life can predispose for visceral fat deposition and may alter dietary preferences towards unhealthy diets, amplifying the risk of nutritional mismatch after birth; this can lead to metabolic disturbances in a number of pathways including glucose and lipid metabolism. Providing attention to early life nutrition could therefore be an important tool to reduce the prevalence of lifestyle diseases in Nepal. Future national health policies should thus include changes in research and intervention activities towards preventing averse early life nutritional programming. Availability of free-of-cost and mandatory nutritional education and medical services to pregnant women and their families and better management of national health care systems including digitalization of national health data could be viable strategies to achieve these goals.
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Affiliation(s)
- Prabhat Khanal
- Animal Science, Production and Welfare Division, Faculty of Biosciences and Aquaculture, Nord University, Steinkjer 7713,
Norway
| | - Mette Olaf Nielsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1353,
Denmark
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Wei J, Bhurtyal A, Dhungana RR, Bhattarai B, Zheng J, Wang L, Sun X, Maskey M, Wang Y. Changes in patterns of the double burden of undernutrition and overnutrition in Nepal over time. Obes Rev 2019; 20:1321-1334. [PMID: 31322314 DOI: 10.1111/obr.12883] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 04/26/2019] [Accepted: 04/27/2019] [Indexed: 12/20/2022]
Abstract
Knowledge regarding nutrition transition in Nepal remains limited. This systematic review examined the shifts in undernutrition and overnutrition in Nepal during the past two decades. We searched PubMed for studies and reports published between January 1, 2000, and June 30, 2018. Publications with a sample size greater than or equal to 500 that reported prevalence of nutritional status were included. Six large national reports and 36 studies met study inclusion criteria and were included. Overall, available nationally representative data remained limited. The Nepal Demographic and Health Survey 2001 to 2016 showed that underweight prevalence decreased from 26.7% to 17.2% and prevalence of overweight/obesity increased from 6.5% to 22.1% among women of reproductive age (15-49 years). In preschool children, prevalence of stunting, wasting, and underweight decreased from 57.2% to 35.8%, 11.2% to 9.7%, and 42.7% to 27.0%, respectively. Prevalence of overweight/obesity was low among children and was higher in higher socio-economic status (SES) groups. The overweight-obesity/underweight ratios indicate a shift from undernutrition to overnutrition problem; it was more evident in urban areas and higher SES groups. In conclusion, Nepal is experiencing a nutrition transition. More research is warranted to address this shift, and well-tailored public health efforts need to combat the double burden of overweight/obesity and undernutrition.
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Affiliation(s)
- Junxiang Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.,Global Health Institute, Xi'an Jiaotong University, Xi'an, China
| | - Ashok Bhurtyal
- Global Health Institute, Xi'an Jiaotong University, Xi'an, China.,Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Raja Ram Dhungana
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Basudev Bhattarai
- Nepal Public Health Foundation (NPHF), Maharajgunj, Kathmandu, Nepal
| | - Jinge Zheng
- Global Health Institute, Xi'an Jiaotong University, Xi'an, China
| | - Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee
| | - Xiaomin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.,Global Health Institute, Xi'an Jiaotong University, Xi'an, China
| | - Mahesh Maskey
- Nepal Public Health Foundation (NPHF), Maharajgunj, Kathmandu, Nepal
| | - Youfa Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.,Global Health Institute, Xi'an Jiaotong University, Xi'an, China
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Karki A, Shrestha A, Subedi N. Prevalence and associated factors of childhood overweight/obesity among primary school children in urban Nepal. BMC Public Health 2019; 19:1055. [PMID: 31387571 PMCID: PMC6685156 DOI: 10.1186/s12889-019-7406-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood overweight/obesity has become a major public health concern globally because of its adverse health consequences and escalating prevalence. The factors underlying the disease conditions manifested during adulthood commonly originate in childhood. Nepal is going through a transition where under-nutrition co-exists with obesity; however, there is a lack of well-documented information on childhood overweight or obesity in Nepal. This study was carried out to determine the prevalence and associated factors of childhood overweight/obesity among urban primary school children. METHODS A cross-sectional survey was conducted from May to October of 2017. Behavioral data were collected using a structured self-administered questionnaire with parents of children aged 6-13 years old in grades 1-5 studying in private schools of Lalitpur district in Nepal. Study participants were selected using two-stage cluster random sampling from 10 private schools. Height and weight measurements of 575 children were taken and BMI-for-age-sex was calculated using WHO AnthroPlus. Data were analyzed using SPSS version 21. Associated factors were examined using Chi-square tests followed by multivariate logistic regression analyses. RESULTS The study found that out of 575 students, 107 (18.6%) were overweight and 41 (7.1%) were obese. Among 328 male children, 62 (19.0%) were overweight and 35 (10.6%) were obese. Likewise, among 247 female children, 45 (18.2%) were overweight and 6 (2.4%) were obese. Male children (aOR = 2.21, 95% CI: 1.38-3.53), children of mothers with a high school (aOR = 3.13, 95% CI: 1.39-7.12) or university level of education (aOR = 3.09, 95% CI: 1.23-7.70) and children of mothers in a professional field (aOR = 1.34, 95% CI: 1.02-4.05) had a greater likelihood of being overweight/obese. Likewise, students consuming energy-dense less nutrient food (aOR = 2.92, 95% CI: 1.66-5.12), lacking active travel to and from school (aOR = 2.38, 95% CI: 1.12-4.79) and those having sedentary behaviors (aOR = 3.01, 95% CI: 1.20-7.29) were likely to be overweight/obese. CONCLUSIONS More than one-quarter of the children in urban Lalitpur were found to be overweight/obese. High junk food consumption and sedentary activity were found to be significantly associated with childhood overweight/obesity. School health and awareness programs aiming to reduce the intake of energy-dense foods and promote an active lifestyle including active transportation to school among children are imperative. Future studies to objectively measure the type and amount of food intake and physical activity of students are recommended.
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Affiliation(s)
- Ashmita Karki
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
| | - Archana Shrestha
- Department of Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Narayan Subedi
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Gautam S, Jeong HS. Childhood Obesity and Its Associated Factors among School Children in Udupi, Karnataka, India. J Lifestyle Med 2019; 9:27-35. [PMID: 30918831 PMCID: PMC6425906 DOI: 10.15280/jlm.2019.9.1.27] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 12/29/2018] [Indexed: 11/22/2022] Open
Abstract
Background Childhood obesity has become a serious public health problem in many low-and-middle income countries. This study aims to determine the prevalence and assess the factors associated with obesity among school children. Methods A cross-sectional school-based study was conducted among the 1185 secondary school students in Udupi, India. Data were collected using self-administered questionnaires. Weight and height were measured and Body Mass Index (BMI) was calculated. The z-score was calculated, and BMI was categorized based on its distribution by gender and age according to the World Health Organization (WHO). The BMI categories were reported as frequencies and percentages. Chi-square tests, followed by multiple logistic regressions, were used at 5% level of significance to identify factors associated with overweight and obese children. Results The overall prevalence of overweight and obese children was found to be 10.8% and 6.2%, respectively. Both ‘overweight’ and ‘obese’ were found more frequently among males (11.0% and 7.1%, respectively) than females (10.6% and 5.4%, respectively). Attending private schools, (AOR: 2.87, CI: 1.55–5.31), identifying as Muslim (AOR: 2.26, CI: 1.39–3.67), and having a father with a business occupation (AOR: 2.43, CI: 1.05–5.62) were found to be significantly associated with overweight/obese status. Conclusion We found a high prevalence of overweight and obese children in our study. Since obesity in adulthood has its onset in childhood, it is important to have effective implementation of school health activities to reduce and curb the burden of childhood obesity.
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Affiliation(s)
- Sujan Gautam
- Department of Health Administration, Graduate School, Yonsei University, Wonju, Korea
| | - Hyoung-Sun Jeong
- Department of Health Administration, Graduate School, Yonsei University, Wonju, Korea
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13
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Dereń K, Nyankovskyy S, Nyankovska O, Łuszczki E, Wyszyńska J, Sobolewski M, Mazur A. The prevalence of underweight, overweight and obesity in children and adolescents from Ukraine. Sci Rep 2018; 8:3625. [PMID: 29483604 PMCID: PMC5826931 DOI: 10.1038/s41598-018-21773-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 02/09/2018] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to evaluate the prevalence of overweight, obesity and underweight in children from Ukraine. A cross-sectional study was performed on data collected from a representative sample of Ukraine children (13,739 children (boys 48%, girls 52%) aged 6.0-18.9 years). The measurement of body weight was performed with medical scales and height was measured using a stadiometer. Based on the results obtained, body mass index (BMI) was calculated. Three criteria were used to define childhood underweight, overweight and obesity: The International Obesity Task Force (IOTF) reference, World Health Organization (WHO) child growth standard and The US Center for Disease Control and Prevention (CDC). The combined prevalence of obesity and overweight among children aged 6-18 years old was 12.1%, 17.6%, and 12.6% based on the IOTF reference, WHO growth standard, and the CDC, respectively. Obesity was 2.1%, 4.2%, and 3.6% respectively. Significantly more girls were underweight than boys. Furthermore, a higher prevalence of overweight and obesity was diagnosed in younger that older Ukrainian population.
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Affiliation(s)
| | - Serhiy Nyankovskyy
- Pediatrics Department, Danylo Halytsky L'viv National Medical University, L'viv, Ukraine
| | - Olena Nyankovska
- Department of Pediatrics and Neonatology, Danylo Halytsky L'viv National Medical University, L'viv, Ukraine
| | | | | | - Marek Sobolewski
- Faculty of Management, Rzeszów University of Technology, Rzeszów, Poland
| | - Artur Mazur
- Medical Faculty, University of Rzeszów, Rzeszów, Poland
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Rachmi CN, Li M, Alison Baur L. Overweight and obesity in Indonesia: prevalence and risk factors-a literature review. Public Health 2017; 147:20-29. [PMID: 28404492 DOI: 10.1016/j.puhe.2017.02.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/29/2017] [Accepted: 02/01/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Overweight/obesity is a problem faced by both high- and low- and middle-income countries. This review aimed to report published data on the prevalence of overweight and obesity in Indonesian children, adolescents, and adults, along with the associated risk factors. STUDY DESIGN Literature review. METHODS We conducted a literature search for articles published in English (through Medline via OvidSP, Scopus, Global Health via OvidSP and Web of Science electronic databases) and Indonesian languages (several websites, direct contact with Indonesian public health researchers, practitioners and Ministry of Health staff) from earliest to March 2016. We screened the results and ensured the quality of included studies with Loney's tools for critically appraising prevalence or incidence studies. RESULTS We included 17 papers on the topic which were available in full text and passed the critical appraisal process. The prevalence of overweight/obesity has increased over the past two decades in Indonesian children, adolescents and adults. Prevalence rates are higher in boys than girls among children, but higher in females in the adolescent and adult age groups. The prevalence of overweight/obesity is also higher in those living in urban areas and with higher income or education. CONCLUSIONS Overweight/obesity is a serious public health problem in Indonesia with a continuing increase in its prevalence. Interventions at the household level and beyond are needed to successfully lower the prevalence of overweight/obesity in the country.
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Affiliation(s)
- C N Rachmi
- Discipline of Child & Adolescent Health, The Children's Hospital at Westmead, University of Sydney Clinical School, Sydney, Australia; Fakultas Kedokteran Universitas Padjadjaran, Bandung, Indonesia.
| | - M Li
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - L Alison Baur
- Discipline of Child & Adolescent Health, The Children's Hospital at Westmead, University of Sydney Clinical School, Sydney, Australia; Sydney School of Public Health, The University of Sydney, Sydney, Australia
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15
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Biswas T, Islam A, Islam MS, Pervin S, Rawal LB. Overweight and obesity among children and adolescents in Bangladesh: a systematic review and meta-analysis. Public Health 2016; 142:94-101. [PMID: 28057205 DOI: 10.1016/j.puhe.2016.10.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 07/23/2016] [Accepted: 10/10/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The increasing prevalence of overweight and obesity among children (0-12 years) and adolescents (13-19 years) has emerged as a major public health threat in Bangladesh. Unfortunately, there is a serious paucity of credible data on these issues that can be used for policy and programmatic development. This article presents a systematic review of studies on overweight and obesity to present a more accurate estimate by pooling results. STUDY DESIGN Systematic review. METHODS The study systematically reviewed relevant literature published between 1998 and 2015 using predefined inclusion/exclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used to identify relevant studies. Measures of heterogeneity and variability were calculated, and a random effect model was used to report pooled prevalence rates of overweight and obesity. RESULTS The findings show that prevalence rates of overweight and obesity among children and adolescents varied widely from 1.0% to 20.6% and 0.3% to 25.6%, respectively. The pooled prevalence rates of overweight and obesity were 7.0% (95% confidence interval [CI] 5.0-10.0) and 6.0% (95% CI 4.0-8.0), respectively. The pooled prevalence rate of overweight increased substantially over the years, from 3.6% during 1998-2003 (95% CI 0.3-29.2) to 5.7% during 2004-2009 (95% CI 0.8-30.2) and 7.9% by 2010-2015 (95% CI 5.1-12.1). However, the pooled prevalence rate of obesity registered a sharp decline between 1998-2003 and 2004-2009 - from 9.7% (95% CI 5.7-16.2) to 2.0% (95% CI 0.3-11.1) - and subsequently increased significantly to 9.0% by 2010-2015 (95% CI 5.3-14.6). CONCLUSIONS This review identified increasing trends in the prevalence of overweight and obesity among children and adolescents in Bangladesh. This study underscores the urgent need to promote healthy lifestyles among children and adolescents with a view to effectively address the increasing problem of overweight and obesity. This would also help to prevent the development of chronic non-communicable diseases in adulthood.
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Affiliation(s)
- T Biswas
- Health Systems and Populations Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - A Islam
- School of Health Policy and Management, York University, Toronto, Canada
| | - Md S Islam
- Health Systems and Populations Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S Pervin
- Health Systems and Populations Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - L B Rawal
- Health Systems and Populations Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; James P. Grant Schools of Public Health, BRAC University, Dhaka, Bangladesh
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Hassan NE, El-Masry SA, Farid T, Khalil A. Influence of Parental and Some Demographic Characteristics on Overweight/Obesity Status among a Sample of Egyptian Children. Open Access Maced J Med Sci 2016; 4:342-347. [PMID: 27703553 PMCID: PMC5042613 DOI: 10.3889/oamjms.2016.088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Overweight/obesity is a multi-factorial problem, which results from rapidly changing social, economic, and physical environments that have led to an energy imbalance. AIM To identify the association between childhood overweight/obesity and some socio-demographic risk factors, as parental age, body mass index (BMI), education and occupation, family size and residence (urban/rural). SUBJECTS AND METHODS Cross-sectional study included 154 children of both sexes; aged 5-18 years; with their parents; one of them was working at the National Research Centre and from their relatives and neighbours. Data was collected about the child birth weight, family size, parental ages, education, occupation and place of residence. Anthropometric measurements including weight, height, and body mass index (BMI) of children and their parents were conducted. RESULTS Obesity was detected among 19.5% of children (BMI > 95th percentile), 75.3% of their mothers and 49.6% of their fathers (BMI > 30 Kg/m^2). While overweight was present in 11.0% of the children (BMI > 85th- <95 percentile), 16.9% of their mothers and 36.5% of their fathers (BMI > 25-29.9 Kg/m^2). Child obesity was more prominent in urban than rural areas (21.3% versus 12.5%) and among housewives (22.8%) than among working mothers (16%, p < 0.016). Child overweight was more common in rural than urban areas (12.5% versus 10.7%) and among children with high father education (20%). Child BMI had significant positive correlations only with the child age, parental ages and BMIs, and family size. In spite of that, parental BMIs had significant positive correlations with each other and with family size, and significant negative correlations with maternal education and occupation and paternal education. CONCLUSION Childhood obesity and overweight were more prominent in urban than rural areas, among children with non-working housewives mothers and highly educated fathers (college or above). Parental education and occupation had an indirect significant effect on child BMI through their significant effect on parental BMIs.
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Affiliation(s)
| | | | - Tarek Farid
- Pediatric Department, Medical Research Division, National Research Centre, Cairo, Egypt (Affiliation ID 60014618)
| | - Aya Khalil
- Biological Anthropology Department, Cairo, Egypt
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Sarki M, Robertson A, Parlesak A. Association between socioeconomic status of mothers, food security, food safety practices and the double burden of malnutrition in the Lalitpur district, Nepal. ACTA ACUST UNITED AC 2016; 74:35. [PMID: 27625786 PMCID: PMC5020528 DOI: 10.1186/s13690-016-0150-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/21/2016] [Indexed: 01/05/2023]
Abstract
Background The prevalence of childhood overweight and obesity is increasing in low-and middle income countries such as Nepal. At the same time, high prevalence of chronic undernutrition persists leading to a double burden of malnutrition. Aim To identify associations between the socioeconomic status of mothers, food security, the food safety environment within the household, and prevalence of stunting and overweight of the children. Methods Statistical analysis of socioeconomic, food safety-related and anthropometric data from 289 mother-child dyads in an urban area of the Kathmandu Valley, Nepal. Results According to WHO standards, 26 % of the children, aged 0–59 months, were stunted, 10 % were underweight, and 6.6 % were either overweight or obese. Significantly more boys than girls were underweight (p = 0.004) and stunted (p < 0.001). The higher education level of mothers was associated with a higher height-for-age (HAZ) score in girls, but not with HAZ in boys. Irrespective of sex, children of mothers with highest education level had significantly lower BMI-for-age scores (BAZ) than those of mothers with low education levels. None of the food safety indicators were associated with either HAZ or the BAZ. Conclusion The education level of mothers seems to be relevant to help reduce the double burden of malnutrition at least in some regions of Nepal. This should be taken into consideration when designing programmes to prevent both chronic undernutrition and non-communicable diseases.
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Affiliation(s)
- Mahesh Sarki
- Global Nutrition and Health, Metropolitan University College, Pustervig 8, 1126 København K, Denmark ; Nutrition Promotion and Consultancy Services (NPCS), NGO, Kathmandu, Nepal
| | - Aileen Robertson
- Global Nutrition and Health, Metropolitan University College, Pustervig 8, 1126 København K, Denmark ; WHO Collaborating Centre for Global Nutrition and Health, Copenhagen, Denmark
| | - Alexandr Parlesak
- Global Nutrition and Health, Metropolitan University College, Pustervig 8, 1126 København K, Denmark ; WHO Collaborating Centre for Global Nutrition and Health, Copenhagen, Denmark
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Nam EW, Sharma B, Kim HY, Paja DJV, Yoon YM, Lee SH, Kim EH, Oh CH, Kim YS, Song CH, Kim JK. Obesity and Hypertension among School-going Adolescents in Peru. J Lifestyle Med 2015; 5:60-7. [PMID: 26770892 PMCID: PMC4711960 DOI: 10.15280/jlm.2015.5.2.60] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/01/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. METHODS A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. RESULTS The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p < 0.01). CONCLUSION The prevalence of obesity and hypertension observed in the study area is relatively high. Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.
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Affiliation(s)
- Eun Woo Nam
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | - Bimala Sharma
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | - Ha Yun Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | | | - Young Min Yoon
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | - Sun Ha Lee
- Yonsei Global Health Center, Yonsei University, Wonju, Korea
| | - Eun Hwan Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea
| | | | - Yun Seop Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea
| | | | - Jong Koo Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Department of Family Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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