The prevalence of underweight, overweight, obesity and associated risk factors among school-going adolescents in seven African countries

Rural-Urban Divide in the Prevalence and Correlates of Overweight and Obesity Among Women of Reproductive Age in Nigeria: A Multilevel Analysis of Repeated Cross-Sectional Data

We examined rural and urban prevalence and correlates of overweight/obesity among women of reproductive age using survey data from Nigeria. Overweight and obesity prevalence increased from 16.1% and 6.1% in 2008 to 18.2% and 10.0% in 2018, while underweight prevalence consistently averaged at 12%. Regardless of the residential setting, age, marital status, education, occupation, wealth, and year were associated with higher risk of overweight/obesity, whereas breastfeeding showed a protective effect. Unique risk factors for overweight/obesity in urban areas were higher parity and female-headed households, while ethnicity, media exposure, and state of residence were unique risk factors in rural areas.

Burden of overweight and obesity among adolescents in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Overweight and obesity continue to escalate, despite the regulations and interventions that have been put in place. To support further policy directions, it is necessary to have pooled data that illustrate the burden of overweight and obesity among adolescents nowadays. Thus, this systematic review and meta-analysis aimed to determine the burden of overweight and obesity among Ethiopian adolescents.

METHODS

Embase, Science Direct, Medline, PubMed, Google Scholar and Web of Science were the databases used in the search for publications that ran from inception until 25 October 2023. STATA version 18 was used to analyze data on overweight and obesity in adolescents. Using the random effect model, the pooled estimates with 95% CIs were calculated. Using the Galbraith plot, I2 statistics and Cochrane Q statistics, heterogeneity was investigated.

RESULTS

In total, 20145 adolescents aged 10-19 years were included in this meta-analysis study. The pooled prevalence of overweight and obesity among adolescents in Ethiopia was 10% (95% CI 9 to 12%; I2=94.03%). There was a substantial correlation between being female (OR=1.81, 95% CI 1.47 to 2.15), attending private schools (OR=1.78, 95% CI 1.31 to 2.26), having a family size of ≥4 (OR=1.86, 95% CI 1.14 to 2.58) and being of middle economic status (OR=1.62, 95% CI 1.14 to 2.10).

CONCLUSIONS

In Ethiopia, one in 10 adolescents is overweight/obese. The study's findings clearly show that a large number of adolescents are dealing with this emerging public health issue. Moreover, characteristics related to physical activity, nutrition and sociodemographics were discovered to be associated with overweight and obesity. To lessen the burden of overweight and obesity, the government and other parties should work together to support gender-specific nutritional interventions, encourage healthy lifestyle choices among teenagers and facilitate these efforts.

Overweight and obesity and associated factors among public and private secondary school adolescent students in Harar city, Eastern Ethiopia: A comparative cross-sectional study

Adolescent overweight and obesity are growing public health concerns in developing nations like Ethiopia. They are closely linked to an increased risk of non-communicable diseases, a deterioration in health-related quality of life, subpar academic performance, and a decline in social and emotional well-being. There is, however, little research in this field. Thus, this study aimed to assess overweight and obesity and associated factors among public and private secondary school adolescent students in Harar city, Eastern Ethiopia. A school-based comparative cross-sectional study was conducted among 781 secondary school adolescents in Harar city from February to March 2022. Multi-stage sampling was used to identify 781 study participants (586 in public and 195 in private schools). Anthropometric measures and self-administered structured questionnaires were used to obtain the data. Bivariate and multivariate logistic regression were used to determine the association between independent variables and overweight and obesity. Statistical significance was declared at P < .05. The overall magnitude of overweight and obesity was 9.3% [95% confidence interval (CI) = 7.2-11.4%] with 16.2% in private schools. Being female [adjusted odd ratio (AOR) = 2.04, 95% CI: 1.17-3.55], late adolescent age [AOR = 0.53, 95% CI: 0.31-0.90], bigger family size [AOR = 0.55, 95% CI: 0.31-0.97], high paternal education level [AOR = 2.03, 95% CI: 1.08-3.81], eating meat [AOR = 3.41, 95% CI: 1.27-9.17] and not consuming breakfast daily [AOR = 2.13, 95% CI: 1.24-3.67] were factors associated with overweight and obesity among all secondary school adolescents. A high maternal educational level, not eating breakfast and dinner daily in private secondary school adolescents and having a feminine gender, eating eggs, and not walking or riding a bicycle for at least 10 minutes continuously in public secondary school adolescents were factors associated with overweight and obesity. The extent of overweight and obesity was notably higher in the study area. Communities and educational institutions should work together to promote healthy lifestyle choices among adolescents, with a special emphasis on girls and students enrolled in private schools.

Overweight and obesity among female adolescents in Nigeria; an emerging, but under-reported epidemic

BACKGROUND

Overweight and obesity are increasing at epidemic levels in all ages globally, but there is little nationally representative data on female adolescents in Nigeria. The focus on female adolescents is important because of the negative implications of overweight and obesity on their health and survival, and that of their unborn children.

AIM

To estimate the prevalence and identify the determinants of overweight and obesity among female adolescents in Nigeria.

METHODS

Cross-sectional study using data from the Nigeria demographic and health survey, 2018. A total of 2,721 female adolescents aged 15-19 years were selected using cluster sampling technique. Overweight and obesity were determined using BMI-for-age reference values of World Health Organization and different explanatory variables at the individual, household and community levels were included. Binary logistic regression analysis was used to identify the determinants of overweight/obesity using five models.

RESULTS

The mean age of the respondents was 16.8 ± 1.4 years. The prevalence rate of overweight/obesity was 10.2%, but with a large variation in the geographical and socio-economic distribution. At the crude/unadjusted rate, nearly all the explanatory variables showed a statistically significant association with overweight and obesity, but at the full model which controlled for all the explanatory variables, only the household wealth index retained its statistically significant association, such that female adolescents who were from richer and richest households had about 3 times higher odds of being obese compared to those from the poorest households. (OR: 2.7; p = 0.018; CI: 1.18-6.18), (OR: 2.8; p = 0.027; CI: 1.13-7.06) respectively.

CONCLUSION

The prevalence of overweight/obesity among female adolescents in Nigeria was 10.2%. The household wealth index remained the only factor with a statistically significant association with overweight and obesity after controlling for confounders. Efforts at addressing overweight and obesity among female adolescents in Nigeria should target those from the richer/richest households.

Physical activity and sedentary behavior among school-going adolescents in low- and middle-income countries: insights from the global school-based health survey

Background

The Global School Student Health Survey (GSHS) is being carried out by students in various countries across the globe to advance improved health programs for youth. However, in comparison to high-income countries, adolescents in low- and middle-income countries (LMICs) are generally at an early stage of understanding regarding physical activity (PA) and sedentary behavior (SB), often exhibiting low levels of PA and high levels of SB. Furthermore, there is limited evidence connecting PA and SB in school-going adolescents from LMICs.

Purpose

The objective of this review was to synthesize the available evidence regarding PA and sedentary behavior among school-going adolescents in LMICs using data from the GSHS.

Method

On March 18, 2023, a systematic literature search was performed across four electronic databases, namely Web of Science, PubMed, ScienceDirect, and EBSCO with n odaterestrictions. Studies were eligible if they: (1) utilization of data sourced from the Global Student-based Health Survey; (2) exploration of physical activity; (3) specific focus on adolescents; (4) conducted in low- and middle-income countries; (5) study design encompassing observational; (6) published as English journal articles.

Results

Among the 29 studies included in the analysis, the majority revealed elevated levels of sedentary behavior and diminished levels of PA in low- and middle-income countries. Furthermore, notable disparities in physical engagement and sedentary behavior were noted between male and female adolescents (p < 0.001). Augmented PA among teenagers was observed to correlate with higher consumption of vegetables and fruits (AOR = 1.30; 95% CI [1.13-1.50]; p < 0.001), decreased alcohol consumption, and a reduced prevalence of loneliness and depression (aOR 1.37, 95% CI [1.18-1.59]).

Conclusions

The results of this review affirm that in contrast to high-income countries, adolescents in low- and middle-income countries (LMICs) are in the early stages of comprehending physical activity, marked by low levels of PA. Physical activity and sedentary behavior in school-going adolescents from LMICs appear to be influenced by factors such as policies, cultural norms, socioeconomic conditions, as well as gender, and age.

Risk Factors of Malnutrition among In-School Children and Adolescents in Developing Countries: A Scoping Review

Malnutrition among in-school children is a complex issue influenced by socio-economic, environmental, and health-related factors, posing significant challenges to their well-being and educational trajectories in developing countries. This review synthesized evidence on the multifaceted aspects of child malnutrition within the educational setting in developing countries. This review followed the six steps outlined by Arksey and O'Malley's framework. Four main databases (PubMed, CENTRAL, JSTOR, and Scopus) were searched. Additional searches were conducted in WHO Library, ProQuest, HINARI, Google Scholar, and Google. Reference lists of eligible papers were checked. This review found that low family income, varying family sizes, parental employment status, and educational levels significantly impact malnutrition among in-school children and adolescents. Environmental elements, including rural/urban residence, household sanitation, and living conditions, also influence malnutrition. In addition, nutrition knowledge, dietary habits, nutrient deficiencies, physical activity, and prevalent health conditions compound the risk of malnutrition. This study underscores the extensive health impact of malnutrition on general health, specific nutrient deficiencies, fetal/maternal health concerns, and overall morbidity. Also, malnutrition affects school performance and attendance, impacting cognitive abilities, and academic achievements. Addressing these challenges requires comprehensive policy actions aligned with Sustainable Development Goals, emphasizing poverty alleviation, health literacy, and gender equity.

Body composition is related to cognitive function among young adults in Ghana

BACKGROUND

A growing body of evidence suggests that obesity can affect cognitive function. However, it is unclear whether this effect is independent of obesity-related comorbidities. This study thus sought to determine the association between body composition and cognitive function of young adults in Ghana with less predisposition to obesity-related comorbidities.

METHODS

A cross-sectional study design was employed, involving 381 participants recruited by simple random sampling. After consenting, participants completed questionnaires that assessed sociodemographic characteristics, along with assessments for anthropometric measures and cognitive function. Analyses for associations were conducted by either Pearson's correlation test or chi-Square test of independence.

RESULTS

Over half (60%) of participants were females and 69.6% were in the first year with a mean age of 20.18 ± 2.52 years. Based on Pearson's correlation test, no significant association was found between Body Mass Index (BMI) and Waist to Hip Ratio (WHR), and Trail Making Test-A and B (TMT-A and TMT-B). Nonetheless, a chi-square test showed a significant association, between BMI and TMT-A (p = 0.01), and WHR and both TMT-A (p = 0.001) and TMT-B (p = 0.02). Weak direct correlations were found between body fat percentage and TMT-A (r = 0.120, p = 0.019) and TMT-B (r = 0.133, p = 0.009). Further, a weak inverse correlation was found between muscle mass and TMT-A (r = - 0.141, p = 0.006) and TMT-B (r = - 0.144, p = 0.005).

CONCLUSION

High body fat, low muscle mass and body fat distribution may have a significant association with cognitive functions and must be considered in obesity interventions. This study provided more insight on the association between BMI and cognitive function and would be helpful in designing new weight management interventions or modifying existing interventions to consider the influence of obesity on cognitive function.

Impaired HDL-associated enzymes and proteins in children and adolescents with weight disorders and their association with novel cardiometabolic indexes

BACKGROUND AND AIMS

Overweight/obesity (OW/OB) is associated with modifications in lipoprotein (Lp)-associated enzymes and proteins, such as cholesteryl ester transfer protein (CETP), Lp-associated phospholipase A2 (LpPLA2) and paraoxonase (PON)1. No evidence is available regarding underweight (UW). The following indexes have been proposed to better assess atherogenic risk related to weight alterations: triglycerides-glucose index (TyG), visceral adiposity index (VAI) and height-corrected lipid accumulation product (HLAP).

AIM

To analyze the presence of alterations in Lp-associated enzymes and proteins in children and adolescents with UW and OW/OB and their relation to novel cardiometabolic indexes.

METHODS AND RESULTS

Thirty male children and adolescents with UW, 66 with normal weight (NW) and 30 with OW/OB were included. Anthropometric parameters, glucose, Lp profile and the activities of CETP, LpPLA2 and PON1 were evaluated. Body mass index (BMI)-z, TyG, VAI and HLAP were calculated. UW and NW showed lower CETP activity than OW/OB (Mean ± SD) (218 ± 38vs.224 ± 26vs.237 ± 26%/mL.h; p < 0.05). UW and OW/OB showed lower PON1 activity than NW (318 ± 170vs.409 ± 200vs.310 ± 184 nmol/mL.min; p < 0.05). TyG was higher in OW/OB than UW (p < 0.01), whilst both HLAP (p < 0.05) and VAI (p < 0.01) followed a linear trend across weight categories. After adjusting for age and BMI-z, TyG was an independent predictor of CETP (r2 = 0.25, β = -0.22, p < 0.01) and LpPLA2 (r2 = 0.21,β = -0.21,p < 0.05), while VAI (r2 = 0.21,β = -0.32,p < 0.01) and HLAP (r2 = 0.20,β = -0.31,p < 0.01) of CETP.

CONCLUSIONS

Both UW and OW/OB showed impaired antioxidant PON1 activity. Moreover, TyG, VAI and HLAP were all capable of predicting alterations in crucial modulators of Lp metabolism and vascular inflammation in children and adolescents with varying degrees of alterations in body weight.

Wealth and obesity in pre-adolescents and their guardians: A first step in explaining non-communicable disease-related behaviour in two areas of Nairobi City County

The prevalence of non-communicable diseases is increasing in lower-middle-income countries as these countries transition to unhealthy lifestyles. The transition is mostly predominant in urban areas. We assessed the association between wealth and obesity in two sub-counties in Nairobi City County, Kenya, in the context of family and poverty. This cross-sectional study was conducted among of 9-14 years old pre-adolescents and their guardians living in low- (Embakasi) and middle-income (Langata) sub-counties. The sociodemographic characteristics were collected using a validated questionnaire. Weight, height, mid-upper arm circumference, and waist circumference were measured using standard approved protocols. Socioeconomic characteristics of the residential sites were accessed using Wealth Index, created by using Principal Component Analysis. Statistical analyses were done by analysis of variance (continuous variables, comparison of areas) and with logistic and linear regression models.A total of 149 households, response rate of 93%, participated, 72 from Embakasi and 77 from Langata. Most of the participants residing in Embakasi belonged to the lower income and education groups whereas participants residing in Langata belonged to the higher income and education groups. About 30% of the pre-adolescent participants in Langata were overweight, compared to 6% in Embakasi (p<0.001). In contrast, the prevalence of adults (mostly mothers) with overweight and obesity was high (65%) in both study areas. Wealth (β = 0.01; SE 0.0; p = 0.003) and income (β = 0.29; SE 0.11; p = 0.009) predicted higher BMI z-score in pre-adolescents. In, pre-adolescent overweight was already highly prevalent in the middle-income area, while the proportion of women with overweight/obesity was high in the low-income area. These results suggest that a lifestyle promoting obesity is high regardless of socioeconomic status and wealth in Kenya. This provides a strong justification for promoting healthy lifestyles across all socio-economic classes.

Nutritional status and its associated factors among under five years Muslim children of Kapilvastu district, Nepal

BACKGROUND

Malnutrition is a major public health problem throughout the world especially in Southeast Asia. This study aims to find out nutritional status and its associated factors among under five Muslim children of Kapilvastu district Nepal.

METHODS

Community based cross-sectional study was conducted among 336 under five Muslim children in Kapilvastu district Nepal from December 2021 to May 2022. Multistage probability random sampling was used. Among ten local units, three were selected randomly. Then from selected three units, two wards from each unit which covers large proportion of Muslim were selected purposively. After selecting wards, listing of household having children 6 to 59 months was done with the help of Female Community Health Volunteers and 56 children were selected by simple random sampling from each wards.

RESULTS

About half of Muslim children were underweight, 0.9% were overweight, 17.3% were wasted and 63.1% were stunted. Children with >4 members in family (AOR = 2.82, CI: 1.25-6.38), joint/extended family (AOR = 0.33, CI: 0.16-0.68), living with other than parents (AOR = 2.68, CI: 1.38-5.21), mother having primary (AOR = 2.59, CI: 1.09-6.10) and fathers having SLC and above education (AOR = 0.41, CI: 0.19-0.89), school going children (AOR = 0.27, CI: 0.15-0.48), no having agricultural land (AOR = 2.68, CI: 1.55-4.65), history of chronic diseases (AOR = 3.01, CI = 1.06-8.54) were significantly associated with underweight. Mothers having secondary (AOR = 0.30, CI: 0.10-0.88) and fathers having primary education (AOR = 3.50, CI: 1.26-9.74), school going children (AOR = 0.16, CI: 0.06-0.41), no having own land (AOR = 4.73, CI: 2.13-10.48), history of child chronic disease (AOR = 3.55, CI = 1.38-9.12) were significantly associated with wasting. Similarly, male children (AOR = 1.70, CI: 1.01-2.85), living in rural area (AOR = 0.17, CI: 0.09-0.31), joint/extended family (AOR = 0.28, CI: 0.13-0.64), living with other than parents (AOR = 3.71, CI: 1.84-7.49), fathers having secondary education (AOR = 0.50, CI: 0.27-0.94) and no having own land (AOR = 1.95, CI: 1.13-3.37) were significantly associated with stunting.

CONCLUSIONS

Underweight, wasting and stunting in under-five Muslim children were above the cutoff point from the significant level of public health and higher than national data. Hence, this study suggests collaborative and immediate attention from responsible governmental and non-governmental organizations working in nutrition for providing informal learning opportunity, intervention regarding parental support to child, school enrolment at appropriate age, prevention and treatment of children's chronic diseases, intervention for income generating activities and addressing problems of household food insecurity among Muslim communities.

Nutritional status of school-age children and adolescents in low- and middle-income countries across seven global regions: a synthesis of scoping reviews

OBJECTIVE

To summarise available evidence on the nutritional status of school-age children and adolescents (5-19 years) from seven global regions and on interventions implemented to improve malnutrition in this population.

SETTING

Global.

DESIGN

Findings were compiled from seven scoping literature reviews, including data from low- and middle-income countries within the following UNICEF-defined global regions: East Asia and Pacific; Europe and Central Asia; South Asia; West and Central Africa; Eastern and Southern Africa; Middle East and North Africa and Latin America and the Caribbean.

RESULTS

A double burden of malnutrition was evident across the world regions reviewed: stunting, thinness, anaemia and other micronutrient deficiencies persisted, alongside rising overweight and obesity prevalence. Transitions towards diets increasingly high in energy-dense, processed and micronutrient-poor foods were observed. Evidence from intervention studies was limited, but suggested that providing multiple micronutrient-fortified foods or beverages at school may effectively target micronutrient deficiencies and facilitate weight gain in undernourished populations. Interventions to prevent or manage overweight and obesity were even more limited. There was minimal evidence of using novel technological approaches to engage school-age children and adolescents, or of involving them in designing interventions.

CONCLUSION

The limited data available on nutrition of school-age children and adolescents are neither standardised nor comparable. Consensus on methods for assessing nutritional status and its determinants for this age group is urgently needed to set targets and monitor progress. Additionally, strategies are required to ensure that nutritious, safe and sustainable diets are available, affordable and appealing.

Stunting and thinness in school-attending adolescents in Addis Ababa

BACKGROUND

Adolescent population Global Diet Quality Score (GDQS) is uncommon in low-income settings. Though Global Diet Quality Score is a good measure of dietary diversity, it has not been used in assessing nutritional outcomes among adolescents. Therefore, the aim of this study is to assess school-attending adolescents stunting and thinness status and associations with global diet quality scores in Addis Ababa.

METHODS

A school-based cross-sectional study was conducted among school-attending adolescents in the age group of 10-14 years in urban settings in Ethiopia. A multi-stage stratified random sampling procedure was used to select schools and students. A total of 1200 adolescents were included in the study. Binary and Multinomial logistic regression analyses were used to determine the predictors of stunting and thinness respectively.

RESULTS

The proportion of school-attending adolescents stunting was 8.17% (95% CI: 6.74%,9.85%) and their thinness status 12.66% (95% CI: 10.89%, 14.67%). The overall mean GDQS food groups for Seven days period consumed were 19.99 + 2.81 SD. Male adolescents were 1.95 times more likely to be stunted compared to female adolescents (1.95; 95%CI: 1.11,3.39). Frequent consumption of low-fat dairy increased the risk of thinness, while frequent consumption of citrus fruits and white root tubers decreased the risk of school-attending adolescents' thinness.

CONCLUSION

The proportion of thin or stunted adolescents attending school was high still, about 1 in 10. Stunting and thinness have no association with the overall GDQS. Nutritional interventions need to consider frequent consumption of citrus fruits, low-fat dairy, and white roots and tubers in school adolescents' nutritional programs. Further studies should validate the GDQS for stunting and thinness of school adolescents.

Relation of Depression and Anxiety Disorders in Choosing Obesity Management in Obese Patients

BACKGROUND

Obesity is a chronic medical illness with a higher risk of physical and mental cascade. People who seek obesity treatment were reported to have some psychiatric disorders affecting their disease and selection of management.

AIMS OF THE STUDY

This study aims to estimate the prevalence of depressive and anxiety disorders in obese patients seeking obesity management and explore the relationship between common psychiatric disorders (depression and anxiety disorders) and selection of the type of obesity management (surgical or non-surgical).

METHODS

Patients were recruited from Alazhar Universityhospitals, Egypt, and the total number completing the study was 1115 patients. All subjects underwent psychiatric interview through Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID-5 for DSM-5) for diagnosis of psychiatric disorders and completed two questionnaires, Hamilton Rating Scale for Depression (HRSD) and Hamilton Rating Scale for Anxiety (HRSA).

RESULTS

The prevalences of depressive and anxiety disorders were 29.23% and 25.56%, respectively, in all subjects. The most prevalent diagnoses were dysthymic disorder (20.7%), general anxiety disorder (16.95%), major depressive disorder (13.04%), and social phobia (12.4%). Our sample was divided into two groups (surgical and non-surgical). Dysthymia was more common in the surgical group (21.4% versus 19.8% P = 0.560), whereas major depressive disorder was more common in the non-surgical group (7.4% versus 5.4 P = 0.593); also, the non-surgical group was more likely to have "anxiety disorders" (29.23% versus 22.4%, P = 0.840), but severity of anxiety was higher in the surgical group according to HRSA score with a highly significant difference.

CONCLUSIONS

A high prevalence of depression and anxiety disorders was found among patients who sought obesity treatment. Severity of anxiety was higher in the surgical group according to HRSA score with a highly significant difference, which may affect selection of treatment, so psychiatric evaluation and management are needed before and after obesity management to improve the outcome.

Lifestyle habits, macronutrient intake, and obesity prevalence among adolescents in rural-periurban community senior high schools in the Ho municipality of Ghana

Background

Adolescence is a critical stage in the life cycle that presents a window of opportunity for the formation of lifetime habits or an aversion to childhood malnutrition effects. This study assessed the lifestyle habits, macronutrient intakes, and obesity prevalence among adolescents in some selected Senior High Schools in rural communities in Ho Municipality.

Materials and methods

A cross-sectional survey was conducted among 272 adolescents aged 13–19 years and attending senior high schools in the Ho Municipality of Ghana. Data on sociodemographic, physical activity levels, dietary habits, and anthropometrics were obtained. A body mass index (BMI) and waist circumference (WC) were determined, while a repeated 24-h dietary recall was used to collect the dietary intakes of the participants.

Results

The majority of the adolescents did not meet the Recommended Dietary Allowances (RDA) for calories (94.5%), dietary protein (68.8%), and fibre (91.5%). Adolescent boys consumed more calories (1,969.7 ± 579.9 Kcal) on average than adolescent girls (1,658.0 ± 458.7 Kcal) (p = 0.001). Overweight and obesity prevalence were 15.8 and 8.5%, respectively. About 90.4% of the adolescents did not meet the WHO recommended 150 min per week of physical exercise. On sedentary, 97.6% of adolescents spent half an hour to 5 h per day watching television when at home. Breakfast was the most frequently skipped meal (47.9%), and 59.6% of adolescents consumed fast foods such as pizza, burgers, and ice cream one to three times per week. Adolescent girls also had higher odds of being overweight or obese compared with adolescent boys (AOR = 2.4, p = 0.094, 95% CI = 0.9–6.4). Adolescents who did not meet the RDA for calories had lower odds of being overweight or obese compared with those who did (UOR = 0.3, p = 0.045, 95% CI = 0.1–0.9).

Conclusion

Poor dietary habits and intake, sedentary lifestyle, and obesity prevalence were observed among the adolescents. Being an adolescent girl was associated with obesity risk, while not meeting caloric intake showed a protective effect. Efficient and effective nutrition and lifestyle education programme should be promoted in communities to improve the dietary intake and lifestyle habits of adolescents.

Body image perceptions and avoidance behaviours among a Moroccan group of adolescents

BACKGROUND

Adolescents are a vulnerable group to the body dissatisfaction that causes unhealthy attitudes and behaviours. It has been shown that many factors affect body image dissatisfaction.

AIM

To describe body image size perception, degree of body dissatisfaction, avoidance behaviours, and their relationship with gender, age, and weight status, and to assess the relationship between body dissatisfaction and avoidance behaviours among a group of Moroccan adolescents.

SUBJECTS AND METHODS

This cross-sectional survey was comprised of a sample of 487 adolescents. Stunkard's figure rating scale was used to assess perceptions of current and ideal body image and body dissatisfaction. Body Image Avoidance Questionnaire was employed to assess avoidance behaviours.

RESULTS

Body dissatisfaction was found to be strongly associated with weight status in both male and female adolescents. Avoidance behaviours were positively associated with gender, age, weight status and body dissatisfaction. Indeed, avoidance behaviours were frequently reported among female, young adolescents, those with high BMI z-score and those seeking to lose weight. Adolescents tended to behave under the influence of two factors: clothing and weighing-grooming.

CONCLUSION

Weight status is an important factor which deeply impacts adolescent body dissatisfaction. Adolescents resort to behaviour avoidance and physical appearance control to cope with body dissatisfaction.

Spatiotemporal trends in burden of uterine cancer and its attribution to body mass index in 204 countries and territories from 1990 to 2019

BACKGROUND

Uterine cancer is one of the most common female cancers worldwide, with huge heterogeneity in morbidity and mortality. Although a high body-mass index (BMI) has been linked to uterine cancer, systematic reports about the influence of high BMI and its temporal trends are scarce.

METHODS

The annual morbidity, mortality, and disability-adjusted life years (DALYs) of uterine cancer in 204 countries or territories were retrieved from the GBD 2019 study. To reflect trends in disease burden, we also calculated the estimated annual percentage change (EAPC) based on the age-standardized rates of uterine cancer from 1990 to 2019.

RESULTS

The global incident cases of uterine cancer increased 2.3 times from 187,190 in 1990 to 435,040 in 2019. Although the age-standardized incidence rate (ASIR) of uterine cancer increased worldwide from 8.67/100,000 in 1990 to 9.99/100,000 in 2019, the age-standardized death rate (ASDR) and DALY rate decreased during the same period. High socio-demographic index (SDI) countries tended to have a higher ASIR than developing regions, and their increasing trend in ASIR was also more pronounced. The disease was rare before 40 years old, but its risk rose sharply among women aged 50-70. A high BMI was linked to more than one-third of deaths from uterine cancer in 2019.

CONCLUSIONS

The incidence in developed areas was significantly higher than in developing areas and also increased much more rapidly. Elderly females, especially those with a high BMI, have a higher risk of uterine cancer. Therefore, more health resources may be needed to curb the rising burden in specific populations.

Overnutrition and Associated Factors Among High School Adolescents in Mid COVID-19 Pandemic in Ethiopia: Neglected Public Health Concern

BACKGROUND

Adolescent overnutrition is becoming a global public health problem, increasing at an alarming rate in developing countries. Overnutrition increases the risks of serious diet-related chronic diseases, including type 2 diabetes, hypertension, cardiovascular disease, and stroke. However, there is limited evidence on the magnitude and risk factors of overnutrition in the study area.

OBJECTIVE

To determine the magnitude of overnutrition and associated factors among school adolescents in Dire Dawa, Eastern Ethiopia.

METHODS

A cross-sectional study was conducted from May to June 2021 among 498 adolescent students selected using a multi-stage sampling procedure. A systematic random sampling technique was employed. Self-administered questionnaires, including food frequency and anthropometric measurement, were used to collect the data. The BMI-for-age Z score was calculated using the WHO Anthro-Plus. A binary logistic regression model was fitted with an odds ratio, and 95% confidence levels. Statistical significance is declared at a p-value below 0.05.

RESULTS

A total of 498 (98.4%) were included with the overall prevalence of overnutrition of 26.1% (95% CI: 22.3-29.9), where 23.7% and 2.4% had overweight and obesity, respectively. Being female (AOR = 3.32; 95% CI: 1.65-6.63), attending at private school (AOR = 4.97; 95% CI: 1.72-14.35), having sweet food preferences (AOR = 6.26; 95% CI: 3.14-12.5), snacking (AOR = 3.05; 95% CI: 1.11-8.36), sedentary behavior (AOR = 3.20; 95% CI: 1.67-6.09), and eating while watching TV (AOR= 2.95; 95% CI: 1.47-5.95) were significantly associated with overnutrition.

CONCLUSION

Overnutrition is a major emerging public health problem in eastern Ethiopia. School type, sex, sweet food preferences, habits of snacking, sedentary behaviors, and eating while watching TV were significantly associated with overnutrition. Therefore, public health strategies to curb overweight and obesity among high school adolescents are urgently needed in order to reduce the prevalence and its adverse complications.

Magnitude of Stunting and Associated Factors among Adolescent Students in Legehida District, Northeast Ethiopia

BACKGROUND

Undernutrition including stunting particularly at an adolescent stage was not emphasized by various intervention strategies in the Ethiopian context. Assessing the magnitude and potential risk factors of undernutrition is thus helpful for policymakers to design appropriate intervention strategies. Hence, this study was aimed at assessing the magnitude of stunting and associated factors among adolescent students in Legehida district, Northeast Ethiopia.

METHODS

A school-based cross-sectional study was conducted among 424 adolescent students from February 15th to March 15th, 2018. A stratified sampling followed by a simple random sampling technique was used to select the study participants. A pretested, structured, and self-administered questionnaire was used to collect the required data. Height was measured by using a portable stadiometer and the height-for-age (HFA) z-score was calculated as an indicator of stunting. SPSS version 25 and WHO AnthroPlus software were applied to analyze the data. A multivariable logistic regression analysis was performed to identify factors associated with adolescent stunting. Statistical significance was determined at a p value of <0.05 and association was described by using an odds ratio at a 95% confidence interval.

RESULTS

A total of 406 adolescent students (with a response rate of 95.7%) participated in the study. The magnitude of stunting among adolescent students in this study was 24.9% (95% CI: 24.6%-35.3%).

CONCLUSIONS

Stunting among adolescent students was significantly associated with being male [AOR = 2.1; 95% CI: 1.73-5.90], meal frequency (<3/day) [AOR = 4.6; 95% CI: 2.61-8.24], infrequent handwashing practice [AOR = 3.6; 95% CI: 1.30-9.40], absence of latrine facility (AOR = 5.51; 95% CI: 3.03-9.9), and consumption of unsafe water [AOR = 2.8; 95% CI: 1.35-6.19]. Hence, conducting routine nutrition screenings and assessments, promotion of proper food intake, and emphasis on nutrition education and counseling are needed to be strengthened.

Wealth index and other behavioral and sociodemographic characteristics associated with body mass index in Ethiopia

Background:

Nowadays, the burden of non-communicable diseases including obesity has been an increasing public health concern. This menace can be monitored using indexing method like body mass index. Studies indicate that socioeconomic indicators such as income, biology, behavior, and demographic factors associated with body mass index. In Ethiopia, few studies associate wealth index with body mass index in people of ages between 15 and 49. This study was aimed to assess the association of body mass index with wealth index, and behavioral and sociodemographic population characteristics.

Methods:

A cross-sectional population-based study was conducted using the 2016 Ethiopian Demographic and Health Survey population of ages 15–49. A total of 10,245 individuals were considered to detect the effect of socioeconomic, biological, behavioral, and demographic factors on body mass index using logistic regression.

Results:

The prevalence of underweight, overweight, and obesity among men are 23.8%, 6.6%, and 2.0%, respectively, which is lower than that of women (underweight 25.3%, overweight 9.1%, and obesity 2.9%). The poorest men had higher odds of being underweight (adjusted odds ratio = 2.395%; 95% confidence interval = 2.020–3.544) as compared to the richest men. Merchants and government employees have lower odds (adjusted odds ratio = 0.744; 95% confidence interval = 0.588–0.899) compared to men whose occupation is farming and labor, indicating that merchants and government employees are more likely to become overweight and obese compared to men who are farmers and laborers.

Conclusion:

It is concluded that wealth index is an important socioeconomic determinant of body mass index among men and women of age 15–49 in Ethiopia. A high prevalence of underweight, and overweight, and obesity is observed, which increases instances of non-communicable diseases. Effects of socioeconomic, biological, behavioral, and demographic indicators on body mass index differed according to sex.

Social determinants and behaviors associated with overweight and obesity among youth and adults in a peri-urban area of Maputo City, Mozambique

BACKGROUND

Overweight and obesity are important risk factors for non-communicable diseases (NCDs) such as cardiovascular diseases (CVD), type 2 diabetes and certain cancers. NCDs are responsible for an increased number of deaths worldwide, including in developing countries. We aimed to determine the prevalence of overweight and obesity among youth and adults in a peri-urban area of Maputo city, Mozambique, and to assess their social and behavioral determinants.

METHODS

A cross-sectional study was conducted in a Health and Demographic Surveillance System (HDSS) area in Maputo city. We measured BMI and interviewed 15-64-year-old inhabitants to assess sociodemographic and behavioral characteristics using the STEPwise Approach methodology. A household wealth index was derived through Principal Component Analysis of various household assets and physical activity (PA) was measured using pedometers and accelerometers. Univariable and multivariable analyses were conducted to determine associations between overweight/obesity and social and behavioral determinants.

RESULTS

Among a total of 931 participants, the prevalence of overweight (BMI≥25 kg/m2) and obesity (BMI≥30 kg/m2) was 30.9% (95% confidence interval (CI) = 28.0, 33.9) and 12.6% (95% CI = 10.4, 14.7), respectively; one in every 10 youths and adults were underweight. Being female, older and living in a wealthier household were found to be significantly associated with overweight and obesity. Those with higher levels of education were found to have a reduced risk of being obese compared to those with no or lower levels of education. Behavioral risk factors (diet, alcohol and tobacco consumption and physical activity) did not significantly increase the risk of overweight and obesity.

CONCLUSIONS

Overweight and obesity are highly prevalent in this peri-urban part of the Mozambican capital, where underweight is still present in youth and adults, confirming that the country is facing a double burden of malnutrition. Social determinants of health should be taken into consideration in the design and implementation of NCD prevention programs.

Clustering of multiple health risk behaviours and association with socio-demographic characteristics and psychological distress among adolescents in Ghana: A latent class analysis

This study examined the prevalence of multiple health risk behaviours, the clustering patterns of health risk behaviours, the association between socio-demographic characteristics, psychological distress and clusters and the relationship between number of health risk behaviours and psychological distress among adolescents in Ghana. Participants were senior high school (SHS) students aged 11-19 years who participated in the 2012 Global School-based Students Health Survey (n = 1763). Five health risk behaviours (smoking tobacco, inadequate fruit intake, inadequate vegetable intake, alcohol intake and physical inactivity) were measured. Participants were classified to be at risk if they indicated they smoked tobacco, did not eat fruit ≥ 2 times a day and vegetables ≥ 5 a day, drank alcohol during the past 30 days and did not engage in physical activity for ≥ 60 min per day during the past 7 days. Latent class analysis and latent regression were used to identify the clusters and factors associated with the clusters respectively. Multiple logistic regression was used to determine the relationship between number of health risk behaviours and psychological distress. The prevalence of multiple health risk behaviours (2 or more) was 94.8%. Two clusters emerged: Cluster 1 ("Poor nutrition, inactive, low substance use cluster"; 91%); Cluster 2 ("High Risk Cluster"; 9%). Using cluster 1 as a reference group, adolescents in the 11-15 years category had lower odds of belonging to cluster 2 (OR = 0.21 CI 0.05-0.91, ρ = 0.036) while those experiencing symptoms of depression had higher odds of belonging to cluster 2 (OR = 2.45 CI 1.45-4.14, ρ = 0.001). No significant relationship was found between number of health risk behaviour and psychological distress. Health risk behaviours cluster among adolescents with age and depression associated with the identified clusters. Early interventions that target these clusters are needed at the individual, school and community level to mitigate the burden of non-communicable diseases.

Anthropometric indices and cardiometabolic risk factors in a Ghanaian adolescent population

OBJECTIVES

Adolescent overweight and obesity is a public health concern globally, especially in lower- and middle- income countries where there is an additional burden of undernutrition. The prevalence of adolescent overweight/2obesity has increased markedly over the past three decades. The transition in dietary habits coupled with reduced physical activity has been blamed for the increasing trend. Overweight/obesity in adolescence is complicated by cardiometabolic, respiratory, musculoskeletal and psychosocial disorders. Additionally, adolescent obesity is a predictor of future development of type 2 diabetes, cardiovascular diseases and metabolic disorders. The burden of cardiometabolic risk factors associated with adolescent overweight/obesity in Ghana is lacking, the project, therefore, was undertaken to add to the existing knowledge.

METHODS

The study was undertaken in adolescent students of a tertiary institution in Ghana. Two hundred and one students consented to participate in the study. Questionnaires on sociodemographic characteristics, dietary and substance abuse habits were self-administered. Blood pressure, height, weight and waist circumference measures were performed and venous blood drawn for the determination of fasting serum total/LDL/HDL cholesterol and triglycerides. Body mass indices were determined as the weight per square of their heights.

RESULTS

The prevalence of obesity was determined to be 15.81% generally, 27.71% in the females and 7.08% in the males. Diastolic blood pressure was the only cardiometabolic risk factor significantly associated with obesity in our study.

CONCLUSION

Overweight/obesity is common in Ghanaian adolescents, with the prevalence highest in the female population.

Lifestyle and psychosocial correlates of oral hygiene practice among Indonesian adolescents

Poor oral hygiene leads to poor oral health, which in turn has negative impacts on overall health and quality of life. This study aimed to evaluate the prevalence and associated factors of oral hygiene practice among school-going adolescents in Indonesia. Secondary analysis of cross-sectional, nationally representative data from the 2015 Indonesia Global School-based Health Survey, covering 11,142 students aged 11-18 years, was performed. Multiple logistic regression was employed to explore associations between lifestyle, psychosocial factors, and tooth-brushing frequency. Around 10.8% of the students brushed their teeth less frequently than the recommended twice-daily regimen. Male gender, lower socio-economic status, poor dietary practice, longer sedentary time, drug use, psychological distress, less peer support, and no parental support were associated with infrequent tooth brushing. The findings support the need to integrate oral health promotion into general health actions that target families, schools, and social environments of adolescents to develop healthier habits.

Malnutrition in School-Going Adolescents in Dessie Town, South Wollo, Ethiopia

Background

Malnutrition among adolescents is a global public health problem. Nutrient intake is a proxy measure of nutritional status, but studies in developing countries describing the actual nutrient intake condition associated with nutrition in the adolescents are limited. On top of this, there is inconsistent finding on the extent of malnutrition among adolescents. Hence, the aim of this study was to assess malnutrition and the associated factors among adolescents at Dessie high school.

Methods

A school-based cross-sectional study was conducted among 365 randomly selected high school adolescents. The data were collected using a structured questionnaire adapted from previous literature studies. Nutrient intakes were estimated by ESHA food processor software from a 24-hour recall, and anthropometric indices were calculated from weight, height, age, and sex. The data analysis was managed by SPSS version 23. Binary logistic regression and multinomial logistic regression were used to report the associated factors of malnutrition. Adjusted odds ratio with 95% CI was used to reveal the presence of statistical association.

Results

The percentage of being stunted, underweight, and overweight/obese was 15.7%, 6.3%, and 8.2%, respectively. Snack consumption (AOR = 0.38, 95% CI: 0.20, 0.71) was negatively associated with stunting, while MAR <1 (AOR = 3.36, 95% CI: 1.15, 7.82) was positively associated with stunting. Being a male (AOR = 2.76, 95% CI: 1.03, 7.44) and meal consumption <3 times per day (AOR = 4.21, 95% CI: 1.35, 13.11) were factors positively associated with being underweight/thin. Dietary diversity score <5 (AOR = 0.35, 95% CI: 0.13, 0.89) was negatively associated with overweight/obesity, while MAR < 1 (AOR = 3.14, 95% CI: 1.09, 9.09) was positively associated with overweight/obesity.

Conclusion

The percent of overweight/obesity among adolescents in the study area was higher compared with the national and regional prevalence, and this was found to be a public health concern. Therefore, increasing snack consumption, sex consideration, increasing meal consumption, and intake of diversified foods should be included in the prevention strategies of malnutrition among adolescents.

Underweight and Associated Factors Among Teenage Adolescent Girls in Resource-poor Settings: A Cross-sectional Study

Background and Purpose

Understanding the undernutrition status of teenage adolescent girls living in urban slums and its associated factors is meaningful to formulate customized health strategies. This study aimed to determine the prevalence of being underweight and associated factors among teenage adolescent girls in urban slums.

Materials and Methods

In this cross-sectional study, we enrolled a total of 418 teenage adolescent girls from five of 210 urban slums of Varanasi district, Uttar Pradesh, India employing two-stage probability sampling for the selection of households and subjects, between September 2016 and July 2017. The study of underwight subjects was assessed with BMI for age using standard criteria. Factors associated with being underweight were determined by multivariable logistic regression analysis.

Results

Of 418 study subjects, 49.76% (208/418) were underweight. Results revealed that sociodemographic factors such as teenage adolescent girls who were from SC/ST (schedule caste/schedule tribe) caste/ethnicity (adjusted odds ratio (AOR)=2.02, 95%CI: 1.00–4.23), subjects whose father’s education level was primary or lower (AOR=1.87, 95%CI: 1.12–3.11), and number of people in the family >4 (AOR=2.18, 95%CI: 1.18–4.03) were associated with being underweight. Likewise, dietary behavior-related factors such as vegetarian (AOR=2.21, 95%CI: 1.25–3.92), and <3 meals per day (AOR=2.36, 95%CI: 1.40–3.98) than their counterparts were associated with being underweight. In addition, teenage adolescent girls from food-insecure households (AOR=3.33, 95%CI: 2.01–5.51) were more likely to be underweight than those from food-secure households.

Conclusion

The higher burden of underweight among teenage adolescent girls in Indian urban slums needs to be addressed through specific public health interventions such as by improving education, providing education regarding dietary behavior, and having access to sufficient, safe, and nutritious foods.

Prevalence and Associated Factors of Overweight and Obesity among High School Adolescents in Bahir Dar City, Northwest, Ethiopia: A Cross-Sectional Study

BACKGROUND

Overweight and obesity can be defined as excessive and abnormal fat deposition in our bodies. A body mass index for age of Z scores +2 to +3 was classified as overweight, whereas BMI for age >+3 Z-score was considered as obesity. Overweight and obesity in adolescents are a major health problem in low-income countries like Ethiopia. However, there is not well-established data on adolescents' overweight and obesity. Therefore, this study assessed the prevalence and associated factors of overweight and obesity among high school adolescents in Bahir Dar city, northwest of Ethiopia.

METHODS

An institution-based cross-sectional study was conducted from October 30 to November 30/2019 among 551 high school adolescents. Data were collected using a self-administrative questionnaire. Weight and height were measured by trained health professionals. World Health Organization AnthroPlus software was used to analyze anthropometric data into body mass index for age with z-score to ascertained overweight and obesity. Data were entered using Epi Info version 3.5.3 and transferred to SPSS version 22 for further analysis. Frequency and percentage were presented using tables and figures. A bivariable and multivariable logistic regression analysis was performed to determine the association between the dependent and independent variables. Adjusted odds ratio with 95% CI and p < 0.05 were used to dictate statistical significance for overweight and obesity.

RESULT

In this study, 522 high school adolescents aged 10-19 years were selected using a simple random sampling technique with a response rate of 94.74%. The mean age of the respondents was 17 years with SD ± 1.41. The overall prevalence of overweight and obesity was 12.5% (95% CI: 9.6, 15.2). Males (13.3%) were more than females (11.5%), being overweight and obese. Having self-employed mothers (AOR: 4.57; 95% CI: 1.06, 19.78), having government-employed mothers (AOR: 6.49; 95% CI: 1.96, 21.54), and having school feeding habit (AOR: 0.44; 95% CI: 0.26, 0.76) were factors associated with overweight/obesity among high school adolescents.

CONCLUSION

The prevalence of overweight/obesity in the current study was high. Adolescents having self-employed mothers, adolescents having government-employed mothers, and students having school feeding habits were significant factors of overweight and obesity. Therefore, more emphasis will be given to adolescents having self- and government-employed mothers and adolescents having school feeding habit.

Fast food consumption among young adolescents aged 12-15 years in 54 low- and middle-income countries

BACKGROUND

Most countries worldwide, especially low- and middle-income countries (LMICs), are facing an increasing prevalence of fast-food consumption and multiple burdens of malnutrition among young adolescents.

OBJECTIVE

To compare the prevalence of fast-food consumption among young adolescents in LMICs.

METHODS

We used data from the most recent Global School-Based Student Health Survey (2009-2015), which had been collected using a standardized questionnaire. The weighted prevalence and 95% confidential intervals of fast-food consumption were calculated overall and in subgroups stratified by age, sex, and nutritional status. The pooled overall and regional estimates were obtained using a random-effects model. Heterogeneity was assessed using the I2 statistic. The associated risk factors for fast-food consumption were explored using logistic regression analysis.

RESULTS

Our study comprised 153,496 young adolescents (46.90% boys) from 54 LMICs. Overall, approximately 55.2% (51.3-59.1%) of the adolescents consumed fast food at least 1 day per week, and 10.3% (8.3-12.4%) did so 4-7 days per week. The prevalence of fast-food consumption 4-7 days per week was lowest in the Americas (8.3%; 6.7-9.9%) and highest in Southeast Asia (17.7%; 2.3-33.2%). At a country level, the prevalence was lowest in Pakistan (1.5%; 1.0-2.0%) and highest in Thailand (43.3%; 40.4-46.1%). Furthermore, in subgroups stratified by nutritional status, the prevalence was lowest in the obesity group (6.6%; 4.5-8.7%). Factors such as age, sex, BMI, food insecurity, fruit consumption, vegetable consumption, soft-drink consumption, smoking, physical activity level, and sedentary behavior level were found to be correlated with fast-food consumption.

CONCLUSIONS

The identified high prevalence of fast-food consumption among young adolescents in LMICs indicates the urgent need to prioritize the implementation of healthy-diet promotion programs to improve adolescent health in these countries.

Psychiatric morbidities of female obesity before and after dieting: an Egyptian sample

Background

The rate of occurrence of psychiatric morbidities like anxiety, depression, perceived stress, and the overall quality of life are very high among female patients with obesity; therefore, our study investigates such variables before and after weight loss in female patients on diet restriction; this can help obesity-multidisciplinary teams target these psychiatric correlates to reach a more satisfactory outcome.

Results

Anxiety, depression, and perceived stress scores decreased significantly in parallel to the weight loss reported (p < 0.0001). Except for social functioning, all other domains of quality of life improved significantly after weight loss. Those with higher education level showed significantly lower stress, anxiety, and depression scores before weight loss compared to married and highly educated ones respectively. After weight loss, highly educated participants showed lower perceived stress and depression scores than those with middle education.

Conclusions

Anxiety, depression, and perceived stress factors are significantly decreased after weight reduction with an improved quality of life as well compared to their scores prior.

Magnitude of Overweight, Obesity and Insufficient Physical Sports Activities Among Secondary School Students in Kinondoni Municipal, Dar es Salaam

INTRODUCTION

There is an overwhelming increase of Non-Communicable Disease worldwide such as diabetes and cardiovascular diseases. Overweight and obesity are highly associated with development of these diseases. Unhealthy lifestyle such as excessive sugar, alcohol intake and lack of adequate physical activities has been associated with development of obesity. However, these risk factors are not well elucidated among adolescents in Tanzania. We conducted this survey to determine obesity, overweight, self-reported physical activities, and preferred foods among secondary school students in Kinondoni Municipal in Dar es salaam, Tanzania.

METHODS

A cross sectional descriptive survey was conducted among secondary school students at Kambangwa and Makumbusho secondary schools in Kinondoni municipal in Dar es Salaam city. A simple random sampling technique was used to select participating schools with systemic random selection procedure was used to select participants. A pre structured, self-administered questionnaire was used to collect demographic information from the participants. Anthropometric measurement for Body Mass Index (BMI) was done using standard tools. Interpretation of the findings was done using World Health Organization (WHO) standard charts for age and sex. Data were analysed using Statistical Package for Social Sciences (SPSS version 20; SPSS Inc., Chicago, US).

RESULTS

A total of 234 participants were enrolled in the study. A total of 204 (87.2%) of study participants reported to regularly participate in physical sports activities. Furthermore, Males reported to participate more in physical sports activities compared to females (χ2 (1) =8.13., p = 0.004). During sex-wise comparison, 30 (46.2%) of males reported to participate in sports once per week compared to 71 (51.5%) of females. Reported frequency was influenced by participants' sex (χ2 (3) =16.4., p= 0.001). A total of 28 (12%) participants reported fruits as their favourite food. Food preference was influenced by the participants' sex (X 2 (5) =13.1., p < 0.02). 32(47.7%) of males reported fresh fruits juice as their favourite drink compared to 106(63.5%) of females) while 6(9%) of males reported to prefer commercial industrial juice compared to 4 (2.4%) of females.

CONCLUSION

Obesity and overweight are prevalent among secondary school adolescents in Kinondoni Municipal, Dar es salaam. In addition, the magnitude of physical activities was below the recommended amount. Therefore, awareness campaigns and advocacy programs aiming at preventive measures against NCDs such as healthy eating behaviour and promotion of physical activities among adolescents should be given high priority.

Prevalence, incidence, and trends of childhood overweight/obesity in Sub-Saharan Africa: a systematic scoping review

Background

The growing burden of non-communicable diseases (NDC), particularly in low-and middle-income countries, poses a significant threat to global health. Obesity and overweight constitute major risk factors of NCDs such as heart diseases, diabetes, and kidney disease, and as a result, contribute significantly to the development of chronic morbidities, reduced quality of life, and increased risk of premature death. This study described evidence on the prevalence, incidence, and trends of childhood overweight and obesity in sub-Sahara Africa (SSA).

Methods

We conducted a systematic scoping review employing the Arksey and O’Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. To obtain relevant published articles for this review, we performed a comprehensive keywords search in PubMed, Google Scholar, Web of Science, and CINAHL via EBSCOhost platform for studies published between 2009 and June 2019. Guided by the eligibility criteria, title and abstracts, as well as the full-text articles were independently screened in parallel by two investigators. All relevant data were independently extracted by two investigators using a piloted form designed in Microsoft and thematic analysis conducted.

Results

Of the 81 included studies obtained from 250,148 potentially eligible articles, the majority (25) conducted in South Africa followed by 18 in Nigeria. Six studies were conducted in Ethiopia (6), Tanzania (5), Kenya (4), Cameroon (4), Ghana (3), Uganda (2), Mozambique (2), and Sudan (2). One study each was conducted in Botswana, Gambia, Lesotho, Mauritius, Seychelles, Togo, and Zimbabwe. The remaining three articles were multi-country studies. Most (81.5%) of the included studies were cross-sectional surveys and the majority (79) focused on both male and female participants. The majority (80/81) of the included studies reported on the prevalence of childhood overweight/obesity, 8 on the trends of childhood overweight/obesity, and one presented evidence on the incidence of childhood overweight and obesity in SSA.

Conclusion

This review demonstrates limited studies on childhood overweight/obesity in most SSA countries although the included studies suggest an increasing burden. Considering the consequences of childhood obesity, there is a need for more primary researches to inform policies decision and implementation to halt the rise of childhood obesity/overweight in SSA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-020-00491-2.

Overweight/obesity among 15- to 24-year-old women in Ghana: 21-year trend, future projections and socio-demographic correlates

Although developing countries are experiencing some of the fastest rises in the prevalence of adult overweight and obesity, little is known about the pace of the problem among young people in transition from adolescence to adulthood. This study examined the trend and associated socio-demographic predictors of overweight/obesity (BMI ≥25kg/m2) from 1993 to 2014 among women aged 15-24 years in Ghana and projected the future prevalence from 2019 to 2040. Descriptive statistics, the arithmetic linear change model, and binary logistic regression were applied to data on women aged 15-24 years from five nationally representative Ghana Demographic and Health Surveys conducted in 1993 (N=488), 1998 (N=517), 2003 (N=1832), 2008 (N=1693) and 2014 (N=1491). Overall, overweight/obesity among women aged 15-24 years almost tripled between the 1993 (6.8%; 95% CI=4.9-9.3) and 2014 (19.5%; 95% CI=17.3-21.2) surveys. Based on the arithmetic linear change model, overweight/obesity is projected to increase linearly to over 35% among the 15-24 year cohort of women by 2040. Age, educational level, wealth status, occupation, type of locality, ethnicity, frequency of viewing TV per week, parity and contraceptive use were found to be significant predictors of overweight/obesity among this sub-group of women. The trend of overweight/obesity demonstrated in this group of women could potentially provide momentum for further increases in the prevalence of overweight/obesity and associated health outcomes in the coming years in Ghana. This underscores the need for urgent national-level public health intervention efforts to curtail the problem.

Malnutrition, Hypertension Risk, and Correlates: An Analysis of the 2014 Ghana Demographic and Health Survey Data for 15-19 Years Adolescent Boys and Girls

The sex differences in malnutrition and hypertension during adolescence is largely inconclusive. There is also a paucity of data on the sex-specific correlates of malnutrition and hypertension for adolescents. Hence, this study aimed to assess the association between malnutrition, pre-hypertension/hypertension (PHH) and sex among adolescents. The study also aimed to determine and contrast the factors associated with these risks in Ghana. We analysed data of non-pregnant adolescent girls (n = 857) and adolescent boys (n = 870) aged 15–19 years from the 2014 Ghana Demographic and Health Survey (DHS). We modelled the prevalence risk ratio (PRR) of malnutrition and PHH using Cox proportional hazard models. Compared to adolescent girls, boys were more than twice likely to be stunted (PRR = 2.58, 95% C.I (1.77, 3.76)) and underweight (PRR = 2.67, 95% C.I (1.41, 5.09)) but less likely to be overweight/obese (PRR = 0.85, 95% C.I (0.08, 0.29)). Boys were also about twice likely to have PHH (PRR = 1.96, 95% C.I (1.47, 2.59)) compared to their female peers. Girls were more at risk of the detrimental effects of poor education on stunting and PHH. Empowerment index while protective of stunting for girls (PRR = 0.82, 95% C.I (0.67, 0.99)) also increased their risk of overweight/obesity (PRR = 1.31, 95% C.I (1.02, 1.68)). A higher household wealth index (HWI) increased the risk of overweight/obesity for adolescent girls but was protective of stunting and PHH for adolescent boys. Improvement in household water, hygiene, and sanitation (WASH) reduced the risk of stunting by 15% for adolescent boys. Overall, our findings suggest a double-burden of malnutrition with an up-coming non-communicable disease burden for adolescents in Ghana. Our findings may also be highlighting the need to target adolescent boys alongside girls in nutrition and health intervention programmes.

Risk factors and morbidities associated with childhood obesity in sub-Saharan Africa: a systematic scoping review

BACKGROUND

The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA.

METHODS

Guided by the Arksey and O'Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted.

RESULTS

A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region.

CONCLUSION

This review findings suggest a paucity of literature on the risk factors of childhood obesity and morbidities in most SSA countries. Hence, there is the need to intensify research efforts, especially experimental study designs using innovative strategies to promote healthy lifestyle choices that will prevent or minimize the risks and health consequences of childhood obesity in SSA.

Appraisal of Motor Skills in a Sample of Students within the Moldavian Area

The selection of children for training in a certain sports branch should be based on the assessment of their physical development and their motor skills.

THE AIM OF THE STUDY

the evaluation of the students' motor skills in relation to Body Mass Index (BMI) in order to orient them towards certain sports branches.

METHODS

The research study was conducted on a sample of 220 fifth grade students within the Moldavian Area. We have calculated the BMI and we have assessed the motor skills according to the national standards established for each school grade.

RESULTS

The BMI values are mainly normal (75.45%), yet there are significant differences in development between students in the three counties under analysis, with the most significant values recorded in the county of Suceava (18.48 ± 0.45 for boys and 18.06 ± 0.48 for girls). As far as the push-ups test grading is concerned, 8.63% of the students achieved below 5; there are also significant differences from one region to another (the highest values were recorded in Iasi 11.05 ± 1.00 for boys, 9.93 ± 0.97 for girls, in Suceava 7.98 ± 0.89 for boys and 4.18 ± 0.46 for girls and in Vrancea 9.97 ± 0.48 for boys and 7.70 ± 0.33 for girls). Softball throw was perfectly executed and graded with 10 by 59.09% of the students. Standing long jump was graded with 10 for only 30.45% of the students. The differences obtained according to p-value indicated considerable differences for all motor skills tests and for all study groups.

CONCLUSIONS

there are substantial differences in children's physical development and motor skills from one county to another and this aspect is essential in the selection of young people who will practice high performance sports.

Childhood Obesity and Overweight in Ghana: A Systematic Review and Meta-Analysis

The increasing prevalence of childhood obesity and overweight is considered a public health issue in both developed and developing countries. This systematic review and meta-analysis estimates the prevalence of childhood obesity and overweight in Ghana. A multiple database search was conducted for articles published between January 1, 2001, and October 31, 2019, reporting the prevalence of childhood obesity and overweight in Ghana. Databases searched include PubMed, Google Scholar, Scopus, Cochrane Library, World Health Organization (WHO) Library Information System, and Africa Journals Online. Data were pooled from the articles to calculate an overall estimate of childhood obesity and overweight using a random-effects model after variance stabilization with Freeman–Tukey double arcsine transformation. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sixteen studies with a combined sample size of 29,160 were included in the review. Analysis indicates that approximately 19% of children in Ghana either have obesity or are overweight. The prevalence of childhood obesity and overweight was 8.6% (95% CI: 4.8%–13.4%) and 10.7% (95% CI: 5.9%–16.6%), respectively. Although not significant, higher obesity (4.6% vs. 2.6%) and overweight (11.0% vs. 7.2%) prevalence were estimated for females than for males. There was a significantly higher obesity prevalence estimate (17.4% vs. 8.9%) in rural settings than in urban settings (p=0.0255). The high prevalence of childhood obesity and overweight estimated in this review is of worrying concern. It is a significant public health problem that has implications on the health of present and future generations in Ghana and as such calls for proactive measures to be put in place. Also, the driving forces behind the increasing prevalence of childhood obesity in Ghana need to be investigated.

Association of Hypertension and Obesity with Risk Factors of Cardiovascular Diseases in Children Aged 6-9 Years Old in the Eastern Cape Province of South Africa

Cardiovascular disease (CVD) risk factors are known to begin early in life, but limited data on the relationship of obesity and hypertension with other known CVD risk factors, such as endothelial dysfunction, oxidative stress, and chronic low-grade inflammation is available on children. In this cross-sectional study involving 6–9 years old school children aged from the Eastern Cape Province of South Africa the relationship between obesity/hypertension and other risk factors for CVDs was investigated. General anthropometric parameters were measured, followed by blood pressure (BP) measurements and pulse wave velocity (PWV). Urine samples were collected for the determination of albumin, creatinine, asymmetric dimethylarginine (ADMA), 8-hydroxy-2deoxyguanosine (8-OHdG), and thiobarbituric acid-reactive substance (TBARS). Overweight/obesity (19.28%) and pre-hypertension/hypertension (42.16%) were prevalent in children. Mid-upper arm circumference (MUAC), a marker of obesity, was positively correlated with ADMA, while ADMA and PWV were significantly different (p < 0.05) between hypertensive and normotensive children. Also, TBARS and 8-OHdG were significantly (p < 0.05) increased in hypertensive subjects. Creatinine was significantly (p < 0.05) increased in obese, as well as in hypertensive children, and positively associated with waist circumference (WC) and neck circumference (NC). In conclusion, obesity and hypertension were associated with renal-cardiovascular disease risk, while oxidative stress showed a possible association with obesity in 6 to 9 year old South African children of African descent. This suggests that South African children of African descent may be becoming more prone to developing CVDs, and therefore may require early intervention for the prevention of CVDs in the near future.

Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review

INTRODUCTION

Recently, childhood and adolescence overweight/obesity has increased disproportionately in developing countries, with estimates predicting a parallel increase in future cardiovascular disease (CVD) burden identifiable in childhood and adolescence. Identifying cardiovascular risk factors (CVRF) associated with childhood and adolescence overweight/obesity is pivotal in tailoring preventive interventions for CVD. Whilst this has been examined extensively in high-income countries, there is scant consistent or representative data from sub-Saharan Africa (SSA).

OBJECTIVE

This scoping review synthesises contemporary studies on CVRF associated with overweight and obesity in SSA children and adolescents to provide evidence on the current burden of overweight/obesity and CVD in this population.

METHODS

We searched MEDLINE and Google Scholar up to July 31, 2019 for observational and experimental studies and systematic reviews addressing childhood and adolescence overweight/obesity and CVRF in SSA without language restriction. Four investigators working in four pairs, independently selected and extracted the relevant data. The methodological quality of all included studies was assessed.

RESULTS

We included 88 studies with a total of 86,637children and adolescents from 20 SSA countries. The risk of bias was low in 62 (70.5%), moderate 18 (20.5%), and high in eight (9%) studies. Overweight/obesity in SSA children and adolescents is rising at an alarming rate. Its main associations include physical inactivity, unhealthy diets, high socio-economic status, gender and high maternal body mass index. Identified CVRF in overweight/obese SSA children and adolescents are mainly metabolic syndrome, hypertension, dyslipidaemia, diabetes and glucose intolerance. There is a dearth of guidelines or consensus on the management of either childhood overweight/obesity or CVRF in overweight/obese SSA children and adolescents.

CONCLUSION

The current findings suggest an urgent need to review current health policies in SSA countries. Health education and transforming the current obesogenic environment of the SSA child and adolescent into one which promotes physical activity and healthy dietary habits is required.

Magnitude and associated factors of undernutrition (underweight and stunting) among school adolescent girls in Hawzen Woreda (District), Tigray regional state, Northern Ethiopia: Cross-sectional study

OBJECTIVE

There is a lack of evidence concerning undernutrition (underweight and stunting) among adolescent girls in the study area, therefore, this study aimed to assess the magnitude of undernutrition and associated factors among adolescent girls in Hawzen woreda, Northern Ethiopia.

RESULTS

This study found that 32.2% and 33.2% of school adolescent girls were underweight and stunted respectively. Illiterate fathers were higher among underweight adolescent girls as compared to those normal-weight adolescent girls (AOR = 1.4, 95% CI; 1.1, 1.7). Underweight adolescents were higher among low-grade level adolescents (grade 4-8) as compared to grade 9-12 adolescents (AOR = 2, 95% CI; 1.4, 2.6). Unemployed mothers were higher among stunted adolescent girls as compared to the counterpart (AOR = 2.2, 95% CI; 1.1, 3.3). It would be good to consider the above-mentioned factors during the nutritional intervention of adolescents.

Fruit and vegetable intake in relation to depressive and anxiety symptoms among adolescents in 25 low- and middle-income countries

BACKGROUND

Fruit and vegetable intake (FVI) has been inversely associated with the risk of depression. However, there is a gap in evidence from low- and middle-income countries (LMICs) and among adolescents. Further, little is known about FVI in relation to the risk of anxiety. Therefore, we examined these associations among adolescents in 25 LMICs.

METHODS

Data from the Global School-based Student Health Survey were analyzed in 65267 adolescents aged 12-15 years (mostly nationally representative). Depressive and anxiety symptoms during the past 12 months were self-reported. Frequencies of FVI during the past 30 days were collected. Multivariable logistic regression and meta-analyses of country-wise estimates were undertaken.

RESULTS

The prevalence of depressive and anxiety symptoms were 30.3% and 9.8%, respectively. A meta-analysis indicated that FVI of <5 times/d (vs. higher) was associated with an increased risk of depressive symptoms (OR = 1.10; 95% CI = 1.02-1.18). The pooled estimate for anxiety symptoms was insignificant. When examined separately, fruit intake was significantly associated with both lower risks of depressive and anxiety symptoms; vegetable intake was significantly associated with a lower risk of depressive symptoms, but not with anxiety.

LIMITATIONS

Only adolescents attending school were included; the cross-sectional design cannot reveal causality; outcomes were not measured against the gold-standard diagnostic criteria.

CONCLUSIONS

Our study provides multi-national evidence of the protective effect of FVI against depressive and anxiety symptoms among adolescents in LMICs, enabling key stakeholders to address mental health issues among adolescents globally.

Underweight, body image, and weight loss measures among adolescents in Saudi Arabia: is it a fad or is there more going on?

Background and Objective

Adolescence is considered to be a pivotal point in which optimum nutrition and eating habits are developed. Although tackling the obesity epidemic has been much discussed, addressing the issue of underweight and body image is often neglected. This study was carried out to get a better understanding of underweight status among adolescents in Saudi Arabia, and exploring self-perceptions of body image and weight loss measures among underweight adolescents.

Methods

Data from Jeeluna®, a national cross-sectional school-based survey were utilized. Jeeluna® assessed the health status and health-risk behaviors of adolescents in school through data obtained by a self-administered questionnaire, anthropologic measurements, and laboratory investigations.

Results

A total of 12,463 adolescents participated. Eighteen percent of adolescent males and 12.4% of females were found to be underweight, representing 14.9% of adolescents collectively. Forty-five percent of underweight participants were happy with their weight. Underweight females between the age group of 10 and 14 years were the most likely to believe that they still need to lose weight (16.0%) followed by females aged 15–19 years (9.7%). Underweight females aged 10–14 years were also the group most likely to engage in purging (1.6%). Stepwise logistic regression found that the strongest association with being underweight was with having a lower household income (OR 2.0, CI 1.5–2.7) and having more than 5 siblings (OR 1.8, CI 1.5–2.3).

Conclusion

Underweight status is prevalent among adolescents in Saudi Arabia and deserves more attention as a public health issue. Distorted body image and disordered eating behaviors exist, necessitating further investigation of underlying causes.

Prevalence and associated factors of adolescent undernutrition in Ethiopia: a systematic review and meta-analysis

BACKGROUND

In Ethiopia, there are different pocket studies that assessed adolescent undernutrition which came up with inconsistent and inconclusive findings. Therefore, estimating the pooled prevalence and associated factors of the adolescent undernutrition using meta-analysis is crucial in Ethiopia.

METHODS

A systematic review of eligible articles was conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A comprehensive searching of the literature was made in Pub Med, Scopus, Google, Google Scholar, Cochrane Library and CINAHL. The quality of the articles included in the review was assessed using the Newcastle-Ottawa Scale (NOS) for non-randomized studies in meta-analyses. The pooled prevalence and odds ratio of the associated factors with their 95% confidence interval was computed using STATA version 14 software.

RESULTS

Twenty-two studies were included in the meta-analysis with a total of 17,854 adolescents. Using the random-effects model analysis, the pooled prevalence of stunting and underweight was 20.7% (95% CI: 16.08, 25.33) and 27.5% (95% CI: 17.9, 57.14), respectively. Rural residence, having family size≥5, households with an unprotected water source for drinking and food-insecure household were significant associated factors for adolescent stunting. Early adolescent age (10-14 years), family size≥5, food-insecure household, lack of latrine, WHO diet diversity score < 4, mother educational status (with no formal education) were significant associated factors for adolescent underweight.

CONCLUSION

Adolescent undernutrition remains one of the most important public health problems in Ethiopia. Almost a quarter of Ethiopian adolescents were affected by stunting and underweight. Large family size, rural residence and unprotected source of drinking water were the associated factors for adolescent stunting. Similarly, large family size, early age of adolescent, lack of latrine, low dietary diversity score, mother illiteracy, and food insecure household were the associated factors for adolescent underweight. It would be good to give high emphasis on adolescent undernutrition and it is important to address the above mentioned associated factors during adolescent nutritional interventions in Ethiopia.

Gender differences in nutritional status, diet and physical activity among adolescents in eight countries in sub-Saharan Africa

OBJECTIVE

The objective of this study was to evaluate gender differences in nutritional status, dietary intake, physical activity and hand hygiene among adolescents from diverse geographical settings in sub-Saharan Africa.

METHODS

This study utilised cross-sectional data from six countries (Burkina Faso, Ethiopia, Ghana, Nigeria, Tanzania and Uganda) within the ARISE Adolescent Health Survey (n = 7625). Body mass index (BMI) was calculated using measured heights and weights, and z-scores were calculated based on the 2007 WHO growth standards for age and sex. Information on demographics, diet and health behaviours was collected through face-to-face interviews using a standardised questionnaire. Site-specific and pooled prevalence ratios were determined.

RESULTS

The prevalence of underweight, overweight and stunting pooled across sites was 14.3%, 6.8% and 18.1%, respectively. Female sex was associated with a lower risk of being underweight (pooled prevalence ratio 0.66, 95% 0.57, 0.77) and stunted (pooled PR 0.63, 95% CI 0.55, 0.71), but a higher risk of being overweight (pooled PR 1.60, 95% CI 1.26, 2.06). Females were also less likely to exercise for 1 h or more per day (pooled PR 0.77, 95% CI 0.67, 0.88), and more likely to wash hands after using toilets or latrines and to wash hands with soap (pooled PRs 1.13, 95% CI 1.05, 1.21 and 1.35, 95% CI 1.23, 1.45, respectively).

CONCLUSION

Our results emphasise that sex is a key predictor of nutritional status among sub-Saharan African adolescents and suggest that gender-specific interventions may be required to reduce the double burden of under- and overnutrition.

Prevalence and risk factors associated with malnutrition among adolescents in rural Tanzania

OBJECTIVE

To determine the prevalence and risk factors associated with malnutrition among adolescents in a rural Tanzanian community.

METHODS

Cross-sectional survey of 1226 randomly selected adolescents from the Dodoma Health and Demographic Surveillance System (HDSS) in the Chamwino district in the Dodoma region. Anthropometric measurements for weight and height were collected. Height-for-age-z-scores (HAZs) and body mass index (BMI)-for-age-z-scores (BAZs) were computed. Descriptive estimates were documented in graphs and tables, and weighted linear regression models were used to examine predictors of malnutrition.

RESULTS

Stunting prevalence was 18%, and thinness prevalence was 14%. Overweight and obesity affected 5.23% of participants. Girls had higher HAZs (β: 0.46, 95% CI 0.33, 0.59, P < 0.0001) and BAZs (β: 0.20, 95% CI 0.05, 0.35, P = 0.0098) than boys. Age was inversely associated with HAZs (β: -0.13, 95% CI -0.17, -0.08, P < 0.0001) and BAZs (β: -0.05, 95% CI -0.10, -0.004, P = 0.0327). Wealth score (β: 0.10, 95% CI 0.04, 0.16, P = 0.0009) and dietary diversity score (β: 0.04, 95% CI 0.01, 0.07, P = 0.0080) were positively associated with HAZs and BAZs. Out-of-school adolescents had higher HAZs (β: -0.49, 95% CI -0.75, -0.23, P = 0.0003) and BAZs (β: -0.68, 95% CI -0.99, -0.37, P < 0.0001) than adolescents who attended school.

CONCLUSION

There are substantial variations of HAZs and BAZs across gender, age, education and wealth, with an emerging burden of overweight and obesity among adolescents in this rural population. Interventions are urgently required to curb both ends of the malnutrition spectrum.

Metabolic syndrome in a sample of Egyptian adolescent girls and its association with apolipoprotein E

AIM

Obesity and its metabolic complications are increasing in childhood and extend to adulthood. The aims of this study were to assess the prevalence of metabolic syndrome (MS) in a sample of Egyptian adolescent girls and investigate its association with apolipoprotein E.

METHODS

A cross-sectional study design was used, including 200 Egyptian adolescent girls aged between 12 and 18 years. They were subjected to blood pressure (BP) measurement, anthropometric measurements (weight, height and waist circumference (WC)), laboratory investigations (fasting glucose and lipid profile) and molecular analysis (Apo E).

RESULTS

Overweight/obese girls were suffering significantly, more than normal-weight girls, from hypertension (66.7 vs. 40.8%), diabetes diagnosed by elevated fasting blood glucose (46.7 vs. 31.2%) and low high-density lipoprotein (HDL) (64 vs. 59.2%). Girls with MS had significantly higher values of body mass index Z-score, WC, BP, cholesterol and triglycerides and significantly lower HDL. Allele E3 (59.1 vs. 55.1%) was more frequent among girls with MS, while allele E4 (41 vs. 36.4) was more frequent among girls without MS. MS was the most prominent among girls with the E3/E4 genotype (35.7%), who had the highest frequency of elevated cholesterol, triglycerides, low-density lipoprotein and blood glucose, while girls with the E2/E4 genotype, which was rare among both groups, had the highest frequency of elevated BP (68.8%) and low HDL (71.4%).

CONCLUSION

MS was significantly more prominent among overweight/obese adolescent girls with the E3/E4 genotype, who had the highest frequency of disturbed lipid profile and blood glucose.

Underweight and overweight or obesity and associated factors among school-going adolescents in five ASEAN countries, 2015

PURPOSE

The study examined the prevalence of underweight and overweight or obesity and its correlates among in-school adolescents in five ASEAN countries (Indonesia, Laos, Philippines, Thailand and Timor-Leste) in 2015.

METHODS

Cross-sectional data were analysed from 30145 school-going adolescents (median age 14 years, interquartile range = 2) from Indonesia, Laos, Philippines, Thailand and Timor-Leste that took part in the "Global School-Based Student Health Survey (GSHS)" in 2015. Body weight was examined by self-reported weight and height and the "international child body mass index standards". Associations with underweight and overweight or obesity were assessed using multinomial logistic regression analyses.

RESULTS

The prevalence of underweight was 8.7% and overweight or obesity 14.0%. In adjusted multinomial logistic regression analysis, students residing in Timor-Leste, older age, male sex, bullying victimization and parental supervision were positively associated with underweight, while residing in Laos, current alcohol use and peer support were negatively associated with underweight. Coming from the Philippines and Timor-Leste, older age, experiencing hunger, current alcohol use, and in a physical fight decreased the odds for overweight or obesity, while male sex, fruit consumption, sedentary behaviour, physically attacked and parental bonding increased the odds for overweight or obesity.

CONCLUSION

High prevalences of underweight and overweight/obesity were identified in ASEAN countries and several correlates were identified which can help to tailor interventions.

Weight management among school-aged children and adolescents: a quantitative assessment in a Ghanaian municipality

Background

Childhood and adolescent overweight, obesity and underweight have become an issue of grave concern to both the developed and developing countries in context of global burden of non-communicable diseases. Unhealthy weight status is a significant public health issue for developing countries, of which Ghana is not excluded. This study evaluated the prevalence of overweight, obesity and underweight and its related factors among school-aged children and adolescents.

Methods

A total of 1004 participants were randomly selected from six schools. A structured questionnaire on demography and socioeconomic status of students’ parents/guardians was completed by the selected students. Anthropometric parameters were measured, and body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. BMI-for-age z-scores were used to categorize anthropometric data of the children as underweight, normal, overweight or obese. A cut-off value of > 0.50 was used to define obesity by WHtR.

Results

Overweight prevalence of 13.8% and 12.6 was observed among basic school and high school students respectively based on BMI classification. Obesity prevalence of 8.8% was found in basic school students and 8.9% among high school students. Underweight was observed in 114 (11.3%) basic school students and 86 (8.6%) high school students. There was a difference in sex prevalence in unhealthy weight-behaviours; with more girls being overweight (19.4% vs 7.6%, p < 0.001) and obese (10.2% vs. 7.3%, p = 0.177) compared to boys. High WHtR found in 10.5% of basic students and 5.0% of high school students, with a statistical difference. Overweight/obesity was significantly associated with taking snacks before bed among basic school students [aOR = 10.45(5.95–18)] and high school students [aOR = 10.23(5.95–18.37)] respectively. Watching TV [aOR = 0.39(0.22–0.70)], sleeping during leisure periods [aOR = 0.43(0.23–0.81)] and bicycling as a means of transport [aOR = 0.37(0.19–0.72)] to school was protective of obesity among basic school students.

Conclusion

High prevalence of unhealthy weight-related behaviours was observed among school-aged children in the Bekwai Municipality. Snacking before bed was a major factor promoting obesity among school-aged children while leisure behaviours such as TV watching, and sleeping were protective of obesity. Therefore, it is recommended to promote and support healthy eating habits among school-aged children which are likely beneficial in reducing the risk of childhood unhealthy weight-related behaviours.

Socio-Ecological Model of Correlates of Double Burden of Malnutrition in Developing Countries: A Narrative Review

(1) Background: The double burden of malnutrition (DBM) is a complex problem involving the coexistence of under- and over-nutrition within the same individual, household or population. This review aimed to discuss the correlates of the double burden of malnutrition through the socio-ecological model (SEM); (2) Methods: The PubMed database was systematically searched for peer-reviewed articles related to the double burden of malnutrition. Information on correlates of the double burden of malnutrition was extracted for analysis and discussion in alignment with the levels of the socio-ecological model.; (3) Results and Discussion: The correlates of the double burden of malnutrition identified from previous literature were: Race/genetics; maternal short stature; breastfeeding status; low maternal education; family size; household food security; household dietary diversity; and rural and urban settings. In the absence of evidence linking factors in a certain level of the SEM and the double burden of malnutrition, we employed correlates of overweight status and obesity to complete this narrative. Potential intervention strategies were proposed in alignment with the targets and settings identified, based on the socio-ecological approach; (4) Conclusions: The double burden of malnutrition is a public health phenomenon associated with a variety of socio-ecological determinants. An integrated approach is needed to address the root causes of malnutrition in all its forms, and at all life stages.

Prevalence and associated factors of malnutrition among school going adolescents of Dang district, Nepal

Background

Malnutrition is a quiet emergency and one of the most widespread causes of morbidity and mortality among children and adolescent throughout the world; however there are very limited indications about the cause of malnutrition among adolescents. This study aimed to find out the prevalence and associated factors of malnutrition among school going adolescents of Dang district, Nepal.

Methods

School based descriptive cross-sectional research design among 510 school adolescents studying in grade 9 and 10 between ages 14–17 years on April–October 2017 was conducted in Dang district Nepal. Among total 130 secondary schools, 10 schools were selected; one government and one private from each 5 electoral constituency using multistage probability random sampling.

Results

The mean age and family size was 15.28 ± 0.77 and 5.25 ± 1.56 respectively. Among the total 25.7% of the adolescents are malnourished where 21.8% underweight, 3.1% overweight and 0.8% obese. After adjustment some of the variables such as religion (OR = 0.19; CI = 0.05–0.65, p = 0.008), family type (OR = 0.28; CI = 0.13–0.61, p = 0.001), school type (OR = 0.46; CI = 0.22–0.98, p = 0.044), earning status of family (OR = 4.52; CI = 1.44–14.16, p = 0.010), daily intake of green leafy vegetables (OR = 0.49; CI = 0.26–0.93, p = 0.031) and school sports (OR = 0.49; CI = 0.25–0.96, p = 0.040) were significantly associated with the underweight of adolescent. Similarly, variables such as gender (OR = 0.20; CI = 0.04–0.97, p = 0.046) and religion (OR = 9.75; CI = 2.24–42.39, p = 0.002) were significantly associated with the overweight/obesity of adolescent.

Conclusion

Malnutrition was significantly higher among adolescents living in joint family, family having no earning status. Male adolescents were found more likely to be overweight and obesity. Hence to tie up the good nutrition it is recommended that integrated nutritional intervention and health related services should also be focused on adolescents.