Prevalence and associated factors of overweight/ obesity among children and adolescents in Ethiopia: a systematic review and meta-analysis

The influence of adolescents' nutrition knowledge and school food environment on adolescents' dietary behaviors in urban Ethiopia: A qualitative study

Adolescence is a critical period of physical, cognitive, and social development that needs to be supported with healthy diets. Dietary behaviours of adolescents can be shaped by their nutrition-literacy and their interaction with parents and peers as well as their school food environment. Therefore, the present study aimed to assess factors that influence dietary behaviours of adolescents in urban Ethiopia. Sex-disaggregated, focused group discussions (n = 70) were conducted in 36 private and government schools (n = 12/city) among adolescents (n = 432) 15-19 years of age in Addis Ababa, Bahir Dar, and Dire Dawa. Photovoice was applied in a subgroup of participants (n = 216) to gain further insights into adolescents' perception of their school food environment. Key informant interviews were conducted among school principals (n = 36). Adolescents had a relatively good nutrition knowledge and recognised the importance of diverse diets, but misperceptions also existed. They identified fruit and vegetables as healthy foods, but their consumption was deterred by food safety concerns. The adolescents identified foods high in salt, fat, and sugar, including processed/packaged foods as unhealthy, but still consumed them frequently due to their taste, affordability, availability and accessibility in and around schools. Both undernutrition and overweight/obesity were linked to social exclusion and bullying in school. Effective behavioural change communication is required to address common misperceptions. School nutrition programs should integrate water, sanitation and hygiene programs to ensure food safety. Regulations promoting healthy eating while discouraging unhealthy dietary behaviours are vital. Interventions to make nutrient-dense and healthy foods available, accessible, and affordable are urgently needed to improve the nutrition and health outcome of adolescents.

Prevalence and associated factors of overweight in Chinese adolescents: A cross-sectional study

Background and Aim

Obesity has been a global public health issue due to the increasing mortality rate and prevalence among children. However, there are scarce studies on obesity prevalence in Hong Kong children. The study aims to identify the risk factors of obesity among primary and secondary school students by assessing the relationship between sociodemographic factors, health-related behaviors, and social relationships.

Methods

Self-administrated surveys were collected from 30 primary schools and 25 secondary schools participating in the "Quality Education Fund Thematic Network on Health Schools" project. Descriptive analysis was conducted to examine the proportions of different characteristics and to compare the disparity between primary and secondary school students with obesity.

Results

A total of 4884 responses were collected. A larger proportion of primary school students with obesity were male (adjusted odds ratio [aOR]: 2.55, 95% confidence interval [CI]: 1.77-3.67, p < 0.001) and actively gamed (aOR: 1.64, 95% CI: 1.07-2.51, p = 0.024). Secondary school students with obesity were male (aOR: 1.61, 95% CI: 1.21-2.13, p = 0.001), had poor self-perceived academic performance (aOR:1.51, 95% CI: 1.10-2.08, p = 0.011) and expressed higher life satisfaction (family) (aOR: 1.13, 95% CI: 1.01-1.26, p = 0.032). There were negative associations found between obesity and physical activity, high consumption of sugary drinks, chocolate or candies, and insufficient consumption of vegetables.

Conclusion

Male sex, physical inactivity, low self-perecived academic performance, and poor dietary behaviors were the risk factors for obesity among primary and secondary school students. The findings highlighted the importance of identifying younger individuals who were at risk of becoming clinically obese. Further studies should explore the effectiveness of various interventions through longitudinal study.

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.

Effect of postpartum depression and role of infant feeding practices on relative weight of child at 1 and 3 years of age

BACKGROUND

Childhood obesity has increased and is considered one of the most serious public health challenges of the 21st century globally, and may be exacerbated by postpartum depression (PPD). The purpose of this study was to examine the association between PPD at 1st and 6th month postpartum, infant feeding practices, and body mass index (BMI) z-score of the child at one and three years of age.

METHODS

This study used data from an ongoing prospective maternal-child birth cohort performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan with the period of recruitment from May 13, 2010 to November 28, 2013. Out of 2,309 total number of mothers, 1,279 mother-child dyads were assessed in the study. We performed multivariable linear regression analysis to examine the association between PPD and child's BMI z-score stratified by the child's age at 1 year and 3 years of age.

RESULTS

The prevalence of PPD at 1 month postpartum (17%) was found to be higher than at 6 months (12%). In multivariable linear regression analysis we observed that children at 3 years who had mothers with PPD at 6 months had, on average, a BMI z-score 0.25 higher than children of mothers who did not have PPD at 6 months (ß coefficient 0.25, 95% CI [0.04 to 0.46], p value 0.02), holding all other covariates constant. Also, initiation of weaning food when child is at six months of age was associated with higher BMI z-score of the child at 3 years after adjusting for all covariates (ß coefficient = 0.18, 95% CI [0.03 to 0.34], p-value < 0.05).

CONCLUSION

The significant association between PPD at 6 months and child's BMI z-score at 3 years of age, in conjunction with birth trends and high prevalence of PPD, can add to the body of evidence that there is need for multiple assessment across the first postpartum year to rule out PPD as early screening and early interventions may benefit both maternal health and child development outcomes. These findings can indicate the need for establishing support systems for care-giving activities for mothers with PPD.

Prevalence, inequality and associated factors of overweight/obesity among Bangladeshi adolescents aged 15-19 years

BACKGROUND

The objective of the current study was to estimate the prevalence and associated factors of overweight/obesity among Bangladeshi adolescents aged 15-19 y and to identify whether wealth-related inequality exists for overweight/obesity among Bangladeshi older adolescents.

METHODS

We analyzed publicly available national representative secondary data from the 2019-2020 Bangladesh Adolescent Health and Wellbeing Survey. This cross-sectional survey was carried out among 18 249 adolescents aged 15-19 y regardless of their marital status using a two-stage stratified sampling technique (the data of 9128 eligible adolescents were included in this analysis). The WHO reference population for body mass index-for-age (1+Z score) was considered as overweight/obesity.

RESULTS

We found that girls had significantly (p<0.05) higher prevalence of overweight/obesity (11.63%) than boys (8.25%); however, their biological sex as well their age were not significantly associated with higher odds of overweight/obesity. Those who were in their higher grade (grade 11 and higher) in the school and had been exposed to media were more likely (1.67 and 1.39 times, respectively) to be overweight/obesity compared with primary grade (0-5) and those who experienced no media exposure, respectively. Inequality analysis revealed that adolescents belonging to wealthy households had significantly higher rates of overweight/obesity than those in poorer households (concentration index=0.093).

CONCLUSIONS

The study exhibited the multifaceted nature of overweight/obesity among Bangladeshi older teenagers, revealing that their school grade, exposure to media content and wealth-related inequality emerged as significant contributing factors. The findings underscore the urgent need for targeted interventions and public health strategies to address the escalating burden of overweight and obesity in this age group.

Overnutrition in adolescents and its associated factors in Dale district schools in Ethiopia: a cross-sectional study

Background

Adolescence is the critical stage of an individual's growth and development that determines their nutritional status in the future. Adolescent overnutrition has become an increasing public health concern in developing countries like Ethiopia.

Objective

This study was designed to determine the magnitude and determinants of overnutrition among school-going adolescents in Dale District of Ethiopia.

Methods

An institution-based cross-sectional study was done between November and December 2020. A total of 333 school-going adolescents aged 10-19 years participated in this study. Socio-demographic, lifestyle, physical activity level, dietary energy intake, and height and weight data were collected. Body Mass Index for age Z-score (BAZ) was computed. Binary and multivariable logistic regression models were used to determine the association of outcome variable with explanatory variables, and results were reported using adjusted odds ratio (AOR) with 95% confidence interval.

Results

The magnitude of overnutrition was 7.2% (10.8% in the urban versus. 3.6% of rural schools). Overnutrition was positively associated with lack of sufficient play area within the school (AOR = 2.53, 95% CI [1.02-6.26]), being an urban resident (AOR = 3.05, 95% CI [1.12-8.29]), positive energy balance (AOR = 9.47, 95% CI [1.58-56.80]), consuming fast foods within a month before the survey date (AOR = 2.60, 95% CI [1.93-6.83]), having moderate (AOR = 9.28, 95% CI [6.70-71.63]) or low physical activity (PA) (AOR = 7.95, 95% CI [1.12-56.72]), and consuming snack within last one week before the survey date (AOR = 3.32, 95% CI [1.15-9.58]).

Conclusion

The magnitude of overnutrition among school-going adolescents was suboptimal. Sedentary lifestyles, excess calorie intake, having inadequate play areas within the school, and having snack and fast foods were determinants for overnutrition in the study area.

Double burden of malnutrition and its associated factors among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a multinomial regression model analysis

Background

The double burden of malnutrition (DBM), contained both undernutrition and overnutrition, is a growing public health concern that presents a significant challenge to the food and nutrition policies of developing nations such as Ethiopia. However, the prevalence and contributing factors of DBM among adolescents in the study area have not been adequately investigated by Ethiopian researchers. Therefore, this study aims to determine the prevalence of DBM and contributing factors among secondary school students in Debre Berhan City, Ethiopia.

Methods

A school-based cross-sectional study was conducted among 742 adolescents aged 10-19 years from October 13, 2022, to November 14, 2022, using a multi-stage sampling method. Data were collected using the online Kobo toolbox tool. A multinomial logistic regression model was used to analyze the data. The data were cleaned and analyzed in R software 4.2.2. Adolescents who had body mass index for age Z score (BAZ) < -2 SD, > +1 SD, and > +2 from the median value were considered thin, overweight, and obese, respectively.

Results

The overall prevalence of DBM was 21.5% (14.8% thinness and 6.7% overweight/obesity). In the multivariable multinomial logistic regression analysis models factors such as age [AOR = 0.79, 95% CL: (0.67, 0.93)], sex [AOR = 3.86, 95% CL: (2.35, 6.32)], school type [AOR 5.03, 95% CL: (2.30, 10.99)], minimum dietary diversity score [AOR = 2.29, 95% CL: (1.27, 4.14)], frequency of meals [AOR = 2.09, 95% CL: (1.13, 3.89)], home gardening practice [AOR = 2.31, 95% CL: (1.44, 3.67)], history of illness [AOR = 0.57, 95% CL: (0.36, 0.93)], and knowledge of nutrition [AOR = 4.96, 95% CL: (1.61, 15.33)] were the significant predictors of either thinness or overweight/obesity (DBM).

Conclusion

More than one-fifth of adolescents were affected by DBM in the study area. This prevalence is higher compared with the national and regional prevalence that found to be a public health concern. Thus, interventions like double-duty interventions should consider the age, sex, school type, minimum dietary diversity score, frequency of meals, home gardening practice, history of illness, and nutritional knowledge of adolescents.

Clinical Trial Registration

clinicaltrial.gov, identifier NCT05574842.

The coexistence of stunting and overweight or obesity in Ethiopian children: prevalence, trends and associated factors

BACKGROUND

Double burden of childhood malnutrition is a condition where undernutrition (stunting) along with overweight and obesity coexist within individuals, households, and populations. It reflects a new layer of malnutrition and an understudied phenomenon in many low-income settings. To date, the prevalence and factors that are associated with concurrent stunting and overweight or obesity (overweight/obesity) (CSO) in the same children have not been well researched in Ethiopia. Hence, this study aimed to assess the prevalence, trends, and factors associated with the coexistence of stunting and overweight or obesity among children aged 0-59 months in Ethiopia.

METHODS

Pooled data from 2005, 2011 and 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A total of 23,756 (weighted sample) children aged 0-59 months were included in the study. Height-for-age z-scores (HAZ) less than - 2 SD and weight-for-height z-scores (WHZ) above 2 SD were calculated, and children were classified as stunted and overweight/obese, respectively. A child who is simultaneously stunted and overweight/obese was considered as having HAZ below - 2 SD and WHZ above 2 SD computed into a variable named CSO, and reported as a binary outcome (yes or no). Multilevel logistic regression analysis that adjusts for sampling weights and clustering was used to identify factors associated with CSO.

RESULTS

The prevalence of stunting, overweight or obesity, and CSO among under-five children was 43.12% [95% CI: (42.50, 43.75%)], 2.62% [95% CI: (2.42, 2.83%)], and 1.33% [95% CI: (1.18, 1.48%)], respectively. The percentage of CSO children was reported to have declined from 2.36% [95% CI: (1.94-2.85)] in 2005 to 0.87% [95%CI: (0.07-1.07)] in 2011, and the same appeared to have increased slightly to 1.34% [95%CI: (1.13-1.59)] in 2016. Children who were currently breastfeeding [AOR: 1.64, 95%CI: (1.01-2.72)], born to an overweight mother [AOR: 2.65, 95%CI: (1.19-5.88)], and lived in families with 1-4 household members [AOR: 1.52, 95%CI: (1.02-2.26)] were significantly associated with CSO. At the community level the odds of having CSO were higher among children included from EDHS-2005 [AOR: 4.38, 95%CI: (2.42-7.95)].

CONCLUSION

The study revealed that less than 2% of children had CSO in Ethiopia. CSO was linked to factors at both the individual (i.e. breastfeeding status, maternal overweight, and household size) and community-levels. Overall, the study findings indicated the necessity of focused interventions to simultaneously address double burden of childhood malnutrition in Ethiopia. To further combat the double burden of malnutrition, early identification of at-risk children, including those born to overweight women and children living with multiple household members, is indispensable.

Burden and contributing factors to overweight and obesity in young adolescents in Addis Ababa, Ethiopia

The prevalence of overweight/obesity in adolescents has increased globally, including in low- and middle-income countries. Early adolescence provides an opportunity to develop and encourage positive health and behavioural practices, yet it is an understudied age group with limited information to guide and inform appropriate interventions. This study aims to determine the prevalence of overweight/obesity in young adolescents, aged between 10 and 14 years attending public schools in Addis Ababa, Ethiopia, and to explore the contributing factors. A cross-sectional school-based study was conducted. Adolescents completed individual questionnaires. Weight (kg) and height (m) measurements were converted to BMI-for-age and gender z-scores. Multivariate regression analysis was conducted to determine the associated factors. The overall prevalence of overweight/obesity was 8% among adolescents aged 10-14 years and it was significantly higher in females (13%) than males (2%). The diet quality for the majority of the adolescents was inadequate, putting them at risk for poor health outcomes. The contributors to overweight/obesity were different between males and females. Age and no access to a flush toilet were negatively associated with overweight/obesity in males and access to a computer, laptop or tablet was positively associated. In females, menarche was positively associated with overweight/obesity. Living with only their mother or another female adult and an increase in physical activity were negatively associated with overweight/obesity. There is a need to improve the diet quality of young adolescents in Ethiopia and understand the reasons why females are less physically active to limit the risk of poor diet-related health outcomes.

Food environment around schools and adolescent consumption of unhealthy foods in Addis Ababa, Ethiopia

Adolescent diets may be influenced by the retail food environment around schools. However, international research to examine associations between the proximity of retail food outlets to schools and diet provides equivocal support for an association. This study aims to understand the school food environment and drivers for adolescents' consumption of unhealthy foods in Addis Ababa, Ethiopia. Mixed-methods research was conducted, 1200 adolescents (10-14 years) from randomly selected government schools were surveyed, along with vendors within 5-min' walk of the schools and focus group discussions (FGDs) with adolescent groups. Mixed-effect logistic regression investigated the relationship between the number of vendors around the schools and the consumption of selected unhealthy foods. Thematic analysis was used to summarize findings from the FGDs. Consumption of sweets and sugar-sweetened beverages (S-SSB) and deep-fried foods (DFF) at least once a week was reported by 78.6% and 54.3% of the adolescents, respectively. Although all schools were surrounded by food vendors selling DFF and S-SSB, consumption was not associated with the number of vendors available around the school. However, adolescents' awareness and perception of healthy food, and their concerns about the safety of foods in the market, influenced their dietary choices and behaviours. Lack of financial resources to purchase food as desired also played a role in their selection of food and eating habits. Reported unhealthy food consumption is high among adolescents in Addis Ababa. Thus, further research is warranted to come up with school-based interventions that promote access and healthy food choices among adolescents.

Targeting Nanotechnology and Nutraceuticals in Obesity: An Updated Approach

HYPOTHESIS

This review article represents a brief layout of the risk factors and pathophysiology responsible for obesity, customary treatment strategies, and nanotechnology-based nutraceutical for the therapeutics of obesity.

EXPERIMENTS

An exhaustive search of the literature was done for this purpose, using Google Scholar, PubMed, and ScienceDirect databases. A literature study was conducted using publications published in peer-reviewed journals between 2000 and 2022.

FINDINGS

This was revealed that risk factors responsible for obesity were genetic abnormalities and environmental and socio-economic factors. Several research articles published between 2000 and 2022 were based on phytoconstituents-based nanoformulation for obesity therapeutics and, therefore, have been systematically compiled in this review. Various nutraceuticals like Garcinia cambogia, quercetin, resveratrol, capsaicin, Capsicum, Curcuma longa, Camella Sinensis, Zingiber officinalis, Citrus aurantium, Aegle marmelos, Coffea canephora, Asparagus officinalis, Gardenia jasminoides, Catha edulis, Clusia nemroisa, Rosmarinus officinalis, Cirsium setidens, Betula platyphylla, Tripterygium wilfordi possessing anti-obesity actions are discussed in this review along with their patents, clinical trials as well as their nanoformulation available.

CONCLUSION

This review illustrates that nanotechnology has a great propensity to impart a promising role in delivering phytochemicals and nutraceuticals in managing obesity conditions and other related disorders.

Prevalence of overweight/obesity and associated factors among under-five children in Ethiopia: A multilevel analysis of nationally representative sample

Background

Childhood overweight and obesity are emerging public health challenges of the twety-first century. There was a 24% increase in the number of overweight children under the age of 5 years in low-income countries. Despite the significant risk of childhood overweight/obesity for non-communicable diseases, premature death, disability, and reproductive disorders in their adult life, little attention has been given. Therefore, we aimed to assess the prevalence of overweight/obesity and associated factors among under-five children.

Methods

This study was conducted using data from a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The Mini EDHS was a community-based cross-sectional study that covered all the administrative regions of Ethiopia. The data collection was conducted between March 21, 2019 and June 28, 2019. Both descriptive and analytic findings were produced. The overweight/obesity was measured by the weight-for-height (WFH) index, more than two standard deviations (+2 SD) above the median of the reference population based on the BMI Z-score. To identify significantly asso.

Results

A total of 5,164 under-five children were included in this study cited factors of overweight/obesity, a multilevel binary logistic regression model was fitted to account for the hierarchical nature of the data. Adjusted odds ratio (aOR) with a corresponding 95% confidence interval (CI) was reported to show the strength of association and statistical significance. The overall prevalence of overweight/obesity was 2.14% (95% CI: 1.74-2.53). The odds of overweight/obesity was higher among children aged <6 months (aOR = 5.19; 95% CI: 2.98-9.04), 6-24 months (aOR = 1.97; 95% CI: 1.18-3.29), delivered by cesarean section (aOR = 1.75; 95% CI: 1.84-3.65), living in Addis Ababa city (aOR = 2.16; 95% CI: 1.59-7.81), Oromia region (aOR = 1.93; 95% CI: 1.71-5.24), having mothers with the age 40-49 years (aOR = 3.91; 95% CI: 1.90-16.92), uses traditional contraceptive methods (aOR = 2.63; 95% CI: 1.66-10.47) and households headed by male (aOR = 1.71; 95% CI: 1.84-3.48).

Conclusion

This study showed that the prevalence of overweight/obesity among under-five was low in Ethiopia. There were several factors that affect childhood overweight/obesity including child age, maternal age, mode of delivery, sex of head of household, contraception use, and geography of residence. Therefore, strategies to reduce childhood overweight and obesity should consider an identified multitude of contributing factors.

Improving Skin Carotenoid Levels in Young Students through Brief Dietary Education Using the Veggie Meter

The antioxidant and anti-inflammatory effects of carotenoid have been determined to aid in the prevention of a wide range of oxidative disorders, arteriosclerosis, obesity, and various types of cancers. In order to keep high carotenoid levels in the body, much of the vegetable and fruit (V/F) intake is mandatory. However, the actual intake of V/F is not enough in many countries. The aim of this study was to assess whether brief dietary education using the Veggie Meter (VM) that could measure skin carotenoid (SC) levels could induce the increase in carotenoid levels via V/F intake. Two hundred and sixty-one elementary and junior high school students (ages 7−14 years old) received brief educational session and SC evaluation by VM, and the changes in SC levels were examined after 6 months. The baseline VM scores ranged from 131 to 825, and the average significantly increased from 400.0 ± 124.7 (standard deviation) to 447.4 ± 140.4 at Month 6 (p < 0.0001). The percentage of increase at month 6 was negatively correlated with the baseline values (r = −0.36, p < 0.0001). This finding implies that subjects who became aware of their inferiority tended to make a significant effort to change their behavior. The multivariate logistic regression analysis demonstrated that subjects taking much of green and yellow vegetables, drinking vegetable/tomato juice, and eating any fruit had higher VM scores than the average value. In conclusion, the educational approach using VM was supposed to be an effective method of raising awareness of the V/F shortage and increasing V/F intake that could indue the increase in SC levels.

Determinants of High Fat Mass Index in Preschoolers Living in Brazilian Urban Areas

OBJECTIVE

Determine the social, environmental, and personal factors associated with high fat mass index in preschoolers.

DESIGN

A quantitative, exploratory, and cross-sectional study.

SETTING AND PARTICIPANTS

Fifty-one Brazilian preschoolers from public schools living in urban areas.

MAIN OUTCOME MEASURE(S)

The preschoolers' fat mass index was determined using dual-energy radiological absorptiometry. The quality of home and school environments were accessed using the Early Childhood Home Observation for Measurement of the Environment and Early Childhood Environment Rating Scales. The physical activity levels were recorded by accelerometers. The daily energy intake was recorded and sociodemographic data using the Brazilian Economic Classification criterion. Data on exposure time to screens and parental obesity were collected according to the parents' reports.

ANALYSIS

Data analyses were performed using simple and multiple regressions models.

RESULTS

Parental obesity (β, 0.516; 95% confidence interval [CI], 2.078-5.133), high quality of environmental stimulation of home (β, 0.429; 95% CI, 1.294-4.023), and high exposure time to screens (β, 0.256; 95% CI, 0.215-2.554) explained 43% of preschoolers' high fat mass index.

CONCLUSIONS AND IMPLICATIONS

Identification of parental obesity, high quality of environmental stimulation of home, and high exposure time to screens as the most important determinants of the high fat mass index in preschoolers from Brazilian urban areas.

Prevalence and associated factors of overweight and obesity among primary school children: a cross-sectional study in Thanhhoa City, Vietnam

OBJECTIVE

To determine the prevalence and associated factors of overweight and obesity among primary school children (6-11 years old) in Thanhhoa city in 2021.

DESIGN

Cross-sectional study.

SETTING

Seven primary schools in Thanhhoa city, Vietnam.

PARTICIPANTS

782 children (and their parents).

PRIMARY AND SECONDARY OUTCOME MEASURES

Two-stage cluster random sampling was used for selecting children and data were collected from January to February 2021. A self-administrated questionnaire was designed for children and their parents. Children's height and weight were measured and body mass index (BMI)-for-age z-scores were computed using the WHO Anthro software V.1.0.4. Data were analysed using R software V.4.1.2. The associations between potential factors and childhood overweight/obesity were analysed through univariate and multivariate logistic regression analyses. Variables were selected using the Bayesian Model Averaging method.

RESULTS

The prevalence of overweight/obesity among primary school children in Thanhhoa city was 35.93% (overweight 21.61% and obesity 14.32%). The proportion of overweight girls was nearly equal to that of boys (20.78% and 22.52%, respectively, p=0.6152) while the proportion of boys with obesity was four times as many as that of girls (23.86% and 5.62%, respectively, p<0.0001). Child's sex was the factor significantly associated with childhood overweight/obesity. Boys had double the risk of being overweight/obese than girls (adjusted OR: aOR=2.48, p<0.0001). Other potential factors which may be associated with childhood overweight/obesity included mode of transport to school, the people living with the child, mother's occupation, father's education, eating confectionery, the total time of doing sports, and sedentary activities.

CONCLUSION

One in every three primary school children in Thanhhoa city were either overweight or obese. Parents, teachers and policy-makers can implement interventions in the aforementioned factors to reduce the rate of childhood obesity. In forthcoming years, longitudinal studies should be conducted to determine the causal relationships between potential factors and childhood overweight/obesity.

Gender Difference and Correlates of Physical Activity Among Urban Children and Adolescents in Ethiopia: A Cross-Sectional Study

Background

Studies indicate that children and adolescent populations in most countries show a low level of physical activity (PA) and an increasing prevalence of obesity. Addressing gender disparity in PA is the main element of public health programs. There is currently a paucity of studies, particularly, in developing countries that investigate gender differences and correlates of PA among children and adolescents.

Objective

The study is aimed to assess the gender difference and correlates of PA among children and adolescents in Ethiopia.

Methods

An observational population-based cross-sectional study was conducted in representative samples of children and adolescents in the capital city of Ethiopia, Addis Ababa. Multivariable logistic regression models with robust estimation of SEs were fitted to predict the odds ratios (ORs) and 95% CIs.

Results

A total of 632 children and adolescents-parent dyads were included in the study. More boys than girls (17.0 and 11.7%) were engaged in moderate intensity PA 3 days a week or more (p = 0.057). Age, mothers working in a private business, attending public schools, longer sleep duration, and being taught the benefits of PA were positively associated with meeting moderate-to-vigorous PA (MVPA) in both sexes combined and in a sub-sample of boys. Furthermore, an inverse association was found between overweight/obesity and MVPA in the overall children and girls as well. For moderate PA (MPA); the age of the children, maternal education and occupation, school type, overweight/obesity, and sleep duration on school nights were significant correlates among the studied children.

Conclusions

The present study provided evidence of several correlates identified associated with meeting MVPA and MPA in both sexes combined. Girls are less likely than boys to engage in PA. Therefore, there is a need to take into perspectives the provision of a comprehensive multifaceted health behavior modification and interventions, such as focused and regular physical education in schools.

Magnitude and Determinants of Under-Nutrition Among Late Adolescent Girls in East Africa: Evidence From Demographic and Health Surveys (2010-2016)

Background

Adolescent girls are vulnerable to undernutrition owing to their increased nutrition demand for growth and development, including sexual development and maturation. Despite its public health importance, undernutrition among late adolescent girls has received little attention in health and nutrition policies. Although undernutrition in adolescent girls has been investigated, most of the previous study reports were based on small sample sizes and limited geographic settings. Therefore, we aimed to estimate the prevalence and determinants of undernutrition among late adolescent girls in East Africa.

Methods

Secondary data analysis was conducted among 10 East African countries using the most recent Demographic and Health Survey (DHS) reports. A total of 21,779 adolescent girls aged 15-19 years were included in this study. Descriptive statistics were conducted to describe the study population. The binary logistic regression model was fitted to identify the determinants of undernutrition among late adolescent girls. Variables with a p-value of <0.05 in the multivariate analysis were identified as statistically significant determinants of undernutrition.

Results

The overall magnitude of undernutrition among late adolescent girls in East Africa was 16.50% (95% CI: 16.00-17.00), whereas the overall magnitude of obesity among late adolescent girls in East Africa was 2.41% (95% CI: 2.21-2.62). In the final model of the multivariate analysis, adolescent girls aged 18-19 years [adjusted odds ratio (AOR) = 0.55; 95% CI: 0.51-0.60], having secondary education (AOR = 0.79; 95% CI: 0.68-0.93), being from a rich wealth index family (AOR = 0.63; 95% CI: 0.56-0.69), and being from a medium wealth index family (AOR = 0.80; 95% CI: 0.72-0.89) were negatively and statistically associated with undernutrition. Likewise, having more than seven household members (AOR = 1.36; 95% CI: 1.10-1.67), walking more than 30 min to a water source (AOR = 1.10; 95% CI: 1.01-1.20), and living in Ethiopia (AOR = 1.75; 95% CI: 1.51-2.03) were positive determinants of undernutrition among late adolescent girls.

Conclusion

In this study, undernutrition in late adolescent girls remains a considerable public health problem in East Africa. Age group, educational status, marital status, family wealth index, family size, time taken to reach a water source, media exposure, and country of resident were significant determinants of undernutrition. Therefore, devising strategies that improve the socioeconomic status of households and/or adolescents would help to reduce the risks of undernutrition in late adolescents.

Patterns and Determinants of the Double Burden of Malnutrition Among Adolescents: A 14-Year Follow-Up of a Birth Cohort in Rural China

OBJECTIVE

To examine the prevalence of the double burden of malnutrition and its associated factors among adolescents in rural China.

STUDY DESIGN

A birth cohort of adolescents born to women in northwestern China who participated in a double-blind, randomized, controlled trial of micronutrient supplementation during pregnancy from August 2002 to January 2006 was enrolled. Follow-up was conducted from June to December 2016.

RESULTS

A total of 2115 participants were analyzed (median age 12 years; IQR ± 1), the majority of whom were male (59.7%). The nutritional status distribution was 17.72% underweight, 8.62% overweight, 0.96% obese, and 2.58% stunted. Girls were less likely to be overweight/obese (relative risk ratio [RRR] 0.67, 95% CI 0.48-0.92) but more likely to be underweight (RRR 1.65, 95% CI 1.25-2.17) or stunted (RRR 2.26, 95% CI 1.21-4.22). Children of underweight mothers (RRR 1.63, 95% CI 1.19-2.25) with a history of small for gestational age (RRR 1.64, 95% CI 1.14-2.36) or described as being a "picky eater" (RRR 1.53, 95% CI 1.18-1.99) had a greater risk of being underweight. Children whose fathers' education was primary or below (RRR 2.25, 95% CI 1.11-4.59), with maternal height <150.1 cm (RRR 2.46, 95% CI 1.12-5.39), or who had mothers with underweight (RRR 2.80, 95% CI 1.37-5.72) had a greater likelihood of stunting. Overweight/obesity was associated with high and middle household wealth (RRR 1.62, 95% CI 1.14-2.32), mothers with overweight (RRR 1.86, 95% CI 1.25-2.78), and picky eating (RRR 0.62, 95% CI 0.46-0.84).

CONCLUSIONS

Malnutrition (undernutrition and overweight/obesity) is common in rural Chinese adolescents and is associated with perinatal, genetic, and economic conditions.

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.

Unhealthy Food Consumption Pattern and Nutritional Status among Adolescents: A Cross-sectional Study

Introduction: Nutritional balance is needed during adolescence for health and optimal growth. The aim of the study is to analyse the nutritional status and food consumption patterns of adolescents in Luwuk. Methods: This study was conducted with a cross-sectional design involving 385 adolescents at four high schools (grade 10-12). The sample was divided into four schools and selected by the accidental sampling method. Food consumption patterns were assessed using a World Health Organization-designed Global School-based Student Health Survey questionnaire (modified for Indonesia). Nutritional status is based on the results of anthropometric. Data were analysed using frequency distribution and inferential analysis. Results: Of the total 385 adolescents studied, there were 4.7% adolescents overweight and 2.3% were obese. On the other hand, there are also 10.6% thin adolescents and 4.4% with very thinness. 49.9% of adolescents do not consume fruit, 22.3% do not eat vegetables, 23.5% drink soft drinks with carbonated >=1 time per day, 54.8% eat fast food >=1 day a week, 66 .5% rarely or never breakfast, 58.2% never bring lunch and 18.7% usually eat street snacks. Conclusion: Some adolescents in Luwuk City had nutritional problems and unhealthy food consumption patterns. A nutritional surveillance program is needed for adolescents which includes monitoring nutritional status, consumption patterns, and risk factors related to nutrition.

Psychometric properties of the Generalized Anxiety Disorder-7 Scale in Ethiopian university students

The prevalence of anxiety and its associated factors in Ethiopians necessitates availability of a valid questionnaire tool to screen for this disorder. Therefore, this study aimed to assess the factor structure, its stability, and psychometric measures of the Generalized Anxiety Disorder-7 Scale GAD-7) in Ethiopian university students. A cross-sectional study with random sampling was carried out in students (n = 354, age = 21.79 ± 4.49) attending Mizan-Tepi University, Ethiopia. The GAD-7, the Perceived Stress Scale (PSS), and a sociodemographic questionnaire were completed by participants. The unidimensional model of the GAD-7 showed configural, metric, scalar, and strict invariance among gender groups. The Cronbach's alpha (0.77), item-total score correlations (r = .51-.72, p < .01), and inter-item correlations (all significant, p < .05) indicated adequate internal consistency. GAD-7 scale scores correlated significantly with the PSS, suggesting desired convergent validity. The GAD-7 has good psychometric validity with Ethiopian university students.

Overweight and/or obesity and its determinants among under-five children in East African countries: A multilevel analysis using Bayesian approach

INTRODUCTION

Childhood overweight and/or obesity become a significant public health problem in the 21st century. It is a double burden next to undernutrition and has a dramatic rise in low- and middle-income countries. This study aimed to determine the prevalence of overweight and/or obesity and its determinants among under-five children in East African Countries.

METHODS

Data were retrieved from the recent nationally representative demographic and health survey datasets from eleven East African Countries. A total of 89,091 weighted numbers of under-five children participated. Statistical analysis was performed using the R (Brms R-package) software. Multivariable mixed-effects logistic regression analysis using the Bayesian approach was employed to identify the factors affecting overweight and/or obesity among under-five children.

RESULTS

Overall, 4.59% (95% CI, 4.45-4.73) of under-five children in East African Countries were overweight and/or obese. Under-five children overweight and/or obesity was highest in Comoros and lowest in Burundi. Under-five children aged older than two years (Adjusted odds ratio (AOR) = 0.65, 95% credible interval (CrI), 0.57-0.73), females (AOR = 0.84, 95% CrI:, 0.75-0.94), under-five children live from rich household wealth status (AOR = 1.25, 95% CrI, 1.06-1.49), under-five children living in Malawi (AOR = 2.60, 95% CrI, 1.49-4.51), Mozambique (AOR = 5.26, 95% CrI, 3.52-7.79), Rwanda (AOR = 5.63, 95% CrI, 3.46-9.08), Tanzania (AOR = 2.15, 95% CrI, 1.47-3.12), and Uganda (AOR = 2.62, 95% CrI, 1.71-3.99) were a significant determinant for under-five overweight and/or obesity.

CONCLUSION

Overweight and/or obesity among under-five children become a problem in low and middle-income countries. Older under-five children, male sex, children who live in rich household wealth, and children who live in a country in Malawi, Mozambique, Ruanda, Tanzania, and Uganda were significantly affected by overweight and/or obesity. Therefore, in these countries, responsible stakeholders shall give primary attention to curve the alarming increase in overweight and/or obesity among under-five children.

The association of household and child food insecurity with overweight/obesity in children and adolescents in an urban setting of Ethiopia

BACKGROUND

Existing evidence on the association between food insecurity and childhood obesity is mixed. In addition, literature from developing countries in general and Ethiopia in particular on the nexus and impact of household and child food insecurity on childhood obesity in the context of urbanization remains limited. The objective of this study was to explore the association between household and child food insecurity and childhood obesity in an urban setting of Ethiopia.

METHODS

An observational population based cross-sectional study was conducted in five sub-cities of Addis Ababa. Multi-stage sampling techniques were employed to identify the study unit from the selected sub-cities. Multivariable logistic regression models with robust estimation of standard errors were utilized to determine the associations. Interactions by age and sex in the associations explored were tested.

RESULTS

A total of 632 children and adolescents-parent dyads were included in the study. About 29.4% of those in food secure households and 25% of those in food insecure households were overweight/obese. Similarly, 29.8% of food secure children and 22% of food insecure children were overweight/obese. Household and child food insecurity status were not significantly associated with child and adolescent overweight or obesity in the final adjusted models.

CONCLUSIONS

Household and childhood food insecurity status were not associated with child and adolescent overweight/obesity in the study setting. Interventions aimed at combating overweight and obesity in the study setting should target children and adolescents irrespective of their food security status.

Factors Associated with Over-Nutrition Among Men 15-54 years in Uganda: A National Survey

Background

Globally and in Sub-Saharan Africa (SSA), the prevalence of overweight and obesity are on the rise. Data on overweight and obesity among men are scarce.

Objective

We aimed to determine the prevalence and factors associated with over-nutrition among men in Uganda.

Methods

We used Uganda Demographic and Health Survey (UDHS) 2016 data of 5,408 men aged 15 to 45 years. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Multivariable logistic regression was used to determine factors associated with over-nutrition among 15 to 54-year-old men in Uganda.

Results

The prevalence of over nutrition was 9.1%, where that of overweight was 7.9% (95% CI 7.2-8.7 and obesity was1.2% (95% CI 0.9-1.5). Men who were aged 25 to 34 (AOR = 3.28; 95% CI: 1.92-5.59), 35-44 (AOR = 4.51; 95% CI: 2.61-7.82) and 45 to 54 (AOR = 4.28; 95% CI: 2.37-7.74) were more likely to have over-nutrition compared to those aged 15 to 24 years. Married men (AOR=2.44; 95% CI: 1.49-3.99) were 2 times more likely to have over-nutrition than men who were not married. Men in the central region (AOR = 1.78; 95% CI: 1.22-2.60) were 1.78 times more likely to have over-nutrition than men in the northern region. Men who were in the richest wealth index quintiles were 10 times more likely to have over-nutrition compared to those in the poorest wealth index quintile (AOR = 9.38: 95 % CI 5.14-17.10).

Conclusion

The factors associated with over-nutrition among Ugandan men in our study were increasing age, marital status, increasing wealth and region of origin. This shows the need for measures to abate the regional development inequalities, need to promote physical activity among older men and need to improve on the knowledge of nutrition and dietetic practices for married couples and men of different social classes.

Overweight/Obesity and Associated Factors Among Second Cycle Primary School Children in Kirkos Sub-City, Addis Ababa, Ethiopia

Background

Although overweight/obesity is becoming a public health issue in low income countries, there is a paucity of evidence concerning overweight/obesity in Ethiopia. The aim of the study was to assess the magnitude of overweight/obesity and associated factors among second cycle primary school children in Kirkos Sub-City, Addis Ababa, Ethiopia.

Methods

A school based cross-sectional study was conducted among 482 children from May to June, 2019. Data were collected using a questionnaire and checklist. Data were entered using EpiData version 3.1 and exported into SPSS version 22.0. Bivariable and multivariable logistic regression analyses were done to identify factors associated with overweight/obesity. Level of statistical significance was declared at p ≤ 0.05.

Results

The overall magnitude of overweight/obesity was 21.2%. The magnitude of overweight was 13.7% while obesity was 7.5%. Vehicle availability, being from private school, not having friend(s), preferring sweet foods, eating breakfast irregularly, watching movies/Television while eating and physical inactivity were the factors significantly associated with overweight/obesity among second cycle primary school children.

Conclusions

The magnitude of overweight/obesity was high in the study area. Therefore, health and education sectors should promote healthy lifestyle to curb child overweight/obesity.

Prevalence of excess body weight and associated factors among secondary school adolescent girls in northern Tanzania: a cross-sectional study

Introduction

excess body weight among adolescents is on the increase and has become a global public health challenge. It is likely to persist to adulthood, exposing to risk of developing chronic diseases. However, there is insufficient information on the prevalence of excess body weight and associated factors among adolescent girls in secondary schools in northern Tanzania.

Methods

this cross-sectional study involved 400 secondary school adolescent girls, selected by multi-stage cluster sampling. A self-administered questionnaire was used to gather information. Anthropometric measurements were taken and body mass index calculated. Descriptive statistics summarized the data. Logistic regression was used to model excess body weight resulting into adjusted odds ratios with their 95% confidence intervals and significant level was set at p-value<0.05.

Results

the proportion of adolescents with excess body weight (BMI >+1SD) was 23%. The majority (63%), reported unhealthy dietary habits while half (51.5%) of them had moderate level of knowledge on healthy eating. Compared to working as a civil servant, the odds of having excess body weight among girls whose mothers/female guardians were housewives was less by 60% (aOR=0.4, 95%CI: 0.2, 0.9). Furthermore, the odds of having excess body weight among adolescents eating unhealthy foods were almost six times higher compared to their peers on healthy diet (aOR=5.8, 95%CI: 2.9, 11.3).

Conclusion

prevalence of excess body weight among adolescent girls in northern Tanzania is high. Unhealthy dietary habits and mother's/female guardian's occupation were significant correlates of excess body weight. We recommend platforms to inform adolescents on the importance of proper food intake and to advance knowledge on dangers of excessive weight gain as a strategy towards prevention of nutrition-related diseases.

Concurrence of stunting and overweight/obesity among children: Evidence from Ethiopia

Background

Nutrition transition in many low- and middle-income countries (LMICs) has led to shift in childhood nutritional outcomes from a predominance of undernutrition to a double burden of under- and overnutrition. Yet, policies that address undernutrition often times do not include overnutrition nor do policies on overweight, obesity reflect the challenges of undernutrition. It is therefore crucial to assess the prevalence and determinants of concurrence stunting and overweight/obesity to better inform nutrition programs in Ethiopia and beyond.

Methods

We analyzed anthropometric, sociodemographic and dietary data of children under five years of age from 2016 Ethiopian Demographic and Health Survey (EDHS). A total of 8,714 children were included in the current study. Concurrence of stunting and overweight/obesity (CSO) prevalence was estimated by basic, underlying and immediate factors. To identify factors associated with CSO, we conducted hierarchical logistic regression analyses.

Results

The overall prevalence of CSO was 1.99% (95% CI, 1.57–2.53). The odds of CSO was significantly higher in children in agrarian region compared to their counter parts in the pastoralist region (AOR = 1.51). Other significant factors included; not having improved toilet facility (AOR = 1.94), being younger than 12 months (AOR = 4.22), not having history of infection (AOR = 1.83) and not having taken deworming tablet within the previous six months (AOR = 1.49).

Conclusion

Our study provided evidence on the co-existence of stunting and overweight/obesity among infants and young children in Ethiopia. Therefore, identifying children at risk of growth flattering and excess weight gain provides nutrition policies and programs in Ethiopia and beyond with an opportunity of earlier interventions through improving sanitation, dietary quality by targeting children under five years of age and those living in Agrarian regions of Ethiopia.

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.

A systematic review and meta-analysis of the prevalence and predictors of anemia among children in Ethiopia

Background

Anemia is a wide-spread public health problem characterized by a decrease in hemoglobin concentration and/ or red blood cell volume below an established cut-off value. In developing countries including Ethiopia, about half of children are estimated to be anemic. Therefore, the purpose of this study was to determine the pooled prevalence of anemia and its predictor factors among children in Ethiopia.

Method

The studies were identified through explicit and exhaustive search of reputable databases (PubMed, Google scholar, Science Direct, EMBASE, Cochrane library, and the hand search of reference lists of previous prevalence studies to retrieve more related articles. Thirty-nine studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. In our analysis, considerable heterogeneity was observed. Therefore, a random effect meta-analysis model was used to estimate the pooled prevalence of anemia. Moreover, the predictor factors of anemia were examined.

Results

The forest plot of 39 included studies revealed that the overall pooled prevalence of anemia among children in Ethiopia was 34.4% (95% CI: 29.1, 39.7%). Sub-group analysis showed that the highest anemia prevalence was observed in Somali Region with a prevalence of 49.4 % (95% CI: 20.9, 77.8). Also, anemia in children was found to be highest in the age group of less than five years (45.2, 95% CI: 39.6,50.8). Low literacy of families: 1.3 (95% CI: 1.1, 1.7), low family socioeconomic status: 1.9 (95% CI: 1.1,3.01.3), having housewife mothers or with no job: 1.5 (95% CI: 1.4, 1.9) and rural residence: 3.3 (95% CI: 1.7,6.1) were found to be predictors of anemia among children.

Conclusion

In this study, one in three children were anemic in Ethiopia. It is a moderate public health problem in children in this study. Low literacy, low socioeconomic status as well as rural residence of the families and helminthic infection of the children were found to be predictors of anemia in the children. Community and school-based interventions should be strengthened to improve the problem.

Magnitude of Central Obesity and its Associated Factors Among Adults in Urban Areas of Northwest Ethiopia

PURPOSE

Obesity is becoming one of the most common public health problems worldwide. In particular, central obesity which indicates abnormal fat accumulation in the abdominal regions is highly associated with the risk of getting cardiometabolic diseases and their progression to end stage diseases or death. However, in developing countries, including Ethiopia less attention has been given to analyze the magnitude and associated factors of it. Therefore, we aimed to determine the prevalence of central obesity and its associated factors among adults in urban areas of Northwest Ethiopia.

METHODS

A cross-sectional study was conducted among 773 adults who lived in urban areas of Northwest Ethiopia from April 1 to May 30, 2019. Central obesity was assessed using both waist to hip ratio and waist circumference of the participants. Data were analyzed using STATA 14.0. The factors associated with central obesity were identified by binary logistic regression analyses using 95% confidence interval and the degree of association of the factors was measured using adjusted odds ratio (AOR). P-value <0.05 was used to declare statistical significance.

RESULTS

The prevalence of central obesity with waist circumference and waist to hip ratio definition criteria was 37.6% and 35.7%, respectively. According to body mass index, about 26.26% and 10.29% of the study participants were overweight and obese, respectively. A one-year increase in age (AOR=1.05; 95%CI: 1.03-1.07), being female (AOR=9.62; 95%CI: 4.84-19.12) and eating of liquid oils (AOR=2.58; 95%CI: 1.71-3.90) were found to have statistically significant variables with central obesity.

CONCLUSION

The prevalence of central obesity was relatively high in comparison with similar studies. Thus, governmental and nongovernmental organizations that work in the health system as well as health professionals should focus on the preventive measure of central obesity to control its associated disorders at an early stage.

Correlations between Excessive Body Mass Index, Body Perception, Physical Activity, and Respiratory Functions among Youths in an Urban Setting of Vietnam

Young adults are susceptible to overweight and obesity and their adverse outcomes. However, limited studies have been conducted to understand this health problem in Vietnamese youths. This study was conducted to examine the rate of overweight and obesity, as well as the relationship between this condition on body perception, physical activity, and respiratory function among young adults in Hanoi, Vietnam. We performed a cross-sectional survey with 367 students aged 18-25 years at the Hanoi University of Pharmacy from June 2017 to June 2018. The result showed that the rate of overweight and obesity in our sample was 16.6%. There were 55.7% of overweight/obese students having the misperception of their body image. Results of multivariate regression analysis showed that overweight/obesity increased nearly three times (OR = 2.8, 95% CI: 1.5-5.0) the ability to be active. Overweight/obese students with physical activity had a better respiratory function. To conclude, this study underlined the associations between overweight and obesity with physical activity, body image, and respiratory function in our young sample. Further longitudinal studies should be warranted to examine their causal relationships.

Flatfoot and associated factors among Ethiopian school children aged 11 to 15 years: A school-based study

BACKGROUND

The Foot health of a child plays a pivotal role in their participation in play, locomotive activities, healthy lifestyle, somatic development, and weight management. The burden of flatfoot among children in Ethiopia is not known. The objective of this study was to analyze the structure of the medial foot arch using Staheli plantar arch index and investigate its associated factors among larger sample school children, aged 11-15 years in Ethiopia.

METHODS

A school-based cross-sectional study was conducted among children aged 11-15 years from eleven randomly selected primary schools. The sample size was determined proportionally across school strength and governmental and private schools to ensure variety within the sample. Data collection consisted of physical measurements, footprint-based measures whilst full weight-bearing, and a structured questionnaire on foot pain, footwear type, and physical activity. Data were analyzed descriptively and through uni- and multivariate logistic regression model.

RESULTS

A total of 823 children participated. The overall prevalence of flatfoot was 17.6% with a significant difference between age, gender, type of school, BMI, and type of footwear. Being younger (OR 3.3, 95% CI 1.6-6.7), male (OR 1.6, 95% CI 1.0-2.4), experiencing foot pain (OR 1.9, 95% CI 1.0-3.5), wearing closed shoe (OR 4.4, 95% CI 1.6-11.9), overweight (OR 3.8, 95% CI 1.2-8.7), obese (OR 4.2, 95% CI 2.5-10.9), and low level of physical activity (OR 2.1, 95% CI 1.0-4.6) were significantly associated with flatfoot. Children who were overweight, obese, and also experiencing foot pain have a 2.8 (95% CI 1.62-5.94) and 4.1 (95% CI 2.85-8.31) times greater chance of having flatfoot respectively. The prevalence of flatfoot among 560 normal weight children was 17.5%.

CONCLUSIONS

The findings of this study demonstrated that the overall prevalence and the prevalence of flatfoot among normal-weight children are almost the same. There is a definite need to develop a screening algorithm for diagnosis and treatment indication for this children's lower extremity disorder.

Prevalence of obesity and overweight in Iranian students: a systematic review and meta-analysis

Background Obesity and overweight are among the most common and serious health issues in many countries, leading to numerous medical consequences such as heart disease, hypertension, fatty liver etc. This review article addressed the prevalence of obesity and overweight in Iranian students by using meta-analysis. Methods A number of domestic and international databases were searched, including IranMedex, Magiran, SID, Scopus, PubMed, IranDoc, Web of Science and Google Scholar. Eligible publications were 160 articles that addressed the prevalence of obesity or overweight. Data were combined using random effects model. Heterogeneity of the studies was examined by Q statistics and the I2 index. Data were analyzed using STATA version 11.1. Results In the 160 reviewed studies, a total of 481,070 individuals (6-20 years) were included. The prevalence of obesity among Iranian students based on body mass index (BMI) was 11% (95% confidence interval [CI]: 10%-12%) (in girls 8% [95% CI: 7%-10%] and in boys 11% [95% CI: 10%-13%]). The prevalence of overweight in students based on BMI was 12% (95% CI: 12%-13%) (in girls 13% [95% CI: 11%-14%] and in boys 11% [95% CI: 18%-30%]). The rate of obesity was 13% (95% CI: 11%-16%) in elementary school students, 10% (95% CI: 7%-14%) in secondary school students and 7% (95% CI: 6%-9%) in high school students. Conclusions The prevalence rate of overweight was more than that of obesity with a 1% difference. The prevalence of obesity was higher in boys, while the prevalence of overweight was higher in girls. The prevalence of obesity was higher in primary school students than in secondary school students. This prevalence was higher in secondary school students than in high school students.

Social Stratification, Diet Diversity and Malnutrition among Preschoolers: A Survey of Addis Ababa, Ethiopia

In Sub-Saharan Africa, being overweight in childhood is rapidly rising while stunting is still remaining at unacceptable levels. A key contributor to this double burden of malnutrition is dietary changes associated with nutrition transition. Although the importance of socio-economic drivers is known, there is limited knowledge about their stratification and relative importance to diet and to different forms of malnutrition. The aim of this study was to assess diet diversity and malnutrition in preschoolers and evaluate the relative importance of socioeconomic resources. Households with children under five (5467) were enrolled using a multi-stage sampling procedure. Standardized tools and procedures were used to collect data on diet, anthropometry and socio-economic factors. Multivariable analysis with cluster adjustment was performed. The prevalence of stunting was 19.6% (18.5-20.6), wasting 3.2% (2.8-3.7), and overweight/obesity 11.4% (10.6-12.2). Stunting, overweight, wasting and limited diet diversity was present in all social strata. Low maternal education was associated with an increased risk of stunting (Adjusted odds ratio (AOR): 1.8; 1.4-2.2), limited diet diversity (AOR: 0.33; 0.26-0.42) and reduced odds of being overweight (AOR: 0.61; 0.44-0.84). Preschoolers in Addis Ababa have limited quality diets and suffer from both under- and over-nutrition. Maternal education was an important explanatory factor for stunting and being overweight. Interventions that promote diet quality for the undernourished whilst also addressing the burgeoning problem of being overweight are needed.

Assessment of Physical Activity Indicators for Children and Youth in Ethiopia: Evidence from the Global Matrix 3.0 Study (2017-2018)

Background

Regular physical activity is vital for children’s health, well-being, and development. However, evidence is scant about physical activity indicators for children and youth in Ethiopia. This study aimed to assess physical activity indicators among children and youth in Ethiopia.

Methods

This study was conducted as part of the Active Healthy Kids Global Alliance’s “Global Matrix 3.0” which included 49 countries. Data were collected from December 2017 to April 2018. The country research team included different disciplines related to physical activity. Data were retrieved from pre-reviewed literature, government policy documents, and an expert interview panel. Data were analyzed using the ten physical activity indicators for children and youth. The grading system was done through a harmonized process and the standard grading rubric of the Global Matrix 3.0 study ((A = ≥ 80%, B = 60%–79%, C = 40%–59%, D = 20%–39%, F = < 20%, INC = incomplete data).

Results

For the overall physical activity indicator, 28% of children and youth in Ethiopia met the recommended physical activity of 60 min per day which resulted in a “D” grade. Likewise, the school and government indicator received a “D” grade. Almost 32% of schools in Ethiopia had access to infrastructures and multipurpose spaces for physical activity including outdoor play. The government policy partially existed in the non-communicable diseases agenda but had less focus on children and youth. The active play indicator scored the highest grade of “B.” About 71% of children and youth were involved in active play for at least 2 h a day before, during, and after school. About 50% of children and youth were engaging in organized sport participation, and this indicator was graded a “C.” Similarly, 48% of children and youth walked to and from school as a means of active transportation resulting in a “C” for this indicator. Three indicators (sedentary behavior, family and peers, and community and environment) were graded as an “F.” Approximately 8% of children and youth were living in communities and environments that did not support opportunities for physical activity. Only 13% of children and youth spent less than 2 h per day in sedentary screen time. There was no adequate information to grade the physical fitness indicator.

Conclusion

This study showed that Ethiopian’s children and youth have received low grades for majority of physical activity indicators. Therefore, urgent actions should be taken by the government, policymakers, researchers, and key stakeholders to address the suggested priority areas.

Obesity: global epidemiology and pathogenesis

The prevalence of obesity has increased worldwide in the past ~50 years, reaching pandemic levels. Obesity represents a major health challenge because it substantially increases the risk of diseases such as type 2 diabetes mellitus, fatty liver disease, hypertension, myocardial infarction, stroke, dementia, osteoarthritis, obstructive sleep apnoea and several cancers, thereby contributing to a decline in both quality of life and life expectancy. Obesity is also associated with unemployment, social disadvantages and reduced socio-economic productivity, thus increasingly creating an economic burden. Thus far, obesity prevention and treatment strategies - both at the individual and population level - have not been successful in the long term. Lifestyle and behavioural interventions aimed at reducing calorie intake and increasing energy expenditure have limited effectiveness because complex and persistent hormonal, metabolic and neurochemical adaptations defend against weight loss and promote weight regain. Reducing the obesity burden requires approaches that combine individual interventions with changes in the environment and society. Therefore, a better understanding of the remarkable regional differences in obesity prevalence and trends might help to identify societal causes of obesity and provide guidance on which are the most promising intervention strategies.

Stunting and Overweight among 12-24-Month-Old Children Receiving Vaccination in Ho Chi Minh City, Vietnam

Introduction

Malnutrition and obesity are a double burden on children in developing countries and could induce higher risks of noncommunicable diseases in the long term. In the big cities of Vietnam, both issues are present and share the issue of nutrition problems; the prevalence of malnutrition in children is gradually decreasing while the prevalence of obesity is increasing rapidly. The paper aims to identify the prevalence of stunting and overweight/obesity in apparently healthy young children in Ho Chi Minh City (HCMC).

Methods

A prospective cross-sectional study recruited 12-24-month-old children receiving national vaccination in community health centers in HCMC from February 2016 to July 2017. Sixteen healthcare centers were randomly selected among 8 districts of HCMC. Stunting and overweight were defined by height-for-age z-score <-2 SD and BMI z-score ≥+2 SD.

Results

A total of 768 children had mean age of 16.8±4.2 months old, 51.7% boys. The prevalence of stunting and overweight/obesity was 8.2% and 10.7%, respectively. Stunting was associated with older age, boys, and low birth weight of children and occupation of mothers (P <0.05). No associated risk factor was observed for overweight/ obesity status.

Conclusion

The prevalence of overweight/obesity was higher than the prevalence of stunting in 12-24-month-old children in HCMC. Overweight/obesity would be a public health problem for children in big cities.