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Ozdemir S, Quaife M, Mohamed AF, Norman R. An Overview of Data Collection in Health Preference Research. THE PATIENT 2024:10.1007/s40271-024-00695-6. [PMID: 38662323 DOI: 10.1007/s40271-024-00695-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
This paper focuses on survey administration and data collection methods employed for stated-preference studies in health applications. First, it describes different types of survey administration methods, encompassing web-based surveys, face-to-face (in-person) surveys, and mail surveys. Second, the concept of sampling frames is introduced, clarifying distinctions between the target population and survey frame population. The discussion then extends to different types of sampling methods, such as probability and non-probability sampling, along with an evaluation of potential issues associated with different sampling methods within the context of health preference research. Third, the paper provides information about different recruitment methods, including web-surveys, leveraging patient groups, and in-clinic recruitment. Fourth, a crucial aspect addressed is the calculation of response rate, with insights into determining an adequate response rate and strategies to improve response rates in stated-preference surveys. Lastly, the paper concludes by discussing data management plans and suggesting insights for future research in this field. In summary, this paper examines the nuanced aspects of survey administration and data collection methods in stated-preference studies, offering valuable guidance for researchers and practitioners in the health domain.
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Affiliation(s)
- Semra Ozdemir
- Department of Population Health Sciences, Duke Clinical Research Institute, Duke University, Durham, NC, USA.
| | | | | | - Richard Norman
- Curtin School of Population Health, Curtin University, Perth, Australia
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Sethi V, Bassi S, Bahl D, Kumar A, Choedon T, Bhatia N, de Wagt A, Joe W, Arora M. Prevalence of overweight and obesity and associated demographic and health factors in India: Findings from Comprehensive National Nutrition Survey (CNNS). Pediatr Obes 2024; 19:e13092. [PMID: 38326947 DOI: 10.1111/ijpo.13092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/11/2023] [Accepted: 11/08/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Childhood obesity (5-9 years) in India is likely to contribute 11% to the global burden by 2030. METHODS Data from India's Comprehensive National Nutrition Survey (CNNS, 2016-2018) was used to assess the prevalence and key associated factors of overweight and obesity. Multivariable logistic regression models were applied to identify potential determinants associated with being overweight and obese. RESULTS Overweight prevalence (including obesity) varied from 1.6% (0-4 years) to 4.8% (10-19 years). The majority of states reported a higher proportion of adolescents overweight and obese, than younger age group 5-9 years. A significantly higher prevalence of children and adolescents with obesity was reported in higher wealth quintiles and residents of urban areas. The prevalence of overweight and obesity and associated demographic and health factors in India included: the presence of NCD risk factor (adolescents: 1.68, 95% CI [1.31-2.14]), micronutrient deficiency (5-9 years children: 1.72, 95% CI [1.30-2.28]), mother's education (5-9 years children: 4.84, 95% CI [2.92-8.03]; adolescents: 2.17, 95% CI [1.42-3.32]), wealth (adolescents: 1.92, 95% CI [1.16-3.19]), place of residence (5-9 years children: 1.68, 95% CI [1.39-2.03]; adolescents: 1.39, 95% CI [1.16-1.66]), child age (5-9 years children: 1.64, 95% CI [1.40-1.93], and screen-time (adolescents: 1.63, 95% CI [1.22-2.19]. CONCLUSION The findings set out policy and research recommendations to pave the path for curtailing the increasing prevalence of overweight and obesity and achieving the World Health Assembly's Global Nutrition target of 'no increase in childhood overweight (Target 4) by 2025'.
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Affiliation(s)
- Vani Sethi
- UNICEF-Regional Office for South Asia, Kathmandu, Nepal
| | - Shalini Bassi
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | - Deepika Bahl
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | | | | | - Neena Bhatia
- Department of Food & Nutrition, Lady Irwin College, University of Delhi, New Delhi, India
| | | | - William Joe
- Institute of Economic Growth, New Delhi, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
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Niba LL, Navti LK, Musa AJ. Relationship between measures of adiposity and hypertension amongst secondary school adolescents in an urban setting in Cameroon. Pan Afr Med J 2023; 46:57. [PMID: 38223873 PMCID: PMC10787134 DOI: 10.11604/pamj.2023.46.57.41547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/06/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction measures of obesity such as body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) have been shown to be associated with high blood pressure (BP) in children and adolescents. The purpose of this study was to determine the proportion of secondary school adolescents with elevated BP and high BP in relation to some measures of adiposity (BMI, WC, WHtR) and to examine the association between BP and adiposity indices amongst the children. Methods the study was an institutional-based cross-sectional study involving 534 adolescents (mean age 15.1 ± 2.3 years) attending 4 secondary schools (2 public and 2 private) in the Bamenda municipality of the North West Region of Cameroon. Anthropometric and BP measurements were carried out following standard procedures. Diagnosis of hypertension in the children was done by obtaining three elevated systolic or diastolic BP readings (BP ≥ 95th percentile for the child's age, sex and height). Linear regression was used to determine the relationship between BP and some measures of adiposity (BMI, WC, WHtR) amongst the children. Results the prevalence of elevated BP and hypertension amongst the study participants was 33.3% and 33.3% in the BMI-obese children, 25.9% and 25.2% in the WC overweight/obese children and 29.4% and 41.2% in the "high risk" (WHtR ≥ 0.5) children respectively. Body mass index-obese, WC overweight/obese and "high risk" (WHtR ≥ 0.5) children had a significantly (p <0.05) higher mean SBP and DBP compared to their healthy weight counterparts. Linear regression indicated a significant association (p <0.001) between WC (β=0.75; 95% CI = 0.57, 0.92), BMI (β=0.88; 95% CI = 0.49, 1.25) and WHtR (β= 67.08; 95% CI = 45.64, 88.51) with systolic BP for the unadjusted analysis. After adjusting for age, gender and school type, only WC (β= 0.66; 95% CI = (0.43, 0.89) showed a positive significant (p <0.001) relationship with systolic BP. Conclusion this study has demonstrated that WC is positively associated with high BP in children and adolescents. Thus, WC can be used in predicting children and adolescents with a high risk of developing high BP in our setting.
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Affiliation(s)
- Loveline Lum Niba
- Department of Public Health, The University of Bamenda, Bambili, North West Region, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
| | - Lifoter Kenneth Navti
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
- Department of Biochemistry, The University of Bamenda, Bambili, North West Region, Cameroon
| | - Ahmadou Jingi Musa
- Department of Clinical Sciences, The University of Bamenda, Bambili, North West Region, Cameroon
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Dongmo FFD, Asongni WD, Mba ARF, Etame RME, Hagbe DN, Zongning GLD, Touohou SVN, Sop MMK, Ngane RAN, Gouado I. Knowledge, Attitude, and Practices regarding Obesity among Population of Urban (Douala) and Rural (Manjo) Areas in Cameroon. Int J Chronic Dis 2023; 2023:5616856. [PMID: 37637779 PMCID: PMC10460282 DOI: 10.1155/2023/5616856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/25/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023] Open
Abstract
Knowledge, attitude, and practice (KAP) studies have recently been suggested as a useful tool to understand the specificity of the population related to a disease. However, in Cameroon, there is a lack of information based on KAP studies regarding obesity. This study has been designed to collect basic indicators on the KAP of the populations regarding overweight and obesity in urban and rural areas in Cameroon (Douala and Manjo). For this purpose, an epidemiological community-based cross-sectional descriptive study was conducted in these two areas using a well-structured questionnaire. Sociodemographic and medical characteristics and KAP information were assessed. For the quantification of KAP, a score varying from 0 (poor knowledge, attitude, or practices) to 100 (good knowledge, attitude, or practices) was attributed for each question. Correlations between knowledge, attitude, and practice were determined using inferential statistics tests which were χ2 test, independent Student t-test, ANOVA (followed by Tukey's post hoc test), and Pearson correlation coefficient. Results reveal that living in a rural area (Manjo), being overweight or obese, having complete secondary education, and being married increase the knowledge and the practice score. There is a strong and positive correlation between knowledge and practice score. However, there is no association between attitude and practice and between attitude and knowledge. Reducing the disparities between knowledge, attitude, and practices constitutes a serious track in a holistic strategy for the management of obesity in these areas.
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Affiliation(s)
| | - William Djeukeu Asongni
- Department of Home Economic, Advanced Teacher's Training College for Technical Education, University of Douala, P.O. Box 1872, Douala, Cameroon
| | - Aymar Rodrigue Fogang Mba
- Department of Biochemistry, Faculty of Science, University of Douala, P.O. Box 24157, Douala, Cameroon
| | | | - Diana Ngo Hagbe
- Department of Biochemistry, Faculty of Science, University of Douala, P.O. Box 24157, Douala, Cameroon
| | | | | | - Marie Modestine Kana Sop
- Department of Biochemistry, Faculty of Science, University of Douala, P.O. Box 24157, Douala, Cameroon
| | - Rosalie Annie Ngono Ngane
- Department of Biochemistry, Faculty of Science, University of Douala, P.O. Box 24157, Douala, Cameroon
| | - Inocent Gouado
- Department of Biochemistry, Faculty of Science, University of Douala, P.O. Box 24157, Douala, Cameroon
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Diallo R, Baguiya A, Balde MD, Camara S, Diallo A, Camara BS, Toure AO, Soumah AM, Kouanda S, Compaore E. Prevalence and factors associated with overweight in children under 5 years in West African countries. J Public Health Res 2023; 12:22799036231181845. [PMID: 37465529 PMCID: PMC10350767 DOI: 10.1177/22799036231181845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/24/2023] [Indexed: 07/20/2023] Open
Abstract
Background Overweight is a risk factor for non-communicable diseases and is affecting an increasing number of children worldwide. The objective of this study was to measure the prevalence and related factors to overweight among children under 5 years in five West African countries. Methods This study was a secondary analysis of nationally representative cross-sectional data. These data were drawn from Demographic and Health Surveys (DHS) from five countries in the West African region (Benin, Guinea, Mali, Nigeria, and Togo) from 2015 to 2018.Continuous quantitative data were categorized and all analyses were weighted according to the probability that each participant was selected in the sample. Children under 5 years of age were the study population. Multilevel logistic regression was used with Stata 16.0 software. Results The total sample size for the analysis was 38,657 children. The pooled prevalence of overweight among children under 5 years of age in the five countries was 3%. Guinea had the highest prevalence (6%) compared to the other countries, which had a prevalence of 2%. The likelihood of being overweight was higher among children aged 0-6 months (adjusted odds ratio [AOR] = 3.09; 95% confidence interval [CI] [2.41-3.95]), who had a high birth height (AOR = 1.64; 95% CI [1.29-2.09]), whose mothers were overweight (AOR = 1.35; 95% CI [1.09-1.68]), who lived in households with fewer than five members (AOR = 1.19; 95% CI [1.00-1.46]), or who lived in Guinea (AOR = 2.79; 95% CI [1.62-4.79]). Conclusion This study showed that overweight concerns few children under 5 years of age in West Africa. However, it does exist, and its prevalence could likely increase if its modifiable factors (maternal overweight, household size, and height at birth) are not taken into account in nutritional interventions.
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Affiliation(s)
- Ramata Diallo
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Adama Baguiya
- African Institute of Public Health, Ouagadougou, Burkina Faso
| | | | - Sadan Camara
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Aissatou Diallo
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Bienvenu Salim Camara
- National Center for Training and Research in Rural Health in Maferinyah, Conakry, Guinea
| | - Amadou Oury Toure
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Anne Marie Soumah
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Seni Kouanda
- African Institute of Public Health, Ouagadougou, Burkina Faso
| | - Ella Compaore
- University Joseph Ki-Zerbo of Ouagadougou, Ouagadougou, Burkina Faso
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Tatah L, Bain LE, Kongnyuy E, Assah F, Mbanya JC. Shared correlates of maternal and childhood overweight in Cameroon: a cross-sectional analysis of demographic and health survey data. BMC Public Health 2023; 23:1265. [PMID: 37386386 PMCID: PMC10311895 DOI: 10.1186/s12889-023-16164-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 06/21/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Overweight parents are likelier to bear overweight babies, who are likelier to grow into overweight adults. Understanding the shared risks of being overweight between the mother-child dyad is essential for targeted life course interventions. In this study, we aimed to identify such risk factors in Cameroon. METHODS We conducted secondary data analysis using Cameroon's 2018 Demographic and Health Surveys. We used weighted multilevel binary logistic regressions to examine individual, household, and community correlates of maternal (15-49 years) and child (under five years) overweight. RESULTS We retained 4511 complete records for childhood and 4644 for maternal analysis. We found that 37% [95%CI:36-38%] of mothers and 12% [95%CI:11-13%] of children were overweight or obese. Many environmental and sociodemographic factors were positively associated with maternal overweight, namely urban residence, wealthier households, higher education, parity and being a Christian. Childhood overweight was positively associated with a child being older and a mother being overweight, a worker, or a Christian. Therefore, only religion affected both mothers overweight (aOR: 0.71[95%CI:0.56-0.91]) and childhood overweight (aOR 0.67[95%CI: 0.5-0.91]). Most of the potentially shared factors only indirectly affected childhood overweight through maternal overweight. CONCLUSION Besides religion, which affects both mothers and childhood overweight (with the Muslim faith being protective), much of childhood overweight is not directly explained by many of the observed determinants of maternal overweight. These determinants are likely to influence childhood overweight indirectly through maternal overweight. Extending this analysis to include unobserved correlates such as physical activity, dietary, and genetic characteristics would produce a more comprehensive picture of shared mother-child overweight correlates.
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Affiliation(s)
- Lambed Tatah
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, 8046, Yaoundé, Cameroon
- Medical Research Council Epidemiology Unit, University of Cambridge, CB2 0QQ, Cambridge, UK
| | - Luchuo Engelbert Bain
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
- International Development Research Centre, IDRC, Ottawa, ON, Canada
| | | | - Felix Assah
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, 8046, Yaoundé, Cameroon
| | - Jean Claude Mbanya
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, 8046, Yaoundé, Cameroon
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Sahiledengle B, Mwanri L, Kumie A, Beressa G, Atlaw D, Tekalegn Y, Zenbaba D, Desta F, Kene C, Seyoum K, Gomora D, Woldeyohannes D, Agho KE. The coexistence of stunting and overweight or obesity in Ethiopian children: prevalence, trends and associated factors. BMC Pediatr 2023; 23:218. [PMID: 37147654 PMCID: PMC10163774 DOI: 10.1186/s12887-023-04037-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 04/26/2023] [Indexed: 05/07/2023] Open
Abstract
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.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
| | - Lillian Mwanri
- Centre for Public Health Research, Equity and Human Flourishing, Torrens University, Adelaide Campus, Adelaide, SA, 5000, Australia
| | - Abera Kumie
- School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girma Beressa
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Daniel Atlaw
- Department of Human Anatomy, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Yohannes Tekalegn
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Fikreab Desta
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Chala Kene
- Department of Midwifery, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Kenbon Seyoum
- Department of Midwifery, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Degefa Gomora
- Department of Midwifery, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Demelash Woldeyohannes
- Department of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | - Kingsley Emwinyore Agho
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
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Overweight and obesity in preschool children in Turkey: A multilevel analysis. J Biosoc Sci 2023; 55:344-366. [PMID: 35086578 DOI: 10.1017/s0021932022000025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Childhood obesity/overweight is a worldwide concern and its prevalence is increasing in many countries. The first aim of this study is to analyse the trends in overweight and obesity among children under the age of five in Turkey based on the new World Health Organization (WHO) standards, using data from the 'five-round of the Turkey Demographic and Health Surveys' (TDHSs). The second aim is to examine whether or not the maternal/household and individual-level factors are associated with overweight/obesity using TDHS 2003, 2008, and 2013 datasets. A total sample of 14,231 children under the age of five were extracted from the TDHS in 1993, 1998, 2003, 2008, and 2013 to determine the prevalence of the trend. Pooled data from 8,812 children were included in the analysis to examine factors associated with overweight/obesity. Taking into account the clustered data structure, multilevel logistic regression models were utilised. In 1993, 1998, 2003, 2008, and 2013 the prevalence of overweight children was 5.3%, 4.9%, 10.0%, 11% and 11.6%, respectively. The factors that were independently associated with overweight/obesity were as follows: living in single-parent households (adjusted odds ratio (aOR) = 2.27, 95%CI = 1.21-4.26), compared to living in dual-parent households; having an obese mother (aOR = 4.25, 95%CI = 1.73-10.44), overweight mother (aOR = 3.15, 95%CI = 1.29-7.69), and a normal-weight mother (aOR = 2.70, 95%CI = 1.11-6.59) compared to having an underweight mother; being aged between 13-24 months (aOR = 1.72, 95%CI = 1.30 to 2.27), compared to being aged 0-12 months; male gender (aOR = 1.30, 95%CI = 1.11 to 1.53); being stunted (aOR = 2.18, 95%CI = 1.74 to 2.73); high birth weight (aOR = 1.55, 95%CI = 1.08 to 2.23) compared to low birth weight. In addition, overweight was higher in children of mothers who had completed primary school (aOR = 1.21, 95%CI = 1.01 to 1.59) than children of mothers who had not completed primary school. These findings reveal that, over the years, there has been a substantial increase in obesity/overweight among children which demonstrates the importance of evaluating the overweight indicators at the maternal/household level.
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Ghofranipour F, Hamzavi Zarghani N, Mohammadi E, Mehrizi AAH, Tavousi M, De Craemer M, Cardon G. An internet-based educational intervention for mothers targeting preschoolers' weight management promotion (PWMP): a pilot study. BMC Public Health 2022; 22:2220. [PMID: 36447163 PMCID: PMC9707417 DOI: 10.1186/s12889-022-14543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 11/03/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The prevalence of overweight and obesity among children has raised public health concerns. This study aimed to design and evaluate a behaviour change intervention program to promote weight management among Tehranian preschoolers. METHODS The PRECEDE-PROCEED model is one of the most popular models in health education used to develop and evaluate most educational interventions. In this one-group pre and post-pilot study, 13 mothers of preschoolers were recruited from preschools in Tehran (the capital of Iran), in August 2020. Mothers received a six-week educational intervention, including text messages and educational videos via WhatsApp, to increase their self-efficacy to overcome barriers changing their children's lifestyle. Mothers reported preschoolers' height and weight to assess Body Mass Index and filled out the Food Frequency Questionnaire, the Persian version of the children's health-related quality of life questionnaire, and demographic features. The "Children's physical activity and sedentary behaviors checklist," newly designed by the researchers, was also filled out by mothers. These behaviors were measured according to the minutes that children were involved in these activities in a day, and the days they spent in a week for them. All variables were measured at baseline, immediately after the intervention and three months later. Data analysis was performed using SPSS IBM statistics version 22. Friedman test was used to evaluate changes over time. RESULTS The findings demonstrated that the mean BMI z-score stayed steady between baseline, immediately after the intervention and after three months (P = 0.60). Besides, after three months, the intervention programme led to a decrease in soft drink consumption (P = 0.001), and an increase in parental perception of their child's general health (P = 0.05), the parental concern regarding their child's emotional and physical health (P = 0.002) and minutes of physical activity per day (P = 0.02). However, fruit intake decreased (P = 0.01), and simple sugar, such as cube, increased (P = 0.03). CONCLUSION Results from this study are promising but should be interpreted with caution and should be replicated on a larger scale and compared with a control group to evaluate whether effects are maintained in a larger sample.
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Affiliation(s)
- Fazlollah Ghofranipour
- grid.412266.50000 0001 1781 3962Department of Health Education and Health Promotion, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Najmeh Hamzavi Zarghani
- grid.412266.50000 0001 1781 3962Department of Health Education and Health Promotion, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Eesa Mohammadi
- grid.412266.50000 0001 1781 3962Department of Nursing, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Ali Asghar Haeri Mehrizi
- grid.417689.5Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Mahmoud Tavousi
- grid.417689.5Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Marieke De Craemer
- grid.5342.00000 0001 2069 7798Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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Sserwanja Q, Gatasi G, Musaba MW. Evaluating continuum of maternal and newborn healthcare in Rwanda: evidence from the 2019-2020 Rwanda demographic health survey. BMC Pregnancy Childbirth 2022; 22:781. [PMID: 36261801 PMCID: PMC9583497 DOI: 10.1186/s12884-022-05109-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 09/19/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Access to a complete continuum of maternal and child health care has been recommended globally for better pregnancy outcomes. Hence this study determined the level (pooled prevalence) and predictors of successfully completing continuum of care (CoC) in Rwanda. METHODS We analyzed weighted secondary data from the 2019-2020 Rwanda Demographic and Health Survey (RDHS) that included 6,302 women aged 15 to 49 years who were selected using multistage stratified sampling. We analyzed complete continuum of care as a composite variable of three maternal care services: at least four ANC contacts, SBA, maternal and neonatal post-natal care. We used the SPSS version 25 complex samples package to conduct multivariable logistic regression. RESULTS Of the 6,302 women, 2,131 (33.8%) (95% CI: 32.8-35.1) had complete continuum of care. The odds of having complete continuum of care were higher among women who had exposure to newspapers (adjusted odds ratio (AOR): 1.30, 95% CI: 1.11-1.52), those belonging to the eastern region (AOR): 1.24, 95% CI: 1.01-1.52), southern region (AOR): 1.26, 95% CI: 1.04-1.53), those with health insurance (AOR): 1.55, 95% CI: 1.30-1.85), those who had been visited by a field health worker (AOR: 1.31, 95% CI: 1.15-1.49), those with no big problems with distance to health facility (AOR): 1.25, 95% CI: 1.07-1.46), those who were married (AOR): 1.35, 95% CI: 1.11-1.64), those with tertiary level of education (AOR): 1.61, 95% CI: 1.05-2.49), those belonging to richer households (AOR): 1.33, 95% CI: 1.07-1.65) and those whose parity was less than 2 (AOR): 1.52, 95% CI: 1.18-1.95). CONCLUSION We have identified modifiable factors (exposure to mass media, having been visited by a field health worker, having health insurance, having no big problems with distance to the nearest health facility, belonging to richer households, being married and educated), that can be targeted to improve utilization of the entire continuum of care. Promoting maternity services through mass media, strengthening the community health programmes, increasing access to health insurance and promoting girl child education to tertiary level may improve the level of utilization of maternity services.
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Affiliation(s)
| | - Ghislaine Gatasi
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Ministry of Education, Southeast University, 210009, Nanjing, Jiangsu Province, China
| | - Milton W Musaba
- Department of Obstetrics and Gynaecology, Mbale Regional Referral and Teaching Hospital, Mbale, Uganda.,Department of Obstetrics and Gynaecology, Busitema University, Tororo, Uganda
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Gebremichael MA, Mengesha MM, Hailegebreal S, Abdulkadir H, Arja A, Wolde BB. Prevalence of overweight/obesity and associated factors among under-five children in Ethiopia: A multilevel analysis of nationally representative sample. Front Public Health 2022; 10:881296. [PMID: 36159318 PMCID: PMC9500235 DOI: 10.3389/fpubh.2022.881296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/16/2022] [Indexed: 01/21/2023] Open
Abstract
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.
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Affiliation(s)
- Mathewos Alemu Gebremichael
- Department of Public Health, College of Health Sciences, Bonga University, Bonga, Ethiopia,*Correspondence: Mathewos Alemu Gebremichael
| | - Melkamu Merid Mengesha
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Samuel Hailegebreal
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Hanan Abdulkadir
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Asrat Arja
- Department of Data Repository and Governance, National Data Management Centre for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Biruk Bogale Wolde
- School of Public Health, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Aman, Ethiopia
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Overweight/Obesity Prevalence among Under-Five Children and Risk Factors in India: A Cross-Sectional Study Using the National Family Health Survey (2015–2016). Nutrients 2022; 14:nu14173621. [PMID: 36079879 PMCID: PMC9460849 DOI: 10.3390/nu14173621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
The occurrence of overweight and obesity has increased in recent years in India. In this study, we investigate the prevalence and associated risk factors of overweight/obesity among children aged 0–59 months in India. Using data from the 2015–2016 National Family Health Survey-4 (NFHS-4), the research sample included 176,255 children aged 0 to 59 months. Bivariate and multivariate techniques were used to analyze children’s risk factors for overweight/obesity. We identified that the prevalence of overweight/obesity among children aged 0–59 was 2.6% in India. The study findings reveal that factors such as child sex, age, birth weight, birth rank, maternal education, number of children, age at marriage, mother’s BMI, media exposure, social group, and dietary diversity score were most significantly correlated with childhood overweight and obesity in India. Furthermore, we found that male children (ARR: 1.08) aged between 0 and 11 months (ARR: 3.77) with low birth rank (ARR: 1.24), obese (ARR: 1.81) children whose mothers married after the age of 18 (ARR: 1.15), children who belong to a scheduled tribe family (ARR: 1.46), and children who consumed 7–9 food items (ARR: 1.22) were at highest risk of being overweight and obese. However, breastfeeding (ARR: 0.85) and Muslim families (ARR: 0.87) appeared to be protective factors with respect to childhood overweight and obesity in India. Pertinent public health programs, clinical follow-up, and awareness about sedentary lifestyles can help to reduce overweight/obesity risks in children.
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Kuwornu JP, Amoyaw J, Manyanga T, Cooper EJ, Donkoh E, Nkrumah A. Measuring the Overall Burden of Early Childhood Malnutrition in Ghana: A Comparison of Estimates From Multiple Data Sources. Int J Health Policy Manag 2022; 11:1035-1046. [PMID: 33589568 PMCID: PMC9808187 DOI: 10.34172/ijhpm.2020.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 12/09/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Childhood malnutrition contributes to nearly half (45%) of all deaths among children under 5 globally. The United Nations' Sustainable Development Goals (SDGs) aims to end all forms of malnutrition by 2030; however, measuring progress towards these goals is challenging, particularly in countries with emerging economies where nationally-representative data are limited. The primary objective of this study was to estimate the overall burden of childhood malnutrition in Ghana at national and regional levels using 3 data sources. METHODS Using data from the long-standing Ghana Demographic and Health Surveys (GDHS), Ghana Multiple Indicator Cluster Survey (GMICS), and the emerging Ghana Socioeconomic Panel Survey (GSPS), we compared the prevalence of malnutrition using the extended composite index of anthropometric failure (eCIAF) for the period 2008- 2011. This study included data for children aged 6-59 months and calculated all anthropometric z-scores based on the World Health Organization (WHO) Growth Standards. We tested for differences in malnutrition subtypes using two-group configural frequency analysis (CFA). RESULTS Of the 10 281 children (6532 from GMICS, 2141 from GDHS and 1608 from GSPS) included in the study, the only demographic difference observed was the children included in the GSPS were slightly older than those included in the GDHS and GMICS (median age of 36 vs 30 vs 33 months, P<.001). Based on the eCIAF, the overall prevalence of malnutrition at the national level was higher among children in the GSPS (57.3%, 95% CI: 53.9%-60.6%), followed by the GDHS (39.7%, 95% CI: 37.0%-42.5%), and then those in the GMICS (31.2%, 95% CI: 29.3%-33.1%). The two-group CFA showed that the 3 data sources also estimated different prevalence rates for most of the malnutrition subtypes included in the eCIAF. CONCLUSION Depending on the data source adopted, our estimates of eCIAF showed that between one-third and half of all Ghanaian children aged 6-59 months had at least one form of malnutrition over the period 2008-2011. These eCIAF estimates should complement the commonly reported measures such as stunting and wasting when interpreting the severity of malnutrition in the country to inform policy decisions.
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Affiliation(s)
- John Paul Kuwornu
- Research Department, Saskatchewan Health Authority, Regina, SK, Canada
| | - Jonathan Amoyaw
- Department of Sociology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Taru Manyanga
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Elizabeth J. Cooper
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Elvis Donkoh
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
| | - Amos Nkrumah
- Department of Sociology & Anthropology, Mount Saint Vincent University, Halifax, NS, Canada
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Kwansa AL, Akparibo R, Cecil JE, Infield Solar G, Caton SJ. Risk Factors for Overweight and Obesity within the Home Environment of Preschool Children in Sub-Saharan Africa: A Systematic Review. Nutrients 2022; 14:nu14091706. [PMID: 35565675 PMCID: PMC9100775 DOI: 10.3390/nu14091706] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.
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Affiliation(s)
- Albert L. Kwansa
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Robert Akparibo
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Joanne E. Cecil
- School of Medicine, Population and Behavioural Sciences, University of St Andrews, St Andrews KY16 9TF, UK;
| | | | - Samantha J. Caton
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
- Correspondence:
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Oliveira MMD, Santos EESD, Bernardino ÍDM, Pedraza DF. Fatores associados ao estado nutricional de crianças menores de cinco anos da Paraíba, Brasil. CIENCIA & SAUDE COLETIVA 2022; 27:711-724. [DOI: 10.1590/1413-81232022272.46652020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 01/22/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivou-se analisar se o estado nutricional de crianças menores de cinco anos de idade está relacionado às condições biológicas de suas mães, ao acesso a serviços de saúde, ao benefício de programas sociais e às condições socioeconômicas. Trata-se de um estudo transversal realizado no contexto da Estratégia Saúde da Família, em sete municípios do interior do estado da Paraíba. A metodologia incluiu o diagnóstico do déficit de estatura e do excesso de peso (sobrepeso e obesidade) das crianças, cujos determinantes foram analisados por meio de árvore de decisão. Como resultado, foram avaliadas 469 crianças, das quais 7,9% apresentaram déficit de estatura e 12,8% excesso de peso. Encontrou-se associação desses desfechos com o estado nutricional materno. A baixa estatura também teve como exposições relevantes a idade da criança inferior a dois anos (p = 0,018) e a insegurança alimentar e nutricional moderada/grave (p = 0,008). Para o excesso de peso, não ser beneficiário do Programa Bolsa Família (p = 0,049) e a pior situação socioeconômica (p = 0,006) também representaram fatores associados ao desfecho. Como conclusão do presente estudo, podemos afirmar que existe uma associação entre o estado nutricional materno e o da criança.
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Tiruneh SA, Gebremariam AD, Engidaw MT, Tesfa D, Dagnaw FT, Zewde EA, Azanaw MM. Overweight and/or obesity and its determinants among under-five children in East African countries: A multilevel analysis using Bayesian approach. Heliyon 2021; 7:e08643. [PMID: 35005288 PMCID: PMC8718964 DOI: 10.1016/j.heliyon.2021.e08643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/28/2021] [Accepted: 12/16/2021] [Indexed: 10/26/2022] Open
Abstract
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.
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Affiliation(s)
- Sofonyas Abebaw Tiruneh
- Department of Public Health (Epidemiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alemayehu Digssie Gebremariam
- Department of Public Health (Human Nutrition), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melaku Tadege Engidaw
- Department of Public Health (Human Nutrition), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Desalegn Tesfa
- Department of Public Health (Reproductive Health), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fentaw Teshome Dagnaw
- Department of Public Health (Health Service Management), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Edgeit Abebe Zewde
- Department of Biomedical Science (Medical Physiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkalem Mamuye Azanaw
- Department of Public Health (Epidemiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Sserwanja Q, Musaba MW, Mutisya LM, Olal E, Mukunya D. Continuum of maternity care in Zambia: a national representative survey. BMC Pregnancy Childbirth 2021; 21:604. [PMID: 34482830 PMCID: PMC8420052 DOI: 10.1186/s12884-021-04080-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/29/2021] [Indexed: 01/20/2023] Open
Abstract
Background Globally, over half of maternal deaths are related to pregnancy-related complications. Provision of a continuum of care during pregnancy, childbirth and the postnatal period results in reduced maternal and neonatal morbidity and mortality. Hence this study determined the prevalence of the continuum of care and its determinants among women in Zambia. Methods We used weighted data from the Zambian Demographic and Health Survey (ZDHS) of 2018 for 7325 women aged 15 to 49 years. Multistage stratified sampling was used to select study participants. Complete continuum of care was considered when a woman had; at least four antenatal care (ANC) contacts, utilized a health facility for childbirth and had at least one postnatal check-up within six weeks. We conducted multivariable logistic regression to explore continuum of care in Zambia. All our analyses were done using SPSS version 25. Results Of the 7,325 women, 38.0% (2787/7325) (95% confidence interval (CI): 36.9-39.1) had complete continuum of maternal healthcare. Women who had attained tertiary level of education (adjusted odds ratio (AOR): 1.93, 95% CI: 1.09-3.42) and whose partners had also attained tertiary level of education (AOR: 2.58, 95% CI: 1.54-4.32) were more likely to utilize the whole continuum of care compared to those who had no education. Women who initiated ANC after the first trimester (AOR: 0.46, 95% CI: 0.39-0.53) were less likely to utilize the whole continuum of care compared to those who initiated in the first semester. Women with exposure to radio (AOR: 1.58, 95% CI: 1.27-1.96) were more likely to utilize the whole continuum of care compared to those who were not exposed to radio. Women residing in the Western province were less likely to utilize the entire continuum of care compared to those in the other nine provinces. Conclusion Level of education of the women and of their partners, early timing of ANC initiation, residing in other provinces other than the Western province, and exposure to information through radio were positively associated with utilization of the entire continuum of care. Improving literacy levels and promoting maternity services through radio may improve the level of utilization of maternity services. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04080-1.
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Affiliation(s)
- Quraish Sserwanja
- Programs Department, GOAL, Arkaweet Block 65 House No. 227, Khartoum, Sudan.
| | - Milton W Musaba
- Department of Obstetrics and Gynaecology, Busitema University, Mbale, Uganda
| | - Linet M Mutisya
- Maternal and Child Health Project, Swedish Organization for Global Health, Mayuge, Uganda
| | | | - David Mukunya
- Department of Community and Public Health, Busitema University, Mbale, Uganda.,Sanyu Africa Research Institute, Mbale, Uganda
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Sserwanja Q, Mutisya LM, Olal E, Musaba MW, Mukunya D. Factors associated with childhood overweight and obesity in Uganda: a national survey. BMC Public Health 2021; 21:1494. [PMID: 34344336 PMCID: PMC8330108 DOI: 10.1186/s12889-021-11567-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/29/2021] [Indexed: 01/19/2023] Open
Abstract
Background Childhood obesity is an emerging public health problem globally. Although previously a problem of high-income countries, overweight and obesity is on the rise in low- and middle-income countries. This paper explores the factors associated with childhood obesity and overweight in Uganda using data from the Uganda Demographic and Health Survey (UDHS) of 2016. Methods We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4338 children less than 5 years. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Overweight and obesity were combined as the primary outcome. Children whose BMI z score was over two were considered as overweight while those with a BMI z score greater than three were considered as obese. We used multivariable logistic regression to determine factors associated with obesity and overweight among children under 5 years of age in Uganda. Results The prevalence of overweight and obesity was 5.0% (217/4338) (95% CI: 4.3–5.6), with overweight at 3.9% (168/4338: 95% CI: 3.2–4.3) and obesity at 1.1% (49/4338: 95% CI: 0.8–1.5). Mother’s nutritional status, sex of the child, and child’s age were associated with childhood obesity and overweight. Boys were more likely to be overweight or obese (aOR = 1.81; 95% CI 1.24 to 2.64) compared to girls. Children who were younger (36 months and below) and those with mothers who were overweight or obese were more likely to have obesity or overweight compared to those aged 49–59 months and those with underweight mothers respectively. Children from the western region were more likely to be overweight or obese compared to those that were from the North. Conclusion The present study showed male sex, older age of the children, nutritional status of the mothers and region of residence were associated with obesity and overweight among children under 5 years of age.
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Affiliation(s)
- Quraish Sserwanja
- Programs Department, GOAL, Arkaweet Block 65 House No, 227, Khartoum, Sudan.
| | - Linet M Mutisya
- Maternal and Child Health Project, Swedish Organization for Global Health, Mayuge, Uganda
| | | | - Milton W Musaba
- Department of Obstetrics and Gynaecology, Busitema University, Mbale, Uganda
| | - David Mukunya
- Department of Community and Public Health, Busitema University, Mbale, Uganda.,Sanyu Africa Research Institute, Mbale, Uganda
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Reis CLB, Barbosa MCF, Henklein S, Madalena IR, de Lima DC, Oliveira MAHM, Küchler EC, de Oliveira DSB. Nutritional Status is Associated with Permanent Tooth Eruption in a Group of Brazilian School Children. Glob Pediatr Health 2021; 8:2333794X211034088. [PMID: 34350311 PMCID: PMC8295946 DOI: 10.1177/2333794x211034088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/01/2021] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to investigate the association between nutritional status with delayed tooth eruption (DTE). Oral examination was performed in schoolchildren (8-11 years old), and DTE was defined by absence of dental gingival emergence or when primary tooth was still present in the oral cavity after the expected time. BMI z-score of each child were collected and nutritional status was defined. Chi-square test and binary logistic regression adjusted by age and gender were performed. Odds ratio (OR) and 95% Confidence Interval (95% CI) were calculated. The established alpha was 5%. Among 353 included children, 247 were classified as eutrophic, 16 as underweight, 64 as overweight, and 26 as obese. Underweight was associated as a risk factor to DTE (P = .014; OR = 3.5; 95% CI = 1.3-9.8), and underweight girls had more chance to present DTE than eutrophic girls (P = .048; OR = 4.4; 95% CI = 1.1-17.2) in chi square test. In logistic regression, underweight was associated as a risk factor to DTE (OR = 4.21; CI 95% = 1.42-12.43; P = .009). Underweight children have a higher risk of DTE in permanents.
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Affiliation(s)
- Caio L B Reis
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Mariane C F Barbosa
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Suelyn Henklein
- Department of Dentistry, University of the Region of Joinville-Univille, Joinville, Brazil
| | - Isabela R Madalena
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniela C de Lima
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, Brazil
| | - Maria A H M Oliveira
- Department Master's Program of Dentistry, School of Dentistry of Uberaba-UNIUBE, Uberaba, Brazil
| | - Erika C Küchler
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniela S B de Oliveira
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, Brazil
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Reddy P, Dukhi N, Sewpaul R, Ellahebokus MAA, Kambaran NS, Jobe W. Mobile Health Interventions Addressing Childhood and Adolescent Obesity in Sub-Saharan Africa and Europe: Current Landscape and Potential for Future Research. Front Public Health 2021; 9:604439. [PMID: 33777878 PMCID: PMC7991289 DOI: 10.3389/fpubh.2021.604439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
Child and adolescent overweight is a growing public health problem globally. Europe and low and middle-income (LMIC) countries in Sub-Saharan Africa provide sufficiently suitable populations to learn from with respect to the potential for mobile health (mHealth) interventions in this area of research. The aim of this paper is to identify mHealth interventions on prevention and treatment of childhood and adolescent obesity in Sub-Saharan Africa and Sweden and report on their effects, in order to inform future research in this area. A search of peer-reviewed publications was performed using PubMed, ScienceDirect, EBSCOhost, and Scopus. The search included all articles published up to August 2019. The search strings consisted of MeSH terms related to mHealth, overweight or obesity, children, adolescents or youth and individual countries in Europe and Sub-Saharan Africa. Second, a combination of free-text words; mobile phone, physical activity, exercise, diet, weight, BMI, and healthy eating was also used. Seven studies were reported from Europe and no eligible studies from Sub-Saharan Africa. The results of this narrative review indicate a lack of research in the development and testing of mHealth interventions for childhood and adolescent obesity. There is a need for an evidence base of mHealth interventions that are both relevant and appropriate in order to stem the epidemic of overweight and obesity among children and adolescents in these countries. Uptake of such interventions is likely to be high as there is high penetrance of mobile phone technology amongst adolescents, even within poor communities in Africa.
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Affiliation(s)
- Priscilla Reddy
- Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa.,Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | - Natisha Dukhi
- Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - Ronel Sewpaul
- Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | | | - Nilen Sunder Kambaran
- Analytics, Retirement, Compensation and Health Actuarial Consulting, Westlake, Cape Town, South Africa
| | - William Jobe
- Department of Informatics, University West, Trollhättan, Sweden
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Concurrence of stunting and overweight/obesity among children: Evidence from Ethiopia. PLoS One 2021; 16:e0245456. [PMID: 33449970 PMCID: PMC7810347 DOI: 10.1371/journal.pone.0245456] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 01/02/2021] [Indexed: 12/11/2022] Open
Abstract
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.
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Navti LK, Foudjo BUS. 10-Year Changes in Adiposity in Cameroon School-Age Children: Evidence for Increasing Central Adiposity and Higher Adiposity Levels in Tallest-for-Age Children. J Obes 2021; 2021:6866911. [PMID: 34691777 PMCID: PMC8536440 DOI: 10.1155/2021/6866911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/04/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To examine changes in measures of adiposity and determine the prevalence of excess adiposity in relation to height in school children between 2010 and 2020. METHODS 5-12-year-old urban school-age children participated in two cross-sectional surveys in 2010 (n = 1274) and 2020 (n = 1550). Standard procedures were used for anthropometric measurements. Changes in BMI, waist circumference (WC), and waist-to-height ratio (WHtR) and the corresponding proportions of children with excess adiposity were analyzed and adjusted for design variables (class and school type) and age. Children were classified according to quartiles of height z-score and prevalence of excess adiposity estimated across each quartile. RESULTS There was a 2.4% and 3.3% increase in adjusted mean BMI and WC, respectively, between 2010 and 2020. The prevalence of central overweight/obesity (WC) and WHtR ≥ 0.5 increased by 7.3% (X 2 = 27.151, p < 0.001) and 5.3% (X 2 = 26.117, p < 0.001), respectively, between the two surveys except BMI overweight/obesity. The odds of excess adiposity significantly increased in 2020 for central overweight/obesity (WC) (OR 2.8, 95% CI 2.0-3.6) and WHtR ≥ 0.5 (OR 1.8, 95% CI 1.3-2.4) and not for BMI overweight/obesity (OR 1.3, 95% CI 0.8-1.7). The prevalence of BMI overweight/obesity significantly increased from 33% in 2010 to 51.5% in 2020 in the fourth quartile of height z-score (X 2 = 19.198, p < 0.001). Similarly, the prevalence of central overweight/obesity (WC) significantly increased from 23.5% in 2010 to 42.4% in 2020 in the fourth quartile of height z-score (X 2 = 18.733, p < 0.001). CONCLUSION Central overweight/obesity has increased more than BMI overweight/obesity over the last decade. Children with a higher height-for-age tend to accumulate more adiposity. Objective monitoring of adiposity levels and height of children is needed in future to identify groups for targeted intervention and prevention of chronic diseases.
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Affiliation(s)
- Lifoter K. Navti
- Department of Biochemistry, The University of Bamenda, P.O. Box 39,Bambili, Bamenda, Cameroon
- Department of Biochemistry, Catholic University of Cameroon (CATUC), Bamenda P.O. Box 782, Bamenda, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
| | - Brice U. S. Foudjo
- Department of Biochemistry, The University of Bamenda, P.O. Box 39,Bambili, Bamenda, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
- Association Sahelienne de Recherche Appliquee Pour le Developpement Durable (ASRADO), P.O. Box 2449, Djamena, Chad
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Danquah FI, Ansu-Mensah M, Bawontuo V, Yeboah M, Kuupiel D. Prevalence, incidence, and trends of childhood overweight/obesity in Sub-Saharan Africa: a systematic scoping review. ACTA ACUST UNITED AC 2020; 78:109. [PMID: 33292679 PMCID: PMC7599109 DOI: 10.1186/s13690-020-00491-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/20/2020] [Indexed: 02/08/2023]
Abstract
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.
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Affiliation(s)
- Frederick Inkum Danquah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Monica Ansu-Mensah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Vitalis Bawontuo
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana.,Research for Sustainable Development Consult, Sunyani, Ghana
| | - Matilda Yeboah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Desmond Kuupiel
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana. .,Research for Sustainable Development Consult, Sunyani, Ghana. .,Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001, South Africa.
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Danquah FI, Ansu-Mensah M, Bawontuo V, Yeboah M, Udoh RH, Tahiru M, Kuupiel D. Risk factors and morbidities associated with childhood obesity in sub-Saharan Africa: a systematic scoping review. BMC Nutr 2020; 6:37. [PMID: 32884829 PMCID: PMC7460801 DOI: 10.1186/s40795-020-00364-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/24/2020] [Indexed: 12/25/2022] Open
Abstract
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.
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Affiliation(s)
- Frederick Inkum Danquah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Monica Ansu-Mensah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Vitalis Bawontuo
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
- Research for Sustainable Development Consult, Sunyani, Ghana
| | - Matilda Yeboah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Roseline H. Udoh
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Mohammed Tahiru
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Desmond Kuupiel
- Research for Sustainable Development Consult, Sunyani, Ghana
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Durban, 4001 South Africa
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Haile D, Luo H, Vosti SA, Dodd KW, Arnold CD, Engle-Stone R. Micronutrient Fortification of Commercially Available Biscuits Is Predicted to Have Minimal Impact on Prevalence of Inadequate Micronutrient Intakes: Modeling of National Dietary Data From Cameroon. Curr Dev Nutr 2020; 4:nzaa132. [PMID: 32908959 PMCID: PMC7467246 DOI: 10.1093/cdn/nzaa132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Voluntarily fortified snack products are increasingly available but are not necessarily formulated to meet known dietary nutrient gaps, so potential impacts on population micronutrient intake adequacy are uncertain. OBJECTIVES We modeled the impacts of hypothetical micronutrient-fortified biscuits on inadequate micronutrient intake in children and women of reproductive age (WRA) in Cameroon. METHODS In a nationally representative survey stratified by macro-region (North, South, and Yaoundé/Douala), 24-h dietary recall data were collected from 883 children aged 12-59 mo and from 912 WRA. We estimated usual nutrient intake by the National Cancer Institute method for vitamin A, folate, vitamin B-12, zinc, and iron. We simulated the impact of biscuit fortification on prevalence of micronutrient intake below the estimated average requirement, given observed biscuit consumption, in the presence and absence of large-scale food fortification (LSFF) programs. RESULTS Biscuit consumption in the prior 24-h by children and WRA, respectively, ranged from 4.5% and 1.5% in the South, to 20.7% and 5.9% in Yaoundé/Douala. In the absence of LSFF programs, biscuits fortified with retinol (600 μg/100 g), folic acid (300 μg/100 g), and zinc (8 mg/100 g) were predicted to reduce the prevalence of inadequacy among children by 10.3 ± 4.4, 13.2 ± 4.2, and 12.0 ± 6.1 percentage points, respectively, in Yaoundé/Douala. However, when existing vitamin A-fortified oil, and folic acid-fortified and zinc-fortified wheat flour programs were considered, the additional impacts of fortified biscuits were reduced substantially. Micronutrient-fortified biscuits were predicted to have minimal impact on dietary inadequacy in WRA, with or without LSFF programs. CONCLUSIONS Given observed patterns of biscuit consumption in Cameroon, biscuit fortification is unlikely to reduce dietary inadequacy of studied micronutrients, except possibly for selected nutrients in children in urban areas in the absence of LSFF programs. As voluntary fortification becomes increasingly common, modeling studies could help guide efforts to ensure that fortified products align with public health goals.
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Affiliation(s)
- Demewoz Haile
- Department of Nutrition, University of California, Davis, CA, USA
- Institute for Global Nutrition, University of California, Davis, CA, USA
| | - Hanqi Luo
- Department of Nutrition, University of California, Davis, CA, USA
- Institute for Global Nutrition, University of California, Davis, CA, USA
| | - Stephen A Vosti
- Department of Agricultural and Resource Economics, University of California, Davis, CA, USA
| | - Kevin W Dodd
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles D Arnold
- Institute for Global Nutrition, University of California, Davis, CA, USA
| | - Reina Engle-Stone
- Department of Nutrition, University of California, Davis, CA, USA
- Institute for Global Nutrition, University of California, Davis, CA, USA
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Breastfeeding Practices and Overweight/Obesity Among Children Under 5 Years of Age: A Multistage Random Sampling Survey in Central and Western China. Matern Child Health J 2020; 24:998-1007. [PMID: 32356132 DOI: 10.1007/s10995-020-02945-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To describe the prevalence of overweight and obesity among children under 5 years old, assess the indicators of breastfeeding practices, and explore the associations between breastfeeding practices and early childhood overweight/obesity. METHODS The survey was conducted in 20 counties in central and western China in 2016. All children under 5 years old were physically measured for anthropometric data and their breastfeeding practices were obtained through a face-to-face questionnaire interview. We performed logistic regressions to assess the associations of different breastfeeding practices with overweight/obesity. RESULTS The prevalence of overweight and obesity among children under 5 years old were 8.7% and 2.6%, respectively. Overall, 93.6% of children were breastfed, while only 20.7% had exclusive breastfeeding under 6 months of age and about half of the children under 5 years old were weaned at 12 months. Compared with children with a duration of breastfeeding ≥ 12 months, children who have been breastfed for < 6 months were significantly associated with a 97% increased risk of overweight/obesity (OR 1.97, 95% CI 1.34-2.88, P = 0.001). CONCLUSIONS FOR PRACTICE The present study showed that overweight and obesity among children under 5 years old in central and western China remained an important childhood health concern. The rates of most indicators of breastfeeding practices were low, which needed more public attention. Moreover, we found that a shorter duration of breastfeeding was associated with an increased risk of overweight/obesity among children in central and western China.
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Choukem SP, Tochie JN, Sibetcheu AT, Nansseu JR, Hamilton-Shield JP. Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2020; 2020:6. [PMID: 32211050 PMCID: PMC7092532 DOI: 10.1186/s13633-020-0076-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 02/13/2020] [Indexed: 01/19/2023]
Abstract
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.
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Affiliation(s)
- Simeon-Pierre Choukem
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Diabetes and Endocrine Unit, Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Joel Noutakdie Tochie
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Aurelie T. Sibetcheu
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Jobert Richie Nansseu
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaoundé, Cameroon
| | - Julian P. Hamilton-Shield
- Bristol Biomedical Research Centre (Nutrition Theme), University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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Trends in the prevalence of overweight among Bangladeshi children aged 24-59 months (2004-2014) by sex and socioeconomic status. Int J Obes (Lond) 2019; 44:664-674. [PMID: 31848457 DOI: 10.1038/s41366-019-0507-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/07/2019] [Accepted: 12/01/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND While recent evidence suggests that the overall prevalence of overweight in young children in Bangladesh is low, little is known about variation in trends by sex, socioeconomic status, urbanicity, and region. We investigated the trends in overweight among children aged 24-59 months by these factors, using nationally representative samples from Bangladesh Demographic and Health Surveys (BDHS) between 2004 and 2014. METHODS Data from four BDHS surveys conducted between 2004 and 2014, with valid height and weight measurements of children, were included in this study (n = 15,648). BMI was calculated and the prevalence of overweight (including obesity) was reported using the International Obesity Taskforce (IOTF) classification system. To explore the association between socioeconomic status and childhood overweight, we used multivariable logistic regression. RESULTS The overall prevalence of overweight among children aged 24-59 months increased from 1.60% (95% CI: 1.20-2.05%) in 2004 to 2.33% (95% CI: 1.82-2.76%) in 2014. Among girls, the overweight trend increased significantly (adjusted odds ratio (OR) comparing 2014 vs. 2004: 2.02 95% CI: 1.52-2.68), whereas among boys the trend remained steady. When compared with households with the poorest wealth index, households with richest wealth index had higher odds of childhood overweight among both boys (OR 2.39, 95% CI: 1.76-3.25) and girls (OR 1.86, 95% CI: 1.35-2.55). Higher household education level was also associated with childhood overweight. Subgroup analyses showed that relative inequalities by these factors increased between 2004 and 2014 when adjusted for potential confounders. CONCLUSIONS There is a rising trend in overweight prevalence exclusively among girls aged 24-59 months in Bangladesh. Childhood overweight is associated with higher household education and wealth index, and the relative disparity by these factors appears to be increasing over time. These unmet inequalities should be considered while developing national public health programs and strategies.
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Danquah FI, Yeboah M, Bawontuo V, Kuupiel D. Mapping evidence on the burden and distribution of childhood obesity in sub-Saharan Africa: a scoping review protocol. Syst Rev 2019; 8:274. [PMID: 31722737 PMCID: PMC6868500 DOI: 10.1186/s13643-019-1189-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/07/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Obesity in childhood is associated with adverse health outcomes and complications throughout the life-span of a child. Available evidence suggests a dramatic increase in childhood obesity in sub-Saharan Africa (SSA) over the past two decades. The health risks associated with obesity/overweight are particularly problematic in children due to the potential for long-term health concerns. The researchers propose to conduct a systematic scoping review to map evidence on the burden and distribution of childhood obesity in SSA. METHODS The study will be guided by the scoping review framework proposed by Arksey and O'Malley. A comprehensive literature search will be performed in the following electronic databases: PubMed, Web of Science, African Index Medicus, and CINAHL with full text via EBSCOhost platform. Primary studies both published in peer-reviewed journals and gray literature such as unpublished studies, thesis, and studies in press addressing the research topic will be included. One reviewer will conduct title screening, and the results will be exported to Mendeley Desktop library. Two independent reviewers will perform both abstract and full article screening in parallel as well as data extraction from eligible studies. The Preferred Reporting Items for Systematic Reviews and Meta-analysis: Extension for Scoping Review (PRISMA-ScR) will be utilized to present the study findings of the proposed scoping review. NVivo version 11.0 will be used to extract the relevant outcomes from the included studies, a content thematic analysis performed, and the results reported using a narrative approach. The Mixed Method Quality Appraisal Tool Version 2018 will be used to assess the methodological quality of all included studies. DISCUSSION We anticipate that the proposed study will contribute to the existing body of knowledge on childhood obesity, identify gaps in knowledge on the topic, inform future research direction, and provide evidence-based information to strengthen health systems and policies on childhood obesity towards achieving the WHO global target of halting the rise in obesity by 2025.
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Affiliation(s)
- Frederick I. Danquah
- Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Matilda Yeboah
- Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Vitalis Bawontuo
- Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
- Research for Sustainable Development Consult, Sunyani, Ghana
| | - Desmond Kuupiel
- Research for Sustainable Development Consult, Sunyani, Ghana
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Weldearegay HG, Gebrehiwot TG, Abrha MW, Mulugeta A. Overweight and obesity among children under five in Ethiopia: further analysis of 2016 national demographic health survey: a case control study. BMC Res Notes 2019; 12:716. [PMID: 31672167 PMCID: PMC6822342 DOI: 10.1186/s13104-019-4752-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/18/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE The objective of this study was to assess the determinants of overweight and obesity among children under 5 years in Ethiopia. RESULTS Data from a total of 672 (224 cases and 448 controls) under 5 years of age children were included in the study. Urban residence (AOR = 2.63, 95% CI 1.29, 5.34), boys (AOR = 1.56, 95% CI 1.10, 2.22) and age of the child less than 6 months (AOR = 3.40, 95% CI 2.05, 5.64) were the determinants for being childhood overweight and obesity.
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Affiliation(s)
| | | | | | - Afework Mulugeta
- College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Sampling strategies for species with high breeding-site fidelity: A case study in burrow-nesting seabirds. PLoS One 2019; 14:e0221625. [PMID: 31454375 PMCID: PMC6711508 DOI: 10.1371/journal.pone.0221625] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 08/12/2019] [Indexed: 11/19/2022] Open
Abstract
Sampling approaches used to census and monitor populations of flora and fauna are diverse, ranging from simple random sampling to complex hierarchal stratified designs. Usually the approach taken is determined by the spatial and temporal distribution of the study population, along with other characteristics of the focal species. Long-term monitoring programs used to assess seabird population trends are facilitated by their high site fidelity, but are often hampered by large and difficult to access colonies, with highly variable densities that require intensive survey. We aimed to determine the sampling effort required to (a) estimate population size with a high degree of confidence, and (b) detect different scenarios of population change in a regionally important species in the Atlantic, the Manx shearwater (Puffinus puffinus). Analyses were carried out using data collected from tape-playback surveys on four islands in the North Atlantic. To explore how sampling effort influenced confidence around abundance estimates, we used the heuristic approach of imagining the areas sampled represented the total population, and bootstrapped varying proportions of subsamples. This revealed that abundance estimates vary dramatically when less than half of all plots (n dependent on the size of the site) is randomly subsampled, leading to an unacceptable lack of confidence in population estimates. Confidence is substantially improved using a multi-stage stratified approach based on previous information on distribution in the colonies. In reality, this could lead to reducing the number of plots required by up to 80%. Furthermore, power analyses suggested that random selection of monitoring plots using a matched pairs approach generates little power to detect overall population changes of 10%, and density-dependent changes as large as 50%, because variation in density between plots is so high. Current monitoring programs have a high probability of failing to detect population-level changes due to inappropriate sampling efforts. Focusing sampling in areas of high density with low plot to plot variance dramatically increases the power to detect year to year population change, albeit at the risk of not detecting increases in low density areas, which may be an unavoidable strategy when resources are limited. We discuss how challenging populations with similar features to seabirds might be censused and monitored most effectively.
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Zhou J, Zeng L, Wang D, Li C, Liu Y, Yan H, Xiao Y. Effects of birth weight on body composition and overweight/obesity at early school age. Clin Nutr 2019; 39:1778-1784. [PMID: 31395416 DOI: 10.1016/j.clnu.2019.07.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/11/2019] [Accepted: 07/19/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The prevalence of childhood obesity has increased substantially. We aimed to characterize the effect of birth weight on body composition and overweight/obesity at early school age. STUDY DESIGN A total of 1669 children with available birth records from a double-blind cluster-randomized controlled trial exploring micronutrient supplementation during pregnancy were included. Data regarding school-aged body composition, social-demographic factors and health behaviours were prospectively collected. RESULT s: The study population consisted of 1004 boys and 665 girls aged between 7 and 10 years. The prevalence of overweight/obesity (>85th age-sex-specific percentiles) was 7.4% for boys and 5.0% for girls. Generalized estimating equation models were used to account for the cluster nature of the data. A significant upward trend across quintiles of birth weight was observed for fat mass index (boys: P for trend 0.002; girls: P for trend <0.001), fat-free mass index (boys: P for trend <0.001; girls: P for trend <0.001), and percentage of body fat (boys: P for trend 0.003; girls: P for trend <0.001). A birth weight in the higher three quintiles could increase the risk ratios [RRs (95% CI) third quintile: 2.88, (1.13, 7.32); fourth quintile: 2.40, (0.87, 6.66); top quintile: 2.31, (0.92, 5.80)] of overweight/obesity at early school age compared with the RRs of the reference group (the second quintile of birth weight) among boys. CONCLUSIONS Higher birth weight could increase the risk of being overweight/obese among 7- to 10-year-old boys in rural western China. Sex differences in this association need to be considered when planning interventions. RESEARCH REGISTRATION This trial was registered at www.isrctn.com with the identifier ISRCTN08850194.
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Affiliation(s)
- Jing Zhou
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Duolao Wang
- Department of Clinic Science, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Chao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Yuesheng Liu
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China; Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi, PR China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Yanfeng Xiao
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.
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Ntenda PAM, Mhone TG, Nkoka O. High Maternal Body Mass Index Is Associated with an Early-Onset of Overweight/Obesity in Pre-School-Aged Children in Malawi. A Multilevel Analysis of the 2015-16 Malawi Demographic and Health Survey. J Trop Pediatr 2019; 65:147-159. [PMID: 29800293 DOI: 10.1093/tropej/fmy028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Overweight/obesity in young children is one of the most serious public health issues globally. We examined whether individual- and community-level maternal nutritional status is associated with an early onset of overweight/obesity in pre-school-aged children in Malawi. DESIGN Data were obtained from the 2015-16 Malawi Demographic and Health Survey (MDHS). The maternal nutritional status as body mass index and childhood overweight/obesity status was assessed by using the World Health Organization (WHO) recommendations. To examine whether the maternal nutritional status is associated with overweight/obesity in pre-school-aged children, two-level multilevel logistic regression models were constructed on 4023 children of age less than five years dwelling in 850 different communities. RESULTS The multilevel regression analysis showed that children born to overweight/obese mothers had increased odds of being overweight/obese [adjusted odds ratio (aOR) = 3.11; 95% confidence interval (CI): 1.13-8.54]. At the community level, children born to mothers from the middle (aOR: 1.68; 95% CI: 1.02-2.78) and high (aOR: 1.69; 95% CI: 1.00-2.90) percentage of overweight/obese women had increased odds of being overweight/obese. In addition, there were significant variations in the odds of childhood overweight/obesity in the communities. CONCLUSIONS Strategies aimed at reducing childhood overweight/obesity in Malawi should address not only women and their children but also their communities. Appropriate choices of nutrition, diet and physical activity patterns should be emphasized upon in overweight/obese women of childbearing age throughout pregnancy and beyond.
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Affiliation(s)
- Peter Austin Morton Ntenda
- School of Public Health, College of Public Health, Taipei Medical University, No. 250, Wu-Hsing St, Taipei City, Taiwan
| | - Thomas Gabriel Mhone
- Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, No. 100, Shiquan 1st Road, Sanmin District, Kaohsiung City, Taiwan
| | - Owen Nkoka
- School of Public Health, College of Public Health, Taipei Medical University, No. 250, Wu-Hsing St, Taipei City, Taiwan
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Influence of sexual maturation status on the relationship between body adiposity indicators and age: a cross-sectional study. BMC Res Notes 2019; 12:61. [PMID: 30683149 PMCID: PMC6347827 DOI: 10.1186/s13104-019-4095-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 01/16/2019] [Indexed: 11/10/2022] Open
Abstract
Objectives To determine the influence of sexual maturation status on adiposity indicators of children and adolescents. Results 2412 individuals participated, 1285 (47.4%) males and 1408 (52.6%) females. There was moderate to weak correlation between age and adiposity indicators for both sexes. By analyzing the relationship between age and body fat indexes adjusted for Sexual Maturation Status, several changes were observed, mainly in girls. Precocious maturation was associated with increased adiposity indicators in girls, whereas late maturation was associated with decreased adiposity indicators in both sexes. Precocious maturation was associated with increased adiposity indicators in girls, whereas late maturation was associated with decreased adiposity indicators in both sexes. Electronic supplementary material The online version of this article (10.1186/s13104-019-4095-5) contains supplementary material, which is available to authorized users.
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Nejadsadeghi E, Shojaeizadeh D, Sadeghi R, Majlesi F, Djazayeri A, Yekaninejad MS, Amanat M. Demographic determinants of obesity, and adherence to dietary and physical activity guidelines among 4 to 6-year-old children in Behbahan city, southwest Iran, 2016. Electron Physician 2018; 10:6554-6562. [PMID: 29765582 PMCID: PMC5942578 DOI: 10.19082/6554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/28/2017] [Indexed: 12/15/2022] Open
Abstract
Background and aim The world is experiencing an alarming increase in prevalence of childhood obesity. The aim of this study was to determine the demographic determinants of obesity and adherence to dietary and physical activity guidelines among children aged 4 to 6 years old in Behbahan city, southwest Iran, in 2016. Methods This cross-sectional study was conducted on 120 preschool children aged 4 to 6 years old in Behbahan city, southwest Iran, in 2016. Multi-stage random sampling was done. The weight and height of the children were measured with standard methods. The demographic and behavioral factors data were collected in self report questionnaires which were completed by the children’s mothers. The Chi-square test, Independent-samples t-tests, One-way analysis of variances and logistic regression analysis were used for data analysis. SPSS software (version 22) was employed. Results This study showed that 88.3% of the children did not meet the guideline of 5 servings per day of fruit and vegetables. Only 2.5% met the guideline of 60 minutes of structured physical activity every day. Sex and mother’s occupation status were associated with adhering to screen time guideline. This study found a significant difference in the mean of screen time between sexes. Boys were more likely to meet the screen time guideline. A significant association between adhering to physical activity guidelines and mother’s occupation status was revealed. Significant statistical relationship between demographic factors and BMI categories was not illustrated. Demographic covariates were not significantly related to adherence to dietary and physical activity guidelines. Conclusion In preventive programs of obesity among 4 to 6-year-old children key lifestyle behaviors and demographic factors need to be considered.
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Affiliation(s)
- Elham Nejadsadeghi
- Ph.D. Student of Health Education and Promotion, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davood Shojaeizadeh
- Ph.D. of Health Education and Promotion, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Ph.D. of Health Education and Promotion, Associate Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Majlesi
- Ph.D. of Maternal and Child Health, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolghassem Djazayeri
- Ph.D. of Nutrition, Professor, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Ph.D. of Biostatistics, Assistant Professor, Department of Biostatistics and epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Amanat
- M.Sc. Student of Psychometrics, Department of Assessment and Measurement, School of Psychology and Educational Sciences, Allameh Tabatabai University, Tehran, Iran
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Sorrie MB, Yesuf ME, GebreMichael TG. Overweight/Obesity and associated factors among preschool children in Gondar City, Northwest Ethiopia: A cross-sectional study. PLoS One 2017; 12:e0182511. [PMID: 28787013 PMCID: PMC5546603 DOI: 10.1371/journal.pone.0182511] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/12/2017] [Indexed: 11/25/2022] Open
Abstract
Background Overweight and obesity among children has emerged as one of the most serious public health concerns in the 21st century, which is a predictor of adulthood obesity, morbidity and mortality. The objective of this study was to assess the prevalence of overweight /obesity and associated factors among preschool children. Methods A community based cross-sectional study was conducted in Gondar City from February 14 to March 4, 2016. Multi stage sampling technique was used to select a total of 504 preschool children. Data were collected using structured interviewer administered questionnaire and anthropometric measurements. Data were entered using Epidata version 3.1 and analyzed using SPSS version 20 and WHO 2007 Anthro version 2.0.4 software. Both bivariate and multivariate logistic regression analysis were performed to identify associated factors. P values <0.05 with 95% confidence level were used to declare statistical significance. Results A total of 500 study participants were included with 99.2% response rate and 51.6% were girls while 48.4% were boys. The mean (±SD) age of participants was 47.68 ±7.19 months. The combined prevalence of overweight /obesity was 13.8% (95%CI; 10.6, 17.2) the specific being 9.6% for overweight and 4.2% for obesity. The multivariable analysis indicated that the age group between 36–47 months [AOR = 2.38 (95%CI; 1.27,4.46)],high dietary diversity[AOR = 3.73(95%CI;1.15,12.54),consumption of sweet food[AOR = 2.69 (95%CI,1.21, 5.98)],time spent in watching television>2hr/day [AOR = 4.01 (95%CI;2.22, 7.26)] and mother’s education at secondary level [AOR = 0.35 (95% CI; 0.12, 0.96)] were associated with overweight/obesity among preschool children. Conclusions Once considered a high income country problem, result of this study in urban city like Gondar reveals that overweight/obesity is on the rise in urban Ethiopia, which indicates the need for formulating preventive programs and policies during a child’s early years.
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Affiliation(s)
- Muluken Bekele Sorrie
- Arbaminch University College of Medicine and Health Sciences Department of Midwifery, Arbaminch, Ethiopia
| | - Melkie Edris Yesuf
- University of Gondar College of Medicine and Health Sciences Institute of Public Health, Gondar, Ethiopia
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Chi DL, Luu M, Chu F. A scoping review of epidemiologic risk factors for pediatric obesity: Implications for future childhood obesity and dental caries prevention research. J Public Health Dent 2017; 77 Suppl 1:S8-S31. [PMID: 28600842 DOI: 10.1111/jphd.12221] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/06/2017] [Indexed: 01/31/2023]
Abstract
RESEARCH QUESTIONS What are the non-modifiable (socioeconomic, genetic) and modifiable factors (physical activity, dietary behaviors) related to childhood (under age 12) obesity? How can this knowledge be applied to oral health professionals' efforts to prevent or manage dental caries in children? OBJECTIVES Studies have identified risk factors for childhood obesity. The purpose of this scoping review was to develop a conceptual model to identify non-modifiable and modifiable risk factors for childhood obesity and to illustrate how these findings are relevant in developing interventions aimed at preventing obesity and dental caries in children. METHODS The authors searched PubMed and Embase and limited the study to English-language publications. A total of 2,572 studies were identified. After de-duplication, 2,479 studies remained and were downloaded into a citation-management tool. Two authors screened the titles and abstracts for relevance. Two hundred and sixty studies remained and were retrieved for a full-text review, and 80 studies were excluded, resulting in 180 studies included in the scoping review. An inductive content analytic methods was used to organize all statistically significant obesity risk factors into seven domains, which were classified as non-modifiable or modifiable; then a conceptual model of common risk factors associated with childhood obesity and dental caries was developed. RESULTS Non-modifiable obesity risk factors include biological and developmental (e.g., genes, developmental conditions, puberty), sociodemographic and household (e.g., race/ethnicity, socioeconomic status, parent education, unemployment), cultural (e.g., degree of acculturation), and community (e.g., neighborhood composition). Modifiable risk factors included behavioral (e.g., diet, physical activity, weight), psychosocial (e.g., maternal stress, family functioning, parenting practices, child temperament), and medical (e.g., parent smoking, maternal health, child health). CONCLUSIONS Identifying common risk factors has important implications for future oral health research aimed at preventing childhood obesity and dental caries. Epidemiologic knowledge gleaned from the literature can be used to develop rigorous interventions and programs aimed at preventing these highly prevalent diseases and improving health outcomes for children.
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Affiliation(s)
- Donald L Chi
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Monique Luu
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Frances Chu
- Oral Health Sciences, University of Washington, Seattle, WA, USA
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Kondolot M, Poyrazoğlu S, Horoz D, Borlu A, Altunay C, Balcı E, Öztürk A, Mazıcıoğlu MM, Kurtoğlu S. Risk factors for overweight and obesity in children aged 2-6 years. J Pediatr Endocrinol Metab 2017; 30:499-505. [PMID: 28315857 DOI: 10.1515/jpem-2016-0358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 11/21/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Understanding risk factors that may vary culturally can help improve preventive strategies for obesity. This is the first cross-sectional study aimed to determine the risk factors for overweight/obesity in children aged 2-6 years in a central Anatolian city in Turkey. METHODS A total of 1582 children (1351 healthy, 231 overweight/obese) aged 2-6 years were included from the Anthropometry of Turkish Children aged 0-6 years database. Age, gender, birth weight, birth order, mother's age, mother's body mass index (BMI), weight gain of mothers during pregnancy, presence of gestational diabetes, breastfeeding duration, history of formula feeding, mother's and father's education, mother's job, monthly income, smoking at home and physical activity, sleep duration and duration of television (TV) watching of the children were evaluated as independent risk factors. Logistic regression analyses were performed to investigate risk factors for overweight/obesity. RESULTS Having a high family income compared to bad [odds ratio (OR)=1.96; 95% confidence interval (CI): 1.237-3.106], increased the time of watching TV during the weekend (OR=1.094; 95% CI: 1.032-1.159), and similar physical activity level according to their peers compared to less (OR=2.957; 95% CI: 1.056-8.282) were found to be significantly associated with a higher risk of overweight/obesity in children aged 2-6 years old. CONCLUSIONS The early childhood period seems to be important in the establishment of healthy behavioral patterns, especially limitation of TV watching and encouragement of physical activity. Obesogenic environment in families with high incomes need to be revealed.
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Affiliation(s)
- Meda Kondolot
- Department of Pediatrics, Social Pediatrics Unit, Erciyes University Faculty of Medicine, Kayseri
| | | | - Duygu Horoz
- The Head of Local Health Authority, Melikgazi, Kayseri
| | - Arda Borlu
- Department of Public Health, Erciyes University Faculty of Medicine, Kayseri
| | - Canan Altunay
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri
| | - Elcin Balcı
- Department of Public Health, Erciyes University Faculty of Medicine, Kayseri
| | - Ahmet Öztürk
- Department of Biostatistics, Erciyes University Faculty of Medicine, Kayseri
| | - Mümtaz M Mazıcıoğlu
- Department of Family Medicine, Erciyes University Faculty of Medicine, Kayseri
| | - Selim Kurtoğlu
- Department of Pediatric Endocrinology, Erciyes University Faculty of Medicine, Kayseri
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Aminde LN, Atem JA, Kengne AP, Dzudie A, Veerman JL. Body mass index-measured adiposity and population attributability of associated factors: a population-based study from Buea, Cameroon. BMC OBESITY 2017; 4:1. [PMID: 28078091 PMCID: PMC5219758 DOI: 10.1186/s40608-016-0139-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 12/19/2016] [Indexed: 12/21/2022]
Abstract
Background Obesity is currently a global health challenge driven by a mix of behavioural, environmental and genetic factors. Up to date population-based disease burden estimates are needed to guide successful prevention and control efforts in African countries. We investigated the prevalence and population attributable fractions of overweight and obesity in Buea, the Southwest region of Cameroon. Methods Data are from a community-based cross-sectional study involving randomly selected adults conducted in 2016. Body mass index (BMI) was categorized according to the WHO classification. Multivariable logistic regressions were used to investigate factors independently associated with obesity. Corresponding population attributable fractions were estimated. Results Among the 1,139 participants, age-standardized prevalence (95% CI) of overweight and obesity were; 36.5 (33.7–39.3) and 11.1 (9.3–12.9) percent respectively. Mean BMI was 25.3 ± 4.3 kg/m2; women were heavier than men (25.8 vs. 24.4 kg/m2; p <0.0001). Factors associated with obesity were; female gender [odds ratio 3.20 (95% CI: 1.93–5.59)], age > 31 years [3.21 (1.86–5.28)] and being married [2.10 (1.60–3.51)]. At the population level; older age, being married, low level of education, high monthly income and physical inactivity accounted respectively for 11.9%, 21.8%, 11.6%, 6.4% and 8.7% of overweight and obesity among the women, while older age and being married explained 9.2% and 28.3% of overweight and obesity in men. Conclusion The prevalence of overweight and obesity in this semi-urban Cameroonian population is high, affecting over a third of individuals. Community-based interventions to control weight would need to take into account gender specificities and socio-economic status.
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Affiliation(s)
- Leopold Ndemnge Aminde
- The University of Queensland, School of Public Health, Herston, QLD 4006 Australia ; Non-communicable Diseases Unit, Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon
| | - Jeannine A Atem
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Andre Pascal Kengne
- Non-communicable Diseases Unit, Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon ; South African Medical Research Council and University of Cape Town, Cape Town, South Africa
| | - Anastase Dzudie
- Non-communicable Diseases Unit, Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon ; Faculty of Health Sciences, University of Buea, Buea, Cameroon ; Department of Medicine, Douala General Hospital and Faculty of Medicine & Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - J Lennert Veerman
- The University of Queensland, School of Public Health, Herston, QLD 4006 Australia
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