ABSTRACT
Adolescent obesity isslowly
emerging as a serious public health problem. This is due to the strong
relationship with adult obesity and its related health problems. It has been
established that adolescent obesity is significantly associated with depression,
anxiety, low self-esteem and peer rejection.Despite the high level of
information and knowledge of obesity among secondary school adolescents, there
is still an increase in the prevalence of obesity among them. Studies have
shown that there is a continuous rise in the prevalence of obesity in developed
and developing countries. This informed the objective of this study which is to
assess the socio-ecological factors predicting obesity among senior secondary
school students.
This research was a cross sectional
survey which was carried out among selected secondary schools in Ado Local
Government in Ado-Ekiti, Ekiti State. Random sampling was used to select 4
senior secondary schools where 387 students between the ages of 10-19 years
were selected. A self-structured
questionnaire was used to collect data. Body Mass Index was measured with a
weighing scale and stadiometer. The data collected were analysed using
Statistical Package for Social Science (SPSS) version 21 with levels of
significance set at 0.05.
There were 205 (53%) female and 182
(47%) male participants between the ages 10 and 19 years.The results revealed
that the prevalence of obesity among the respondents was 2.84% which simply
means that out of every 10 students, 3 is obese. Findingsalso revealed that the
average physical activities among respondents does not have any significant relationship
with their low level of prevalence of obesity. It was found that there was no
significant relationship between school environment and intrapersonal factors
predicting obesity of respondents (Correlate = -0.58; P = 0.253) while a
significant relationship was established between Intrapersonal factors and
Interpersonal factors affecting obesity (Correlate = 0.249; R Square = 0.062; P < 0.05) and a significant
relationship between Interpersonal factors and school environment factors
affecting obesity (Correlate = 0.204; R Square = 0.042; P < 0.05).
This study revealed that sedentary
behaviour, increased intake of junks and physical inactivity were predisposing
factors to obesity. Indicating presence of these factors may subsequently lead
to high incidence rate of obesity. Based on the findings, control of access to
unhealthy food, assess to healthy food, health education on obesity and
mandatory time for physical activities should be paid more attention.
CHAPTER ONE
INTRODUCTION
1.1
Background to the Study
Obesity is the result of long-term
energy imbalances in which daily energy intake exceeds daily energy
expenditure. Energy balance is modulated by a myriad of factors, including
metabolic rate, appetite, diet, and physical activity. In some instances,
endocrine problems, genetic syndromes, and medications can be associated with
excessive weight gain (Ogden, Flegal, Carroll & Johnson, 2002). Over 2.8
million people die annually due to overweight or obesity. A global estimate of
2.3% (35.8 million) DALYs (Disability Adjusted Life Year) is as a result of
being overweight and obese (WHO, 2015).
In Nigeria, the prevalence of overweight
individuals ranged from 20.3%–35.1%, while the prevalence of obesity ranged
from 8.1%–22.2% (Chukwuonye,Chuku,
John,Ohagwu,Imoh, Isa et al 2013). According to WHO (2014), it
was projected that chronic diseases account for 24% of all deaths in Nigeria
with cardiovascular disease accounting for 7% of this. Globally, the prevalence
of overweight and obesity among children and adolescents has significantly
increased over the last three decades particularly in Africa, Eastern
Mediterranean Region (EMR) and Asia (Gupta, Goel, Shah & Misra, 2012). It
has been recorded in Sagamu, Ogun State (south western Nigeria) that there is a
prevalence of overweight of 8.1% in males and 8.1% in females. It further
showed a low prevalence of obesity of 2.7% in males and 1.9% in females
(Akinpelu, Oyewole & Oritogun, 2008).
World Health Organization defined
overweight and obesity as abnormal or excessive accumulation of fat that may
impair health (WHO, 2014). The pandemic of obesity and overweight has engulfed
children and adolescents. It is estimated that 200 million school-aged children
worldwide are overweight, of which 40-50 million are obese (WHO, 2014).
Today it is estimated that over 250
million people in low and middle income countries suffer from obesity, but
globally more than one billion are overweight and 300 million are obese
(Sabageh & Ojofeitimi, 2013). Once considered a high-income country
problem, overweight and obesity are now on the rise in low and middle income countries
particularly in urban settings (WHO, 2014).
Overweight and obesity have been
recognized as one of the public health concern of the 21st century
by World Health Organization (WHO, 2015). In the last few decades, the cause of
death especially in the developing country like Nigeria has gradually been
shifting from the infectious diseases to Non Communicable Diseases (NCDs) that
were strongly attributed to overweight and obesity (Hallström, Labayen, Ruiz, Patterson, Vereecken &
Breidenassel, 2013).
Overweight and obesity are
nutritional disorders emanating from calorie imbalances. These disorders
develop when calorie consumption surpasses calorie expenditure, and the excess
calorie gradually accumulates which later results into abnormal weight gain
(Mokdad, Ford & Bowman, 2003).In Sub- Saharan Africa, there is an evidence
of transition to obesity in adolescents despite historically known food
shortages (Muthuri, Francis, Wachira, LeBlanc, Sampson, Onywera et al., 2014). These obese adolescents
are likely to stay obese into adulthood and are more likely to develop
non-communicable diseases (WHO, 2014).
Obesity is a major risk factor for
non-communicable diseases such as cardiovascular diseases, diabetes,
musculoskeletal disorders and cancers of breast, endometrial and colon. Obesity has played an important role in
causing “double burden” of diseases that developing countries are now
facing (WHO, 2014).
Due to increased dietary changes,
reduction in physical activity and increased obesity, it is estimated that the
prevalence of diabetes will triple within the next 25 years (Swift, Glazebrook
& Macdonald, 2006). Both obesity and type 2 diabetes are major public
health problems throughout the world and are associated with significant
potentially life-threatening co-morbidities and enormous economic costs.
Obesity represents a serious threat to health through its association with
conditions such as type 2 diabetes mellitus, coronary heart disease and certain
types of cancers (Gordon, 2001). The increase in the prevalence of diabetes
parallels that of obesity and both are emerging pandemics in the 21st century.
Some experts call this dual epidemic “diabesity”.
People who are obese more than 20% over their ideal body weight for their
height, have insulin resistance and are at particularly high risk of developing
type 2 diabetes and its related medical problems (Yaturu, 2011).
Urbanization, modernization,
sedentary lifestyle, consumption of oily and junk foods, and other lifestyle
changes have contributed to overweight and obesity. Leaving aside the adult
community, today, more and more adolescents are being diagnosed with diabetes,
hypertension, and other comorbid conditions that are associated with obesity
(Brahmbhatt & Oza, 2012). In adolescents, obesity is slowly emerging as a
main public health issue in many developing countries. Adolescence is a pivotal
period of life, where major physiological and psychological changes take place,
which would transform into adult behaviour and health status. Adolescence is
the period of crucial growth. During this phase physical changes including
growth, the onset of menarche for the girls, and increase in fat and muscle
mass takes place. This contributes to
obesity.
Leisure pursuits are suspected as
major contributors to rising levels of obesity (WHO, 2004). The frequency of
consumption of energy dense snacks and sugary beverages has increased
considerably particularly among the adolescent students in urban areas and in
private schools. Also physical inactivity which has been observed to increase
among the adolescents due to the use of varieties of electronic devices that
keep them busy during the day and awake
throughout the night (Mar Bibiloni, Pich, Córdova, Pons & Tur,
2012).
It has been established through
several studies that overweight and obesity caused high morbidity and mortality
among different age groups (Wang, Jahns, Tussing-Humphreys, Xie, Rockett, Liang
et al., 2010). Adolescents who are
overweight could experience conditions like depression, anxiety, low
self-esteem and peer rejection. (Aounallah-Skhiri, El Ati, Traissac,
Romdhane, Eymard-Duvernay, Delpeuch et al.,
2012).
1.2 Statement of the Problem
The dietary transition recently
going on in Africa is contributing greatly to high mortality and morbidity
attributed to overweight and obesity (Smpokos, Linardakis, Sarri,Papadaki,
Theodorou & Kafatos, 2013). It has exposed a lot of Africans to a new
lifestyle, a lot of things are done which pose a threat to lives such as poor
diet, lack of physical activities, spending too much time watching the
television, intake of energy drinks and soda. Adolescents adopt this new
lifestyle and engage in intake of junks which has been referred to as fast
food, intake of energy drinks as much as they can get, intake of alcohol,
sedentary lifestyles such as spending hours watching the television. These
contribute a great deal to the amount of calories gained, and the accumulation
of these overtime leads to weight gain that cannot be controlled due to the
consistent intake of these foods (Mozaffarian, Hao, Rimm, Willett & Hu,
2011).
Studies have revealed sedentary
behaviour, increased intake of junks and physical inactivity to be predisposing
factors to obesity. Indicating presence of these factors may subsequently lead
to high incidence rate of obesity. In a study carried out by Mustapha and
Sanusi (2013) in Ondo state showed that about 5.76% adolescents were overweight
while 1.13% were obese which may be regarded as low compared to other developed
countries.
Obesity has become a major problem
of adolescents and this has been associated with adulthood. Despite the high
level of information and knowledge of obesity as evident in researches carried
out by Marta, Magdalena, Aleksandra, Sylwia, Lukasz, Tomasz et al., (2014), there is still an
increase in the prevalence of obesity among secondary school adolescents as a
result of the research carried out by Jaja & Alex, 2016. This indicates
that there are other factors which might be responsible for the increase in the
prevalence of obesity especially social factors including knowledge, attitude,
and behaviour related to diet, exercise, nutrition, and overall health in
addition to age, race, and gender (Sarrafzadegan, Rabeje, Nouri, Mohammadifaed,
Moatter, Roohafza et al., 2013).
Literature have been showing incoherent data
about the prevalence of obesity among adolescents. No literature has yet been
released on the prevalence of obesity among adolescents in Ekiti and also the
presence of the factors preceding obesity among adolescents has not been
documented which this study intends to explore.
1.3 Objective of the Study
The
general objective of this study is to assess the socio-ecological factors
predicting obesity among senior secondary school students in Ado-Ekiti, Ekiti
state, Nigeria.
The specific objectives are to:
- identify
the prevalence of obesity among respondents;
- determine
the influence of intrapersonal factors on prevalence of obesity among
respondents;
- assess
the influence of interpersonal factors on prevalence of obesity among
respondents and
- find out the influence of school environment on the respondents.
1.4 Research Questions
- At
what level is the prevalence of obesity among respondents?
- How
does intrapersonal factors influence the prevalence of obesity among
respondents?
- To
what extent does interpersonal factors influence the prevalence of obesity
among respondents?
- What is the level of the influence of school environment on the respondents?
1.5 Justification for the Study
Obesity is a condition resulting in
undesirable metabolic changes and elevate the risk of non-communicable diseases
(Brahmbhatt & Oza, 2012). There has been an increase in the prevalence of
obesity which constantly leads to the increase of cardiovascular diseases such
as high blood pressure, diabetes etc. This study will contribute to the
existing knowledge of obesity and it will help to reduce the prevalence of
these diseases.
The presence and increase in the
documented identified factors poses a higher risk of prevalence of obesity over
a subsequent period of time. This is why this study is of great importance, not
only in diagnosing the prevalence of obesity but also in identifying the
presence of predisposing factors predicting possible increase in the prevalence
of obesity.
This study will change the
perception of adolescents about the consumption of junks and encourage a higher
intake of fruits and vegetables and also promote physical activity. It will add
to the existing knowledge. If these factors are present among adolescents of
the randomly selected schools, it will be a gateway to the development of
intervention towards the prevention and control of obesity among population
with similar characteristics.
1.6 Hypotheses
H1: There is a significant
difference in obesity across demographic factors.
H2: There is a significant
relationship between intrapersonal factors and obesity.
H3:
There is a significant relationship between interpersonal factors and obesity.
H4: There is a significant
relationship between school environment and obesity.
H5: There is a significant
relationship between physical inactivity and obesity.
H6: There is a significant relationship between school
environment and intrapersonal factors predicting obesity.
Operational
Definition of Terms
Obesity: In
the context of this study, obesity is defined as an excess proportion of total
body fat. A person is considered obese when his or her weight is 20% or more
above the normal weight. The most common measure of obesity is the body mass
index. A person is considered overweight if his or her BMI is between 25 and
29.9, a person is considered obese if his or her BMI is above 30.
Adolescent: A
term referring to a boy or girl who is in the developmental stage of
adolescence. In the context of this study, an adolescent refers to a boy or
girl within the ages of 12 and 17.
Adolescence: Adolescence
is a dynamically evolving theoretical construct informed through physiologic, psychosocial,
temporal and cultural lenses. This critical developmental period is
conventionally understood as the years between the onset of puberty and the
establishment of social independence (Steinberg, 2014).
Intrapersonal Factors: In
the context of this study, this refers to the knowledge and the willingness of
the adolescents to engage in physical activities.
Interpersonal Factors: In
the context of this study, this refers to the parental motivation to physical
activities by adolescents.
School Environment: In
the context of this study, this refers to the availability of school policy
encouraging physical activities and healthy diet by students.
================================================================
Item Type: Project Material | Attribute: 68 pages | Chapters: 1-5
Format: MS Word | Price: N3,000 | Delivery: Within 30Mins.
================================================================
No comments:
Post a Comment