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ORIGINAL ARTICLE
Year : 2014  |  Volume : 27  |  Issue : 3  |  Page : 529-532

Prevalence of obesity in primary school children living in Alexandria governorate


Department of Pediatrics, Menoufia University, Menoufia, Egypt

Date of Submission17-Nov-2013
Date of Acceptance13-Mar-2014
Date of Web Publication26-Nov-2014

Correspondence Address:
Abdelhamed Mohamed Dohein
Department of Pediatrics, Menoufia University, Menoufia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.145502

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  Abstract 

Objective
The aim of the work was to assess the prevalence of obesity among children of primary schools in Alexandria governorate.
Background
Childhood obesity has more than tripled in the past 30 years. The prevalence of obesity among children aged 6-11 years increased from 6.5% in 1980 to 19.6% in 2008.
Participants and methods
A cross-sectional study was carried out on 3500 Egyptian children to calculate prevalence of overweight and obesity among primary school children at age of 6-12 years living in Alexandria governorate. Four schools from urban areas and two from rural areas including both sexes were selected randomly in this study.
They were subjected to physical examination and anthropometric measurements including BMI. Data were expressed in terms of Z-scores using the WHO Z-score cutoff points.
Conclusion
Pediatric obesity is a prevalent and rapidly increasing problem that poses a serious risk to the health and well-being of the nations' youths. Overweight and obesity were relatively high among age group 6-12 years. It was more common in female individuals than male individuals. It was more common in urban than rural areas. It was common in private schools than in governmental schools. Children of high socioeconomic level were more obese than other children.

Keywords: Alexandria, obesity, school children


How to cite this article:
El-Shafie AM, Hogran HH, Dohein AM. Prevalence of obesity in primary school children living in Alexandria governorate. Menoufia Med J 2014;27:529-32

How to cite this URL:
El-Shafie AM, Hogran HH, Dohein AM. Prevalence of obesity in primary school children living in Alexandria governorate. Menoufia Med J [serial online] 2014 [cited 2020 Jul 10];27:529-32. Available from: http://www.mmj.eg.net/text.asp?2014/27/3/529/145502


  Introduction Top


The prevalence of childhood obesity is rising at an alarming rate worldwide [1] .

Childhood obesity has more than tripled in the past 30 years. The prevalence of obesity among children aged 6-11 years increased from 6.5% in 1980 to 19.6% in 2008 [2] .

Obesity is an excessive accumulation of fat that adversely affects the health [3] .

Obesity is the result of caloric imbalance (too few calories expended for the amount of calories consumed) [4] .

The causes of obesity are multifactorial and include genetic predisposition, sedentary lifestyle, overeating, fast food diet, lack of adequate nutritional education, school environment, and advertising and marketing of unhealthy foods [5] .

It is well accepted that childhood obesity relates to adulthood overweight/obesity [6] . There is evidence that higher BMI percentiles (>99th percentile) in children are associated with increased health risks [7] .

Endocrine and cardiovascular abnormalities are among the most well-documented health factors associated with overweight in children; these include insulin resistance, hypertension, and hyperlipidemia [8] . Other health conditions seen more frequently in overweight compared with normal weight children include sleep apnea, gallbladder disease, elevated liver enzymes, pseudotumor cerebri, polycystic ovarian disease, and orthopedic problems [8] .

It was found that obese children are three times more likely to have hypertension than nonobese children and also have risk factors for later disease, such as type 2 diabetes [9] .

In the absence of effective strategies to prevent and treat childhood obesity, millions of children will enter adulthood with the physical and psychological consequences of excess adiposity [10] .

It is commonly agreed that prevention is better than cure. Hence, obesity prevention is the primary and most obvious strategy to control this disease [11] .

The healthy diet and regular exercise are the cornerstone of overall good health for prevention of childhood obesity [11] .


  Participants and methods Top


A cross-sectional study was carried out on 3500 Egyptian children to calculate prevalence of overweight and obesity among primary school children at age of 6-12 years living in Alexandria governorate. Two schools were randomly selected from rural areas and four schools from urban areas including male and female children. All cases were subjected to the following:

(1) Clinical history taking with special emphasis on:

(a) Personal data: name, age, sex, and residence.

(b) Assessment of socioeconomic standard of family with questions about the father's education and occupation, mother's education and occupation, and family income according to modified Fahmy and El Sherbini [12] .

(2) Physical examination with special emphasis on anthropometric measurements including weight, height, and BMI.

Statistical analysis

Collected data were compiled, coded, and verified; thereafter, analysis was performed using SPSS (v.17; SPSS Inc., Chicago, Illinois, USA) software for Microsoft Windows 7. Data were expressed in terms of SD scores (Z-scores) using the WHO AnthroPlus software provided by WHO website; the Z-score cutoff points recommended by the WHO were used [13] .


  Results Top


We found from this study that prevalence of obesity among primary school children was 9%.

Obesity was more common in female children than in male children.

Obesity was more common in urban than in rural areas.

Obesity was more common in private than in public schools.

Obesity was more common in high socioeconomic standard children.

Weight-for-age reference Z-scores are not available beyond the age of 10 years (120 months) because this indicator does not distinguish between height and body mass during an age period where many children are experiencing the pubertal growth spurt and may appear as having excess weight (by weight-for-age) when in fact they are just tall [13] ([Figure 1], [Figure 2], [Figure 3] [Figure 4] and [Figure 5] and [Table 1], [Table 2] and [Table 3]).
Figure 1: Prevalence of obesity in studied sample.

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Figure 2: Comparison between prevalence of obesity between male and female children.

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Figure 3: Comparison between prevalence of obesity in rural and urban area.

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Figure 4: Comparison between prevalence of obesity in public and private schools.

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Figure 5: Comparison between prevalence of obesity regarding socioeconomic standard of living.

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Table 1: General descriptive data of studied sample


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Table 2: Classification of anthropometric measurements of studied children according to Z-scores


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Table 3 Risk factors for obesity


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  Discussion Top


This study included 3500 primary school children in Alexandria governorate; their age ranged from 6 to 12 years. With respect to the BMI for age Z-score of children in present study, we found 13 (0.4%) children with less than 3 SD (severe thinness) and 194 (5.5%) children with less than 2 SD (thinness), whereas the number of children who were greater than 1 SD (overweight) was 588 (16.8%), greater than 2 SD (obese) was 230 (6.6%), and greater than 3 SD (obese) was 84 (2.4%). The prevalence of overweight and obesity in our study (16.8 and 9%, respectively) was higher than that reported from previous Egyptian study conducted by El-Shafie et al. [11] who showed the prevalence of overweight and obesity of 11.5 and 8.8%, respectively, among children in El-Bagour district. In addition, prevalence in our study is higher than in other study conducted by Bahbah et al. [14] who found that the prevalence of overweight and obesity in El-Sinbellawin district was 11.5 and 8.5%, respectively. Regarding BMI Z-score classes, we found that prevalence of obesity among female individual (10.10%) was higher than in male individual (7.70%); this could be due to reduced activity levels of girls in the school or out of the school. This is in agreement with most previous studies conducted in Egypt that showed increase in female percentage of obesity compared with boys. Regarding BMI Z-score classes, we found that percentage of overweight and obesity was 18.4 and 10.1%, respectively, in urban children, which was higher than in rural children, 12.1 and 5.6%, respectively; this could be explained by dietary variation between rural and urban areas.


  Acknowledgements Top


Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.Veugelers PJ, Fitzgerald AL. Prevalence of and risk factors for childhood overweight and obesity. GMAJ 2005; 173 :607-613.  Back to cited text no. 1
    
2. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents (2007-2008). JAMA 2010; 303 :242-249.  Back to cited text no. 2
    
3. Kanagalingam MG, Forouhi NG, Greer IA. Changes in booking body mass index over a decade: retrospective analysis from a Glasgow Maternity Hospital. Br J Obstet Gynaecol 2005.  Back to cited text no. 3
    
4. Daniels SR, Arnett DK, Eckel RH, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 2005; 111 :1999-2002.  Back to cited text no. 4
    
5. Hassink SG. editor. Childhood obesity: and over viewPediatric obesity: prevention, intervention, and treatment strategies for primary care. ELK Groove Village, IL: American Academy of Pediatric; 2007. 1-6, 22-25  Back to cited text no. 5
    
6. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents: a follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992; 327 :1350-1355.  Back to cited text no. 6
    
7. Barlow SE, Dietz WH. Obesity evaluation and treatment: expert committee recommendations. Pediatrics 1998; 102 :e29.  Back to cited text no. 7
    
8. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101 :518-525.  Back to cited text no. 8
    
9. Wiegand S, Dannemann A, Krude H, Grtiters A. Impaired glucose tolerance said type 2, diabetes mellitus: a new field for pediatrics in Europe. Int J Obes 2005; 29 :S136.  Back to cited text no. 9
    
10.Olshansky SJ, Passaro DJ, Hershow RC, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005; 352 :1138-1145.  Back to cited text no. 10
    
11.El-Shafie MA, Allam AA, Ayad MM. Prevalence of obesity in primary school children living in Menoufyia governorate (El-Bagour district) [Master Degree]. Menoufyia: Pediatrics, Menoufyia University; 2011.  Back to cited text no. 11
    
12.Fahmy IS, El Sherbini AF. Determining simple parameters for social classifications for health research [Vol. X111]. Alexandria: High Institute of Public Health Alexandria University; 1983.  Back to cited text no. 12
    
13.WHO WHO AnthroPlus software; 2007. Available at: http://www.who.int/growthref/en/.  Back to cited text no. 13
    
14.Bahbah HM, Hogran HH, Metwaly MM. Prevalence of obesity in primary school children living in El-Sinbelaween District, Dakahlya Governorate. 2013.  Back to cited text no. 14
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]


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