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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 35  |  Issue : 3  |  Page : 1143-1149

Prevalence and risk factors of overweight and obesity among adolescents: a cross-sectional study


Department of Family Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Date of Submission22-Dec-2021
Date of Decision03-Feb-2022
Date of Acceptance06-Feb-2022
Date of Web Publication29-Oct-2022

Correspondence Address:
Samar Abd El-Rhman Alkaffas
Menoufia University, Menoufia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_307_21

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  Abstract 


Objective
This study aimed to assess the prevalence and risk factors of overweight and obesity among adolescents.
Background
Obesity is a significant public health concern affecting more than half-a-billion people worldwide, with increasing its prevalence among adolescents.
Its consequences include hypertension, diabetes mellitus, hyperlipidemia, coronary-artery diseases, and some cancers.
Patients and methods
This cross-sectional study included 200 adolescents aged 10–19 years old from two preparatory schools and two secondary schools in Shebin El-kom district (one city and one village selected randomly). Data were collected through a predesigned questionnaire. Participants were evaluated for sociodemographic characteristics, nutritional, family history, and physical activity. The studied participants were categorized (normal, overweight, and obese) according to BMI.
Results
Out of 200 adolescents recruited in this study 31.5% were overweight and obese. There was a statistically significant relation between adolescents' BMI, sex, residence, practicing sports, eating fast food and dessert, and family history of obesity. The most significant factor predicting overweight and obesity among adolescents was family history of obesity [odds ratio (OR): 5.2, confidence interval (CI): 1.9–15.6] followed by eating sugary/creamy dessert [OR: 4.8 (CI: 2.3–10.2)] followed by female sex [OR: 3.1 (CI: 1.6–6.1)]. The most protective factor was practicing any kind of sport [OR: 0.4 (CI: 0.2–0.9)].
Conclusions
Overweight and obesity are prevalent problems among adolescents, parents' obesity, female sex, urban residence, dietary habits, and physical activity are the most predicting factors.

Keywords: adolescent, obesity, overweight, physical health, predicting factors


How to cite this article:
Elmoselhy HM, El-Srrigy FA, Alkaffas SA. Prevalence and risk factors of overweight and obesity among adolescents: a cross-sectional study. Menoufia Med J 2022;35:1143-9

How to cite this URL:
Elmoselhy HM, El-Srrigy FA, Alkaffas SA. Prevalence and risk factors of overweight and obesity among adolescents: a cross-sectional study. Menoufia Med J [serial online] 2022 [cited 2024 Mar 29];35:1143-9. Available from: http://www.mmj.eg.net/text.asp?2022/35/3/1143/359491




  Introduction Top


WHO defines 'adolescents' as individuals between 10 and 19 years, 'youth' between 15 and 24 years, and 'young people' between 10 and 24 years[1].

The prevalence of childhood and adolescent obesity has increased in the developed world. The same trend has been observed in developing countries[2].

Obesity is highly complex in terms of etiology and prevalence. Genetic predisposition, race, socioeconomic status, accessibility of healthy and affordable foods, sleep habits, and geographic region all play a role[3].

Adolescent obesity can profoundly affect adolescents' physical health, self-esteem, and social and emotional well-being. It is also associated with poor academic performance and a lower quality of life experienced by the child[4].

Parental BMI is a reliable predictor of obesity in their offspring, because it reflects both environmental and genetic factors thought to promote weight gain[4].

Moreover, adolescents' obesity has been linked to numerous medical conditions that include fatty liver disease, sleep apnea, type-II diabetes, asthma, hepatic steatosis (fatty-liver disease), cardiovascular disease, high cholesterol, cholelithiasis (gallstones), glucose intolerance and insulin resistance, skin conditions, menstrual abnormalities, impaired balance, and orthopedic problems[5].

It has thus become necessary to track the changes associated with obesity in order to reverse the negative impact they portend on public health.

Therefore, this study aimed to assess the prevalence and risk factors of overweight and obesity among adolescents in Shebin El-Kom District, Menoufia Governorate.


  Patients and methods Top


The study was approved by the Research Ethics Committee in Faculty of Medicine Menoufia University, and written informed consent was signed by one of the parents. A cross-sectional study included 200 adolescents aged 10–19 years old from two preparatory schools and two secondary schools in Shebin Al-Kom District (one city and one village selected randomly). Data collection was starting from the January 1, 2019, to the end of June 2019. The sample size was calculated using the online Rao soft program. At 95% confidence interval (CI) and prevalence of 4% of overweight and obesity in Egyptian adolescents, the calculated sample size was 198 and it was increased to 220 to avoid dropout[6]. The sample was proportionally allocated according to the total number of children in each school. Adolescents who have any known causes of secondary obesity (hypothyroidism, Cushing, and genetic diseases) chronic diseases, such as diabetes mellitus, hypertension, chronic medication use, uncooperative adolescents and underweight adolescents were excluded.

A pilot study was done on a convenient sample and then excluded.

Each participant was interviewed in the school's clinic and evaluated through a face-to-face predesigned questionnaire and physical examination.

The questionnaire had the following three sections:

Section 1: for assessment of personal socioeconomic status according to Fahmy et al.[7], family history of obesity, or overweight.

Section 2: for nutritional assessment using a predesigned questionnaire[8], it included 13 questions for nutritional assessment. Eight questions for evaluation of physical activity and six questions about medical history. Then it was translated into Arabic language. The questionnaire was tested for reliability using alpha Cronbach's test. The alpha reliability was 0.83.

BMI was calculated for adolescents by measuring height (m2) and weight (kg) of the adolescents and parents.

BMI = weight (kg)÷height (m2)[9].

Statistical analysis

The results were statistically analyzed by Statistical Package for the Social Science (SPSS), version 20 (using IBM Corp. Released 2011. Armonk, NY personal computer). Quantitative data were expressed as mean and SDs and analyzed by applying Student t test. Qualitative data were expressed as number and percentage and analyzed by applying χ2 test. P value more than 0.05 was considered statistically nonsignificant, P value less than 0.05 was considered statistically significant, and P value less than 0.001 was considered statistically highly significant.


  Results Top


Among 200 studied adolescents, about two-thirds of them were within the normal range of BMI 137 (68.5%), and 52 (26.0%) of them were overweight. Also, 11 (5.5%) were obese [Figure 1].
Figure 1: BMI of the studied participants. Prevalence of overweight and obesity among the studied participants. This figure shows that among 200 studied adolescents, about two-thirds of them were within the normal range of BMI 137 (68.5%), and 52 (26.0%) of them were overweight. Also, 11 (5.5%) were obese.

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The mean age of the studied participants was 13.58 ± 4.67 years. More than two-thirds of participants were male (64.0%). About two-thirds of them were living in urban areas (60.5%). Most of their fathers were employees (97.5%) and 66% of them had university education. More than half of their mothers were housewives (57.5%) and 58.0% of them had university education.

Also, 65.0% of participants had medium socioeconomic level. [Table 1],[Table 2],[Table 3] illustrate that about two-thirds of them were within the normal range of BMI, 137 (68.5%) and 52 (26.0%) of them were overweight. Also, 11 (5.5%) were obese.
Table 1: Sociodemographic characteristics of the studied participants

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Table 2: Relation between BMI and sociodemographic characteristics of the studied participants

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Table 3: Relationship between BMI and physical activity of the studied group

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There is no statistically significant difference between BMI and sociodemographic characteristics among the studied participants (P > 0.05), except for sex, residence, and family history of obesity where 69.2% of overweight were female and 72.7% obese were from urban areas, 82.96% of overweight have family history of obesity.

There was no statistically significant relation between the studied groups regarding nutritional history (P > 0.05), except for eating fast food and creamy or sugary dessert as there was a statistically significant relation with BMI (P = 0.023, P < 0.001), respectively, as 57.7% were overweight and sometimes eat creamy sugary desserts [Table 4]. There was no statistically significant difference between the studied groups regarding physicalactivity parameters (P > 0.05), except for practicing sports (P = 0.025) as 63.5% and 54.5% of overweight and obese were not practicing sport, respectively [Table 5].
Table 4: Relationship between BMI and nutritional history

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Table 5: Prediction of overweight and obesity among the studied adolescent

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The most significant factor was family history of obesity among the studied group [odds ratio (OR): 5.2 (CI: 1.9–15.6)] followed by eating sugary/creamy dessert [OR: 4.8 (CI: 2.3–10.2)] followed by female sex [OR: 3.1 (CI: 1.6–6.1)]. The most protective factor was practicing any kind of sport [OR: 0.4 (CI: 0.2–0.9)] [Table 5].


  Discussion Top


The current study showed that the prevalence rates of overweight and obesity among the studied adolescents were 26 and 5.5%, respectively. This was consistent with the findings of the study conducted by Abiri et al.[10], which indicated that the overall prevalence rates of underweight, normal, overweight, and obesity in 14–17-year-old female adolescents in Tehran were 14.3, 55.2, 24.1, and 6.5%, respectively, with the highest prevalence of overweight and obesity in the lowest socioeconomic district (South). Obesity is a significant public health concern affecting more than half-a-billion people worldwide. In 2018, more than 1.9 billion were overweight and 600 million were obese. About 39% of adolescents less than 18 years were overweight in 2018 and 13% were obese. In Egypt, the estimated prevalence of overweight increased from 4% in 1990 to 7% in 2011 and is expected to increase[11].

These results are consistent with the study evaluated by Kautiainen et al.[12] who discovered no relation between the time spent on playing digital games and overweight. In contrast to our results, Abiri et al.[10] found a significant difference in physical activity level between the four groups (underweight, normal, overweight, and obese), with the highest level among normal weight and the lowest in obese groups. In addition, a significant difference was observed between the four groups in terms of the time spent on computer, with the longest duration among underweight and the lowest in overweight adolescents.

This study showed that there was a statistically significant relation between the studied groups and eating fast food and creamy or sugary dessert and BMI. This is consistent with Talat and El Shahat[13] study, which found that there was no significant association between obesity and number of meals, thus showing the importance of the amount and type of the meal content rather than the number of daily meals.

This agrees with Akil and Top[14] study, which revealed that the obese adolescents choose energy-dense food. Also, according to Talat and El Shahat[13], there was no relation between obesity and age of the studied participants (P > 0.05). Several variables were tested to determine their effect on BMI. Data showed that illiterate fathers and mothers, frequently eating snacks, frequently fast-food consumption, watching TV more than 2 h, missing breakfast eating, frequently eating while watching TV, and physical inactivity lead to higher BMI.

While our results disagreed with the study conducted by Seyyedin et al.[15] shedding light on the dietary behavior and lifestyle of the general preparatory-school students. They revealed that skipping breakfast is associated with overweight/obesity in children and adolescents.

Our results disagreed with Saikia et al.[16] who found that vegetarian adolescents were more at risk of becoming obese; however, no association was seen between overweight and the type of diet. They also showed that significantly more overweight/obese adolescents were having three or more extra snacks in-between meals. This may have some association with breakfast-skipping habit and a fewer number of major meals per day among overweight and obese adolescents. About 26.6% of the adolescents never took green leafy vegetables and were found to be significantly associated with obesity.

This study showed that the most significant factor was obesity of studied-group parents followed by eating sugary/creamy dessert followed by female sex. The most protective factor was practicing any kind of sport. The findings agreed with the study of Saikia et al.[16], who demonstrated that the overall prevalence of overweight and obesity was significantly more in girls (33.9%). According to Pathak et al.[17], the prevalence of overweight/obesity in girls (17.4%) was more than boys (15.2%).

Conclusion and recommendation

Overweight and obesity are prevalent problems among adolescents. Female sex, urban residence, dietary habits, and physical activity are the most predicting factors. The initiatives to combat overweight and obesity among children and adolescents must include monitoring of nutritional status at both the individual and the collective level, and strategies for the prevention, diagnosis, and early treatment of overweight and obesity should be introduced before the problem spreads more widely.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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