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Life style patterns and obesity prevalence among male intermediate school students in Riyadh City, KSA.

Childhood obesity has increased at an alarming rate, becoming one of the most serious public health challenges of the 21st century. This study was conducted to assess the prevalence of overweight and obesity among male intermediate school students in Riyadh City and investigate influencing life style factors.
The study population included male students affiliated to both public and private intermediate schools (7th, 8th, and 9th grades) in Riyadh City. A multistage stratified random sampling technique with proportional allocation was used as sampling design. Accordingly, three public male schools and one private school were randomly selected. Four hundred and thirty six (436) students participated in this cross-sectional study. Data was collected on a pre-prepared self-administered questionnaire. Weights and height were measured by the investigators at the time of questionnaire submission.
Among all study participants, 81.0% were Saudi and 19.0% were non Saudi. Based on WHO criteria, 3.2% were underweight, 49.3% were within normal weight, 24.5% were overweight, and 23.0% were obese.
Among Saudi students, overweight was observed in 24.4% and obesity in 23.5%, while among non Saudis, overweight was seen in 25.3% and obesity in 20.5%. The difference was not statistically significant (p=0.252). Overweight and obesity was lower among public school students than private school students, but the difference was not statistically significant (45.9% compared to 52.3%, p=0.243).
Table 1 demonstrates the different factors influencing overweight and obesity among our study population. It was found that the levels of obesity declined with increasing duration of sports activities (p<0.01). However, overweight and obesity rose with increasing durations of inactivity interests, such as watching television (TV), using computers, and/or playing video games (p<0.001). Higher levels of overweight and obesity were significantly associated with more hours of watching TV (p<0.001), sleeping after midnight (p=0.014), consuming more than 3 meals/day (p=0.031), consuming a higher number of fast food meals/week (p<0.001), and drinking soft and/or canned beverages (p=0.002).
Eating breakfast daily was significantly higher among students whose mothers were housewives (p=0.025). On the other hand, overweight and obesity were found to be significantly higher among students who had working mothers (p=0.007), as was eating fast food 4 times or more/week (p=0.028).
Drinking soft and/or canned drinks was higher among Saudis (p=0.026), almost half (47.0%) of whom consumed > 3 meals/day than non-Saudis (34.9%) (p=0.046). A higher proportion of non-Saudis (14.5%) did not consume any fast food meals compared to Saudis (6.0%) (p=0.025), and sleeping before midnight was reported more frequently among non Saudis (p=0.005).
- Reported by: Dr. Mansour Alelyani, Dr. Sami Almudarra, Dr. Ibrahim Kabbash (Field Epidemiology Training Program).

Editorial note:

Obesity has become an epidemic health problem worldwide. The problem of childhood obesity is global and is steadily affecting many low- and middle-income countries, particularly in urban settings. In 2010 the number of overweight children under the age of five was estimated to be over 42 million globally, close to 35 million are in developing countries.1,2

Overweight and obese children are likely to stay obese into adulthood and are more likely to develop non-communicable diseases at a younger age. The most immediate consequence of overweight as perceived by the children themselves is social discrimination, which is associated with poor self-esteem and depression.1,2,3 Prevention of childhood obesity is, therefore, of high priority.
Maintenance of a normal body weight is a function of balancing energy intake and expenditure. However, the etiology of obesity involves a complex interaction of several factors. Recently, many developing countries including Saudi Arabia have witnessed rapid economic developments and enormous changes in dietary intake and habitual physical activity. These lifestyle-related changes have contributed significantly to the increased prevalence of obesity.4

Recently, Saudi Arabia has seen an increase in the prevalence of overweight and obesity among children and adolescents. The overall prevalence of overweight was reported as 11.7% and obesity as 15.8%. In 1996, the highest prevalence (18.0%) was recorded in Riyadh and the lowest in Sabea (11.1%).5 At the same time, the proportion of inactive children and youth is considerably high. Several local Saudi studies have reported a rising trend in body mass index (BMI) and high prevalence of physical inactivity among school children and adolescents. Nearly 60% of Saudi children and over 70% of youth do not engage in physical activity of sufficient duration and frequency. Also, increasing time is spent on television viewing, video games, and computer use, which has also contributed immensely to the inactivity and obesity epidemic.4,6

Our study showed an alarming prevalence of overweight and obesity (24.5% and 23.0%, respectively) among male intermediate school students, showing a significant association with inactivity, which calls for immediate intervention by the concerned authorities.
Table 1: Physical activity and daily habits of male intermediate school students and their association with body weight.
Categories
Normal weight
Overweight
Obese
Total
p
n(229)
%
n(107)
%
n(100)
%
n(436)
%
Availability of Playing yard

Yes

160
52.3
76
24.8
70
22.9
306
100.0
0.899

No

69
53.1
31
23.8
30
23.1
130
100.0
Leisure Time

Physical activity

80
57.9
34
24.6
24
17.4
138
100.0
0.233

Entertainment

149
50.0
73
24.5
76
25.5
298
100.0
Time spent in Sports

<30 min

98
45.8
50
23.4
66
30.8
214
100.0
<0.010

30 min - <1 hr

43
60.6
16
22.5
12
16.9
71
100.0

1-2 hrs

63
56.2
33
29.5
16
14.3
112
100.0

>2 hrs

25
64.1
8
20.5
6
15.4
39
100.0

Inactivity Time

<3 hrs

114
71.3
26
16.3
20
12.5
160
100.0
<0.001

3-6 hrs

74
43.8
51
30.2
44
26.0
169
100.0

>6 hrs

41
38.3
30
28.0
36
33.6
107
100.0

TV watching time/day

<2 hrs

167
62.8
56
21.1
43
16.2
266
100.0
<0.001

2 hrs or more

62
36.4
51
30.0
57
33.5
170
100.0

Computer use time/day

<30 min

80
60.2
27
20.3
26
19.5
133
100.0
0.244

30 min - 1.5 hrs

81
53
38
24.8
34
22.2
153
100.0

>1.5hrs

68
45.3
42
28.0
40
26.7
150
100.0

Video game play time/day

<30 min

110
60.4
39
21.4
33
18.1
182
100.0
0.092

30 min – 2 hrs

72
51.5
35
25.0
33
23.6
140
100.0

>2 hrs

47
41.2
33
28.9
34
29.8
114
100.0

Time of sleeping at night

Midnight & before

130
59.9
41
18.9
46
21.2
217
100.0
0.014

After midnight

99
45.2
66
30.1
54
24.7
219
100.0
References:

1.WHO. Childhood overweight and obesity on the rise. Available at http://www.who.int/dietphysicalactivity/childhood/en/index.html. Accessed April 29, 2010.

2.WHO. Growth reference 5-19 years. Available at http://www.who.int/growthref/who2007 weight for age/en/index.html. accessed July 2, 2010.

3.US Department of Health and Human Services. Overweight in Children and Adolescents. Available at http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_adolesce… accessed April 29, 2010.

4.Al-Hazzaa, H. Rising trends in BMI of Saudi adolescents: Evidence from three national cross sectional studies. Asia Pac J Clin Nutr. 2007;16:462-466.

5.Al-Nuaim AR,Bamgboye EA,Al-Herbish A. The pattern of growth and obesity in Saudi Arabian male school children. Int J Obes Relat Metab Disord.1996;20(11):1000-5.

6.Al-Hazzaa H. Physical activity, fitness and fatness among Saudi children and adolescents: implications for cardiovascular health. SMJ 2002; 23:144-150.

البدانة و نمط الحياة بين طلاب المدارس بالمرحـلة المتوسطة للبنين بمدينة الرياض خلال عـام 2010 (1431 هـ).
تعتبر البدانة لدى الأطفال احدى أهم تحديات الصحة العامة في القرن الحادي و العشرين. على المستوى العالمي في عام 2010، يقدر عدد الذين يعانون من البدانة و زيادة الوزن ممن هم دون سن الخامسة من الأطفال أكثر من 42 مليون. و في المملكة العربية السعودية، يقدر عدد الذين يعانون من البدانة 11,7% و الذين يعانون من زيادة الوزن 15.8% من إجمالي عدد السكان. أجريت هذه الدراسة لتقييم مدى انتشار البدانة و زيادة الوزن بين طلاب المدارس بالمرحـلة المتوسطة في مدينة الرياض و مدى ارتباطها بنمط الحياة السائد بين هؤلاء الطلاب.
أجريت الدراسة كدراسة مقطعية عرضية بمشاركة 436 طالباُ من المرحلة الدراسية المتوسطة.
أظهرت النتائج ان 3.2% من أصل 436 طالباً كانوا يعانون من قلة الوزن، و كان 24.5% يعانون من زيادة الوزن، و 23.0% من البدانة. كما أظهرت هذه الدراسة أن هناك علاقة ذات قيمة إحصائية بين معدل كتلة الجسم(BMI)و كل من قلة النشاط البدني، مدة ساعات مشاهدة التلفزيون، مدة استخدام الحاسب الآلي، مدة ممارسة ألعاب الفيديو، وظيفة الأم، وقت النوم ليلاُ، عدد الوجبات اليومية، عدد الوجبات السريعة المتناولة خلال الأسبوع و نوع المشروبات. و قد أظهرت الدراسة أن الطلاب الذين كانت أمهاتهم من ربات منازل يستهلكون عدداً أقل من الوجبات السريعة (p<0.05).
بناءً على ما أظهرته هذه الدراسة من نتائج، فيمكننا القول بأن عدد الذين يعانون من البدانة و زيادة الوزن بين طلاب المدارس المتوسطة في مدينة الرياض قد وصل إلى مراحل منذرة بالخطر، مما يدعو إلي ضرورة التدخل السريع لمحاولة إرجاع هذه الأعداد إلي المستويات الطبيعية مرة أخرى. كما يمكننا القول بأن البدانة و زيادة الوزن تتأثران بأنماط الحياة السائدة بين الطلاب فيما يتعلق بالنشاط البدني، العادات الغذائية و أنماط الترف المعيشي.
هناك ضرورة ملحة لنشر الوعي عن مخاطر السمنة وطرق الوقاية منها بين الأهالي، كما يجب تشجيع مكافحة السمنة عن طريق الأسر للحصول على نتائج مرضية على المدى الطويل. و قد أصبحت برامج التثقيف الغذائي و البدني في المدارس ضرورية لتحفيز الأنماط الحياتية والعادات الغذائية الصحية.
إعداد: د. منصور سالم العلياني، د. سامي سعيد المدرع، د. إبراهيم كباش (برنامج الوبائيات الحقلي).