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

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Volume: 17
Year: 2010
Month: October
Issue: 4
Pages: 28-29

Reference: Al-Elyani M., AlMudarra S., Kabbash I., .Saudi Epidemiology Bulletin. 2010;17(4):28-29.

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 (7^th, 8^th, and 9^th 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
Categories	n(229)	%	n(107)	%	n(100)	%	n(436)	%	p
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	0.899
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	0.233
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	<0.001
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	0.014

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.