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Can modern food retailers improve diets and nutrition in urban Africa? Empirical evidence from ZambiaKhonje, Makaiko 19 May 2020 (has links)
No description available.
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Hypertension in Overweight and Obese Primary Care Patients Is Highly Prevalent and Poorly ControlledBramlage, Peter, Pittrow, David, Wittchen, Hans-Ulrich, Kirch, Wilhelm, Boehler, Steffen, Lehnert, Hendrik, Hoefler, Michael, Unger, Thomas, Sharma, Arya M. January 2004 (has links)
Background: Although the relationship between body weight and blood pressure (BP) is well established, there is a lack of data regarding the impact of obesity on the prevalence of hypertension in primary care practice. The objective of this study was to assess the prevalence of hypertension and the diagnosis, treatment status, and control rates of hypertension in obese patients as compared to patients with normal weight.
Methods: A cross-sectional point prevalence study of 45,125 unselected consecutive primary care attendees was conducted in a representative nationwide sample of 1912 primary care physicians in Germany (HYDRA).
Results: Blood pressure levels were consistently higher in obese patients. Overall prevalence of hypertension (blood pressure ≥140/90 mm Hg or on antihypertensive medication) in normal weight patients was 34.3%, in overweight participants 60.6%, in grade 1 obesity 72.9%, in grade 2 obesity 77.1%, and in grade 3 obesity 74.1%. The odds ratio (OR) for good BP control (<140/90 mm Hg) in diagnosed and treated patients was 0.8 (95% confidence interval [CI] 0.7– 0.9) in overweight patients, 0.6 (95% CI 0.6–0.7) in grade 1, 0.5 (95% CI 0.4–0.6) in grade 2, and 0.7 (95% CI 0.5– 0.9) in grade 3 obese patients.
Conclusions: The increasing prevalence of hypertension in obese patients and the low control rates in overweight and obese patients document the challenge that hypertension control in obese patients imposes on the primary care physician. These results highlight the need for specific evidence-based guidelines for the pharmacologic management of obesity-related hypertension in primary practice.
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Overweight And Obesity In Canada: Understanding The Individual and Socio-environmental Determinants / Understanding The Determinants of Obesity In Urban CanadaPouliou, Theodora 09 1900 (has links)
<p> This research examined the geographic variability as well as the individual-and neighbourhood-level determinants of overweight and obesity in Canada. Overweight and obesity represent a significant public health problem with grave implications for individuals as well as populations. Over the past two decades, the prevalence of overweight and obesity has reached epidemic proportions with the most substantial increases observed in economically developed countries. The World Health Organization indicated that globally 1.6 billion adults (age 15+) are overweight and at least 400 million adults were obese. In a Canadian context, recent data from Statistics Canada confirms that over the past twenty-five years, adult obesity rates in Canada have doubled (23% ), while childhood obesity rates have nearly tripled. </p>
<p> Until recently, research has focused on biological and behavioural determinants of obesity, and currently there is a great deal of knowledge regarding the relationships between weight status and various risk factors at the individual-level (e.g. age, sex, socioeconomic deprivation, diet, physical activity). However, the majority of existing research has ignored the potential role played by the environment in the development of these conditions, despite a growing consensus that environmental and/or societal constraints may be major influences on increasing prevalence rates. </p>
<p> Using data from the Canadian Community Health Surveys and the Desktop Mapping Information Technologies Incorporated spatial database, this research addressed the following objectives: (I) to examine sex-specific spatial patterns of overweight/obesity in Canada as well as investigate the presence of spatial clusters (2) to investigate the prevalence and determinants of overweight and obesity in Canada using spatial analysis and geographical information systems (GIS) and (3) to identify heterogeneities associated with the relationships between individual and socioenvironmental determinants and overweight and obesity at the individual-and community-levels. </p>
<p> Results revealed marked geographical variation in overweight/obesity prevalence with higher values in the Northern and Atlantic health-regions and lower values in the Southern and Western health-regions of Canada. Significant positive spatial autocorrelation was found for both males and females, with significant clusters of high values or 'hot spots' of obesity in the Atlantic and Northern health-regions of Alberta, Saskatchewan, Manitoba and Ontario. Results also demonstrate the important role of the built-environment after adjustment demographic, socio-economic and behavioural characteristics. With regard to the built environment measures, landuse mix and residential density were found to be significantly associated with BMI. This study also demonstrated significant differences at the area-level of analysis, supporting related research that has suggested that individual-level factors alone cannot explain variation in obesity rates across space. In particular, average dwelling value was related to BMI independently of individual-level characteristics. Ultimately, this research has demonstrated that Canadian urban environments play a small but significant role in shaping the distribution of BMI. Yet, reversing current trends will require a multifaceted public health approach where interventions are developed from the individual-to the neighbourhood-level, specifically focusing on altering obesogenic environments. </p> / Thesis / Doctor of Philosophy (PhD)
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And yet Again: Having Breakfast Is Positively Associated with Lower BMI and Healthier General Eating Behavior in SchoolchildrenOber, Peggy, Sobek, Carolin, Stein, Nancy, Spielau, Ulrike, Abel, Sarah, Kiess, Wieland, Meigen, Christof, Poulain, Tanja, Igel, Ulrike, Lipek, Tobias, Vogel, Mandy 05 May 2023 (has links)
Given the high prevalence of childhood overweight, school-based programs aiming at nutritional behavior may be a good starting point for community-based interventions. Therefore, we investigated associations between school-related meal patterns and weight status in 1215 schoolchildren. Anthropometry was performed on-site in schools. Children reported their meal habits, and parents provided family-related information via questionnaires. Associations between nutritional behavior and weight status were estimated using hierarchical linear and logistic regression. Analyses were adjusted for age, socio–economic status, school type, migration background, and parental weight status. Having breakfast was associated with a lower BMI-SDS (βadj = −0.51, p = 0.004) and a lower risk of being overweight (ORadj = 0.30, p = 0.009), while having two breakfasts resulting in stronger associations (BMI-SDS: βadj = −0.66, p < 0.001; risk of overweight: ORadj = 0.22, p = 0.001). Likewise, children who regularly skipped breakfast on school days showed stronger associations (BMI-SDS: β = 0.49, p < 0.001; risk of overweight: OR = 3.29, p < 0.001) than children who skipped breakfast only occasionally (BMI-SDS: β = 0.43, p < 0.001; risk of overweight: OR = 2.72, p = 0.032). The associations persisted after controlling for parental SES and weight status. Therefore, our data confirm the school setting as a suitable starting point for community-based interventions and may underline the necessity of national programs providing free breakfast and lunch to children.
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SOBREPESO E OBESIDADE ENTRE OS FUNCION?RIOS DA UNIVERSIDADE ESTADUAL DE FEIRA DE SANTANA, 2004.Caires, No?lia Fonseca Ramos 25 February 2005 (has links)
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Previous issue date: 2005-02-25 / The obesity is considered, nowadays, serious problem in the public health, it has been constituted as a risk factor for chronic disease in the modern society, as mellitus diabetes, high levels of cholesterol, heart diseases and some kinds of cancer. In order to contribute for the knowledge of prevailing of the overweight and the obesity and its factors of risk, in Feira de Santana city, it has been evaluated a significative sample of the employees of Feira de Santana State University (number of 435 persons 73,2%). We use a questionnaire applied during the interview were identified biological variables (gender, age, birth ability, familiar history of obesity, presence of diseases related to obesity); socioeconomic variables (education and family income) and socio-behavioral (marital status, food habits, practice of physical activity, smoking and consumption of alcoholic drinks).Overweight and obesity were defined through the body mass index (BMI) adapting the established criteria by WHO (1997): values between 25 and 29,9 kg\m2 for overweight and the same values or bigger of 30kg/m2 for obesity. The measure of the abdominal circumference was used to evaluate the risks of heart diseases, adopting the suggested values by Latin American Consensus of obesity (1998): high risk ≥ 94 cm in men and ≥80 in women; very high risk ≥ 102 cm in men and ≥ 88cm in women. In the descriptive analysis were included all the individuals, and in the exploratory analysis were excluded the individuals with low weight (number of 18). Among the 435 participants of the study, the prevailation of overweight and obesity was 31,15% and 10,34% respectively. Among men, these prevailations were of 34,55% and 10,81% ; and among the women of 30,66% and 10,10% respectively. Using the X2 test, it has been observed age, birth condition, family history, daily frequency of food, and kind of physical activity are the variables which show differences in the distribution of weight. For a multivariate analysis it has been made a model using multiple regression with the following variables: age, family history of obesity, birth condition, individuals with and without mates, education, income, practice, duration and frequency of physical activity, number of meals, the use of alcoholic drinks, smoking. It has been done three analyses, the first with men and women; the second only with men and the third only with women. The BMI presented a positive association with family history in all the analyses; the same occurred with income among men and women. In relation to the education the BMI decreases in the answer to the increasing of the level of education only with women. An inverse association occurred with smoking among men and women, and among men isolated. The obtained results point to the necessity of the measures aiming for the control and the prevention of obesity by the official health institutions. / A obesidade ? considerada, atualmente, grave problema de sa?de p?blica, constituindo-se em fator de risco para doen?as cr?nicas freq?entes na sociedade moderna, como diabetes melitus, dislipidemias, doen?as cardiovasculares e certos tipos de c?ncer. Objetivando contribuir para o conhecimento da preval?ncia do sobrepeso e da obesidade e seus fatores de risco, na cidade de Feira de Santana, foi avaliada amostra significativa dos funcion?rios da Universidade Estadual (n=435 -73,2%). Atrav?s de question?rio aplicado em entrevista foram identificadas vari?veis biol?gicas (g?nero, idade, paridade, hist?ria familiar de obesidade, presen?a de doen?as relacionadas ? obesidade); socioecon?micas (escolaridade e renda familiar) e sociocomportamentais (estado civil, h?bitos alimentares, pr?tica de atividade f?sica, tabagismo e consumo de bebidas alco?licas). Sobrepeso e obesidade foram definidos atrav?s do ?ndice de Massa Corp?rea (IMC) adotando os crit?rios definidos pela OMS (1997): valores entre 25 e 29,9 kg/m2 para sobrepeso e valores iguais ou maiores de 30 kg/m2 para obesidade. Medida da circunfer?ncia abdominal foi utilizada para avalia??o dos riscos de comorbidades, adotando valores sugeridos pelo Consenso Latino Americano de Obesidade (1998): risco elevado ≥ 94 cm no homem e ≥ 80 cm na mulher e risco muito elevado ≥ 102 cm no homem e ≥ 88 cm na mulher. Na an?lise descritiva foram inclu?dos todos os indiv?duos, e na an?lise explorat?ria, foram exclu?dos os indiv?duos com baixo peso (n=18). Dentre os 435 participantes do estudo, a preval?ncia de sobrepeso e obesidade foi de 31,95% e 10,34%, respectivamente. Entre os homens, estas preval?ncias foram de 34,46% e 10,81% e entre as mulheres de 30,66% e 10,10%, respectivamente. Utilizando o teste de Qui-quadrado, foi observado que idade, paridade, hist?ria familiar, freq??ncia di?ria da alimenta??o e tipo de atividade f?sica s?o as vari?veis que apontaram diferen?as na distribui??o do peso. Para an?lise multivariada, foi constru?do modelo utilizando a regress?o m?ltipla com as seguintes vari?veis: idade, hist?ria familiar de obesidade, paridade, indiv?duos com e sem companheiros, escolaridade, renda, a pr?tica, a dura??o e a freq??ncia da atividade f?sica, n?mero de refei??es, uso e quantidades de bebidas alco?licas, tabagismo. Foram realizadas tr?s an?lises, uma com homens e mulheres, outra apenas com homens e outra apenas com mulheres. O IMC apresentou associa??o positiva com a hist?ria familiar em todas as an?lises; o mesmo ocorreu com a renda entre homens e mulheres. Em rela??o ? escolaridade, o IMC diminui em resposta ? eleva??o do n?vel de escolaridade apenas entre as mulheres. Associa??o inversa ocorreu com o tabagismo entre homens e mulheres e entre os homens, isoladamente. Os resultados obtidos apontam para a necessidade de medidas objetivando o controle e a preven??o da obesidade por parte dos ?rg?os de sa?de.
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Föräldrars påverkan i utvecklingen av övervikt och fetma hos barn / Parental influence on the development of overweight and obesity in childrenBrantmark, Anna, Karlsson, Rebecca January 2011 (has links)
Övervikt och fetma hos barn är ett allvarligt och växande problem. Det är ett tillstånd som för med sig många olika sjukdomar och i och med att antalet överviktiga barn ökar hastigt kommer det att vara en stor belastning för den framtida hälso- och sjukvården. Prevalensen är särskilt stor i vissa delar av världen och inom vissa grupper i samhället. Föräldrar spelar en väsentlig roll i huruvida barnen lever hälsosamma liv eftersom de bär ansvaret för barnen. Syftet med denna litteraturstudie var att undersöka föräldrars påverkan i utvecklingen av övervikt och fetma hos barn och genom en systematisk bearbetning av litteraturen granskades och bearbetades slutligen 19 vetenskapliga artiklar till resultatdelen i studien. Socioekonomiska faktorer, faktorer inom familjen och föräldrars roll var tre teman som utmärkte sig där det under varje rubrik beskrivs hur föräldrar påverkar med att bidra till eller motverka riskfaktorer till en ohälsosam viktstatus hos barn. Föräldrar har ett behov av stöd i form av information och kunskap och hälso- och sjukvården bär ett stort ansvar i att stödja föräldrar, förebygga sjukdom och främja hälsa. / Overweight and obesity in children are serious conditions, with many negative consequences to the health of individuals and the health care system as a whole. The prevalence is particularly great in certain groups of people and the frequency of these conditions is increasing at an alarming rate. Parents, as the primary caregivers, play a vital role in determining whether or not their children lead a healthy lifestyle. The aim of this literature review was to establish the influence that parents have on the development of overweight and obesity in their children. 19 articles were systematically reviewed and the results showed three main areas of influence; socio-economic factors, factors within the family and the role of the parent. In each of these areas, risk factors of developing overweight and obesity in children were identified. In general, parents lack information about these conditions and are in need of support from nurses and other health care professionals, who in turn carry the responsibility to support the parents, promote good health and prevent disease.
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Enfermagem na aten??o prim?ria em sa?de no screening de adolescentes com excesso de peso / Nursing in primary health care in the screening of adolescents with overweightVieira, Caroline Evelin Nascimento Kluczynik 29 November 2013 (has links)
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Previous issue date: 2013-11-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / One of the Primary Health Care strategies for adolescent health is the growth and
development follow-up and the early detection of overweight adolescents. Even though the
School Health Program in Brazil proposes to evaluate the nutritional state of the school
population in the corresponding community health units, not all cities have adhered to the
Program and many nurses do not recognize overweight as a problem in their territory. The
objective of the study was to identify the nurse?s participation in the screening of overweight
adolescent students in their work territory. Cross sectional study conducted in eight state
supported schools of the municipality of Natal/RN and in four Primary Health Units. The total
student population was 27.277. A stratified sample was statistically calculated based on the
student population of the four city geographical zones: 112 North , 74 West; 108 East; and 78
South, totalizing 372 adolescents. The students were selected by a probability process where
eight schools were first selected, two per district, until the number per subsample in each
district was reached. Four primary health nurses, responsible for the health units were
included. Two instruments were used for data collection, a screening questionnaire and a
semi-structured interview form for questioning of the nurses. The content of both instruments
was validated. Anthropometric and health data were collected from the students and analyzed
with descriptive and analytical statistics. Interview data were transcribed and submitted to
content analysis. The nursing diagnosis of overweight was identified in 50 (13,5%) of the
adolescents and its association with consumption of foods that have cardiovascular risk
(canned foods, pasta and fried food). An association of the nursing diagnosis was identified
with family history (diabetes, hypertension, obesity, and kidney disease). The nurses judged
that care of overweight adolescents was important but noted difficulties because of the
absence of this population in the health units, because of their work overload, and the lack of
school articulation. The nurses do not have impacting actions with this population and
delegate the responsibility to other professionals. It is concluded that overweight is a
nutritional problem relevant to the adolescent school population in Natal/RN, with a 13,5%
prevalence and that it is related to food consumption with cardiovascular risk and family
health history. The nurses consider overweight as an important public health problem but do
not envision ways to maintain linkage with adolescents and with the school to promote the
needed care / Uma das principais estrat?gias da enfermagem na Aten??o prim?ria em Sa?de (APS) ? o
acompanhamento do crescimento e identifica??o precoce do excesso de peso em adolescentes.
Apesar dos incentivos do Programa Sa?de na Escola (PSE) no Brasil, que prop?s avaliar o
estado nutricional dos escolares pelas Unidades B?sicas de Sa?de (UBS), ainda n?o h? ades?o
de todos os munic?pios e muitos enfermeiros n?o reconhecem o excesso de peso como um
problema. O objetivo desse estudo foi identificar a participa??o do enfermeiro da APS no
screening de adolescentes escolares com excesso de peso na sua ?rea de atua??o. Estudo
transversal, realizado em oito escolas estaduais de Natal-RN e em quatro UBS. A popula??o
de alunos das escolas estaduais foi 27.377. Com base em procedimento estat?stico, definiu-se
uma amostra estratificada pelas quatro zonas municipais: 112 na Norte, 74 na Oeste, 108 na
Leste e 78 na Sul, o que totalizou 372 adolescentes. Na sele??o de alunos, sortearam-se
aleatoriamente as escolas e as turmas participantes, at? totalizar o tamanho das subamostras
por zona. Participaram quatro enfermeiras respons?veis pelas UBS inclu?das. Dois
instrumentos de coleta de dados foram utilizados, um formul?rio para o screening e um
roteiro de entrevista semi-estruturada para questionar os enfermeiros. O conte?do dos
instrumentos foi validado por especialistas. A coleta de dados com os adolescentes
compreendeu a verifica??o de peso, altura e condi??es de sa?de e analisados por meio
estat?stica descritiva e anal?tica. Os ?udios das entrevistas foram gravados, transcritos e
analisadas quanto ao conte?do. Dentre os adolescentes, 50 (13,5%) foram identificados com o
Diagn?stico de Enfermagem (DE) excesso de peso, com associa??o ao consumo de alimentos
de risco cardiovascular (embutidos, macarr?o e fritura). Identificou-se associa??o entre o DE
e a hist?ria familiar de doen?as (diabetes, hipertens?o, obesidade e doen?a nos rins). As
enfermeiras julgaram fundamental a assist?ncia aos adolescentes com excesso de peso, mas
apontaram dificuldades devido a pouca procura dessa clientela pelos servi?os de sa?de, pelo
excesso de tarefas que realizam nas UBS e pela baixa articula??o com as escolas. Elas se
isentaram de condutas de maior impacto e atribu?ram a outros profissionais a responsabilidade
maior. Conclui-se que o excesso de peso ? um desvio nutricional relevante na popula??o de
adolescentes de escolas estaduais de Natal/RN, com frequ?ncia de 13,5% e que o problema
est? relacionado ao consumo de alimentos de risco cardiovascular e ? hist?ria familiar de
doen?as. Os enfermeiros consideram o excesso de peso como importante problema de sa?de
p?blica, que necessita de assist?ncia de enfermagem, mas n?o vislumbram estrat?gias para
manter o v?nculo com o adolescente e com a escola para promover a assist?ncia resolutiva
diante esse DE
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The role of informal online social support in facilitating long-term weight management : an online longitudinal phenomenological studyChen, Zemin January 2014 (has links)
The term ‘epidemic’ is often used to describe the obesity phenomenon and indicate that overweight or obesity is a worldwide phenomenon. While the prevalence of overweight and obesity has been increasing, reviews on overweight and obesity studies indicate a clear need for further effectiveness studies of innovative and cost-effective strategies to improve the long-term outcomes of weight loss and weight maintenance programmes in large populations. Current weight loss interventions, while successful in the short term, are often not cost effective enough to deliver on a large scale because they are labour and time intensive. Most importantly, they do not cover large populations. Despite some individual successful weight loss in these interventions programmes, individuals still need to self- manage their weight following intervention. It is unrealistic to expect health professionals and clinicians to provide timely and long-term ongoing support for 2.1 billions overweight and obesity populations around the world (OECD Health Statics, 2014).Therefore, the solutions for weight control may be more effective if grounded within the online community, that is, design long-term solutions that build and draw on social capital to support weight maintenance and are scaled to cope with large populations. Understanding the individual weight loss experiences through informal online social support and utilising the advantages of computer-mediated communication (CMC) can be a timely and cost-effective way to help people self-manage their weight. A three-month online longitudinal phenomenological interview of 17 informants recruited from an online community forum was applied to explore the weight loss experiences with assistance of informal online social support. Four weight loss threads selected by the informants during their weight loss process were also interpreted to map out the key roles of informal online social support and the interaction process that takes place in an online community forum. This research describes the lived experiences of individuals’ self-help weight loss process and maps out the critical moments and differential experiences involved in the Stages of Change (SoC) to explain the individual differences during different weight loss stages. This research also identifies the interrelationships of Processes of Change (PoC) for facilitating behaviour change. The findings of this research contribute to demonstrate the interaction process between community members and the process of providing and receiving social support at different individual members’ weight loss stages, which helped them to continue to lose weight or maintain their weight. The informal online social support could meet different self-help weight loss individual’s needs during different weight loss stages, which is difficult to be provided by the healthcare providers. The findings also contribute to social marketing as a way of offering a cost-effective and efficient way to assist the self-help individual to self- manage their weight in the long term. It may also be a viable way of addressing the issues of costs and labour intensity found in the current weight loss interventions that want to serve large populations.
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Prevalence of and risk factors for body fatness and nutritional status of urban and rural primary school children between the ages of six and nine years in the Polokwane Local Municipality, Limpopo Province, South AfricaMokabane, Mamogobo Nelly January 2019 (has links)
Thesis (M. Sc.(Physiology)) -- University of Limpopo, 2019 / Aim: The purpose of this study was to assess the prevalence and risk factors associated with malnutrition and nutritional status of rural and urban primary school children aged 6–9 years.
Literature background: Malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries, affecting 10.9% of people globally, particularly in Southern Asian (15.7%) and sub-Saharan African (23.2%) countries undergoing urbanisation. Urbanisation affects diet, physical activity levels, body fatness, body composition and socio-economic factors. There is currently a shortage of information on the effect of urbanisation on nutritional status, especially in poor areas such as the Limpopo Province of South Africa. It is important to understand the effects that body fatness and associated risk factors have on stunting, wasting, underweight, and overweight/obesity in urban and rural children.
Subjects and design: This was a cross-sectional study including rural (n=106) and urban (n=68) primary school children aged 6–9 years. Anthropometric (weight and height) and skinfold measurements were taken and a 24-hour recall dietary assessment was conducted twice to include a week day and a weekend day. A questionnaire was used to gather demographic, health, dietary and physical activity information.
Results: The prevalence of stunting, wasting, underweight, and overweight/obese children in this population was 14%, 6%, 20%, and 26% respectively. Furthermore, the prevalence stunting, wasting, and underweight were higher in rural areas compared to urban areas. Meanwhile, the prevalence of overweight/obesity was higher in urban areas as compared to rural areas. Gender, area (urban/rural) (p=0.0001), birthweight, time spent on sedentary activities, monthly household income (p=0.0210), mode of transport to school, and breastfeeding (p=0.0560) were all found to be significantly associated with malnutrition. Weekday dietary intake of Vitamins A and D was significally associated with BF%, whereas weekend consumption of energy, protein, calcium, iron, phosphorus, and zinc were not significantly associated with BF%. The mean energy and calcium intake between the urban and rural
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population only differed significantly over weekends and not during the week, while vitamin D differed significantly between urban and rural populations during the week only.
Conclusions: The current study demonstrates that children in rural areas were significantly more wasted than those residing in urban areas, while those residing in urban areas were significantly more overweight/obese compared to rural areas. All indicators used for undernutrition were associated significantly with gender and the prevalence were higher males compared to females, but this significance disappeared for overnutrition. Families with a higher income tended to have children who were overweight or obese compared to families with a lower income. Children spending a lot of time on sedentary activities were more likely to be overweight or obese, and breastfeeding seemed to protect children from becoming overweight or obese, while low birth weight was associated with stunting. The weekaday and week-end diets indicate that school feeding schemes in the rural areas may be effective in increasing total energy intake in children and this should be further investigated. In this population, stunting, wasting, and underweight were not limited to rural areas, and should still be a health concern in urban areas, despite the fact that overweight/obesity is also prevalent in urban areas. Thus, overweight/obesity in this population can be prevented by promoting breastfeeding and physical activity, while at the same time discouraging children from partaking in too many sedentary activities. / National Research Foundation (NRF)
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Prevalence of and risk factors for body fatness and nutritional status of urban and rural primary school children between the ages of six and nine years in the Polokwane Local Municipality, Limpopo Province, South AfricaMokabane, Mamogobo Nelly January 2019 (has links)
Thesis (M. Sc. (Physiology)) -- University of Limpopo, 2019 / Aim: The purpose of this study was to assess the prevalence and risk factors associated with malnutrition and nutritional status of rural and urban primary school children aged 6–9 years.
Literature background: Malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries, affecting 10.9% of people globally, particularly in Southern Asian (15.7%) and sub-Saharan African (23.2%) countries undergoing urbanisation. Urbanisation affects diet, physical activity levels, body fatness, body composition and socio-economic factors. There is currently a shortage of information on the effect of urbanisation on nutritional status, especially in poor areas such as the Limpopo Province of South Africa. It is important to understand the effects that body fatness and associated risk factors have on stunting, wasting, underweight, and overweight/obesity in urban and rural children.
Subjects and design: This was a cross-sectional study including rural (n=106) and urban (n=68) primary school children aged 6–9 years. Anthropometric (weight and height) and skinfold measurements were taken and a 24-hour recall dietary assessment was conducted twice to include a week day and a weekend day. A questionnaire was used to gather demographic, health, dietary and physical activity information.
Results: The prevalence of stunting, wasting, underweight, and overweight/obese children in this population was 14%, 6%, 20%, and 26% respectively. Furthermore, the prevalence stunting, wasting, and underweight were higher in rural areas compared to urban areas. Meanwhile, the prevalence of overweight/obesity was higher in urban areas as compared to rural areas. Gender, area (urban/rural) (p=0.0001), birthweight, time spent on sedentary activities, monthly household income (p=0.0210), mode of transport to school, and breastfeeding (p=0.0560) were all found to be significantly associated with malnutrition. Weekday dietary intake of Vitamins A and D was significally associated with BF%, whereas weekend consumption of energy, protein, calcium, iron, phosphorus, and zinc were not significantly associated with BF%. The mean energy and calcium intake between the urban and rural
vi
population only differed significantly over weekends and not during the week, while vitamin D differed significantly between urban and rural populations during the week only.
Conclusions: The current study demonstrates that children in rural areas were significantly more wasted than those residing in urban areas, while those residing in urban areas were significantly more overweight/obese compared to rural areas. All indicators used for undernutrition were associated significantly with gender and the prevalence were higher males compared to females, but this significance disappeared for overnutrition. Families with a higher income tended to have children who were overweight or obese compared to families with a lower income. Children spending a lot of time on sedentary activities were more likely to be overweight or obese, and breastfeeding seemed to protect children from becoming overweight or obese, while low birth weight was associated with stunting. The weekaday and week-end diets indicate that school feeding schemes in the rural areas may be effective in increasing total energy intake in children and this should be further investigated. In this population, stunting, wasting, and underweight were not limited to rural areas, and should still be a health concern in urban areas, despite the fact that overweight/obesity is also prevalent in urban areas. Thus, overweight/obesity in this population can be prevented by promoting breastfeeding and physical activity, while at the same time discouraging children from partaking in too many sedentary activities. / National Research Foundation (NRF)
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