1.1 Background to the study
The English word “obesity” derives, from the Latin word obesus meaning ‘fat’ or plump. The first English use of the word was made in 1651 in Noah Bigg’s medical book ‘metaeotechnia medicinae praxeos’ (Mckeigne, 1996). Clinical evidence of obesity can be dated as far back as Greece Roman times but little scientific progress was made towards understanding the condition until the 20th century (James, 2005). Also, the discovery that fat is stored in ‘cells’ the basic unit of biology, led to the idea that obesity could be caused by the presence of too many fat cells (hyperplasia) (WHO, 1990).
Obesity in children is a complex disorder. Childhood obesity predisposes them to insulin resistance and type 2 diabetes, hypertension, hyperlipidemia, liver and renal disease, and reproductive dysfunction. This condition also increases the risk of adult-onset obesity and cardiovascular disease.The body mass index (BMI) has not been consistently used or validated in children younger than 2 years, because weight varies in a continuous rather than a stepwise fashion, the use of these arbitrary criteria is problematic and may be misleading. Nevertheless, children and adolescents defined as overweight or obese according to published criteria are highly likely to maintain this ponderal status as adults. Metabolism, lifestyle, and eating habits, are believed to play a role in the development of obesity.
In Nigeria, like in most developing countries of Africa, the emphasis has been on under nutrition and food security rather than overweight, since obesity is viewed as a disease of affluence, but recent studies has proved otherwise (Power, Lake & Cole, 1999).
Obesity is negatively affecting adults. Recent studies have shown that there are approximately 550 million obese people with a BMI of 30.0 and over 2 billion overweight people with a BMI of 25 and over in the world. (American Obesity Association (AOA), 2005) Overall, about 3 million deaths are attributed to overweight/obesity world-wide. The World Health Organization (WHO) in their recent national survey for chronic, non- communicable disease risk factors, identified that between 8% and 10% of Nigerian people are obese (WHO, 2002).
Children and teenagers are becoming obese at an alarming rate (Whitaker, Wright, & Pepe 1999). The prevalence of childhood obesity in the world has risen dramatically in the past several decades with 25-30 percent of children being affected; it is not confined to the industrialized countries, as high rates are already evident in developing countries (Moran, 1999). All children gain weight as they grow older but extra pound more than what is needed to support their growth and development can lead to childhood obesity. Childhood obesity is a serious medical condition that affects children and adolescents. It occurs when a child is well above the normal weight for his or her age and height. Childhood obesity is particularly troubling and can be dangerous to ones health. The treatment of obesity in adults give disappointing results because, rebound weight gain within months is present in the vast majority of adults who loose weight, but behavioral interventions in children population may yield greater weight loss and better maintenance than in adults (Epstein, 1998). Moran(1999) have recommended that making steady changes in eating and physical activity habits overtime, will bring about weight loss, better feeling and overall health improvement.
1.2 Statement of the Problem
The prevalence of childhood obesity has highly increased in several traditional populations. This is not only of social concern, it is also of public health concern, (Garrow, 1991). Obesity is considered a disease and one of the key risk factors for many chronic non-communicable diseases, such as type 2 diabetes mellitus, high blood pressure, heart disease and some cancers. The most important long term consequence is their persistence into adulthood, with all the associated health risks (Anderson & Musaiger, 2006). The rapid increase in childhood obesity predicts the future health consequences.
The Centre for Disease Control and Prevention (2003), reported that social and psychological problems are the most significant consequences of obesity in children. Furthermore, obese children may have psychological problems because the extra weight often place kids on the path to health problems such as diabetes, high blood pressure and high cholesterol that were once confined to adults. Dietz (1999) reported that, obesity has so many complications. The glaring rise in childhood obesity forced the World Health Organisation (WHO) to include childhood obesity on the list of essential health problems worldwide, and proposed it as the most frequent cause of preventable deaths, after smoking (WHO, 1998).This rise is attributed to drastic changes in the lifestyle of the children.
The dietary habits of the average Nigerian child in the urban communities had shifted from natural traditional foods to high-calorie foods (fast food and confectionary) which are relatively cheap and heavily promoted, specifically for children. Exercise is no longer a regular part of daily activity. Some children never walked or cycled to school or play any kind of sport. Schools in the urban areas do not have enough open play ground for the children. This has promoted in door games such as video games for children in the schools in recent times. It is not unusual now for children to spend hours in front of a television or computer.
The National Institute for Clinical Excellence (2000) observed that 4 out of 10 boys and 6 out of 10 girls scarcely perform a minimum one hour daily physical activity recommended by the health education authority. The past generation was hard-working and produced hard-working children who maintained active life style and such did not have to deal with the issues and complications of childhood obesity. The growth of economy led children of affluent parents to have no interest in manual labour. This may have precipitated a society of children suffering from overweight and obesity. This is supported by several studies that observed that childhood obesity is increasing. The option available is a strategy to reduce and prevent it. It was in the light of this study emanated, to conduct an extensive study on the prevalence of childhood obesity among children residing in the rural and the urban communities of Enugu South Local Government Area of Enugu State, Nigeria. The study provided evidence on prevalence of obesity in the communities and possible means of reducing it.
1.3 Objectives of the Study
1.3.1 General objective
The general objective of this study was to assess the prevalence of childhood overweight and obesity; and influence of exercise in children aged (6-12 years) living in rural and urban communities of Enugu South local Government Area, Enugu State, Nigeria.
1.3.2 Specific objectives:
The specific objectives were to:
1. determine the prevalence of childhood overweight and obesity in school children in Enugu South Local Government Area using anthropometric measurements;
2 determine the effect of gender, location and income of the parents on overweight and obesity in children using questionnaire.
3. assess the food consumption pattern of a sub-sample of the subjects using weighed food intake;
4. assess the effect of physical exercise on a sub-sample of the subjects weight; and
5. assess the effect of lifestyle on the subjects’ weights.
1.4 Significance of Study
Childhood obesity is not just a matter of social concern, but is also a health concern that can lead to health problems. The result of having obesity at such a young age means that these children are more susceptible to diseases, the majority of which would be completely preventable if obesity was avoided or reversed. Parents need to be willing to work out ways to keep children free from this disease and this will begin by creating awareness on the existence of this killer disease among our children and its resultant consequences.
The risk of health problems starts when someone is very slightly overweight, and the likelihood of problems increases as the person becomes more overweight and obese. Many of these conditions cause long-term suffering for individuals and families. In addition, the costs for the health care system are extremely high. This study therefore aims at unraveling the existence of this disease among children living in both the urban and rural areas of Enugu State, within the age range of 6-12 years, by first, carrying out an anthropometric measurement of the sampled population and calculating their BMI with the figures gotten.
To reach this goal of ideal body weight, people can limit energy intake from total fats and shift fat consumption away from saturated fats to unsaturated fats; increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts; and limit their intake of sugars. And to increase calories used, people can boost their levels of physical activity – to at least 30 minutes of regular, moderate-intensity activity everyday.
The study could identify the major causes of obesity in children and ways of addressing the problem. The study will expose parents to the reality of obesity in children, its prevailing threats. and how to control and monitor the weight of a younger person. The result of this study will be of immense relevance to both adults, the children and virtually everybody who desire to live a healthy happy life. Parents will learn ideal home made delicacies that will positively affect the lives of these younger generations.
This study will reassure hope to those who are already victims of obesity. The Scientists, the Nutritionists, the Dietitians and all other concerned individuals including the various government units, will updatetheir knowledge on the prevalence of childhood obesity in the localities and the most appropriate means of fighting it. It is also assumed that this study will be useful in obtaining and disseminating information that will educate everybody especially parents on how to prevent the early onset of obesity among children.