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The determinants of overweight and obesity among 10- to 15-year-old schoolchildren in the North West Province, South Africa – the THUSA BANA (Transition and Health during Urbanisation of South Africans; BANA, children) study

Published online by Cambridge University Press:  02 January 2007

R Kruger ,
HS Kruger  and
UE MacIntyre
R Kruger*
Affiliation:
Department of Consumer Science, University of Pretoria, South Africa
HS Kruger
Affiliation:
School for Physiology, Nutrition and Consumer Sciences, North-West University (Potchefstroom Campus), South Africa
UE MacIntyre
Affiliation:
Department of Paediatrics and Child Health, University of Limpopo (Medunsa Campus), South Africa
*
*Corresponding author: Email [email protected]
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Abstract

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Aim

To investigate the determinants of overweight and obesity among 10- to 15-year-old schoolchildren in a population in the transitional phase in the North West Province of South Africa.

Methods

A cross-sectional survey was used to investigate weight status (anthropometric indicators) and determinants of overweight/obesity including dietary intake, physical activity and socio-economic status. A single, random sample (n=1257), stratified for gender, type of school and ethnic group, was used. Data were collected on demographics, family circumstances, habitual physical activity, dietary intake and anthropometry to evaluate weight status and body fat content. One-way analysis of variance, the generalised linear models procedure of SAS and the Tukey post hoc honest significant difference test were used to analyse the data.

Results

Few children were overweight or obese (7.8%) according to International Obesity Task Force (IOTF) standards (body mass index (BMI)-for-age). These standards were compared with other accepted standard values. Both Cole's IOTF/BMI-for-age standard and the sum of skinfold thicknesses standard classified normal-weight status similarly at a level of 92% (P<0.01) and were found to be useful in determining overweight/obesity. The prevalence rate was higher in females and white children, and was more apparent in urban areas, smaller households and children of parents with low- or high-income occupations. Boys and pre-menarcheal girls had mean body fat percentage in the normal/optimal range, whereas that of post-menarcheal girls was moderately high. Few variables showed a significant association with high body fat percentage: in boys, only the number of members in the household and physical activity levels over the weekend; in girls, only age. The overweight/obese boys mostly lived in smaller households, and the overweight/obese post-menarcheal girls were most inactive on both weekdays and weekends, and more overweight with increasing age.

Conclusion

Smaller households, inactivity and increasing age for girls were found to be determinants that influence the development of overweight/obesity, while female gender and age post-menarche were identified as determinants of higher body fat content. For overweight/obesity prevention, the focus should be on pre-menarcheal girls, aged 10–13 years, using these determinants to identify overweight/obesity risk. Preventive programmes should aim to increase the physical activity of children to improve their current and future weight status.

Keywords

OverweightObesityDeterminantsAdolescentsDietary intakeBody mass indexBody fat percentage
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 3 , May 2006 , pp. 351 - 358
Copyright
Copyright © The Authors 2006

References

1Popkin, BM, Doak, CM. The obesity epidemic is a worldwide phenomenon. Nutrition Reviews 1998; 56(4): 106–14.CrossRefGoogle ScholarPubMed
2Parsons, TJ, Power, C, Logan, S, Summerbell, CD. Childhood predictors of adult obesity: a systematic review. International Journal of Obesity and Related Metabolic Disorders 1999; 23(Suppl. 8): S1–107.Google ScholarPubMed
3Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. British Medical Journal 2000; 320(7244): 1240–3.CrossRefGoogle ScholarPubMed
4Davison, KK, Birch, LL. Childhood overweight: a contextual model and recommendations for future research. Obesity Reviews 2001; 2(3): 159–71.CrossRefGoogle ScholarPubMed
5Baur, LA. How do we define or diagnose overweight and obesity in childhood?. In: O'Connor, HT, Eden, BD, eds. Recommendations for Nutrition and Physical Activity for Australian Children [special issue]. Medical Journal of Australia 2000; 173(Suppl.): S1–17.Google Scholar
6Livingstone MBE. Childhood obesity in Europe: a growing concern. Public Health Nutrition 2001; 4(1): 109–16.CrossRefGoogle Scholar
7He, Q, Ding, ZY, Fong, DYT, Karlberg, J. Risk factors of obesity in preschool children in China: a population-based case–control study. International Journal of Obesity and Related Metabolic Disorders 2000; 24(11): 1528–36.CrossRefGoogle Scholar
8Wang, Y, Popkin, BM, Zhai, F. The nutritional status and dietary pattern of Chinese adolescents, 1991 and 1993. European Journal of Clinical Nutrition 1998; 52(12): 908–16.CrossRefGoogle ScholarPubMed
9Bellizzi, MC. New IOTF international BMI cut-offs for underweight, overweight and obese youngsters. International Association for the Study of Obesity (IASO) Newsletter. 1999; (Spring): 11.Google Scholar
10Jonnalagadda, SS, Mitchell, DC, Smiciklas-Wright, H, Meaker, KB, Van Heel, N, Karmally, W, et al. Accuracy of energy intake data estimated by a multiple-pass, 24-hour dietary recall technique. Journal of the American Dietetic Association 2000. 100(3): 303–8.CrossRefGoogle ScholarPubMed
11Venter, CS, MacIntyre, UE, Vorster, HH. The development and testing of a food photograph book for use in the THUSA study. Journal of Human Nutrition and Dietetics 2000; 13(3): 205–11.CrossRefGoogle Scholar
12Gibson, S. Obesity: is it related to sugar in children's diets? Nutr Food Sci 1997; 97(5): 184–7.CrossRefGoogle Scholar
13Lee, RD, Nieman, DC. Nutritional Assessment, 3rd ed. London: McGraw-Hill, 2003.Google Scholar
14Trost, SG, Ward, DS, McGraw, R, Russel, RP. Validity of the previous day physical activity recall in fifth-grade children. Pediatrics and Exercise Science 1999; 11: 341–8.CrossRefGoogle Scholar
15Whitney, EN, Rolfes, SR. Understanding Nutrition, 9th ed. London: Wadsworth Thomson Learning, 2002.Google Scholar
16Labadarios, D ed. The National Food Consumption Survey (NFCS) – children aged 1–9 years, South Africa, 1999. South African Journal of Clinical Nutrition 2001; 14(2): 62–75.Google Scholar
17Wang, Y. Cross-national comparison of childhood obesity: the epidemic and the relationship between obesity and socioeconomic status. International Journal of Epidemiology 2001; 30(5): 1129–36.CrossRefGoogle ScholarPubMed
18Ramachandran, A, Snehalatha, C, Vinitha, R, Thayyil, M, Sathish Kumar, CK, Sheeba, L, et al. Prevalence of overweight in urban Indian adolescent school children. Diabetes Research and Clinical Practice 2002; 57(3): 185–90.CrossRefGoogle ScholarPubMed
19Benadé, AJS, Oelofse, A, Faber, M. Body composition of different ethnic groups in South Africa. Asia Pacific Journal of Clinical Nutrition 1996; 5(4): 226–8.Google ScholarPubMed
20Kruger, HS, Venter, CS, Vorster, HH, Margetts, BM. Physical inactivity is the major determinant of obesity in black women in the North-West Province, South Africa: the THUSA study. Nutrition 2002; 18(5): 422–7.CrossRefGoogle ScholarPubMed
21Jerum, A, Melnyk, BM. Effectiveness of interventions to prevent obesity and obesity-related complications in children and adolescents. Pediatric Nursing 2001; 27(6): 606–10.Google ScholarPubMed
22Hassapidou, MN, Bairaktari, M. Dietary intake of pre-adolescent children in Greece. Nutri Food Sci 2001; 31(3): 136–40.CrossRefGoogle Scholar
23Mo-Suwan, L, Tongkumchum, P, Puetpaiboon, A. Determinants of overweight tracking from childhood to adolescence: a 5y follow-up study of Hat Yai schoolchildren. International Journal of Obesity and Related Metabolic Disorders 2000; 24(12): 1642–7.CrossRefGoogle ScholarPubMed
24Blundell, JE, Cooling, J. Routes to obesity: phenotypes, food choices and activity. British Journal of Nutrition 2000; 83(Suppl. 1): S33–8.CrossRefGoogle ScholarPubMed
25Livingstone, MBE, Robson, PJ. Measurement of dietary intake in children. Proceedings of the Nutrition Society 2000; 59(2): 279–93.CrossRefGoogle ScholarPubMed
26Ebbeling, CB, Pawlak, DB, Ludwig, DS. Childhood obesity: public-health crisis, common sense cure. Lancet 2002; 360(9331): 473–82.CrossRefGoogle ScholarPubMed
27Bray, GA, Popkin, BM. Dietary fat intake does affect obesity!. American Journal of Clinical Nutrition 1998; 68(6): 1157–73.CrossRefGoogle ScholarPubMed
28Dietz, WH. Periods of risk in childhood for the development of adult obesity: what do we need to learn? Journal of Nutrition 1997; 127(Suppl.): S1884–6.CrossRefGoogle ScholarPubMed
29Elrick, HD, Samaras, TT, Demas, A. Missing links in the obesity epidemic. Nutrition Research 2002; 22: 1101–23.CrossRefGoogle Scholar
30Popkin, BM. Worldwide trends in obesity. Journal of Nutritional Biochemistry 1998; 9: 487–8.CrossRefGoogle Scholar