The influence of socio-demographic factors on the nutritional intake of overweight and obese children in the Stellenbosch area, Western Cape

Kirsten, Anna Petronella (2011-12)

Thesis (MNutr)--Stellenbosch University, 2011.

Thesis

ENGLISH ABSTRACT: Introduction: The worldwide increase in the prevalence of childhood overweight and obesity has been identified as a major threat to children’s health and South Africa has not been spared. A child’s food environment is constrained and shaped by their parents/carers who provide food based on own food preferences and food selections, which in turn are determined by the larger cultural, social and economic context. Risk factors for childhood obesity are not well established. Existing prevention strategies, focusing on late childhood and adolescence, are largely unsuccessful. There is however an increasing body of evidence that the early life environment is an important determinant of risk of obesity in later life. Aim: To determine prevalence and socio-demographic risk factors associated with childhood overweight and obesity in the Stellenbosch area, Western Cape Province. Methods: Cross-sectional, comparison study. A representative group of 638 children (aged 6- 13 years) attending three randomly selected Stellenbosch primary schools were weighed and measured to calculate body mass index (BMI) using international obesity task force (IOTF) guidelines in the screening phase of the project to determine the prevalence of overweight and obesity. The comparison study phase identified 84 overweight and obese children and 84 children of normal weight (comparison group) to comprise a sample population of 168 children. Socio-demographic data were determined with a structured questionnaire and compared between the overweight/obese group and comparison group (normal weight) to identify associated risk factors and investigate the Ho. Results: The prevalence of overweight and obesity in the sample of primary school children was 13% (n=84) as determined by BMI, of which 9% (n=57) were classified as overweight and 4% (n=27) as obese. Socio-economic factors including maternal employment hours (p=0.0462), family characteristics e.g. number of children in the household (p=0.0231), eating behaviour like consuming brown rice (p=0.0371), pork (p=0.0143), canola/olive-based margarine (p=0.0398) or poly-unsaturated margarine (p=0.0481), doughnuts (p=0.0280) and time spent doing sport (p=0.0450) were significantly associated with overweight or obesity. Ho were thus rejected. Conclusion: The results suggest that maternal working hours, the number of children in the household, poor eating habits and time spent doing sport are important predictor variables for childhood overweight and obesity. Socio-economic status, infant feeding practices and family characteristics like marital circumstances, household number, and mother’s age did not appear to play a role in the development of childhood overweight and obesity in this population. In light of this evidence, preventative initiatives should pro-actively promote healthy eating behaviour and physical activity to children at an early age, in particular girls. Involving families and schools in these initiatives is recommended as well as a national childhood obesity monitoring system to identify children at risk and tracking trends of childhood obesity in guiding evidence-based interventions to tackle this major health problem.

AFRIKAANSE OPSOMMING: Inleiding: Die wêreldwye toename in die prevalensie van kinder-oorgewig en vetsugtigheid is geïdentifiseer as 'n groot bedreiging vir kinders se gesondheid en Suid-Afrika word nie gespaar nie. 'n Kind se voedingsomgewing is beperk en word gevorm deur ouers of versorgers wat voedsel voorsien gebaseer op hul eie kos voorkeure en voedsel keuses, wat op sy beurt deur die groter kulturele, sosiale en ekonomiese konteks bepaal word. Risiko faktore vir kinder-vetsugtigheid is nie goed gevestig nie. Bestaande voorkoming strategieë, wat fokus op die laat kinderjare en vroeë adolessensie, is grootliks onsuksesvol. Daar is egter voortdurende toename in bewyse dat die vroeë lewensomgewing ‘n belangrike bepalende risiko faktor is vir vetsugtigheid in latere lewe. Doelstellings: Bepaling van prevalensie en sosio-demografiese risiko faktore wat geassosieer word met kinder-oorgewig en vetsugtigheid in die Stellenbosch area, Wes-Kaap Provinsie. Metodes: Deursnit, vergelykende studie. ‘n Verteenwoordigende groep van 638 kinders (ouderdom 6-13 jaar) skoolgaande by drie ewekansig geselekteerde Stellenbosch primêre skole was geweeg en gemeet om Liggaamsmassa Indeks (LMI), volgens die internasionale obesiteit werkgroep (IOTF) riglyne te bereken in die siftingsfase van die projek ter bepaling van prevalensie van oorgewig en vetsugtigheid. Die vergelykende fase het 84 oorgewig en vetsugtige kinders geidentifiseer en 84 kinders met normale gewig (vergelykende groep) ter samestelling van ‘n steekproef populasie van 168 kinders. Sosio-demografiese data was verkry deur ‘n gestruktureerde vraelys en vergelykings was getref tussen oorgewig/vetsugtige groep en vergelykende groep (normale gewig) ter identifisering van geassosieerde risiko faktore en ondersoek van die Ho. Resultate: Prevalensie van oorgewig en vetsugtigheid in die steekproef van primêre skool kinders was 13%(n=84) waarvan 9%(n=57) geklassifiseer was as oorgewig en 4%(n=27) as vetsugtig. Sosio-ekonomiese faktore soos moeders se werksure (p=0.0462), familie kenmerke soos aantal kinders in ‘n huishouding (p=0.0231), eetgedrag nl. bruin rys (p=0.0371), varkvleis (p=0.0143), canola/olyf-gebaseerde margarien (p=0.0398) of polionversadigde margarien (p=0.0481), oliebolle (p=0.0280) en tyd gespandeer aan sport (p=0.0450) was beduidend geassosieer met oorgewig en obesiteit. Ho was dus verwerp. Gevolgtrekking: Die resultate dui daarop dat moeders se werksure, aantal kinders in ‘n huishouding, swak eetgewoontes en tyd gespandeer aan sport, belangrike voorspellers vir kinder-oorgewig en vetsugtigheid is. Sosio-ekonomiese status, baba-voedingspraktyke en familie kenmerke soos huwelikstatus, huishoudelike getal en moeders se ouderdom blyk nie ‘n rol te speel in die ontwikkeling van kinder-oorgewig en obesiteit in hierdie populasie nie. Na aanleiding van hierdie bevindinge moet voorkoming inisiatiewe pro-aktief gesonde eetgewoontes en fisiese aktiwiteit in kinders aanmoedig reeds op 'n vroeë ouderdom, veral in meisies. Die betrekking van gesinne en skole in hierdie inisiatiewe word aanbeveel asook 'n nasionale kinder vetsugtigheids-moniteringstelsel om risiko kinders te identifiseer en die tendense van kinder-vetsugtigheid te volg in die begeleiding van navorsings-gebaseerde intervensies om hierdie belangrike gesondheidsprobleem aan te spreek.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/17955
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