Prevalence of Obesity Among Thi-Qar University Students During the Year 2015- 2016

Abstract

Background: The prevalence of overweight and obesity is increasing in both developed and developing countries. Obesity is a major risk factors for many chronic diseases including diabetes, hypertension and ischemic heart disease, so it is considering a major Public health problem. Objectives: to study the prevalence of obesity and it is risk factors among Thi-Qar university students. Subjects and Method: A cross sectional study had been extended from 1st of April 2016 to10th of June 2016, a total of 841 students (358 of male and 456 of female) between 18 years and 36 years of age (mean 21.7 ± 2.3years) were selected randomly from 24 colleges of both Thi-Qar university and Mazzia college. Each participants subjected to a questionnaire that include: personal socio-demography, time of sleep per night, types of activity during leisure times, height, weight and waist circumference were measured and body mass index was calculated and used to asses’ weight status. The data was analyzed by using SPSS. p value less than 0.05 was considered as statistically significant. Result: The mean BMI was 24.17 ± 4.0; more than half (59.2%) of students were of normal weight ( 63.8% of male students and 55.2% of female students ) ; whereas the prevalence of overweight and that of obesity among them was 28.3% and 8.1% respectively. The prevalence of obesity was nearly similar between male and female students, while the prevalence of overweight was more common among females students as compared to males (32% of females vs. 23.1% of males).The prevalence of underweight was more common among male than female students (5.1 % of male vs. 3.7 % of female ) . Depending on their waist circumferences 3% of male and 18 % of female students where at a higher risk of developing abdominal obesity co morbidities. There was significant higher prevalence of obesity and mean waist circumference with in students of more than 26 years old age and of less than 6 household family number (p < .05 for both variables). A relatively high proportion (42.7 % for male and 35.8 % for female) spend more than two hours on screen time daily. Females where significantly (p< .05) much less physically active than male. Conclusion: there was high prevalence of obesity among ThiQar university students and the study supports the multi factorial etiology of obesity; it demonstrated that age, parent’s education and household number are risk factors. The study also shows high prevalence of sedentary behaviors, physical inactivity among Thi-Qar university students. Recommendation: the study results mandate the need for a Public Health strategies to Thi-Qar Medical Journal (TQMJ): Vol.(12), No.(2), 2016 https://jmed.utq.edu.iq Web Site: Email:utjmed@utq.edu.iq 25 prevent overweight and obesity and adopt a healthy dietary habit and life style. Key word: Prevalence, Obesity, Overweight, Cross sectional study, Dietary habit, Life style. Abbreviations: WHO, World Health Organization; WC, waist circumference; BMI, body mass index; SPSS, Statistical Package for Social Sciences. Introduction: Obesity: is defined by WHO as a state of excess adipose tissue mass that cause health impairment (1), while overweight means increased body weight in relation to height which then compared to a stander acceptable (2). Obesity worldwide considered as a pandemic with highly disastrous effects for human health. More than 30% of adult in USA, and more than 20% of UK are obese (with a BMI equal or more than 30%) (3). In the last two decades the prevalence of overweight and obesity has increase three fold and the prevalence continue to rise (3). At the beginning the increasing prevalence is started in high income countries now the increasing rates include low and middle income countries specially in urban communities. The rates of childhood obesity in developing country increased to 30% due to emerging economies (1). During the year 2015 the WHO project that around 700 000 million adult aged 18 years and above were obese and 2.3 billion were overweight (4). The four years’ rate for individual to developing obesity around 5% -7% among non-obese women and around 7%-9% among non-obese man. In general, the risk for developing overweight is 1 in 2 individuals, and 1 in 4 persons to develop obesity while the risk for developing severe obesity is 1 in each 10 individual (5). The prevalence of obesity is varied among the world being higher in United State, European countries up to 25 % of both gender and Arab countries rich in oil 30% for male and 40% for female (6). This rapid increasing involve both men and women, more in women, Hispanics, Native Americans, African Americans at a more risk of obesity, low socioeconomic status, low educational level and rural residency are a risk factors behind obesity (4). During the year 2010, obesity and overweight causes 3.4 million death, 3.9% years of human life lost by obesity, and about 3.8 % of DALYS (disability adjusted life years) worldwide (7). Obesity account for 0.72.8 % of total health care, the obese person spent approximately 30% on medical care than normal individual (8). According to the results of the National survey in Iraq at 2006 around (63.6% and 69.6%) of adult males and females respectively were obese or overweight and 11% of children below 5 years of age and around 7% of school age children were either obese or overweight (10). WHO Step wise NCD (noncommunicable disease) Risk Factor Survey at 2015 showed that the prevalence of overweight was 31.9% for adult in Iraq it was (33.1% for male and 30.6% for females), while the prevalence of obesity was 33.5% for adult it was (25.6% for males and 42.6% for females) (11). The body mass index (BMI) which is equal to body weight in kilogram (kg) divided by squared height in meter (m2), it is one of the commonest method to classify obesity (12). The WHO considered a BIM 18.5-24.9 as normal ,25-29.9 as overweight ,3034.9 class 1 obesity, 35-39.9 class2 ,40 Thi-Qar Medical Journal (TQMJ): Vol.(12), No.(2), 2016 https://jmed.utq.edu.iq Web Site: Email:utjmed@utq.edu.iq 26 and more class3. For further assessment in term of fat distribution through measuring waist circumference ,which reflect what is called central or abdominal obesity, while the subcutaneous fat accumulation which indicate generalized obesity .The central type of obesity more common in men and associated with risk of metabolic syndrome ,type 2 diabetes mellitus and cardiovascular diseases this differences in fat distribution due to vascular anatomy ,the substance that released from abdominal fat such as free fatty acid and tumor necrosis factor drains to the portal vein and as a result being in high concentration in the liver and promoted the development of diabetes mellitus.(3) Obesity is the result of interaction of environmental factor, genetic and lifestyle. In general, it caused by a combination of high caloric dietary intake, reduce physical activity and genetic susceptibility. however, there are few cases are caused by endocrine disorder, psychiatric illness, medications, and genes (4). So it is a preventable condition through a variety of changes including personal choices and social changes. (1) Obesity has adverse health sequences effect on both mortality and morbidity. The less mortality rates were seen among individual with BMI range 18.5-24. Framingham data collected from USA population showed that; a people at 30-42 years old with 1% per year increased risk of death for each half kilogram increase in body weight, as the age increase the risk will be risen. As a result, the obesity will decrease the individual life expectancy by 7.1(3). The obese and overweight individual are more prone to develop diabetes mellitus, cardiovascular disease, Dyslipidemia, musculoskeletal disorder breathing difficulty during sleep and cancer (13). Rationale of the study: During the last several year Iraq is financially growing, as a result high availability of food, open market, possible reason for less activity including: easily transport, increase time spent on watching television, playing computer and video games, and using social media, the university student as part of the community affected by these changes. As a result, overweight and obesity are expected to be increasingly among these age groups. Many researches have been conducted to assess the nutritional status of children including school age group and infant but a little research to evaluate this adolescence and young adult age group as undergraduate university students, these little attentions specially nutritionally may be due to researcher believe that this group is not a vulnerable one. This study tried to understanding the life style risk factors among university student and if there is a gender differences among students for developing a public health polices and strategies to treat and prevent the obesity. Furthermore, data from university student could be used to facilitate the implementations of nutritional programs for the population at a low cost. Objective of the study: This study was aimed to determine the extent of overweight and obesity among Thi-Qar university students and studying the risk factors of the problem and compare its occurrence between governmental and private colleges. Subjects and method: Design and setting: This study was university based cross Thi-Qar Medical Journal (TQMJ): Vol.(12), No.(2), 2016 https://jmed.utq.edu.iq Web Site: Email:utjmed@utq.edu.iq 27 sectional study carried out in college studentsThi-Qar governorate -Iraq, during the academic year 2015 – 2016, from the 1 st of April – 10 th June 2016 after taken the permission of the university authority. The population under the study included some of university students both private and governmental, both sex male and female, while the students of colleges that located ten kilometers away from Al-Nasiriya city were excluded, the students who were refused and the pregnant female student also exclud