PREVALENCE AND DETERMINANTS OF OBESITY AMONG SCHOOL-AGED CHILDREN IN IBADAN, SOUTH WEST, NIGERIA

Abstract

Childhood obesity is associated with adverse health outcomes and ultimately lays a template for obesity and other non communicable diseases (NCDs) in later adulthood. In SubSaharan African region and other Low and Medium Income Countries (LMICs), over nutrition is rapidly swapping with under nutrition leading to a prevalence of overweight and obesity especially among children. Despite the teeming development of Ibadan, a growing city in South West Nigeria, there is dearth of data about the prevalence and risk factors for overweight/obesity among school aged children. Hence, this study provides valuable data to ascertain the current nutritional status among this population. To estimate the prevalence of obesity and its associated risk factors among eligible school aged children in Ibadan metropolis. A cross-sectional study design was used to enroll 947 children and adolescents aged 8 to 19 years across randomly selected schools in five local government areas (3 urban and 2 semi-urban) within Ibadan metropolis, southern Nigeria. Using a modified questionnaire, information on the background and socioeconomic status of both children and their parents were obtained, while measurements of weight, height, and blood pressure (BP) were collected using standard methods. Overweight and obesity were defined according to 2007 WHO reference values for comparison. Children were classified into pre-high blood pressure (pre-HBP) and high blood pressure (HBP) using National High Blood Pressure Education Program Working Group on High Blood Pressure. Data analysis was done by descriptive statistics, chi-squared tests and binary logistic regression, with results interpreted at 5% level of statistical significance. Participants included 40.5% males and 59.5% females, with 54.0% from private schools, while 66.4% attended schools in urban areas. Overall, the prevalence of overweight, obesity and combined overweight/obesity were 14.3%, 7.7% and 21.8% respectively. Overweight and obesity was highest among pre-teens (9 - 12 years) compared to older adolescents/teenagers (≥13 years) with highest estimates obtained for age 11 years. Females tended to be more overweight and obese (16.6% and 8.4%) compared to their male counterparts (11% and 6.30%), while children attending private schools and children from urban schools were significantly more overweight and obese (p < 0.05). The type of school attended, consumption of confectioneries and a desire to lose weight were statistically associated with overweight/obesity in children/adolescents at multivariate analysis. Children who attended private schools were about five times more likely to be overweight/obese (OR: 4.65; 95% Cl: 0.09 - 0.50), while children who consumed confectioneries at least once a day had about 5 times odds of being overweight/obese (OR: 5.36; 95% CI: 1.69 - 16.97). The prevalence of high blood pressure (HBP) was 12.0%, while 16.7% of the study participants were pre-hypertensive (pre-HBP). The mean systolic and diastolic blood pressures were 112.29 ± 12.95 mmHg and 66.66 ± 12.95 mmHg respectively. BMI was also positively correlated with systolic blood pressure. Findings from this study provides evidence of an increasing prevalence of both overweight and obesity among school aged children in growing cities across Nigeria, intervention efforts are needed focusing on dietary pattern particularly among children attending private schools to curb this menace.