|Year : 2015 | Volume
| Issue : 1 | Page : 73-77
Prevalence of obesity and overweight in primary school children living in Menoufia governorate, Menouf district
Mohamed H Bahbah1, EL-Sayed I Slama2, Abd-El Hafiz M Ramadan MD 3, Mohamed A Abo Zeed4
1 Department of Paediatrics, Faculty of Medicine, Menoufia University, Menoufia Governorate, Egypt
2 Department of Paediatrics, National Liver Institute, Menoufia University, Menoufia Governorate, Egypt
3 Department of Paediatrics, Shebin El-Koom Teatching Hospital, Menoufyia University, Menoufia Governorate, Egypt
4 Department of Paediatrics, Menouf General Hospital, Menoufia Governorate, Egypt
|Date of Submission||12-May-2015|
|Date of Acceptance||27-May-2015|
|Date of Web Publication||26-Nov-2015|
Abd-El Hafiz M Ramadan
Department of Paediatrics, Shebin EL-Koom Teaching Hospital, Menoufia Governorate
Source of Support: None, Conflict of Interest: None
Obesity is an excessive accumulation of fat that adversely affects well-being and health. It is a major public health problem that affects nearly 18% of teenagers.
This study was conducted on primary school children in Menouf district to study the prevalence of obesity and overweight and some associated risk factors.
Obesity was more prevalent in children between 6 and 9 years of age, and it is more prevalent in girls than in boys. The incidence of obesity was higher among urban than among rural children, and children attending private schools and of high socioeconomic levels were more obese.
Conclusion and recommendation
Childhood obesity has tripled in the past 30 years. The prevalence in 11 years has increased from 6.5% in 1980 to 19.6% in 2008.
There is an urgent need to spread awareness about obesity, its consequences, and ways and means of prevention, especially among children and their families.
Keywords: Body Mass Index (BMI), Obesity, Overweight
|How to cite this article:|
Bahbah MH, Slama ESI, Ramadan AEM, Abo Zeed MA. Prevalence of obesity and overweight in primary school children living in Menoufia governorate, Menouf district. Benha Med J 2015;32:73-7
|How to cite this URL:|
Bahbah MH, Slama ESI, Ramadan AEM, Abo Zeed MA. Prevalence of obesity and overweight in primary school children living in Menoufia governorate, Menouf district. Benha Med J [serial online] 2015 [cited 2018 Apr 26];32:73-7. Available from: http://www.bmfj.eg.net/text.asp?2015/32/1/73/170572
| Introduction|| |
Obesity is an excessive accumulation of fat that adversely affects well-being and health  . Obesity is a major public health problem that affects nearly 18% of teenagers  . The prevalence of obesity often doubles between the age of 4-5 years and the age of 10-11 years from 10.4 to 20% in boys and from 8.8 to 16.6% in girls  . The BMI, a number that conveys the weight-for-height relationship as a ratio (weight in kilograms divided by the square of height in meters), is the standard measure for assessing obesity in children and adolescents (Krebs et al., 2007)  .
The causes of obesity are multifactorial and include genetic predisposition, sedentary lifestyle, overeating, fast food diet, lack of adequate nutritional education, school environment, and influence from advertising and marketing of unhealthy food  .
In Egypt, as in other parts of the world, the obesity epidemic affects a growing number of children and adolescents , .
It is commonly agreed that prevention is better than cure. Therefore, obesity prevention is the primary and most obvious strategy to control this disease  .
A healthy diet and regular exercise are the cornerstone for overall good health for prevention of childhood obesity  .
| Aim|| |
The aim of this work was to study the prevalence of obesity and overweight among primary school children in Menouf district in Menoufia governorate.
| Patients and methods|| |
An approval from the Menoufia Faculty of Medicine ethical committee was taken before beginning of the study. A cross-sectional study was carried out on 4047 Egyptian children to determine the prevalence of overweight and obesity among primary school children between 6 and 12 years of age who live in Menouf district. Three schools were randomly selected from the rural and three schools from the urban areas, including male and female children. Written consent form was signed by the manager of each school and authorities in the education ministry.
- Children between 6 and 12 years of age.
- Children of both sexes.
- Children from Menouf district.
- Children younger than 6 years.
- Children older than 12 years.
- Children with any chronic disease.
All cases were subjected to the following:
- Clinical history taking with special emphasis on the following:
- Personal data: name, age, sex, and residence.
- Assessment of the socioeconomic standard of family, which includes questions on father's education and occupation, mother's education and occupation, and family income, according to modified Fahmy and El-Sherbiny classification  .
Physical examination with special emphasis on anthropometric measurements, including weight, height, and BMI.
Weight was measured on a digital electronic scale. The scale was set to zero before the patient was made to stand on the scale and was checked weekly with known calibration weights. Weight measurements were taken with the child wearing little or no outer clothing and no shoes. The weight was approximated to nearest 100 g  .
Height was measured with a tape measure permanently fixed to a wall or door frame and the head was held firmly at the top of the board.
Body mass index
BMI is a ratio between weights measured in kilograms to height measured in meters using the following formula:
Collected data were complied, coded, and verified and then analysis was performed using SPSS (v.18; SPSS Inc., Chicago, Illinois, USA) software for Microsoft Windows 7.
Data were expressed in terms of standard deviation scores (Z scores) using WHO AnthroPlus software provided by WHO website  .
| Results|| |
Girls showed significantly higher mean weight, height, and BMI compared with boys.
Children from rural areas showed lower mean weight and BMI compared with those in urban areas. The mean weight and mean BMI were significantly higher in children of high socioeconomic level and in children attending private schools ([Table 2]).
As regards the BMI Z score, girls, children from urban areas, and children from higher socioeconomic levels and private schools showed significantly higher positive deviations from mean ([Table 3]).
In all age groups, obesity was more prevalent in girls than in boys. Moreover, obesity was more prevalent in children between 6 and 9 years of age in both sexes ([Table 4]).
Obesity was significantly more prevalent in children from urban areas, those from higher socioeconomic standards, and those attending private schools ([Table 5]).
In all age groups, overweight was more prevalent in female children than in male children ([Table 6]).
Overweight was significantly more prevalent in female children, children from urban areas, and those attending private schools ([Table 7]).
| Discussion|| |
Childhood obesity has tripled in the past 30 years. The prevalence of obesity among children aged 6-11 years increased from 6.5% in 1980 to 19.6% in 2008  .
In this study, on comparing the distribution of students as regards sex, 45.7% were female and 54.3% were male ([Table 1]).
|Table 2 Comparison between anthropometric measurements of children as regards sex, residence, school type, and socioeconomic standard|
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|Table 3 Comparison between different demographic factors as regards body mass index Z score classes|
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|Table 5 Sex-specific prevalence of obesity in studied children based on demographic factors|
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|Table 7 Sex-specific prevalence of overweight in studied children based on demographic factors|
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This is in disagreement with that reported by El-Shafie et al.  , who found in the study conducted in El Bagour district that the proportion of girls was higher compared with that of boys.
The prevalence of overweight and obesity in this study was higher than that reported in previous Egyptian study conducted by Hafez et al.  , who showed that the prevalence of overweight and obesity was 11 and 3.8%, respectively, among children attending government schools in Cairo.
El-Shafie and colleagues ,, found that the prevalence of overweight and obesity was 11.5 and 8.5%, respectively.
The percentage of obesity in the present study was 9.6% ([Table 4]). This is higher than the values described by El-Masry and colleagues ,,,, . This variation might be partially attributed to the difference in standard curves used for BMI Z score classes. This study reported that the prevalence of overweight and obesity among female children was 16.1 and 11.9%, respectively; the prevalence was higher among female children than among male children (9.2 and 7.8%, respectively) ([Table 4]). This could be due to reduced activity levels of girls in the school or outside. This study is in agreement with most previous studies conducted in Egypt, which showed significant increase in female percentage of obesity compared with male percentage. As regards BMI Z score classes, this study revealed that the percentage of overweight and obesity was 18.3 and 15%, respectively, in urban children and 7.1 and 4.8%, respectively, in rural children (higher in urban children with significant difference) ([Table 3] and [Table 7]). This variation could be attributed to dietary variation between urban and rural children.
In the present work, the prevalence of overweight and obesity in private schools was 13.7 and 16.6%, respectively, and was higher than that in government schools (12.3 and 9.0%, respectively), with highly significant difference ([Table 5]). It was found that the Z score for BMI for age increased with the increase in socioeconomic class (in the high class 16.2% of children were obese and 16% were overweight, in the middle class 8.8% of children were obese and 13.1% were overweight, in the low class 7.4% of children were obese and 8.6% were overweight, and in the very low class 4.9% of children were obese and 6.2% were overweight) ([Table 5]).
This may be attributed to the excessive intake of processed meat, processed cheese, rice, artificial juices, and aerated drinks , as well as longer duration of sitting when playing video and computer games and influence from advertisements on fattening food, among children from high socioeconomic classes.
From this study, the following are recommended:
- There is an urgent need to spread awareness about obesity, its consequences, and ways and means of prevention, especially among young and their families, by promoting healthy eating and physical activities.
- This study recommends that other studies be conducted in different places in Menoufia governorate and other governorates to compare the results with each other.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kanagalingam MG, Forouhi NG, Greer IA. Changes in booking body mass index over a decade: retrospective analysis from a Glasgow Maternity Hospital. Br J Obstet Gynaecol 2005; 112
Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007-2008. JAMA 2010; 303
Ridler C, Townsend N, Dinsdale H, Mulhall C, Rutter H. National child measurement programme: detailed analysis of the 2007/08 national dataset
. London HM gov; 2009.
Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P. Assessment of childhood and adolescent overweight and obesity, Pediatrics 2007; 120
Hassink SG. Childhood obesity and overweight. In: Pediatric obesity: prevention, intervention, and treatment strategies for primary care
. Elk Grove Village, IL: American Academy of Pediatric. 2007. 1-6.
El-Masry SA. Nutritional assessment of Egyptian children. Egypt Med J 2007; 6
Shaaban SY, El-Masry SA, Younis NT, Mohamed HH. Malnutrition among preschool children in Cairo. Egypt Paed Assoc Gaz 2008; 56
El-Shafie MA, Bahbah MH, Randa AM. Recent advances in pathophysiology and management of childhood obesity (Master essay). Menoufia: Faculty of Medicine Menoufia University; 2011.
Fahmy SI, El-Sherbiny AF. Determining simple parameters for social classification for health research. Bull High Inst Pub Health 1983; X111
Mascarenhas MR, Zemel B, Stallings VA. Nutritional assessment in pediatrics. Nutrition 1998; 14
WHO. Standard deviation of anthropometric Z-score, Available at web site: (http://www.who.int /bulletin/volumes/85/6/06-034421/en/), (2006).
El-Shafie MA, El Nemer MF, El Lahoni D, et al
. Assessment of parasitic infestation and its effect on school performance in El-Bagor center in Menoufia governorate [Master thesis]. Menoufia: Faculty of Medicine, Menoufia University; 2009.
Hafez AS, EI-Awady MY, Hassan NE. Obesity profile among primary school children in Cairo. Egypt J Commun Med 2000; 18
Babah MH, Hegran HH, Metwaly MM. Prevalence of obesity in primary school children living in Dakahlia governorate (El-Sinbellaween district) [Master thesis in pediatrics]. Menoufia: Faculty of Medicine, Menoufia University; 2012.
El-Shafie AM, Sleem AA. 2013; Prevalence of obesity in primary school children living in Dakahlia governorate (Mit-Ghamr State) [Master thesis in Pediatrics]. Menoufia: Faculty of Medicine, Menoufia University; 2013.
El-Damatti S, et al
. Prevalence and socioeconomic risk factors of obesity among primary school children
. Cairo, Egypt: Ain-Shams International Medical Congress 1996; 19
Ismail G. Study of the problem of obesity among primary school children in Alexandria. Alexandria: High Institute of Public Health Alexandria; 1998.
Mahfouz EM. Main health problems among school obligatory education public health [MD thesis]. El-Minia: Faculty of Medicine, El-Minia University; 1995.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]