2020 Volume 7 Issue 4

Adolescent Obese Females and Quality of Lifestyle: An Examination of Anthropometric and Socio-Economic Factors in Tehran-Iran


Ahmad Reza Dorosti Motlagh, Davoud Shojaeizadeh, Kamal Azam, Nayere Esmaeil Kaboli
Abstract

Background: Due to the social development and concurrent lifestyle changes, the spread of overweight and obesity, as well as related chronic and metabolic diseases, is on the rise. Various studies have indicated that family lifestyle modifications can have beneficial effects on childhood obesity prevention in the long term. This study aimed to determine the effect of lifestyle changes on anthropometric indices and other related factors in obese female students aged 11-14. Methods: This study was performed on 452 random obese female high-school students in three low-income areas of Tehran who had BMI greater than 2SD above the WHO 2007 reference. General information and a lifestyle questionnaire were provided by their parents. Anthropometric indices and body fat percentage were calculated by skin folds and calipers. Finally, all of the information was analyzed by SPSS. Results: There was a significant and direct relationship between the lifestyle score and the father’s employment status (p<0.001), mother’s employment status (p=0.004), father’s education (p=0.005), mother’s education (p= 0.017), family economic status (p<0.001) and homeownership status (p<0.001). Among the anthropometric variables, there was a significant difference only between weight (p=0.09) and height (p=0.003) with lifestyle. Conclusion: The results of this study showed that factors such as parents' occupation and education, homeownership status and household economic status have a significant relationship with lifestyle scores.


How to cite this article
Motlagh A R D, Shojaeizadeh D, Azam K, Kaboli N E. Adolescent Obese Females and Quality of Lifestyle: An Examination of Anthropometric and Socio-Economic Factors in Tehran-Iran. Entomol appl sci lett 2020;7(4):66-70

Adolescent Obese Females and Quality of Lifestyle: An Examination of Anthropometric and Socio-Economic Factors in Tehran-Iran

 

Ahmad Reza Dorosti Motlagh1, Davoud Shojaeizadeh2, Kamal Azam 3, Nayere Esmaeil Kaboli4*

 

1 Department of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

2Ph.D. Professor, Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

3Ph.D. Associate Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

4Ph.D. student of Nutrition Sciences, Tehran University of Medical Sciences, Tehran, Iran.


ABSTRACT

Background: Due to the social development and concurrent lifestyle changes, the spread of overweight and obesity, as well as related chronic and metabolic diseases, is on the rise. Various studies have indicated that family lifestyle modifications can have beneficial effects on childhood obesity prevention in the long term. This study aimed to determine the effect of lifestyle changes on anthropometric indices and other related factors in obese female students aged 11-14. Methods: This study was performed on 452 random obese female high-school students in three low-income areas of Tehran who had BMI greater than 2SD above the WHO 2007 reference. General information and a lifestyle questionnaire were provided by their parents. Anthropometric indices and body fat percentage were calculated by skin folds and calipers. Finally, all of the information was analyzed by SPSS. Results: There was a significant and direct relationship between the lifestyle score and the father’s employment status (p<0.001), mother’s employment status (p=0.004), father’s education (p=0.005), mother’s education (p= 0.017), family economic status (p<0.001) and homeownership status (p<0.001). Among the anthropometric variables, there was a significant difference only between weight (p=0.09) and height (p=0.003) with lifestyle. Conclusion: The results of this study showed that factors such as parents' occupation and education, homeownership status and household economic status have a significant relationship with lifestyle scores.

Keywords: lifestyle, obesity, girl students, anthropometric indices, Socio-Economic Factors.


INTRODUCTION

In 1997, overweight (BMI>25 kg/m2) and obesity (BMI>30 kg/m2) were highlighted by the WHO as public health problems. Living in developed countries with characteristics such as energy intake, exceeding energy needs, and reduced physical activity, which are the main causes of obesity, have led to the upward trend of this disease [1, 2]. In Iran, according to the latest WHO report in 2011, the prevalence of overweight and obesity were 51.4% and 19.4%, respectively [3]. According to available statistics, the prevalence of obesity in children aged 7-12 years old is also growing [4]. Additionally, obesity raises the risk of chronic diseases, which can cause many health-economic costs to the country and patients, due to their complications [5-7]. Studies have always shown that the prevalence and incidence of obesity increase with unhealthy lifestyles, and in particular inappropriate diet and inactivity [8, 9]. Lifestyle modifications are effective in preventing obesity in the long term [10]. The lifestyle modification approach is based on the following four strategies: 1. Increasing awareness about dietary habits and exercise; 2. Modifying stimulants that affect eating; 3. Improving eating principles such as controlling eating speed, and; 4. Positive reinforcement and motivation for weight loss [11, 12]. Studies have shown that applying non-invasive methods and training can be effective in correcting the way people live [13]. Besides, in many studies, fat-rich foods have generally been associated with obesity, increased energy intake, and nutrient deficiencies [14]. It has also been reported that most children and adolescents are more likely to have high-fat diets and consume less fruit and vegetables [15]. Different studies have identified changes in traditional family structures, the appetizing nature of these foods, their low cost and easy access, as causes of the prevalence and dramatic increase in fast food consumption [16]. Also, increased demand for fast food and high-fat food consumption has been directly linked to watching TV and inactivity in various studies [17]. According to several papers, there is probably a link between lifestyle improvements and the reduction of the prevalence of obesity in households, and especially in children. The aim of this study, therefore, was to determine the effect of lifestyle changes on anthropometric indicators and other related factors in obese female students aged 11-14.

 

MATERIALS AND METHODS

452 overweight (z score>2) female students aged 11-14 were randomly selected with similar general characteristics. After receiving written consent from their parents, information about the age, sex and socioeconomic level of the family were collected through interviews with the students. Body weight was measured to the nearest 0.1 kg using a Seca scale with subjects wearing light clothing (i.e. no sweaters, jackets, or belts) and no shoes. Height was measured to the nearest 0.1 of a centimeter using a Seca stadiometer, in a standing position and with shoes removed. Body mass index (BMI) was calculated from the height and weight data; BMI=kg/m2.

Obese people with z score> 2 were selected using standard BMI curves determined by the WHO. To determine the percentage of body fat, the skin fold was calculated by caliper in the triceps of the arm. A lifestyle score was obtained through a lifestyle questionnaire (LSQ). The Health & Lifestyle Questionnaire (HLQ) was launched in 2014 to better describe TRA membership through the publication of summary statistics to both the twin and the researcher communities. The questionnaire contained demographic questions and covered a broad range of health conditions and risk factors. The present study was conducted to construct and determine the validity and reliability of the lifestyle questionnaire related to cancer. Based on the findings, this questionnaire is a reliable one. Lifestyle is defined as behaviors that are often controlled by persons or behaviors that increase health risks. The questionnaire consisted of 29 phrases and 4 dimensions: physical health, nutrition, and weight control, exercise and health, and psychological health. The scores of this questionnaire range from 29 to 174.

Lali et al. had previously confirmed the validity of the lifestyle questionnaire as a multi-dimensional tool for assessing and measuring lifestyle by using a factor analysis test [18]. The reliability of this questionnaire has also been calculated using Cronbach's alpha method. Cronbach's alpha for the dimensions of the lifestyle questionnaire has been measured as 0.89, 0.87, 0.85 and 0.88, respectively. The test grading took place on a 6-point scale, from 1 (opposite) to 6 (totally agree). Finally, all data extracted from this study were analyzed with SPSS software version 17. The expression of the data is in the form of a mean±standard deviation. Also, the chi-square and one-way ANOVA tests were used to evaluate the quantitative and qualitative variables of this study, respectively, and p <0.05 was considered significant.

 

RESULTS:

According to the findings, lifestyle score was classified into three categories: weak, moderate and high. Based on the analyses, the associations of all quantitative and qualitative data of participants with lifestyle were examined, and are displayed in Table 1. There was a significant and direct relationship between the lifestyle score on the one hand, and the father's employment status (p<0.001), mother’s employment status (p=0.004), father’s education (p=0.005), mother’s education (p= 0.017), family economic status (p<0.001) and homeownership status (p<0.001) on the other, according to Table 1. Also, the relationship between the area of residence and lifestyle was statistically near significant (p=0.068). However, among the anthropometric variables, there was a significant relationship observed only between weight (p=0.09) and height (p=0.003) with lifestyle.

According to the results, participants with the highest weight and height demonstrated higher lifestyle scores, while the lowest rate of these indicators had poor lifestyle scores.

 

DISCUSSION:

In a study by Amal A. Mohammed et al., which aimed to investigate the effects of educational interventions on lifestyle modifications in patients with high blood pressure, the results showed that lifestyle modifications in the intervention group, as well as blood pressure, cholesterol, physical activity, and dietary habits, were significantly different from the control group [19]. Also in a study by Entezari et al., the effects of educational interventions on lifestyle modifications based on choice theory were studied in women with obesity. The results of this study showed that educational intervention improved physical health, weight control, exercise, and the psychological health of the intervention group, with a statistically significant difference from the control group [20]. There are few studies in this field, but existing studies are consistent with the present study, and show the relationship between participants’ height and weight, lifestyle scores, and socioeconomic status.

CONCLUSION:

In general, trying to change the lifestyle of children and adolescents can undoubtedly reduce the prevalence of obesity and its complications at that age, and reduce the excessive costs of healthcare and treatment. The results of this study showed that factors such as parents' occupation and education, homeownership status, and household economic status have a significant relationship with lifestyle scores.

Limitation:

We had a lot of limitations in this study such as not using the DEXA method because of budget constraints, the insufficient sample size in each group and in general, the methods available in this scheme.

 

 

Table 1- Quantitative and Qualitative Characteristics of Participants Based on Lifestyle*

 

 

Weak

Moderate

Excellent

P-value**

Mean or N

% or SD

Mean or N

% or SD

Mean or N

% or SD

School Grade

7th

12

27.3

53

34.4

99

30.4

0.68

 

8th

20

45.5

57

37.0

121

37.1

 

 

9th

12

27.3

44

28.6

106

32.5

 

Head of the Family

Father

38

86.4

147

95.5

303

92.9

0.107

 

Mother or other

6

13.6

7

4.5

23

7.1

 

Father’s Occupation

Unemployed

6

14.6

7

4.5

5

1.5

<0.001

 

Self-employment

23

56.1

105

68.2

196

60.5

 

 

Retired or workman

5

12.2

12

7.8

33

10.2

 

 

Clerk or manager

7

17.1

30

19.5

90

27.8

 

Mother’s Occupation

Housekeeper

39

88.6

134

87.0

256

78.8

0.044

 

Employee

5

11.4

20

13.0

69

21.2

 

Father’s Education

Illiterate or primary school

6

14.6

23

14.9

52

16

0.005

 

High school or diploma

33

80.5

112

72.7

198

60.9

 

 

Academic education

2

4.9

19

12.3

75

23.1

 

Mother’s Education

Illiterate or primary school

8

18.2

32

20.8

43

13.2

0.017

 

High school or diploma

33

75.0

108

70.1

224

68.7

 

 

Academic education

3

6.8

14

9.1

59

18.1

 

Residential Region

Region 9

7

15.9

13

8.4

60

18.4

0.068

 

Region 14

12

27.3

46

29.9

99

30.4

 

 

Region 16

11

25.0

37

24.0

68

20.9

 

 

Region 17

2

4.5

16

10.4

40

12.3

 

 

Region 18

12

27.3

42

27.3

59

18.1

 

Economic Status

Weak

25

56.8

37

24.0

24

7.4

<0.001

 

Mild

18

40.9

115

74.7

254

77.9

 

 

Good

1

2.3

2

1.3

48

14.7

 

House Ownership

Owner

8

18.2

56

36.4

157

48.2

<0.001

 

Tenant, organizational or other

36

81.8

98

63.6

169

51.8

 

House Type

Apartment

42

95.5

141

91.6

288

88.3

0.24

 

Villa

2

4.5

13

8.4

38

11.7

 

Age (years)

13.950

0.813

13.812

0.871

13.838

0.865

0.64

Weight (kg)

79.564

6.627

80.384

9.697

82.030

9.832

0.09

Height (cm)

157.500

5.612

157.951a

6.071

159.631a

5.816

0.003

Body Mass Index (kg/m2)

32.074

2.077

32.150

2.771

32.098

2.386

0.97

Thickness of Skinfold (mm)

43.643

5.835

43.584

6.223

44.134

5.770

0.60

Number of Sisters and

Brother

1.20

0.795

1.32

0.934

1.21

0.983

0.48

Number of People Living in Household

4.00

0.778

4.12

0.959

4.07

0.916

0.69

** presented as Mean (SD) for quantitative variables and frequency (%) for qualitative variables

** calculated by chi-Square or one-way ANOVA test; Significant at the 0.05 level.

 

 

REFERENCES

  1. Kopelman PG, Caterson LD, Dietz WH. Clinical obesity in adults and children, 3rd edition. 2010; 351-365.
  2. Mahan LK, Stump E. Obesity, and overweight management. In: Mahan LK, Stump E. Krauses food and the nutrition care process. 13th ed. New York: Elsevier. 2012; Pp: 462-88.
  3. World Health Organization - NCD Country Profiles, 2011. available at: www.who.int/entity/nmh/countries/irn_en.pdf
  4. Primary school children aged 7-12 years, Babol; 2009. Journal of Babol University of Medical Sciences. 2009; 10: 81-93. Persian.
  5. Veldhuis L, Struijk MK, Kroeze W, Oenema A. Be active, eat right. BMC Public Health. 2009; 9: 177-88.
  6. Lau DCW, Douketis JD, Morrison Km, Hraniak IM, Sharma AM. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJJ AMC 2007;178(8): 51-13.
  7. Sedaghat Z, Zibaeinejad M, Fararoyi M. Adherence of hypertension patients to a healthy lifestyle and its relation with anthropometric indices. Journal of health education and health promotion. 3(3).2015; Pp: 232-241.
  8. Jago R, Baranowski T, Baranowski JC, Thompson D, Greaves KA. BMI from 3–6 y of age is predicted by TV viewing and physical activity, not a diet. Int J Obes (Lond) 2005;29:557–64.
  9. Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition 2007; 23:887–94.
  10. Sadeghi Kh, Gharaie B, Fata L, Mazhari S. [Efficacy of cognitive-behavioral therapy in treating patients with obesity]. Iranian Journal of Psychiatry and Clinical Psychology. 2011; 16(2):107-117(Persian).
  11. Fesharaki M, Sahebzamani M, Rahimi R. [The effectiveness of education on improving the lifestyle of elementary school students Suffered from overweight]. Iranian Journal of Diabetes and Lipid. 2010; 9(3): 290-295 (Persian).
  12. Eghbali E, Arazi H, Elahi M. The Relationship Between Some Health Indicators and Anthropometrics with Hand Strength, Biomechanical Indices and Second to Fourth Finger Aspects in Children. Razi medical journal. 24(158), 2018.
  13. Drohan SH. Managing early childhood obesity in the primary care setting: A behavior modification approach. Journal of Pediatric Nursing. 2002; 28(6): 599-610.
  14. Bowman SA, Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DS. Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Pediatrics 2004; 113(1 Pt 1): 112-8.
  15. French SA, Story M, Neumark-Sztainer D, Fulkerson JA, Hannan P. Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioral and psychosocial variables. Int J Obes Relat Metab Disord 2001; 25(12): 1823-33.
  16. Driskell JA, Meckna BR, Scales NE. Differences exist in the eating habits of university men and women at fast-food restaurants. Nutr Res 2006; 26(10): 524-30.
  17. Sothern MS. Obesity prevention in children: physical activity and nutrition. Nutrition 2004; 20(7-8): 704-8.
  18. Lali M, Abedi A, Kajbaf MB. [Construction and Validation Lifestyle Questionnaire (LSQ)]. Journal of Psychological Research. 2013; 15(1):64-80 (Persian).
  19. Amal A. Mohamed, Amal Fehr, Entisar G. Sabaan, and Shima G. Yeseaf. Impact of Health Education on Lifestyle Modification for Patients with Hypertension. Med. J. Cairo Univ 2015; 83(1) D: 1135-1143.
  20. Entezari Meybodi MR, Afkhami I, Nasirian M. The effectiveness of treatment based on “Choice Theory” on improving the lifestyle of women suffered from obesity. en.journals.sid.ir. 2015;4(2):1-6.

 


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