Category: Nutrition

The object that I have chosen for this essay is tea, as this object is one of the most important agricultural products in Africa. While coffee might seem to be the ‘go-to’ hot beverage, the world actually runs on tea. Tea is the most popular drink in the world after water, and in the United States alone, tea imports have risen over 400% since 1990 (Szenthe, 2019). Globally 80% of tea produced in black tea, 18% is green tea and 2% is oolong. Compared to coffee, tea has 50% less caffeine, which means you can consume it without those pesky effects on your nervous system (Lesile Bonci, n.d.).

In 1669, the English East India Company brought its first shipment of Chinese tea to Britain (Tea and Progress, n.d.). Till today the British Cultural Institution that this is the ‘cuppa’, which has become very popular. Tea is grown in 36 countries, however the six largest producing countries are China, India, Kenya, Sri Lanka, Indonesia and Turkey, and these six countries outweigh 80% of the world output (The Canadian Fair Trade Network, n.d.). The global tea market was valued almost 50 billion US dollars in 2017, and is expected to rise over 73 billion dollars by 2024 (Conway, 2019). Tea came in to the Western Hemisphere long ago before coffee. The debate surrounding tea is much greater impact on humans than the environment, especially in India and Africa. Globally, tea continues its steady increase in production. Farmers and workers depend on tea for their living, especially in Africa, where tea is an economically important crop contributor significantly to foreign exchange earnings and rural development.

The tea crops are available in tropical and sub-tropical climates, specific requirements of temperatures between the range of 10-30 degrees Celsius, with a minimum annual precipitation of 1250 mm. This is why tea production is only successful in a few countries, as it requires highly sensitive growing conditions. However, due to globally worming there is a high risk on the growing conditions due to climate change.

The main determinant for the growth of the global tea economy is demand for the commodity. Tea prices are rising due to the demand being strong despite economic downturn, if people’s income fall, demand won’t as consumers see tea as an essential product. Therefore, tea is an inferior good and we can say that the demand for tea is income inelastic. However, drought and floods in major areas of production such as Malawi, between 2015 floods and 2015-16 drought, the crop estimates shows that the overall food production has declined by 12.4 percent from 2014-15, which was already down by about 30 percent due to the floods in 2015. The nature of growing tea is that the producers aren’t able to increase supply in the short term. Demand is price inelastic, therefore an increase in the price of tea doesn’t affect consumers from buying it, due to there are fewer alternatives to tea thus increase in price won’t affect demand (Pettinger T., 2009).

Health has a great influence with the consumption of tea. Tea has been believed to have originated in China as a medicinal drink (Szenthe, 2019). Tea contains antioxidants which prevent the body’s version of rust, and thus help us young and protect us from damage from pollution. There’s a lot of literature out there on tea and heart health. It is claimed that there is a nearly 20% reduction in the risk of heart attack and a 35% reduction in the risk of stroke among those who drink one to three cups of green tea per day.

Tea was originally used as a medical beverage; the drink was popular for recreational use during the Tang Dynasty and spread to other Asian countries (Conway, 2019). Tea is a product which through trade has been globalized. Trade, travel and technology all come together, so tea can be adopted as a customary and popular beverage in many countries. For example, in India and Africa, where tea is produced in different types, thus becoming popular and distinct to their cultures. Globalization of tea has been positive in human history as it provided us with a beverage which can be modified to the cultures specific tastes and traditions.

Fair Trade has taken into account the environmental and human issues associated with the sale of certain products, including tea. Fair Trade has included tea as a commodity in its repertoire since 2000. The premise of all Fair Trade programs is that, when a fair and stable price is paid for raw goods, living conditions of those involved will be improved. Critics claim that the Fair Trade label benefits only the farmer or larger company, and benefits do not trickle down to the workers, or that the standards set by the organization are not high enough. Supporters cite specific programs that have benefitted workers. In addition to ensuring that farming techniques are as sustainable as possible and workers are provided with a living wage for food, clean water, housing and healthcare, Fair Trade works with some of its certified tea growers in China, India, Kenya and other places on specialty programs, such as organic cultivation, gender equality initiatives, advanced education for workers to break the cycle of poverty, pensions, infrastructure, and access to technology and information. Fair Trade products, including teas, are sold in many markets for higher prices than conventional goods. It is important that the public remain conscientious of the people who may have suffered to produce a cup of tea, but solutions, like Fair Trade, awareness, and legislation, have also made an impact and improved the lives of tea growers significantly in the past century.

In the 21st century, tea is still hand-picked, where pollution is taken into account, however the only environmental impact of the tea production is deforestations. Farmers use hectors of land for tea plantation, and this has affected the surroundings of our ecosystem today. Today, forests cover 30% of the earths land and will continue to decrease. Deforestation had caused the removal or trees to make room for agricultural plantations, resulting to several impacts. 70% of the worlds land animals and plants live is the forest, where deforestation has an effect on the habitat, and this is why these organisms don’t survive. On the other hand, tress play a critical role which the prevention of global warming, they responsible for the absorption of many of the greenhouse gasses, which penetrate the atmosphere and directly lead global warming itself. Although tea planation may not be the sole cause of deforestation, it’s a primary contributor. In India especially, thousands of acres of the forest have been cut down to make room for more profitable plantations.

A lot is changing in our world today and a vast majority of this change occurs in Nutrition. Nutrition is a constantly evolving area of research and I must evolve with it. I was very certain that after my undergraduate degree, I would broaden my horizon and have a feel of a new experience in nutrition by furthering my studies at one of Canada’s best universities, I opted for the University of Manitoba to acquire an MSc in Human Nutritional Sciences.

My interest in the application of nutrition to improve nutritional well-being and quality of life arose when I carried out my internship program at the University College Hospital, Ibadan, Oyo state, and witnessed how poorly young and old individuals practiced nutrition. With the assistance of a dietician, I was privileged to manage a 10-year-old female patient who was diagnosed with PEM (Protein-Energy Malnutrition) and chronic kidney failure due to poverty and poor traditional practices in her family. Managing her condition was a challenge because the amount of protein given to the patient had to be sufficient enough to manage the PEM and critically monitored so as not to further complicate the kidney disease. I have been opportune to attend numerous workshops and seminars that proved to help get insight on many malnutrition cases that are present in Nigeria and how the situation keeps escalating.

Choosing to study nutrition and dietetics at the undergraduate level was an obvious decision for me. I come from a family where obesity is prevalent and hereditary, I struggled with weight problems when I was younger and decided to take charge of my life and make a difference in my family for others to follow. I began this journey at Babcock University from where I graduated with a First Class (Honours). Through the course of the 4 year program, some areas that I found very involving were; Diet Therapy, Community Nutrition, Public Health Nutrition, and Nutritional Assessment.

The University of Manitoba is known for its outstanding student experience, and excellent research focus and has been recognized as an International center of research and study. A master’s degree in human nutritional sciences from this University would empower me in a particular area of research I am interested in and that is the Role of Diet in Aging. Diseases such as diabetes and hypertension are becoming prevalent amongst middle-aged individuals, in past years these diseases were identified with mostly older age groups starting from 60 years. Aging individuals must be aware of the metabolic changes that occur in their bodies and make certain dietary changes to avoid the onset of diseases.

I would be honored to be allowed to be part of the Department of Human Nutritional Sciences as I hope to convey my drive and passion.

Introduction

Obesity was defined as excessive or abnormal fat accumulation that may impair health. A crude population measure of obesity is the body mass index, a person’s weight (in kilograms) divided by the sq. of his or her height (in meters). A person having a BMI of 30 or more is considered obese. A person with a body mass index equal to or more than 25 is considered overweight. For children, age needs to be considered when defining obesity. (WHO 16th February 2018)

Childhood obesity is predictive of adult obesity and is one of the most serious public health challenges of the 21st century. Lifestyle, nutritional status, and Food habits are the major contributors in childhood that determine the health of an adult. Lack of physical activity and an unhealthy diet during childhood are the leading risk factors accounting for the burden of non-communicable disease in adulthood (Bharati et al., 2008).

Worldwide, the prevalence of combined overweight and obesity rose by 27.5% for adults and 47.1% for youngsters between 1980 and 2013. In developing countries with rising economies (classified by the World Bank as lower- and middle-income countries) the speed of increase in childhood overweight and obesity has been quite 30% over that of developed countries (WHO, 2015).

Worldwide obesity has nearly tripled since 1975. Over 340 million kids and adolescents aged 5-19 were overweight or obese in 2016. (WHO 16th February 2018)

A child with a BMI at 85th or below 95th percentile for age and sex is considered at risk of being overweight, whereas a child with a BMI at or above 95th percentile is obese. Children with very high BMI are at greater risk of morbidity related to childhood obesity. Childhood obesity increases the risk of morbidity related to childhood obesity. Childhood obesity increases the risk of dyslipidemia, cardiovascular disease, impaired glucose tolerance, chronic inflammation, gall stones, non-alcoholic fatty liver diseases, pancreatitis, and many other musculoskeletal, and neurological alterations and consequently, the children are at higher risk of being obese as adults (Ekelund et al., 2006).

The role of physical activity in weight maintenance is very much evident. But nowadays it has become difficult for children to be physically active. Children consume a substantial proportion of their daily energy intake while watching television and TV commercials, which typically promote high sugar, high fat, and processed food and can, have a large impact on children’s food choices. In addition satiety cues and are therefore more likely to overeat (Susan & Jane 2008). Besides the obesogenic environment, there are some other variables that are associated with childhood obesity. Factors such as family history, high birth weight of the child, long sleeping hours, maternal employment, parental obesity, their own food eating behavior with regard to time of eating, food selection, and place of eating are correlated with the child’s food behavior (Moria et al., 2004).

Objective

1. To find out the prevalence rate of childhood obesity in school-going children.
2. To study the causes or causative factors of obesity in school-going children.
3. To assess the dietary pattern and nutritional status of selected school-going children.
4. To develop teaching aids to create awareness through nutrition education in years-old school-going children.
5. To determine the impact of nutrition education on the prevention of obesity.

Review of literature

The available literature on the present investigation and related aspects have been thoroughly reviewed and presented under the following heads and subheads:

1. Prevalence of childhood obesity
2. Obesity and its complications
3. Nutritional status of school-going children by anthropometry
4. Anthropometric measurements
5. Impact of nutrition education
6. Prevention of childhood obesity

1. Prevalence of childhood obesity:

Siddique et al. (2015) conducted a study in a private school in Dhaka involving 140 students and reported that 50% of the students were either overweight or obese out of which 26.4% were obese. The majority of those found overweight and obese consumed fast foods and houses children from mostly middle to high-income families.

Dyson et al. (2014) reported that rates of hypertension, obesity and, overweight are high in school children in China, India and, Mexico. Obesity and overweight prevalence rates varied by country and were 16.6% in China, 4.1% in India, and 37.1% in Mexico. A cross-sectional study of hypertension (Badi et al., 2012) in relation to obesity and overweight among school children aged 6-16 years in Aden, Yemen done on 1885 children showed the prevalence of obesity as 8% and overweight 12.7%.

Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years (NCHS, 2012). The percentage of children aged 6-11 years within the United States who were obese, increased from 7% in 1980 to almost 18% in 2012. Similarly, the percentage of adolescents aged 12-19 years who were obese, increased from 5% to nearly 21% over the same period(Ogden et al., 2014)

2. Obesity and its complications:

Leonard et al. (2004) studied the association between childhood overweight and adult disease. The relation between Body Mass Index (BMI) in childhood and adult cardiovascular mortality in a 57-year follow-up cohort study disclosed that cardiovascular mortality was related to higher childhood BMI. From the general public health perspective, ways geared towards reducing weight in childhood were important but may also affect adult health if such weight reduction persists into adulthood.

Schulze et al. 2004 revised the evidence on the diet and nutrition causes of obesity and recommended strategies to reduce obesity prevalence. The protection issue against obesity was considered to be regular physical activity, a high intake of dietary non-starch polysaccharides /fiber, supportive home and school environments for children, and breastfeeding. Risk factors for obesity were thought of to be sedentary lifestyles, a high intake of energy-dense, micronutrient-poor food, significant selling of energy-dense foods and nourishment shops, sugar-sweetened soft drinks and fruit juices, adverse social and economic conditions in developed countries, especially in women. Strategies suggested to cut back obesity prevalence included influencing the food offered to make selections easier, reducing the selling of energy-dense foods and beverages to children, influencing urban environments and transport systems to promote physical activity, increasing communications about healthy eating and physical activity, and improved health services to promote breastfeeding and manage current overweight or obese people.

3. Nutritional status of school-going children by anthropometry:

Sharma et al. (2017) designed a study to assess and compare the nutritional status of government and private school children in Muzaffarnagar city. A total of 1960 (980 each from private and government schools) schoolchildren of class 6-12 were studied for socio-epidemiological details, dietary habits, and physical activity. Information on education status, occupation, and monthly income of their parents was also collected. Required anthropometric measurements were taken. Out of 980 children from private schools, 90 (9.18%) were underweight, 138 (14.08%) were overweight, and 137 (13.97%) were obese. The majority of children from government schools were underweight 215 (21.94%) except for 24 (2.45%) overweight children. This study shows the dual nature of nutritional problems and under-nutrition among the lower socioeconomic class of govt. school at one side and the worrisome epidemic of obesity among the affluent of private schools.

Deren et al. (2018) evaluated the prevalence of overweight, obesity, and underweight in children from Ukraine. The measuring of body weight was performed with medical scales and height was measured employing a stadiometer. Based on the results obtained, body mass index (BMI) was calculated. The combined prevalence of obesity, and overweight among children aged 6-18 years old was 12.1%, 17.6%, and 12.6% based on the IOTF reference, WHO growth standard, and the CDC, respectively. Obesity was 2.1%, 4.2%, and 3.6% respectively. Significantly more girls were underweight than boys.

4. Anthropometric measurements:

Menon et al. (2007) conducted a study on 36 children (26 boys and 10 girls, age 1.5 to 15 years) and 37 adults (21 men and 16 women, age 25 to 69 years) with obesity and 29 non-obese (15 children and 14 adults). All anthropometric parameters were higher in obese subjects compared to non-obese. BMI was >28 kg/m2 in all obese children and >31 kg/m2 in eight.

Mehta et al. (2007) reported that twenty-one out of 22 obese girls (95.4%) were centrally obese (waist circumference > 80 cm). out of the 21 girls whose waist circumference was> 80 cm, 10 girls had a waist circumference greater than 100 cm, and even among the rest, it was just below 100 cm for 5 girls. Twelve (54.6%) girls among the 22 obese were found to be having central obesity (waist-hip ratio > 0.85).

5. Impact of nutrition education:

Shin et al. (2004) reported that a well-designed nutrition education program for obese children and their parents can be an effective approach to help them improve their nutrition knowledge and establish desirable food habits and eating behaviors. Nutrition education based on decreasing portion sizes, decreasing sugared drinks, lowering fat intake, and increasing lean meats and fish, fruit, whole grains, and vegetables imparted to the parents showed a gain in their knowledge level (Engels et al., 2005).

Nutrition education, behavioral interventions, and exercise are the mainstay of treatment for obese parents (adults) and at risk for obese or obese children (Wadden and Stunkard, 2002) and are aimed at improving nutritional choices, decreasing sedentary activity, and increasing physical activity. Children and adults may be targeted separately or together (Berry et al., 2004).

Omar (2000) studied meal planning and its relation to the nutritional status of preschool children aged 2-4 years in Egypt. Special emphasis was given to the socioeconomic status and education level of the families. The results and nutritional quality of meal planning by housewives.

6. Prevention of childhood obesity:

According to Berge et al. (2014), there is a significant association between positive family and parent-level interpersonal dynamics (i.e., parental positive reinforcement, warmth, and group enjoyment) at family meals and reduces the risk of childhood obesity. In addition, vital associations were found between positive parental and family-level food-related dynamics (i.e., food communication, warmth of food, parental food positive reinforcement) and reduced risk of childhood obesity.

Obesity management at a younger age may have a greater effect for several reasons, including:

• Motivation may be easier to generate and maintain, for both the child and other family members while the child is small;
• There may be more frequent opportunities for medical observations during earlier childhood compared with later years;
• It can be easier to modify and control behavior in younger individuals; there may be less resistance to treatment stigmatization and greater influence of the family on the child;
• Longitudinal growth and an increase in lean body mass occur during childhood so that children can grow into their weight (Lobstein et al., 2004).

References

1. Bharati, D. R., Deshmukh, P. R. and Garg, B. S., 2008. Correlates of overweight and obesity among school-going children of Wardha city, Central India. Indian Journal of Medical Research. 127: 539-543.
2. Eklund U, Ken Ong, Yvonne Linne, Martin Neovius, Soren Brage, David B Dunger, Nicholas J Wareham and Stephan Rossner 2006 upward weight percentile crossing in infancy and early childhood independently predicts fat mass in a young adult: the Stockholm Weight Study (SWEDES) Am J Clin Nutr 83: 324-30.
3. Moria Golan, Ph.D., and Scott Crow, MD 2004 Parents are key players in the prevention and treatment of weight-related problems Nutrition Reviews 62(1) 1-7.
4. Susan Carnell and Jane Wardle 2008 Appetite and adiposity in children: evidence for a behavioral susceptibility theory of obesity Am J Clin Nutr 88:22-9.
5. Leonard M B, Shults J, Wilson B A, et al. 2004 Obesity during childhood and adolescence augments bone mass and bone dimensions. American J. Clinical Nutrition, Vol. 69: 608-1.
6. Schulze M B, Liu S, Rimm E B, et al. 2004 Glycemic index, Glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women. American J. Clinical Nutirion, 80: 348-56.
7. Deren K, Nyankovskyy S, Nyankovska O, Luszczki E, Wyszynska J, Sobolewski M and Mazur A. 2018. The prevalence of underweight, overweight and obesity in children and adolescents from Ukraine, Scientific Reports, 8(3625):1-7.
8. Sharma S, Muzammil K, Singh R, and Siddiqui S. 2017. Assessment and comparison of nutritional status of government and private secondary school children of Muzaffarnagar, Indian Journal of Community Health, 29(3): 265-270.
9. Menon, P.S.N., Dubey, S., Kabra, M., Bajpai, A., Pandey, R.M., Hasan, M. and Gautam, R.K. 2007. Serum leptin levels in obese Indian children: Relation to clinical and Biochemical Parameters. Indian Pediatrics, 44: 257-262.
10. Mehta, M., Bhasin, S.K., Agarwal, K. and Dwivedi, S. 2007. Obesity amongst affluent adolescent girls. Indian Journal of Pediatrics. 74 (7): 619-622.
11. Siddique, L.S., Nahar, S and Parvin, T. 2015. Frequency of High Body Mass Index in School-going Children in Dhaka City. University Heart Journal. 10(1): 23-26.
12. Dyson, P.A., Anthony, D., Fenton, B., Matthews, D.R and Stevens, D.E. 2014. High rates of child hypertension associated with obesity: a community survey in China, India, and Mexico. Pediatrics and International Child Health. 34(1): 43-49.
13. Ogden, C.L., Carroll, M.D., Kit, B.K and Flegal, K.M.. 2014. Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association. 311(8): 806-814.
14. Berge, J.M., Rowley, S., Trofholz, C., Rueter, M., MacLehouse, R.F and Neumark-Sztainer, D. 2014. Childhood Obesity and Interpersonal Dynamics during Family Meals. Pediatrics. 134(5): 923-32.
15. Shi, E.K., Lee, H.S. and Lee, Y.K. 2004. Effect of Nutrition Education Program on Obese Children and Their Parents(2): Focus on Nutrition Knowledge, Eating Behaviors, Food Habits, and Nutrient Intake. Korean Journal of Community Nutrition. 9)5): 578-588.
16. Engels, H.J, Gretebeck, R.J., Gretebeck, K.A. and Jimenz, L. 2005. Promoting healthful diets and exercise: efficacy of a 12-week after-school program in urban African Americans. Journal of the American Dietetics Association. 105(3): 455-4599.
17. Wadden, T.A and Stunkard, A.J. 2002. Handbook of Obesity Treatment. New York: The Guilford Press; 2002.
18. Berry, D., Sheehan, R., Heschel, R., Knafl, K., Melkus, G. and Grey, M. 2004. Family-based interventions for childhood obesity: A review. Journal of Family Nursing. 10:429-449.
19. Omar, K.O.A. 2000. Meal planning and its relation to the nutritional status of preschool children. Roczniki Panstwowego Zakladu Higieny. 51(2): 163-166.

A lot is changing in our world today and a vast majority of this change occurs in Nutrition. Nutrition is a constantly evolving area of research and I must evolve with it. I was very certain that after my undergraduate degree, I would broaden my horizon and have a feel of a new experience in nutrition by furthering my studies at one of Canada’s best universities, I opted for the University of Manitoba to acquire an MSc in Human Nutritional Sciences.

My interest in the application of nutrition to improve nutritional well-being and quality of life arose when I carried out my internship program at the University College Hospital, Ibadan, Oyo state, and witnessed how poorly young and old individuals practiced nutrition. With the assistance of a dietician, I was privileged to manage a 10-year-old female patient who was diagnosed with PEM (Protein-Energy Malnutrition) and chronic kidney failure due to poverty and poor traditional practices in her family. Managing her condition was a challenge because the amount of protein given to the patient had to be sufficient enough to manage the PEM and critically monitored so as not to further complicate the kidney disease. I have been opportune to attend numerous workshops and seminars that proved to help get insight on many malnutrition cases that are present in Nigeria and how the situation keeps escalating.

Choosing to study nutrition and dietetics at the undergraduate level was an obvious decision for me. I come from a family where obesity is prevalent and hereditary, I struggled with weight problems when I was younger and decided to take charge of my life and make a difference in my family for others to follow. I began this journey at Babcock University from where I graduated with a First Class (Honours). Through the course of the 4 year program, some areas that I found very involving were; Diet Therapy, Community Nutrition, Public Health Nutrition, and Nutritional Assessment.

The University of Manitoba is known for its outstanding student experience, and excellent research focus and has been recognized as an International center of research and study. A master’s degree in human nutritional sciences from this University would empower me in a particular area of research I am interested in and that is the Role of Diet in Aging. Diseases such as diabetes and hypertension are becoming prevalent amongst middle-aged individuals, in past years these diseases were identified with mostly older age groups starting from 60 years. Aging individuals must be aware of the metabolic changes that occur in their bodies and make certain dietary changes to avoid the onset of diseases.

I would be honored to be allowed to be part of the Department of Human Nutritional Sciences as I hope to convey my drive and passion.

Introduction

Obesity was defined as excessive or abnormal fat accumulation that may impair health. A crude population measure of obesity is the body mass index, a person’s weight (in kilograms) divided by the sq. of his or her height (in meters). A person having a BMI of 30 or more is considered obese. A person with a body mass index equal to or more than 25 is considered overweight. For children, age needs to be considered when defining obesity. (WHO 16th February 2018)

Childhood obesity is predictive of adult obesity and is one of the most serious public health challenges of the 21st century. Lifestyle, nutritional status, and Food habits are the major contributors in childhood that determine the health of an adult. Lack of physical activity and an unhealthy diet during childhood are the leading risk factors accounting for the burden of non-communicable disease in adulthood (Bharati et al., 2008).

Worldwide, the prevalence of combined overweight and obesity rose by 27.5% for adults and 47.1% for youngsters between 1980 and 2013. In developing countries with rising economies (classified by the World Bank as lower- and middle-income countries) the speed of increase in childhood overweight and obesity has been quite 30% over that of developed countries (WHO, 2015).

Worldwide obesity has nearly tripled since 1975. Over 340 million kids and adolescents aged 5-19 were overweight or obese in 2016. (WHO 16th February 2018)

A child with a BMI at 85th or below 95th percentile for age and sex is considered at risk of being overweight, whereas a child with a BMI at or above 95th percentile is obese. Children with very high BMI are at greater risk of morbidity related to childhood obesity. Childhood obesity increases the risk of morbidity related to childhood obesity. Childhood obesity increases the risk of dyslipidemia, cardiovascular disease, impaired glucose tolerance, chronic inflammation, gall stones, non-alcoholic fatty liver diseases, pancreatitis, and many other musculoskeletal, and neurological alterations and consequently, the children are at higher risk of being obese as adults (Ekelund et al., 2006).

The role of physical activity in weight maintenance is very much evident. But nowadays it has become difficult for children to be physically active. Children consume a substantial proportion of their daily energy intake while watching television and TV commercials, which typically promote high sugar, high fat, and processed food and can, have a large impact on children’s food choices. In addition satiety cues and are therefore more likely to overeat (Susan & Jane 2008). Besides the obesogenic environment, there are some other variables that are associated with childhood obesity. Factors such as family history, high birth weight of the child, long sleeping hours, maternal employment, parental obesity, their own food eating behavior with regard to time of eating, food selection, and place of eating are correlated with the child’s food behavior (Moria et al., 2004).

Objective

1. To find out the prevalence rate of childhood obesity in school-going children.
2. To study the causes or causative factors of obesity in school-going children.
3. To assess the dietary pattern and nutritional status of selected school-going children.
4. To develop teaching aids to create awareness through nutrition education in years-old school-going children.
5. To determine the impact of nutrition education on the prevention of obesity.

Review of literature

The available literature on the present investigation and related aspects have been thoroughly reviewed and presented under the following heads and subheads:

1. Prevalence of childhood obesity
2. Obesity and its complications
3. Nutritional status of school-going children by anthropometry
4. Anthropometric measurements
5. Impact of nutrition education
6. Prevention of childhood obesity

1. Prevalence of childhood obesity:

Siddique et al. (2015) conducted a study in a private school in Dhaka involving 140 students and reported that 50% of the students were either overweight or obese out of which 26.4% were obese. The majority of those found overweight and obese consumed fast foods and houses children from mostly middle to high-income families.

Dyson et al. (2014) reported that rates of hypertension, obesity and, overweight are high in school children in China, India and, Mexico. Obesity and overweight prevalence rates varied by country and were 16.6% in China, 4.1% in India, and 37.1% in Mexico. A cross-sectional study of hypertension (Badi et al., 2012) in relation to obesity and overweight among school children aged 6-16 years in Aden, Yemen done on 1885 children showed the prevalence of obesity as 8% and overweight 12.7%.

Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years (NCHS, 2012). The percentage of children aged 6-11 years within the United States who were obese, increased from 7% in 1980 to almost 18% in 2012. Similarly, the percentage of adolescents aged 12-19 years who were obese, increased from 5% to nearly 21% over the same period(Ogden et al., 2014)

2. Obesity and its complications:

Leonard et al. (2004) studied the association between childhood overweight and adult disease. The relation between Body Mass Index (BMI) in childhood and adult cardiovascular mortality in a 57-year follow-up cohort study disclosed that cardiovascular mortality was related to higher childhood BMI. From the general public health perspective, ways geared towards reducing weight in childhood were important but may also affect adult health if such weight reduction persists into adulthood.

Schulze et al. 2004 revised the evidence on the diet and nutrition causes of obesity and recommended strategies to reduce obesity prevalence. The protection issue against obesity was considered to be regular physical activity, a high intake of dietary non-starch polysaccharides /fiber, supportive home and school environments for children, and breastfeeding. Risk factors for obesity were thought of to be sedentary lifestyles, a high intake of energy-dense, micronutrient-poor food, significant selling of energy-dense foods and nourishment shops, sugar-sweetened soft drinks and fruit juices, adverse social and economic conditions in developed countries, especially in women. Strategies suggested to cut back obesity prevalence included influencing the food offered to make selections easier, reducing the selling of energy-dense foods and beverages to children, influencing urban environments and transport systems to promote physical activity, increasing communications about healthy eating and physical activity, and improved health services to promote breastfeeding and manage current overweight or obese people.

3. Nutritional status of school-going children by anthropometry:

Sharma et al. (2017) designed a study to assess and compare the nutritional status of government and private school children in Muzaffarnagar city. A total of 1960 (980 each from private and government schools) schoolchildren of class 6-12 were studied for socio-epidemiological details, dietary habits, and physical activity. Information on education status, occupation, and monthly income of their parents was also collected. Required anthropometric measurements were taken. Out of 980 children from private schools, 90 (9.18%) were underweight, 138 (14.08%) were overweight, and 137 (13.97%) were obese. The majority of children from government schools were underweight 215 (21.94%) except for 24 (2.45%) overweight children. This study shows the dual nature of nutritional problems and under-nutrition among the lower socioeconomic class of govt. school at one side and the worrisome epidemic of obesity among the affluent of private schools.

Deren et al. (2018) evaluated the prevalence of overweight, obesity, and underweight in children from Ukraine. The measuring of body weight was performed with medical scales and height was measured employing a stadiometer. Based on the results obtained, body mass index (BMI) was calculated. The combined prevalence of obesity, and overweight among children aged 6-18 years old was 12.1%, 17.6%, and 12.6% based on the IOTF reference, WHO growth standard, and the CDC, respectively. Obesity was 2.1%, 4.2%, and 3.6% respectively. Significantly more girls were underweight than boys.

4. Anthropometric measurements:

Menon et al. (2007) conducted a study on 36 children (26 boys and 10 girls, age 1.5 to 15 years) and 37 adults (21 men and 16 women, age 25 to 69 years) with obesity and 29 non-obese (15 children and 14 adults). All anthropometric parameters were higher in obese subjects compared to non-obese. BMI was >28 kg/m2 in all obese children and >31 kg/m2 in eight.

Mehta et al. (2007) reported that twenty-one out of 22 obese girls (95.4%) were centrally obese (waist circumference > 80 cm). out of the 21 girls whose waist circumference was> 80 cm, 10 girls had a waist circumference greater than 100 cm, and even among the rest, it was just below 100 cm for 5 girls. Twelve (54.6%) girls among the 22 obese were found to be having central obesity (waist-hip ratio > 0.85).

5. Impact of nutrition education:

Shin et al. (2004) reported that a well-designed nutrition education program for obese children and their parents can be an effective approach to help them improve their nutrition knowledge and establish desirable food habits and eating behaviors. Nutrition education based on decreasing portion sizes, decreasing sugared drinks, lowering fat intake, and increasing lean meats and fish, fruit, whole grains, and vegetables imparted to the parents showed a gain in their knowledge level (Engels et al., 2005).

Nutrition education, behavioral interventions, and exercise are the mainstay of treatment for obese parents (adults) and at risk for obese or obese children (Wadden and Stunkard, 2002) and are aimed at improving nutritional choices, decreasing sedentary activity, and increasing physical activity. Children and adults may be targeted separately or together (Berry et al., 2004).

Omar (2000) studied meal planning and its relation to the nutritional status of preschool children aged 2-4 years in Egypt. Special emphasis was given to the socioeconomic status and education level of the families. The results and nutritional quality of meal planning by housewives.

6. Prevention of childhood obesity:

According to Berge et al. (2014), there is a significant association between positive family and parent-level interpersonal dynamics (i.e., parental positive reinforcement, warmth, and group enjoyment) at family meals and reduces the risk of childhood obesity. In addition, vital associations were found between positive parental and family-level food-related dynamics (i.e., food communication, warmth of food, parental food positive reinforcement) and reduced risk of childhood obesity.

Obesity management at a younger age may have a greater effect for several reasons, including:

• Motivation may be easier to generate and maintain, for both the child and other family members while the child is small;
• There may be more frequent opportunities for medical observations during earlier childhood compared with later years;
• It can be easier to modify and control behavior in younger individuals; there may be less resistance to treatment stigmatization and greater influence of the family on the child;
• Longitudinal growth and an increase in lean body mass occur during childhood so that children can grow into their weight (Lobstein et al., 2004).

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