Prevalence and factors associated with overweight and obesity among University undergraduates in Nigeria
Background to the Study
Overweight and obesity are the most common nutritional disorder of recent years, despite the knowledge on its prevention; health implications and advancement in its treatment, there seem to be a number of new cases each year. Overweight and obesity was previously a problem of high- income countries, but is now on the rise in low-and-middle- income countries, especially in urban settings. This is mostly due to consumption of energy dense food that is high in sugar and also fats. Overweight and obesity is attributed to decreased physical activity and has leads to increase morbidity and mortality worldwide.
Olusanya (2008) defined obesity as an abnormal accumulation of fat in the adipose tissue throughout the body. It is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health (WHO, 2000). It is defined by body mass index
(BMI) and further evaluated in terms of fat distribution via waist-hip ratio and total cardio-vascular risk factors (Sweeting, 2007). Overweight and obesity increases the likelihood of various diseases, particularly heart diseases, type2 diabetes, breathing difficulties during sleep, certain types of cancer and osteoarthritis. Obesity is most commonly caused by a combination of excessive dietary calories, lack of physical activities and genetic susceptibility, although a few cases are caused permanently by genes, endocrine disorders, medications or psychiatric illness (Haslam and James, 2005). Total increase in overweight and obesity attributable to several factor including foods that are high in fat and sugars and low in minerals and vitamins and other micro nutrients, increasing low-intensity work form due to urbanisation, new modes of transportation and decreased physical activity in general (Kids health, 2010).
Projections in 2005 by WHO shows that about 2.3 billion adults were overweight globally (WHO, 2008). In both the developed and developing world, obesity has reached epidemic proportions (Derek, Dard, and Kelly, 2006). More than 10% of the world’s adult population was estimated obese with over 200 million men and nearly 300 million women as at 2008 (WHO, 2008). There is a vast amount of evidence worldwide that shows obesity is chronic disease which can predispose to potential fat at chronic conditions, such as type2 diabetes, cardiovascular disease and stroke (Bjorntorp, 2001).
The increase in the prevalence of overweight and obesity is probably associated with industrialisation and urbanisation, which results in changed eating habits and lifestyles in the population (Pop kin and Gordon-Larsen, 2004).
A study conducted in Northern Nigeria reported 210/1000 prevalence of overweight with higher prevalence among females than males (29.8% vs 9.3%). (Kolawole, Wahab, Sani, Bashir, Maru, Akeem, and Mamud, 2011). A 2006 review identified ten other possible contributors to the recent increase of obesity. Insufficient sleep, endocrine disruptors (environmental pollutant that interfere with lipid metabolism), variability in ambient temperature, decreased rate of smoking, because smoking suppresses appetite, increased use of medications that can cause weight gain, proportional increase in ethnic and age groups that tends to be heavier, pregnancy at late age (which may cause susceptibility in children obesity), risk factor passed on generationally, natural selection for higher BMI and assortative mating leading to obesity. (This would not necessarily increase the number of obese people, but would increase the average population weight) (Keith, Raddden, Kat, and Zmarzyt, 2006).
A study in southwestern Nigeria indicated a high prevalence of overweight and obesity among females (Akinpelu, Oyewolu, and Oritogun, 2008). However, a study in Greece reported a higher incidence of overweight among males than female (Bertsias, Mammas, Linacalkis, and Kafatos, 2003).
Obesity is a global health problem and little is known about its prevalence among undergraduates in Plateau state Nigeria. This study will provide a baseline data that will kick-start the process of ensuring a healthy life among students.
1.2 Statement of the Problem
The dietary transition recently going on in Africa is contributing greatly to high mortality and morbidity attributed to overweight and obesity (Smpokos, Linardakis, Sarri,Papadaki, Theodorou & Kafatos, 2013). It has exposed a lot of Africans to a new lifestyle, a lot of things are done which pose a threat to lives such as poor diet, lack of physical activities, spending too much time watching the television, intake of energy drinks and soda. Adolescents adopt this new lifestyle and engage in intake of junks which has been referred to as fast food, intake of energy drinks as much as they can get, intake of alcohol, sedentary lifestyles such as spending hours watching the television. These contribute a great deal to the amount of calories gained, and the accumulation of these overtime leads to weight gain that cannot be controlled due to the consistent intake of these foods (Mozaffarian, Hao, Rimm, Willett & Hu, 2011).
Studies have revealed sedentary behaviour, increased intake of junks and physical inactivity to be predisposing factors to obesity. Indicating presence of these factors may subsequently lead to high incidence rate of obesity. In a study carried out by Mustapha and Sanusi (2013) in Ondo state showed that about 5.76% adolescents were overweight while 1.13% were obese which may be regarded as low compared to other developed countries.
Obesity has become a major problem of adolescents and this has been associated with adulthood. Despite the high level of information and knowledge of obesity as evident in researches carried out by Marta, Magdalena, Aleksandra, Sylwia, Lukasz, Tomasz et al., (2014), there is still an increase in the prevalence of obesity among secondary school adolescents as a result of the research carried out by Jaja & Alex, 2016. This indicates that there are other factors which might be responsible for the increase in the prevalence of obesity especially social factors including knowledge, attitude, and behaviour related to diet, exercise, nutrition, and overall health in addition to age, race, and gender (Sarrafzadegan, Rabeje, Nouri, Mohammadifaed, Moatter, Roohafza et al., 2013).
Literature have been showing incoherent data about the prevalence of obesity among students. No literature has yet been released on Prevalence and factors associated with overweight and obesity among University undergraduates in Nigeria and Gombe state in particular and also the presence of the factors preceding obesity among students has not been documented which this study intends to explore.
1.3 Objective of the Study
The general objective of this study is to assess the Prevalence and factors associated with overweight and obesity among University undergraduates in Nigeria with a specially attention to Gombe state university students.
The specific objectives are to:
- identify the prevalence of overweight and obesity among Gombe state undergraduate students;
- determine the influence of intrapersonal factors on prevalence of overweight and obesity among Gombe state undergraduate students;
- assess the influence of interpersonal factors on prevalence of overweight and obesity among Gombe state undergraduate students; and
- find out the influence of school environment on the respondents.
1.4 Research Questions
- At what level is the prevalence of overweight and obesity in Gombe state undergraduate students?
- How does intrapersonal factors influence the prevalence of obesity among Gombe state undergraduate students?
- To what extent does interpersonal factors influence the prevalence of obesity among Gombe state undergraduate students?
- What is the level of the influence of school environment on the respondents?
1.5 Justification for the Study
Obesity is a condition resulting in undesirable metabolic changes and elevate the risk of non-communicable diseases (Brahmbhatt & Oza, 2012). There has been an increase in the prevalence of obesity which constantly leads to the increase of cardiovascular diseases such as high blood pressure, diabetes etc. This study will contribute to the existing knowledge of obesity and it will help to reduce the prevalence of these diseases.
The presence and increase in the documented identified factors poses a higher risk of prevalence of obesity over a subsequent period of time. This is why this study is of great importance, not only in diagnosing the prevalence of obesity but also in identifying the presence of predisposing factors predicting possible increase in the prevalence of obesity.
This study will change the perception of Gombe state undergraduate students about the consumption of junks and encourage a higher intake of fruits and vegetables and also promote physical activity. It will add to the existing knowledge. If these factors are present among students of the randomly selected school, it will be a gateway to the development of intervention towards the prevention and control of obesity among population with similar characteristics.
H1: There is a significant difference in obesity across demographic factors.
H2: There is a significant relationship between intrapersonal factors and obesity.
H3: There is a significant relationship between interpersonal factors and obesity.
H4: There is a significant relationship between school environment and obesity.
H5: There is a significant relationship between physical inactivity and obesity.
H6: There is a significant relationship between school environment and intrapersonal factors predicting obesity.
Operational Definition of Terms
Obesity: In the context of this study, obesity is defined as an excess proportion of total body fat. A person is considered obese when his or her weight is 20% or more above the normal weight. The most common measure of obesity is the body mass index. A person is considered overweight if his or her BMI is between 25 and 29.9, a person is considered obese if his or her BMI is above 30.
Intrapersonal Factors: In the context of this study, this refers to the knowledge and the willingness of the adolescents to engage in physical activities.
Interpersonal Factors: In the context of this study, this refers to the parental motivation to physical activities by adolescents.