Obesity: The Health Impacts and Relationship With Reproduction

Obesity: The Health Impacts and Relationship With Reproduction

Chapter One

broad objective of the study is to assess the health impact of obesity and its implications on reproductive health.

Specific Objectives

To assess the consumption pattern of high-calorie foods among women of reproductive age.
To describe the attitude of women of reproductive age towards
To assess the level of knowledge of women of reproductive age on risk factors to
To assess the level of knowledge of women of reproductive age on the implications of obesity on reproductive
To assess the nutritional status of the target population using anthropometric

CHAPTER TWO

LITERATURE REVIEW

Global Perspectives on Obesity

In many developing countries, research and investment in health have been mainly devoted to infectious diseases, despite the growing need to address chronic diseases with more effort and resources (WHO, 2005). Deaths from infectious diseases, maternal and perinatal conditions, and nutritional deficiencies combined are projected to decline by 3.0% over the next 10 years, while at the same time deaths due to chronic diseases are projected to increase by 17.0% (WHO, 2005). As a result, it is estimated that of the projected 64 million deaths worldwide in 2015, 41 million (64.0%) will result from chronic diseases; unless urgent action is taken (WHO, 2005). Obesity is a chronic disease characterized by an excess of adipose tissue. It should be considered a serious medical condition that can lead to significant morbidity and mortality rather than a character flaw or personal weakness. Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health.

Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m²). BMI values are age-independent and the same for both sexes. It is the most commonly used measure for monitoring the prevalence of overweight and obesity at population level. It is also the most commonly used way of estimating whether an individual person is overweight or obese.

BMI (kg/m²) was categorized using the World Health Organization (WHO) definitions:

Underweight: < 5 kg/m²
Normal: 5-24.9 kg/m²
Overweight: 25-29.9 kg/m²
Obese: ≥30 kg/m²

Obesity was further sub-classified into

Grade 1 (30-34.9 kg/m²),
Grade 2 (35-39.9 kg/m²) and
Grade 3 (≥40 kg/m²) (WHO, 2000)

Waist-to-hip ratio (WHR) is also used as a measurement of obesity, which in turn is a possible indicator of other more serious health conditions. WHR is the ratio of the circumference of the waist to that of the hips. It does not matter which units of measurement is used, as long as it is the same for each measure. Women who have WHR that is ≥0.85 are classified as having abdominal or truncal obesity.

Prevalence of Obesity

In Nigeria, although both under-nutrition and over-nutrition are common problems, obesity and its associated problems have been identified as a public health problem among rural women, men and children (Bakari, Onyemelukwe, Sani, Hassan and Aliyu, 2007). World Health Organisation global estimates from 2008 revealed that more than 1.4 billion adults, 20 years and older, were overweight. Of these overweight adults, over 200 million men and nearly 300 million women were obese. Overall, more than 10.0% of the world‘s adult population was obese (WHO, 2013). Once considered a high-income country problem, overweight and obesity are now on the rise in low and middle income countries, particularly in urban settings. It is now estimated that over 1 billion adults worldwide are overweight, 300 million of who are clinically obese (WHO, 2004). In 2011, more than 40 million children under the age of five were overweight. More than 30 million overweight children are living in developing countries and 10 million in developed countries (WHO, 2013). Lanigan and Power (2008) noted a high prevalence of overweight among 6-11 years old and reported that 75.0% of respondents view childhood obesity prevention as a high priority. The authors also reported that only 8.0% of parents take time to address the problem.

Based on measured weight and height, the prevalence of obesity in the United States was found to be 30.5% in a survey conducted from 1999 to 2000 while in the United Kingdom, the prevalence was 23.0% among men and 24.0% among women (Flegal, Carroll, Ogden, Johnson, 2002; British Heart Foundation, 2006). In the West African countries of Ghana and Republic of Benin, obesity was found in 13.6% and 18.0% respectively among adults (Amoah, 2003; Sodjinou, Aguey, Fayomi and Delisle, 2008) while Abubakari, Lauder, Agyemang, Jones, Kirk and Bhopal, 2008 reported a prevalence of 10.0% in the West African sub-region with the odd of being obese being 3.2 among urban women compared to men. The estimated prevalence of obesity, based on BMI, was 17.1% in women and 5.4% in men in urban Cameroon in 2002 (Sobngwi, Mbanya, Unwin, Kengne, Fezeu, Minkoulou, Aspray and Alberti, 2002). The prevalence of obesity estimated from the CamBoD Baseline survey was particularly high in women, and increased markedly between 15–34 years and 35–44 years in both sexes. Prevalence of obesity was 5 times higher in females aged 15–34 years compared to men (Kamadjeu, Edwards, Atanga, Kiawi, Unwin, Mbanya, 2006). In South Africa, obesity in women seems to start at a young age; these data show that 10.0% of women were obese at the ages 15 to 24 years (Puoane, Steyn and Bradshaw 2002). Therefore, primary prevention of obesity must start at a young age, particularly for girls.

CHAPTER THREE

METHODOLOGY

Study Design

This study was a descriptive cross sectional survey among women of reproductive age in Ibadan South West Local Government Area, Ibadan.

Study Population

The study population for this research consisted of women of reproductive age ranging from 15-49 years according to National Population Commission and ICF Macro, 2009. All women who fall between the age brackets stated above either married or not were included in the study while men and women with ages outside the stated age brackets were excluded from the research.

Determination of Sample Size

The sample size for the study was determined by using Leslie Kish (1965) formula

CHAPTER FOUR

RESULTS

Socio-demographic Characteristics of Respondents

About a quarter (22.2%) of the respondents was aged 25-29 years while respondents aged 40- 44 and 45-49 years were 6.6% and 9.2% respectively. Respondents who were married were 50.6% while 41.4% were single. Majority of the respondents were Christian (79.0%) and Yoruba (84.0%). More than half (60.0%) of the respondents had biological children, 40.0% did not have biological children while 52.8% and 6.2% were in a monogamous and polygamous marriage respectively. The respondents‘ husband‘s occupations were Artisans (12.8%), Traders (18.2%), Civil servants (12.8%), Professionals (10.8%), Students (0.2%) and 0.2% were not working. Details of the socio-demographic characteristics of the respondents are presented on Table 4.1.

CHAPTER FIVE

DISCUSSION, CONCLUSION AND RECOMMENDATIONS

This chapter focuses on the discussion of the key findings, conclusions and recommendations.

Socio-demographic Characteristics of Respondents

The study was carried out among women of reproductive age (15-49 years) as previous studies (Levine et al., 2007, Lombard et al., 2009) has shown that this group are at a particularly high risk of weight gain.

Consumption Pattern of High Calorie Food

Consumption pattern of high calorie food was documented with the aid of a food frequency questionnaire. The result showed that respondents had a very risky consumption pattern for beverages/cocoa-based drinks, soft drinks, snacks and fried foods. Forslund, Togerson, Sjostron and Lindross (2005) revealed from their study that women were more frequent snackers than men. This is also similar to the findings of Olumakaiye, Atinmo, and Olubayo- Fatiregun (2010) that showed that about 33.0% of their respondents consumed snacks daily but to a varying degree. Other research has suggested that because diets high in refined grains, added sugars, and added fats generally cost less than healthful diets composed of lean meats and fresh fruits and vegetables; consuming excessive amounts of these food items may result in overweight and obesity (Drewnowski, 2004; Richards and Smith, 2006; Hendrickson, Smith, and Eikenberry, 2006).

This study also revealed that majority (88.6%) of respondents consumed high calorie food items at a low risk. This shows that that consumption pattern of high calorie food among women of reproductive age in the study area is low but we cannot conclude that they consume healthy diet because the instrument used in documenting their feeding pattern as not standardized to make that conclusion. This study also reveals that there is also no relationship between the consumption pattern of respondents and their BMI or WHR. This is at variance with the findings of Prabhat and Begum (2012) which revealed that prevalence of central obesity was a common phenomenon in the majority of the selected women regardless of their dietary practices. Duvigneaud, Wijndaele, Matton, Philip-paerts, Lefevre and Thomis (2007) and Vilela, Sichieri, Pereira, Cunha, Rodrigues, Gonçalves-Silva, Ferreira (2014) in their separate studies conducted among adult males and females showed that there is positive association between a high intake of fat and central adiposity (increased waist circumference and WHR)

Implications for Health Education

It is glaring from the findings of this study that there are health promotion and education implications which call for multiple interventions directed at tackling the increasing prevalence of overweight and obesity. Health education principles, strategies and methods such as health talks, lecture, dramas and advocacy should be employed to address the negative findings identified in this study.

Majority of the participants in this study were favourably disposed towards obesity, this implies that there is urgent need to change their attitude and perception. This can be achieve by embarking on public and community health programmes that is focused on increasing the knowledge of implications of obesity. Informed and increased knowledge will go a long way in influencing change of attitude. Findings from this study also showed that there is no association between knowledge of risk factors to obesity and BMI of respondents; health education strategies should also be directed towards encouraging putting into practice the good information women have on healthy diets and positive lifestyles.

The study revealed the degree of knowledge and the range of attitude regarding obesity among this peculiar age group. The results from this study provided information that can be used to influence the planning, development, and implementation of programmes for obesity prevention and reduction.

Finally, informing policy makers about the study findings would increase their commitments to reducing the prevalence of overweight and obesity. Potential focus for future interventions must include public health policy to support promotion of adequate diet, regular exercise and increase public awareness on the fatal consequences of not adhering to healthy lifestyles and behaviours.

Conclusion

This research focused on assessing the level of knowledge of women of reproductive age on the risk factors to obesity and its implication on their reproductive health. Findings from the study revealed that the participants had high knowledge of the risk factors of obesity but their knowledge of health implications was very low. The participants were also favourably disposed towards obesity and the prevalence of obesity was 18.6%

This study provides insights that can be useful for planning and implementing programmes on obesity prevention and reduction. From the results of this study, it could be postulated that there is an urgent need to mount an intensive public health education with the aim of reducing the present unacceptably high prevalence of overweight and obesity in the study population. Healthy living in terms of consumption of fruits and vegetables, regular aerobic exercises and discouragement of consumption of calorie-dense diets are some of the issues that should be addressed in educating the populace on this avoidable epidemic.

Recommendations

In the light of the findings of this study, Federal and State Ministries of Health, Non- Governmental Organizations and other relevant Government agencies including Ministry of Education should design and implement wellness programmes for all women. Such programmes should include health education campaigns aimed at upgrading women‘s knowledge on obesity especially its implications on reproductive health and emphasis on good nutrition. The programmes should also implement behavioural change communication intervention and lifestyle modifications aimed at reducing excessive weight gain, dispelling fears and misconceptions which makes women to be favourably disposed towards obesity.

The following recommendations are suggested and appropriate actions need to be taken by relevant and concerned agencies:

Promote from early age the knowledge of food and nutrition, healthy diets and
Improve labeling of food products; limit and regulate advertising of processed food to
Promote from the early age the importance of physical activity on health.
Provide adequate sport and activity facilities in schools and work
Embark on in-depth public enlightenment campaign on the implications of excess weight gain on health, especially reproductive health

Suggestion for Further Study

There is a need to carry out a similar study among the general population in the study area to allow for a comparison of findings.

REFERENCES

Abubakari A.R., Lauder W., Agyemang C., Jones M., Kirk A., and Bhopal R.S. 2008. Prevalence and Time Trends in Obesity Among Adult West African Populations: a Metaanalysis. Obes. Rev 9. (4) 297–311.
Ajala, C.G. and Meludu N.T. 2006. Food consumption patterns of adult rural dwellers in Oluyole Local Government Area of Oyo State, Nigeria. Journal of Agriculture and Social Research 6:2
Akpa M.R., and Mato C.N. 2008. Obesity in Nigeria: Current Trends and Management.
Nigerian Medical Practitioner 54. (1) 11–15.
Al-Muraikhi A. E. and Al-Kuwari M. G. 2008. Primary Care Physicians’ Knowledge, Attitude, and Practice Toward Obesity Management in Qatar. Middle East Journal of Family Medicine 6:13-16
Amoah A.G. 2003. Obesity on Adult Residents of Accra, Ghana. Ethn Dis 13. (2 Suppl 2) S97–101.
Amodu P.H., Mba I.O., and Lawson L. 2005. Prevalence of Obesity and Dyslipidemia in Hypertensives in Abuja, Nigeria. Scan J Clin Lab Inv 240: 14–17.
Bray G.A. 2003. Risks of obesity. Endocrinol Metab Clin N Am 32:787- 804.
British Heart Foundation, 2006. Diet, Physical Activity and Obesity Statistics Retrieved April 4, 2012, from http://www.heartstats.org/database.asp?id=5749.
Brown, P.J. 1991. Culture and the evolution of obesity. Hum. Nat. 2: 31–57.
Brownell K. D. 2002. The Environment and Obesity. In: Fairburn C. G; Brownell, K.D (Eds), Eating Disorders and Obesity: A Comprehensive Handbook. 2nd ed. New York: Guilford Press.
Butland B., Jebb S., Kopelman P., McPherson K., Thomas S., Mardell J. and Parry V. 2007. Foresight. Tackling Obesity: Future Choices. Project Report. Retrieved July 20, 2013, from http://www.foresight.gov.uk/obesity/obesity_final/.

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