The Prevalence of Malnutrition and Obesity in Schoolchildren in the Southeast Anatolia Region of Turkey

Year 2010, Volume: 12 Issue: 1, 54 - 62, 01.03.2010

Bünyamin Dikici Servet Yel Özcan Özdemir İsmail Hamdi Kara

Abstract

Objective: The aim of this study was to determine the frequency of malnutrition, obesity andoverweight, calculated by body mass index (BMI), in elementary school children in theSoutheast Anatolia Region of Turkey. Method: This research is a cross-sectional epidemiological study and elementary schoolchildren with aged 7-16 years were included randomly by layered random sampling method. Atotal of selected 20 schools and 1912 students filled the questionnaires in Diyarbakır and MardinCity Centers. A questionnaire included questions related to the educational and professionalstatus of parents, siblings, household conditions, children’s demographic characteristics andbody mass indexes, body weight and heights was applied to each student. Determined BMIswere classified according to the percentile values of Center for Disease Control and Prevention(CDC-US) growth charts and International Obesity Task Force (IOTF).Results: Mean age of 1040 boys (52,3%) and 872 girls (47,7%), totally 1912 students was10,8±2,4 years and mean BMI was 17,6±2,8 kg/m2. According to CDC classification, 7,2% ofmale students were categorized as “underweight”, 12,3% of them as “overweight”, and 3,4%of them as “obese” whereas 5,5% of them were categorized as “overweight” and 0,6% of themas “obese” according to IOTF classification. In female students, 8,4% were categorized as“underweight”, 11,1% “overweight”, and 3,3% as “obese” according to CDC classificationwhereas 5,2% were categorized as “overweight” and 1,2% “obese” according to IOTF. Theprevalences were not between boys and girls (p>0.05). Conclusion: In school children in the Southeast Anatolia Region, one of the most importanthealth problems was malnutrition; however prevalances of overweight and obesity had alsononignorable levels

Keywords

elementary schools, student, malnutrition, obesity, education

Güneydoğu Anadolu Bölgesinde Okul Çocuklarında Malnutrisyon ve Obezite Prevalansı

Abstract

Amaç: Bu çalışmada, Güneydoğu Anadolu Bölgesinde, ilköğretim okullarındaki çocuklarda,vücut kitle indeksi (VKI) ile hesaplanan malnutrisyon, kilolu olma ve obezite sıklığınınbelirlenmesi sosyodemografik özelliklerin belirlenmesi amaçlandı. Yöntem: Araştırma, kesitsel tipte epidemiyolojik bir çalışma olup, “Tabakalı rasgele örneklemeyöntemi” kullanılarak belirlenen 7-16 yaş grubundaki ilköğretim okul çocuklarınıkapsamaktadır. Diyarbakır ve Mardin iI merkezlerinde, toplam 20 okul ve 1912 öğrenci anketformlarını doldurdu. Vücut ağırlığı ve boy ölçümlerinden elde edilen vücut kitle indeksi (VKI),çocukların demografik özellikleri, kardeş sayısı, konut-yaşam koşulları, anne ve baba çalışmave eğitim durumlarına ilişkin ile ilgili soruların yer aldığı bir anket uygulandı. VKI, InternationalObesity Task Force (IOTF) ve Center for Disease Control and Prevention (CDC-US) gelişimkartlarının persentil değerlerine göre sınıflandırıldı.Bulgular: 1040 erkek (%52,3) ve 872 kız (%47,7), toplam 1912 öğrencinin yaş ortalaması10,8±2,4 yıl ve VKI ortalaması 17,6±2,8 kg/m2’dir. CDC sınıflamasına göre, erkek öğrencilerin%7,2’si “düşük kilolu” %12,3’ü “aşırı kilolu ve %3,4’ü “obez” iken; IOTF sınıflamasına gorebunların %5,5’u “aşırı kilolu”, %0,6’sı ise “obez” olarak sınıflandırılmıştı. Kız öğrencilerin,CDC sınıflamasına göre %8,4’ü “düşük kilolu” %11,1’i “aşırı kilolu ve %3,3’ü “obez” iken;IOTF sınıflamasına gore bunların %5,2’si “aşırı kilolu”, %1,2’si ise “obez” olaraksınıflandırılmıştı. Kız ve erkek öğrenciler arasında prevalanslar açısından fark bulunmuyordu(p>0.05). Sonuç: Güneydoğu Anadolu Bölgesinde, ilköğretim okullarındaki çocuklarda en önemli sağlıkproblemlerinden birisi malnutrisyondur; ancak aşırı kilo ve obezite prevalansı da ihmaledilmeyecek düzeylerdedir

Keywords

ilköğretim okulları, öğrenci, malnutrisyon, obezite, eğitim

References

• United Nations: The sex and age distribution of the world populations: The 1996 revision. New York: United Nations, 1997.
• Delisle H, Chandra-Mouli V, de Benoist B: Should adolescents be specifically targeted for Nutrition in developing countries? To address which Problems, and how? WHO Publications, available at “www.who.int/child- adolescent-health /New_Publications/NUTRITION/ Adolescent_nutrition_paper.pdf”. Accessed January 24, 2006.
• World Health Organization: Obesity: preventing and managing the global epidemic. Report of a WHO Consultation on Obesity, 3–5 June, Geneva, WHO/NUT/NCD/98.1.1997.
• Himes JH, Dietz WH: Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services. Am J Clin Nutr. 59:307–16, 1994.
• Barlow SE, Dietz WH: Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics. 102:E29, 1998.
• Must A, Jacques PF, Dallal GE, Dietz WH: Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness. Am J Clin Nutr. 53:839-46, 1991.
• WHO Expert Committee: Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 854:1–452, 1995.
• Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, et al: CDC growth charts: United States advance data from vital and health statistics, no. 314. Hyattsville, MD: National Center for Health Statistics. 2000.
• Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 320:1240–3, 2000.
• Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL: Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index. Am J Clin Nutr. 73:1086–93, 2001.
• Stephenson LS, Latham MC, Ottesen EA: Malnutrition and parasitic helminth infections. Parasitology. 121: Suppl S23−S38, 2000.
• Partnership for Child Development: The anthropometric status of schoolchildren in five countries in the partnership for child development. Proc Nutr Soc. 57: 149−158, 1998.
• Lwambo NJ, Brooker S, Siza JE, Bundy DA, Guyatt H: Age patterns in stunting and anaemia in African schoolchildren: a cross- sectional study in Tanzania. Eur J Clin Nutr. 54: 36−40, 2000.
• Leenstra T, Petersen LT, Kariuki SK, Oloo AJ, Kager PA, ter Kuile FO: Prevalence and severity of malnutrition and age at menarche; cross-sectional studies in adolescent schoolgirls in western Kenya. Eur J Clin Nutr. 59:41−48, 2005. doi: 10.1038/sj.ejcn.1602031.
• Anand K, Kant S, Kapoor SK: Nutritional status of adolescent school children in rural North India. Indian Pediatr. 36(8):810- 5, 1999.
• Wang Y, Monteiro C, Popkin BM: Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia. Am J Clin Nutr. 75(6):971- 7, 2002.
• Oner N, Vatansever U, Sari A, Ekuklu E, Guzel A, Karasalihoglu S, Boris NW: Prevalence of underweight, overweight and obesity in Turkish adolescents. Swiss Med Wkly. 134(35-36):529-33, 2004.
• Organisation for Economic Co-operation and Development. Policy Brief. Economic Survey of Turkey, 2004. OECD Observer. Available at “http://www.oecd.org/dataoecd/42/47/33821199.pdf” Accessed January 26, 2006.
• Presidency of State Statistical Institute - General Population Census (2000) DİE publications. Available at: “www.die.gov.tr/nufus_sayimi/ 2000Nufus_Kesin1.htm” Accessed January 26, 2006.
• Lissau I, Overpeck MD, Ruan WJ, Due P, Holstein BE, Hediger ML: Health Behaviour in School-aged Children Obesity Working Group. Body mass index and overweight in adolescents in 13 European countries, Israel, and the United States. Arch Pediatr Adolesc Med. 158(1):27-33, 2004.
• Uckun-Kitapci A, Tezic T, Firat S, Sipahi T, Barrier R, Edwards LJ, Calikoglu AS: Obesity and type 2 diabetes mellitus: a population-based study of adolescents. J Pediatr Endocrinol Metab. 17(12):1633-40, 2004.
• Krassas GE, Tzotzas T, Tsametis C, Konstantinidis T: Prevalence and trends in overweight and obesity among children and adolescents in Thessaloniki, Greece. J Pediatr Endocrinol Metab. 14 Suppl 5:1319-26, 2001; discussion 1365.
• Agirbasli M, Ciliv G, Cakir S, Srinivasan S, Berenson GS, Ozme S: Body mass index and lipid levels in children from Ankara, Turkey versus Bogalusa, Louisiana. Prev Med. 41(5- 6):843-5, 2005. Epub 2005 Sep 16.
• Fredriks AM, Van Buuren S, Sing RA, Wit JM, Verloove- Vanhorick SP: Alarming prevalences of overweight and obesity for children of Turkish, Moroccan and Dutch origin in The Netherlands according to international standards. Acta Paediatr. 94(4):496-8, 2005.
• Canning PM, Courage ML, Frizzell LM: The authors respond: Definitions of pediatric obesity. CMAJ. 172(3):310, 2005.