Lise Öğrencilerinde Sedanter Yaşam, Beslenme Davranışları ve Fazla Kiloluluk-Obezite Arasındaki İlişkinin Değerlendirilmesi: Bir Vaka Kontrol Çalışması

Öz

Giriş: Çocukluk çağı obezitesi, 21. yüzyılın en ciddi halk sağlığı sorunlarından biridir. Obezitenin en yaygın sebepleri arasında sedanter yaşam tarzı ve sağlıksız beslenme alışkanlıkları yer almaktadır. Amaç: Bu çalışmanın amacı bir grup adölesanda fazla kilolu ve obezite sıklığını belirlemek ve obezite oluşumunda sedanter yaşam tarzı ve beslenme davranışları ilişkisini incelemektir. Yöntem: Bu çalışma, kesitsel-vaka kontrol araştırmasıdır. Çalışmada, fazla kilolu ve obez olduğu tespit edilen 44 öğrenci ile kontrol grubu olarak alınan 53 öğrenci fazla kiloluluk ve obeziteye neden olabilecek çeşitli risk faktörleri bakımından incelenmiştir. Veri toplama aracı olarak sedanter yaşam tarzı ve beslenme davranışlarına ilişkin soru formu kullanılmıştır. Verilerin analizinde Mann-Whitney U testi, ki-kare ve lojistik regresyon analizi kullanılmıştır. Bulgular: Öğrencilerde fazla kilolu ve obezite prevalansı %10.9 bulunmuştur. Ailede kilolu birey varlığı, günlük fiziksel aktivite süre ve sıklığı, günlük televizyon/bilgisayarda vakit geçirme ve ders çalışma süresi, okul içinde spor aktivitelerine katılmama ve ekran karşısında yiyecek yeme durumu vaka grubunda istatistiksel olarak anlamlı şekilde daha yüksektir. Ailede kilolu birey varlığı (OO = 14.56, %95 GA = 4.09-51.82), erkek cinsiyet (OO = 2.95, %95 GA = 6.82-53.61), dershaneye/kursa gitme (OO = 1.12, %95 GA = .03-.45) ve bilgisayar/TV izlerken yiyecek yeme (OO = 1.22, %95 GA = .06-.72) fazla kiloluluk ve obezite riskini artırmaktadır. Sonuç: Bu çalışmada, öğrencilerde fazla kiloluluk ve obezite için en önemli risk faktörleri ailede kilolu birey varlığı, dershaneye/kursa gitme ve bilgisayar/televizyon izlerken yiyecek yemedir.

Anahtar Kelimeler

• Adölesan
• Fazla Kilo ve Obezite
• Sedanter Yaşam
• Beslenme Davranışı
• Hemşirelik

Assessment of The Relationship Between Sedentary Lifestyle, Nutritional Behaviors and Overweight-Obesity among High School Students: A Case Control Study

Öz

Background: Childhood obesity is one of the most serious public health problems of the 21st century. Sedentary lifestyle and unhealthy eating habits are among the most common causes of obesity. Objectives: The aim of this study is to determine the prevalence of overweight and obesity in a group of adolescents and to examine the relationship between sedentary lifestyle and nutritional behaviors in obesity formation. Methods: This study is a cross-sectional nested case-control study. In the study, 44 students who were found to be overweight and obese and 53 students who were taken as a control group were examined in terms of various risk factors that may cause overweight and obesity. A questionnaire regarding sedentary lifestyle and nutritional behaviors was used as a data collection tool. In the analysis of the data, Mann-Whitney U, chi-square and logistic regression analyzes were used. Results: The prevalence of overweight and obesity among students was found to be 10.9%. The presence of overweight individual in the family, the duration and frequency of daily physical activity, daily television/computer time and study time, not participating in sports activities at school, and eating food in front of the screen were statistically significantly higher in the case group. The presence of an overweight family member (OR = 14.56, %95 GA = 4.09-51.82), male gender (OR = 2.95, 95% CI = 6.82-53.61), going to the course (OR = 1.12, %95 GA = .03-.45) and eating food while watching a computer/television (OR = 1,22, %95 GA = .06-.72) increase the risk of overweight and obesity. Conclusion: In this study, the most important risk factors for overweight and obesity among students are presence of overweight individuals in the family, going to classrooms/courses and eating food while watching computers/television.

Anahtar Kelimeler

• Adolescent
• Overweight and Obesity
• Sedentary Life
• Nutritional Behavior
• Nursing

Kaynakça

1. 1. Yurt S. Okul sağlığında özel sorunlar: Obezite. İçinde Gözüm S, Okul Dönemindeki Çocukların Sağlığının Geliştirmesi. 1. Baskı. İstanbul: Vize; 2016: 342-46.
2. 2. World Health Organization. Overweight and obesity. Children and Adolescent aged 5-19. 2018; URL:https://www.who.int/gho/ncd/risk_factors/overweight_adolescents_text/en/ 01.10.2020
3. 3. World Health Organization. Obesity. 2018. URL:https://www.who.int/topics/obesity/en/ 11.11.2020
4. 4. Centers for Disease Control and Prevention. About BMI for Children & Teens. 2018. URL:https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html 01.10.2020
5. 5. Aktaş D, Öztürk FN, Kapan Y. Adölesanlarda obezite sıklığı ve etkileyen risk faktörleri, beslenme alışkanlıklarının belirlenmesi. TAF Preventive Medicine Bulletin 2015;14(5): 406-12.
6. 6. Yılmaz M, Mayda AS. Determination of the obesity prevalence and risk factors in school children in Düzce. Düzce Tıp Fakültesi Dergisi 2017;19(2): 42-47.
7. 7. Öztürk A, Aktürk S. İlköğretim öğrencilerinde obezite prevalansı ve ilişkili risk faktörleri. TAF Preventive Medicine Bulletin 2011;10(1): 53-60.
8. 8. Wen J, Zhu L, Ji C. Changes in weight and height among Chinese preschool children during COVID-19 school closures. International Journal of Obesity 2021; 1-5.

9. 9. Kim ES, Kwon Y, Choe YH, & Kim MJ. COVID-19-related school closing aggravate obesity and glucose intolerance in pediatric patients with obesity. Scientific Reports 2021; 11(1), 1-7.
10. 10. Rubenstein C. Child and adolescent health. In: Stanhope M, Lancaster J, editors. Public Health Nursing: Population-Centered Health Care in the Community. Missouri: Elsevier; 2012. p. 654-57.
11. 11. Mendoza JA, Zimmerman FJ, Christakis DA. Television viewing, computer use, obesity, and adiposity in US preschool children. International Journal of Behavioral Nutrition and Physical Activity 2007;4(1): 1-10.
12. 12. GodakandaI, Abeysena C, Lokubalasooriya A. Sedentary behavior during leisure time, physical activity and dietary habits as risk factors of overweight among school children aged 14–15 years: case control study. BMC Research Notes 2018;11(1): 1-10.
13. 13. Allender JA, Rector C, Warder KD. School-age children and adolescent. In: Community & Public Health Nursing Promoting the Public’s Health. 8rd ed. China: Wolters Kluwer Health; 2014. p. 717-19.
14. 14. Rathnayake KM, Roopasingam T, Wickramasighe VP. Nutritional and behavioral determinants of adolescent obesity: a case–control study in Sri Lanka. BMC Public Health 2014;14(1):1-6.
15. 15. Kim SE, Kim JW, Jee YS. Relationship between smartphone addiction and physical activity in Chinese international students in Korea. Journal of Behavioral Addictions 2015;4(3):200-205.
16. 16. Li M, Dibley MJ, Sibbritt D, Yan H. Factors associated with adolescents' overweight and obesity at community, school and household levels in Xi'an City, China: results of hierarchical analysis. European Journal of Clinical Nutrition 2008;62(5): 635-45.
17. 17. Martin A, Booth JN, Laird Y, Sproule J, Reilly JJ, & Saunders DH. Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Cochrane Database of Systematic Reviews 2018;(1): CD009728.
18. 18. Erol S. Okul sağlığı taramaları. İçinde Gözüm S, Okul Dönemindeki Çocukların Sağlığının Geliştirmesi. 1. Baskı. İstanbul: Vize; 2016: 114-16.
19. 19. Honório RF, Hadler MCCM. Factors associated with obesity in Brazilian children enrolled in the School Health Program: a case-control study. Nutricion Hospitalaria. 2014;30(3): 526-34.
20. 20. Patsopoulou A, Tsimtsiou Z, Katsioulis A, Rachiotis G, Malissiova E, Hadjichristodoulou C. Prevalence and risk factors of overweight and obesity among adolescents and their parents in central Greece (FETA Project). International Journal of Environmental Research and Public Health. 2016;13(1): 1-10.
21. 21. Bhuiyan MU, Zaman S, Ahmed T. Risk factors associated with overweight and obesity among urban school children and adolescents in Bangladesh: a case–control study. BMC Pediatrics. 2013;13(1): 1-6.
22. 22. Neutzling MB, Taddei JAA, Gigante DP. Risk factors of obesity among Brazilian adolescents: a case–control study. Public Health Nutrition. 2003;6(8): 743-49.
23. 23. T.C. Millî Eğitim Bakanlığı. Eğitimi Araştırma ve Geliştirme Dairesi Başkanlığı. Öğrencilerin Okul Kantinlerindeki Tüketim Tercihleri ve Kantinlerin Değerlendirilmesi. Ankara; 2008. p. 17-19.
24. 24. Kudret M, Budak N. Kuzey Kıbrıs Türk Cumhuriyeti Doğu Akdeniz Üniversitesi Öğrencilerinin Sabah Kahvaltısı Yapma Alışkanlıklarının Saptanması. International Peer-Reviewed Journal of Nutrition Research. 2017;9: 51-64.
25. 25. World Health Organization. WHO child growth standards: training course on child growth assessment. Switzerland: WHO Press; 2018. p. 15-18.
26. 26. Campbell ET, Franks AT, Joseph PV. Adolescent obesity in the past decade: A systematic review of genetics and determinants of food choice. Journal of the American Association of Nurse Practitioners. 2019;31(6): 344-51.
27. 27. Centers for Disease Control and Prevention. National Center for Health Statistics. Children and Adolescents: Percentage of Children and Adolescents Who are Overweight or Obese. 2018. URL: https://nccd.cdc.gov/CKD/detail.aspx?QNum=Q248 11.11.2020
28. 28. Nirmala A, Venkataraman P, Kanniammal C, Rani A, Arulappan J. Prevalence of Obesity and Associated Risk Factors among Adolescents in Kancheepuram, south India. International Journal of Nursing Education. 2018;10(1): 55-60.
29. 29. Meşe Yavuz C, Koca Özer B. Adölesan dönem okul çocuklarında beslenme alışkanlıkları ve beslenme durumunun değerlendirilmesi. Journal of Tourism and Gastronomy Studies. 2019;7(1): 225-43.
30. 30. Yılmaz SK, Özel HG. Okul çağı çocuklarda şekerli içecek tüketimi ile obezite riski arasındaki ilişki. Beslenme ve Diyet Dergisi. 2016;44(1): 3-9.
31. 31. Agadayı E, Çelik N, Çetinkaya S, Karaca SN. Sivas ili kırsal bir ilçede okul çağı çocuklar ve adölesanlarda obezite sıklığının ve etkileyen faktörlerin belirlenmesi. Ankara Medical Journal. Ankara Medical Journal. 2019;19(2): 325-36.
32. 32. Gürel AN, Hisar F. Adölesanlarda şekerli içecek tüketiminin obezite ile ilişkisi. Hacettepe University Faculty of Health Sciences Nursing Journal. 2018;5(3): 177-91.
33. 33. An R. Projecting the impact of the coronavirus disease-2019 pandemic on childhood obesity in the United States: A microsimulation model. Journal of sport and health science 2020; 9(4), 302-312.
34. 34. Spencer RA, Rehman L, Kirk SF. Understanding gender norms, nutrition, and physical activity in adolescent girls: a scoping review. International Journal of Behavioral Nutrition and Physical Activity 2015;12(1): 1-10.
35. 35. Qi L, Cho YA. Gene-environment interaction and obesity. Nutrition Reviews 2008;66(12):684-94.
36. 36. Van Dijk SJ, Molloy PL, Varinli H, Morrison JL, Muhlhausler BS. Epigenetics and human obesity. International Journal of Obesity. 2015;39(1): 85-97.
37. 37. Travis S, Bisogni C, Ranzenhofer L. A conceptual model of how US families with athletic adolescent daughters manage food and eating. Appetite. 2010;54(1):108–17.
38. 38. Guerra S, Teixeira-Pinto A, Ribeiro JC, Ascensão A, Magalhães J, Andersen LB ve ark. Relationship between physical activity and obesity in children and adolescents. Journal of sports medicine and physical fitness. 2006;46(1): 79-83.
39. 39. Muthuri SK, Wachira LJM, Onywera VO, Tremblay MS. Correlates of objectively measured overweight/obesity and physical activity in Kenyan school children: results from ISCOLE-Kenya. BMC Public Health. 2014;14(1): 436.
40. 40. Anteneh ZA, Gedefaw M, Tekletsadek KN, Tsegaye M, Alemu D. Risk factors of overweight and obesity among high school students in Bahir Dar City, north West Ethiopia: school based cross-sectional study. Advances in Preventive Medicine. 2015;3:1-9.
41. 41. Rizwan W, Bhatti T. Risk factors for development of obesity in children. Pakistan Journal of Medical & Health Sciences. 2017;11(1): 438-40.
42. 42. Hadianfard AM, Mozaffari-Khosravi H, Karandish M, & Azhdari M. Physical Activity and Sedentary Behaviors (Screen Time and Homework) Among Overweight or Obese Adolescents Before The COVID-19 Pandemic: A Cross-Sectional Observational Study in Yazd, Iran. BMC Pediatr. 2021;21(1):421.
43. 43. Rundle AG, Park Y, Herbstman JB, Kinsey EW, & Wang YC. COVID-19 related school closings and risk of weight gain among children. Obesity (Silver Spring). 2020;28(6):1008.
44. 44. Yılmaz BÖ, Çiçek B, Kaner G. Kayseri İlindeki liselerde öğrenim gören adölesanlarda obezite düzeyinin ve ilişkili risk faktörlerinin belirlenmesi. Türk Hijyen ve Deneysel Biyoloji Dergisi 2018;75(1): 77-78.
45. 45. Ren H, Zhou Z, Liu W, Wang X, Yin Z. Excessive homework, inadequate sleep, physical inactivity and screen viewing time are major contributors to high pediatric obesity. Acta Paediatrica. 2017;106(1): 120-27.