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Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review.

ABSTRACT: Introduction:Recently, childhood and adolescence overweight/obesity has increased disproportionately in developing countries, with estimates predicting a parallel increase in future cardiovascular disease (CVD) burden identifiable in childhood and adolescence. Identifying cardiovascular risk factors (CVRF) associated with childhood and adolescence overweight/obesity is pivotal in tailoring preventive interventions for CVD. Whilst this has been examined extensively in high-income countries, there is scant consistent or representative data from sub-Saharan Africa (SSA). Objective:This scoping review synthesises contemporary studies on CVRF associated with overweight and obesity in SSA children and adolescents to provide evidence on the current burden of overweight/obesity and CVD in this population. Methods:We searched MEDLINE and Google Scholar up to July 31, 2019 for observational and experimental studies and systematic reviews addressing childhood and adolescence overweight/obesity and CVRF in SSA without language restriction. Four investigators working in four pairs, independently selected and extracted the relevant data. The methodological quality of all included studies was assessed. Results:We included 88 studies with a total of 86,637children and adolescents from 20 SSA countries. The risk of bias was low in 62 (70.5%), moderate 18 (20.5%), and high in eight (9%) studies. Overweight/obesity in SSA children and adolescents is rising at an alarming rate. Its main associations include physical inactivity, unhealthy diets, high socio-economic status, gender and high maternal body mass index. Identified CVRF in overweight/obese SSA children and adolescents are mainly metabolic syndrome, hypertension, dyslipidaemia, diabetes and glucose intolerance. There is a dearth of guidelines or consensus on the management of either childhood overweight/obesity or CVRF in overweight/obese SSA children and adolescents. Conclusion:The current findings suggest an urgent need to review current health policies in SSA countries. Health education and transforming the current obesogenic environment of the SSA child and adolescent into one which promotes physical activity and healthy dietary habits is required.

SUBMITTER: Choukem SP

PROVIDER: S-EPMC7092532 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review.

Choukem Simeon-Pierre SP Tochie Joel Noutakdie JN Sibetcheu Aurelie T AT Nansseu Jobert Richie JR Hamilton-Shield Julian P JP

International journal of pediatric endocrinology 20200324

<h4>Introduction</h4>Recently, childhood and adolescence overweight/obesity has increased disproportionately in developing countries, with estimates predicting a parallel increase in future cardiovascular disease (CVD) burden identifiable in childhood and adolescence. Identifying cardiovascular risk factors (CVRF) associated with childhood and adolescence overweight/obesity is pivotal in tailoring preventive interventions for CVD. Whilst this has been examined extensively in high-income countrie ...[more]

PMID: 32211050

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Project description:Background: The growing burden of non-communicable diseases (NDC), particularly in low-and middle-income countries, poses a significant threat to global health. Obesity and overweight constitute major risk factors of NCDs such as heart diseases, diabetes, and kidney disease, and as a result, contribute significantly to the development of chronic morbidities, reduced quality of life, and increased risk of premature death. This study described evidence on the prevalence, incidence, and trends of childhood overweight and obesity in sub-Sahara Africa (SSA).Methods: We conducted a systematic scoping review employing the Arksey and O'Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. To obtain relevant published articles for this review, we performed a comprehensive keywords search in PubMed, Google Scholar, Web of Science, and CINAHL via EBSCOhost platform for studies published between 2009 and June 2019. Guided by the eligibility criteria, title and abstracts, as well as the full-text articles were independently screened in parallel by two investigators. All relevant data were independently extracted by two investigators using a piloted form designed in Microsoft and thematic analysis conducted.Results: Of the 81 included studies obtained from 250,148 potentially eligible articles, the majority (25) conducted in South Africa followed by 18 in Nigeria. Six studies were conducted in Ethiopia (6), Tanzania (5), Kenya (4), Cameroon (4), Ghana (3), Uganda (2), Mozambique (2), and Sudan (2). One study each was conducted in Botswana, Gambia, Lesotho, Mauritius, Seychelles, Togo, and Zimbabwe. The remaining three articles were multi-country studies. Most (81.5%) of the included studies were cross-sectional surveys and the majority (79) focused on both male and female participants. The majority (80/81) of the included studies reported on the prevalence of childhood overweight/obesity, 8 on the trends of childhood overweight/obesity, and one presented evidence on the incidence of childhood overweight and obesity in SSA.Conclusion: This review demonstrates limited studies on childhood overweight/obesity in most SSA countries although the included studies suggest an increasing burden. Considering the consequences of childhood obesity, there is a need for more primary researches to inform policies decision and implementation to halt the rise of childhood obesity/overweight in SSA.

Project description:Background:The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA. Methods:Guided by the Arksey and O'Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted. Results:A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region. Conclusion:This review findings suggest a paucity of literature on the risk factors of childhood obesity and morbidities in most SSA countries. Hence, there is the need to intensify research efforts, especially experimental study designs using innovative strategies to promote healthy lifestyle choices that will prevent or minimize the risks and health consequences of childhood obesity in SSA.

Project description:BackgroundPrevalence of childhood overweight/obesity has increased considerably in recent years. The transition to higher rates of overweight/obesity has been well documented in high income countries; however, consistent or representative data from lower income countries is scarce. It is therefore pertinent to assess if rates of overweight/obesity are also increasing in lower income countries, to inform public health efforts.ObjectiveThis systematic review aimed to investigate the evidence for an overweight/obesity transition occurring in school-aged children and youth in Sub Saharan Africa.MethodsStudies were identified by searching the MEDLINE, Embase, Africa Index Medicus, Global Health, Geobase, and EPPI-Centre electronic databases. Studies that used subjective or objective metrics to assess body composition in apparently healthy or population-based samples of children and youth aged 5 to 17 years were included.ResultsA total of 283 articles met the inclusion criteria, and of these, 68 were used for quantitative synthesis. The four regions (West, Central, East, and South) of Sub Saharan Africa were well represented, though only 11 (3.9%) studies were nationally representative. Quantitative synthesis revealed a trend towards increasing proportions of overweight/obesity over time in school-aged children in this region, as well as a persistent problem of underweight. Weighted averages of overweight/obesity and obesity for the entire time period captured were 10.6% and 2.5% respectively. Body composition measures were found to be higher in girls than boys, and higher in urban living and higher socioeconomic status children compared to rural populations or those of lower socioeconomic status.ConclusionsThis review provides evidence for an overweight/obesity transition in school-aged children in Sub Saharan Africa. The findings of this review serve to describe the region with respect to the growing concern of childhood overweight/obesity, highlight research gaps, and inform interventions.Prospero registration numberCRD42013004399.

Project description:ImportanceTime-trend studies of overweight and obesity in childhood by sociodemographic factors are important for prioritizing public health initiatives. However, little is known about these trends in Spain, where high levels of obesity are found and where important demographic changes have occurred during the last 2 decades.ObjectiveTo examine how time trends in the prevalence and incidence of overweight and obesity among children and adolescents differ by age, sex, socioeconomic status, urban/rural residence, and nationality.Design, setting, and participantsThis cohort study included 1.1 million children and adolescents (aged 2-17 years) with at least 1 measure of height and weight in Catalonia, Spain, from 2006 to 2016. Electronic health records were accessed from the Information System for Research in Primary Care. Data analysis was conducted from January to December 2018.Main outcomes and measuresPrevalence and incidence rates and trends of overweight/obesity and obesity (overweight/obesity defined as having of BMI z score greater than 2.0 among children aged <5 years and greater than 1.0 among children aged ≥5 years; obesity defined as having of BMI z score greater than 3.0 among children aged <5 years and greater than 2.0 among children aged ≥5 years) between 2006 and 2016 were calculated and stratified by sociodemographic characteristics (ie, age, sex, deprivation index, urban/rural residence, and nationality).ResultsThe study population included 1 166 609 children and adolescents (570 982 [48.9%] girls; median [interquartile range] age at entry to electronic health record system, 2.4 [0-7.7] years; 1 006 892 [86.3%] with Spanish nationality). Of 941 041 children (80.7%) who lived in urban areas, 197 427 (20.7%) lived in the most deprived areas. Overall, the prevalence of overweight/obesity and obesity decreased between 2006 and 2016 in all sex and age groups; for example, among boys and girls aged 6 to 11 years, overweight/obesity prevalence decreased from 41.9% (95% CI, 41.5%-42.2%) to 39.9% (95% CI, 39.6%-40.3%) and from 39.7% (95% CI, 39.3%-40.2%) to 37.6% (95% CI, 37.3%-38.0%), respectively. Incidence rates of overweight/obesity and obesity were highest among children aged 6 to 7 years (overweight/obesity among boys: 11.9 [95% CI, 11.8-12.0] new cases per 100 person-years; obesity among boys: 4.9 [95% CI, 4.8-4.9] new cases per 100 person-years). Prevalence and incidence rates were highest in the most deprived areas, in urban areas, and among children with North, Central, or South American nationalities. Between 2006 and 2016, prevalence increased in the most deprived areas in almost all sex and age groups. Among girls aged 6 to 11 years living in the most deprived areas, the obesity prevalence ratio increased from 1.59 (95% CI, 1.46-1.74) to 2.03 (95% CI, 1.88-2.19) compared with those living in the least deprived areas. Furthermore, during this period, prevalence increased among children with non-Spanish nationalities, especially in the African and Asian nationality groups (eg, boys aged 6-11 years with Asian nationality compared with Spanish nationality, 2006: prevalence rate, 0.78 [95% CI, 0.60-1.01]; 2016: prevalence rate, 1.27 [95% CI, 1.15-1.39]). Incidence rates decreased among younger groups (eg, ≤7 years: incidence rate ratio for January 1, 2006, to June 30, 2011, vs July 1, 2011, to December 31, 2016: 0.94; 95% CI, 0.91-0.98) but remained stable in older groups.Conclusions and relevanceIn this study, the overall prevalence and incidence rates of childhood overweight/obesity and obesity slightly decreased during the last decade. However, increased deprivation disparities in childhood obesity were found, given that the prevalence increased among children living in deprived areas and with non-Spanish nationalities.

Project description:Objective: The purpose of this paper is to explore multidimensional factors related to childhood obesity and overweight based on the data gathered on different aspects of the general health status were assessed among a large number of Iranian children and adolescents in the fourth phase of the "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease" survey. It also aims to determine the degree to which each ecological context contributes to childhood overweight/obesity. Method: A total of 14,880 students and their parents were recruited. They filled out a questionnaire on their relationship with peers, body image, and psychosocial environment of school, dietary habits, life-style habits, physical activity pattern and socioeconomic status (SES). Their height, weight, was measured and body mass index (BMI) was calculated. Obesity and overweight was defined based on the WHO growth chart. Multilevel modeling using three-level random intercept logistic regression models were used to assess predictors of overweight and obesity. In our hierarchical models, children (first level) were conceptualized as being nested within provinces (second level) and provinces within quad regions (third level). Result: From among the 13,486 recruited students, 9.7% were overweight and 11.9% were obese. In multivariate model (adjusted model), being boy (OR:1.58), living in urban area (OR:1.58), having positive family history of obesity (OR = 2.04), breakfast skipping (OR: 1.46), socioeconomic status (OR moderateSES/lowSES = 1.44 and OR highSES/lowSES = 1.89), and birth weight (BW) (OR normalBW/lowBW = 1.33 and OR highBW/lowBW = 1.8) were associated with childhood obesity. Increasing age was the only factor in the obesity model that had a significant preventive effect on the odds of becoming obese (OR = 0.96, P < 0.001). In multivariate model, living in urban area, increasing age, high and moderate SES, high BW and family history of obesity were the significant predictors of overweight. Conclusion: Our findings show that high BW, sociodemographic characteristics, breakfast skipping, and family history of obesity are associated with childhood obesity and overweight. Therefore, developing strategies that consider the effects of diverse sociodemographic and environmental factors on childhood overweight and obesity would be the most effective way to prevent and manage this multifactorial health concern.

Dataset Information

Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review.

Publications

Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review.

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