ASSESSING KNOWLEDGE OF RISK FACTORS AND PREVENTIVE BEHAVIOURS OF CHILDHOOD OBESITY IN CAMEROON, THE CASE OF BUEA

Abstract
This study aims at assessing knowledge of risk factors and preventive behaviors of childhood obesity in Cameroon, the case of Buea.

Four research objectives were formulated to guide and direct this study.

The objectives were: determine the prevalence of childhood obesity in Buea, assess the knowledge of childhood obesity, preventive behavior of childhood obesity in both children and caregivers, evaluate the practice and perception of preventive action of childhood obesity in children and caregivers, respectively and determine the association of consumption patterns of children with childhood obesity.

Survey design was adopted for the study.

A sample of 400 respondents were selected.

The main instruments for data collection was a well validated structured questionnaire.

Data collected were analyzed using descriptive statistics of simple percentages presented in the form of tables, pie and bar charts.

Findings revealed that a majority 59.8% of the participants don’t have knowledge about obesity while only 40.2% of the study respondents do have knowledge about obesity.

Generally, in assessing the overall knowledge of caregivers about childhood obesity survey findings indicate that 52.5% of the caregivers had incorrect responses while 47.5% chose the correct. Most 52.6% of the participants were inadequately knowledgeable on strategies use to prevent childhood obesity.

In an attempt to bring out caregivers’ perception on preventive measures of childhood obesity, the respondents were asked how concern they will be if their child was overweight or obese.

Findings show that, greater proportions (59.5%) of the respondents are concerned and 40.5% are not concerned if their children were overweight or obese.

Also, 51.9% of caregivers indicated that they will be concerned with the amount of exercise your children do while 48.1% of care givers indicated that they won’t be concerned. In conclusion Childhood obesity is a disease with cause’s irregularities in children and emphasis should be placed to mitigate this phenomenon.

The children’s knowledge on obesity was found to be very low, maybe due to the fact that the parents were inadequately knowledgeable as well.

Also food pattern of children was found to have a significant relationship with the obesity status of children.

This implies that the categories of food giving to a child will contribute to the child being or not being obese.
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
One of the most mutual issues related to lifestyle today is being overweight.

Severe overweight is a key risk factor in the development of many chronic diseases, including cancers as well as premature death.

New scientific revisions and data from life insurance companies have proven that the health risks of excessive body fat are linked with relatively small increases in body weight, not just with marked obesity (WHO, 1995 [World Health Organization]).
Obesity is a substantial health problem globally.

It adds to poor health and functioning, emotional problems, premature deaths and escalating healthcare costs.

Most deaths are attributable to non-communicating diseases (about 3.5 million) worldwide, including obesity which is the second leading cause of preventable deaths. Obesity among young people is a growing problem in most countries, owing to eating patterns and sedentary life styles.

Obesity has been estimated to affect 20 to 40% of the adults and 10 to 20% of children and adolescents in developed countries (WHO, 1995).

Disturbingly, obesity in childhood, particularly in adolescence is a crucial predictor for obesity in adulthood (Goran 2001).
Childhood obesity is one of the most serious public health challenges of the 21st century (WHO 2012).

Obesity can harm nearly every system in a child’s body-heart and lungs, muscles and bones, kidneys and digestive tract, as well as the hormones that control blood sugar and puberty-and can also take a heavy social and emotional toll.

According to Ebbeling CB (2002), What’s worse, youth who are overweight or obese have substantially higher odds of remaining overweight or obese into adulthood, Singh AS (2008) increasing their risk of disease and disability later in life.
The problem is global and is steadily affecting many low- and middle-income countries, particularly in urban settings.

The prevalence has increased at an alarming rate.

Globally, in 2016 the number of overweight children under the age of five, is estimated to be over 41 million.

Almost half of all overweight children under 5 lived in Asia and one quarter lived in Africa. Globally, an estimated 43 million preschool children (under age 5) were overweight or obese in 2010, a 60 percent increase since 1990.

The problem affects countries rich and poor, and by sheer numbers, places the greatest burden on the poorest: Of the world’s 43 million overweight and obese preschoolers, 35 million live in developing countries.

By 2020, if the current epidemic continues unabated, 9 percent of all preschoolers will be overweight or obese-nearly 60 million children (de Onis M, 2010).
Obesity rates are higher in adults than in children.

But in relative terms, the U.S., Brazil, China, and other countries have seen the problem escalate more rapidly in children than in adults.

Of course, some regions still struggle mightily with child hunger, such as Southeastern Asia and sub-Saharan Africa.

But globalization has made the world wealthier, and wealth and weight are linked.

As poor countries move up the income scale and switch from traditional diets to Western food ways, obesity rates rise.

One result of this so-called “nutrition transition” is that low- and middle-income countries often face a dual burden: the infectious diseases that accompany malnutrition, especially in childhood, and, increasingly, the debilitating chronic diseases linked to obesity and Western lifestyles (Popkin B, 2012)
It’s surprisingly challenging to track childhood obesity rates across the globe.

Many countries do not field nationally representative surveys that measure heights and weights of school-aged children, or don’t have repeated consistent measurements over time.

Dueling definitions of childhood obesity-from the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and the International Obesity Task Force (IOTF)-further complicate matters, making it hard to compare data between regions.
Overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases like diabetes and cardiovascular diseases at a younger age. Overweight and obesity, as well as their related diseases, are largely preventable. Prevention of childhood obesity therefore needs high priority.

The WHO Member States in the 66th World Health Assembly have agreed on a voluntary global NCD target to halt the rise in diabetes and obesity.

The prevalence of overweight and obesity in adolescents is defined according to the WHO growth reference for school-aged children and adolescents (overweight = one standard deviation body mass index for age and sex, and obese = two standard deviations body mass index for age and sex).
Childhood obesity is a condition where excess body fat negatively affects a child’s health or well-being.

As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI.

Due to the rising prevalence of obesity in children and its many adverse health effects it is being recognized as a serious public health concern (Cooperman, 2005).

The term overweight rather than obese is often used when discussing childhood obesity, especially in open discussion, as it is less stigmatizing.
The healthy body composition includes; the active mass (muscle, liver, heart, etc.); the fatty mass; the extra cellular fluid (blood, lymph etc.) and the connective tissue (skin, bones, connective tissue).

Structurally speaking, the state of obesity is characterized by an increase in the fatty mass at the expense of the other parts of the body.

The water content of the body is never increased in case of obesity (Park, 2009).
By contrast, overweight is usually due to obesity but can arise from other causes such as abnormal muscle development and fluid retention (Aykroyd & Mayer, 2008).

Obesity is often defined simply as a condition of abnormal or excessive fat accumulation in the fatty tissues (adipose tissues) or the body leading to health hazards.

The underlying cause is a positive energy balance leading to weight gain, that is when the calories consumed exceed the calories expended (WHO, 1995).

Globally, there is a disturbing trend towards adiposity, and in developing countries, this had been attributed to the so-called nutritional transition (Tremblay et al. 2002).
Obesity is a chronic disease which develops gradually and is fueled by environmental factors such as nutrition, physical activity, drugs and genetic influences.

It is pr that 1.7 billion people all over the world are overweight or obese, and most of these live in the developed countries of Europe, America and Asia (Kumanyka et al., 2002).

Obesity is often associated with and predisposes to the development of non-communicable diseases such as hypertension, insulin resistance, type 2 diabetes mellitus, hypercholesterolemia and coronary heart disease.

It has also been observed that the prevalence of type 2 diabetes parallels that of obesity (Mollentze et al. 1995 & Mokdad. et al., 2001).
The OCC and prevalence of obesity are rising globally, and most of it is believed to be driven by the rising prevalence in developing countries, which are undergoing economic transition. The consequence of economic change and globalization is rapid and unplanned urbanization resulting in nutritional development with exposure to and consumption of high fat and refined foods as obtained in developed countries, tobacco and alcohol consumption and physical inactivity (Boone et al. 2002).

In these developing countries, it is observed that the rising prevalence of obesity cuts across all age groups and economic levels (Popkin, 1994), unlike the situation in developed countries.
It has been predicted that wide reaching, over 22 million kids under the age limit of 5 are obese and one in 10 kids is overweight (Kosti et al., 2006).

A wide range of prevalence level exists with the prevalence of overweight in Africa and Asia averaging well below 10%.
Huntington Press, (2009).

One in three American kids is now seen to be either overweight or obese, and Michel Obama has kicked off a campaign intended to end childhood obesity, so reports New York Times. Furthermore, the Obama administration aimed to push candy and sugary drinks out of schools (New York Times, 2011).

It is challenging to come up with the size of the issue and compare the incidence rates in other countries, as no exact figures are available and also because the definitions of obesity are not standardized.
One of the most common issues linked to peoples’ way of life nowadays is being overweight.

Extreme weight or obesity is a key risk factor in the development of many chronic diseases, including cancers as well as premature demise.

New scientific studies and data from life insurance corporations have revealed that the health risks of too much body fat are connected with relatively small growth in body weight, not just with discernable obesity (WHO, 1995 [World Health Organization]).
Obesity is a substantial health problem globally.

It contributes to poor health and functioning, emotional problems, premature deaths and escalating healthcare costs.

Most deaths are attributable to non-communicating diseases (about 3.5 million) worldwide, including obesity which is the second leading cause of preventable deaths.

Obesity among young people is a growing problem in most countries, owing to eating patterns and sedentary life styles.

Obesity has been estimated to affect 20 to 40% of the adults and 10 to 20% of children and adolescents in developed countries (WHO, 1995).

Disturbingly, obesity in childhood, particularly in adolescence is a crucial predictor for obesity in adulthood (Goran 2001).
Obesity is the state of having abnormal body fat; when a person consumes more calories than the body needs, the body stores these additional calories as fat, causing subsequent weight gain (Bailey et al. 1995).

Although similar, the term overweight is defined as excess body weight for height. Bodyweight is limited, though easily obtainable, index of obesity (Bradford, 2009).
It has been estimated that universally, over 22 million kids under the age of 5 are obese and one in 10 kids is overweight (Kosti et al., 2006).

A wide range of prevalence level exists with the prevalence of overweight in Africa and Asia averaging well below 10%.
According to Huntington Press (2009), nearly one in three American children is seen to be either overweight or obese, and Michel Obama has kicked off a campaign intended to end childhood obesity, so reports New York Times.

Furthermore, the Obama administration aimed to push candy and sugary drinks out of schools (New York Times, 2011).

It is challenging to measure the size of the issue and compare the incidence rates in different countries, as no specific figures are available and also because the definitions of obesity are not standardized.
1.2 Statement of the Problem
Obesity is linked with both physical and emotional morbidity (Jain et al., 2001).

Many of the cardiovascular problems that characterize adult-onset obesity are preceded by abnormalities that start in childhood.

Hyperlipidemia, hypertension, and abnormal glucose tolerance occur with increased frequency in obese children and adolescents (Dietz, 1998).

Buea is experiencing rapid and unplanned urbanization in the recent past and since little or nothing is being done to curb the nutritional habits and way of life that come with urbanization as concerns children especially.

The health of children in future may be in jeopardy.
There exist No policies/legislation that regulate the advertisement of energy drinks, fast foods promoting healthy eating and lifestyle among adolescent.

Mainly through the urban school system to encourage physical activity are in place.

Stakeholders which the researcher believes are serious gaps, requiring collective efforts to stem the suspected rising tide of obesity another “silent killer” through early intervention.
1.3 Objectives
To determine the prevalence of childhood obesity in Buea
To assess the knowledge of childhood obesity, preventive behavior of childhood obesity in both children and caregivers.
To evaluate the practice and perception of preventive action of childhood obesity in children and caregivers, respectively.
To determine the association of consumption patterns of children with childhood obesity.