- Title
- Diet, physical activity, environments and their relationship to the emergence of adolescent overweight and obesity in Ho Chi Minh City, Vietnam
- Creator
- Tang, Hong Kim
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2005
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Introduction: Overweight and obese children and adolescents are becoming more prevalent in urban areas of Vietnam, however scientific data describing the situation remain incomplete. There have been no studies to examine the variation in overweight and obesity by child and parental characteristics, and household socioeconomic status, and no assessment of the risk factors for obesity in adolescents. Furthermore there are no reports of trends in child overweight and obesity to understand how rapidly the problem is emerging. Objective: This thesis aims to evaluate reliability and validity of the FFQ among adolescents, to assess the magnitude and trends of adolescent obesity in urban areas of Ho Chi Minh City and to identify risk factors for overweight and obesity in this population. Methods: The FFQ was evaluated by a test-retest and validity study in 180 students randomly selected from 3 classes of three junior high school schools in Ho Chi Minh City. Short-term reproducibility was assessed by interviews with the FFQ twice one month apart and long-term reproducibility was assessed by comparing the third FFQ with the first FFQ by an interval of six months. The validity study was conducted using 4 24h-recalls as a reference method. Cross sectional surveys were then conducted in secondary high schools located in urban areas of Ho Chi Minh City using multi-stage cluster sampling. In 2002, anthropometry and socioeconomic information was collected from 1504 students from 31 schools across Ho Chi Minh City including urban and rural areas. In 2004, anthropometry, socioeconomic, dietary (with validated FFQ) and physical activity information was collected from 2684 junior high schools students from 17 schools of wealthy districts and 14 schools from less wealthy districts. To examine the trends in overweight and obesity over the two years, data from the survey in 2002 were restricted to urban schools yielding 1003 students for analysis. For the 2004 survey data, multivariate logistic regression was used to model risk factors associated with overweight and obesity in adolescents in urban areas of HCMC. Main outcome measures: Anthropometric indicators of body mass index (BMI), and pubertal status were assessed. Dietary intake and physical activity were measured with a validated food frequency questionnaire and a physical activity questionnaire. Parents’ and household characteristics as well as neighbourhood and school environment, were also measured. Prevalence of underweight, overweight and obesity between the two surveys were compared across gender, age group, school location and household wealth index to see the trends. Results: The results of the validation study showed that the FFQ had high reliability and validity, especially for fibre, carbohydrate, phosphorous and sodium intake. The 2004 survey revealed the prevalence of underweight, overweight and obesity was 6.7%, 11.7%, 2.0%, respectively. From 2002 to 2004 there was a dramatic increase in the prevalence of overweight and obesity, from 5.0% and 0.8% in 2002, to 11.7% and 2.0% in 2004, respectively. In contrast, the percentage of underweight adolescents decreased rapidly from 12.1% to 6.7%. After adjusting for other study factors in the multivariate logistic regression of the 2004 survey data, the following factors were all significantly associated with an increased risk of overweight/obesity in adolescents: male gender (OR=3.1), younger age (OR=3.3), school location in wealthy district (OR=1.6), higher family economic status (OR=2.1), higher parental education (OR=1.9), overweight or obese parents (OR=4.1), more time spent watching TV (OR=3.9), frequent consumption of soft drinks (OR=2.9), and more time studying after class (OR=1.7). The following factors were all significantly associated with a reduced risk of overweight/obesity in adolescents: availability of fruit at home (OR=0.6), frequent consumption of fruit/vegetables (OR=0.3), active level of physical activity (OR=0.4). Conclusions: Urban areas of Ho Chi Minh City currently confront a nutrition transition with the double burden of underweight and overweight in adolescents. Appropriate public health policies are needed to deal with both problems and long term follow up of these subjects should be undertaken to have a better understanding of the risk factors underlying this rapid increase in overweight and obesity, and to identify potential preventive interventions for overweight and obesity in this population.
- Subject
- overweight children; childhood obesity; teenagers; adolescents; diet; nutrition; Vietnam
- Identifier
- http://hdl.handle.net/1959.13/1387013
- Identifier
- uon:32505
- Rights
- Copyright 2005 Hong Kim Tang
- Language
- eng
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