Obesity in Children in United Arab Emirates

Abstract

Background: Obesity is one of the key factors affecting the health and fitness of people across all ages. Obesity causes a number of health issues. The definition of obesity is determined as shown in the WHO as “Abnormal or unhealthy accumulation of fat which presenting a health risk”. The trend towards obesity in UAE school children is not evident, because the prior local reports could not be calculated as the BMI definition was different. CDC, WHO, and IOTF interpretations of the BMI yield different results for same population. Though obesity is one of the world’s main health challenges, it can be preventedThe UAE has taken numerous steps to deal with this problem from governmental and voluntary organizations. The intervention plans are primarily aimed at young people and children.

Objectives: Determining Obesity among UAE school children is the main goal of this work.

Results & Conclusions: Obesity in the United Arab Emirates has become an epidemicThe issue of about 71% of the Emirates is today obese, and these have risen to about 81%, is increasing in both the adult and the child population in the UAE. The study reported that childhood obesity in UAE has already been alarmingly growing. The rate of obesity increases from 3 to 12 y.

Approximately a quarter of 11–14 children are overweight or severely obese. 10% of boys are extremely obese between the ages of 15 and 18 and 3% of girls are extremely obese. In order to tackle this emerging problem in the country, better social awareness and preventative measures are necessary.

Keywords: Obesity, UAE school children, Prevalence of obesity, BMI.

Introduction

Obesity is one of the main factors that affect the health and fitness of individuals around cultures at all levels (Kelly, 2006). Obesity leads to a number of medical problems. The word obesity is described as “abnormal or unhealthy deposition of fat which poses health risks” according to the WHO (WHO, 2006).

Epidemiology

At least 1.6 billion people of the age 15 years and older are estimated to be obese worldwide. At least 20 million children below 5 years of age still suffer from obesity (WHO, 2006). The Body Mass Index (BMI) is the criterion for determining whether the person is obese or not. The BMI is computed by dividing the person’s weight by kilograms to the height by meters. If the BMI is more than 30 people, a person is considered obese (Zimmerman, 2005).

Recent estimates suggest that about 1.5 billion people are obese globally and the prevalence of obesity is increasing (Al Bawaba, 2006). Obesity is a UAE occurrence (Baxar, 2009). The concerns of obesity in both adults and children in the UAE are increasing, with about 71% of the Emirati population now obese and these have risen to 81%. Al-Bawaba report also indicates that obesity in the UAE is worrying. Females were shown to be more susceptible than men to obesity. While in whole the country approximately 77.8% of Emirati females and 70.8 % of Emirati males are obese.

Obesity has historically been studied by multiple BMI classification approaches in the UAE; Centers for Disease Control (CDC) (Al-Haddad, 2000, p. 12) (Al-Hourani, 2003, p.15), IOTF (Al-haddad, 2005, p. 32) (Malik & Bakir, 2007, p. 8) or World Health Organization (WHO) (Bin Zaal, 2009, p.24) (Ng et al, 2011). For boys 6-16 y the CDC form is used, Overweight and obesity prevalences respectively were 17% and 8% (Al-Haddad, 2000, p. 12). For children of age 5 to 17 years, using the IOTF process Overweight and obesity prevalences respectively were 22 % and 14 % (Malik & Bakir, 2007, p. 8). According to the WHO model, overweight and obesity prevails in children of age 6–18 years respectively at 17% and 16% (Ng et al, 2011).

The history of obesity in UAE schoolchildren is ambiguous; because the national research used various BMI definitions could not quantify it. CDC, WHO and IOTF analysis of BMI produce different outcomes in the same population (Kain et al, 2002, p. 56) (Zimmermann et al, 2004, p.79).

Pathology

The essence of the diets, sedentary lifestyles and the special climate causes obesity in the UAE.

1. The main cause of obesity in the UAE is dietary styles (Wigglesworth, 2008). The United Arab Emirates is a wealthy country that has high income. Nearly all food types, including junk foods which is full of fat and soft drinks with high calories, are plentifully available in the country. The abundance of different fatty foods and population accessibility to have it could have contributed to a high accuracy to such dietary types. Fatty food and highly-calorie soft drinks have become a part of the country’s lifestyles. According to Naidoo & Moussly’s study (2009) In the UAE, more than 80% of teenagers regularly consume high calorie beverages which are extremely likely to lead to obesity. These foods are less expensive than other foods. Fast foods are more tasty than traditional foods, which make it more attractive to people. Maybe that’s the main reason why in GCC countries including the UAE the obesity level is very high.
2. Other relevant causes of obesity involve sedentary lifestyles. Physical activity is not usually part of a culture in the UAE. The Emiratis do not seem to be aware of the significance of physical activity for preserving fitness and healthy human health. Parents thus believe that it is not important to develop such patterns in their children’s lives and spend little deliberate cost to inspire them doing some physical work (Naidoo & Moussly, 2009). The cultural expectations of the UAE seem to make people less involved and give Emiratis a high chance of being overweight. Higher income is another important factor that makes Emiratis people lazy and eventually lead to healthy lifestyles. The Emiratis have better financial status in common. The Emiratis quite often choose to use their private automobiles to ever even walk distances and implicitly add extra weight to their bodies in order to make them obese.
3. The climate is very hot and humid in the region. This tough and adverse season remains in the country for more than six months, preventing people from doing physical activities outdoors. This is particularly devastating to children and youth who often enjoy playing outdoor games and sport with family and friends. This problem will potentially be very serious in urban areas (Zain, 2008). The environmental factors such as high temprature and humid usually develop sedentary lifestyles for obese people throughout urban areas. In contrast, modern motor activity is also an important factor in obesity in the UAE (Wigglesworth, 2008).

Methods

This research is being done in the Ras Al Khaimah government school. Student health is constantly monitored and managed by this school and accurately measured by head nurses and doctors. More than 90% of the students attending these 91 high school kindergartens are UAE residents.

Standing height was measured with rigid stadiometers as well as the students were upright and shoes free. Weight with adjustable stability scales was measured, with students wearing school uniforms and without shoes. Both interventions are carried out by professional nurses (certified and licensed under the health ministry). The generic formula was used for measuring body mass index (BMI): weight (kg)/height (m).

Using gender specific BMI for age charts, US growth charts (BMI — percentile 85 and < 95) have been used to classify overweight (BMI — percentile 95 and < 99) and extremely obese adolescents (BMI — percentile 99) (Kuczmarski et al, 2000). In addition, overweight, obese, and extremely obese children were also identified with the cut off values of IOTF and WHO (Onis et al, 2007, p.85).

Results

This study was attended by 49% women; 94% residents of the UAE.

Overweight, obesity and extreme obesity rates rely on the cut-off criterion for IOTF, WHO and CDC.

Among 3–12 y boys, overweight and extreme obesity increased linearly to 30% with age. The average for boys was 29% higher than for girls the lowest among children was obesity and extreme obesity aged 11–14 y, at 23%.

For boys 3–17 years of age the incidence of extreme obesity rose even linearly. In children 3–12 years incidence of overweight, obesity and extreme obesity increased linearly with age.

In this analysis, important results have been found including:

• The rising obesity rate in children between 3 and 18 years.
• The reality that obesity occurs in childhood and progresses with age linearly.
• Extreme obesity is high, mostly among boys.

Such patterns need early diagnosis (for example, more parental control on food choices and physical exercise for younger children), strengthened school-related health policies and practices and improved general awareness of obesity and its adverse health effects (the capability to reduce risk of obesity through proper exercise and food choices). Need for early intervention. Such criteria are particularly relevant to the UAE, as analphabetism is very widespread (Al-Kaabi et al, 2015, p. 9).

Discussion

How to Deal

While obesity is one of the world’s biggest health concerns, it can be prevented (WHO, 2006). Government and charitable organizations in the UAE took many steps to tackle the problem. The intervention plans are mostly targeted at young people and children. Naidoo and Moussely (2009) reported on the country’s major anti-obesity initiatives.

The authors say that VLCC, Zayed University and Dubai Women’s College do their best to support people educate about the dangers of obesity. They also encourage people to have healthy lifestyles and diets. Apart from supporting people to educate more, these organizations are also working to prohibit the advertising by schools and college cafes of fast-fed foods and calorie-rich soft drinks. State efforts to fight obesity in the UAE are also very relevant.

Zain (2009) focused on multidimensional programs in the UAE on obesity prevention. The author stated that the world is gaining momentum from public awareness campaigns and personal advice on causes, implications and methods of avoiding obesity.

All state and private organizations visit schools, hospitals and shopping centers around the world to disseminate healthy lifestyles and information on anti-obesity. It is also recorded that primary health centers offer counseling to resolve their anxiety and depression and take legal action to decrease body weight (Zain, 2009). Collective efforts aim to address the problems of obesity in the UAE, which would definitely mitigate the country’s rising long-term problem of obesity.

Across urban centres, the leisure and lifestyles of children also aid in increasing obesity (Zimmerman, 2005). The pattern of preference for high-tech games over traditional games among children of today is rising, particularly in city areas. TV and video games have become a part of children’s lives (Zimmerman, 2005). Traditional games are more activity-oriented and help children mark their bodies’ excess weight; hi-tech games are less active, but more fun and enticing to children. They are more engaging. Children tend to favor hi-tech fun with traditional games which provide children with great opportunities to become obese (Zimmerman, 2005).

Recommendations for Minimizing the Prevalence of Obesity

Campaigns to encourage broad public health approaches which go outside medical contexts have triggered the increasing prevalence and serious consequences of obesity (Guion et al, 2009). The key settings for population-based intercessions to counter obesity are educational institutions (Guion et al, 2009). The main aim of encouraging a healthier lifestyle through healthy eating and constructive live practices must be harmonized with HEAL Public Health initiatives in the United Arab Emirates in an effort to limit obesity in Arab young people at Dubai University, United Arab Emirates. There are numerous reports on the efficacy and target markets of health promotion and disease prevention programmes (Foster et al, 2008, p.21). In order to communicate health relevant information to the university efficiently, the transition process would include a number of public awareness measures such as the news media on campus. (Reger et al, 1998, p. 115) (Samuels, 1993)

The self-assessment of students in schools using a School Health Index is another way of implementation 31 Where eating habits rates , rates of physical activity can be reported initially, during and till the end of the 12-week HEAL campaign general education Program. In fact, staff training could be undertaken before deployment that provides a chance to work in partnerships and share, share ideas with their counterparts (Guion et al, 2009). One way to achieve this is through nutrition education, where university teaches young people how to make better food choices and how healthy exercises are implemented so as to affect beneficial behavioral changes (Brown et al, 2010. P.21) (Guion et al, 2009) Another way of promoting the HEAL public health initiative is by establishing a school diet program in which all foods purchased and consumed on campus are compatible with the School Health Index dietary guidelines and expectations(Guion et al, 2009).

The public health campaign for healthy eating and active living (HEAL) will promote a healthy lifestyle by adopting a balanced diet focused on the good food options, foods required by the youth and how we can maintain a healthy weight in compliance with world health guidelines (CDC, 2012).

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