Prevalence and known risk factors for overweight and obesity in adolescents in urban Maseru

English: Chronic diseases of lifestyle (cardiovascular disease, Type 2 diabetes, cancer) remain the leading causes of death and illness among people in both developed and developing countries. The prevalence of obesity, which is one of the main risk factors for developing these diseases, has risen to epidemic proportions. Overweight and obesity are becoming more and more prevalent at ever younger ages, trigerring health consequences in children and adolescents that track into adulthood. No data is available yet regarding overweight and obesity in Lesotho. A cross-sectional descriptive study was conducted to determine the prevalence and known risk factors for overweight and obesity in adolescents in urban Maseru, Lesotho. A sample size of 251 students (125 boys and 126 girls) was randomly selected from the 20 schools in urban area of the Maseru district. Only learners 16-year olds in Form 4 were included in the study due to limited resources. The final study population was 221 students. Approval to undertake the study was obtained from the Ethics Committee of the Faculty of Health Sciences at the University of the Free State. Permission was also required from the Chief Inspector in the Ministry of Education and Training and the heads of the selected schools. Signed .informed consent and assent was obtained from the parents and the learners, respectively. Structured interviews were conducted on the school premises, using a questionnaire to record demographic data, birth weight and height, lifestyle factors, diet history, physical activity and knowledge, attitudes and practices (KAP) in nutrition. The participants were weighed and measured to calculate their body mass index (BMI). Reliability interviews of 10% of the sample were conducted one month after the initial interview. Data collected were described as means and standard deviations and percentages. Pearson correlation analyses were performed to evaluate associations between parameters. The analysis was performed be the Department of Biostatistics at the University of the Free State. The results of this study revealed that the prevalence of overweight/obesity in adolescents in urban Maseru is lower than in SA, with females having higher prevalences (11.3% and 20%, respectively) than (2.1 % and 4.1 %, respectively). When comparing different standards for interpretation of results, the World Health Organisation (WHO) standards identified more overweight males (4.1 %) than females (20.0%) than the Centre of Disease Control and prevention (CDC) growth standards (3.1 % males and 16% females) and the International Obesity Task Force (lOTF) cut-off-points. When using a 24-hour recall, the majority of participants reported lower than the recommended intakes of fruits (86.4%) and vegetables (91.4%), and dairy products (91.0%), but higher than the recommended intakes of grains and starchy vegetables (74.7%). These trends were confirmed by the results of a food frequency questionnaire which revealed that fruits, vegetables, diary, meat and pulses were not consumed on a daily basis. Maize porridge (56.1 %) and bread (63.8%) were eaten by most on a daily basis. Margarine/butter/oil, salt and sugar were consumed daily by most. Most students (54.3%) bought food (including processed meat which are high in fat and salt) from the tuck shop on a weekly basis, while 18.6% did so daily. Despite poor eating habits, most participants had adequate nutrition knowledge and a negative attitude towards obesity. The majority of participants were vigorously to moderately physically active, but no one out of five (22.7%) were not active. The majority of participants watched TV for less than 4 hours per a day, while computer usage outside school hours was low. Energy intake and physical activity were identified to be significantly associated with BMI. Alcohol and cigarette usage were lower than among South African adolescents. The results indicate that overweight and obesity, and the associated risk factors are emerging problems among Lesotho adolescents. Lesotho is apparently following South Africa in undergoing a nutrition transition from a traditional diet high in unrefined grains, fruits an vegetables, to a more westernised diet high in fat, salt and sugar; accompanied by increased alcohol and cigarette usage, while more sedentary practices such as TV watching are also emerging. Data collected from this study will be used as baseline data to enable individuals, health care teams and/or government of Lesotho to design programmes to address these identified problems.