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Discuss about the Experiment Design.

Worldwide, the prevalence of childhood obesity is sky-scraping. More than 65 % school children are obese (Ogden et al., 2008). Importance has been given in the school to identify causes of obesity and to take necessary measures to turn around obesity epidemic. One of the main causes identified for the obesity in school going children is consumption of the junk food which mainly includes sweetened beverages, fast foods, refined grains, processed meats, desserts, pizza, fries potatoes and sweets.  It has been observed that there is the positive relation between the body mass and the low nutrient, high energy, low fibre, and high glycemic load food (Fox et al., 2009; Datar and Nicosia, 2012). BMI (kg/m2) is calculated by body mass (kilograms) divided by square of the body height (m2) (kg/m2). BMI is one of the parameters to measure the obesity. WHO set cut off values of BMI as 30, 35 and 40 for moderately obese, severely obese and very severely obese respectively. BMI is calculated in the same manner in children also; however it is compared to the other children of the same age group for making conclusion. In an initiative to promote healthy and safe diet, on January 21, 2011, WHO recommended to ban junk foods in schools and playgrounds. Countries which banned sale or marketing of junk food in the school or school premises include Britain, Scotland, US, Mexico, United Arab Emirates, Canada and Denmark. 

Causes of obesity identified are: high energy food, sedentary lifestyle, lack of sufficient sleep, certain medications, genetic factors, and family history.  

Initially observational study has been conducted on the school children and it has been established that obesity in these children is due to the mixed causes. Out of these causes, junk food is the major cause for epidemic of the obesity. Hence, this study has been designed to establish further correlation of consumption of junk food and obesity.

Observations: 

Table 1: Observations from History taking from Two-Hundred School Children with Obesity

Observations from history taking from two-hundred school children with obesity

Causes of Obesity

Number of children affected

Number of children not affected

Junk Food

170

30

Sedentary lifestyle

150

50

Lack of sufficient sleep

80

120

Certain medications

90

110

Genetic factors and family history

120

80

I interviewed 200 children and their parents to get insight into the dietary habits, lifestyle, family history and medications. Information about the junk food consumption was collected by interviewing the children and their parents. Junk food consumption since last three years was considered. Junk food consumption for more than four days a week was considered. Also junk food consumption in restaurants and cafeteria for more than 2 times a week was considered. Consumption of junk food for breakfast, lunch and dinner was considered. Sedentary lifestyle information was collected from the children and parents by interviewing them. Children not playing in school and at home for four or more than four days were considered sedentary lifestyle. Those children, whom didn’t take part in sports activities since one year in the school, were considered sedentary lifestyle. Information about the lack of sleep was collected by asking the parents and children about the number of hours sleep per day children were taking. Children sleeping for five hours or less than five hours were considered lack of sleep. Information about the obesity prone medication consumed by the children was collected from their physicians. Children consumed medications in the last three months were considered. Information about the genetic factors and the family history was collected from the parents by asking them the family history of obesity either maternal or paternal side.

Hypothesis

Obesity is considered to be a disorder of energy imbalance, occurring when energy expenditure is no longer in equilibrium with daily energy intake, so as to ensure body weight homeostasis. Although the etiology of obesity is complex, dietary factors, particularly the consumption of junk food, is considered a risk factor for its development. This junk food constitutes around 15-40 % consumption of the caloric intake in the children. In one study it has been found that there is the statistically significant correlation between the junk food intake and augmented energy intake of around 190 calories per day in children consuming junk food as compared to the children not consuming junk food (Bowman et al., 2004). With the consumption of the junk food there is the increase in the energy intake, which ultimately leads to the increase in the body weight. There is the positive correlation established between obesity and consumption of junk food. There is more prevalence of obesity in children with higher consumption of processed carbohydrates and saturated fat as compared to the sugar fee and low fat diet. Abdominal obesity is prevalent in around 15 % children. Obesity in the children is also responsible for the metabolic disorders such as hypertension, type-2 diabetes, and hyperlipidemia. This childhood obesity leads to the mortality and morbidity in the adult age due to complex metabolic disorders (de Man r et al., 1991; Khashayar et al., 2013).

Table 2: Types of Junk Food and its Contents

Salt content

(g/100 g)

Fat content

(g/100 g)

Trans fat content

(% of total fat)

Potato chips

2.3

33

4.5

Snacks

2.5

35.9

4.3

Noodles

2.7

14.1

4.6

Carbonated drinks

0.0

0

0.0

Burgers

1.5

11.9

3.5

Pizza

1

7.1

1.1

Fries

0.4

19.9

8.1

Fried chicken

0.9

23.4

2.9

If consumption of junk food is the risk factor for the obesity development in the school going children, then amount and rate of consumption of junk food is higher in obese children as compared to the non-obese children.

Null Hypothesis:

If consumption of junk food is not a risk factor for the obesity development in the school going children, then amount and rate of consumption of junk food should not be higher in obese children as compared to the non-obese children.

This experiment was carried out in 200 school going children.

  1. I interviewed 200 school going children and their parents for the dietary habit of children.
  2. Based on the interview, I collected data for the frequency and amount of junk food consumption.
  3. I divided children into two groups i.e. i) junk food eating and ii) junk food non-eating.  
  4. Junk food eating is case group while junk food non-eating is a control group.
  5. In this experiment control group is important because there are other factors are also responsible for the childhood obesity and control group rule out the other risk factors and also rule out the effect of healthy diet.
  6. I calculated BMI of the both the case group and control group.

I asked following questions in the interview of children and their parents :

  1. Weekly how many times child is taking junk food?
  2. What type of junk food child is taking?
  3. What is the amount of junk food child is consuming on daily bases?
  4. Whether child is consuming junk food in house or outside?

This is an example of ordinal data. This data can be classified into the four subgroups.

  1. School children with obesity, and who used to consume junk food.
  2. School children without obesity, and who used to consume junk food.
  3. School children with obesity, and who never used to consume junk food.
  4. School children with obesity, and who never used to consume junk food. 

Table 3: Data Collected from the Interview of Children and Parents

No. of obese children

No. of non-obese children

School children with obesity, and who used to consume junk food

120

-

School children without obesity, and who used to consume junk food

-

5

School children with obesity, and who never used to consume junk food

30

-

School children without obesity, and who never used to consume junk food

-

45

Graph 1: Data collected from the Interview of Children and Parents

Data collected from the interview of children and parents

I would go to analyze to get the relationship between the consumption of junk food and the prevalence of obesity in school going children. Also, data would be analyzed to get information whether children with obesity consumed junk food in more amount and frequency than the nonobese children. Also, data would be analyzed to get information whether children not consuming junk food, have evidence of obesity.

References:

Bowman SA, Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DS. Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Pediatrics. 2004;113(1 Pt 1):112-8.

Datar A, Nicosia N. Junk Food in Schools and Childhood Obesity. J Policy Anal Manage. 2012; 31(2):312-337.

de Man SA, André JL, Bachmann H, Grobbee DE, Ibsen KK, LaaserU, et al. Blood pressure in childhood: pooled findings of six European studies. J Hypertens. 1991; 9: 109-14.

Fox MK, Dodd AH, Wilson A, Gleason PM. Association between school food environment and practices and body mass index of US public school children. J Am Diet Assoc. 2009 ; 109(2 Suppl): S108-17.

Khashayar P, Heshmat R, Qorbani M, Motlagh ME, Aminaee T,Ardalan G, et al. Metabolic syndrome and cardiovascular riskfactors in a national sample of adolescent population in the Middle East and North Africa: The CASPIAN III Study. Int J Endocrinol. 2013; https://www.hindawi.com/journals/ije/2013/702095/

Ogden CL, Carroll MD, et al. Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA. 2010; 303(3):242–249.

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