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Causes and factors that influence the emergence of this disease.

Discuss about the Prevalence Trends and Environmental Influences.

Obesity and child overweight are prevalent globally. The issue of obesity and child overweight is associated with hypertension, heart diseases, and diabetes just to mention a few. Childhood and adult obese are related to the number of obese males and female children account for 66% and 79%, which is similar to obese adults. Health services and district/country- childhood has focused economic cost upon hospitalization for the commodities of obesity, the increased expenditures are due to the increase in the outpatient and emergency room visits as well as prescription drug expenditures. When the normal children are compared with the overweight children, we find that the children suffering from obesity register a higher outpatient visit expenditure, higher prescription drug expenditures, and emergency room visit expenditure. Obesity is measured using the BMI.

The paper assesses the national prevalence of obesity in school going children of the United Arab Emirates (UAE). A 10% stratified random sample of children was taken from a completely 16,391 children in the United Arab Emirates[3]. Physicians and trained nurses measured the height and weight of these children and their body mass index (BMI) was computed. The BMI s of the United Arab Emirates were the compared with the most recent international standards that had been published and it showed that the children are a high increased risk of overweight and obesity. For example, the obesity in the female children is same as the obesity in a male who are fourteen years old. At eighteen years in females, the obesity is 1.9 fold higher than the most recent international standards that were published. In general, the rate of obesity among the youth is two to three times greater than the most recent published international standard. Obesity and overweight have very significant consequences as well as implications for a person’s health, social care and the economy of the country. Effects of obesity on the following levels; as an individual with the condition of obesity, one will face several challenges in life like; theis increased in the risk of developing a wide range of serious diseases such as heart disease, high blood pressure, strokes, type II diabetes, non-alcoholic fatty liver disease, fertility problems, as well as some cancers. In childhood obesity, there consequences in physical and mental health both long term and short term.

In addition, obesity facilitates to several psychological problems like anxiety, mood disorder, poor self-esteem, poor quality of life, and dissatisfaction of the body. Obesity has been linked with low concentration levels, social exclusion in schools and poor academic success. Social lives of children who are obese are also at risk, they tend to suffer from discrimination and prejudice, fewer friends and a very low educational attainment. Families are the most important influences on the health choices that the children and youth make. Therefore, parents and guardians have a higher potential for preventing obesity and excess weight gain. The lifestyles we have adopted promote unhealthy eating and encourage sedentary activities better than physical activities. However, parents and guardians can take charge, provide their children, and share experiences necessary to ignore and put away the unhealthy cues and be able to make healthy choices to prevent excess weight gain and obesity.

Role played by globalization, culture, and nutrition transition in the development or extent of obesity

Childhood has focused economic cost upon hospitalization for the commodities of obesity; the increased expenditures are due to the increase in the outpatient and emergency room visits as well as prescription drug expenditures. When the normal children are compared with the overweight children, we find that the children suffering from obesity register a higher outpatient visit expenditure, higher prescription drug expenditures, and emergency room visit expenditure.

Looking at obesity just on the surface, its cause looks to be very simple, that once you consume high levels calories compared to what your body can burn as energy through the physiological activities then one will simply increase weight. However, like many other things this simple explanation is always incomplete. The risk factors, which eventually lead to obesity, are a combination of socioeconomic factors, genetics, lifestyle choices, metabolic factors, and many other factors. Other causes are endocrine disorders, medicines, and diseases[4]. The common factors causing obesity include:

According to Malik, one can inherit a tendency that will lead to obesity. If it happens that one or both of one’s parents is obese then the chances of being obese increase by a whole twenty-five percent[5]. Heredity tends to also influence where one can carry weight, could be the hips, or the middle of one’s body. Metabolic – expending energy is different in different people. Hormonal factors and metabolism are not the similar for everyone, but these factors play a major role in one’s weight gain. Studies prove that peptide hormone and ghrelin regulate appetite, other peptide trigger hunger and give one a feeling of being full after eating[6].

Overeating combined with sedentary lifestyle leads majorly to obesity. Changing one’s character can easily change these lifestyle decisions. If one’s diet contains calories from highly fat, sugar, and refined foods then one is likely to gain weight and be obese. Coupling this with no regular exercises it becomes very difficult or one to lose weight or just maintain their weight. In children and the youth, activities, which do not expend energy, like watching TV and sitting at a personal computer greatly leads to weight gain.

Role played by globalization, culture, and nutrition transition in the development or extent of obesity

Nutrition transitions refer to the modernization, development of the economy, urbanization and increased income, which facilitates to the predictable shifts in diet[7]. Nutrition transition is categorized into five distinctive patterns they are;

These are individuals, who lead a very active lifestyle; they hunt and forage for food. Their diet is composed of fibrous plants and very rich in protein from the lean animals they hunt in the wild[8].

The effects of sex, age, and genetics

As the income, keeps increase these individuals, have a better access to the abundant foods rich in calories, and thus become lesser active. This, therefore, leads to obesity and other obesity-related chronic diseases like heart disease, some cancers, and diabetes[9].

In response to the high frequency of obesity and the obesity-relateddiseases, these individuals are forced to change their behaviors and the community promote the character changes which will avoid such conditions.

The middle-income countries like the United Arab Emirates are moving from pattern three rapidly, which is the end of drought to part four, which is consuming many energy-dense diets. This kind of shift from the traditional cultural diets to the lifestyle in the developed countries is the major contributor to obesity and excess weight gain.

Science proves that genetics have a role in obesity. Genes have the power to cause obesity in disorders like Prader-Willi syndrome. Genes will not always predict one’s future health but genes and character are both needed for one to be obese. In many occasions, multiple genes will require one’s susceptibility to excess weight gain and other factors required such as little or no physiological work. Women have a poor obesity-related QOL as compared to the men. In lower age groups, obese women have a poor obesity-related QOL as compared to the normal women’s weight. In men, however, the obese men have no difference at all in obesity-related QOL. In older age groups, obese men have better QOL than the normal men and the women still have a poor QOL[10].

Obesity has become the main influence on the development of the cardiovascular diseases and thereby affecting the physical and also social functioning as well as the quality of life. The importance of effective interventions that will reduce obesity has really increased as the number of children and the adults who are obese is now at epidemic proportions[11]. Population-based strategies prevent the development of obesity and overweight throughout life by improving physical and social environments contexts for physical activity and healthy eating is very important.

The population-based approaches to prevent obesity and overweight recommend approaches that can complement individually oriented interventions and also clinic-based prevention as well as programs for treatment. Almost all the current eating and activity patterns in the United Arab Emirates are those that lead to weight gain and obesity. Population approaches coupled with policy and environmental changes have the capability to increase the opportunities for healthier eating behaviors, physical activity that will not require a deliberate action by individuals and will help in addressing inequalities[12].

Modifying people’ lives through population-based approaches to affect people’s choices includes having the following areas assessed to identify the targets for change; locations of first food restaurants, adequate sidewalks that will promote physical activity, availability of public means of transport, restaurant portion sizes and the availability of low-fiber foods, high fat and sweetened foods.

Reducing the mobility and mortality that is related to obesity is actually a public health priority. The government has come up with various interventions in schools in the United Arab Emirates, which aim to achieve or maintain a healthy weight among the children and the youth. A good example of the strategies to prevent obesity is the School-Based Programs. The school environment is very important being that ninety percent of the Arab children and youth at the age of five to seventeen are in school and they eat one to two meals there[13]. This program targets the children in schools and the intended outcome is to achieve or maintain a healthy weight.

This program includes nutrition education as well as exercise components. This prevention strategy in schools is implemented in the following ways; limiting access to unhealthy foods such as refined grains, potatoes, sweets, red and processed meat in the school environment, increasing physical activities by incorporating games after classes, P.E lessons where children play, including sports days in the school calendar etc[14]. Giving the students enough homework so as to limit the television time, screen time and all other set time activities which do not expend energy. In addition, lower grade children should be allocated time for sleeping in order to reduce their stress levels[15]. When all this is done properly in an institution then the risk of obesity will be highly reduced.

The numbers of the controlled preventive strategies that target children are relatively small. School-based programs have succeeded in reducing the dietary fat intake, energy intake and limiting the sedentary activities like watching television. The short-term intervention programs have been documenting successful BMI changes, which in turn open long-term interventions[16].

However, there is an increased concern in the ‘obesogenic environment’. The characteristics of this environment make energy balance maintenance become difficult. The environment has high energy density and foods that aren’t expensive, which increase the opportunities to consume[17]. Reduced physical activities due to automobile, elevators, as well as escalators, are the major causes of obesity. The sedentary leisure time is increased and there are limited opportunities to have physical recreational activities. Definitely, both children and their families are always put to this kind of unhealthy environment and thus all efforts that are associated with modifying excess weight gain and obesity must address the societal and cultural factors or at the very least consider the potential impact on household based or school prevention programs[18].

The government of the United Arab Emirates should insist on the prevention strategies of obesity and excess weight gain and limit the sedentary lifestyle completely. This can be done by making policies that people will be forced to adhere to. Incorporating prevention strategies at almost all public and private setting is yet another solution towards the challenges faced in preventing obesity[19].

Conclusion

Obesity is associated with some of the major leading cause of health complications. In addition, obesity can contribute to psychological issues like depression, anxiety, low quality of life, and poor self-esteem. For school going children, obesity can lead to reduced concentration levels, low level of academic success, and exclusion. In this case, the social life of obese children is wanting as most of this children face discrimination from the other children. Parents and caregivers have the responsibility of ensuring children take the right foods and in correct portions. Therefore, parents and caregivers have the duty to prevent overweight and obesity in children. Other than food intake, parents should encourage their children to participate in physical activity. In addition, proper health choices should make available to children in order to prevent obesity and overweight.

Al-haddad FH, Little BB, Abdul Ghafoor AG. Childhood obesity in United Arab Emirates schoolchildren: a national study. Annals of Human Biology. 2005 Jan 1;32(1):72-9

Malik M, Barry A. Prevalence of overweight and obesity among children in the United Arab Emirates. Obesity reviews. 2007 Jan 1;8(1):15-20

Wang Y, Lim H. The global childhood obesity epidemic and association between socio-economic status and childhood obesity.

Kelishadi R. Childhood overweight, obesity and the metabolic syndromes in developing countries. Epidemiolic reviews 2007;29(1).62-76

Salmon J. Prevalence trends and environmental influences on child and youth physical activity. Med Sport Sci. (Review).  Medicine and Sport Science 2007;12(1).67-3

Pollan, Michael. You Are What You Grow” New York Times Retrieved 200;7(1).30-1

Metabolism alone doesn’t explain how thin people stay thin. John Schieszer. The Medical Post.

Farooqi S. Genetics of obesity in humans” Endocr Rev. (Review) 2006;27(7): 710-18. Walley, Andrew. The Genetic Contribution of non-syndromic human obesity” Nat Rev. Genet. 2009;12(1):45-6

Harman A. Regulation of Energy Balance by Leptin. Exp. Clin. Endocrinol. Diabetes (Review). 2016;104 (4): 293-300

Gupta N, Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocrine reviews. 2012 Jan 12;33(1):48-70.

Musaiger AO, Radwan HM. Social and dietary factors associated with obesity in university female students in the United Arab Emirates. Journal of the Royal Society of Health. 1995 Apr;115(2):96-9

Kelishadi R. childhood obesity in developing countries. Epidemiologicreviews. 2007;29(1):62-76

Musaiger AO. Overweight and obesity in theeastern Mediterranean region: prevalence and possible causes. Journal of obesity. 2011 Sep 18;2011

Cubeddu LX, Effects of a sedentary lifestyle. American Journal. 2008 Jan1;21(1):105-10

Henry CJ, Al-Hourani HM. Prevalence of overweight and obesity among adult females in the United Arab Emirates. International journal of food sciences and nutrition. 2009 Jan 1;60(3);26-33

Scott K, Parents, Teachers and Student’s Perceptions of Childhood Obesity in the Middle East. European Scientific Journal. 2013. Dec. 1

Scott KD Teachers’ parents’ and students’ perceptions of childhood obesity in the Middle East. (Doctoral dissertation.) TEACHERS COLLEGE COLUMBIA UNIVERSITY.

Bloushi KA. Diabetes mellitus and periodontal diseases in the United Arab Emirates. International Dental Journal 2008 Aug 1;58(S4)

Harman A. Regulation of Energy Balance by Leptin. Exp. Clin. Endocrinol. Diabetes (Review). 2016;104 (4): 293-300

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