Individual, Familial, and Community Determinants of Child and Adolescent Overweight and Obesity in Colombia Open Access

Gonzalez Casanova Soberon, Ines (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/5h73pw23g?locale=en
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Abstract

The general objective of this dissertation was to describe the epidemiology of child and adolescent overweight and obesity in Colombia. Two National Nutrition Surveys from Colombia 2005 and 2010 were analyzed to 1) Compare prevalence estimates of the most commonly used international classification systems to assess overweight and obesity in children 5 to 18; 2) Describe changes in the prevalence of overweight and obesity in Colombian children and adolescents between 2005 and 2010, by screen time, wealth, urbanization, and region; and 3) Identify the main predictors of overweight in Colombian children and adolescents at the individual, familial, and community level. The first study found that the prevalence estimates of overweight and obesity varied among the three main international classification systems. Further, results also show that the association (odds ratios and 95% confidence intervals) between combined overweight and obesity, and age and sex varied by system. Results from the second study show no significant change in the prevalence of overweight or obesity in Colombian children and adolescents 5-18 years overall (overweight= 12.2 to 12.7%; obesity=3.5 to 3.9%, p>0.05), or within sex, wealth, urban, rural, or region specific subgroups during this 5 year period. This unchanged and low prevalence of overweight and obesity in children and adolescents suggest a slow nutrition transition in Colombia compared to other low and middle income countries. Finally, for the third study results from this dissertation suggest the following associations: height and being a girl were positively associated and age was inversely associated with Body Mass Index Z-score (BMI-Z). At the family level overweight. BMI-Z and the odds of overweight were inversely associated with family size and living in an urban household, and positively associated with being part of an extended family and with wealth. The community level explained only between 2 and 3% of the variability in BMI. Through these three studies, a distinct epidemiologic pattern of child and adolescent overweight and obesity in Colombia was portrayed. Results from this dissertation have the potential to inform the design and implementation of programs and policies to prevent child and adolescent obesity in Colombia.

Table of Contents

TABLE OF CONTENTS
CHAPTER 1: INTRODUCTION
CHAPTER 2: LITERATURE REVIEW
OVERVIEW OF OVERWEIGHT AND OBESITY IN CHILDREN AND ADOLESCENTS
Physiology of childhood overweight and obesity: definition, consequences, and etiology
The influence of the family as a social determinant of child and adolescent overweight and obesity
Community Determinants of child and adolescent overweight and obesity
CHAPTER 3: LITERATURE REVIEW
EPIDEMIOLOGY OF OVERWEIGHT AND OBESITY
The Nutrition Transition
Overweight and obesity in children and adolescents from High Income Countries
Overweight and obesity in Latin America and other Low and Middle Income Countries
CHAPTER 4: METHODS
Setting
Data sources
Conceptual Framework
Data Analysis
CHAPTER 5: COMPARING THREE BODY MASS INDEX CLASSIFICATION SYSTEMS TO ASSESS OVERWEIGHT AND OBESITY IN CHILDREN AND ADOLESCENTS
Introduction
Methods
Results
Discussion
CHAPTER 6: CHANGES IN OVERWEIGHT AND OBESITY AMONG CHILDREN AND ADOLESCENTS IN COLOMBIA BETWEEN 2005 AND 2010
Introduction
Methods
Results
Discussion
CHAPTER 7: INDIVIDUAL, FAMILIAL, AND COMMUNITY PREDICTORS OVERWEIGHT AND OBESITY IN CHILDREN AND ADOLESCENTS
Introduction
Methods
Results
Discussion
CHAPTER 8: SUMMARY AND CONCLUSIONS
Key Findings
Strengths and Limitations
Discussion and Recommendations
Implications of Study Findings
LITERATURE CITED. Chapters 1-4, 8

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