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
About this Dissertation
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