Obesity among adolescent girls in Saudi Arabia: Sports inequality and prevention

Gender Inequity in Sports Has Led to Obesity Among Adolescent Girls in Saudi Arabia

Gender Inequality in sports has led to Obesity among Adolescent Girls in Saudi Arabia

Obesity is one of the most rapidly escalating phenomena in the entire world. It is influencing the lifestyle and lifestyle choices of both adults and teenagers specifically young females across all ethnicities and races as well as social statures (World Health Organization [WHO], 2006). Obese individuals are mostly the ones who are anticipated to have shorter life spans than usual primarily because of the offset health and dietary structure that they sustain (American Academy of Pediatrics [AAP], 2003). Even though, a large extent of research has focused on and been devoted to obesity as it relates to young females, there have nevertheless been limited efforts made from the domain of teenage girls in Saudi Arabia and in helping them overcome their obesity problems as well as sustain a healthy lifestyle through engaging in sports activities through their academic years. This paper will hence conduct a risk assessment of teenage girls in Saudi Arabia suffering from issues of obesity across generations and assessments will be done on the patterns of nutrition and sports activities in order to break the habit of unhealthy lifestyle choices (Yujin & Dong Sik, 2007). The proposed study has been tailored to support proper nutrition and exercise in the chosen gender with the ultimate goal of preventing obesity reversions.

Introduction

The current generation, more than before is tackling the dangers of obesity. It is a fact that there are many parts of the world, especially in the African and Asian countries where people literally die of starvation, malnutrition and under-weight issues, yet it is a fact as well that the world is growing more and more obese currently than it has been at any other time in history.

Putting it simply, obesity can be described as the excessive accumulation of fats in the body. These are fats that the body does not need or cannot digest and utilize in fulfillment of physical activities. From a medical perspective, when the body mass index (BMI) goes beyond the limit 30 from where it should be, only then is one considered obese. The BMI is calculated by dividing the weight of an individual by the Square of the Height in Meters (WHO, 2011).

There are two major causes of obesity; the ingestion of fat rich foods and energy dense foods, which are also rich in sugar and salt. These foods are also noted to be low in essential minerals, vitamins and the essential micronutrients. The other cause of obesity that WHO (2011) places much emphasis upon is the sedentary lifestyle that one lives. This lifestyle can be occasioned by urbanization and the reduced active life that urbanization comes with, the docile employment environments that many are exposed to of late as well as the evolving means of transport that leaves little space for daily exercise. Some of the factors caused by increasing urbanization revolve around preferring fast food over home-made meals, overeating, preferring food that is high in calorie, fat and sugar while low in fiber and calcium and increased consumption of soft drinks. This behavior is further enhanced by a surrounding where high-fat foods are easily available, can be bought easily and can be readily eaten without much preparation (Raj and Kumar, 2010).

Background

A number of research studies have been carried out to measure the extent, scope, magnitude and implications of teenage obesity. For instance, According to World Health Organization (WHO) statistics for 2005, at least 20 million children around the world are overweight (WHO, 2006). In the United States alone, 11% of the preschool population has been diagnosed as over weight (Johnson, Clark, Goree, O'Conner, & Zimmer, 2008). Teenage obesity is currently viewed as a worldwide epidemic that exists among all ethnic groups, social categories, and economic classes (Lee, 2007). The rising prevalence of both overweight and obese young females has evolved into an indisputable public health concern and is placing a tremendous burden on the country's health care system (Wake, Hardy, Canterford, Sawyer, & Carlin, 2007).

Similarly, according to the Centre for Disease Control and Prevention (CDC), Obese young females have a 70% chance of becoming obese adults, with resulting higher risks for diseases such as heart disease, diabetes, stroke, and several types of cancer. Obese young females have a greater risk of social and psychological problems such as depression, discrimination, and poor self- esteem. Obesity leads to heart disease caused by high cholesterol and/or high blood pressure, type 2 diabetes, asthma, sleep apnoea, and/or social discrimination (Centre for Disease Control and Prevention [CDC], 2008a and 2008b).

Time Plan

Activity Completed

Time Allowed

Thesis Proposal Completed

Expand and synthesise the literature review

Literature Review (Chapter 2) completed

4 months

Ethics Committee (waiting )

Conduct Focus Groups (done)

Questionnaire designed and tested (designed not tested yet )

1-month

Methodology (Chapter 3) completed

2 months

Tests issued and returned

Collection completed

6 months

Data Analysis completed

2 months

Introduction (Chapter 1) completed

Data analysis (Chapter 4) completed

2 months

Conclusion (Chapter 5) completed

1-month

Chapter revisions completed

Thesis submitted

1-month

Innovative Character of the Study

The innovative character of this study is in the specific approach that it has taken. Previous obesity studies have focused on intervention for obesity. This study joins the small list of research efforts aimed at preventing obesity in the teenage female student. The study is further innovative in nature because it focuses on the female student body within Saudi Arabia and the factors that lead to increasing obesity within this specific demographic. This study will use a preventive teaching strategy in a real-life classroom in Saudi Arabia where teenage girls typically learn the importance of sports. Neither the classroom environment nor the class routine will be altered in any way during this study.

Scientific Relevance

The thesis is going to be focused on the research area of healthcare problems that face the younger female students. The specific health problem that this study will focus on will be obesity and the specific location will be Saudi Arabia; hence all female students chosen for the sample in this study will be studying in Saudi Arabian institutes. The approach for this is based upon Erikson's stages of development, which postulate that during the academic years, females play and imitate those around them (Learning-Theories.com, 2008). Preventive strategies are critical in the fight against obesity. Such efforts are proven to be more cost-effective than intervention strategies (Cochran, 2008). Hence, the unique contribution of this study to the healthcare domain will be to focus on the prevention strategies and how important they are for the future generations both in terms of health as well as cost-effectiveness. However, this study will also highlight some intervention strategies which, at times complement prevention strategies, and also help in reducing the current obesity levels in the chosen region.

Hypothesis

This analysis seeks to divulge the extent to which gender inequality especially in schools and the consequent denial of sports participation among girls in Saudi Arabia is a contributor to the rise in obesity in the region. This quest is informed by the ever increasing number of obesity cases among girls of the ages between 14 and 18 years. Hence the most appropriate hypotheses for this study will include:

H1: if educators and health workers use preventive measures successfully, then gender inequity in Saudi Arabia may be decreased

H2: if the gender inequity is decreased, then sports activities amongst the girls may improve

H3: if the sports activities amongst the girls are improve, then overall obesity ratios for girls may improve

It is important to note that all hypotheses above are interlinked as they answer the main research question of how obesity can be decreased among the young girls in Saudi Arabia. For this purpose, the proposal focuses on aspects like the dangers of obesity on health, the penetration of obesity as a disease in the modern world, as well as, the approach of the school/educators/health workers to address the issue.

Literature Review

Obesity is one of the most serious public health problems of the 21st century. Although the patterns of obesity differ between developing and developed countries, obesity rates are generally on the increase worldwide. According to Speiser et al. (2005), 250 million people, literally 7% of the world's current population is obese. For example in Canada, 40 to 60% of the population is obese while in the United States over 65% are obese and around 65% of the American population falling under this category (The Toronto Sun, 2011).

The statistics provided by the Ministry of Health in Saudi Arabia indicates that well over three million people in the region are obese; this translates to a ratio of 1 in 5 people being obese on average. It is also noted that a bigger percentage of these obese people are women as compared to the male counterparts, and in Saudi Arabia 66% of the women are said to be obese (Ministry of Health, 2005).

To narrow down the statistics, El Mouzan and colleagues (2010) conducted a study that indicates that of the student population in Saudi Arabia, between 14 -- 18 years, 40% are obese. This is a grim situation as this is the population that is supposed to be most active since they are young and still in school hence should engage in many physical activities yet they have fallen prey to the menace of obesity.

In the 40% population of teenage Arabians who are obese, there are further indications that it is still the girls who are more predisposed to obesity than the boys in the institutions. Alam et al. (2008) conducted a research in Bahrain that was purposed at finding the proportion of obesity cases between the boys and girls and the results were quite shocking, bearing the diversity in the ratios that were found. There was a ratio of 13.5% overweight cases among the girls as compared to the 9.1% overweight cases among the boys.

Another compelling research results was from one conducted in Al-Khobar city by Abahussain where 679 adolescents were observed and their nutritional status taken. From their BMI, it was determined that a significant 28% of these girls were either overweight or obese.

This misbalance in the distribution of obesity between the boys and girls has been widely viewed to be due to the gender inequity. This prescribes the duties and responsibilities of the different genders in the Saudi community and even the participation in sports. Girls at home are seen to be confined in the kitchen and used as maids for the domestic chores hence they do not get any time for exercises. This is further compounded at school and the higher learning institutions where the girls are not allowed and not encouraged to participate actively in sports that need physical involvement. This expresses the institutionalization of gender inequality and biasness that directly affects the girls in Arabia. The inequality stems from the cultural bias that is experienced in the community which transcends the social boundaries to the academic spheres.

The lack of participation in sports, or less of it among the girls automatically leads to a docile lifestyle both at school and at home. This then makes the girls to resort to inactive leisure as compared to their male counterparts who engage in active leisure hence having lesser risk of getting predisposed to obesity (Berger & Peerson 2009, pp. 117-124).

The well-being regulations are an important part of reducing weight problems for the chosen segment in this study. Research projects have given abundant information on this topic. Weak diet and minimal physical exercise among the teenage girls has adversely influenced their bodily, interpersonal, and psychological wellness, along with their academic and occupational accomplishment (Williams, 2005; as cited in Agron et al., 2010). Furthermore, childhood weight problems place the youngsters in danger of persistent illnesses in their adult years (Schwimmer, 2003 as cited in Agron et al., 2010). The recommendation here is to register the girls in schools that focus on nourishment and physical health as well as academic performance. Hence, this is where the role of the schools and government comes in. Educational institutions carry out a critical function in nourishing learners, offering programs for physical exercise, and adding to lifelong healthiness. Thus, awareness, execution and assessment of a healthy nutrient-rich diet along with physical activity have been recognized as aspects of particular importance as a measure for obesity reduction in the chosen segment (Agron et al., 2010).

The educational policymakers acknowledge that educational institutions have an important part to place in fostering the wellness of their pupils, in deterring adolescent obesity and in dealing with issues that are related to weak diets and lack of adequate physical activity among girls. To systemize and motivate this function the Saudi government could learn from the United States where the Congress agreed upon the legislation in 2004 making compulsory for all school districts to contribute and take part in federal nutrition programs so that a wellness policy could be designed (Agron et al., 2010). The policy in the region of Saudi Arabia thus could incorporate:

1- Diet recommendations and guidelines for all the food present in the institution

2- The objective of providing diet-based information, exercise and other such activities

3- Assertion that the district's policies for reimbursable lunch not be less constraint than federal policies

4- An outline for gauging the application of well-being regulations (Agron et al., 2010).

Inadequate nutritional or dietary strategies along with training materials may be partly to blame for the knowledge deficit about proper nutrition and exercise, as many families find it challenging to engage in a learning process that lacks creativity and originality for the teenage girls in their family (Forshaw, 2009). Because perceptions, attitudes, and habits form during the preschool years and the culture thereof, school nurses and educators must try innovative instructional strategies of health and wellness education approaches to point the young girls as well as their family toward a healthy lifestyle. Hence, adequate planning, instruction, and evaluation are vital in creatively seeking to educate the young girls and their families about nutrition and exercise primarily from the school nurses and therapists (Perkins, 2009).

Proper nutrition and adequate physical activity are vital for the growth and development of the girls and for the establishment of a healthy lifestyle that prevents future obesity (Bellows, Anderson, Martin, & Auld, 2008). The teenage school years present optimal times to not only help establish healthy lifestyle patterns for the child and her family but also to influence family meal planning in the home (Papas, Hurley, Quigg, Oberlander, & Black, 2009). The training materials given by the nurses to the family will thus need to be evaluated by assessing the knowledge, attitudes and behaviours of the girls and their parents initially regarding fundamental concepts of health and wellness.

Methodology

The qualitative method will be the most appropriate for this study. The qualitative tool kit will be used before (pre test) and after (post test) the interventions are administered. This information will serve as both a baseline for the student and as equilibrium among groups. The pre-test will allow the groups to be evaluated for symmetry. The researcher anticipates that all three groups will produce similar results, showing that the groups are comparable (Saunders et al., 2009).

The interventions will be randomly assigned to each of the three groups. The interventions will be presented to the groups in brown envelopes. Each group will receive one of the following in their envelopes (health fable, pamphlet or unrelated reading material). The group which receives the unrelated reading material will serve as the control group for this study. The students will be asked to bring their envelope home to their parent/caregiver. A letter to the parent will accompany each envelope. Each parent will be asked to read the enclosed material to their child two times over a one week period. Upon completion of this request, they will also be asked to sign a form stating that the task is complete. When the child returns with his or her form, he or she may choose something from the researchers treasure box. Treasure box picks will also be awarded to each child after he or she completes the pre and post tool kit evaluation.

Based upon interviews with several teachers, the interventions will be limited to one concentrated week every week. The anticipation is that the study will capture and hold the interest of students and parents for one week, but if it goes any longer the participants may lose interest, materials may be misplaced and overall effectiveness diminished. This part of the study has been scheduled for six-month. During the first months, the study will be introduced and consent forms will be sent home for parents to sign. In the second and third months, the researcher will administer the pre-study tool kit and advertise the study details. In the fourth month, the researcher, school nurse and preschool teachers will blindly match groups and interventions and distribute the envelopes. Finally, in the fifth and sixth month, the post-study tool kit will be administered. Afterward, data analysis will begin.