Vision 2030 Issue of Child

Vision 2030

Issue of Child Obesity in Saudi Arabia

Obesity is one of the most pressing and serious public health problems of the 21st century. Although the patterns of obesity differ between developing and developed countries, obesity rates are increasing worldwide. According to Speiser, Rudolf, Anhalt, Camacho-Hubner, Chiarelli, Eliakim et al. (2005), as many as 250 million people, or about 7% of the world's current population, are obese

According to the ministry of health, SA more than 3 million individuals are suffering from obesity which means 1 in every 5 persons is obese. The statistics also show that obesity rate is higher among women as compared to men in SA. Saudi Ministry of Health indicated that more than half of the Saudi adults are considered overweight while 66% women in Saudi Arabia are overweight. (Ministry of Health, 2005).

The improvement of the economic status in the Saudi government helped each Saudi citizen get free social services, especially health services. This resulted in a low infant mortality rate of 11.9-4 per 1000 live births in 2008 compared to 47.94 in 2003 (Ministry of Health, 2009). Where there is improvement as regard mortality rate and health status of the Saudi citizens, there is also obesity problem due to diet with high caloric diet intakes with added sugar and fat, and s sedentary lifestyle. As the country is rich due to its oil resources, this prosperity led to use of servant in most household. This type of lifestyle has caused increases in chronic diseases such as obesity, diabetes, CVDs and being overweight (Lobstein, 2004; Must, 1991; Deckelbaum and Williams, 2001).

According to the Ministry of Planning and Population in Saudi Arabia, the population of Saudi Arabia is characterized by fast growth and a large cohort of youths. The age percentage of the population in Saudi Arabia is as follows: 38% of children aged 10-14 years; 59% of the population aged 15-64 years; 2% of the population aged 65 years and over. These percentages show that more than 40% of the Saudi population is children and young adolescents (Ministry of Planning and Population, 2008).

So far, there are limited studies on successful treatment of childhood obesity (Collins, 2006). The main focus of my research paper is inequality related to physical activity and sports activities for boys and girls in Saudi Arabia. The sports are not allowed for Girls in Saudi Arabia due to which the prevalence of obesity is more likely in girls as compared to boys.

Focusing on child obesity in Saudi Arabia and ban on sports in girls schools, the author will present a vision of 2030 where this inequality has been addressed. The author will discuss in detail the in-equality in 2011 and how this in-equality has been addressed during the 19 years.

2. Vision of 2030

Now it is 2030, the issue of child obesity has been resolved. Steps were taken at government and community level to address this issue. The struggle started in 2010 when public and government started giving attention to the problem. Ministry of Health took initiative and created awareness about healthy diet and benefits of physical activity as well as health risks related to obesity. Different NGO's played a significant role in this awareness campaigns.

Government allowed sport and physical education in girls' schools as there was demand on national levels from parents and school administration. Motivational programs were created and shown through media. People were motivated to eat healthy food and take part in physical activities for their own benefit. Parents were motivated to have check on the diet of their children.

Now there are girls' teams at national and district level for all sports and Saudi women teams take part in all major international tournaments. Lunch provided to school children is less in calories and fats. Every child has to attend physical education class daily.

Child Obesity in Saudi Arabia in 2011

The fast economic development due to oil boom since 20th century and urbanization established a new living style among Saudi citizens. The physical activity have been lessened due to prosperity and dependence on servants for all type of physical work. Furthermore, economic growth and urbanization led to a change in eating habits and open the door to fast food and convenient food with high calories, fat, salt and sugars. This more fattening food and inactive living style have caused an epidemic of overweight in Saudi Arabia with 18% of elementary children and up to 40% of secondary children (Ministry of Health, 2005).

The main focus of my research paper is inequality related to physical activity and sports activities for boys and girls in Saudi Arabia. The sports are not allowed for Girls in Saudi Arabia due to which the prevalence of obesity is more likely in girls as compared to boys. This is evident from study conducted by Mohsen (2002) and others who aimed at determining the prevalence of obesity in Saudi children from different regions of Saudi Arabia. The sample size for this study was 12701 children (6281 boys and 6420 girls) all around SA within the age group of 1-18 years. The study was conducted during a household screening program in different provinces of Saudi Arabia. The results of this study indicated that occurrence of obesity was 10.7% % among boys and 12.7% among girls. Obesity occurrence was higher in girls at 6.7%. Thus, the obesity rate was reported higher among girls as compared to boys which show that there is a need to focus on this issue and government should allow physical activities in Girls Schools.(Mohsen, 2002)

Similarly another study conducted by Soyannwo (1995) show that obesity rate is higher in girls as compared to boys. The study sample consisted of 2,727 males and 3,317 girls. The study concluded that the trend of increase in BMI was recorded increasing with the age in both genders but it was comparatively high in females. 9 Soyannwo, 1998, Madani, 1995).

The higher obesity rates in females in Saudi Arabia because of different factors. For instance, socially they have restriction to go out and participate in outdoor physical activity as compared to males. Besides the sports in girls schools are not allowed by government due to which they are not bound to indulge in physical activity in home or at school.

Childhood obesity is less in rural areas of Saudi Arabia as compared to Urban areas because in the rural areas people are less dependent on fast food and are indulged in physical activity. The research study on the child obesity show that occurrence of overweight in children in Eastern provinces was higher as compared to prevelance of obesity and overweight in the Southern province. It is a fact that Eastern provinces are more urbanized than the Southern province (Mohsen, 2002),

The results of the study conducted by Al-Nuaim (1997) also show that the occurrence of overweight and obesity was greater in females as compared to males and lesser in persons living in rural areas with traditional lifestyle than those in more urbanized areas (Al-Nuaim, 1997).

Health risks caused by Obesity

In the United States, more than 300,000 adult deaths are caused by obesity-related diseases. Research indicates that obesity incurs more than $100 billion in health care costs annually (Allison, Fontaine, Manson, Stevens & VanItallie, 1999; Must, Spadano, Coakley, Field, Colditz & Dietz, 1999; Blumenthal, 2001; American Academy of Pediatrics, 2002). The Institute of Medicine of the National Academies (2005) estimated that "after adjusting for inflation and converting estimates to 2004 dollars, the national direct and indirect health-care costs related to overweight and obesity ranged from $98 billion to $129 billion" (p. 70).

The health and economic impacts of escalating overweight and obesity rates are found not only among adults but also among children and adolescents. That is, overweight and obesity rates among children and adolescents are increasing in many countries. For example, a study of German preschoolers showed that between 1982 and 1997 the obesity increased from 1.8% to 2.8% (Kalies, Lenz & Kries, 2002; Lissau, Overpeck, Ruan, Due, Holstein & Hediger, 2004). The occurrence of being overweight and obese among children aged seven to eleven in England, however, increased by more than 20% for girls and more than 15% for boys between mid-1970 and 1998 (Lobstein, James & Cole, 2003; Lissau., 2004). Although obesity rates fell in rural areas of China during a period from 1989 to 1997, obesity among children aged two to six increased from 1.5% to 12.6% in the urban areas of the country within the same period of time (Luo & Hu, 2002).

Previously, when a child was found to be overweight or obese, he or she would be considered a healthy child. In those days, food treats were viewed more as a cultural index of parental caring rather than as a health risk. More recently, however, obesity among children and adolescents is considered a disease associated with significant health problems. It is also looked upon as an important risk factor for morbidity and mortality of children and adolescents. Indeed, obesity among children and adolescents is even associated with an increase in economic costs. It is estimated that the hospital costs for obesity-related disease among children and adolescents increased from $35 million in 1979-1981 to $127 million in 1997-1999, which represents more than three times the costs of 20 years ago (Wang & Dietz, 2002).

Numerous obesity-related health complications such as high cholesterol, high blood pressure, type II diabetes mellitus, coronary plaque formation, and serious psychosocial implications, are also affecting children and adolescents (Freedman & Stern, 2004; Pinhas-Hamiel, Dolan, Daniels, Standiford, Khoury & Zeitler, 1996; Ludwig & Ebbeling, 2001; Dietz, 1998; American Academy of Pediatrics, 2002). Since the increase in such health problems has generally paralleled that of the obesity epidemic, Anderson and Butcher (2006) remarked that there should be an association between these health problems and childhood obesity.

Guo, Wu, Chumlea & Roche (2002) indicated that overweight children often become overweight adolescents and adults. This notion only adds to the seriousness of childhood obesity. Indeed, the National Institute of Health (1998) identified that obesity is a serious health risk among children and adolescents of all age groups.

If particular causes of obesity could be known, then health experts, policymakers and others could design programs to reduce overweight and obesity among younger age groups. Therefore, it would be very helpful if a research based understanding regarding what social aspects encourages childhood obesity could be developed. This thesis intends to generate a knowledge base that could contribute to such an overall understanding.

Bearing this intention, this research paper aims to find out whether there are relationships between the likelihood of being overweight or obese among children and adolescents and the social factors. The literature suggests that the prevalence of overweight or obesity differs based on different social factors. For example, the literature suggests an inverse relationship between physical activities and the prevalence of overweight or obesity. The relationships, however, change when the prevalence of overweight or obesity is associated with other social factors like television watching, listening to music and playing computer games. In particular, this paper focuses on the in equal government policy towards allowing physical activity in boys and girls schools in Saudi Arabia. Further the research paper will explore main factors which are associated with overweight or obesity among children and adolescents: socio demographic factors, preference for certain activities, and health conditions.

Definition of Obesity

Typically, obesity and overweight in adults are defined in terms of body mass index (BMI), which in turn is defined as weight in kilograms divided by height in meters squared (kg/m2) (Centers for Disease Control and Prevention (CDC), 2000). Guidelines issued by the National Institutes of Health (1998) consider an adult underweight if his or her BMI is less than 18.5, overweight if BMI is 25 or more, and obese if BMI is 30 or more. These guidelines also indicate that the standard BMI for a healthy body is between 18.5 -- 25 kg/m..

BMI is also used to identify children who are overweight or at a risk of becoming overweight. The cutoff criteria, however, are mostly based on the age-and-sex-specific BMI growth charts for the United States produced by Centers for Disease Control and Prevention (CDC) in 2000 (Bouchard & Rankinen, 2005). CDC experts recommend that children with BMI values at the 85th percentile and at or above the 95th percentile of the age-and-sex-specific BMI growth charts be categorized as overweight and obese, respectively (National Center for Health Statistics, 2005).

Logically, the increase in childhood obesity is associated with the increase in adult obesity. That is, children who are overweight and obese during their childhood are more likely than normal weight children to remain and become overweight and obese during adolescence and adulthood (Anderson & Butcher, 2006). Whitaker and his colleagues (1997) found that 52% of children who were obese when they were at the ages of three to six remained obese at the age of twenty-five, compared to only 12% of children who were normal and underweight when they were at the ages of three to six becoming obese at the age of twenty-five.

The Causes and the Correlates of Obesity

The medical and sociological literatures suggest various factors associated with the obesity epidemic. Different researchers, however, have different views regarding the causes of obesity. Some researchers focus on the physical structures of communities. Suburban sprawl, absence of sidewalks, reliance on automobile are, thus, seen to be major causes of obesity (Bouchard & Rankinen, 2005; Corless & Ohland, 2005; Russonello & Stewart Research and Communications, 2003; Fertig, Glomm & Tchernis, 2005). Other investigators view the changes in the food market, the increase in advertising targeted toward children and adolescents, and the adaptation of fast foods by children and adolescents as major factors behind the causes of obesity (Paxson, Donahue, Oreleans & Grisso, 2006; Anderson & Butcher, 2006; American Academy of Pediatrics, 2004; Jeffery & Utter, 2003).

The literature also supports the idea that there have been many changes in the school environment today, particularly in the availability of fast foods and beverages in schools and the decline in physical education. Generally, most children and adolescents rely on vending machines for food during school time, which allow for the purchase of high-calorie foods like sodas, chips and candy (Anderson & Butcher, 2006; Anderson, Butcher & Levine, 2003). Logically, a greater consumption of high-calorie foods causes children and adolescents to be overweight and obese. Therefore, the greater reliance on vending machines food by children and adolescents is thought to be associated with increasing obesity or overweight rates. The lack of opportunities for exercise has also been associated with this trend of overweight or obesity among children and adolescents. Koplan, Liverman and Kraak (2005) remarked that many American schools have reduced their commitment to provide students with regular and adequate physical activities. This reduction has been attributed to budget cuts and the pressure to increase academic course offerings in order for schools to maintain standards and remain competitive with other schools.

Gender & Obesity

Research indicates that there are gender differences in the likelihood of overweight and obesity among children and adolescents. Ogden and his colleagues (2006) reported that there is a significant relationship between the trend of overweight or obesity among male and female children and adolescents. They indicated that the prevalence of obesity in female children and adolescents increased from 13.8% in 1999-2000 to 16.0% in 2003-2004, whereas the prevalence of obesity in male children and adolescents increased from 14.0% to 18.2% over the same time period. Other studies have indicated that female children and adolescents are more likely to be overweight or .obese than male children and adolescents (Wang, 2002; Hill & Lissau, 2002; Gordon-Larsen et al., 2004; Stanton & Hills, 2004; Hills, 2006). It should be, however, noted that several investigations indicate that the likelihood of overweight and obesity between male and female children and adolescents vary according to their racial background (Freedman & Stern, 2004; Taylor et al., 2005; American Heart Association, 2004).