Obesity in Children (Essay Sample)

Dissertation Proposal for Prevention of Obesity in Children: From Infants to Adolescents
Abstract
Obesity has been defined as an excess of body fat beyond the normal limits. Usually it is expressed in the BMI scale of >29.9. Apart from diet both genetic and environmental influences are associated with the genesis of obesity, leading to various physiological and psychological issues. Hence obesity imposes an enormous social and economic constraint for various societies (Reinehr and Wabitsch, 2011).
Obesity has both short term and long term consequences. These include psychosocial issues like depression, isolation and low self esteem (Reinehr and Wabitsch, 2011). Further if obesity is not managed it may lead to diabetes, dyslipidemia and cardiovascular diseases that may increase the morbidity and mortality in the long run. Evaluating the consequences of obesity it becomes very pertinent to implement preventive measures that can reduce the menace of obesity. The most sought preventive measures are the incorporation of physical activity, balanced diet and controlled life style.
The subjective and objective analysis conducted to evaluate the effect of intervention measures through statistical tests of significance will indicate such factors that may be statistically significant or correlated to the development of obesity will provide tailor made prevention strategies for individual subjects (Burnham and Anderson, 2002).
Background
Obesity has been defined as an excess of body fat beyond the normal limits. Usually it is expressed in the BMI scale of >29.9. Apart from diet both genetic and environmental influences are associated with the genesis of obesity, leading to various physiological and psychological issues. Hence obesity imposes an enormous social and economic constraint for various societies (Reinehr and Wabitsch, 2011). The different variations in height and relative muscle mass in different populations indicate that obesity cannot be evaluated by weight measures alone, particularly in the case of children and adolescents. Hence the Body mass index (BMI; weight in kilograms divided by height in meters squared) serves a useful measure of adiposity (Cole, 2000).
Various factors have been associated with the development of childhood obesity: which includes intrauterine environment, presence of diabetes, maternal smoking, and passive smoking, duration of breast feeding, early feeding practices complementary food introduction and weight gain in early childhood and during puberty (Campbell, 2002). Obesity has both short term and long term consequences. These include psychosocial issues like depression, isolation and low self esteem (Strauss, 2000). Further if obesity is not managed it may lead to diabetes, dyslipidemia and cardiovascular diseases that may increase the morbidity and mortality in the long run (Allen and Myers, 2006). Evaluating the consequences of obesity it becomes very pertinent to implement preventive measures that can reduce the menace of obesity. The most sought preventive measures are the incorporation of physical activity, balanced diet and controlled life style (Gortmaker, 1999 (Thompson, Ballew and Resnicow, 2004). Hence this dissertation will aim to indicate which intervention measure/s would be most suitable to manage the prevalence of childhood obesity that can be prioritized and implemented as a long term strategy.
Review of Literature
Availability and palatability of food and low levels of physical activity are frequently associated with increase in the incidences of obesity. A number of studies have indicated that nutrition during early development period may have permanent and long-term effects on the risk of future obesity (Bessesen, 2000). The management and prevention of obesity in children and adolescents must include healthy and balanced diet with physical activity.
Balanced diet means that the intake of calories should be as per the recommended dietary allowance. Further the proportion of carbohydrates, fats and proteins should also be specific for the population in question (Videon and Manning, 2003). The reason for implementing such preventive measures is due to the fact that anti-obesity drugs are not considered safe and effective for all age groups (Fitzgibbon, 2002).
Methodology
Proposed approach and design to tackle the above question/aim/hypothesis
The proposed approach and design for the dissertation will be based on both subjective and objective parameters. The subjective features will deal with the assessment of a questionnaire set before and after the proposed intervention procedures/ preventive measures in a group of obese individuals. The objective analysis will include the assessment of obesity parameters through the measurement of body mass index, lean body mass and body mass composed of fats and also measurement of central or peripheral obesity through standardized procedures. The objective analysis will also be done before and after the proposed intervention procedures/ preventive measures the same group of obese individuals in whom the subjective analysis will be conducted. The intervention measures will be sorted out from the responses of the questionnaire set which are statistically significant.
After sorting for the probable preventive measures such measures will be designed and implemented such group of individuals. As stated the subjective and objective analysis will again be conducted to evaluate the effect of intervention measures through statistical tests of significance. If such factors come out to be statistically significant or correlated then regression equations will be conducted of obesity on the various intervention measures.
Sample Selection and Site of Proposed Study
The samples that would be selected will be in the range of 5 years to 17 years from 15 schools and the proposed sample size would be 150 individuals who at least have type 1 obesity as per BMI. The initial sample collection will be to accommodate ten individuals from each school. The sampling will be based on stratified random sampling along with purposive sampling. This means purposive sampling will be done to eliminate the non obese group of individuals from the study and include only those who will present at least have type 1 obesity.
The stratified sampling will be created by segregating the individuals into various age groups, to identify the specific role of the each preventive factor on the various age groups. The age groups selected will be in the range of >5 years to <8 years, >8 years to <12 years and >12 years to <17 years. In brief the method of sample selection will eliminate bias and will fairly represent the population of obese individuals proposed for the study.
Inclusion and Exclusion Criteria
The inclusion criteria will be the newly diagnosed individuals in the range of 5 years to 17 years and should not be under any medication. The ethnicity selected will be uniform to eliminate chances of genetic bias and does not pertain to any issues of racial discrimination. The ethnicity to be selected is the most common ethnic group presented to these chambers and there will be no preconceived bias of selection. Children in whom parental consent will be provided should only be included in the study. Only male subjects will be included to eliminate gender bias.
The exclusion criteria will be individuals who do not fall in the range of 5 years to 17 years and those under any form of medication. The less proportion of ethnic groups will not be included in the study. Further children I whom family history of obesity is evident will not be included also to eliminate chances of genetic bias. Children in whom parental consent will not be provided will not be included in the study.
Gaining Access
To gain access to the affected group of individuals proper sanction letter from the proper channel of the University will be taken and presented to necessary authorities. Further a brief awareness program will be conducted in the school in the form of audiovisual presentation to aware the parents regarding the short term and long-term effects of obesity.
Ethical Approval
The point of reference for such application will be based on protecting the individual information of the children and their families highly confidential. The study will not be detrimental to the existing health of the individuals selected for the study. Moreover the study should not invite any legal implications neither for the university or the school. There should not be any sort of intrinsic interventions in the form of medication either orally or through injectables and if such act is initiated law will take its own course and there would be no implications on the neither the university, nor the school.
Data Collection
As proposed the data collection will be based on both subjective and objective parameters. The subjective features will deal with the assessment of a questionnaire set before and after the proposed intervention procedures/ preventive measures in a group of obese individuals. The proposed questionnaire set is formatted as follows as per Appendix-1:
Planned Interventions
The interventions planned will be to inculcate specified regime of physical activity as would be evident from literature. Moreover this study will focus the ideal dosage of physical activity that is to be standardized. Further the dietary interventions will be recommended as per Recommended Dietary Allowance and also on the basis of BMI with extra allowances for Specific Dynamic Action.
The objective analysis will be the evaluation of the criteria and degree of obesity as evident from:
i. Body Mass Index to be calculated from the formula:
BMI= Weight in Kilograms/ (Height in meters)2
ii. Central or Peripheral Obesity
If the BMI indicates certain degree of obesity then it will be of importance to find out whe...