Obesity prevalence and contributing factors among adolescents in secondary schools in Pemagatshel district, Bhutan

Norbu, Wang; Wangdi, Ugyen; Dorji, Desang; Soonthornworasiri, Ngamphol; Maneekan, Pannamas; Thongthien, Pimpimon; Prangthip, Pattaneeya

doi:10.1515/ijamh-2016-0143

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…88 Other school environment Finally, there was one poor study of the school food environment in which we were unable to categorise the characteristics investigated as the methodology simply stated that the researchers used 10 questions to collect data on school environment without giving details of the questions. 92 This study reported no association between the 'school environment' and BMI.…”

Section: School Marketing and Regulationmentioning

confidence: 60%

The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review

et al. 2021

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IntroductionDiet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions.MethodsWe conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of the food environment and a diet, nutrition or health outcome. Study selection was done independently in duplicate. Data extraction and quality appraisal using the National Heart Lung and Blood Institute checklists were completed based on published reports using a prepiloted form on Covidence. Data were synthesised narratively.Results74 studies met eligibility criteria. Consistent evidence reported an association between availability characteristics in the neighbourhood food environment and dietary behaviour (14 studies, 10 rated as good quality), while the balance of evidence suggested an association with health or nutrition outcomes (17 of 24 relevant studies). We also found a balance of evidence that accessibility to food in the neighbourhood environment was associated with diet (10 of 11 studies) although evidence of an association with health outcomes was contradictory. Evidence on other neighbourhood food environment characteristics was sparse and mixed. Availability in the school food environment was also found to be associated with relevant outcomes. Studies investigating our other primary outcomes in observational studies of the school food environment were sparse, but most interventional studies were situated in schools. We found very little evidence on how workplace and home food environments are associated with relevant outcomes. This is a substantial evidence gap.Conclusion‘Zoning’ or ‘healthy food cart’ interventions to alter food availability may be appropriate in urban LMIC.PROSPERO registration numberCRD42020207475.

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Section: School Marketing and Regulationmentioning

confidence: 60%

The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review

et al. 2021

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“…By comparison, the reported prevalence of overweight in Bangladesh, Nepal, and Thailand were 16.9%, 21%, and 28.3%, respectively [ 20 , 22 , 24 ]. Rapid urbanization, low nutrition literacy, sedentary lifestyle, and high carbohydrate and low protein diets are among the drivers of the global epidemic of overweight or obesity [ 25 – 27 ]. Similar to studies in other low-middle income countries, the prevalence of overweight or obesity increased with age, being female, engaging in certain occupations (e.g., homemakers or government employees), and residing in urban areas associated with physically inactive [ 20 , 22 , 24 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Noncommunicable diseases risk factors in Bhutan: A secondary analysis of data from Bhutan’s nationwide STEPS survey 2014

Sithey

Wen

Dzed³

2021

PLoS ONE

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Background Bhutan is facing an epidemic of noncommunicable diseases; they are responsible for 53% of all deaths. Four main modifiable risk factors, including tobacco use, harmful use of alcohol, physical inactivity, and unhealthy diet, are the causes of most noncommunicable diseases (NCDs). This study aimed to assess 1) the prevalence of NCDs modifiable risk factors in Bhutan’s adult population and 2) associations between the sociodemographic factors and the NCDs modifiable risk factors with overweight or obesity, hypertension, and diabetes. Methods We used the 2014 Bhutan WHO Stepwise Approach to NCD Risk Factor Surveillance (STEPS) Survey dataset in this study. Data were analyzed using multiple logistic regressions, constructed with overweight or obesity, hypertension, and diabetes as outcome variables and modifiable risk factors as independent variables. Results The prevalence of tobacco use, harmful use of alcohol, unhealthy diet (low fruits and vegetables intake) and physically inactive was 24.8% (95% CI: 21.5, 28.5), 42.4% (95% CI: 39.4, 45.5), 66.9% (95% CI: 61.5, 71.8), and 6.2% (95% CI: 4.9, 7.8), respectively. The prevalence of overweight or obesity, hypertension and diabetes was 32.9% (95%CI: 30.0, 36.0), 35.7% (95% CI: 32.8, 38.7) and 6.4% (95% CI: 5.1, 7.9), respectively. Multiple logistic regression showed that older age groups were more likely to be overweight or obese, hypertensive, and diabetic. Our analysis also found that tobacco users were less likely to be overweight or obese (aOR 0.71, 95% CI 0.52, 0.96), and to be hypertensive (aOR 0.74, 95% CI 0.56, 0.97); but they were more likely to be diabetic (aOR 1.64, 95% CI 1.05, 2.56). Alcohol users were more likely to be hypertensive aOR 1.41 (95% CI 1.15, 1.74). Furthermore, vigorous physical activity could protect people from being overweight or obese, aOR 0.47 (95% CI 0.31, 0.70), and those consuming more than five serves of fruits and vegetables per day were more likely to be overweight or obese, aOR 1.46 (95% CI 1.17, 1.82). Conclusion The prevalence of NCDs modifiable risk factors and overweight or obesity and hypertension was high in Bhutan. We found strong associations between tobacco use and diabetes, alcohol use, hypertension, physically inactive, and overweight or obesity. The results suggest that the government should prioritize NCDs prevention and control programs, focusing on reducing modifiable risk factors. The health sector alone cannot address the NCDs epidemic in Bhutan, and we recommend the whole of government approach to tackle NCDs through the Bhutan Gross National Happiness framework.

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“…16 A study conducted in eastern part of Bhutan among secondary school students reported a higher prevalence of obesity in adolescent female population. 17 On the other hand, T1DM is significantly low in CRRH, only three cases of T1DM were recorded in last 5 years at CRRH.…”

Section: Discussionmentioning

confidence: 86%

Diabetes Case Burden at Central Regional Referral Hospital, Gelephu, Bhutan; A Retrospective Study

Chhetri¹,

Pokhrel²,

Zangmo³

et al. 2020

IHRJ

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BACKGROUND: Diabetes is a metabolic disorder affecting millions of people globally. The incidence of type 2 diabetes is increasing rapidly in Bhutan. Anecdotal evidences show poor compliance and loss to follow up among the Bhutanese population living with diabetes. This study was conducted to understand the case load, age and gender distribution and compliance to follow up among diabetic patients registered at Central Regional Referral Hospital, Gelephu, Bhutan. MATERIALS & METHOD: All the patients diagnosed and registered with Diabetic Clinic between 1st January 2014 to 31st December 2018 were included in the study.RESULTS: There was a sharp increase in number of registered diabetic patients from 641 cases in 2014 to 1590 cases in 2018. A total of 949 new cases were diagnosed and registered during the study period of which 52% were women. The overall diabetes prevalence under Gelephu CRRH catchment area is found to be 2.91% with lowest at Chhudzom (1.01%) and highest in Samtenling Gewog (3.18%). Lost to follow up among new cases for past four years was found to be 3.96%, 5.0%, 6.47% and 5.85% from 2015 to 2018 respectively.CONCLUSION: The ageing population and sedentary lifestyle has contributed to the sharp escalation of type 2 diabetes cases in Gelephu. The hospital recorded total of 1590 cases in 2018 which is a two-fold increase in case load within a span of five years. The current analysis found that loss to follow up was 3.96%, 5.0%, 6.47% and 5.85% from 2015 to 2018 respectively among new cases of diabetes registered with the hospital.

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Obesity prevalence and contributing factors among adolescents in secondary schools in Pemagatshel district, Bhutan

Cited by 6 publications

References 21 publications

The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review

The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review

Noncommunicable diseases risk factors in Bhutan: A secondary analysis of data from Bhutan’s nationwide STEPS survey 2014

Diabetes Case Burden at Central Regional Referral Hospital, Gelephu, Bhutan; A Retrospective Study

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