Abstract

Background:Obesity is a growing public health concern in Bangladesh

Aim: The aim of the study was to determine the risk factors of grade 2 and 3 obesity

Methods: This study was done in the Department of Endocrinology, BSMMU from May 2019 to March 2020 in children with primary exogenous obesity. Childhood obesity was classified using charts of the US Centers for Disease Control and Prevention. Risk factors (family, screen time, diet and physical activity domains) were assessed with an open ended structured questionnaire.

Results: The study included 189 children with a mean age of 12.27±3.22 years and mean BMI of 29.61±6.79 kg/m2. Children with grade 2 and 3 obesity spent more time on computer/laptop/tablets due to academic purpose (2.07 ±2.00 vs 0.33 ± 0.71 hours/day, p=0.029). After controlling for other factors, only duration of private tuition was related with BMI (β=0.883, p=0.02, 95% CI=0.147-1.620). Sleep deprivation (z=1.332, SE=0.101, p=0.183) and screen time due to academic purpose (z=1.523, SE=0.282, p=0.128) were not mediators of private tuition and obesity. Duration of private tuition (OR=1.309, p=0.053, 95%CI 0.997-1.721), private tuition duration > 1 hour/day times (OR=2.078,p=0.040, 1.034-4.173), screen time ≥2 hours/day (OR=5.732, p=0.021, 1.304-25.201), snacking (OR=11.872, p=0.033,1.218-115.730), maternal obesity (OR=2.963, p=0.033, 1.094-8.023), maternal obesity and no access to playground (OR=1.463, p=0.009, 95% CI=1.258-4.823) were independent predictors of grade 2 and 3 obesity.

Conclusion: Duration of private tuition, screen time, maternal obesity and snacking were risk factors of grade 2 and 3 obesity in children. Effect of private tuition on obesity was direct. Lack of access to playground was a risk factor only in those with a family history of maternal obesity.