THE EFFECTIVENESS OF DIETARY INTERVENTION STRATEGIES (AS PART OF PRIMARY HEALTH CARE) AIMED AT REDUCING OBESITY PREVALENCE AMONGST ADULTS

THE EFFECTIVENESS OF DIETARY INTERVENTION STRATEGIES (AS PART OF PRIMARY HEALTH CARE) AIMED AT REDUCING OBESITY PREVALENCE AMONGST ADULTS

BACKGROUND OF THE STUDY

Obesity, a global health concern, is defined as having a body mass index (BMI) greater than or equal to 30 kilograms per square meter (kg/m2). According to the World Health Organization (WHO), in 2014, 1.9 billion adults were overweight (i.e., had a BMI of 25–30 kg/m2) while 600 million were obese (i.e., had a BMI of 30 kg/m2 or more). In addition, about 41 million children under age 5 years were considered overweight or obese (WHO 2016).

The prevalence of obesity and overweight is high and is increasing worldwide. The prevalence in adults increased from 28.8% in 1980 to 36.9% in 2013 for men, and from 29.8% to 38.0% for women (Ng et al. 2014). Among children and adolescents, in 2013, 23.8% of boys and 22.6% of girls in developed countries were considered overweight or obese, as compared to 12.9% of boys and 13.4% of girls in developing countries (Ng et al. 2014). The majority of overweight and obese children live in developing countries, where the prevalence of obesity is increasing at a higher rate than in developed countries (WHO 2014).

Strong and consistent evidence indicates the negative health impacts of overweight and obesity. Obesity is an independent risk factor for many noncommunicable diseases such as type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, some types of cancers, and sleep apnea (Guh 2009, Luppino 2010). In addition, a positive relationship seems to exist between overweight and obesity and all causes of mortality (The Global BMI Mortality Collaboration 2016). In 2010, about

3.4 million deaths were caused by obesity and overweight, resulting in 3.8% global disability-adjusted life years (DALYs) (Lim et al. 2012).

In addition to its negative impact on health outcomes, obesity imposes a substantial economic burden. Evidence consistently indicates that health care costs of an overweight and obese individual are higher than those of the general population (Colagiuri et al. 2010, Hoque et al. 2016). One systematic review revealed that obesity accounts for 0.7%–2.8% of a country’s total health expenditures (Withrow and Alter 2011). Another review in 10 European countries indicated that the cost of obesity is responsible for 0.09%–0.61% of the gross domestic product (Müller-Riemenschneider 2008). Several studies have also examined the economic cost of obesity in Asia-Pacific countries (Ko 2008, Zhao 2008, Pitayatienanan et al. 2014), while a recent systematic review (Hoque 2016) identified 13 articles examining the economic burden of obesity in Australia; the People’s Republic of China (PRC); Hong Kong, China; Japan, the Republic of Korea; New Zealand; Taipei,China; and Thailand. It revealed that overweight and obesity was responsible for 1.5%–9.9% of their total health expenditures.

Generally, obesity and overweight are caused by an energy imbalance that occurs when energy intake is greater than energy expenditure over a prolonged period of time, resulting in the accumulation of excess body fat. The intake of high-density energy food, especially sugars and fats, and an increasingly sedentary lifestyle due to increased urbanization, are two main factors contributing to the increased prevalence of obesity worldwide (Powell et al. 2014).

1.2 STATEMENT OF THE PROBLEM

In response to the obesity epidemic and negative consequences of obesity on health and the economy, the prevention and control of obesity have become a high priority for public health. Since the etiology of obesity is complex, a variety of interventions aimed to prevent and control obesity has been developed. These interventions mainly target increasing physical activity levels, decreasing energy-dense food consumption, and increasing fruit and vegetable consumption. Examples include those that aim to improve diet and/or physical activity through schools, primary care clinics, child care settings, communities, or workplaces; focus on food policy and regulation (e.g., taxation of unhealthy foods, marketing restrictions on unhealthy foods, labeling regulations, and fruit and vegetable subsidies); and promote walking, cycling, and using public transport for commuting. Implementation of these interventions is regarded as a public health priority, so evidence on effectiveness is necessary (Powell et al. 2014).

1.3 OBJECTIVES OF THE STUDY

The main aim objective of study is to examine the effectiveness of dietary intervention strategies (as part of primary health care) aimed at reducing obesity prevalence amongst adults. Precisely, other objectives of this study are to:

1. Determine the prevalence of obesity among adults.
2. Ascertain the health effect of obesity.
3. Determine whether primary healthcare plays a significant roles in the reduction of prevalence of obesity among adults
4. Determine the effectiveness of primary healthcare in curtailing the prevalence of obesity through dietary intervention strategy.
5. Determine the effectiveness of primary healthcare in controlling the weight of obese adults.
6. Ascertain the factors  affecting the effectiveness of primary healthcare in reducing the prevalence of obesity among adults.

1.4 RESEARCH QUESTIONS

The following research questions will be answered in this study:

1. What is the prevalence of obesity among adults?
2. What are the health effect of obesity?
3. Does primary healthcare play a significant roles in the reduction of prevalence of obesity among adults?
4. Is the primary healthcare effective in curtailing the prevalence of obesity through dietary intervention strategy?
5. Is the primary healthcare effective in controlling the weight of obese adults?
6. What are the factors  affecting the effectiveness of primary healthcare in reducing the prevalence of obesity among adults?

1.5 SIGNIFICANCE OF THE STUDY

This study will be greatly beneficial to the public as the findings of this study will reveal the extent of obesity prevalence amongst adults, the health impacts, and the different measures at reducing obesity among adults.

Additionally, this study will be beneficial to scholars as it will serve as a reference point for further studies and future research.

1.6 SCOPE OF THE STUDY

This study is focused on the effectiveness of dietary intervention strategies (as part of primary health care) aimed at reducing obesity prevalence amongst adults. Specifically, this study is focused on determining the prevalence of obesity among adults, ascertaining the health effect of obesity, determining whether primary healthcare plays a significant roles in the reduction of prevalence of obesity among adults, determining the effectiveness of primary healthcare in curtailing the prevalence of obesity through dietary intervention strategy and ascertaining the factors  affecting the effectiveness of primary healthcare in reducing the prevalence of obesity among adults.

Selected staff of primary health care, Ikorodu will serve as participants of this study.

1.7 LIMITATIONS OF THE STUDY

This study is limited to the effectiveness of dietary intervention strategies (as part of primary health care) aimed at reducing obesity prevalence amongst adults. Specifically, this study is limited to determining the prevalence of obesity among adults, ascertaining the health effect of obesity, determining whether primary healthcare plays a significant roles in the reduction of prevalence of obesity among adults, determining the effectiveness of primary healthcare in curtailing the prevalence of obesity through dietary intervention strategy and ascertaining the factors  affecting the effectiveness of primary healthcare in reducing the prevalence of obesity among adults.

Selected staff of primary health care, Ikorodu will serve as participants of this study, thus further research is required before the findings of this study can be used any where else.

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