Association between breast feeding and childhood obesity among school-going children (5-16 years of age) in Karachi, Pakistan
Date of Award
Master of Science in Nursing (MScN)
School of Nursing and Midwifery, Pakistan
Background: Overweight and obesity in children are major risk factors for adult obesity, associated chronic diseases, and premature deaths worldwide. According to the International Obesity Taskforce (2010) estimates, globally 200 million school aged children are overweight. Out which 40-50 million school aged children are obese. Effects of rapid globalization in the developing countries, have resulted in profound implications for poorly resourced countries like Pakistan where the rate of overweight and obesity among children is on rapid rise. Early identification of protective factors is the key to prevention in this vulnerable group that accounts for 45 percent of the total population in Pakistan. A substantial body of evidences has suggested breast feeding, asbeing protective against childhood obesity. However, such an association is neither conclusive in literature nor has it been explored in the Pakistani context. Objective: This study aimed to investigate the association between breast feeding and childhood obesity in school going children (5-16 years of age) in Karachi. Pakistan. Methodology: A matched-case control study was conducted during April 2012 to July 2012.In this study, 528 school going children, aged 5-14 years of age (132 cases and 396 controls) matched on age and gender, were recruited from public and private schools. Data was collected face to face using a pre-tested structured questionnaire on socio-demographic profile, and lifestyle domains (dietary patterns, physical activity, sedentarism, and breast feeding) from children and their mothers at the schools. Anthropometric measurements were done using standardized procedures and BMI was calculated using the Centre of Disease Control growth charts. Analysis was done using the Statistical Package for Social Sciences (SPSS version 19.0), and Statistical Analysis System (SAS version 9.2). Findings: Conditional logistic regression results showed that having a history of not being exclusively breast fed [mORadj= 5.5; 95% CI (2.3-12.9)], exclusively breast fed for less than 3 months [mORadj= 4, 95% CI (2.0-7.8)], and exclusively breast fed for 4-5 months in school going children was [mORadj= 2.6; 95% CI (1.5-4.7)] associated with a higher obesity risk. However, in this study being moderately active [mORadj=0.5; 95% CI (0.3-0.8)], as well as lower extent of participation [mORadj=0.3; 95% CI (0.15-0.7)] in moderate to vigorous physical activity was protective against childhood obesity. Conclusion: Longer duration of exclusive breast feeding have a protective effect against childhood obesity in a dose-response manner. In Pakistan, future longitudinal studies are urged to confirm this association because of its implications for public health. Further studies are also needed to better understand the independent link between physical activity and sedentarism in children.
Sachwani, S. A. (2012). Association between breast feeding and childhood obesity among school-going children (5-16 years of age) in Karachi, Pakistan (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.