الفهرس 
Acknowledgment
Dietary factors and obesityOnly 14 pages are availabe for public view
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Abstract
Obesity is now a prevalent condition that it can reasonably be referred as a global obesity epidemic, obesity certainly the most important nutritional disease in developed countries, where its prevalence has increased particularly rapidly over the last two decades. However, even in developing countries where traditionally nutritional problems relate to under nutrition, overweight and obesity are increasing at an alarming rate. The aim of our work was to detect the prevalence of obesity among the primary school students in Assiut city, identification of risk factors of obesity and assessment of the nutritional knowledge, attitude and practice of the primary school students toward obesity. The study is a cross-sectional study in which random sample of 1000 primary school students were selected from four schools, which represent different types of education (general and private) in both boys and girls. The study includes collection of data by one questionnaire which include personal data, data about physical activity, nutritional knowledge, attitude and practice of the students toward obesity, and the anthropometric sheet that include measuring of weight and height. The students were examined for weight and height on a standardized manner, and then classified into 4 categories by using body mass index –for age and sex percentiles. We found that the prevalence of obesity in the primary school students was 4.6% and the students at risk of obesity (overweight) were 9.6%.We found that underweight is still high prevalent in primary school students (41.5%) and stunting is also prevalent in students (12.8%).Obesity and overweight were more prevalent in girls (16%) than boys (12.5%), while the problem of underweight was more prevalent in boys (42.8%) than girls (40.1%).Obesity increase with age as 20% of students above 12 years were obese compared to 15% of students between 10-12 years and 7.3% of students below 10 years. Obesity was more prevalent in private schools than in general schools This finding suggest that children belonging to relatively higher socioeconomic strata who are likely to study in private schools, are at higher risk of obesity. So obesity was more prevalent in high socioeconomic class than in low socioeconomic class. Physical inactivity plays a very important role in the development of obesity among the school students and is one of the most important risk factor which contributes to increasing the prevalence of obesity in the last decade, as 67.6% of the obese students never participated in physical activity compared to 32.4% of the non-obese students. There was deficiency in the nutritional knowledge of all students toward obesity as only 19.7% of the students identified the ideal weight correctly. Obesity increase significantly among the students eating more than three meals per day (65.0% of the obese students eat more than three meals compared to 22.6% of the normal weight students) (P=0.000), and eating in between meals (18.2% of the obese students eat in-between meals compared to 2.7% of them not eat between meals) (P= 0.000). Drinking soft drinks and juice was also significantly associated with obesity (26.8% of the obese students drink soft drinks and juice compared to 0.4% of them not used to drink soft drinks) (P=0.000). Obesity was found also to be increased significantly among the students who skipping breakfast (28.7%) of the obese students skip breakfast and do not eat it compared to 6.6% of them eat breakfast) (P <0.000). Obesity was found also to be increase significantly among the students who consume fast food (8o.7% of the obese students consume fast food compared to 17.0% of the normal weight students) (P =0.0001). We found 6 risk factors associated with obesity and they were in order of the strength of association as follows. Fast food consumption (Beta =0.567 & P = 0.000) then eating between foods, nibbling (Beta 0.218 & P=0.000), older age (Beta = 0.136 &P=0.000), irregular physical activity (Beta = 0.111 & P= 0.000), the dietary habit of eating 4 meals or more (Beta= 0.058 & P=0.026), while the least contributing risk factor was lack of eating vegetables (Beta = 0.046 & P= 0.050). While the dietary habit of skipping breakfast and the nutritional knowledge toward obesity were not found to be risk factors for obesity (table 22). Obesity should be viewed as a very serious medical problem especially in children and its prevention should begin as early as possible and on the lights of our results we recommend the followings. Parents showed learn how to monitor the weight of their children, to encourage healthy dietary habits and physical activities to them. A national program to prevent and treat obesity should be developed as soon as possible and all the community should share in its implementation. Schools should encourage physical activity and consider the physical activity lesson as important as the other lessons and should incorporate a variety of these activities in the teaching curricula. Periodic screening of the school students to detect early obesity and inform the student and their parents about the dangerous health consequences of obesity and continues observation of these students are recommended. In the new towns construction, traffic and town planning policies should be developed to facilitate the everyday sidewalks and to encourage physical exercise in adults and children. Contentious observation of the obese students in their schools by a specialized medical and physical team and availability of reduction unites to them. Fast food consumption should be restricted in children and adolescents and not easily available to them Improvement of the nutritional knowledge of the students by introduction of materials of proper nutrition in the teaching curriculum.