NATIONAL SURVEY ON NUTRITIONAL STATUS OF SCHOOL-CHILDREN IN BULGARIA IN 2011 - BACKGROUND, AIM AND OBJECTIVES, DESIGN AND METHODS OF INVESTIGATION
Journal Title: Българско списание за обществено здраве (Bulgarian Journal of Public Health) - Year 2016, Vol 0, Issue 1
Abstract
In recent decades, obesity in childhood is growing steadily in all countries and has become an epidemic and one of the priority public health problems. Overweight and obesity are associated with serious implications for the health and development of children, which significantly increase the risk of chronic noncommunicable diseases (NCDs) in later life. Nowadays, obesity in children is a serious health problem in Bulgaria. Five national surveys of dietary intake and nutritional status of the population conducted in the period 1997-2008, including children from different age groups showed that obesity arises as a problem at the early age, but is most frequent in children aged 7 -18 years. Meanwhile there was evidence of thinness and growth stunting in some age groups. Monitoring of health-risk behavioural factors for obesity and thinness is crucial for assessing the effectiveness of the interventions. To identify current problems and trends in the nutritional status of schoolchildren; to assess the major related risk factors on nutrition and physical activity, a national epidemiological survey of a nationally representative sample of 4227 students aged 7-18 years was conducted. A cross-sectional study was carried out in the period from November 2010 to March 2011. The surveyed students’ sample is representative for the country, stratified by regions and urban/rural location; made of 36 randomly selected schools from all schools throughout the country; students are differentiated according to quotas by age and sex, the proportion of boys is 50.4 percent, and girls - 49.6%. Nutritional status was assessed based on anthropometric indicators. Dimensions are height, weight and waist circumference according to a standardized methodology and protocol of the WHO. Height was measured with a portable stadiometers TANITA with an accuracy of 0.1 cm, body weight with composition analyzers TANITA with an accuracy of 0.1 kg and waist circumference with unstretchable centimeters with an accuracy of 0.1 cm. Evaluation of thinness, overweight and obesity of children is made by Body Mass Index (BMI) for relevant age and sex, according to the WHO growth reference for school-aged children (5-19 years), 2007 and the cut-offs of International Obesity Task Force (IOTF) 2000, 2007. It has been studied the relationship between BMI, waist circumference and waist/height ratio in the surveyed schoolchildren. Nutrition is explored through personal interviews with students by using the Food Frequency Questionnaire. Data on physical activity were collected through a standardized and validated questionnaire. The eating attitudes and behaviors, and risk of eating disorders were studied by self-administered validated Eating Attitudes Test (EAT- 26). At all stages of the study quality control of data was carried out. Data from this study were compared with results from previous national surveys of children in the same age groups. Variance and correlation analysis of the data through the statistical program SPSS 15 and the software WHO Anthro were conducted. The modern design of the national survey on the nutritional status of students, the representative sample, the realized control in the collection and analysis of data, applications of validated and standardized methods and modern criteria are grounds for the confidence and reliability of the data obtained.
Authors and Affiliations
Stefka Petrova, Veselka Duleva, Lalka Rangelova, Maya Konstantinova, Plamen Dimitrov
Keywords
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