European Journal of Epidemiology

, Volume 15, Issue 1, pp 41–49 | Cite as

Factors associated with obesity in Kuwaiti children

  • M.A.A. Moussa
  • A.A. Shaltout
  • D. Nkansa-Dwamena
  • M. Mourad
  • N. AlSheikh
  • N. Agha
  • D.O. Galal


The prevalence of adult obesity in Kuwait is among the highest in the Arab peninsula, and cardiovascular disease, for which obesity is a risk factor, is the leading cause of death. This study reports familial and environmental factors associated with childhood obesity; in addition to adverse effects of obesity on children's serum lipids, lipoproteins, apolipoproteins, insulin, and blood pressure profiles. The authors carried out a pair-matched case–control study including 460 obese (body mass index >90th percentile of the age/sex specific reference value of the National Center for Health Statistics), school children 6 to 13 years old matched by age and gender to 460 normal weight controls. We ascertained obese children in a cross-sectional survey of a representative sample of 2400 school children selected from 20 schools by multistage stratified random sampling. Biochemical variables and blood pressure were adversely affected in obese children. The conditional logistic regression analysis showed that family history of obesity, and diabetes mellitus, respiratory and bone diseases in child were significant associated factors with obesity after adjusting for social and behavioural factors. Physical activity and parental social class were not significant. We recommend early preventive measures with emphasis on families in which one or both parents are overweight.

Child Kuwait Matched case–control study Obesity Risk factors 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sorensen TIA, Holst C, Stunkard AJ. Genetic and environment influences on body mass index in childhood — The Danish Adoption Study. Int J Obes 1991; 15(Suppl. 1): 12.Google Scholar
  2. 2.
    Berkowitz RI, Agras WS, Korner AF, Kraemer HC, Zeanah CH. Physical activity and adiposity: A longitudinal study from birth to childhood. J Pediatr 1985; 106: 734–738.Google Scholar
  3. 3.
    Sobal J, Stunkard AJ. Socioeconomic status and obesity: A review of the literature. Psychol Bull 1989; 105: 260–275.Google Scholar
  4. 4.
    Rona RJ, Chinn S. National Study of Health and Growth: Social and family factors and obesity in primary school children. Ann Hum Biol 1982; 9: 131–145.Google Scholar
  5. 5.
    Moussa MAA, Skaik MB, Selwanes SB, Yaghy OY, Bin-Othman SA. Contribution of body fat and fat pattern to blood pressure level in school children. Eur J Clin Nutr 1994; 48: 587–590.Google Scholar
  6. 6.
    Asayama K, Hayashibe H, Dobashi K, Uchida N, Kawada Y, Nakazawa S. Relationship between biochemical abnormalities and anthropometric indices of overweight, adiposity and body fat distribution in Japanese elementary school children. Int J Obes 1995; 19: 253–259.Google Scholar
  7. 7.
    Wilcken DEL, Lynch JF, Marshall MD, Scott RL, Wang XL. Relevance of body weight to apolipoprotein levels in Australian children. MJA 1996; 164: 22–25.Google Scholar
  8. 8.
    Jiang X, Srinivason SR, Webber LS, Wattigney WA, Berenson GS. Association of fasting insulin level with serum lipid and lipoprotein levels in children, adolescents, and young adults: The Bogalusa Heart Study. Arch Intern Med 1995; 155: 190–196.Google Scholar
  9. 9.
    Raitakari OT, Porkka KVK, Ronnemaa T, et al. The role of insulin in clustering of serum lipids and blood pressure in children and adolescents — The cardiovascular risk in young Finns study. Diabetologia 1995; 38: 1042–1050.Google Scholar
  10. 10.
    Abdella N, Khogali M, Al-Ali S, Gumaa K, Bajaj J. known type 2 diabetes mellitus among the Kuwaiti population — A prevalence study. Acta Diabetol 1996; 33: 145–149.Google Scholar
  11. 11.
    Ministry of Health. Kuwait health 1995. Vital and health statistics: Kuwait, 1996.Google Scholar
  12. 12.
    Cochran WG. Sampling techniques. New York: John Wiley, 1977: 100–110.Google Scholar
  13. 13.
    Najjar MF, Rowland M. Anthropometric reference data and prevalence of overweight, United States 1976–80, Vital and Health Statistics Series 11, No. 238, DHHS Pub. No. (PHS) 87–1688. National Center for Health Statistics, Public Health Services. Washington: U.S. Government Printing Office, October 1987.Google Scholar
  14. 14.
    Garrow JS, Webster Y. Quetelet's index (W/H2) as a measure of fatness. Int J Obes 1985; 9: 147–153.Google Scholar
  15. 15.
    Kirkendall WM, Feinleib M, Freis ED, Mark AL. American Heart Association. Recommendations for human blood pressure determination by sphygmomanometer. Hypertension 1981; 3; 509–519.Google Scholar
  16. 16.
    Beckman SYNCHRON CX4/5. Chemistry Information Manual, 015–248053. Brea, California: Beckman Instruments, 1991.Google Scholar
  17. 17.
    Public Health Service. A proposed method for determining FPG using hexokinase and FPG-6-phosphate dehydrogenase. Atlanta, Georgia: Centers for Disease Control and Prevention, 1976.Google Scholar
  18. 18.
    Bucolo G, David H. Quantitative determination of serum triglycerides by the use of enzymes. Clin Chem 1973; 19: 476–482.Google Scholar
  19. 19.
    Allain CC, Poon LS, Chen CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem 1974; 20: 470–475.Google Scholar
  20. 20.
    Burstein M, Scholnick HR, Mordin R. Rapid method for isolation of lipoproteins from human serum by precipitation by polyanions. J. Lipid Res 1970; 11: 583–595.Google Scholar
  21. 21.
    Friedewald WT, Levy RI, Friedrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.Google Scholar
  22. 22.
    Marcovina SM, Albers JJ, Dati F, Ledue TB, Richie RF. International Federation of Clinical Chemistry Standardization Project for Measurements of Apolipoproteins A1 and B. Clin Chem 1991; 37: 676–862.Google Scholar
  23. 23.
    Sternberg JC. A rate Nephelometer for measuring specific proteins by immunoprecipitin reactions. Clin Chem 1977; 23: 1456.Google Scholar
  24. 24.
    SPSS for Windows. User's Guide, release 7.05. New York: McGraw Hill, 1995.Google Scholar
  25. 25.
    EGRET. Epidemiological Graphics, Estimation and Testing Package Reference Manual. Seattle, Washington: Statistics and Epidemiology Research Corporation, 1993.Google Scholar
  26. 26.
    Stewart KJ, Brown CS, Hickey CM, McFarland LD, Weinhofer JJ, Gottlieb SH. Physical fitness, physical activity, and fatness in relation to blood pressure and lipids in preadolescent children — Results from the FRESH study. J. Cardiopulmonary Rehabil 1995; 15: 122–129.Google Scholar
  27. 27.
    Waliul Islam AHM, Yamashita S, Kotani K, et al. Fasting plasma insulin level is an important risk factor for the development of complications in Japanese obese children — Results from a cross-sectional and a longitudinal study. Metabolism 1995; 44: 478–485.Google Scholar
  28. 28.
    Sveger T, Flodmark CE, Fex G, Henningsen NC. Apolipoproteins A–I and B in obese children. J Pediatr Gastroenterol Nutr 1989; 9: 497–501.Google Scholar
  29. 29.
    Dahlstrom S, Viikeri J, Akerblom HK, et al. Atherosclerosis precursors in Finnish children and adolescents. II. Height, weight, body mass index and skinfolds, and their correlation to metabolic variables. Acta Paediatr Scand 1985; 318(suppl): 65–78.Google Scholar
  30. 30.
    DeFronzo RA, Ferrannini E. Insulin resistance: A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14; 173–194.Google Scholar
  31. 31.
    Lewis GF, Uffelman KD, Szeto LW, Steiner G. Effects of acute hyperinsulinaemia on VLDL triglyceride and VLDL apo B production in normal weight and obese individuals. Diabetes 1993; 42: 833–842.Google Scholar
  32. 32.
    Golay A, Zech L, Shi M-Z, et al. Role of insulin in regulation of high density lipoprotein metabolism. J Lipid Res 1987; 28: 10–18.Google Scholar
  33. 33.
    Applebaum-Bowden D, Haffner SM, Wahl PW, et al. Postheparin plasma triglyceride lipases: Relationships with very low density lipoprotein triglyceride and high density lipoprotein 2 cholesterol. Arteriosclerosis 1985; 5: 273–282.Google Scholar
  34. 34.
    Landsberg L, Kreiger DR. Obesity, metabolism and the sympathetic nervous system. Am J Hypertens 1989; 2(suppl.): 125s-132s.Google Scholar
  35. 35.
    Baum M. Insulin stimulates volume absorption in the proximal convoluted tubule. J Clin Invest 1987; 79: 1104–1109.Google Scholar
  36. 36.
    Waxman M, Stunkard A. Caloric intake and expenditure of obese boys. J Pediatr 1980; 96: 187–193.Google Scholar
  37. 37.
    Muecke L, Simons-Morton B, Huang IW, Parcel G. Is childhood obesity associated with high-fat foods and low physical activity? J Sch Health 1992; 62: 19–23.Google Scholar
  38. 38.
    Lissau I, Sorensen TIA. Prospective study of influence of social factors in childhood on risk of overweight in young adulthood. Int J Obes 1992; 16: 169–175.Google Scholar
  39. 39.
    Wolfe WS, Campbell CC, Frongillo EA, Haas JD, Melnik TA. Overweight schoolchildren in New York State: Prevalence and characteristics. Am J Public Health 1994: 84: 807–813.Google Scholar
  40. 40.
    Maffeis C, Micciolo R, Must A, Zaffanello M, Pinelli L. Parental and perinatal factors associated with childhood obesity in north-east Italy. Int J Obes 1994; 18: 301–305.Google Scholar
  41. 41.
    Antonella EP, Luca S, Emilia DF, et al. Familial and environmental influences on body compositions and body fat distribution in childhood in Southern Italy. Int J Obes 1994; 18: 596–601.Google Scholar
  42. 42.
    Rona RJ, Chinn S. National Study of Health and Growth: social and biological factors associated with weight-for-height and triceps skinfold of children from ethnic groups in England. Ann Hum Biol 1987; 14: 231–248.Google Scholar
  43. 43.
    Duran-Tauleria E, Rona RJ, Chinn S. Factors associated with weight for height and skin fold thickness in British children. J Epidemiol Community Health 1995; 49: 466–473.Google Scholar

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • M.A.A. Moussa
    • 1
  • A.A. Shaltout
    • 2
  • D. Nkansa-Dwamena
    • 3
  • M. Mourad
    • 3
  • N. AlSheikh
    • 4
  • N. Agha
    • 4
  • D.O. Galal
    • 1
  1. 1.Department of Community Medicine & Behavioural SciencesKuwait UniversitySafatKuwait
  2. 2.Department of Pediatrics, Faculty of MedicineKuwait UniversitySafatKuwait
  3. 3.Department of Clinical LaboratoriesAmiri HospitalKuwait
  4. 4.Department of School HealthMinistry of HealthKuwait

Personalised recommendations