RISK FACTORS ASSOCIATED WITH OVERWEIGHT AND OBESITY IN REPRODUCTIVE AGED KIRATI FEMALES IN KIRAT COLONY OF BHADRAPUR MUNICIPALITY Name: Nabina Lawoti Address: Bhadrapur:14, Jhapa E-mail : [email protected] Mobile number: 9803329137 Faculty: BSc.Nutrition and Dietetics Roll no: 14/070 RISK FACTORS ASSOCIATED WITH OVERWEIGHT AND OBESITY IN REPRODUCTIVE AGED KIRATI FEMALES IN KIRAT COLONY OF BHADRAPUR MUNICIPALITY By Nabina Lawoti Department of Nutrition and Dietetics Central Campus of Technology Institute of Science and Technology Tribhuvan University, Nepal 2018 Risk factors associated with Overweight and Obesity among reproductive aged kirati females in kirat colony of Bhadrapur municipality A dissertation submitted to the Department of Nutrition and Dietetics, Central Campus of Technology, Tribhuvan University in partial fulfillment of the requirements for the Bachelor Degree in Nutrition and Dietetics by Nabina Lawoti Department of Nutrition and Dietetics Central Campus of Technology Institute of Science and Technology Tribhuvan University, Nepal June, 2018 Tribhuvan University Institute of Science and Technology Department of Nutrition and Dietetics Central Campus of Technology, Dharan Approval Letter This dissertation entitled Risk Factors Associated with Overweight and Obesity Among Reproductive Aged kirati Females in kirat colony of Bhadrapur municipality presented by Nabina Lawoti has been accepted as the partial fulfillment of the requirements for the degree of Bachelor of Science in Nutrition and Dietetics. Dissertation Committee 1. Head of the Department _______________________________ (Mr. Dambar Bdr. Khadka, Asst. Prof.) 2. External Examiner ____________________________________ (Mr. Pramod Koirala, Chief. RFTQC) 3. Supervisor ____________________________________ (Mr. Dinesh Shrestha, Teaching Asst.) 4. Internal Examiner __________________________________ (Mr. Arjun Ghimire, Asst. Pof.) Date: June, 2018 iv Acknowledgements Though only my name appears on the cover of this dissertation, many great people have helped me along the way giving me time knowledge and guidance. First of all, I would like to express my deepest sense of gratitude to my respected supervisor Mr.Dinesh Shrestha, Teaching assistant, Central Campus of technology, Dharan for his constructive guidance, encouragement and invaluable time and suggestion for this dissertation work from the very beginning to the end. I am also grateful to Dambar Bahadur Khadka, Department Head of Nutrition and Dietetics, Central Campus of Technology. I am extreamely thankful and indebted to him for sharing expertise, sincere and valuable guidance and encouragement extended to me and also for providing me with all the necessary facilities for the research. Also, I would like to thank Prof. Dr.Dhan Bahadur Karki, Campus Chief, Central Campus of Technology, for enormous support. I take this opportunity to express gratitude to all of the department faculty members, batch mates and juniors of Nutrition and dietetics for their help and support. I would also like to thank my all seniors who indirectly supported me to complete my dissertation, in particular I would like to thank Ms. Prabina Bhattarai Niraula who helped me in every possible way to finish this task. I cannot forget friends who went through hard times together, cheered me on and celebrated each accomplishment. Also I would like to acknowledge my friends, in particular, Nuna, Sarju, Bristy, Leena and Garima who were very supportive during my data collection time. I am indebted to all of the people living in Kirat colony of Bhadrapur municipality because of their enormous help and passion in providing data and support my research team during research activities. I also place on record, my sense of gratitude to one and all, who directly or indirectly have lent their hands in this venture. ______________ Date of submission: (Nabina Lawoti) v Abstract Obesity is a multifactorial disorder in which excessive body fat deposition arises when energy intake is higher than expenditure. It has become a major global public health challenge not only in developed countries but equally in developing countries like Nepal. The aim of the present work was to find out the risk factors associated with overweight and obesity in reproductive aged kirati females in Kirat Colony of Bhadrapur municipality of Jhapa District. Anthropometric measurements and basic associated factors were collected. SPSS version 20 and Microsoft excel 2010 were used for the analysis. Chi-square technique was used to assess factors associated to overweight and obesity of reproductive aged females. The analysis of the study revealed that 27.7% were overweight and 19.6% were obese according to International BMI classification, similarly it was found that 33% and 32.1% were overweight and obese according to Asian BMI classification. The mean waist circumference was found to be (87.57 ± 16.54) cm. 25.9% of kirati females were at level I risk and 44.6% were at level II risk. According to WHR ratio 67% of the respondents were abdominally obese. This study also analysed many factors associated with overweight and obesity. According to the WHO BMI cut-off the factors associated were age, parity, medication, protein intake, salt intake. Similarly for waist circumference, age, marital status, drink, medication, protein intake factors were found to be associated. Also there are many factors found to be associated with abdominal obesity (WHR) that are age, marital status, drink, medication. The dietary intake was also analysed where it was found out that 33% of respondents were having low fat diet, 48.2% were having inadequate protein, majority i.e 84.8% were having low carbohydrate diet, 92% were having inadequate energy and for calcium majority of respondents that is 74.1% were having inadequate calcium. vi Contents Approval Letter .................................................................................................................. iv Acknowledgements .............................................................................................................. v Abstract ............................................................................................................................... vi List of Tables ...................................................................................................................... xii List of Figures ................................................................................................................... xiii List of Abbreviations ........................................................................................................ xiv 1. Introduction ..................................................................................................................... 1 1.1 General introduction ................................................................................................ 1 1.2 Statement and Justification ...................................................................................... 2 1.3 Conceptual Framework............................................................................................ 4 1.4 Objective of the study .............................................................................................. 5 1.4.1 General objective ........................................................................................ 5 1.4.2 Specific objectives ...................................................................................... 5 1.5 Research questions .................................................................................................. 5 1.6 Significance of the study ......................................................................................... 5 1.7 Limitation ................................................................................................................ 6 2. Literature review ........................................................................................................ 7-28 2.1 Overweight and obesity ........................................................................................... 7 2.2 Theories on Obesity .................................................................................................. 8 2.2.1 Fat cell theory ............................................................................................. 8 2.2.2 Set point theory ......................................................................................... 8 2.2.3 Thrifty genotype theory .............................................................................. 9 2.3 Types of obesity....................................................................................................... 9 2.3.1 Based on BMI ............................................................................................. 9 2.3.1.1 Grade I ....................................................................................... 9 2.3.1.2 Grade II ................................................................................... 10 vii 2.3.1.3 Grade III .................................................................................. 10 2.3.2 Based on onset of obesity ......................................................................... 10 2.3.3 Fat storage ................................................................................................ 11 2.3.3.1 Android obesity ....................................................................... 11 2.3.3.2 Gynoid obesity .......................................................................