Noncommunicable diseases have become the main causes of death in several developing countries. There is a severe shortage of information about the risk factors for these diseases in Iraq.
Objective
To explore the eating habits, physical activity, and sedentary behaviors of adolescents in Mosul City, Iraq, as risk factors for noncommunicable diseases.
Methods
A multistage stratified sampling method was carried out on adolescents aged 15 to 18 years in Mosul City, Iraq. A pretested and validated questionnaire was used to obtain information on frequency of intake of certain foods, physical activity, and screen time (television, video, and computer). Weight and height were measured to obtain the body composition status. The total sample included 723 adolescents (350 boys and 373 girls).
Results
There were significant differences between boys and girls in most eating habits and activity behaviors. The frequency of skipping breakfast and the intakes of fruits and vegetables, french fries, and sweets and chocolates were significantly higher among girls than boys (p < .001). Boys were significantly more likely to consume fast foods, sugar-sweetened drinks, and energy drinks than girls. Boys spent more time in physical activity (p < .001) and looking at screens than girls.
Conclusions
The health authorities of Iraq should focus not only on interventions for undernutrition among adolescents, but also on behavioral risk factors for diet-related noncommunicable diseases.
GarfieldRCheng-ShuinL. A multivariate method for estimating mortality rates among children under 5 years from health and social indicators in Iraq. Int J Epidemiol2000;29:510–5.
2.
AscherioAChaseRCoteTDehaesGHoskinsELaaouejJPasseyMQaderiSShuqaidefSSmithMCZaidiS. Effect of the Gulf War on infant and child mortality in Iraq. N Engl J Med1992;13:931–6.
3.
Editorial. The deteriorating health situation in Iraq. Lancet2007;369:1834.
4.
MichaelsJ. Iraqi restaurants are trying to satisfy Western taste. USA Today, 6 November 2012.
SubhiMD. Blood pressure profiles and hypertension in Iraqi primary school children. Saudi Med J2006;27:482–6.
10.
LatlaRKKhadimMJ. Children obesity in Iraq: prevalence and possible risk factors. Ann Saudi Med2005;5:389–93.
11.
MusaigerAOMiladiS, eds. Establishing food composition data for the Near East. Bahrain: Bahrain Center for Studies and Research, 1998.
12.
CadeJEBurleyVJWarmDLThompsonRLMargettsBM. Food-frequency questionnaires: a review of their design, validation and utilization. Nutr Res Rev2004;17:5–22.
Al-Hazzaa HM, Musaiger AO; ATLS Research Group. Arab Teens Lifestyle Study (ATLS): objectives, design, methodology and implications. Diabetes Metab Syndr Obes2011;4:417–26.
15.
Al-HazzaaHMAbahussainNAl-SobayelHQahwajiDMusaigerAO. Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region. Int J Behav Nutr Phys Act2011;8:140.
16.
ColeTBellizziMFlegalKDietzW. Establishing a standard definition of child overweight and obesity worldwide: international survey. BMJ2000;320:1240–3.
17.
Al-HazzaaHMAl-AhmadiM. A self-reported questionnaire for the assessment of physical activity in youth 15–25 years: development, reliability and construct validity. Arab J Food Nutr2003;4:279–91.
18.
Al-HazzaaHMAl-SobayelHIMusaigerAO. Convergent validity of the Arab Teens Lifestyle Study (ATLS) physical activity questionnaire. Int J Environ Res Public Health2011;8:3810–20.
19.
AinsworthBEHaskellWLHerrmannSDMeckesNBassettDRJrTudor-LockeCGreerJLVezinaJWhitt-GloverMCLeonAS. 2011 compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc2011;43:1575–81.
20.
RidleyKAinsworthBOldsT. Development of a compendium of energy expenditure for youth. Int J Behav Nutr Phys Act2008;5:45.
21.
TremblayMSWarburtonDEJanssenIPatersonDHLatimerAERhodesREKhoMEHicksALeblancAGZehrLMurumetsKDugganM. New Canadian physical activity guidelines. Appl Physiol Nutr Metab2011;36:36–46, 47–58.
22.
CadeJThompsonRBurleyVWarmD. Development, validation and utilization of food frequency questionnaires—a review. Public Health Nutr2002;5:567–87.
23.
MusaigerAOBaderZAl-RoomiKD'SouzaR. Dietary and lifestyle habits amongst adolescents in Bahrain. Food Nutr Res2011; 557122-DOI: 10-3402/fnr.v55;0.7122.
24.
NHANES Food Frequency Questionnaire. National Health and Nutrition Examination Survey. Available at: www.cdc.gov/nchs/nhanes.htm. Accessed 8 December 2013.
25.
MorenoLARodriguezG. Dietary risk factors for development of childhood obesity. Curr Opin Clin Nutr Metab Care2007;10:336–41.
26.
Al-HazzaaHMAbahussainNAAl-SobayelHIQahwajiDMMusaigerAO. Physical activity, sedentary behavior and dietary habits among Saudi adolescents relative to age, gender and region. Int J Behav Nutr Phys Act2011;8:140.
27.
Bin ZaalAAMusaigerAOD'SouzaR. Dietary habits associated with obesity among adolescents in Dubai, United Arab Emirates. Nutr Hosp2009;24:437–44.
28.
SchaefflerVDöringAWinklerGKeilU. Trends in food consumption in a South German population from 1984/85 to 1989/90: results from the WHO MONICA Project Augsburg. Ann Nutr Metab1996;40:129–36.
29.
SavigeGSBallKWorsleyACrawfordD. Food intake patterns among Australian adolescents. Asia Pacific J Clin Nutr2007;16:738–46.
30.
MusaigerAO. The food dome: dietary guidelines for Arab countries. Nutr Hosp2012;27:109–15.
31.
Keski-RahkonenAKapridJRissanenAVirkkunenMRoseRJ. Breakfast skipping and health-compromising behaviours in adolescents and adults. Eur J Clin Nutr2003;57:842–53.
32.
TimlinMTPereiraMAStoryMNewmork-SztainerD. Breakfast eating and weight change in a 5-year prospective analysis of adolescents: Project EAT (Eating among Teens). Pediatrics2008;121:e638–45.
33.
MusaigerAO. Knowledge and attitudes of Bahraini adolescents toward obesity. J Consum Stud Home Econ1991;15:321–5.
34.
Terry-McElrathYMO'MalleyPMDelvaJJohnstonL. The school food environment and student BMI and food consumption: 2004 to 2007 national data. J Adolesc Health2009;45:545–56.
35.
LevinKAKirbyJ. Irregular breakfast consumption in adolescence and family environment: underlying causes by family structure. Appetite2012;59:63–70.
36.
RampersaudGC. Benefits of breakfast for children and adolescents: update and recommendations for practitioners. Am J Lifestyle Med2009;3:86–103.
37.
RossiterMDEversSEPenderAC. Adolescents' diets do not comply with 2007 Canada's food guide recommendations. Appetite2012;59:668–72.
38.
HilsenMEikemoTABereE. Healthy and unhealthy eating at lower school in Norway. Scand J Public Health2012;38(suppl)5:7–12.
39.
LockKPomerleauJCauserLAltmannDRMcKeeM. The global burden of disease attributable to low consumption of fruit and vegetables: implications for the global strategy on diet. Bull World Health Organ2005;83:100–8.
40.
HungHCJoshipuraKJJiangRHuFBHunterDSmith-WarnerSAColditzGARosnerBSpiegelmanDWillettWC. Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst2004;96:1577–84.
41.
SpenceLAGifelliCJMillerGD. The role of dairy products in healthy weight and body composition in children and adolescents. Curr Nutr Food Sci2011;7:40–9.
RosenhackR. Fast food consumption and increased calorie intake: a systematic review of a trajectory toward weight gain and obesity risk. Obes Rev2008;9:535–47.
46.
HarringtonS. The role of sugar-sweetened beverage consumption in adolescent obesity: a review of literature. J Sch Nurs2008;24:3–12.
47.
Al-SabbahHVereeckenCKolsterenPAbdeenZMaesL. Food habits and physical activity patterns among Palestinian adolescents: findings from national study of Palestinian school children (HBSC-WBG 2004). Public Health Nutr2007;10:739–46.
48.
NasreddineLMehio-SibaiAMrayatiMAdraNHwallaN. Adolescent obesity in Syria: prevalence and associated factors. Child Care Health Dev2010;36:404–13.
49.
JanssenILeBlancAG. Systematic review of health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act2010;7:40.
50.
US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta, Ga, USA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.
51.
MusaigerAO. Overweight and obesity in Eastern Mediterranean region: prevalence and possible causes. J Obes2011;2011:407237. doi: 10.1155/2011/407237.
52.
Al-NozhaMAl-HazzaaHArafahMRAl-KhadraAAl-MazrouYYAl-MaatouqMAKhanNBAl-MarzoukiKAl-HarthiSSAbdullahMAl-ShahidMS. Physical activity and inactivity among Saudi aged 30–70 years: a population-based cross-sectional study. Saudi Med J2007;28:559–68.
KelishadiRPourMHSarraf-ZadeganNSadryGHAnsariRAlikhassyHBashardoustN. Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Programme-Heart Health Promotion from Childhood. Pediatr Int2003;45:435–42.
55.
FazahAJacobCMoussaEEl-HageRYoussefHDelamarcheP. Activity, inactivity and quality of life among Lebanese adolescents. Pediatr Int2010;52:573–8.
56.
HuffmanFGVaccaroJAExebioLCZariniGGKatzTDixonZ. Television watching, diet quality and physical activity and diabetes among these ethnicities in the United States. J Environ Public Health2012; 191465. doi: 10.1155/2012/191465.
57.
VasquesCMotaMCorreiaTLopesV. Prevalence of overweight/obesity and its association with sedentary behavior in children. Rev Port Cardiol2012;31:783–8.
58.
TemblayMSLe BlancAGKhoMESaundersIJLaroucheRColleyRCGoldfieldGGorberC. Systematic review of sedentary behavior and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act2011; Sep 21, doi: 10.1186/1479-5868-8-98 8:98.
59.
Commonwealth Department of Health and Aging. Physical activity recommendations for children and young people. Canberra: Commonwealth of Australia, 2004.
60.
Fuller-TyszkiewiczMSkouterisHHardyLLHalseC. The association between TV viewing, food intake, and BMI. A prospective analysis of data from the longitudinal study of Australian children. Appetite2012;59:945–8.
61.
HardyLKingLKellyBFarrellLHowlettS. Munch and Move. Evaluation of a preschool healthy eating and movement skill program. Int J Behav Nutr Phys Act2010;7:80.
62.
HardyLDobbinsTDenney-WilsonEOkelyABoothM. Sedentariness, small-screen recreation, and fitness in youth. Am J Prev Med2009;36:120–5.
63.
Al-HazzaaHMMusaigerAOAbahussainNAAl-SobayelHIQahwajiDM. Prevalence of short sleep duration and its association with obesity among adolescents 15–19 years old: a cross-sectional study from three major cities in Saudi Arabia. Ann Thorac Med2012;7:133–9.
64.
OrtegaFBChillonPRuizJRDelgadoMAlbersUAlvarez-GrandaJLMarcosAMorenoLACastilloMJ. Sleep patterns in Spanish adolescents: associations with TV watching and leisure-time physical activity. Eur J Appl Physiol2010;110:563–73.
65.
American Academy of Pediatrics. Committee on Public Education. Children, adolescents, and television. Pediatrics2001;107:423–6.
