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Childhood overweight and obesity in Kilimanjaro- Tanzania may seem paradoxical at first. After all, this is a region combating poverty and nutritional deficiencies. However, a recent study by Mary Mosha, a THRiVE PhD fellow, is showing overweight and obesity are growing problems here. In 2017, with a PhD fellowship offer in hand and determination at heart, she set out to examine claims regarding the health conditions among primary school children. Her study is titled, ‘Understanding modifiable factors associated with childhood overweight and obesity in Tanzanian
primary schools: establishing a foundation for evidence-based obesity prevention intervention.’ As part of her PhD research, Mosha conducted a pilot study to validate self-reported physical activity by accelerometry among primary school children in Kilimanjaro. Here, she assessed children reporting accuracy on their physical activity levels, and used accelerometers as a reference method.
Accelerometers operate on the principle that they measure change in velocity over time (acceleration) enabling intensity of physical activity to be quantified. In this pilot, Mosha enrolled 51 children, aged 9-11, and each wore an accelerometer for a week. These children were supposed to remove the accelerometers when involved in water activities and when going to bed because the study did not aim to track the sleeping levels.
Instead, they would put them on in the morning when going to school and remain with them throughout the day. At the end of the seven days, data from the accelerometers was downloaded using software and physical
activity levels tracked.
“For long, people who want to assess levels of physical activity use self-reports and thus children have had to report their physical activity levels. From my pilot study, I found that self-reports were moderately relating with accelerometers,”
Mosha said in an interview.
She added that if one wants to understand physical activity as a modifiable factor, they should consider using self-reports and accelerometers if it is feasible. But for now, one can still use self-reports as a substitute for understanding physical activity levels. For the main study, Mosha employed the Socio-Ecological model of overweight and obesity which illustrates how the health and well-being of an individual is determined by multiple influences that interact at macro and micro-level environments.
“There are a lot of factors surrounding a child that may predispose him/her to being overweight or obese. So in my main study, I examined
Mosha said.
various factors associated with overweight and obesity at different influence levels such as the home, neighborhood and school environments. I focused on those areas in order to understand what could be done if we wanted to develop an intervention,”
Preliminary findings indicate that prevalence of overweight and obesity in Kilimanjaro is about 15%, an increase from 8% in 2015. This implies that childhood obesity is a growing trend in Kilimanjaro and should be given attention. Ironically, she also found thinness among some children, implying that two forms of malnutrition exist in Kilimanjaro namely: overweight/ obesity and thinness. Therefore, if someone wants to understand the nutritional status for children in Kilimanjaro, he/she has to focus on these two forms of malnutrition. Starting Out Mosha is no stranger to studies that focus on nutrition and body weight. She did a Bachelors of Home Economics and Human Nutrition at Sokoine University of Agriculture in Tanzania. Later, she pursued her first master’s degree in Public Health from the Kilimanjaro Christian Medical College (KCMUCo) and second in Nutrition for Global Health from the London School of Hygiene and Tropical Medicine (LSHTM). It’s during her second master’s
degree that she nurtured the idea of pursuing a PhD study on overweight and obesity in children. This is because she realized that it was aurgeoning problem in low and middle income countries, and Tanzania is among those.
