Altarrah, Danah Khalid; (2018) Preschool Obesity in the United Arab Emirates: Determinants and Effectiveness of the Ten Step Healthy Lifestyle Tool for Toddlers: Eat Right Emirates Study. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Childhood obesity has reached epidemic proportions globally, and poses a considerable burden on a child’s short- and long-term health. Most obesity presents in the early (preschool) years, and once established tracks into later life. Therefore, identification of risk factors in the preschool period is considered critical for prevention of long-term obesity. In the United Arab Emirate (UAE), the rising prevalence of childhood obesity is of great public health concern. However, no previous study has explored risk factors for obesity in preschool children. This PhD aimed to: (i) identify risk factors for preschool obesity in the UAE (Study 1); (ii) describe dietary intake and patterns of preschool children, and explore their associations with risk of obesity (Study 2); and (iii) in a randomised controlled trial investigate the effectiveness of the ‘Eat Right Emirates’ (ERE) tool, a simple leaflet intervention designed to encourage a healthy lifestyle and prevent preschool obesity (Study 3). Study 1 showed that a longer duration of breastfeeding, and later introduction of complementary foods were associated with lower BMI z-score. Study 2 found that, compared with UK dietary guidelines, preschool children in the UAE exceeded intakes of protein, but did not meet recommended intakes for fibre. A high carbohydrate intake as a percentage of energy was associated with lower BMI z-score, whereas a high fat intake was associated with higher BMI z-score. A priori derived diet score found diets of preschool children were suboptimal, and principal component analysis identified three dietary patterns (‘traditional/health-conscious’, ‘processed/western’ and ‘convenience/snack’), which were not associated with BMI z-score. Study 3 found that the ERE tool was effective in reducing obesity risk compared to controls at 6-month follow-up. These findings, and the high compliance rate, suggest that the simple intervention is a promising approach for prevention of obesity in the UAE.

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