MILITARY MEDICINE, 179, 10:1158,2014
Factors Associated With Obesity: A Case-Control Study of Young Adult Singaporean Males CPT Haiyuan Shi, MBBS*; Bo Jiang, BSocSc, M SocScf; Joshua Dao Wei Sim, BSc*; Zhi Zhen Chum, BEng*; MAJ Noreffendy Bin Ali, MBBS, MSc*; Mun Heng Toh, BA, BSocSc, MSocSc, PhDf
ABSTRACT A case-control study among Singapore Armed Forces’ newly enlisted Servicemen was conducted to examine factors associated with male obesity. Four hundred and fifty-nine individuals from the Obese Basic Military Training program were selected as “cases” (average age: 19.5, body mass index: 30.4) and another 340 individuals were selected from the Normal Basic Military Training program as “controls” (average age: 19.3, body mass index: 21.4). Information such as family background, socioeconomic factors, and lifestyle practices were captured using facilitator-led questionnaires. Several variables were significantly associated with obesity after adjustments for possible confounders. These include childhood obesity (odds ratio [OR] = 2.06), less than an hour of exercise per day (OR = 2.97), Indian ethnicity (OR = 2.22), specific education backgrounds (especially that of Institute of Technical Education— OR = 2.75), father’s employment at nonmanagerial/professional jobs (OR = 1.52), mother’s employment at managerial/professional jobs (OR = 2.02), regular smoking (OR = 1.73) and alcohol consumption (OR = 2.26), 6 horn's or less of sleep (OR = 3.73), obesity among family members (OR = 1.86 for mother; OR = 2.98 for siblings), parental history of diabetes mellitus (OR = 2.22 for father; OR = 2.70 for mother), and eating at inexpensive local food stalls (OR = 1.82). Our study found that a number of factors, ranging from personal and family backgrounds to lifestyle choices, were significantly associated with obesity among male youths.
INTRODUCTION The rate of obesity is rising on a global scale.' It is currently considered an epidemic, and arguably the greatest prevent able health-related cause of mortality and morbidity next to cigarette smoking.2 Prevention and control strategies should be initiated early in life as obesity during childhood and adolescence strongly predicts obesity in adulthood.3-5 Fur thermore, adults who were obese during childhood have increased morbidity and mortality independent of eventual adult weight.6-8 The higher rate of rise in body mass index (BMI) and persistence of obesity into adulthood among boys4,9 calls for a more focused evaluation among this subpopulation of chil dren and adolescents. To this date, several well-designed studies have been con ducted worldwide to facilitate better understanding of obesity in the young. Some of the most widely studied aspects include socioeconomic factors and lifestyle practices that differ between races, cultures, countries, and regions. There are not many studies in Asia or Southeast Asia, such as that of He et al10 on preschool children in China, which took on a broad examination of possible risk factors associated with over weight and obesity in the younger population. Singapore is an industrialized multiethnic country in Southeast Asia, with an obesity (BMI equal or greater than 30 kg/m2) rate of 10.8% for those aged between 18 and 69." *Soldier Performance Centre, Singapore Armed Forces Medical Corps, 701 Transit Road No. 03-04 Singapore 778910. ■[Department of Strategy and Policy, National University of Singapore, 15 Kent Ridge Drive, BIZ2 Building No. 03-22, Singapore 119245. doi: 10.7205/MILMED-D-14-00064
1158
The rate of rise is notably higher among the male population, from an age-adjusted prevalence of around 6% (between 1992 and 2004) to 12.1% (2010), as opposed to that of around 7% to 9.5% among the female population, respectively. Singaporean males are mandated to serve National Ser vice after completion of postsecondary education and/or on reaching the age of 18, with the majority being drafted into the Singapore Armed Forces (SAF) as conscript sol diers. Those who are considered medically fit are grouped based on BMI and drafted into either the Normal or Obese Basic Military Training (BMT) programs. Such an artificial stratification of Singapore’s young male population allowed for a focused survey of factors that may be associated with obesity.
METHODS AND PROCEDURES Study Population All study participants were Singaporean males who were newly enlisted into the BMT School of the SAF between June 2010 and June 2011. Before commencement of training, medically fit (deter mined at pre-enlistment medical screening) recruits would be stratified based on BMIs. Classification of BMI in the SAF is aligned to that of the World Health Organization,12 with “overweight” defined as 25 kg/m2 or more. “Mildly” (BMI 25-26.9 kg/m2) overweight individuals are considered suitable for the Normal BMT program, whereas the Obese BMT program specifically selects pre-enlistees with BMI from 27 to 40 kg/m2).
MILITARY MEDICINE, Vol. 179, October 2014
Factors Associated With Obesity: Case-Control Study of Adult Singaporean Males
459 individuals from the Obese BMT program were selected as “cases” (BMI27 to
Factors Associated With Obesity: A Case-Control Study of Young Adult Singaporean Males CPT Haiyuan Shi, MBBS*; Bo Jiang, BSocSc, M SocScf; Joshua Dao Wei Sim, BSc*; Zhi Zhen Chum, BEng*; MAJ Noreffendy Bin Ali, MBBS, MSc*; Mun Heng Toh, BA, BSocSc, MSocSc, PhDf
ABSTRACT A case-control study among Singapore Armed Forces’ newly enlisted Servicemen was conducted to examine factors associated with male obesity. Four hundred and fifty-nine individuals from the Obese Basic Military Training program were selected as “cases” (average age: 19.5, body mass index: 30.4) and another 340 individuals were selected from the Normal Basic Military Training program as “controls” (average age: 19.3, body mass index: 21.4). Information such as family background, socioeconomic factors, and lifestyle practices were captured using facilitator-led questionnaires. Several variables were significantly associated with obesity after adjustments for possible confounders. These include childhood obesity (odds ratio [OR] = 2.06), less than an hour of exercise per day (OR = 2.97), Indian ethnicity (OR = 2.22), specific education backgrounds (especially that of Institute of Technical Education— OR = 2.75), father’s employment at nonmanagerial/professional jobs (OR = 1.52), mother’s employment at managerial/professional jobs (OR = 2.02), regular smoking (OR = 1.73) and alcohol consumption (OR = 2.26), 6 horn's or less of sleep (OR = 3.73), obesity among family members (OR = 1.86 for mother; OR = 2.98 for siblings), parental history of diabetes mellitus (OR = 2.22 for father; OR = 2.70 for mother), and eating at inexpensive local food stalls (OR = 1.82). Our study found that a number of factors, ranging from personal and family backgrounds to lifestyle choices, were significantly associated with obesity among male youths.
INTRODUCTION The rate of obesity is rising on a global scale.' It is currently considered an epidemic, and arguably the greatest prevent able health-related cause of mortality and morbidity next to cigarette smoking.2 Prevention and control strategies should be initiated early in life as obesity during childhood and adolescence strongly predicts obesity in adulthood.3-5 Fur thermore, adults who were obese during childhood have increased morbidity and mortality independent of eventual adult weight.6-8 The higher rate of rise in body mass index (BMI) and persistence of obesity into adulthood among boys4,9 calls for a more focused evaluation among this subpopulation of chil dren and adolescents. To this date, several well-designed studies have been con ducted worldwide to facilitate better understanding of obesity in the young. Some of the most widely studied aspects include socioeconomic factors and lifestyle practices that differ between races, cultures, countries, and regions. There are not many studies in Asia or Southeast Asia, such as that of He et al10 on preschool children in China, which took on a broad examination of possible risk factors associated with over weight and obesity in the younger population. Singapore is an industrialized multiethnic country in Southeast Asia, with an obesity (BMI equal or greater than 30 kg/m2) rate of 10.8% for those aged between 18 and 69." *Soldier Performance Centre, Singapore Armed Forces Medical Corps, 701 Transit Road No. 03-04 Singapore 778910. ■[Department of Strategy and Policy, National University of Singapore, 15 Kent Ridge Drive, BIZ2 Building No. 03-22, Singapore 119245. doi: 10.7205/MILMED-D-14-00064
1158
The rate of rise is notably higher among the male population, from an age-adjusted prevalence of around 6% (between 1992 and 2004) to 12.1% (2010), as opposed to that of around 7% to 9.5% among the female population, respectively. Singaporean males are mandated to serve National Ser vice after completion of postsecondary education and/or on reaching the age of 18, with the majority being drafted into the Singapore Armed Forces (SAF) as conscript sol diers. Those who are considered medically fit are grouped based on BMI and drafted into either the Normal or Obese Basic Military Training (BMT) programs. Such an artificial stratification of Singapore’s young male population allowed for a focused survey of factors that may be associated with obesity.
METHODS AND PROCEDURES Study Population All study participants were Singaporean males who were newly enlisted into the BMT School of the SAF between June 2010 and June 2011. Before commencement of training, medically fit (deter mined at pre-enlistment medical screening) recruits would be stratified based on BMIs. Classification of BMI in the SAF is aligned to that of the World Health Organization,12 with “overweight” defined as 25 kg/m2 or more. “Mildly” (BMI 25-26.9 kg/m2) overweight individuals are considered suitable for the Normal BMT program, whereas the Obese BMT program specifically selects pre-enlistees with BMI from 27 to 40 kg/m2).
MILITARY MEDICINE, Vol. 179, October 2014
Factors Associated With Obesity: Case-Control Study of Adult Singaporean Males
459 individuals from the Obese BMT program were selected as “cases” (BMI27 to
