The Relationship between Overweight, Obesity and Academic Performance of Adolescents in a Senior High School in Accra

Abstract

Introduction: Obesity has been described as an epidemic with more than one-third of children aged of 2 to 19, said to be overweight or obese, as at 2013 (CDC). Adult obesity has been strongly linked with obesity in childhood and adolescence. It is therefore imperative to tackle this problem in the adolescent stage, to prevent entering adulthood with one of the major risk factors for Non-Communicable diseases. Known immediate consequences of obesity include self-esteem, reduced cognitive capabilities and memory functions. Academic performance has also been found to be related to cognitive and memory functions. The aim of this study therefore was to investigate the association between overweight/obesity and students academic performance in a senior high school setting. Methods: A descriptive cross sectional study was done. A mixed public school in Accra, with students belonging to families to the high and low socio-economic class, which consented to giving access to students’ end-of-term marks, was selected. A multi-stage sampling design was used to select the form (based on years spent in school) and classes (based on courses offered). A simple random sampling was then used to select a representative sample of 390 adolescents (aged 10 to 19) in the school. Pre-coded structured questionnaires were administered to obtain information on sociodemographics, genetic, dietary and general lifestyle factors. Using a standardized protocol, height (to the nearest centimetre) and weight (to the nearest kilogram) were measured. Overweight was defined as BMI more than or equal to 85th percentile but less than the 95th percentile, while obesity as more than or equal to 95th BMI percentile, using the Centre for Disease Control and Prevention Growth Charts (2000). Data on academic performance for each participant were extracted from school records and classified into Good (40%+) and Poor (<40%) grades. Data were assessed for association using Pearson’s chi-squared test and binary/multivariate logistic regression analysis after adjusting for covariates. Results: The prevalence of underweight, overweight and obesity was 9.2% (95% CI: 6.6–12.6%), 10.3% (95% CI: 7.5–13.9%) and 5.0% (95% CI: 3.2–7.8%) respectively. The risk factors associated with overweight and obesity were female gender, offering home economics, having a slim/slender best friend, eating after 8pm, engaging in less or no vigorous physical activity, friends perception of being big/very big and perceiving ones self as big/very big. These were statistically significant (P<0.001). However there was no significant association between overweight/obesity and academic performance after controlling for socio-demographic, genetic and lifestyle factors. Absenteeism was the most important predictor for poor academic performance in this study (P<0.001). Conclusion: There is no association between overweight/obesity and academic performance in the classroom setting among adolescents in Accra. Based on this finding, good academic performance cannot be used to justify measurement of success in obesity prevention initiatives. However, students can be encouraged to ignore their weight status as part of reason for their non-performance or otherwise in the senior high schools.