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THE EFFECT OF EXERCISE ON OBESE PEOPLE IN NIGERIA

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

The increasing westernization, urbanization and mechanization occurring in most countries around the world is associated with changes in the diet towards one of high fat, high energy-dense foods and a sedentary lifestyle. This shift is also associated with the current rapid changes in childhood and adult obesity. Even in many low income countries, obesity is now rapidly increasing, and often coexists in the same population with chronic undernutrition, WHO(2015).

The nutrition transition in developing countries leads to dietary intakes of micronutrient-poor, energy-dense foods, which may be important determinants of overweight/obesity and important for child development.

Overweight and obesity has reached epidemic proportions globally. Increasing prevalence of obesity, seen both in the developed and developing countries, is primarily driven by imbalanced diets and sedentary lifestyles. Sedentary lifestyle that is characterized by physical inactivity has been associated with adiposity and increased weight gain.

The World Health Organization defines overweight and obesity as follows: Overweight is a BMI greater than or equal to 25; and Obesity is a BMI greater than or equal to 30. BMI provides the most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages of adults.

Unhealthy dietary habits characterized by the consumption of fast foods, drinking of sugar sweetened beverages, low fruits and vegetables intakes contributes to the increasing trend of overweight and obesity. Snacking and fast food consumption have been identified as a contributory factor to the development of childhood overweight and obesity in Nigeria. Studies have shown that youths are particularly vulnerable to poor eating habits and are said to be in the habit of eating “junks'' Papadaki(2000). It has been shown that adolescents leaving their parents and living away from home to attend college experience numerous health-related behavioral changes, which includes adoption of unhealthy dietary habits. These adopted habits are mostly attributed to drastic changes in the environment and resources available, frequent exposure to unhealthy foods and habits.

Nutrition-related health problems such as overweight and obesity in adolescents are increasingly significant causes of disability and premature death both in developed and developing countries including Nigeria. According to World Health Organization estimates, in 2016, more than 1.9 billion adults (aged 18 years and older were overweight), of which over 650 million adults were obese. Studies have examined lifestyles (dietary habits and Physical activity) and association with nutritional status.

Purposeful weight loss continues to be the primary focus for treating obesity. Behavioral recommendations for weight loss include lifestyle modifications that reduce caloric intake from diet and increase caloric output with increased physical activity. However, this strategy appears to be inadequate as obesity rates continue to rise and the myriad of benefits of physical activity that affect multiple health outcomes related to obesity and associated comorbidities are not integrated into treatment strategies.

Independent of weight loss or changes in body mass index (BMI), there are emerging co relational data in individuals with obesity that demonstrate physical activity can be beneficial to many critical health markers, Gaesser(2021).

Epidemiological studies noted specific relationships between physical activity and health outcomes that include increased cardio respiratory and muscle fitness, Barry(2014) as well as decreased risk of all cause mortality and cardiovascular disease. In a prospective epidemiological study, metabolically healthy but obese individuals had a lower risk of all-cause mortality, non-fatal and fatal cardiovascular disease and cancer mortality than their metabolically unhealthy obese peers, while no significant differences were observed between metabolically healthy but obese and metabolically healthy normal-fat individuals Ortega(2013) Furthermore, data indicate that physical activity can improve other markers of health in normal-weight and overweight individuals, such as overall quality of life, brain health, cognition, memory, sleep, and anxiety Gordon(2017). Yet, there are limited intervention studies specifically examining individuals with obesity that investigate health markers independent of weight loss as primary outcomes. This is a major gap in the literature, and there have been recent calls to characterize outcomes in people with obesity, particularly in obesity subtypes, Mayoral(2020).

By not investigating the benefits of physical activity independent of weight loss, there is a missed opportunity to enhance the physical and mental health of individuals with obesity, perhaps even leading to incorrect courses of treatment by exclusively recommending pounds of weight lost as the primary outcome. This systematic review was designed to examine interventions with outcomes related to the effects of physical activity on health markers, independent of weight loss, in individuals with obesity. The intention was to highlight potential gaps in the literature and to understand which health outcomes are causally affected by physical activity in this understudied population. Based upon the evidence available, we identified four specific physical activity outcomes that affect individuals with obesity, independent of weight loss and include cellular, metabolic (i.e., fuel utilization), systemic (i.e., cardiovascular) and brain health outcomes.

1.2 STATEMENT OF THE PROBLEM

Despite the well-documented health benefits of exercise interventions for individuals with obesity, there remains a need to further investigate the specific effects of different exercise modalities on various health outcomes, particularly in populations living in low socioeconomic communities. Existing literature suggests that exercise training may positively impact sleep quality, depressive symptoms, metabolic health, and overall quality of life in individuals with obesity. However, there is still a lack of comprehensive understanding regarding the optimal exercise strategies and their mechanisms of action in addressing these health concerns, especially within specific demographic groups such as women. Therefore, this study aims to evaluate the effects of structured exercise programs on sleep quality, depressive symptoms, metabolic parameters, and overall quality of life in women with obesity residing in low socioeconomic communities in Nigeria.

1.3 OBJECTIVES OF THE STUDY

The main objective of this study is to determine the effect of exercise on obese people in Nigeria.

Specific objectives include;

1. To investigate the impact of structured exercise programs on weight loss among obese individuals in Nigeria.

2. To assess the correlation between exercise frequency and changes in body mass index (BMI) among obese individuals in Nigeria.

3. To examine the psychological effects of exercise on motivation and adherence to weight loss efforts among obese individuals in Nigeria.

1.4 RESEARCH QUESTIONS

1. How does participation in structured exercise programs influence weight loss among obese individuals in Nigeria?

2. What is the relationship between the frequency of exercise and changes in BMI among obese individuals in Nigeria?

3. What are the psychological factors influencing motivation and adherence to exercise among obese individuals in Nigeria?

1.5 RESEARCH HYPOTHESES

H1: Participation in structured exercise programs will lead to significant weight loss among obese individuals in Nigeria.

H2: There is a positive correlation between the frequency of exercise and changes in BMI among obese individuals in Nigeria.

H3: Psychological factors such as motivation and adherence to exercise will mediate the relationship between participation in exercise programs and weight loss among obese individuals in Nigeria.

1.6 SIGNIFICANCE OF THE STUDY

The significance of this study lies in its potential to contribute valuable insights into the effectiveness of exercise interventions for improving health outcomes in women with obesity living in low socioeconomic communities. By examining the impact of structured exercise programs on sleep quality, depressive symptoms, metabolic health, and overall quality of life, this research addresses important gaps in the existing literature. The findings from this study can inform the development of targeted and culturally sensitive exercise interventions tailored to the specific needs of this demographic group, ultimately promoting better health outcomes and enhancing the overall well-being of women with obesity in Nigeria and similar settings.

1.7 SCOPE OF THE STUDY

This study focuses on evaluating the effects of structured exercise programs on sleep quality,depressive symptoms, metabolic parameters, and overall quality of life in women with obesity residing in low socioeconomic communities in Nigeria. The research will employ a quantitative approach to assess the impact of exercise interventions over a specific timeframe. The study will involve participant recruitment, intervention implementation, data collection, and analysis to determine the outcomes of interest. While the scope of the study is limited to women with obesity in low socioeconomic communities, the findings may have broader implications for informing public health interventions and policies aimed at addressing obesity and related health concerns in similar populations globally.

1.8 LIMITATIONS OF THE STUDY

Limitations of the study include the potential for selection bias due to the recruitment of participants from specific low socioeconomic communities in Nigeria, limiting the generalizability of the findings to broader populations. The study's reliance on self-reported measures of sleep quality, depressive symptoms, and physical activity may introduce response bias and inaccuracies. Additionally, the relatively short duration of the intervention period may not capture long-term effects of exercise on health outcomes. The lack of control over extraneous variables such as dietary habits and medication use could confound the results. Finally, the small sample size may limit the statistical power and robustness of the findings.

1.9 DEFINITION OF TERMS

1. Exercise: Physical activity that is planned, structured, and repetitive for the purpose of conditioning the body and improving health and fitness.

2. Obesity: A medical condition characterized by excess body fat accumulation to the extent that it may have adverse effects on health, leading to increased risk of various diseases and health conditions.

3. Structured Exercise Program: A systematic and organized regimen of physical activities designed to achieve specific health or fitness goals, typically involving a combination of aerobic, strength training, and flexibility exercises.

4. Body Mass Index (BMI): A measure of body fat based on height and weight that applies to adult men and women, used as a screening tool to identify individuals who are underweight, normal weight, overweight, or obese.

5. Weight Loss: The reduction of body weight, typically achieved through a combination of dietary changes, increased physical activity, and behavior modification.

6. Motivation: The psychological process that drives behavior towards a specific goal, such as participating in exercise programs or achieving weight loss objectives.

7. Adherence: The extent to which individuals follow prescribed recommendations or instructions, such as sticking to a structured exercise program or dietary regimen.

8. Psychological Effects: The impact of exercise and weight loss interventions on mental and emotional well-being, including factors such as self-esteem, mood, and stress levels. 

9. Nigeria: A country located in West Africa, with a diverse population and varying socioeconomic conditions, serving as the geographical context for the study.

10. Correlation: A statistical measure indicating the extent to which two variables change together, often assessed in relation to exercise frequency and changes in BMI among obese individuals in Nigeria.

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