Prospectus: Effects of Physical Activity on Childhood Obesity and Diabetes Type II
Problem Statement
While there is substantive evidence that childhood obesity raises the risk of the patient developing other life-threatening diseases and that physical activity intervention can help prevent obesity, the questions that still need to be addressed is, what is the link between type II diabetes, overweight or obesity, and physical activity? In their recent study, Bellou et al. (2018) assessed association between physical inactivity, being overweight, and diabetes type II. The findings of their research indicated that if an individual partly prevents obesity or engage in physical exercises, the approach will not only help reduce type II diabetes related to one of these the factors but also the cases related to the interaction of physical inactivity and obesity.
The findings imply that physical inactivity interacts with obesity to cause diabetes rather than independent effects. Bellou et al. (2018) concluded that the risks of developing diabetes type 2 tend to be higher among overweight people than those with normal body mass index and that engagement in physical activity had negligible impact on preventing diabetes type 2. Therefore, the question remains whether increasing physical activity in children with obesity can prevent diabetes type II.
Abundant studies exist in the link between childhood obesity and type II diabetes. According to Tai, Wong, and Wen (2015), childhood obesity is strongly linked to the development of type 2 diabetes. Smith and Smith (2016) hold a similar view that the prevalence of childhood obesity coincides with the increasing prevalence rate of diabetes type II diabetes. Smith and Smith (2016) examined the impacts of physical activity on childhood obesity. The study involved 25 students aged 4 to 15 who had been diagnosed with obesity. The outcomes of the research showed a positive correlation between physical activity and decreasing obesity among children.
Sahoo et al. (2015) in their recent study also explored the correlation between physical activity and obesity during childhood. The researchers used exergaming as a physical activity component in an attempt to reduce childhood obesity. The study compared the participants’ weight before and after completing the physical activity program (Sahoo et al., 2015). The findings of the research illustrated that increased physical activity led to decreasing obesity (Sahoo et al., 2015). In a related study, Li et al. (2015) explored the impact of physical activity on type II diabetes. The study engaged children aged 6-13 years who could participate in a moderate physical activity. The findings did not show a significant relationship between physical activities and type II diabetes (Li et al., 2015). However, holds a contrasting view that type 2 diabetes hinders physical activity which in turn increases risks of individual developing types 2 diabetes.
Popov et al. (2017) observational study on the effects of weight loss on the rate of childhood mortality showed that the rate of mortality decreases with obesity-related co-morbidities such as diabetes. However, Myung et al. (2019) raise a contrasting view that individuals with low BMI are more likely to consume high fats foods, be sedentary, and have lower aerobic fitness which in turn exposes them to life-threatening disorders. Moreover, most studies have examined the impact of physical activity on type II diabetes or physical activity and childhood obesity. However, little or no research explores the correlation between childhood obesity, types 2 diabetes, and physical activity among children in Wake Forest, North Carolina. The prospective study seeks to address this research gap by examining the association between childhood obesity, diabetes type 2 and physical activity.
Purpose
Diabetes and overweight have become common health issues among children (Fogel et al., 2014). There is a common concern among health professionals that these conditions expose people to other illnesses such as hypertension, liver diseases, and hypercholesterolemine hence the need to address them on time (CDC, 2018). Physical activity is a widely accepted approach to addressing obesity. However, still there are inadequate evidence-based research that link physical activity to diabetes and obesity among children particularly in Wake Forest, North Carolina. Therefore, the purpose of the prospective study is to examine whether or not physical activity is an effective remedy for obesity and diabetes among children in Wake Forest, North Carolina.
Significance of the Study
This study will uniquely address the need to examine whether or not type II diabetes, physical activity, and childhood obesity are related. The findings will guide public health care providers in designing effective physical activity interventions to decrease childhood obesity and diabetes type II among children not only in the Wake Forest area but also in other regions globally. Remarkably, there are minimal exergaming programs in the city. The results of the proposed research will guide the design of effective physical programs for reducing the prevalence of obesity and types II diabetes. Additionally, given the limited research carried out on the correlation between childhood obesity, type 2 diabetes, and physical activity in North Carolina, the proposed research will aid in setting the groundwork for possible future studies on this topic.
The findings of the proposed study will offer valuable background information for researchers interested in further exploration of this topic. The electronic exergaming intervention will encourage physical activity while taking into account lifestyle behavioral changes to decrease diabetes related to childhood obesity among low-income children. Knowledge regarding a possible association between the three can help in designing effective intervention measures for these health issues.
Background
Childhood obesity has become a major public health concern in the US. Recent research shows that nearly 12 million children in the US are obese (CDC, 2018). CDC (2018) clarifies that currently, one in every six children in the US is considered overweight. In North Carolina, the rate of childhood diabetes is on the higher end. According to Knopf (2018), 15% of children aged 2-18 years in the country are obese. Knopf’s (2018) report shows that North Carolina ranks seventh for obesity in children in the US.
Childhood obesity rates in the country began increasing in the 1980s. Knopf’s (2018) report further shows that the rates of childhood obesity in children aged 6-11 was 7% in 1980 but rose to more than 18% by 2017. Knopf (2018) clarifies that childhood obesity is high in North Carolina due to poverty, lack of access to proper nutrition and lack of physical activity.
Obesity is linked to an imbalance between the level of energy intake and expenditure. Energy use involves physical activity, basal metabolic rate, and the thermic effects of food take. Physical activity can further be broken into two sub-categories. The classes include activity-associated thermogenesis or volitional exercise and non-activity-linked exercise thermogenesis which include activities an individual performs which are not related to “sporting-like” exercise. According to Xu and Xue (2016), activity thermogenesis accounts for 15-50% of everyday energy expenditure among sedentary and active populations, respectively.
Sahoo et al. (2015) also assert that spontaneous minor physical activity undertaken during the day accounts for about 20% of the energy expenditure differences in 24 hours duration. Further important information to note is that minimal amounts of physical activity are the leading cause of accumulation of fat mass in the case of overfeeding in humans. However, further research on the causes of obesity shows that behavioral and genetic factors also play a key role in the etiology of obesity.
Research links obesity to types 2 diabetes implying that addressing obesity might lower cases of type 2 diabetes. Insulin, whose resistance is associated with diabetes, is an anabolic hormone in regards to muscle and fat. Remarkably, insulin directs the storage and use of energy in the adipocytes (Lecka‐Czernik & Rosen, 2015). In this regard, when an individual becomes insulin resistant, more amount of insulin is secreted from the pancreas beta cells. Lecka‐Czernik and Rosen (2015) assert that abnormal obesity is associated with insulin resistance and type II diabetes. Shin et al. (2017) underscore that while increased body weight lowers peripheral and hepatic insulin sensitivity, central obesity leads to fat greater impairments and subsequent insulin resistance. Furthermore, nearly 85 percent of diabetes patients fall into the type 2 group and 70 percent of the diabetics are obese, with a BMI of 30 or higher.
Shin et al. (2017) and Lecka‐Czernik and Rosen (2015) views coincide with CDC’s (2018) warns that overweight children are at a high risk of acquiring type II diabetes type among other health issues. According to the CDC (2018), obesity is linked to various health issues including liver diseases, type 2 diabetes, hypertension, and hypercholesterolemine. Others diseases that have been associated with obesity include osteoarthritis, coronary heart disease (CHD), and hypertension. Diabetes is a disease that causes glucose levels to higher than normal limits (CDC, 2018).
Various researchers, health providers, and dieticians have acknowledged the use of physical activities as an effective measure for preventing obesity not only among children but also adults. Given the link between obesity and type II diabetes, the management of obesity through physical activities should be at the forefront of research on this health issue.
Theoretical Framework
Modification geared towards increasing physical activity should focus on the limitation of sedentary time and reinforcement of physical activity. The theory of planned behavior has been widely studied in the study of exercise or physical activity hence it will be suitable for the proposed study. Rebar et al. (2016) clarify that behavioral intentions, in this case, engagement in exercise and healthy eating depend on three factors. Such constructs include the subjective norm or perceived social pressure to undertake a particular conduct, apparent behavioral control, and the subjective individual attitude, negative or positive examination of a particular behavior.
In the context of this prospective study, children, who are the target study population for this suggested study are likely to engage in physical activity if they perceive it positively or have positive attitudes towards the activity, if they believe that they will succeed in addressing the health issue through the activity, and if they feel socially pressurized to partake in the physical activity. Therefore, the theory of planned behavior is suitable for the proposed study because it helps to predict the involvement and maintenance of physical activity as an intervention for obesity and type 2 diabetes.
The study will also be based on the Transtheoretical Model. According to Romain et al. (2018), the transtheoretical model of behavior change is an integrative therapy theory which examines one’s readiness to adopt a new healthier conduct or act. The model offers processes or strategies of change to guide the target individual. The model recommends the use of a healthy lifestyle rather than weight loss in weight management.
Romain et al. (2018) applied the transtheoretical model in a cross-sectional clinic-based weight management study. The study included 150 obese children aged 5-12 years. The program ran for three months of intense intervention followed by another three months of reduced clinical contacts. The participants experienced a considerable decline in weight, BMI, percentage body fat, total caloric intake, total cholesterol, and the level of energy intake from dietary fat. Similarly, the proposed study seeks to establish whether increased physical activity can lower obesity and type II diabetes. As such, the model is appropriate for the proposed study.
Research Question(s) and Hypotheses
The study looks forward to answering the following questions;
- What is the impact of exergaming on childhood obesity
- How does exergaming affect type 2 diabetes among children?
- What is the relationship between exergaming, childhood obesity, and type 2 diabetes?
The proposed study seeks to test and approve or reject the hypothesis below:
H1: Exergaming and childhood obesity are negatively related to the extent that, increased exergaming significantly reduces childhood obesity.
H0: Exergaming and childhood obesity are not related hence an increase in Exergaming does not have a significant reduction in childhood obesity.
H1: Exergaming is positively linked to type 2 diabetes hence an increase in exergaming reduces risks of developing type 2 diabetes among children.
H0: Exergaming is not linked to type 2 diabetes hence an increase in exergaming does to reduce risks of developing type 2 diabetes among children.
Nature of the Study
The proposed study will use mixed methods approach; quantitative and qualitative research methods. Mayoh and Onwuegbuzie (2015) suggest the use of combined methods approach arguing that numerical data is essential for validating or invalidating qualitative data. Data from self-reported questionnaires will be incorporated into the study to measure the physical activity determinants and outcome expectations. The independent variables are diabetes type II and childhood obesity and the dependent variable physical activity. The study will examine how physical activity, particularly, exergaming influences the prevalence of childhood obesity and type II diabetes where a converse relationship is expected between the variables. A cohort study will be used to investigate childhood obesity and type 2diabetes, establishing the effectiveness of physical activity interventions in addressing childhood obesity and type II diabetes.
Possible Types and Sources of Data
The research will employ secondary and primary data. Bryman (2016) approves the use of the two types of the two forms of data as they complement each other hence fostering an in-depth understanding of the phenomenon under study and lead to an informed conclusion. Secondary data will be obtained from documentary review including peer-reviewed journals, health lifestyle magazines, and books. Although secondary data has been criticized for consuming time in collection and analysis, the data is available in plenty and for free (Bryman, 2016).
On the other hand, primary data will be sourced from the respondents through semi-structured interviews and questionnaire. The choice of the questionnaire was guided by Patten’s (2016) view that questionnaires help the researcher to ask similar questions to all respondents thus not only ensuring unbiased views but also making data analysis easy. On the other hand, interviews help to obtain first-hand information that might not be accessible through any other approach.
Limitations, Challenges, and/or Barriers
The proposed has some limitations. First thing, any study for a causal relationship should be carried out within various dimensional identities. That is, there is a need to understand and take into account sociological, educational, political, and economic factors which might affect information sharing among respondents involved in a particular research. Although these factors are not among key constructs that will be considered in the proposed study, it will be imperative to contextualize them by understanding practical but local ways of addressing them since they influence the correlation between variables. The other limitation is that the suggested study intents to use only one form of physical activity yet, no single activity suits all the respondents and that, different activities might have different effects on childhood obesity and type 2 diabetes. Therefore, restricting the study to one type of physical activity might adversely affect the generalizability of the results.
References
Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E. (2018). Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses. PloS One, 13(3), e0194127.
Bryman, A. (2016). Social research methods. Oxford university press.
CDC. (2018). Childhood obesity facts. Centers for Disease Control and Prevention.
Fogel, V. Miltenberger, R. Gaves, R. Koehler, S. (2014). The effects of exergaming on physical activity among inactive children in a physical education classroom. Journal of Applied Behavior Analysis, 43(4).
Knopf, T. (2018). North Carolina health news. Retrieved from https://www.northcarolinahealthnews.org/2018/03/15/22222/
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Li, R., Qu, S., Zhang, P., Chattopadhyay, S., Gregg, E. W., Albright, A., & Pronk, N. P. (2015). An economic evaluation of combined diet and physical activity promotion programs to prevent type 2 diabetes among persons at increased risk: a systematic review for the Community Preventive Services Task Force. Annals of Internal Medicine, 163(6), 452-460.
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