2

and bone disorder. Obesity may affect liver causing fatty degeneration of liver. Many

superstitions that people believed are false, since they contradict to bodily health intake

and needs.

The public is always hearing about various different miracle diets, like the Atkins

diet. Most people suggest the basic outline of the Atkins diet where you can eat

anything you want just stay away from carbohydrates like bread, rice or pasta. Most

don’t know that without bread, rice, pasta and other carbohydrates you tend to lose the

nutrients that can only come in those foods and while you may have lost the weight, you

may have caused another disease to happen (Ramirez 2016). These types of

superstitions make people more confused about the truth in prevention of obesity. And

that is our main purpose, to investigate the factors of obesity for them to figure out the

cuts they should do. Tackling childhood obesity will require a many-pronged approach.

The good news is that the causes of the increase in obesity are environmental, which

means they can be changed. Ensuring that children's natural inclination to be active is

not thwarted should be a high priority. Where parents can't or won't make sure their

children get enough exercise, schools will have to. If they are already significantly

overweight, restricting children's food consumption may be necessary. But routinely

putting all children on a low-fat diet should not be.

At young age, children must be healthy for they need it as they grow. But their

health must also be monitored. They should not become obese for it has consequences

when they become adults. It can harm their lives so while they are at early age, they

should pay attention on practicing healthy lifestyle. As they learn on how to discipline

their selves, they will be doing it as they grow.

 3

Data about obese children are collected worldwide periodically. And these data

shows huge increase in obesity rate throughout the world, most of which occurred in the

21st century. Either caused by heredity or uncontrolled eating, it is a fact that obesity has

increased its rate throughout the years. Childhood obesity is one of the most serious

public health challenges of the 21st century. The prevalence has increased at an

alarming rate. Globally, in 2013 the number of overweight and obese children under the

age of five is estimated to be over 42 million. 31 million of these are living in developing

countries. On the other hand, the number of overweight or obese infants and young

children (aged 0 to 5 years) increased from 32 million globally in 1990 to 42 million in

2013(Andersen 2010). The vast majority of overweight or obese children live in

developing countries, where the rate of increase has been more than 30% higher than

that of developed countries. If current trends continue the number of overweight or

obese infants and young children globally will increase to 70 million by 2025.Without

intervention, obese infants and young children will likely continue to be obese during

childhood, adolescence and adulthood (Evans 2013).In 2014, an estimated 41 million

children under the age of 5 years were overweight or obese. Once considered a high-

income country problem, overweight and obesity are now on the rise in low- and middle-

income countries, particularly in urban settings.

Philippines, on the other hand, also share the same predicament. There’s quite a

bit of diversity from region to region in Asia, however. Although child hunger is one of

the most targeted problems, the rate of obesity can be observed to increase as well.

Overall in Asia, excluding Japan, nearly 5 percent of preschoolers were estimated to be

overweight or obese in 2010, a 53 percent increase in prevalence since 1990. That

 4

translates into 17.7 million Asian preschoolers being overweight or obese.

Around the world the prevalence of obesity among children and adolescents has

increased substantially over the last decade. The Philippines is not spared from this

scenario, and results of national nutrition surveys are showing slow but increasing

childhood overweight and obesity rates. The 8th National Nutrition Survey reveals that

the prevalence of overweight among children 0-5 years old has significantly risen from 1

percent in 1989 to 5 percent in 2013. Similarly, prevalence of overweight among

children 5-10 years old has also risen from 5.8 percent in 2003 to 9.1 percent in 2013.

Philippines and India are among the developing countries with high-levels of obesity

and under-nutrition (UN-FAO). The prevalence among children is fast, doubling from six

percent to twelve percent over the same period. For children aged five to ten, the

prevalence of obesity and overweight was higher than 5.8 percent in 2003 but it went

down to five percent in 2013. The prevalence of obese Filipino children is expected to

increase significantly by 2016.

Obesity can also be observed locally. For instance, here in Daet, Camarines Norte,

certain children can be observed being obese based on their appearance. Various

Barangay Health Centers conducts a regular health check on children. For instance, in

Barangay Mantagbac, 8 children had been found out to be obese. In Barangay

Camambugan, as of March 2016, 12 had been identified as obese. Barangay Ilaod also

shares the same predicament, holding 5 obese children. These data only show that

many obese children truly are in our community, and that they are facing something

more severe than just obesity itself.

 5

There is little hard proof, but there are many theories about the factors that might have

driven down obesity rates in young children. More women are breast-feeding, which can

lead to healthier infant weights. Children are consuming fewer sugary beverages. Many

child care centers have promoted healthier foods and more physical activity. There is no

simple solution to the obesity epidemic. People need to make better choices, but we

also have to change those choices in our schools, in our child-care settings, in our work

sites, and in our communities (Preventive actions are necessary for this type of

disorder. Obesity rates are increasing truly at an alarming rate, and as a result, more

children will suffer from cardiovascular diseases once they have reach adulthood ages.

Therefore it would be necessary for everyone to be aware of this situation and help kids

combat this condition. It is locally observed that obese children can be seen in our

streets in Daet. The findings of this study will benefit everyone to be informed about the

primary factors of obesity on which, they must help children avoid.

In this study, the proponents aim to target the primary and most common factors

of how and why a child is obese. It is a fact that obesity puts children at a higher risk for

developing certain medical problems later in life. And as mentioned earlier, extra

pounds can also lead to poor self-esteem and depression. Improving the health of

children is one responsibility among many in the fight against poverty and poor lifestyle.

Childhood obesity can affect children’s health for the rest if their lives if no actions are

done immediately. It is directly associated with adult obesity, itself associated with many

health problems. A good understanding of the causes and consequences of this

problem is necessary in order to take preventive action. This study will not only assess

and figure out the primary factors, but will also seek solutions in avoiding obesity. The
 6

findings of this study will redound to the benefit of society considering that obesity is a

very critical prevalence worldwide. This study will apprehend not only for the obese

children, but also those whom seek care for their body, since the purpose of this

research is to seek the primary factors of obesity in children, which is also applicable for

adults.

Statement of the Problem

The main objective of this study is to determine the Eating practices of obese

children.

Specifically, this study sought to answer the following questions:

1. What is the profile characteristics of the respondents in terms of:

a. Age

b. Gender

c. Weight

d. Height

e. Arm Circumference

f. Waist Circumference

2. What are the factors that result to obesity among children in relation to:

a. Daily activities

b. Food intake

c. Eating practices

3. What family center dietary practices based on the findings may be recommended
 7

to prevent obesity among children?

Assumption

1. The profile of the respondents varies.

2. There are factors that result to obesity among children in relation to daily

activities, food in-take and eating practices.

3. There are recommendations that may be suggested based on the findings of the

study to control the increase of obesity among children.

Significance of the Study

The findings of this study will redound to benefit the following:

Children.This research will give sufficient information in order for them to increase their

awareness about the certain issue. The findings will help them to be cognizant in

accordance to the disadvantages of obesity and will encourage them to take necessary

actions to improve their health status in order to battle obesity.

Mother.The findings of this study will help contribute in giving sample information for

them to use as a guide to properly raise their children in a normal state of body

composition. It will give knowledge on how to raise children properly and discipline

them in relation to a proper food intake control.

Family.The findings of this study help to give information that can be used to make the

children to be physically fit for becoming adult. And also encourage their children to
 8

improve their health and their lifestyle. Such changes include eating more healthily and

doing plenty of physical activity to become an active member of the family.

Community.Theresults if this investigation will help the community to be apprehended

about the imperative factors of obesity in order for to take to take preventive actions.

The findings of this research will also help in giving them information in order for them to

be a less obese community.

Rural health unit.Findings of this study will enable the local government to acquire on

in-depth understanding about the primary factors of obesity among children. It will also

serve as their basis on how to prevent obesity among children. Rural communities can

develop programs and services that help rural residents learn about and adopt healthy

habits to control obesity.

Future researcher.It will serve as a guide and will give background information to the

future researchers. It will provide a unique opportunity to follow interest in an area of

research and make an important contribution to the development of chosen research

area. It helps in motivating future researcher on conducting their own research.

Scope and Delimitation

This research was administered to identify and discern the Eating Practices of

Filipino Obese children. This study limited its coverage on to five barangays. This was

administered from January 2017 to February 2017 in selected barangays in Daet,

Camarines Norte, such as Barangay Ilaod, Mantagbac, Pasig, Salcedo and Magang.
 9

There wasa total enumeration of respondents t observed and interviewed for this

study. All were children of ages 2 to 7 years of age. The respondents observed were the

children. The person who answered the questionnaire was the child and parent of the

child. Therespondents are those specifically considered to be obese in terms of their

Body Mass Index (BMI). Educational background and other variables are not to be

considered as criteria of obesity. The data gathering tools were mainly a checklist/

questionnaire and picture questionnaire with the aid of interview guide. These were

used to enhance the assessment guide for the respondents. Descriptive statistics

specifically weighted mean, frequency counts and percentage technique are the

statistical tool used in the analysis and interpretation of data, with unbiased inference.

DEFINITION OF TERMS

For the purpose of clarification, the following terms are hereby defined based on

conceptual and operational resources:

Arm circumference.As stated in Free Dictionary, it is the measurement of the

circumference of the arm at a midpoint between the tip of the acromial process of the

scapula and the olecranon process of ulna. It is an indication of upper arm muscle

wasting. In the study, it has the same denotation.

Daily activities.As specified in Merriam Webster, these are the activities that are

happening, done, made, or existing every day; are routine activities that people tend do

every day without needing assistance. In the study, it has the same meaning.
 10

Eating practices.In accordance with Collins dictionary, it is the way a person or

group eats, considered in terms of what types of food are eaten, in what quantities;

refers to why and how people eat, which foods they eat, and with whom they eat, as

well as the ways people obtain, store, use, and discard food.In the study, it has the

same rendition.

Food intake.In line with Merriam Webster, it is the amount of food that is taken into

your body; it is the ingestion of any substance consisting of carbohydrates, proteins,

fats, vitamins and minerals. The intake of food is very important as it provides energy,

promotes growth and maintains life of an individual. The actual food intake is the

amount of food that you actually consume. In the study, it has the same description.

Obesity.Based on Merriam Webster, it is a condition characterized by the excessive

accumulation and storage of fat in the body; is a medical condition in which excess body

fat has accumulated to the extent that it may have a negative effect on health.In the

study, it has the same implication.

Primary factors.In accordance to the definition of westcoastpeaks.com, it is known

term among mountain enthusiasts. In short, it represents the vertical drop between one

mountain and a higher mountain. In the study, it is defined as the primary cause of

certain subject.

Waistcircumference.On the authority ofMerriam Webster,it is the middle part of your

body between the hips and chest or upper back that is usually narrower than the areas

above and below it. In the study, it has the same interpretation. As being stated in free

dictionary, a measurement that has been shown to be a valid index identifying people
 11

who need weight management if they are to avoid a significance risk of heart attacks.

Notes

Andersen F. (March 2010) Charts and tables: WHO child growth standards for

children aged under 5 years retrieved on June 2016 from

http://www.who.int/childgrowth/standards/weight_for_height/en/

Evans P. (2013) Rising Rates of Global Obesity Revealed in New Report

retrieved on March 21, 2016 from http://www.aljazeera.com/news/2016/04/rising-rates-

global-obesity-revealed-report-160401050929417.html

Torres T. (2014) “PHL Leads Countries with High Obesity Levels” retrieved from

http://www.philstar.com/headlines/2014/10/20/1382165/phl-leads-countries-highest-

obesity-levels

Ramirez R. (2016) “Number of obese, overweight Pinoys increasing” retrieved from

 12

http://www.philstar.com/headlines/2015/07/02/1472373/number-obese-overweight-pinoys-

increasing

Paul R. (2011) Childhood Obesity: A Global Public Health Crisis retrieved on January

2013 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278864/

Chapter II

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter deals with related literature and studies relevant to the study,

synthesis of the art, theoretical framework, conceptual framework, and definition of

terms. Those that were included in this chapter helps in familiarizing information that are

relevant and similar to the present study.

Related Literature

The review of related literature tackled the topics taken from 23 authors and

references. There were a total of 5 topics, which includes various definitions of obesity,

global on concerns of obesity, causes of obesity, and health risks of obesity.

 13

Obesity, or the accumulation of too much fat in the person’s body, has grown into

a problem of metric portions, as stated by Van der Merwe (2012). Although the disease

was red flagged as an epidemic, obesity is still mainly considered as a superficial and

aesthetic disease.Overweight and obesity are not new problems, and they are not local

problems. It used to be a neglected problem, paradoxically co-existing with under-

nutrition. This health problem continues to escalate worldwide and have brought

“Globesity” concerns. Obesity is a complex condition with serious social and

psychological dimensions that affect virtually all ages and socio-economic groups,

which continue to threaten developed, developing, and under developed countries. To

date, there are about 300 million individuals who are possibly affected with this health

problem. This health problem is an inter-play of lifestyle, heredity and some diseases

conditions; luckily, there is one modifiable risk factor- lifestyle (Sumpio 2011).According

to Sy (2013), Obesity is a disorder in which the human body is at least 20 percent over

the normal body weight. Obesity always involves a high proportion of body fat in relation

to muscle and bone. The body needs food as a source of energy to maintain body

temperature and to fuel chemical and physical functions.

Body mass index (BMI) is one way to measure if a certain person is obese. As

stated by Adams (2010), there are some other reasons as to why children gain weight

like genetic problems or certain medications. A BMI of greater than 25kg/m2 is defined

asoverweight and a BMI of greater than 30kg/m2 is defined as obese.Health economist

Finkelstein (2011) points out that obesity is now a lifestyle choice. Obesity is a natural

extension of an advancing economy. As you become a First World economy and you

get these labor-saving devices and low-cost, easily accessible foods, people are going
 14

to eat more and exercise less. Finkelstein even stated that knowing that the population

in Third World countries is aware of their situation, it’s easy for them to

schadenfreude(German for ‘enjoyment obtained from the trouble of others’)

Obesity has become so increasingly common that is already considered a global

epidemic by the World Health Organization; and the problem is not limited to first world

countries alone. In the Philippines for example, a considerable percentage of the

population is overweight. Particularly alarming is the growing number of children who

are overweight (Gonzales 2012). Studies show that children who are fat when they are

between 11 years old frequently carry the condition to adulthood. If present trends

continue, today’s generation will be the first to have a lifespan that is shorter than their

parents because overweight children are –as you expect- susceptible to a myriad of

health problems. Stovitz (2010) stated that Childhood obesity is a major risk factor for

adult obesity, and obese children tend to be taller than their normal-weight peers.

Childhood obesity is a serious medical condition that affects children and adolescents.

Children who are obese are above the normal weight for their age and height.

Based on Tounian (2014), severely obese children, who have a body mass index

(BMI) three times or more than average children of the same age, have early

abnormalities in their arteries.Children eat more ravenously than other youngsters do

and are less able to compensate by eating sparingly the rest of the day (Haney 2011). A

thin line exists between cute and chubby, and fat and dangerously unhealthy (Pujalte

1013). Add to this fact that, when it comes to the parents, most think that their obese

children are just simply cute and chubby. As specified by Gallen (2014), the problem

has also been linked to the lack of exercise, standardization of meals, and the bad
 15

example given by parents themselves.

But, what does make a child obese? Certain resources suggest various factors.

Eduward (2015) suggests that in general, it is simply the result of too much intake of

fatty foods coupled with sedentary living over a long period of time. Children need extra

nutrients and calories because they are still growing physically. Nevertheless, if they

consume more calories than they require for their daily activities and normal physical

growth and development, they become overweight to obese. There are several risk

factors that work in concert to bring about obesity in children, the more important are: 1)

a diet that is high-calorie and high-fat, the sort that children who regularly eat in fast

foods, or are fond of drinking soft drinks or eating candy, ice cream and desserts get; 2)

a sedentary lifestyle that is typified by long periods of watching television, playing

computer games, and surfing the Internet; 3) a family history of obesity; and, 4)

psychological and social factors such as emotional stress for which overeating is

sometimes used as a coping mechanism.

Supported by the statement of Que (2015), some causes of obesity are 1) waist

circumference which is an indicator of central obesity; 2) blood chemistry values: fasting

blood sugar level, cholesterol, blood pressure; 3) body composition: body fat

percentage, bone mass, visceral fat, muscle mass; 4) family history of diseases; 5)

Lifestyle: eating, exercise and coping or behavior patterns; 6) age and gender; and, 7)

smoking alcohol and substance abuse Hope (2012) elaborated that eating too quickly –

and until absolutely full – may be a huge significant factor in the obesity epidemic. The

joint impact of eating fast and until full overrides signals in the brain which would

normally encourage a little more self control.

 16

According to Craig (2009), arm circumference (MUAC) is an easy, quick and

inexpensive field measure most commonly used tool for obesity, or its use in older

children and adolescents.

According to the statement of Winfield (2009), most kids at a very young age,

eats omelets, eggs, hotdogs, and bacons during breakfast. On the contrary, very few

children eat meats and bacons and ham. The parents however, elaborated that they do

not feed their children bacons and ham due to it being unaffordable.

An article on a magazine elaborated by Manoli (2015) stated that bad nutrition

and too little physical activity are often to be blamed to obesity. A recent study by the

National Heart, Lung and Blood Institute (NHLBI 2012) found that approximately one

third of the total daily calories consumed by the children in the study came from snack

foods, desserts, and pizza. There is a void in getting critical information out to parents

on how they can be role models for their children. They can begin to turn the tide (of

childhood obesity). Parents need to make this happen.

Strowmann (2011) on the other hand elaborated that one of the reasons a child

is obese is due to the greater availability of high-energy-dense foods and sugar

sweetened beverages. The effect of chocolate in body weight is truly breathtaking. A

concern is that excessive consumption if chocolate may promote high calorie intake and

weight gain, a risk factor for many diseases, including cardiovascular diseases.

Community environment is another cause for child obesity. American society has

become characterized by environments that promote increased consumption of less

healthy food and physical inactivity. It can be difficult for children to make healthy food
 17

choices and get enough physical activity when they are exposed to environments in

their home, child care center, school, or community that are influenced by 1) advertising

of less healthy foods; 2) variation of licensure regulations among child care centers; 3)

no safe appealing place, in many countries, to play or be active; 4) limited access to

healthy affordable foods; 5) greater availability of high-energy-dense foods and sugar

sweetened beverages; 6) increasing portion sizes; and, 7) lack of breastfeeding

support (Strowmann 2011)

But food intake and daily activities are not the only suggested factors of obesity.

According to Humml (2012), genes affect weight more than environment and upbringing

or so it seems too many people, especially if they are fat. In a pioneering study of more

than 500 adopted children in 2011, US psychiatrist Albert Stunkard found that their

weight correlated to that of their biological, not adoptive parents. Clearly, the genes fat-

storing capacity has been selected by evolution for physically active people facing

periods of going without food. So office workers who constantly snack are often

overweight.

The statement if key informant 4 show significance to the claim of Faghriet. al

(2015) whereas less physical activities may lead to obesity. Sedentary lifestyle

compounded with lack of physical activity causes significant decline in muscle integrity

and increase in body fat which may lead to obesity.

Health economist Finkelstein (2011) points out that obesity is now a lifestyle

choice. Obesity is a natural extension of an advancing economy. As you become a First

World economy and you get these labor-saving devices and low-cost, easily accessible
 18

foods, people are going to eat more and exercise less.

The increase in childhood obesity is attributable to an increasingly sedentary

lifestyle and poor nutrition (Galson 2008). Sedentary behavior such as television

viewing, computer use, and video game playing often replace vigorous physical activity

in children. The youth’s lack of physical activity may be addressed as the cause of

obesity. Warner (2013) suggests that overeating is directly linked to obesity; she defined

obesity as the occurrence when a person consumes, over the long term, more food than

a person actually needs to maintain a good health.

Hewitt (2011) pointed out that hormonal imbalance makes the body feel hungrier.

Leptin is the hormone that contributes to this manner. It is protein made and released by

the fat cells of the body. It circulates in the bloodstream, goes to the hypothalamus, and

tells the body whether it has enough energy stored in the fat cells. Harvey (2012)

supports this claim, stating that most of the obese people feel this way, and it is the

reason why they always get easily hungry, thus maintained to be obese. As revealed by

George Mateljan (2011), pumpkin is a very strong source of other key antioxidant

nutrients, including the carotenoids lutein and zeaxanthin. about 85-90% of the total

calories in squashes (as a group) come from carbohydrate, and about half of this

carbohydrate is starch-like in composition and composed of polysaccharides.

But gene’s influence on weight, though considerable, is not total (Pudel 2015).

Environmental factors are also important. And people can shape to a degree. Part of

this is just a genetic predisposition. The rate at which food is metabolized depends on

one’s genetic make-up. Some overweight/obese people have defective melanocortin-4

 19

receptor, which means their brains receive messages from leptin, the appetite-blunting

hormone, poorly or not at all. Other overweight and obese people, though very few,

have a defective gene for leptin. Released by the body’s fat cells, leptin plays a major

role in obesity in any case. The more fat cells a person has, the more leptin the cells

release. But the body develops resistance to the excessive amounts of the hormone,

and does not react normally to it. For example, the hormone doesn’t bind to the receptor

as well, or the message is passed on in a weekend form. So the urge to eat is not

curbed; a vicious circle that is hard to break.

Humml (2012) stated that genes affect weight more than environment and

upbringing or so it seems too many people, especially if they are fat. In a pioneering

study of more than 500 adopted children in 2011, US psychiatrist Albert Stunkard found

that their weight correlated to that of their biological, not adoptive parents. Clearly, the

genes fat-storing capacity has been selected by evolution for physically active people

facing periods of going without food.

Hereditary traits are always passed down from generations to generations. And

just like obesity, it can be inherited. Genes of an obese parent can be a cause of obesity

for the children. However, the Harvard School of Public Health (HSPC) notes that the

variation in how people’s weight responds to the same environment suggests that

genes do play a role in the development of obesity. However, the genetic predisposition

if obesity can be counteracted by leading healthy lifestyle.

Another study does support this claim. Future genetic tests may help guide

eating and prevent obesity to spread at such enormous rate (Schurmann, Meyerhof et
 20

al. 2015). It is quite possible that doctors in several decades, on the basis of genetic

profiles, will be able to give people specific advice on eating behavior. You can eat more

intelligently when you know what your personal risks are.

Parents are the ones to be blamed for children’s obesity. Parents, not fast-foods

restaurants, are most responsible for the rise of obesity in children, a survey said.

Obesity among children has become a high profile (Dorfman 2013). Schools are also

being pressured to remove vending machines carrying sugar-laden sodas and fat-filled

snacks. In the United States, 61 percent of adults aged 20 to 74 and about a quarter

children are considered overweight or obese.

More than three out of four households said schools should adopt new policies to

address child obesity. Forty-one percent called for an outright ban on the sale or

consumption of unhealthy foods and beverages in schools, while 38 percent said they

should not be sold but that students should be allowed to bring them. Even when

allowed to name more than one culprit for childhood obesity, parents took the bulk to

blame, with 86 percent of households saying that parents or guardians have at least

some responsibility, while fast food restaurants were named 60 percent of the time.

Manufacturers came in at the bottom of the list, named by only 18 percent of

households. Ninety percent of those surveyed were either very concerned or somewhat

concerned with child obesity.

Key informant 8 shows common intake of hotdogs. And in accordance to the

statement of Carrie (2015), hotdogs are one of the most common processed foods

eaten globally. The bad thing about processed foods, however, is that they tend to be
 21

high in sodium, bad sugars, carbohydrates, and fats. Processed foods are also low in

dietary fiber, vitamins, and minerals. When it comes to carbohydrates, it is the simple

ones that a child must avoid, as they can be very starchy and problematic. A child who

ate foods with simple carbohydrates, like potato chips and hotdogs, had an average

yearly increase of about two pounds. A person who ate high-starchy foods, and

neglected physical activity gains a huge amount of body mass.

BistroMD (2015) said that those who slept for less than six hours per night, or

more than eight, experienced an increase in weight gain. Oversleeping or not getting

enough rest can have a big impact on weight. This is especially true when it comes to

abdominal fat retention.

Medical condition is also another factor suggested by Pudel (2015). Though not

common, there are certain genetic diseases and hormonal disorders that can

predispose a child to obesity, such as hyperthyroidism, (when the thyroid gland, located

in the neck just below the voice box, is underactive and does not release enough of the

hormones that contrl metabolism), Prader-Will syndrome (a genetic disorder affecting

the part of the brain that controls feelings of hunger) and Crushing’s syndrome (a

disorder in which your body is exposed too much of the hormone cortisol from

overproduction in the adrenal glands or use of medications such as those for asthma).

Another factor suggested by Rohrer (2014) is that big families add to higher risk

of obesity. Cheaper food, lack of exercise, and the increasing “couch potato” culture in

western nations have been blamed for a rising number of people becoming overweight

or obese. Due to the adaptive nature of the human body, its tendency is to adapt to the
 22

environment around him, thus, having an obese environment with very few physical

activities, may result in gaining more weight.

Eduward (2015) suggests that in general, it is simply the result of too much

intake of fatty foods coupled with sedentary living over a long period of time. Children

need extra nutrients and calories because they are still growing physically.

Nevertheless, if they consume more calories than they require for their daily activities

and normal physical growth and development, they become overweight to obese.

Marmot (2012) elaborated that whereas socioeconomic status can have a

significant impact in childhood obesity. Wealth appears to be a risk factor for obesity in

children living in a wealthy lifestyle, rather than those who have lower incomes. Marmot

also suggest that a reversal in the social distribution of obesity risk is occurring which

can be explained by the large increase in obesity levels in higher socioeconomic groups

between a long term period.

Childhood obesity has numerous health risks. Many of the chronic diseases of

adults such as type 2 diabetes, hypertension, high blood levels of cholesterol, metabolic

disease and coronary artery disease actually start to develop in childhood and one of

the greatest contributors to the development of these diseases is obesity. Obese

children also have a high risk of asthma and other respiratory disease, liver disease,

skin infections, sleep and eating disorders, and precocious puberty (Gonzales 2012). In

addition, obese children who carry their condition into adulthood have a high risk of

developing gallbladder disease, sexual and reproductive problems, sleep apnea and

respiratory problems, osteoarthritis; varicose veins and some cancers notably of the
 23

breast, uterus, cervix, ovary, and gallbladder among women, and colon, rectum,

prostate, pancreas, and stomach among men.

Obesity in children entrails in carrying some social and emotional baggage. Many

obese children have low self-esteem; are often teased and bullied; and are susceptible

to depression. Likewise, they have a tendency to be maladjusted and become slow

learners. Obesity, when left untreated, usually worsens, but when treated, it can be

corrected. For children under seven who have no other health concerns, the treatment

goal may be simply weight maintenance and just allow the child to grow its weight.

However, for an overweight over seven and obese under seven, the goal may have to

include weight reduction.

A growing number of people who are slightly overweight disregard the fact that

optimum health can only be achieved when one maintains the right weight. This is

because in some cultures, being “slightly overweight” is a sign of affluence, or worse,

“being healthy” (Donato 2012). But based on medical findings, a person who is slightly

overweight with 10 to 20 pounds of excess body fat should not be considered healthy.

In fact, the risk of serious diseases that could at least impair the quality of life and at

most could prove to be fatal could dramatically increase.

Sanderson’s (2011) study shows that genetics plays a role in obesity. Genes can

directly cause obesity in disorders such as Bardet-Biedl syndrome and Prader-Willi

syndrome. However genes do not always predict future health. Genes and behavior

may both be needed for a person to be overweight. In some cases multiple genes may

increase one’s susceptibility for obesity and require outside factors; such as abundant
 24

food supply or little physical activity.Clustering of cases within a family, the congruence

of body weight for monozygotic twins, and the discovery of genes associated with

obesity are all arguments reinforcing the genetic dimension of obesity

It is now well established that overweight and the different forms of obesity are

conditions tending to concentrate within a family Rohrer (2014). Obesity risk is two to

eight times higher for a person with a family history as opposed to a person with no

family history of obesity, and an even higher risk is observed in cases of severe obesity.

Heritability of obesity may vary depending on the phenotype studied, however it tends to

be higher for phenotypes linked to adipose tissue distribution and for weight or body fat

excess. Weight gain and adiposity increase with age, an effect also influenced by

heredity.

The result was supported by the statement of Holick (2010) that milk proteins,

milk sugar, fat, and saturated fat in dairy products pose health risks for children and

encourage the development of obesity, diabetes, and heart disease. While low-fat milk

is often recommended for decreasing obesity risk, a study published in the Archives of

Disease in Childhood showed that children who drank 1 percent or skim milk, compared

with those who drank full-fat milk, were not any less likely to be obese.

One study enlightened the risks of obesity which most would lead to early death.

Studies and statistics indicate that obesity is associated with increase in illness and

death from diabetes mellitus, stroke, coronary artery disease, and kidney and

gallbladder disorders. The more overweight you are, the stronger this association

becomes. Statistics suggests that if you are 40 percent overweight, you are twice as
 25

likely to die of coronary heart disease as compared to a person who is not overweight. If

you are 20 to 30 percent overweight, you may be three times more likely to die of

diabetes. The risks seem higher when the excess weight is concentrated around the

waist, and the ratio of the waist to the hip measurement is sometimes used to

measure this risk. People with a high waist-to-hip ratio are at greater risk than those

whose excess fat is distributed in the hip area (Sy 2013).

Failure to lead a healthy lifestyle is not only costly in terms of health, but also

from the economic point of view. WHO estimates that obesity accounts for between 2

and 6 percent of total health care costs in developed countries. Obesity also has a

severe impact in terms of lost productivity. Studies have reported a strong relationship

between obesity, decreased physical functioning and a reduction in overall productivity

(Rigillo 2014). Obesity affects productivity not only by an increase in mortality, but also

through an increase in morbidity.

An obese person reportedly experiences a 50 percent increase in lost

productivity and visits a doctor 88 percent more than a healthy person during a six-year

period in the United States. Overeating also appears unacceptable from a moral point of

view in a world which more than 850 million people are still chronically hungry.

While experts concede that genes play an important factor in determining a

person’s susceptibility to weight gain, they stress that the person’s energy balance is

determined by calorie intake and physical activity. In short, obesity and overweight is

mostly the result of a bad lifestyle.

The gradual way that obesity had developed in societies was the reason nothing
 26

had been done before. Obesity and all that it brings has no intermediate impact like bird

flu or SARS. It creeps up slowly on society. Chubby children were said to be healthy. As

society becomes more affluent people’s life styles change with that growth affluence.

They tend to adopt more sedentary life styles, get bogged down with work; life becomes

more stressful and fast foods and processed foods become the norm (Galea 2015)

An obese person is at an increased risk of developing Syndrome X, a collection

of cardiovascular risk factors including insulin resistance, elevated triglycerides, glucose

intolerance, and hypertension (high blood pressure) which may ultimately lead to heart

disease, diabetes, and stroke. Treating syndrome X will, therefore reduce the likelihood

of developing these diseases (Kendall 2011). Primarily a nutritional disease, Syndrome

X is caused by eating too much energy dense food and leading an inactive or exercise-

free lifestyle.

Related Studies

Several studies relate on primary factors of obesity. One review article (Hollands

2012) of the association between the fast-food environment and obesity investigated

that frequent consumption of fast-food is associated with weight gain and, therefore,

hypothesized that relative availability of fast-food is a risk factor of obesity. This

research studied 40 respondents suffering from obesity. This investigation examined the

association between the neighborhood-level density of fast-food outlets and adult body

mass index (BMI) in Canada. Population-based data on BMI and socio-economic

variables from the 2011 Canadian Community Health Survey (CCHS) and selected

neighborhood-level socio-economic data from the Canadian Census were merged with
 27

a commercial database containing geographic locations of all restaurants in Canada.

The association between BMI and fast-food density (per 10,000 people in CCHS

respondent’s FSA) was analyzed using ordinary least squares regression. Spatial

clustering of BMI was also investigated and spatial-regression analysis was conducted.

FSA-level fast-food density is significantly associated with BMI in Canadian adults,

predominantly in females and non-rural area. This population-based analysis

established that availability of fast-food restaurant is an important risk factor for obesity

in Canada. This study recommends that fast-foods should not be eaten at a regular

basis.

Obesity in adolescents may also have a similar connection to those who suffer in

childhood obesity. Kautiainen (2015) conducted an investigation about overweight and

obesity in adolescence. The aim of this investigation was to study whether the time

spent on different forms of information and communication technology was associated

with overweight and obesity among Finnish 147 to 18-year-old adolescents in the 2012

survey. The main novelty of the study was its ability to explore separately the times

spent on television, digital games, and especially computer (e-mail, writing, surfing

social media). The study has found that an increase in time spent on viewing television

and using computer were associated with higher prevalence of overweight mainly

among girls, whereas playing digital games was not associated with obesity. Taken

together, these results emphasize the need to continuously monitor trends in overweight

and obesity, as well as in the entire BMI distribution. This study recommends the

adolescents to engage in outdoor and vigorous activities and spend less time in

technological devices.
 28

One country, specifically Kuwait, suffers the same prevalence as well. One study

conducted an investigation in Kuwaiti women. Al-Hamad’s (2012) study focuses about

the determinants and consequences of obesity in adult Kuwaiti females. The result of

the study of 324 randomly selected adult Kuwaiti women conducted March 2011 to July

2012 has shown various outcomes.In the prevalence of the statistics, 27 percent was

overweight and 56 percent was obese. Anthropocentric analysis has shown that the

mean BMI was 32.0 with a predominantly central fat distribution. The mean age was 35

years; nearly 75 percent were married women. Univariate and multivariate analysis

were used to assess the association between socio-demographic factors, life style

factors, and reproductive and maternal factors with the risk of weight gain and obesity in

this sample of women. The results indicated that only two factors, namely, age and

inability to return to pre-pregnancy weight, were independent risk factors for the risk of

obesity even after controlling other variables. Al-Hamad’s study recommends that a

health committee should be set up to take the responsibility of developing, on a short

term and long term bases, a practical and population oriented plan for reducing the

prevalence of obesity and its health implications in allo sub-groups of the population,

especially women and children.

Tom (2011) investigated the factors that relate to overweight and obesity in

preschool children. The goal of the study was to assess the 2010 prevalence of

overweight percentile and obesity percentile among preschool children in San Luis

Obispo County, compare top the results to 2006 and to identify if there were

associations to demographic, lifestyle, and parental factors. A total of 474 preschool

children from 24 preschools participated in the physical assessments. A questionnaire

 29

was given to parents or guardians whose child comp[leted the physical assessment to

determine demographic, lifestyle, and parental factors related to overweight or obesity.

There was a 50 percent response rate for the questionnaires. The results concluded

that almost one-third of the preschool children were overweight and obese, and about

half of these children were obese. Child health insurance plan, child birth weight, milk

intake, and parental BMI were found to be signified in effecting weight classification.

This study, therefore, suggests that current programs and funding are not sufficient in

reducing the overweight/obesity prevalence of preschool children in San Luis Obispo

County.

Community health programs also have a huge obligation in maintaining a child’s

health. A study conducted by Himathongkam (2011) approaches on the topic about the

effectiveness in school health programs in preventing childhood obesity. This study

evaluated the effectiveness of the Coordinated School Health Program model in

reducing childhood rates using state-level data collected by the Centers for Disease

Control and Prevention (CDC) for the years 1999, 2006, and 2009. It measured the

effectiveness of school health policies including routine BMI screening, joint activities

between education and food service staff training on nutrition, staff training on exercise,

whether schools teach about nutrition in class, and whether schools teach about

exercise in class.The only significant variables are BMI Screen and Staff Nutrition

Training. BMI Screen is positively associated with the childhood obesity rate, suggesting

that states may only include BMI screening as part of routine check up after obesity

rates have reached a critical stage, not as a preventive measure. Providing training in

nutrition for school staff is the only policy that is by it effective in reducing the state
 30

childhood obesity rate.

A study conducted in Montana’s CHIP program and its pediatric primary provider

and their current role for monitoring and managing obesity in children. The purpose of

the study of Schwarzkopf (2013) was to strengthen knowledge of current rural provider

practice in order to better focus research and clinical efforts to reverse current childhood

obesity trends. A descriptive, cross-sectional study of pediatric providers was conducted

from a randomly selected group of providers who care for children ensured by

Montana’s CHIP program. A survey was used to collect demographic and current

practice information regarding methods used for monitoring a child’s growth. Providers

were also asked to present their perceptions on the problem of childhood obesity

related to the children they see in their practice barriers they face when treating

children.

Study findings illustrate child visits are fewer than expected, suggesting many

Montana children may not be seen for the AAP recommended well child appointments.

This creates a need for further research to clarify whether this is a concern specific to

Montana, rural children of all children. Findings on the Montana pediatric providers

suggest a strong concern for the prevalence of overweight children and offer insight into

barriers they face. These results strengthen findings from studies conducted across

various regions and diverse populations. This suggests many treatments for childhood

obesity utilizing a team approach of many support services may not be accessible in

this state. Montana providers might be urged to focus on the strengths of rural

communities when considering prevention and treatment of childhood obesity.

 31

A child’s awareness in his own body also has an impact on the outcome of his

body composition. Pallan (2013) investigates the body dissatisfaction and weight status

in south asian 5 to 7 year old children. The findings of this study support the idea that

even at a young age, children have an awareness of their body image, and have

desires to be different body shapes, with children of increasing weight experiencing

higher levels of body dissatisfaction and desire to be thinner. This suggests that children

as young as 5 are subjected to societal influences, such as the media, that portray the

thin ideal. These findings have implications for childhood obesity prevention. With this

approach, interventions will minimize potential harm to children and may have more

beneficial outcomes, not only in terms of reducing obesity, but also by maximizing

psychological health. The findings of this cross-sectional study, together with analyses

of follow up data from the exploratory trial on body image and dissatisfaction, will inform

further refinement of the intervention and implementation to safeguard and potentially

improve psychosocial health.

Food intake is one of the most important thing to be observed in terms of obesity.

Bradshaw et al. (2015) investigated the relationship of extra food intake and depressive

symptoms in adolescents. This pilot study explored the potential role of food on young

people’s mental health. Specifically, the aim was to determine if a relationship exists

between extra food intake and depressive symptoms in adolescent’s age 12-17 years.

Extra food intake and depressive symptoms were collected from girls and boys in ages

12-17 at one middle socio-economic secondary school located in Perth metropolitan

area.

The study identifies the potential role of food intake on mental health problems.
 32

The results of this study have revealed important interactions between different types of

food and specific years beyond age 14. In particular the consumption of drinks in year

10 is associated with a higher level and severity of depressive symptoms. Another

important finding was the pattern of depressive symptoms between boys and girls, with

girls having significantly higher depressive symptoms in year 8 and 9. This study

recommends the resilience in young people increasing their ability to confront everyday

stressors, rebound positively from adversity and become stronger to face future

challenges.

Mahajan’s (2012) study discusses the obesity related perceptions and practices

among educators in expanded food and nutrition education program. The purpose of

this study was to examine the relationships between obesity related behaviors and

nutrition education among Appalachian participants in the Expanded Food and Nutrition

Education Program (EFNEP). For this study, eleven educators from the Appalachian

region who work with the EFNEP/SNAP-Education program were interviewed by

telephone. Their responses to questions were coded according to a pre-prepared

answer guide. From answers provided by staff there are some areas that the EFNEP

program couldn’t focus on more. Some of these areas include educating participants on

budgeting and family finance, cooking skill, parenting skills, and physical activity.

Answers provided by the participants in this study suggest that educators feel fairly

successful with making changes related to healthy eating but less successful with

making changes in participant’s physical activity.

Local investigations have also been conducted in relation to the topic concerning

obesity and its factors. For instance, de Mesa’s (2013) study focuses on food concepts
 33

and eating habits among intermediate school children. Based on the conducted

observation and interviews, the study was able to disseminate the problem regarding to

the extent of the pupils to identify 3 basic food groups and heating habits. According ti

the data gathered, 3 negative eating habits that the pupils commonly identified were 1)

drinking soft drinks is better than fruit juices; 2) eating ampalaya and celery is bad

because of its taste; and, 3) talking while eating.

This study recommends that the school must conduct a teaching by the use of

actual objects in food and nutrition. It also recommends that positive eating habits and

beliefs must be done and reinforced at home by parents.

Same research was done by Florentino (2013), but aims to answer a different

question. It sought to answer what factors are associated with the children’s food

concept and eating habits and beliefs. And in his findings, after conducting this

investigation in two schools, most of the respondents in the two schools answered that

family’s head education was associated with positive eating habit. Therefore, this study

recommends that the home should help the school in providing suitable nutrition

education. The parents must continue reading magazines like Health and Home and

other related literature.

A local study about food quality and food composition was also disseminated.

Valenzuela (2014) conducted a research about the food quality and student’s physical

fitness. The purpose of the study is to know the quality of food composition of the intake

of students. Dissemination, the study was able to identify the calorie intake of the

students.
 34

Breakfast: 600g/2400 Carbohydrates, 29.25g/117 Proteins, and 8.75g/78.75 Fats

Lunch: 756.75g/3063 Carbohydrates, 32.50g/90 Proteins, and 13.25g/119.25 Fats

Dinner: 655g/2620 Carbohydrates, 29.25g/117 Proteins, 7g/63 Fat

This study recommends that rice intake must be measured and reduced in

nighttime; more veggies must be added. Eating more fruits and increase in water intake

is highly suggested.

Local and barangay health centers also hold a huge burden in maintaining a

discipline in a child’s health care. Favenir (2011) investigated the contribution of

barangay day care centers in child community development, more specifically, physical

development. The purpose of this study is to identify the provided services of day care

centers that could benefit the child physically. This investigation is questionnaire and

observation based. And according to the provided questionnaire, most common

provided services were: good grooming (4.49), self-help (4.27), and physical fitness and

exercise (4.22). In the other hand, frequently provided services were: basic health and

nutrition (4.00), play outdoor skills (3.98), and fine motor skills development (3.82).

Therefore, these services must be upgraded for a more extensive provision for physical

fitness.

Noble (2012) also researched about significant relationship of food quality and

Physical fitness. And according to the findings of the study, food quality is positively

correlated with the student’s level of participation in physical education-related activities

(correlation coefficient= 0.8943). Thus, this study recommends that there should be an

increase participation in physical education related activities.

 35

Synthesis of the State of the Art

The previous studies enabled the researcher to find out that almost all of the

studies were related to the present study regarding the eating practices of obese

children in selected barangays in Daet, Camarines Norte. The discussion built a

delineation of different related literature and studies that helped the researchers

theorized and conceptualized the work. Similarities and differences are cited in

connection with the study undertaken by the researchers. Moreover, these literature and

studies served as the baseline for the study.

The researchers also found out that despite the similarities found, there were

also differences that were cited between the previous studies and the study. Just like

other previous studies, this study also seemed to identify the eating practices of obese

children. The study of Hollands (2012) about frequent fast-food consumption and its

association with weight gain. The study proved that fast-food is a risk factor of obesity.

Kautiainen (2015) evaluates the obesity in adolescence, specifically, the

significant relation of time spent in using technological gadgets and its association with

overweight and obesity. Al-Hamad’s (2012) study, focuses on the determinants and

consequences of obesity in adult Kuwaiti females wherein it identifies the most common

cause of obesity.

Two studies investigated the impact of obesity in childhood ages. For instance,

Tom (2011) investigated the factors that relate in childhood obesity, specifically,

preschoolers, and the effectiveness of the implementation of programs and funding in

 36

controlling the certain prevalence. But Himathongkam’s (2011) study suggests that the

school health policies are implemented accordingly and in a routine.

The study conducted by Schwarzkopf (2013) aims to strengthen the knowledge

of current rural provider practice in order to better focus research and clinical efforts to

reverse current childhood obesity trends. Providers were also asked to present their

perceptions on the problem of childhood obesity related to the children they see in the

barriers of their everyday lives.

Pallan’s (2013) findings, on the other hand, support the idea that even at such a

young age, children can shows their awareness in body image and body composition.

Although, reading the statistics of this investigation, most children show dissatisfaction

in their body and desire to be thinner is one of the goals they wish to achieve in their

body.

One study investigated the relationship of food intake and depressive symptoms

(Bradshaw 2015). This pilot study explored the potential role of food on young people’s

mental health. The findings of this study have revealed important interactions between

different types of food and specific years beyond age 14.

Another study discusses the obesity related perceptions and practices among

educators in expanded food and nutrition program. Mahajan’s (2012) study was to

examine the relationships between obesity related behaviours and nutrition education

among Appalachian participants in the Expanded Food and Nutrition Education

Program (EFNEP). The findings of the study suggest that educators feel fairly

successful with making changes related to healthy eating but less successful with
 37

making changes in participant’s physical activity.

Local studies have also been conducted which are related to this topic. One

example is the study of de Mesa (2013). De Mesa’s study focuses on food concepts

and eating habits among school children. The findings show that children show less

awareness in eating habits. One of which is the belief that soft drinks are better than

fruit juice.

Florentino (2013) conducted the same dissemination, but answer a different

question. It sought to answer what factors are associated with the children’s food

concept and eating habits and beliefs. And in his findings, after conducting this

investigation in two schools, most of the respondents in the two schools answered that

family’s head education was associated with positive eating habit. Therefore, this study

recommends that the home should help the school in providing suitable nutrition

education. The parents must continue reading magazines like Health and Home and

other related literature.

Valenzuela (2014), on the other hand, studied the food quality and student’s

physical fitness. This study has found that most student consume more carbohydrates

in dinner meals than in breakfast meals. Valenzuela (2014) suggests that rice intake

must be measured and reduced and an increase of consumption of water and fruits is

necessary.

Favenir (2011) conducted an investigation in relation to the effectiveness of child

development in barangay day care centers. And based on the conducted dissemination,

the three least provided services are health and nutrition (4.00), play outdoor skills
 38

(3.98), and fine motor skills development (3.81). Therefore, these services must be

upgraded for a more extensive provision for physical fitness.

Noble (2012) also researched about significant relationship of food quality and

Physical fitness. And according to the findings of the study, food quality is positively

correlated with the student’s level of participation in physical education-related activities

(correlation coefficient= 0.8943). Thus, this study recommends that there should be an

increase participation in physical education related activities.

All of the studies present greater emphasis in combating obesity, identifying its

causes, and enlightening strategies it prevents such predicament and prevalence to the

community.This study, on the other hand, focuses more in identifying the eating

practices of obese children in selected barangays in Daet, Camarines Norte.

Gap Bridged by the Study

A careful investigation of literature and studies are being conducted in relation to

determine the primary factors of obesity among children in selected barangays in Daet,

Camarines Norte.

Several studies discussed about the eating practices of obese children

includingWang et al, Williams et al and Kraaketal.But these studies emphasized only

the bad habit and unhealthy lifestyle. Their study focused on the practices of the obese

children.The study was primarily an offshoot of the three past studies aimed at

discovering the eating practices of obese children of the community.

 39

Discovering the similarities among the respondents, the researcher broaden the

evaluation ofWang et al, Williams et al and Kraak et al.By knowing the results of coping

measure implemented by the local government, the researcher gauged the awareness

level of the respondents toward the obesity prevention among children.This is the gap,

which was the study bridged.

Theoretical Framework

The study is anchored on the set-point theory, which explains why repeated

dieting is unsuccessful in producing long-term change in body weight or shape. Going

on a weight –loss diet is an attempt to overpower the set point, and the set point is a

seemingly tireless opponent to the dealer.

According to the set-point theory, there is a control system built into every person

dictating how much fat he or she should carry- a kind of thermostat for body fat. Some

individuals have a high setting, others have a low one. According to this theory, body fat

percentage and body weight are matters of internal controls that are set differently in

different people. The set point itself keeps weight fairly constant, presumably because it

has more accurate information about the body’s fat stores than the conscious mind to

change behavior, produce feelings of hunger or satiety. Studies show that a person’s

weight as the set point is optimal for efficient activity and a stable, optimistic mood.

When the set point is driven too low, depression and lethargy may set in as a way of

slowing the person down and reducing the number of calories expanded.

The ideal approach to eight controls would be a safe method that lowers or
 40

raises the set point rather than simply resisting it. So far no one knows for sure how to

change the set point, but some theories exist. Of these, regular exercise is the most

promising: a sustained increase in physical activity seems to lower the setting (Wilmore

et al. 2010).

The set point, it would appear, is very good a t supervising fat storage, but it

cannot tell the difference between dieting and starvation. The dieter who begins a diet

with a high set point experiences constant hunger, presumably as part of her body’s

attempt to restore the status quo. Even dedicated dieters often find that they cannot

lose much weight as they would like. After an initial, relatively quick loss, dieters often

become stuck at a plateau and then lose weight at a much slower rate, although they

remain as hungry as ever.

Dieting research demonstrates that the body has more than one way to defend

its fat stores. Long-term caloric deprivation, in a way that is not clear, acts as a signal

for the body to turn down its metabolic rate. Calories are burned more slowly, so that

even a meager diet almost suffices to maintain weight. The body reacts to stringent

dieting as thought famine has set in. Within a day or two after semi-starvation begins,

the metabolic machinery shifts to a cautious regimen designed to conserve the calories

it already has on board. Because of this innate biological response, dieting becomes

progressively less effective, and (as generations of dieters have observed) a plateau is

reached at which further weight loss seems all but impossible.

Set-point theory is the theory chosen for this study since it is closely related to

the topic, and it can be used as a basis for the causes of childhood obesity. In relation
 41

to the study, the theory stated can be a proposed factor for obesity of a child. This

theory can point out a reason of why the body fat of a child remains constant.

Figure 1 offers a view in the theory created by Benett and Gurin. The key point is

diagrammed at the cycle shown. Whenever a person gains weight (1), the tendency is

to reduce weight by proper diet and performing exercise (2). The purpose of the

hormones is to indicate that when the weight of the body exceeds or goes below the set

point of the body (3). But when the body goes below the particular set point, both

metabolism and appetite adjust to try to return to that set point. The metabolism will

slow down to conserve energy (4).

 42

Figure 1

Theoretical Paradigm of the Study

 43

Conceptual Framework

This study focused on the eating practices of obese children in selected

barangays in Daet, Camarines Norte including Barangay Ilaod, Mantagbac, Pasig,

Magang and Salcedo. This study was based on the system concept which includes the

input, process, and output patterns as shown in figure 2. The conceptual framework of

this study is essential in order for the reader to easily understand, visualize and interpret

the flow of ideas of the research. The input consists of the profile characteristics of the

respondents as to age, gender, monthly family income, weight, height, arm

circumference, and waist circumference. Together with this, it also involves the factors

that result to obesity among children in relation to daily activities, food intake and eating

practices. Daily activities are significant to the study for it will determine the usual

activities being done by the obese children. Food intake is also significant because it will

determine the food that is being usually taken by the obese children. Eating practices is

also significant to determine the way obese children eat their food including their

snacks, breakfast, lunch and dinner.

In this research, process includes the distribution of questionnaires/checklist,

picture questionnaire with the aid of interview guide, gathering data and observation

among respondents.

Through this, the output or the product of accomplishment in this study refers to

the recommendations that may be suggested based on the findings of the study to

prevent obesity among children such as different programs and practices concerning
 44

obesity. The government must also take their part through the widespread health

education concerning the awareness of the people to prevent obesity among children.

Moreover, it will provide the respondents to lead them to a more productive life as they

can be.

The conceptual framework is illustrated in Figure 2.

INPUT PROCESS OUTPUT

 Profile of the  Distribution of  Family center

respondents as questionnaires/chec dietary practices
to age, gender, k-list, picture based on the
monthly family questionnaire with findings of the
income, weight, the aid of interview study to prevent
height, arm guide obesity among
circumference,  Gathering of data children.
waist  Observation among
circumference. respondents
 Factors that  Interview
result to obesity  Analysis and
among children interpretation of
in relation to daily data
activities, food
intake and eating
practices.
 45

FEEDBACK

Figure 2

Conceptual paradigm of the study

Notes

Van der Merwe E. (July 2012) Prevalence of Overweight and Obesity among
Children retrieved from: http://jama.jamanetwork.com/article.aspx?articleid=198912

Sumpio L. (2011) Obesity in Children retrieved from:

http://www.webmd.com/children/guide/obesity-children#1

Sy P. (Aug. 2013) Unlocking the Secrets of Weight Loss retrieved from:

https://books.google.com.ph/books?
id=QxLACwAAQBAJ&printsec=frontcover&dq=obesity&hl=en&sa=X&ved=0ahUKEwiu6
b_G5LbPAhVFp5QKHTJxARAQ6AEIITAB#v=onepage&q=obesity&f=false

Finkelstein G. (2011) Weight Management and Obesity Information retrieved

from
http://www.heart.org/HEARTORG/HealthyLiving/WeightManagement/Obesity/Obesity-
Information_UCM_307908_Article.jsp#.V-4x6Pl97IU

Gonzales M. (2012) Obesity Epidemic to Worsen as Today’s Children Grow up

 46

retrieved from http://www.huffingtonpost.com.au/2016/09/29/australias-obesity-

epidemic-to-worsen-as-todays-children-grow/

Tounian V. (June 2014) “dult Obesity Causes and Consqequences retrieved from
https://www.cdc.gov/obesity/adult/causes.html

Haney A. (2011) Strategies to Prevent Obesity retrieved from

https://www.cdc.gov/obesity/strategies/index.html

Eduward D. (February 2015) Nutrition, Food Choices, and Eating Behaviour

retrieved from http://ebook.ecog-obesity.eu/chapter-nutrition-food-choices-eating-
behavior/?gclid=CN2dtb3mts8CFceWvQodT5oAXA

Que B. (2015) Psychological AssesmentOf the Obese Child and Adolescent

retrieved form http://ebook.ecog-obesity.eu/chapter-psychological-assesment-
disturbances/?gclid=CNTOx-fmts8CFZCXvQodft8DBA

Manoli L. (2015) World Health Organization Reference Curves retrieved from

http://ebook.ecog-obesity.eu/chapter-growth-charts-body-composition/?
gclid=CKSg3Z7nts8CFdcmvQodkjIFkQ

Gallen A. (2014) OBESITY retrieved from

http://www.medicinenet.com/obesity_weight_loss/page3.htm

Jebb H. (2011) The Environment and Physical Activity retrieved from

http://ebook.ecog-obesity.eu/chapter-society-communication-environment-obesity/?
gclid=CMi7soDots8CFUUDvAod6z8HfA

Humml G. (2012) Law, Healthy Diets and Obesity Prevention retrieved from
http://ebook.ecog-obesity.eu/chapter-society-communication-environment-obesity/law-
healthy-diets-obesity-prevention/

Pudel G. (2015) History And Meaning Of The Body Mass Index. Interest Of Other
Anthropometric Measurements retrieved from http://ebook.ecog-obesity.eu/chapter-growth-
 47

charts-body-composition/history-meaning-body-mass-index-interest-anthropometric-
measurements/

Schurmann D., Meyerhof R. et al (2015) Early Immune Disorders Induced By Childhood

Obesity retrieved from http://ebook.ecog-obesity.eu/chapter-biology/early-immune-disorders-
induced-childhood-obesity/

Dorfman Y. (2013) Physical Activity and Play in Children who are Obese retrieved from
http://ebook.ecog-obesity.eu/chapter-energy-expenditure-physical-activity/physical-activity-play-
children-obese/

Rohrer P. (2014) Putting the physical back into activity retrieved from:
https://bakeridi.edu.au/research/research-agenda/physical-activity?
gclid=CPf_xtHpts8CFQ4DvAodA1MLRw

Donato N. (2012) Overweight and Obesity retrieved from https://www.cdc.gov/obesity/

Rigillo T. (2014) Individual behaviors and environmental factors retrieved from

http://frac.org/initiatives/hunger-and-obesity/what-factors-contribute-to-overweight-and-obesity/

Galea K. (2015) Approach Considerations in Obesity Treatments retrieved from

http://emedicine.medscape.com/article/123702-treatment

CHAPTER III

RESEARCH DESIGN AND METHODOLOGY

This chapter presents the discussion of the design and methodology in the

research. It also discusses the methods and procedures which were undertaken to

attain the objectives of the study. It explains the manner of gathering the data and the

statistical tools used to analyze and interpret the data collected.

Research Design
 48

The researchers used the mixed method of Qualitative and Quantitative method

of research focusing on the eating practices of obese children. These methods of

research was chosen for this study as it aims to gather data and information that

determinedthe eating practices of obese children in barangay Ilaod, Mantagbac, Pasig,

Salcedo and Magang in Daet.

According to Hiatt (2010), Qualitative research focus on discovering and

understanding the experiences, perspectives, and thoughts of participants—that is,

qualitative research explores meaning, purpose, or reality.In other words,qualitative

research is a situated activity that locates the observer in the world.It consists of a set of

interpretive, material practices that make the world visible. These practices transform

the world. They turn the world into a series of representations, including field notes,

interviews, conversations, photographs, recordings, and memos to the self. At this level,

qualitative research involves an interpretive, naturalistic approach to the world. This

means that qualitative researchers study things in their natural settings, attempting to

make sense of, or interpret, phenomena in terms of the meanings people bring to them.

On the other hand, Lincoln and Cuba (2011) define Quantitative research that

attempts to maximize objectivity, reliability, and generalizability of findings, and are

typically interested in prediction. Integral to this approach is the expectation that a

researcher will set aside his or her experiences, perceptions, and biases to ensure

objectivity in the conduct of the study and the conclusions that are drawn. Key features

of many quantitative studies are the use of instruments such as tests or surveys to

collect data, and reliance on probability theory to test statistical hypotheses that

correspond to research questions of interest. Quantitative methods are frequently

 49

described as deductive in nature, in the sense that inferences from tests of statistical

hypotheses lead to general inferences about characteristics of a population.

Quantitative methods are also frequently characterized as assuming that there is a

single “truth” that exists, independent of human perception.

The researchers believed that the mixed method of Qualitative and Quantitative

research is the most appropriate in this kind of research work as it is the most effective

to be used through its multiple approaches in answering research questions, rather than

restricting or constraining researchers’ choices.

Respondents of the Study

The respondents of this study areobese children with ages ranging from two to

seven years old. They are from barangay of Ilaod, Mantagbac, Pasig, Salcedo and

Magangin Daet. There was a total enumeration of all the respondents. The respondents

were mostly girls than boys. All in all, there were a total of 19 girls and 16 boys, totaling

to 35.

Research Methodology

In the research study, the kind of research methodology used was Purposive

Sampling. Purposive sampling is the best type of Non-probability sampling for this

research. According to Kozier (2010), purposive sampling is a sampling method and it

occurs when elements selected for the sample are chosen by the judgment of the

researcher. Researchers often believe that they can obtain a representative sample by

using a sound judgment, which will result in saving time and money.
 50

The researchers gathered a list of obese children in the five selected barangays.

Once the data has been gathered, total enumeration has been used.

Data-gathering Method

A letter was first designed asking permission and was sent to the barangay

captain of the barangays where the respondents live, informing them that a study would

be conducted by the researchers .The researchers used purposive sampling and used

all the respondents on the list from each barangay which includes Barangay Ilaod,

Mantagbac, Pasig, Salcedo and Magang. The respondents informed about the purpose

of the interview. The researchers used the questionnaire/checklist for the mother or

respondents’ parent, picture questionnaire for the children who were the respondents

and interview guide for meal recall, the answers of the respondents’ parent and the

children who are the main respondents were treated with strict confidentiality.

Questionnaire/checklist for mother or parents, picture questionnaire and interview guide

were the ways in gathering data. The researchers also used tape measure to measure

waist circumference, arm circumference, height, and weighing scale to measure the

weight of the respondents.

The profile of the respondents described in terms of age, gender, weight, height,

arm circumference and waist circumference on the questionnaire/checklist made by the

researchers for the respondents’ parent. To determine the eating practices by obese

children, the researchers distributedpicture questionnaire that was given personally to

the respondents. The questionnaire also answered on the same day as it is given to

them. The checklist/questionnaire answered by the researchers was based on the

 51

observations and measurements gathered from the respondents. Interview guide also

used for meal recall.

Results of the observation and the analysis of the data gathered were the basis

for interpretation and conclusions of the study. The findings from the data gathered also

helped the researcher for the recommendations that were suggested to prevent obesity

among children.

Research Instrument

An instrument for gathering essential data needed in the study was developed by

the researchers. Researcher used questionnaire/checklist, picture questionnaire and

interview guide as a method of gathering information from the respondents. The

researchers used questionnaire/checklist answered by the respondents’ parents; it

includes the responses and measurements made from the respondents to gather

information regarding the profile of the children, while the picture questionnaire was

answered directly by the respondents that helped determine the eating practices of

obese children.

The questionnaire/checklist was consists of the profile of the respondents and

the factors that may cause obesity among children in terms of daily activities, food

intake and eating practices while the picture questionnaire was consists of the foods

that is usually taken by the child. The interview guide was consists of questions

regarding the last meal taken by the child and other questions related to it. The

respondents/cases were assured that all their answers were treated with strict

confidentiality.
 52

This questionnaire/checklist, interview guide and picture questionnaire guided the

researchers to be able to come up or obtain the needed information for their study.

Statistics

The data gathered from the questionnaire and the checklist will be tabulated and

analyzed. For valid analysis and interpretation of data, statistical tools will be utilized.

Frequency count and percentage technique will be used in analysis and interpretation of

the data gathered from the checklist.

Shown below is the formula in computing the frequency and percentage of the

gathered data.

f
P= x 100
n

Whereas:

f = frequency

n = number of respondents

P = percentage

100 = constant

Ranking identified the position of one answer in relation to the rest. In ranking,

the number with the highest percentage and last number represent the lowest
 53

percentage.

In order to analyze and interpret the data gathered from the checklist, average

weighted mean will be used. Mean in which each item being averaged is multiplied by a

number (weight) based on the item’s relative importance. The result is summed and the

total is divided by the sum of the weights. Weighted average will be used in this

descriptive analysis.

∑ ( x 1∗x 2 )
x́= i=1 n

∑ w1
i=1

Whereas:

∑ . = the sum of

w = weights

x = the value
 54

Notes:

J Clarke (2011) “What is the meaning of the descriptive method in research?”

retrieved from https://www.reference.com/world-view/meaning-descriptive-method-

research-5d4d26e2ac405cbb#

B Rutherford (2009) Essentials to Research and Thesis Writing retrieved from

http://www.socialresearchmethods.net/kb/sampprob.php
 55

Chapter 4

Eating Practices of Obese Children in Some Selected Barangays in Daet,Camarines

Norte

This chapter discusses the research findings on the eating practices of Filipino

obese children living in Barangay Ilaod, Mantagbac, Magang, Pasig and Salcedo as to
 56

their socio-demographic profile and the factors that result to obesity among children in

relation to daily activities, Food intake and eating practices. The data was gathered

through questionnaire/checklist and picture questionnaire with the aid of interview guide

and will be presented in this chapter. Since this is mixed method of Qualitative and

Quantitative research, the responses of all the respondents from the interview guide will

be shown and the data gathered from the questionnaires are presented in numerical

form which is analyzed with the use of the statistical treatment of data. Percentages are

computed using the frequency and percentage formula, and the ratings of the

respondents regarding the research questions are treated using the general weighted

mean.

From the beginning of January 13 to February 8, 2017, the researchers

interviewed the respondents from their own houses. The interview aims to know the last

meal taken by the child and to know the answers on questions related to it.

Key Informant 1

The first key informant is a 5 year old boy living in Purok 9, Barangay Mantagbac.

He is an obese child, the chubbiness in is body is truly cunning. When the mother was

asked about his last meal taken, she responded the following: “Nag

gatastapostinapayangagahannyan. Taposnung snack nya, nagkainsyangbiskwit at

gatas.” [milk and bread for breakfast and biscuits and milk for snacks]. For lunch, he ate

some “sitaw” [string beans] and rice. And for dinner, he ate instant noodles and

complimented with rice. And these given foods are not always eaten by the child, except

eating biscuits during snacks. When asked when these are his favorite foods, the kid
 57

said that only the pancit canton is.

His hobbies are mostly playing outdoors and basketball. The mother added that

his obesity is hereditary from the genes of his father. Although most of the time he is in

outdoors playing, it is his eating habit that makes his body maintain an obese body.

When askedif he gets easily hungry, the child nods his head signifying that he does

agree to the question. Moreover, the child also eats quickly whenever partaking heavy

meals.

Plate1: The parent of the key informant one being interviewed by the researchers
 58

Discussion

The gathered data by the researchers reaffirms the study of Que (2015) stating

that one main cause of obesity is sedentary lifestyle such as food intake. It is stated that

no matter how much a person engage to any physical activity, his food intake may

disrupt its effect. For instance, if a person goes to a gym but eats plenty of foods, his

physical exercise would be useless. The data gathered also shows accordance to the

statement of Humml (2012) that genes affect weight more than environment and

upbringing or so it seems too many people, especially if they are fat. The genes fat-

storing capacity has been selected by evolution for physically active people facing

periods of going without food.

For a child who plays basketball, but remains to be fat, his experience further

implies Que’s (2015) statement that physical activities are pointless without proper

discipline in food intake. The body mass will have no significant difference whatsoever

since eating takes back the burned body fats. The inheritance of genes could be

another angle of the root of his obesity,

The researchers learned that regardless of how much a person participate to any

physical activities but have no discipline in food intake, the body will have no significant

effect, thus, would gain more fat in the body. The researchers also learned that heredity

can also be the case as to why a certain person is obese.

 59

Key Informant 2

The next key informant is a 3 year-old girl currently residing at Purok 7, Barangay

Mantagbac. She always stays at home with no further physical activities such as

outdoor games or simply chores which can at least exercise her body even as a

youngling.

When the researchers asked her previous meal taken, she elaborated the

following: For breakfast, she ate hotdog with rice, and ate bread during the morning

snack. At lunch, she ate some Tinolawith rice. And at dinner, she ate fish with rice.

When asked if these are the foods that she always eats at a daily basis, the mother

responded that “Minsan man langsyakumainngmgayan, peroisdaangmadalastalaga” [he

don’t always eat those foods, except for fish, because he always eat it].

She doesn’t have any hobbies other than just watching TV and playing on her

mother’s phone. Her obesity is not caused by heredity, as stated by her mother, but

rather, due to overfeeding since her birth. The child gets easily hungry. For instance,

after eating breakfast, she asks for food just an hour later. Furthermore, the child also

eats very quickly, same as the other respondents interviewed.

 60

Plate 2: The Researcher Conducting the Interview to the 2 nd Key Informant’s Parent

Discussion

The second key informant can be reaffirmed by the study of Eduward (2015) that

one of the several risk factors of obesity is sedentary lifestyle that is typified by long

periods of watching television, playing computer games, and surfing the Internet. Being

exposed in watching television for a long period of time may contribute to the increase

of body mass.

The data gathered can also acknowledge the statement of Hope (2012) that

eating too quickly – and until absolutely full – is a significant factor in the obesity

epidemic. The joint impact of eating fast and until full overrides signals in the brain
 61

which would normally encourage a little more self-control.

The second key informant is shown to have pleasure in eating fish, which is a

protein-rich food, however, his body is still shown to be obese. The researchers learned

that no matter what food a person ingests, his lifestyle may disrupt its certain effect, just

as how it does to the second key informant. Eating habits such as quick eating may also

be a point out to the cause of obesity.

Key Informant 3

The next key informant is a 3 year-old boy whom still breastfeeds with his

mother. Most of the time, he just stay indoors watching videos in his laptop or playing

games in a cell phone. The last meal he took was eggs and rice for breakfast, sky flakes

and water in the morning snacks, rice with fish for lunch, and rice with chicken for

dinner. The mother said that these foods are always eaten by the child regularly.

Same as the other children interviewed, most of the time he just stay indoors.

“Palagilangsyangnanonoodng TV, nagcecellphone, o kaya,

naglalarolangsamgalaruannya” [he would always watch TV, play games in the phone, or

play with his toys]. His obesity, on the other hand, is also not hereditary. And at the age

of three, he still continues to drink milk from his mother. And when asked if he gets

easily hungry, both he and her mother agree. The child eats fast but neatly, as

elaborated by the mother.

 62

Plate 3: The Researcher Gathering Data from the Third Key Informant’s Guardian

Discussion

The statement of the fourth key informant asserts the claim of Hewitt (2011) that

most obese children never feel full. Hewitt pointed out that hormonal imbalance makes

the body feel hungrier. Leptin is the hormone that contributes to this manner. It is

protein made and released by the fat cells of the body. It circulates in the bloodstream,

goes to the hypothalamus, and tells the body whether it has enough energy stored in

the fat cells. Harvey (2012) supports this claim, stating that most of the obese people

feel this way, and it is the reason why they always get easily hungry, thus maintained to

be obese.

The statement of key informant for shows accordance to the claim of Hewitt,
 63

showing the trait of always being hungry for no apparent reason. And that trait is due to

the contradiction of hormones, between leptin and insulin, whereas insulin stops leptin

from getting full signal, and tricks the person into thinking that they are always hungry.

Key informant three also shows accordance to the claim of Eduward (2015) that

sedentary lifestyle (long periods of watching TV, couch potatoes, and always using

phones) can be a cause of obesity.

The researchers learned that lifestyle and hormones can be a root of obesity.

The researchers learned that obesity will be maintained by the driving force of

hormones, no matter how healthy you eat. And the everyday doings can also have an

impact in obesity, such as sedentary lifestyle or lack of physical movement/activity.

Key Informant 4

The fourth key informant is a 4-year old girl born at April 12, 2012. His arm is not

as bulky as most of the child but his weight is heavier than expected having a lower

height but a wider waist circumference. She is delighted in playing with toys and watch

TV. The last meal that he took was cup noodles mixed with rice for breakfast, some

biscuits for the morning snacks, pork giniling [ground pork] with rice for lunch, and

paksiw with rice for dinner. Most of these foods, however, are not always eaten

regularly. Some of the foods she always eats are fish and bread. Moreover, the mother

implied: “isda at tinapayanglaginyangkinakain” [fish and bread are the ones he always

eat].
 64

She didn’t state any hobby. However, her mother said that playing with toys and

watching TV are the things that she always do. Her obesity is not caused by heredity.

She continues to breastfeed from her mother at the age of 4. She gets easily hungry

and is fast in eating heavy meals.

Plate 4: The Researcher and the mother of the key informant in a Conversation

Discussion

The statement if key informant 4 show significance to the claim of Faghriet. al

(2015) whereas less physical activities may lead to obesity. Sedentary lifestyle

compounded with lack of physical activity causes significant decline in muscle integrity

and increase in body fat which may lead to obesity.

 65

The increase in childhood obesity is attributable to an increasingly sedentary

lifestyle and poor nutrition (Galson 2008). Sedentary behavior such as television

viewing, computer use, and video game playing often replace vigorous physical activity

in children. The youth’s lack of physical activity may be addressed as the cause of

obesity.

The researchers have understood that sedentary behavior is a big deal for

obesity. This type of habit overtakes the engagement of vigorous activities, especially

for the child. The researchers also conclude that due to modernization of technologies,

sedentary lifestyle may grow throughout the field of obesity.

Key Informant 5

The next key informant is a 3 year-old girl living in Happy Homes Alpine,

Barangay Magang. She is always indoors playing with her Barbie dolls. When asked

what her last taken meal was, he and her mother articulated that the last breakfast she

ate was egg with fried rice and milk, bananas and biscuit in her snack,

paksiwnabanguswith rice for lunch, and sisig, barbeque and rice with juice for dinner. All

of these however, are not the usual foods that she eats at a regular basis.

When asked what her hobbies are, the mother said: “lagilang yang nasaloob,

Palagingnaglalarongmgabarbienya o kaya ay nagbabahay-bahayan” [always indoors.

She would always play with her Barbie dolls or play house]. Her obesity is due to

heredity as believed by the mother. The mother agreed when asked the question if her

child gets hungry easily. She also eats very fast and during heavy meals whenever she
 66

is finished, she would always ask to add her food.

“Kapagtaposnasyangkumain,napadagdag pa syangulam at kanin.

Taposkapagnasarestawran kami, palagisyangnagpapadagdadgngpagkain” [everytime

she finished her meal, she would ask to have another. And when we eat at a restaurant,

she would always ask for additional meal]

Plate 5: The Researcher Conducting an Interview to the Fifth Key

Discussion

The fifth key informant shows the habit of overeating, as shown by asking of
 67

additional meal. Warner (2013) suggests that overeating is directly linked to obesity; she

defined obesity as the occurrence when a person consumes, over the long term, more

food than a person actually needs to maintain a good health.

Key informant 5 also shows accordance to the claim of Hewitt (2011). Hewitt

pointed out that hormonal imbalance makes the body feel hungrier. Leptin is the

hormone that contributes to this manner. It is protein made and released by the fat cells

of the body. It circulates in the bloodstream, goes to the hypothalamus, and tells the

body whether it has enough energy stored in the fat cells. Harvey (2012) supports this

claim, stating that most of the obese people feel this way, and it is the reason why they

always get easily hungry, thus maintained to be obese.

The researchers have asserted that the habit of asking additional foods may

directly link to obesity. It may also be the effect of the imbalance of leptin and insulin

hormones. Those type of habit can be a trait of overeating, on which, is significant for

the contribution of body fats.

Key Informant 6

The sixth key informant is a 5 year-old girl currently residing at Happy Homes

Alpine, Barangay Magang. She loves playing outside with her neighbors. The most

recent food she ate were just milk for breakfast, bread and milk for her snack, fish with

rice for lunch, and also fish and rice for dinner. Out of all the said foods, fish and milk

are the ones always eaten by the child regularly. “Mahiligsyasaisda” [she loves to eat

fish], the mother said.

 68

Her hobbies are going outside playing with friends, which could aid in helping her

lose weight. Although she always spend her time outside and being exposed to physical

activities, her eating practices are the ones preventing her body to lose weight. Her

obesity is a hereditary trait from her father. She gets hungry at such a fast rate. And

during heavy meals, she eats very quickly, thus as a result, her wanting more to eat and

adding the food she intakes.

Plate 6: The child of the sixth Key Informant

Discussion

The data gathered from this key informant is in accordance to the statement of

Humml (2012) that genes affect weight more than environment and upbringing or so it

seems too many people, especially if they are fat. In a pioneering study of more than

500 adopted children in 2011, US psychiatrist Albert Stunkard found that their weight
 69

correlated to that of their biological, not adoptive parents. Clearly, the genes fat-storing

capacity has been selected by evolution for physically active people facing periods of

going without food.

Hereditary traits are always passed down from generations to generations. And

just like obesity, it can be inherited. Genes of an obese parent can be a cause of obesity

for the children. However, the Harvard School of Public Health (HSPC) notes that the

variation in how people’s weight responds to the same environment suggests that

genes do play a role in the development of obesity. However, the genetic predisposition

if obesity can be counteracted by leading healthy lifestyle.

The researchers have figured out that heredity can have a huge impact in the

child’s obesity. But, the environment of the child may also be a root for its predicament.

And hereditary obesity can be easily combated. Therefore, it would be important for the

entirety of the household to help the child combat such prevalence.

Key Informant 7

The next key informant is a 3 year-old girl who loves sweets such as chocolates

and candies. This girl is hyperactive, meaning; she does a lot of physical activities such

as playing outdoors and running along inside the house. When asked about the

previous meal she had taken, she and her mother said that for breakfast, she ate egg

with rice, and biscuits and some cookies for snacks. She ate pork adobo for lunch and

dinner as well. The researchers asked what her favorite food is, the mother replied

“Mahiligsyamasyadosamgamatatamis, gayang chocolate, o kaya ay candy.” [She loves

 70

to eat sweets like chocolates and candies]

Her hobbies are playing outside, running around the house, and sometimes

watching the television. She loves playing outdoors playing with friends. Her obesity is

caused by too much food intake rather than heredity. She gets hungry very easily

whenever she finished eating a heavy meal. She also eats very fast, as stated by her

mother.

Plate 7: The seventh key informant (at the left)

Discussion

Accounting that the child have said, the seventh key informant can be supported
 71

by the statement of Strowmann (2011) whereas one of the reasons a child is obese is

due to the greater availability of high-energy-dense foods and sugar sweetened

beverages. The effect of chocolate in body weight is truly breathtaking. A concern is that

excessive consumption if chocolate may promote high calorie intake and weight gain, a

risk factor for many diseases, including cardiovascular diseases.

As a consequence, consuming large quantities of dark chocolate in an attempt to

protect against cardiovascular diseases is likely to add excessive calories and induce

weight gain. An article on a magazine elaborated by Manoli (2015) stated that bad

nutrition and too little physical activity are often to be blamed to obesity. A recent study

by the National Heart, Lung and Blood Institute (NHLBI 2012) found that approximately

one third of the total daily calories consumed by the children in the study came from

snack foods, desserts, and pizza. There is a void in getting critical information out to

parents on how they can be role models for their children. It can begin to turn the tide

(of childhood obesity).

The researchers overall, understood the significant effect of chocolate and other

sweets to the weight gain of the child, whereas it contains a high amount of calories

which contributes to the induction of body mass ad body weight for the child. It would be

important for the parents to help the child in reducing weight by showing them discipline

in chocolate intake.

Key Informant 8

For the eighth key informant, the researchers interviewed a 4 year-old girl

currently residing at Purok 5, Barangay Pasig. She is a bit shy and timid throughout the
 72

entirety of the interview. Due to her being tremulous, she frequently goes outside to

play, and rather, just stay indoors. The researchers asked about the previous meal she

had taken. Her mother answered the question for her saying that her breakfast was

eggs, hotdogs, and rice. She ate biscuits for snacks, eggs with rice for lunch and

hotdogs for dinner. When asked she would always eat these foods every day, he

mother said “hotdog tapositloglaginyangkinakain, perosaagahanlang” [hot dogs and

eggs, but only during breakfasts].

She doesn’t have much hobby. But her mother said that most of the time, she

would just sleep and for almost the entire day and spends very little time outdoors.

“Mahiyainkasisya kaya di syalumalabasngbahay” [she doesn’t go out of the house very

often because she is very shy]. Heredity is traced out as the cause of her obesity. She

gets hungry very easily typically during heavy meals. But she eats very slow compared

to the other respondents.

 73

Plate 8: The mother of the eight key informant answering the questionnaire prepared by

the researchers

Discussion

Key informant 8 shows common intake of hotdogs. And in accordance to the

statement of Carrie (2015), hotdogs are one of the most common processed foods

eaten globally. The bad thing about processed foods, however, is that they tend to be

high in sodium, bad sugars, carbohydrates, and fats. Processed foods are also low in

dietary fiber, vitamins, and minerals. When it comes to carbohydrates, it is the simple

ones that a child must avoid, as they can be very starchy and problematic. A child who

ate foods with simple carbohydrates, like potato chips and hotdogs, had an average

yearly increase of about two pounds. A person who ate high-starchy foods, and
 74

neglected physical activity gains a huge amount of body mass.

BistroMD (2015) said that those who slept for less than six hours per night, or

more than eight, experienced an increase in weight gain. Oversleeping or not getting

enough rest can have a big impact on weight. This is especially true when it comes to

abdominal fat retention.

The researchers have learned that too much intake of hotdogs or similar

processed foods can have a huge impact on weight gain. It is important to know when

or how a person must eat this certain food, for it contains too much calories and starch.

The researchers also learned that sleep also has a significant effect in obesity. It is

important that average time of sleep is necessary to avoid weight gain.

Key Informant 9

The next key informant is an energetic 2 year-old girl who loves to play outside.

She always loves to play with her friends outside rather than spending the entire day

inside. The most recent food she ate are sopas [macaroni soup] for breakfast, bread

and milk for her morning snack, fried fish and rice for lunch, and “longganisa” and fried

fish with rice for dinner.

Her hobby, as stated by the mother is playing outside with her friends, although

when returning home after playing, she immediately sleeps. The cause of her obesity is

hereditary. When asked if she gets hungry very easily, both the child and the mother

agreed. Additionally, the child also eats fast during heavy meals.
 75

Plate 9: The ninth informant key

Discussion

The statement of the ninth key informant asserts the claim of Hewitt (2011) that

most obese children never feel full. Hewitt pointed out that hormonal imbalance makes

the body feel hungrier. Leptin is the hormone that contributes to this manner. It is

protein made and released by the fat cells of the body. It circulates in the bloodstream,

goes to the hypothalamus, and tells the body whether it has enough energy stored in

the fat cells. Harvey (2012) supports this claim, stating that most of the obese people

feel this way, and it is the reason why they always get easily hungry, thus maintained to

be obese.

The statement of key informant for shows accordance to the claim of Hewitt,

showing the trait of always being hungry for no apparent reason. And that trait is due to
 76

the contradiction of hormones, between leptin and insulin, whereas insulin stops leptin

from getting full signal, and tricks the person into thinking that they are always hungry.

The statement of the ninth key informant, as to what the other informant said,

gave the researchers more knowledge as to why an obese person feels hungry most of

the time. The researchers also observed that the child would always go outside being

hyper while playing, but, to the contrary, remains to be obese further strengthen the

claim.

Key Informant 10

A three year old female is the tenth informant, living as an informal settler near

the Daet River in Barangay Mantagbac. But even though she lives in a less wealthy

lifestyle, she still managed to be obese and eats plenty of foods. As to the last meal she

took, her breakfast was bread with milk, she had no snack, her lunch was fish and rice,

and her dinner was also fish and rice. And when the mother was asked whether these

foods are commonly eaten by the child, the mother nodded, but pointed out the fish

only.

Being exposed in an environment full of children, her hobby is to play outdoors,

typically during daytime. The cause of her obesity may is hereditary since his father side

has a history of obese family members. The child eats very fast and gets hungry very

easily, even after she already took her snack.

 77

Plate 10: The researcher discussing matters with the parent of the tenth key
Discussion informant

The case of the tenth informant is another hereditary trait which can be relatable

to Sanderson’s (2011) study. It is shown that genetics plays a role in obesity. Genes

can directly cause obesity in disorders such as Bardet-Biedl syndrome and Prader-Willi

syndrome. However genes do not always predict future health. Genes and behavior

may both be needed for a person to be overweight. In some cases multiple genes may

increase one’s susceptibility for obesity and require outside factors; such as abundant

food supply or little physical activity.Clustering of cases within a family, the congruence

of body weight for monozygotic twins, and the discovery of genes associated with

obesity are all arguments reinforcing the genetic dimension of obesityIt is now well

established that overweight and the different forms of obesity are conditions tending to

concentrate within a family Rohrer (2014). Obesity risk is two to eight times higher for a

person with a family history as opposed to a person with no family history of obesity,

and an even higher risk is observed in cases of severe obesity. Heritability of obesity
 78

may vary depending on the phenotype studied, however it tends to be higher for

phenotypes linked to adipose tissue distribution and for weight or body fat excess.

Weight gain and adiposity increase with age, an effect also influenced by heredity.

Sometimes, no one is to be blamed for a certain predicament. Same as the

situation of the tenth key informant whereas he was obese only due to heredity. But the

researchers believe that the child could still decrease his body weight overtime, since

according to Pudel (2013), hereditary obesity can be faced by healthy lifestyle as they

grow older.

Key Informant 11

The next key informant is a 4 year-old boy living in a wealthy family. The boy had

a twin but sadly, he passed away just a year ago. Living in a wealthy family gave a

result of him being overfed, said by the mother. His previous meal taken was eggs with

rice and Energen for breakfast, cupcake and chuckie for his morning snacks, pork

chops for lunch, and chicken for dinner. The mother even added that most of the time,

the boy commonly eats fast foods like Jollibee or Mc Donald’s every dinner whenever

his father arrive from work. “mahiligsyasa Jollibee. Lagi din kasingnabili papa

niyapaggalingsatrabaho” [he loves Jollibee. Mainly because his father would always buy

one whenever he comes home from work]

The boy has no specific hobbies, but in a regular basis, he is always playing with

his toys and watches TV. He plays outdoors very frequently. Furthermore, the father

stated that his obesity is hereditary. Her mother even added “nasanayna din

kasisiyangpalagingpinapakainng papa niya” [he is already used to his father always

 79

feeding him]. When asked if the child gets hungry easily, the mother said yes, and she

even said that he gets hungry at almost every 3 hours. Additionally, the boy eats

quickly.

Plate 11: The eleventh key informant answering the checklist with the researcher

Discussion

The data gathered can be reaffirmed to the claim of Meyerhof (2015) whereas,

fast foods affect children and youth often worse than adults. This is because most of the

fast foods are targeted towards children and there is a sustained pattern of eating fast

foods and eating out. Children with a sustained excess energy imbalance intake

approximately 2 percent result in the development of obesity over time. A 2 percent

 80

imbalance could mean an excess of only about 30 kilocalories per day. This

corresponds to two-thirds of a chocolate cookie, fewer than two French fries or one-

fourth of a can of soda.

Studies have shown that over the past four decades, consumption of food eaten

away from home has also risen alarmingly. According to Mandal (2012) it is well known

that eating out may lead to excess calorie intake and increases the risk of obesity

because of large portion sizes and increased energy density of foods. Fast foods are

typically high in calories, fat, saturated and trans fat, sugar, simple carbohydrates, and

sodium (salt).

These further signify that eating fast foods very often may result to obesity. The

researchers have learned that most of the fast foods have certain contents such as

calories, fats, and carbohydrates that can contribute to the increase of body weight and

further diseases. It is important to trace out this case because the rate of the intake of

fast foods has grown alarmingly throughout the globe.

Key informant 11 showed lack of physical activity and sedentary lifestyle,

common to most common to the key informants interviewed. Key informant 11 also

shares the same negative trait to other key informants such as quick in eating and gets

easily hungry.

Key Informant 12

The twelfth key informant is a 4 year-old boy also living a wealthy lifestyle. Most

of the time, he spends his time inside his house rather than playing outside. When

asked for the last meal taken, the mother responded: “isdaangagahannyan,
 81

palaginaman. Tapospagkamasnacksya, makainsyangtinapay.N’ungtanghalian,

nagkainsyang pork chop, taposisda at itlognamannghapunan” [For breakfast, the boy

ate fried fish with rice, for his snacks in the morning, he ate bread. He ate pork chop and

rice for lunch and fried fish and egg with rice for dinner].

The child is a bit shy therefore the mother is the one always answering the

questions. When asked what his hobbies are, the mother said that he loves to play ball

games but inside the house only. The mother is unsure whether the cause of obesity is

hereditary or not. But the mother does agree that the child gets easily hungry and eats

quickly during heavy meals.

Plate 12: The researchers discussing matters with the twelfth key informant’s
 82

Discussion

The wealth of the family of the twelfth key informant is supported by the study of

Marmot (2012) where as socioeconomic status can have a significant impact in

childhood obesity. Wealth appears to be a risk factor for obesity in children living in a

wealthy lifestyle, rather than those who have lower incomes. Marmot also suggest that a

reversal in the social distribution of obesity risk is occurring which can be explained by

the large increase in obesity levels in higher socioeconomic groups between a long term

period.

The twelfth informant also showed another negative habit. According to West

(2013), American children had on average only four to seven minutes of unstructured

play per day. All this time spent indoors is having a negative effect on youth that can be

detrimental not only to the mind, but also the body.

West believes that outdoor play is the perfect solution to obesity in children

because it allows children the ability to have self-directed physical activity. Outdoor play

is physically stimulating while increasing a child’s awareness to his surroundings.

The researchers learned that wealth or income can have a huge effect to the

eating habits and practices of a child, but it can also be minimized. Rather than

overfeeding the child, the parent must know how to balance the money to be spent for

the needs of the child.

Key Informant 13
 83

A 5 year-old boy is the next key informant. He is always indoors playing rather

than engaging to outdoor activities. His previous food intake in heavy meals are egg

and hotdog with fried rice for breakfast, bread and rice for his morning snack, adobo

and rice with soft drinks for his lunch, and adobo and egg with rice for his dinner. The

researchers asked if those foods are always eaten, the mother said “yung adobo lang,

at yunang favorite nya” [he always eats adobo, and it’s his favorite]

Some of his hobbies are watching the television and playing video games.

Although he is already 5 years of age, he still breastfeeds from his mother.

“nasanaynayanmagbreast-feed sakin” [she is already used in breastfeeding]. When

asked if he gets easily hungry, both the mother and the child agree. And the mother

also agreed to the question if the child eats fast during heavy meals.

Plate 13: The researcher asking varied questions to the thirteenth key informant’s

mother
 84

Disscussions

Thefindings of the answers of the thirteenth key informant can The habit of maintaining a

healthy lifestyle, including regular exercise and a nutritious diet ideally begins in childhood and

we hope that parents and schools everywhere will use this day to spread this message," said

DrGro Harlem Brundtland, WHO’s Director-General. "We should all be ready to move for health

and to adopt healthy and active lifestyles. World Health Day 2002 is a call to action to

individuals, families, communities, governments and policy-makers to move for health," she

added.

Among the preventive measures recommended by WHO are moderate physical activity for up to

30 minutes every day, tobacco cessation, and healthy nutrition. In addition to individual lifestyle

changes, governments and policy makers are also recommended to "move for health" by

creating a supportive environment for people. Among the measures recommended:

implementing transportation policies that make it safer for people to walk and ride bicycles;

legislating tobacco-free public buildings and spaces; building accessible parks, playgrounds and

community centers; and promoting physical activity programs in schools, communities and

health services.

Key Informant 14

The fourteenth key informant will be a 4 year old girl. Living as an informal settler,

life is not as easy for this little girl. When asked for her meal recall, her mother

elaborated the following: For breakfast, she ate eggs with rice and milk, and for her

snacks, she ate biscuits and milk. For her lunch, she ate soup (not pointed out whether
 85

it is just soup) with rice, and for dinner, she ate salted egg with rice.

“mahiligsyasasabaw” [she loves soup], the mother said.

Her hobbies are playing indoors like playing with Barbie dolls and watching TV.

Her obesity is not hereditary. When asked if she gets, easily hungry, she replied yes.

She replied the same answer when asked if she eats quickly during heavy meals.

“hindisyaagadnakukuntentopagkontilangangkinain” [she is not well contented when she

eats very few] stated by the mother.

Plate 14: The fourteenth key informant being measured by her height

Discussions

The habit of the fourteenth key informant about always being hungry reflects the

claim of Hewitt (2011) that most obese children never feel full. Hewitt pointed out that

hormonal imbalance makes the body feel hungrier. Leptin is the hormone that
 86

contributes to this manner. It is protein made and released by the fat cells of the body. It

circulates in the bloodstream, goes to the hypothalamus, and tells the body whether it

has enough energy stored in the fat cells. Harvey (2012) supports this claim, stating that

most of the obese people feel this way, and it is the reason why they always get easily

hungry, thus maintained to be obese.

The statement of key informant shows accordance to the claim of Hewitt,

showing the trait of always being hungry for no apparent reason. And that trait is due to

the contradiction of hormones, between leptin and insulin, whereas insulin stops leptin

from getting full signal, and tricks the person into thinking that they are always hungry.

The fourteenth informant is similar to the other informants regarding to their

hormonal imbalance regarding to food leptin and insulin. The researchers have learned

that there is a reason why an obese child is always hungry. It is not because of his/her

negative behavior, but rather, a hormonal condition.

Key Informant 15

For the next key informant, the researchers interviewed a 3 year-old boy who is

also wealthy, living in Purok 7, Barangay Pasig. He is limited to going outdoors due to

the accident that he had a couple of months ago, thus, leaving him playing indoors only.

“Nabanggaansyang tricycle dati. Edi yun, natraumana, di

naniyagustonglumabasngbahay” [he was hit by a tricycle a few months back.So I guess

he was traumatized and never want to leave the house]. For the last food taken, he ate

tocino and rice for breakfast, an apple for his snack, pork steak with rice for his lunch,
 87

and chicken and hotdog with rice for his dinner. Her mother said that chicken is always

being eaten by her child.

The boy is unsure of what his hobbies are, but the mother said that he always

watches TV and plays indoors with his toys and action figures. Heredity is not the case

for his obesity. The boy gets easily hungry as stated by the mother, and he also eats

fast most of the time.

Plate 15: The fifteenth key informant

Discussions

The statement if key informant 15 show significance to the claim of Faghri et al.

(2015) whereas less physical activities may lead to obesity. Sedentary lifestyle

compounded with lack of physical activity causes significant decline in muscle integrity

and increase in body fat which may lead to obesity.

 88

The increase in childhood obesity is attributable to an increasingly sedentary

lifestyle and poor nutrition (Galson 2008). Sedentary behavior such as television

viewing, computer use, and video game playing often replace vigorous physical activity

in children. The youth’s lack of physical activity may be addressed as the cause of

obesity. Moreover, the World Health Organization (WHO 2012) that physical inactivity,

along with poor diet and nutrition, are increasingly becoming part of today’s lifestyle

leading to the rapid rise of diseases such as cardiovascular diseases, diabetes, and

obesity. The researchers have traced out that sedentary lifestyle is one of the most

common habits shown by most of the key informants.

Key Informant 16

The next informant is a 4 year old boy living near the river at Barangay

Mantagbac. This boy plays both indoors and outdoors subsequently, meaning that he

can engage to both activities and exercise his body at the same time. “Minsan, gusto

niyasalabas, perominsan, saloob, dependeatasa mood niya” [sometimes he wants to go

outside, sometimes, stay indoors. Maybe it depens on his mood] The previous food he

ate are as follows: hotdog and rice for breakfast, monggo and rice for his snack, pork

with soup and rice for lunch, and chicken with rice for dinner.
 89

His hobbies are playing both indoors and outdoors with his friends and watching

TV. He also loves to play ball games. His obesity is hereditary from his mother’s side.

And when asked if he eats very fast, his grandfather said yes, and so does the child. He

also eats quickly.

Platen 16: The sixteenth key informant

Discussions

The response of the key informant can be supported byManoli (2015) as he

stated that bad nutrition and too little physical activity are often to be blamed to obesity.

A recent study by the National Heart, Lung and Blood Institute (NHLBI 2012) found that

approximately one third of the total daily calories consumed by the children in the study

came from snack foods, desserts, and pizza. There is a void in getting critical

information out to parents on how they can be role models for their children. They can

begin to turn the tide (of childhood obesity).

The researchers have inquired the knowledge that sedentary lifestyle is the most
 90

common prevalence of obesity. Most of the key informants show such habits which, as

a result, grow more body mass and body fat.

Key Informant 17

The seventeenth key informant is a 4 year-old boy also living near the river on

Barangay Mantagbac. This boy always stayed inside the house and rarely goes

outdoors. When asked for his previous meal taken, he and his grandmother said that his

breakfast was hotdog with rice and milk, his snack was bread. The lunch that he ate

was Jollibee, and his dinner was chicken with rice and milk. The researchers asked if

the child always eats fast foods, but the mother said “minsanlangnaman,

nagkataonlangnanagdatingpinsanniya” [sometimes. It just so happened that his cousin

is here].

His hobbies are watching TV and using gadgets like phones, tablets, laptops,

and more. According to his grandmother, the cause of his obesity is hereditary. The

child easily gets hungry and eats quickly during heavy meals.
 91

Plate 17: The seventeenth key informant watching the data gathering method

Discussion

The statement of the seventeenth key informant rhymes with the statement of

Dorfman (2014). He explained that many causes of the obesity epidemic exist. Fast

food likely contributes to overconsumption, and a sedentary lifestyle reduces energy

expenditure. A sedentary lifestyle interacts with overconsumption to produce obesity.

Dorfmanbelieved that energy intake falls out of homeostasis with energy expenditure

when physical activity falls into the sedentary range,even if homeostasis could be

maintained in sedentary people.However, the low energy intake that may prevent

obesity may at the same time deplete micronutrient intake to such an extent that some
 92

metabolic systems would not operate properly. Indeed, many of the foods, including soft

drinks and refined-wheat breads, are low in micronutrients

People who spend more time sitting accumulate more fat on their backsides and

lower bodies. Studies show that fat cells expand when under sustained pressure or

load. The molecules that carry fats known as lipid droplets accumulate, and cells

respond with a change and stiffening in their structure. Additionally, they push out as

they expand, causing neighboring cells to change their shape and composition.

It is shown to the key informant that these results are accurate. A very wide

waistline, compared to others, is clearly a result of his sedentary lifestyle and poor

exposure of physical activity. The researchers have learned that such sedentary lifestyle

can have a huge impact in body mass.

Key Informant 18

The next key informant will be a 3 year old girl. The girl is living wealthily with her

parents owning a private farm in Barangay Pamorangon. In relation to the question of

what food was last taken, the child and her guardian elaborated the following: hotdog

with rice for breakfast, biscuits and milk for snacks, fried fish for lunch, and fried fish

with eggs for dinner. “palagisiyangnakainngitlog, lalonapagagahan” [she always eat

eggs, especially during breakfasts].

The girl’s habit is playing outdoors. The girl is more engaged in physical

activities. Heredity is not yet traced as the primary reason for her obesity. Though when

asked if she gets hungry very easily, she agreed. The researchers also asked if he eats

quickly.
 93

Plate 18: The eighteenth key informant after being scaled in the weighing scale

Discussion

The wealth of the family of the eighteenth key informant is supported by the study

of Marmot (2012) where as socioeconomic status can have a significant impact in

childhood obesity. Wealth appears to be a risk factor for obesity in children living in a

wealthy lifestyle, rather than those who have lower incomes. Marmot also suggest that a

reversal in the social distribution of obesity risk is occurring which can be explained by

the large increase in obesity levels in higher socioeconomic groups between a long term

period.

The eighteenth informant also showed another negative habit. According to West

(2013), American children had on average only four to seven minutes of unstructured
 94

play per day. All this time spent indoors is having a negative effect on youth that can be

detrimental not only to the mind, but also the body.

West believes that outdoor play is the perfect solution to obesity in children

because it allows children the ability to have self-directed physical activity. Outdoor play

is physically stimulating while increasing a child’s awareness to his surroundings.

Multiple substandard habits have been shown by the child, such as fast eating.

The wealth of the family of the child may also contribute to his growth in obesity. The

researchers have assimilated that children living under wealth may become obese most

probably due to overfeeding.

Key Informant 19

The nineteenth informant will be a three year old girl. She is always indoors

rather than going outdoors. Upon being asked why the child does not want to go outside

the mother replied “mahiyainsiya, lagingnatagopag may tao” [she is always shy, and

hides whenever there’s someone here]. When asked for her previous meal taken she

said that her breakfast was egg with rice, her snack was bread and milk, her lunch was

fried fish, and her dinner was salted egg with rice. The parent of the girl is asked if these

foods are eaten frequently, the parent said that all of them.

The girl is always indoors with the hobby of playing indoor games and playing

with gadgets like phone and watching TV. “Halos maghaponnalangyannakababadsa

cell phone o kaya sa tablet” [almost the entire day, he just spends his time playing on
 95

his phone or in the tablet”. The cause of her obesity is most likely due to heredity. The

girl gets hungry very easily and quickly eats heavy meals.

Plate 19: The nineteenth informant key answering the checklist of the researchers

Discussion

The case of the nineteenth informant is another hereditary trait which can be

relatable to Sanderson’s (2011) study. It is shown that genetics plays a role in obesity.

Genes can directly cause obesity in disorders such as Bardet-Biedl syndrome and

Prader-Willi syndrome. However genes do not always predict future health. Genes and

behavior may both be needed for a person to be overweight. In some cases multiple

genes may increase one’s susceptibility for obesity and require outside factors; such as

abundant food supply or little physical activity.Clustering of cases within a family, the

congruence of body weight for monozygotic twins, and the discovery of genes

associated with obesity are all arguments reinforcing the genetic dimension of obesity
 96

It is now well established that overweight and the different forms of obesity are

conditions tending to concentrate within a family Rohrer (2014). Obesity risk is two to

eight times higher for a person with a family history as opposed to a person with no

family history of obesity, and an even higher risk is observed in cases of severe obesity.

Heritability of obesity may vary depending on the phenotype studied, however it tends to

be higher for phenotypes linked to adipose tissue distribution and for weight or body fat

excess. Weight gain and adiposity increase with age, an effect also influenced by

heredity.

Overall, the researchers learned that genetic factors may be involved in the

etiology of obesity and, exclusive of very rare severe obesity cases; the genes involved

are probably genes that interact with environment factors related to energy intake and

expenditure to increase the risk of obesity.

Identification of those genes will help clarify the etiology of obesity and its

metabolic consequences, the metabolic complications of obesity, as well as identify at-

risk individuals or groups in terms of their genetic profile with the goal of developing

personalized prevention and treatment strategies.

Key Informant 20

A three year old female is the next informant, also living as an informal settler

near the Daet River. But even though she lives in a less wealthy lifestyle, she still

managed to be obese and eats plenty of foods.

“Minsannganabilinalangyanngpagkainsatindahannang di akonagaalam” [sometimes,

she would go to the store to buy some snacks without me knowing]. As to the last meal
 97

she took, her breakfast was bread with milk, she had no snack, her lunch was fish and

rice, and her dinner was also fish and rice. And when the mother was asked whether

these foods are commonly eaten by the child, the mother nodded, but pointed out the

fish only.

Being exposed in an environment full of children, her hobby is to play outdoors,

typically during daytime. The mother even stated that she has many friends. The cause

of her obesity may not be hereditary since there is no case of obesity in the family of

both the mother and the father sides. The child eats very fast and gets hungry very

easily, even after she already took her snack.

Plate 20: The researcher asking questions to the twentieth key informant’s grandmother

Discussion
 98

The gathered data reaffirms the study of Fleihr (2013) which states that obesity is linked

to social class, being more common among those in the routine or semi-routine occupational

groups than the managerial and professional groups. The link is stronger among women. In

2010, 47 per cent of women in routine occupations were classified as obese compared with 16

per cent in higher managerial and professional occupations. Social origins may have a long

term impact on obesity. Whether this operates through the early establishment of behavioral

patterns, such as diet and exercise, or through metabolic changes associated with early

deprivation, is still to be determined.

While the exact nature of the causal effect might not be clear from the study, it is evident

that relative deprivation affects not only levels of childhood obesity but, perhaps even more so,

obesity in later adulthood.

Overall, in this key informant, the researchers have assimilated that wealth can have an

impact in obesity. Although there are myths that the more wealth the more prone a person is to

obesity, but, it varies. The researchers also learned that the habit of the family can also

contribute.

Key Informant 21

The next informant is a 5 year old boy. Same as most of the children, this boy

also loves to play outdoors up to the point where the mother is having a hard time

making him go home. The mother joked “minsanngakailangankonasiyanghilahin”

[sometimes, I’m gonna have to forcefully pull him back]. The researchers then asked the

previous meal taken. For breakfast, he ate eggs with rice and milk for his snacks, he ate

some biscuits. For his lunch, he ate kinunotwith rice. And for dinner, he ate chicken with

rice and milk.

 99

Some hobbies of the child include playing basketball, and engaging outdoor

activities. It is yet unknown whether his heredity is the cause of such predicament. But

nevertheless, his obesity is probably caused by his overeating habit. The boy gets

easily hungry, as answered by the mother. Likewise, the boy is also quick in eating

heavy meals.

Plate 21: The researcher discussing things with the twenty-first key informant’s mother

Discussion

The twenty-first key informant shows the habit of overeating, as shown by asking

of additional meal. Warner (2013) suggests that overeating is directly linked to obesity;
 100

she defined obesity as the occurrence when a person consumes, over the long term,

more food than a person actually needs to maintain a good health.

Key informant 5 also shows accordance to the claim of Hewitt (2011). Hewitt

pointed out that hormonal imbalance makes the body feel hungrier. Leptin is the

hormone that contributes to this manner. It is protein made and released by the fat cells

of the body. It circulates in the bloodstream, goes to the hypothalamus, and tells the

body whether it has enough energy stored in the fat cells. Harvey (2012) supports this

claim, stating that most of the obese people feel this way, and it is the reason why they

always get easily hungry, thus maintained to be obese.

The imbalance between the ingesting and letting go of the calories may be the

reason why the child is obese. As stated by the mother, the child is always ouside

playing exposing him to perform physical activities. But even though he engages such

things, he is still obese. That is why the researchers think that the imbalance between

the ingestion and the release of calories have a huge effect in obesity.

Key Informant 22

The next key informant is an energetic 2 year-old girl who loves to play outside. She

always loves to play with her friends outside rather than spending the entire day inside. When

describing how energetic the girl is, the mother said “sobrangsobra” [very much]. Her last meal

taken was scrambled eggs with rice for breakfast, biscuits and milk for her snacks, Fried

chicken with rice for lunch and dinner. The

Her hobby, as stated by the mother is playing outside with her friends, although when

returning home after playing, she immediately sleeps. The cause of her obesity is hereditary.

When asked if she gets hungry very easily, both the child and the mother agreed. Additionally,
 101

the child also eats fast during heavy meals.

Plate 22: The researchers and the twenty-second key informant’s mother having a
conversation
Discussion

The findings of from the key informant 22 can be supported by the statement of Bell

(2012). Fried food may also induce obesity by increasing food energy density. Energy density,

palatability, and are highly rated, and energy density is a primary determinant of voluntary.

Studies have shown that energy density is a better predictor of total than is fat content in both

lean and obese females. Energy density may thus affect independent of macronutrient content

or palatability.

Fat intake with fried foods could be also associated with obesity because fats are

absorbed and metabolized more efficiently than are other macronutrients. Unlike those

mechanisms described above, this type of potential mechanism does not involve greater . It has

been argued that body weight may depend on macronutrient composition in addition to total and

that low-fat, high-protein, and high-complex carbohydrate diets should be recommended for

obesity prevention. This view, however, is controversial. Although short-term studies show a
 102

modest reduction in body weight with low fat diets, long-term studies suggest that total is much

more important than macronutrient composition for body weight

Key Informant 23

The next informant is another energetic 2 year old boy. He loves to play both

indoors and outdoors. When asked about the previous meal he had, her mother

elaborated that her breakfast was soup and milk, some chocolates for snacks, fried fish

for lunch and Chicken adobo for dinner. “mahiligsyasaprito, tapos mas

napapalakasangkainniyakapag may sawsawan” [she loves fried foods. And sometimes,

she eats more if there is a dip]

The boy both loves to play indoors and outdoors and, as the mother stated wants

to explore more. His obesity is hereditary through his father’s genes. The boy gets

easily hungry and eats quickly, as narrated by the mother.

 103

Plate 23: The twenty-third key informant looking at the researchers

Discussions

It is shown that key informant 23 is fond of eating fried foods. This is in accordance to

Lossada (2012) Fried food may also induce obesity by increasing food energy density. Energy

density, palatability, and are highly rated, and energy density is a primary determinant of

voluntary. Studies have shown that energy density is a better predictor of total than is fat

content in both lean and obese females. Energy density may thus affect independent of

macronutrient content or palatability.

Fat intake with fried foods could be also associated with obesity because fats are

absorbed and metabolized more efficiently than are other macronutrients. Unlike those

mechanisms described above, this type of potential mechanism does not involve greater . It has

been argued that body weight may depend on macronutrient composition in addition to total and

that low-fat, high-protein, and high-complex carbohydrate diets should be recommended for

obesity prevention. This view, however, is controversial. Although short-term studies show a

modest reduction in body weight with low fat diets, long-term studies suggest that total is much

more important than macronutrient composition for body weight

Key Informant 24

The next informant is a 6 year old boy. He is always shy in front of other people

but loves to play outdoors with his friends. His last meal taken was hotdog with rice for

breakfast, some biscuits for snacks, pork adobo for lunch, and ginataangisda [fish with

coconut milk extract] for dinner. “Bihira man langniya to karainin, pweralangsahotfod,

lagisyangnakain nun. Kadaumaga” [these foods are not always eaten by the child,

except hotdogs every morning]

 104

The boy’s hobby is playing outdoors for almost an entire afternoon, as stated by

the mother. He loves to play basketball and kept on running with his friends. When

asked if his obesity is hereditary, the mother disagrees, saying that she just overfed the

boy. He gets easily hungry after eating and eats very fast during heavy meals.

Plate 24: The researcher discussing things with the twenty-fourth key informant

Discussion

Key informant 24 shows common intake of hotdogs. And in accordance to the

statement of Carrie (2015), hotdogs are one of the most common processed foods

eaten globally. The bad thing about processed foods, however, is that they tend to be

high in sodium, bad sugars, carbohydrates, and fats. Processed foods are also low in

dietary fiber, vitamins, and minerals. When it comes to carbohydrates, it is the simple

ones that a child must avoid, as they can be very starchy and problematic. A child who

ate foods with simple carbohydrates, like potato chips and hotdogs, had an average
 105

yearly increase of about two pounds. A person who ate high-starchy foods, and

neglected physical activity gains a huge amount of body mass.

The researchers learned that food intake is important to be analyzed. For

instance, this key informant may be obese due to him always eating hotdogs, which, as

stated by Carrie, is one of the fattiest processed foods ever developed globally.

Therefore it is important to consider to think about the food any person is about to eat.

Key Informant 25

The next informant is a 3 year-old boy. As elaborated by his mother, most of the

time he just sleeps all day without much physical activity performed. The last meal he

took was tinapa and rice for breakfast, bread and milk for snacks, fried chicken with rice

for lunch and pork menudo for dinner. The mother clarified that most of the food that he

said isn’t what his child always eats.

The boy does not have any hobby other than sleeping, the mother said. He lacks

physical exercise or activities which can at least help him reduce weight. His obesity is

not hereditary. When asked if the boy gets easily hungry, the mother agreed. The

mother also agreed that the boy eats quickly.

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Plate 25: The researcher having a conversation with the son of the twenty-fifth key

informant

Discussions

Stated by the key informant, the child sleeps most of the time shows accordance

to the findings of Artest (2012) which states that sleeping too much or too little could

make you weigh too much, as well. One recent study showed that people who slept for

nine or 10 hours every night were 21 percent more likely to become obese over a six-year

period than were people who slept between seven and eight hours. This association

between sleep and obesity remained the same even when food intake andexercise were

taken into account.

Short and long sleepers both gained more weight than normal sleepers over the six year

period (1.98 kg and 1.58 kg), and were more likely to experience a significant weight gain.

People sleeping over nine hours were 21% more likely than normal sleepers to become obese
 107

during the study. Other studies generally only support trends of higher body weight for short

sleepers, but it could be that associated factors like diabetes risk contribute to weight gain for

long sleepers.

The researchers have assimilated that sleep can also be a factor for obesity to a certain

person. Oversleeping may also be prevalence in weight gain, and can have a huge impact in

obesity.

Key Informant 26

The 3-year old girl born on September 6, 2013, will be the twenty-sixth key

informant. At that age, he is already taller than most 3-year olds. He is living with her

grandparents since her parents are working abroad. When asked about his last meal,

her grandmother said “agahan, lagi yang naghohotdogtaposkanin” [every breakfast, she

would eat hotdog and rice]. Moreover, her grandmother added that her snack was donut

and milk, her lunch was fried chicken with rice, and her dinner was pizza at Greenwich.

His hobbies mostly rotate inside the house; watching TV, or playing games in the

cell phone. “Palagi yang tulog, taposmagigisingparakumain, tapostulogulit” [He’s always

asleep. He would wake up to find food, and then sleep again]. The cause of his obesity

is not hereditary, as stated by her grandmother. He gets easily hungry and eats fast

during meals.
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Plate 26: The son of the twenty- sixth key informant

Discussion

The twenty-sixth key informant has a wealthy family, considering that both of the

parents of the child is working abroad. This is supported by the study of Marmot (2012)

where as socioeconomic status can have a significant impact in childhood obesity.

Wealth appears to be a risk factor for obesity in children living in a wealthy lifestyle,

rather than those who have lower incomes. Marmot also suggest that a reversal in the

social distribution of obesity risk is occurring which can be explained by the large

increase in obesity levels in higher socioeconomic groups between a long term period.

The twenty-sixth informant also showed another negative habit. According to

West (2013), American children had on average only four to seven minutes of

unstructured play per day. All this time spent indoors is having a negative effect on

youth that can be detrimental not only to the mind, but also the body.
 109

West believes that outdoor play is the perfect solution to obesity in children

because it allows children the ability to have self-directed physical activity. Outdoor play

is physically stimulating while increasing a child’s awareness to his surroundings.

The researchers learned that wealth or income can have a huge effect to the

eating habits and practices of a child, but it can also be minimized. Rather than

overfeeding the child, the parent must know how to balance the money to be spent for

the needs of the child.

Key Informant 27

The next one is a 4-year old girl living in a wealthy family. Her parents weren’t

available at that moment but her baby sitter was. “Medyona-spoil syangmga parents

satotoolang, kaya siguronanaba.” [The truth is, he was spoiled by his parents, maybe

that’s the reason he got fat]. When asked about her last food intake, the baby sitter said

that her breakfast was eggs and ham with rice and milk, her snacks was cookies and

milk, her lunch was bangus with rice, and her dinner was roasted chicken bought from

Chooks to Go.

She would spend most of the time indoors playing on her dolls.

“Ayawniyanglumabaslabasngbahay.” [she doesn’t want to go outside the house to play].

When asked if her obesity is hereditary, the baby sitter was unsure, but she responded

“matabayung papa niya eh, kaya siguronamananiya” [well her father is fat, so maybe

she inherited it]. The researchers never got the chance to meet the girl’s parents

personally. She gets hungry very easily and eats very fast. The baby sitter even

laughed and said “saisangiglap, tapos nay an agadkumain” [all of a sudden, she’s done
 110

eating]

Plate 27: The researcher talking with the key informant and her children

Discussion

The response of the key informant can be supported by Manoli (2015) as he

stated that bad nutrition and too little physical activity are often to be blamed to obesity.

A recent study by the National Heart, Lung and Blood Institute (NHLBI 2012) found that

approximately one third of the total daily calories consumed by the children in the study

came from snack foods, desserts, and pizza. There is a void in getting critical

information out to parents on how they can be role models for their children. They can

begin to turn the tide (of childhood obesity).

 111

The increase in childhood obesity is attributable to an increasingly sedentary

lifestyle and poor nutrition (Galson 2008). Sedentary behavior such as television

viewing, computer use, and video game playing often replace vigorous physical activity

in children. The youth’s lack of physical activity may be addressed as the cause of

obesity.

The researchers have understood that sedentary behavior is a big deal for

obesity. This type of habit overtakes the engagement of vigorous activities, especially

for the child. The researchers also conclude that due to modernization of technologies,

sedentary lifestyle may grow throughout the field of obesity.

The researchers have inquired the knowledge that sedentary lifestyle is the most

common prevalence of obesity. Most of the key informants shows such habits which, as

a result, grows more body mass and body fat.

Key Informant 28

The next key informant is a 7 year-old boy who loves to play basketball. The boy

spends most of his time playing outside since there is a nearby basketball court. His last

food intake in heavy meal is bread and milk for breakfast, cake for snacks, sprouted

beans with rice for lunch and fish with rice and milk for dinner. “Bihiralang yang

kumainnggulay, minsanngatumatago pa pag may gulaysaplatonya” [he seldom eats

vegetables. Sometimes, he would even hide whenever he sees vegetables in his plate].

The boy’s hobby is playing basketball and outdoor games. His obesity is
 112

hereditary, from his father’s side. He gets hungry very easily and eats very fast.

Plate 28: The researcher conducting an interview to the twenty-eighth key informant

Discussion

The response of the key informants reflects the statement of Millar (2014) where

aseating quickly can lead to obesity. This behavior is sometimes due to being distracted

and unaware. If you're engaged in a television show or are busy browsing the web, you

are very likely not paying attention to how fast you're eating. It takes the brain about 20

minutes or longer to register that you are full. When you eat fast, you run a much higher

risk of overeating. By the time you realize this, you might be full and feeling lethargic

from eating too much. Eating late, for some people, is due to boredom, stress or

depression. If you have nothing to do in the evenings, you might be more inclined to eat.

Some foods such as chocolate and potato chips can make you feel happier. The
 113

problem is that the enjoyment of food is temporary. The calories will stay with you

unless you work them off.

The researchers have learned that eating quickly may cause a negative effect, as

such, to obesity. Just as how the statement of Millar said that it may result to weight

gain and additional body mass. This behavior is sometimes due to being distracted and

unaware. Therefore, when eating, a person must be alert to avoid such habit.

Key Informant 29

A 6 year old female born on August 5, 2010 will be the next key informant. The

boy is always inside the house and seldom goes outside. When asked for her last taken

meal, her mother said that her breakfast was eggs and rice, snacks was French fries.

Her lunch is fried pork with soup, and her dinner was bought from Jollibee.

“mahiligyansamga fast foods, lalonaang Jollibee” [she loves fast foods, especially

Jollibee] stated by the mother.

Her hobby is playing with the cell phone and watching TV. Most of the time, she

would also sleep almost the entire afternoon. Her obesity is not due to heredity. She

eats fast and gets easily hungry, same as most of the respondents.
 114

Plate 29: The researcher discussing matters with the daughter of the twenty-ninth key

informant

Discussion

The data gathered can be reaffirmed to the claim of Meyerhof (2015) whereas,

fast foods affect children and youth often worse than adults. This is because most of the

fast foods are targeted towards children and there is a sustained pattern of eating fast

foods and eating out. Children with a sustained excess energy imbalance intake

approximately 2 percent result in the development of obesity over time. A 2 percent

imbalance could mean an excess of only about 30 kilocalories per day. This

corresponds to two-thirds of a chocolate cookie, fewer than two French fries or one-

fourth of a can of soda.

 115

Studies have shown that over the past four decades, consumption of food eaten

away from home has also risen alarmingly. According to Mandal (2012) it is well known

that eating out may lead to excess calorie intake and increases the risk of obesity

because of large portion sizes and increased energy density of foods. Fast foods are

typically high in calories, fat, saturated and trans fat, sugar, simple carbohydrates, and

sodium (salt).

The researchers have further learned that eating fast foods very often may result

to obesity. The researchers have also learned that most of the fast foods have certain

contents such as calories, fats, and carbohydrates that can contribute to the increase of

body weight and further diseases. It is important to trace out this case because the rate

of the intake of fast foods has grown alarmingly throughout the globe.

Key Informant 30

The next key informant is a 6-year old boy living in Happy Homes Fairview Phase

II, Barangay Magang. Same as the other key informants, he does not like to go

outdoors. His last meal was bread and milk for breakfast, fried fish for lunch, and

kinunotnapating [hot and spicy shark in coconut milk] for dinner. These aren’t the food

that he would always eat though.

His hobbies are watching TV and playing in the tablet. “palagi yang tulog.

Pagkamatataposnangkumain, tulogulit.” [He’s always asleep. Even after eating, he

would just sleep immediately]. His obesity is not hereditary. When asked if he eats fast,

the mother agree. Same response was given when asked if he also gets easily hungry.
 116

Plate 30: The researcher comparing the circumference of the forearm of the thirtieth

informant key’s child

Discussion

Stated by the key informant, the child sleeps most of the time shows accordance

to the findings of Artest (2012) which states that sleeping too much or too little could

make you weigh too much, as well. One recent study showed that people who slept for

nine or 10 hours every night were 21 percent more likely to become obese over a six-year

period than were people who slept between seven and eight hours. This association

between sleep and obesity remained the same even when food intake andexercise were

taken into account.

 117

Short and long sleepers both gained more weight than normal sleepers over the six year

period (1.98 kg and 1.58 kg), and were more likely to experience a significant weight gain.

People sleeping over nine hours were 21% more likely than normal sleepers to become obese

during the study. Other studies generally only support trends of higher body weight for short

sleepers, but it could be that associated factors like diabetes risk contribute to weight gain for

long sleepers.

The researchers have disseminated that oversleeping can have a huge impact in

obesity. As shown by the body of the thirtieth key informant whom always shows a habit

of sleeping, oversleeping can have a significant effect in the increase of body fat.

Key Informant 31

The next key informant is a 3 year-old girl, having a wealthy family. She often

goes outside to play with friends. Her recent food eaten was hotdogs and eggs with rice

for breakfast, some biscuits and milk for snacks, porkchop with rice for lunch, and fried

fish with rice and milk for dinner. “madamisyangkinakainpaggabihan” [She eats plenty of

food at dinner].

Her hobbies are mostly playing outside like Chinese garter or bahaybahayan

[play house]. Asked if her obesity was due to heredity, the mother responded no. The

child eats fast, same as the other respondents, and he alse gets hungry very easily.
 118

Plate 31: The researcher talking with the daughter of the thirty-first key informant

Discussions

The thirty-first key informant has a wealthy family, considering that both of the

parents of the child is working abroad. This is supported by the study of Marmot (2012)

where as socioeconomic status can have a significant impact in childhood obesity.

Wealth appears to be a risk factor for obesity in children living in a wealthy lifestyle,

rather than those who have lower incomes. Marmot also suggest that a reversal in the

social distribution of obesity risk is occurring which can be explained by the large

increase in obesity levels in higher socioeconomic groups between a long term period.

The informant also showed another negative habit. According to West (2013),
 119

American children had on average only four to seven minutes of unstructured play per

day. All this time spent indoors is having a negative effect on youth that can be

detrimental not only to the mind, but also the body.

West believes that outdoor play is the perfect solution to obesity in children

because it allows children the ability to have self-directed physical activity. Outdoor play

is physically stimulating while increasing a child’s awareness to his surroundings.

The researchers learned that wealth or income can have a huge effect to the

eating habits and practices of a child, but it can also be minimized. Rather than spoiling

the child, the parent must know how to balance the money to be spent for the needs of

the child.

Key Informant 32

The next key informant is a 3 year-old boy living in Barangay Salcedo. He is

always indoors playing with his action figures. When asked what his last taken meal

was, he and his mother articulated that the last breakfast he ate was egg with fried rice

and milk, bananas and biscuit in his snack, paksiwnabanguswith rice for lunch, and

sisig, barbeque and rice with juice for dinner. All of these however, are not the usual

foods that he eats at a regular basis.

When asked what his hobbies are, the mother said: “lagilang yang nasaloob,

Palagingnaglalarongmgalaruannya o kaya ay naglalarong tablet” [always indoors. She

would always play with his action figures or play on the tablet].
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“Kapagtaposnasyangkumain,napadagdag pa syangulam at kanin.

Taposkapagnasarestawran kami, palagisyangnagpapadagdadgngpagkain” [everytime

he finished his meal, he would ask to have another. And when we eat at a restaurant,

he would always ask for additional meal]

Plate 32: The researcher talking to the son of the son of the key informant

Discussion

The key informant shows the habit of overeating, as shown by asking of

additional meal. Warner (2013) suggests that overeating is directly linked to obesity; she

defined obesity as the occurrence when a person consumes, over the long term, more

food than a person actually needs to maintain a good health.

 121

She also shows accordance to the claim of Hewitt (2011). Hewitt pointed out that

hormonal imbalance makes the body feel hungrier. Leptin is the hormone that

contributes to this manner. It is protein made and released by the fat cells of the body. It

circulates in the bloodstream, goes to the hypothalamus, and tells the body whether it

has enough energy stored in the fat cells. Harvey (2012) supports this claim, stating that

most of the obese people feel this way, and it is the reason why they always get easily

hungry, thus maintained to be obese.

The researchers have asserted that the habit of asking additional foods may

directly link to obesity. It may also be the effect of the imbalance of leptin and insulin

hormones. Those type of habit can be a trait of overeating, on which, is significant for

the contribution of body fats

Key Informant 33

The next informant is a 5 year old boy living near the river at Barangay

Mantagbac. This boy loves to play outdoors, meaning that he can engage physical

activities and exercise his body. The previous food he ate are as follows: hotdog and

rice for breakfast, monggo and rice for his snack, pork with soup and rice for lunch, and

chicken with rice for dinner.

His hobbies are playing both indoors and outdoors with his friends and watching

TV. He also loves to play ball games. His obesity is hereditary from his mother’s side.

And when asked if he eats very fast, his grandfather said yes, and so does the child. He

also eats quickly during heavy meals.

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Plate 33: The researcher having a conversation with the son of the thirty-third key

informant

Discussions

The response of the key informant can be supported byRyden (2015) as he

stated that bad nutrition and too little physical activity are often to be blamed to obesity.

A recent study by the National Heart, Lung and Blood Institute (NHLBI 2012) found that

approximately one third of the total daily calories consumed by the children in the study

came from snack foods, desserts, and pizza. There is a void in getting critical

information out to parents on how they can be role models for their children. They can

begin to turn the tide (of childhood obesity).

The researchers have inquired the knowledge that sedentary lifestyle is the most

common prevalence of obesity. Most of the key informants show such habits which, as
 123

a result, grow more body mass and body fat.

Key Informant 34

The next key informant is a 5 year-old boy who is also very shy, like most of the

child. He frequently goes outside and rather stays indoors. When asked for the meal

recall, the mother responded “Agahannyan ay hotdog at kanin, wala yang snack

kasinatulog lang. Nung lunch, kumainyanngtinolangmanok,

taposadobongbaboynghapunan” [he ate hotdogs with rice for breakfast, but he didn’t

eat some snacks. When at lunch, he ate Chicken Tinola, and then he ate Pork Adobo

for dinner]. Her mother did also elaborate that hotdog is his favorite food.

The boy has no other hobbies rather than watching TV and sleep. His obesity is

not due to heredity. He eats fast and gets easily hungry, same as all of the other

children.
 124

Plate 34: The researcher listening to the response of the key informant thirty-four

Discussion

Key informant 34 also shows accordance to the claim of Hewitt (2011). Hewitt

pointed out that hormonal imbalance makes the body feel hungrier. Leptin is the

hormone that contributes to this manner. It is protein made and released by the fat cells

of the body. It circulates in the bloodstream, goes to the hypothalamus, and tells the

body whether it has enough energy stored in the fat cells. Harvey (2012) supports this

claim, stating that most of the obese people feel this way, and it is the reason why they

always get easily hungry, thus maintained to be obese.

The researchers have gathered the idea that hormonal imbalance between leptin

and insulin resulting in the brain making you think that you are hungry. This knowledge

is beneficial for the obese community of all ages alike.

 125

Key Informant 35

The last informant will be a five year old girl. She is always indoors rather than

going outdoors. Upon being asked why the child does not want to go outside the mother

replied “mahiyainsiya, laging natago pag may tao” [she is always shy, and hides

whenever there’s someone here]. When asked for her previous meal taken she said

that her breakfast was egg with rice, her snack was bread and milk, her lunch was fried

fish, and her dinner was salted egg with rice. The parent of the girl is asked if these

foods are eaten frequently, the parent said that all of them.

The girl is always indoors with the hobby of playing indoor games and playing

with gadgets like phone and watching TV. “Halos maghapon nalang yan nakababad sa

cell phone o kaya sa tablet” [almost the entire day, he just spends his time playing on

his phone or in the tablet”. The cause of her obesity is most likely due to heredity. The

girl gets hungry very easily and quickly eats heavy meals.
 126

Plate 35: The researcher talking to the daughter of the thirty-fifth key
Discussion
informant

The case of the last informant is another hereditary trait which can be relatable to

Sanderson’s (2011) study. It is shown that genetics plays a role in obesity. Genes can

directly cause obesity in disorders such as Bardet-Biedl syndrome and Prader-Willi

syndrome. However genes do not always predict future health. Genes and behavior

may both be needed for a person to be overweight. In some cases multiple genes may

increase one’s susceptibility for obesity and require outside factors; such as abundant

food supply or little physical activity.Clustering of cases within a family, the congruence

of body weight for monozygotic twins, and the discovery of genes associated with

obesity are all arguments reinforcing the genetic dimension of obesityIt is now well

established that overweight and the different forms of obesity are conditions tending to

concentrate within a family Rohrer (2014). Obesity risk is two to eight times higher for a
 127

person with a family history as opposed to a person with no family history of obesity,

and an even higher risk is observed in cases of severe obesity. Heritability of obesity

may vary depending on the phenotype studied, however it tends to be higher for

phenotypes linked to adipose tissue distribution and for weight or body fat excess.

Weight gain and adiposity increase with age, an effect also influenced by heredity.

Sometimes, no one is to be blamed for a certain predicament. Same as the

situation of the tenth key informant whereas he was obese only due to heredity. But the

researchers believe that the child could still decrease his body weight overtime, since

according to Pudel (2013), hereditary obesity can be faced by healthy lifestyle as they

grow older.

Profile characteristics of the respondents

Table 1 to 6 shows the frequency and percentage of the profile of respondents

where the data came from as to age, gender, weight, height, arm circumference and

waist circumference.

Table 1

Profile of Respondents as to Age

AGE FREQUENCY PERCENTAGE

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2 4 11
3 1 3
4 10 29
5 5 14
6 14 40
7 1 3
TOTAL 35 100

Table 1 pertains to the age of the respondents. The Age ranges from 2 to 7, the

highest frequency is 14 and its percentage is 40 which is the age of 6 while the lowest is

1and its percentage is 3 that corresponds to age of 3.

Most of the ages of the respondents are six years old which maybe because of

their breast-feeding on their early ages. They rely much on breast feed when they are

young on their mother that’s why it gives so much impact when they reached at the age

of six.

According to Agras et al. (1990) thatbreast-feeding for more than five months is

associated with greater adiposity at age six years. In a study by Rolls et al.

(2000),younger children up to the age of 5 years did not increase the amount of food

ingested when offered larger portions.

Table 2

Profile of Respondents as to Gender

GENDER FREQUENCY PERCENTAGE

FEMALE 19 54
MALE 16 46
TOTAL 35 100
 129

Profile of respondents as to gender is indicated to Table 2 wherein the highest

has the percentage of 54 which were female while the lowest has the percentage of 46

which were male. The frequencies of all the females were 19 while males were 16.

This means that most of the obese children were female which were supported

by abundant evidence that the proportion of energy derived from fat during exercise is

higher in women than in men. With respect to the total body fat, this finding seems

counterintuitive, as percentage body fat is increased in women.

This finding was connected to what Ellen Blaak (2010) stated that women

generally have a higher percentage of body fat thanmen. Also, women store more fat in

the gluteal-femoral region, whereas men store more fat in the visceral (abdominal)

depot. There is evidencethat in vivo, catecholamine mediated leg free fatty acid release

is lower in women than in men, whereas free fatty acid release from the upper body

depots is comparable. Free fatty acid releaseby the upper body subcutaneous fat

depots is higher in men than in women, indicating a higher resistance to the

antilipolyticeffect of meal ingestion in the upper body fat depots in men. There are

indications that basal fat oxidation (adjustedfor fat free mass) is lower in females as

compared to males, thereby contributing to a higher fat storage in women. Postprandial

fat storage may be higher in subcutaneous adipose tissue in women than in men,

whereas storage in visceraladipose tissue has been hypothesized to be higher in men.

Table 3

Profile of Respondents as to Weight

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WEIGHT FREQUENCY PERCENTAGE

12.0 kg and below 3 9
16.1kg – 20.0 kg 5 14
20.1 kg – 24.0 kg 8 23
24.1 kg – 28.0 kg 7 20
28.1 kg – 32.0 kg 9 26
36.1 kg – 40.0 kg 3 9
TOTAL 35 100

By looking at the Table 3, the frequency and its respective percentages of weight

of the respondents can be identified. The range of the weight with the highest number of

frequency is from 28.1 kg to 32.0 kg which is equivalent to with the percentage of 26

while the lowest, ranges from 12.0 kg and below, and 36.1 kg – 40.0 kg which has the

same percentage of 9.

The result may mean that the reason why their weights have the greater number

from range of 28.1 kg- 32.0 kg is probably because of their genes which were inherited

from their parents and from the health background of their family.

As stated by Adams (2010), there are some other reasons as to why children

gain weight like genetic problems or certain medications. A BMI of greater than 25kg/m2

is defined asoverweight and a BMI of greater than 30kg/m2 is defined as obese.

Table 4

Profile of Respondents as to Height

HEIGHT FREQUENCY PERCENTAGE

85.1 cm – 90.0 cm 2 6
90.1 cm – 95.0 cm 5 14
95.1 cm – 100 cm 7 20
100.1 cm – 105.0 cm 1 3
105.1 cm – 110.0 cm 2 6
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110.1 cm – 115.0 cm 3 9
115.1 cm – 120.0 cm 6 17
120.1 cm – 125.0 cm 4 11
125.1 cm – 130.0 cm 5 14
TOTAL 35 100

As shown above (Table 4), the range with the highest frequency is from 95.1 cm

– 100.0 cm which has the percentage of 20. The lowest is from 100.1 cm- 105.0 cm, its

percentage rated as 3. There is small difference on the other frequencies and

percentages on the ranges of heights.

The results indicated that respondents with the height which ranges from 95.1 cm

– 100cm were maybe because their height is taller than the normal children. Most of the

obese doesn’t fit their age with their height.

Stovitz (2010) stated that Childhood obesity is a major risk factor for adult

obesity, and obese children tend to be taller than their normal-weight peers. Childhood

obesity is a serious medical condition that affects children and adolescents. Children

who are obese are above the normal weight for their age and height.

Table 5

Profile of Respondents as to Arm circumference

ARM CIRCUMFERENCE FREQUENCY PERCENTAGE

12.5 cm – 13 cm 4 11
13 cm – 14.5 cm 6 17
14.5 cm – 16 cm 7 20
16 cm – 17.5 cm 8 23
17.5 cm – 19 cm 9 26
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19 cm and above 1 3
TOTAL 35 100

Of all the respondents that provide the data, Table 5 shows that the arm

circumference with the highest percentage ranges from 17.5 cm – 19 cm which has the

percentage of 26 while the lowest is from 19cm and above.

This reveals that the reason maybe because of less energy expenditure and

more on rest so their arm circumference continuously becoming bigger; they can be

influenced by their environment.

According to Manoli (2015), community environment is another cause for child

obesity. American society has become characterized by environments that promote

increased consumption of less healthy food and physical inactivity.

Table 6

Profile of Respondents as to Waist Circumference

WAIST FREQUENCY PERCENTAGE

CIRCUMFERENCE
47 cm and below 5 14
48 cm – 51 cm 4 11
52 cm – 55 cm 8 23
56 cm – 58 cm 7 20
59 cm – 62 cm 10 29
63 cm and above 1 3
TOTAL 35 100

The profiles of respondents as to waist circumference are presented in Table

6. The highest frequency of waist circumference of the respondents is 10 which has the
 133

percentage of 29 while the range with the fewest frequency was 63 cm and above which

is has the percentage of 3. The highest frequency was very far from the lowest.

Most of the respondents have the waist circumference that ranges from 59cm

– 62 cm which means a lot of fats are being accumulated in waist circumference which

maybe because of the lipids/fats being taken by them.

People with a high waist-to-hip ratio are at greater risk than those whose excess

fat is distributed in the hip area (Sy 2013). Supported by the statement of Que (2015),

some factors of obesity are 1) waist circumference which is an indicator of central

obesity; 2) blood chemistry values: fasting blood sugar level, cholesterol, blood

pressure; 3) body composition: body fat percentage, bone mass, visceral fat, muscle

mass; 4) family history of diseases; 5) Lifestyle: eating, exercise and coping or behavior

patterns; 6) age and gender; and, 7) smoking alcohol and substance abuse.

Factors affecting child’s obesity

The respondents were surveyed concerning the factors that result to childhood

obesity in terms of eating practices, food intake and daily activities. They were given

indicators for the said factors. These indicators were rated by the respondents through

the verbal indicators which ranges from 1-5 wherein 5 represents as “always”, 4 for

“often”, 3 for “sometimes”, 2 for “rarely”, and 1 for “never”.

The following tables show the calculated weighted mean and verbal

interpretation for each indicator.

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Table 7

Factors affecting child’s obesity in relation to Daily Activities

INDICATORS Weighted Verbal

Mean Interpretation
1. He/ She engage to physical activities. 4.11 Often
2. Outdoor activities are rather performed. 3.86 Often
3. Indoor games are rather performed. 4.14 Often
4. Interested in physical activities. 4.17 Often
5. Lack of discipline in simple works. 4.03 Often
6. Shows interest in sports and ball games. 3.57 Often
7. Shows interest in sports and ball games. 3.86 Often
8. Plays computer games and consoles. 3.89 Often
9. Habitual sleeping is always shown. 3.83 Often
10. He/she does her/ his simple household chores. 3.73 Often
Total Weighted mean 3.92 Often
Legend:

4.2- 5.0 – Always

3.4- 4.19 – Often

2.6 – 3.39 – Sometimes

1.8 – 2.09 – Rarely

1.0 – 1.79 – Never

Table 7 is about the respondents’ daily activities which shows the highest

indicator with the weighted mean of 4.17 which has the verbal interpretation ‘Often’ and

the lowest indicator with the weighted mean of 3.57 which also have the same verbal

interpretation. Although they have the same verbal interpretation of ‘Often’, they differ

from the weighted mean.

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The result showed that although respondents were interested in physical

activities, they often lack discipline in simple works. It also showed that indoor games

are their choice rather than outdoor games. These maybe because of their personal

preference on what they want to do.

Health economist Finkelstein (2011) points out that obesity is now a lifestyle

choice. Obesity is a natural extension of an advancing economy. As you become a First

World economy and you get these labor-saving devices and low-cost, easily accessible

foods, people are going to eat more and exercise less.

Table 8

Factors affecting child’s obesity in relation to Food intake

INDICATORS Weighted Verbal

Mean Interpretation
1. Fatty foods are always eaten. 3.43 Often
2. Salty and junk foods are favored to eat. 2.91 Sometimes
3. Fast foods are always eaten in heavy meals. 3.43 Often
4. Always eats sweets and candies. 4 Often
5. More nutrient-rich foods are chosen to eat 3.66 Often
rather than unhealthy foods.
6. Sodas and soft drink than water are drunk. 3 Sometimes
7. He/she always eat fruits and vegetables. 3.91 Often
8. Always eats nuts. 2.81 Sometimes
9. The meals that the child eats are in 3.69 Often
accordance to the food pyramid guide.
10. Protein rich foods such as meats and fish are 4.43 Always
preferred to eat by the child.
Total Weighted Mean 3.53 Often
Legend:

4.2- 5.0 – Always

3.4- 4.19 – Often

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2.6 – 3.39 – Sometimes

1.8 – 2.09 – Rarely

1.0 – 1.79 – Never

The food intake of the respondents can be clearly seen in Table 8. The highest

weighted mean of the indicators is 4.43 with the verbal interpretation ‘Always’ while the

lowest is 2.81 which is interpreted as ‘Sometimes’. The total weighted mean is 3.53

which have the verbal interpretation ‘Often’.

The result means that although they eat protein-rich foods such as meats and fish,

they become obese. This maybe because of overeating protein-rich foods that’s why

they gain more weight.

Eduward (2015) suggests that in general, it is simply the result of too much

intake of fatty foods coupled with sedentary living over a long period of time. Children

need extra nutrients and calories because they are still growing physically.

Nevertheless, if they consume more calories than they require for their daily activities

and normal physical growth and development, they become overweight to obese.

Table 9

Factors affecting child’s obesity in relation to Eating practices

INDICATORS Weighted Verbal

Mean Interpretation
1. Child eats snacks and heavy meals every day. 4.63 Always
2. Taking rests after eating heavy meals is habitual. 3.91 Often
3. Eats more than three times per day. 4.03 Always
4. Eats fast during heavy meals. 4.11 Often
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5. He/she gets easily hungry. 4.09 Often

6. Show habit of skipping heavy meals. 3.34 Sometimes
7. Gets easily distracted while eating. 3.57 Often
8. Showing negative eating habits. 3.14 Sometimes
9. He/she observes proper eating discipline. 4.23 Always
10. Heavy meals during supper. 4.06 Often
Total Weighted Mean 3.91 Often
Legend:

4.2- 5.0 – Always

3.4- 4.19 – Often

2.6 – 3.39 – Sometimes

1.8 – 2.09 – Rarely

1.0 – 1.79 – Never

As shown in Table 9 is the respondents’ eating practices and the indicator with

the highest weighted mean of 4.63 and the lowest is 3.14 are being stated. The highest

weighted mean has the verbal interpretation ‘Always’ while the lowest is ‘Sometimes’.

As revealed by the result, the respondents eat snacks and heavy meals every

day. This maybe because the children use eating due to their emotion and physical

means, they divert their attention on the foods where they eat heavily.

Children stuff themselves even more ravenously than other youngsters do and

are less able to compensate by eating sparingly the rest of the day (Haney 2011).

Bruch (1974) suggests that a severe form of obesity,whose origins are in the first year

of life (although this does notnecessarily present as obesity at this time) may be due to

parents’ failureto distinguish their child’s physical need of food from other emotional
 138

orbiological needs. This results in food being used as the only tool to satisfyany of a

child’s needs. Bruch (1974) suggests that this may result in thechild not differentiating

needs and emotions and using food as a solutionto all their problems.

Legend:

4.2- 5.0 – Always

3.4- 4.19 – Often

2.6 – 3.39 – Sometimes

1.8 – 2.09 – Rarely

1.0 – 1.79 – Never

Checklist/Picture Questionnaire for the Food Intake of the Child

The researchers made checklist/picture questionnaire that were answered by the

respondents which were the obese children. There were 35 respondents who answered

the checklist/picture questionnaire which contains the different types of foods that the

respondents may be interested in.

Table 10

Meats and Protein Rich Foods

Rank Indicators Frequency

1 Eggs 32
2 Hotdogs 26
3 Chickens 25
4 Fishes 21
5 Meats (pork, beef, etc.) 14
6 Bacons & Hams 6
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As indicated in Table 10, the food intake of the child regarding to meat and

protein rich foods. As shown above, 32 out of 35 of the respondents constantly eat eggs

during heavy meals, especially during breakfasts while the lowest is bacons and ham

with the frequency of 6.

The result may mean that the tastes of eggs are most likely to be eaten by the

children and it is also the food that was being first introduced to them. They usually eat

these kinds of foods while bacons and hams are not affordable so it has the lowest

frequency.

And in accordance to the statement of Winfield (2009), most kids at a very young

age, eats omelets, eggs, hotdogs, and bacons during breakfast. On the contrary, very

few children eat meats and bacons and ham. The parents however, elaborated that they

do not feed their children bacons and ham due to it being unaffordable.

Table 11

Fruits

Rank Indicators Frequency

1 Banana 27
2 Mango 20
3 Apple 18
4 Orange 15
5 Watermelon 13
6 Pineapple 9

The table above expounds that the type of fruit with the highest frequency is

banana while the lowest is pineapple with the frequency is 9. The unique thing about the

result is that of its differences are near each other.

The reason why most of the respondents prefer banana is affordable and easy to
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find. This also have the most preferred taste of fruit. The pineapples have the lowest

frequency because it can hurt the taste buds of the tongue. Respondents may also have

the knowledge that banana is full of nutrients so they keep on eating it.

The result supported by what Hrefna Palsdottir (2008) said that over 90 percent

of the calories in bananas come from carbs, as the banana ripens, the starch in it turns

into sugar.For this reason, unripe (green) bananas are high in starch and resistant

starch, while ripe (yellow) bananas contain mostly sugar.

Table 12

Vegetables

Rank Indicators Frequency

1 Pumpkin 24
2 Carrot 19
3 Corn 15
4 Cabbage 8
5 Eggplant 7
6 Ampalaya 6

The rank and frequency of vegetables are clearly stated in Table 12. It is

indicated that the type of vegetables with the highest frequency is pumpkin (kalabasa)

with the frequency of 24 while the lowest is ampalaya.

The ampalaya may not catch the interest of the respondents because of its bitter

taste but the pumpkin (kalabasa) was preferred by the children not only because of its

taste but also the nutrients it contained. They take too much pumpkin as it has the

effect on their weight.

As revealed by George Mateljan (2011), pumpkin is a very strong source of other

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key antioxidant nutrients, including the carotenoids lutein and zeaxanthin. About 85-

90% of the total calories in squashes (as a group) come from carbohydrate, and about

half of this carbohydrate is starch-like in composition and composed of polysaccharides.

Table 13

Sweets

Rank Indicators Frequency

1 Chocolate 29
2 Ice Cream 29
3 Candies 25
4 Cake 22
5 Cupcake 18
6 Donut 11

Above table shows the food intake of the children regarding to sweets. The two

most common sweets eaten by most of the child are chocolate and ice cream, which is,

both 29 out of 35 respondents while the sweets with the lowest frequency is donut.

Chocolate and ice cream maybe the most preferred sweets of respondents

because of its taste. Almost of the children attract with the sweet tastes like chocolate

and ice cream. They have the same frequency maybe because of its same taste. This

gives so much impact on the body when it was being taken too much.

Williams (2010) said that unconstrained consumption of large quantities of any

energy-rich food, such as chocolate, without a corresponding increase in activity,

increases the risk of obesity. Raw chocolate is high in cocoa fiber.

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Table 14

Starchy Foods

Rank Indicators Frequency

1 Rice 35
2 Bread 27
3 Pastas 24
4 Potatoes 18
5 Cheese 14
6 Cereals 13

As indicated in Table 14, the starchy food with the highest number of frequency

is rice which is 35 while the lowest is cereals with the frequency of 13. The highest and

lowest frequencies of starchy foods are far from each other.

Rice is the most preferred by the respondents because it is the most available

and it is the common type of starchy food that was being taken by all the respondents.

Cereals are the lowest maybe because of its price that can’t be afford by the

respondents. Rice was also being consumed by respondents because it lasts for a long

time when it is being taken.

Bellisari (2011) stated that rice consumption causes an increase in postprandial

blood glucose and could be a probable reason for obesity.

Table 15

Snacks & Junk Foods

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Rank Indicators Frequency

1 Fries 30
2 Chips 25
3 Hotdogs (on bun) 16
4 Hamburger 15
5 Barbeque 13
6 Pizza 6

The table shown above states that in category of snacks and junk foods, the

highest frequency are fries. It has the frequency of 30 which is rank 1 among the others

while the lowest is pizza with the frequency of 6 which is rank 6.

The food chains are continuously spreading throughout the different areas, in

relation with this, fries are the most ready-to-eat so a lot of children are buying this, in

addition with it, and it tastes so good for the children. Pizza is not that affordable so

others only can afford it.

The result of the study is connected to what Kiki Michelle (2010) said that fries

are one of the most readily available foods throughout the country. Because fries are

deep fried in oil, they are very high in fat and calories, which can pose a number of

serious health risks if consumed regularly. Deep frying fries makes them very high in fat

and a high-fat diet increases your risk of becoming overweight. Also, a study by the

Diabetes and Obesity Center of Excellence at the University of Washington in Seattle

found that a high fat diet may injure nerve cells in the brain that control body weight.

French fries are particularly rich in trans fats and saturated fats. According to the

American Heart Association, saturated and trans fats raise the level of cholesterol in

your blood, which increases your risk of heart disease, stroke and type 2 diabetes. A

single serving of deep-fried, restaurant style French fries contain 24 grams of fat.
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According to Health.gov, your total fat intake based on a 2000 calorie daily diet should

be no more than 65 grams.

Table 16

Drinks and Beverages

Rank Indicators Frequency

1 Water 35
2 Milk 35
3 Chocolate Drink 30
4 Fruit Juice 19
5 Sodas 9
6 Coconut Drinks 1

The ranks and frequencies for the category of drinks and beverages are

indicated in Table 16. As shown above, the highest is water and milk with the same

frequency which is 35; they are tie for rank 1. The lowest is coconut drinks which have

the frequency of 1 which is rank 6.

Water is the common beverages that are being taken by all so all of the

respondents preferred water. It is the usual drink matched with different foods. Milk was

also the most preferred type of beverages by the respondents maybe because of the

information they know that milk contains a lot of minerals and vitamins. But too much

consumption of these will lead to obesity.

The result was supported by the statement of Holick (2010) that milk proteins,

milk sugar, fat, and saturated fat in dairy products pose health risks for children and

encourage the development of obesity, diabetes, and heart disease. While low-fat milk

is often recommended for decreasing obesity risk, a study published in the Archives of

Disease in Childhood showed that children who drank 1 percent or skim milk, compared
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with those who drank full-fat milk, were not any less likely to be obese. Too much

consumption of water will have the high risk of becoming obese.

Base on the result of the gathered data, there were programs and practices

made by the researchers to prevent obesity among children. The families of the obese

will also be included on this for the children to actively participate to these.

WEEKLY EXERCISE PROGRAM

The two main areas of our Personal Exercise Plan are Health Related Fitness

and Skill Related Fitness. Our aim is to improve the Health and Skill Related Fitness
 146

overall. We will do this by creating a monthlyprogram of all the different exercises that

we do each day. 

In terms of time spent exercising, you can pretty much always burn more

calories during cardiovascular activity; from this we will be choosing two training

methods. These will be Circuit Trainingand Interval Training. Circuit Training is made up

of 5 stations.

At each station you do a specific exercise for a set amount of time before moving

onto the next station. The good thing about Circuit Training is that it is made up of

aerobic exercises which we enjoy doing. We will also do Interval Training. This is a fixed

pattern of fast and slow exercise.We chose these two methods of training because we

felt that they will improve their health Related Fitness and their Skill Related Fitness

themost,And we’re conducting a Zumba dance and teach a simple Zumba dance step

like, Stand with both feet together, step to the right, bend your knees. Return to the

middle, Step to the left, bend your knees slightly, return to the middle then try it faster

and for the children to improve their health status in order to battle obesity.

The importance of this is to lessen the fats and we all know that exercise is

important in our daily lives, but we may not know why or what exercise can do for us.
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HEALTH AWARENESS EDUCATION FOR THE PARENTS OF THE OBESE

CHILDREN

Childhood obesity is a major public health crisis nationally and internationally.

The prevalence of childhood obesity has increased over few years. It is caused by

imbalance between calorie intake and calories utilized. One or more factors (genetic,

behavioral, and environmental) cause obesity in children. Physical, psychological, and

social health problems are caused due to childhood obesity.

Physical activity can be improved by small strategies like parking cars away from

stores so that kids can walk and to take stairs instead of elevators or escalators. It is

essential that parents are aware of the potential risk the child is facing due to obesity
 148

and take actions to control the problem. This program involves the parent fort them to

properly handle the health of the child.

We we’re going to go their house step by step Effective measures to prevent

obesity in future can be promoted by these interventions. These weight-control

interventions can be achieved and sustained by providing good support and a variety of

strategies to parents. And we will go house to house in selected barangay in Daet,

Camarines Norte for us to know the main factor of obesity, We’re continue doing this

kind of activity for us to achieve the purpose of the study.

Childhood obesity problem can be reduced by educating children and parents

about healthy nutrition and encouraging them to be physically active. There are effective

interventions and government policies for prevention and control of childhood obesity.

Sustainability of these interventions is a key factor, so that children can adopt these

healthy behaviors as a lifelong practice and have a healthy life. This will lead to a

nationwide healthy future for the kids.

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HEALTH MONITORING PROGRAM

Obesity is a major public health crisis among children and adults. The range of weights

for individuals if greater than the ideal weight, which is considered healthy for the

particular height, is termed as either overweight or obese. Childhood-related obesity is

an increasing concern with respect to the health and well-being of the child. 

This program will monitor the health of the obese and will be given some

practices to become physically fit. By means of this, the weight will be lessening step-

by-step. The health of the obese will be checked weekly to update if there are some

changes and if there is increase in weight, it will be immediately treated. All of the

aspect of the health of the obese will be checked weekly to achieve becoming physically
 150

fit and to avoid the negative effects of being obese.

In relation with this, the researchers will seek help with RHU to easily monitor the

health of all the obese in respected areas. By working collaboratively, the purpose of

this will be possibly achieved. The parents/guardians will also be involved because they

are the closest family member of all the obese children. They are always with the child

so they know a lot than any other people.

ANTI-OBESITY ADVOCACY

As part of the purpose of this study which is to prevent obesity, campaign

through social media has been utilized. The researchers believe that it will be more

effective to achieve this aim when it is exposed. A lot of people will see this advocacy so

there will be no difficulty in spreading it. There will be no quota for the members of the

group made through the chosen means of social media like facebook. Members will be

added increasingly until many people are able to see these specially those obese.

Different information, pictures and facts will be posted on its page regarding the

prevention of childhood obesity. It will give awareness especially to those in need. They
 151

will clearly understand the obesity and its health risks. The more people who are

included in this group, the more it will become easy to spread information concerning

obesity. Through social media, it will be efficient to share the information regarding

obesity since most of the people nowadays uses accounts in social media for daily use.

Chapter 5

SUMMARY, FINDINGS, CONCLUSIONS AND RECOMMENDATIONS

This chapter presents the summary, findings, conclusions and recommendations

of the study.
 152

Summary

This study aimed to find out the Eating practices of obese children in selected

barangays in Daet, Camarines Norte including Barangay Ilaod, Mantagbac, Magang,

Pasig and Salcedo. The profile of the respondent, factors resulting to childhood obesity

and the family center dietary practices as preventive measures that may be

recommended to prevent obesity among children were the specific factors that this

study looked into.

Specifically, this study sought to answer the following questions:

1. What is the profile characteristics of the respondents in terms of:

a. Age

b. Gender

c. Weight

d. Height

e. Arm circumference

f. Waist circumference

2. What are the factors that result to obesity among children in relation to:

a. Daily activities

b. Food intake

c. Eating practices

3. What family center dietary practices based on the findings may be recommended

to prevent obesity among children?

The study is important to children, mother, family, community, rural health unit
 153

and future researcher. There were 35 respondents observed and interviewed in this

study. All were children of ages 2-7 years old. The researchers undertook an intensive

review of related literature and studies which came up in determining the synthesis of

the state of the art, gap to be bridged, and to conceptualized and theorized research

problem.

On the basis of the objective of the study, mixed method of qualitative and

quantitative research design were utilized. Purposive sampling was used in the study.

Data were gathered through the use of checklist/ questionnaire, picture questionnaire

and interview guide which were prepared for purpose. Results of the data gathered

became the basis for the interpretation and conclusions made. In view of the nature of

the study, several statistical were used including frequency counts, percentage

technique, and weighted mean.

Findings

The findings of the study are as follows,

1. Profile characteristics

Almost half of the respondents of this study belong to 6 years old and

most of them were female. The 26 percent of the respondents have the weight of

28. 1- 32.0 kg, 20 percent of the respondents have the height of 95.1 cm – 100

cm, 26 percent of the respondents have the arm circumference of 17.5 cm – 19

cm and 29 percent of the respondents have the waist circumference of 59 cm- 62

cm.
 154

2. Factors that result to obesity among children

The total weighted mean of the daily activities of the respondents is 3.92

which are being done often. Total weighted mean of respondents’ food intake is

3.53 wherein the foods were being taken often. On the eating practices of

respondents, its total weighted mean was 3.91 which mean it was practiced or

done often. Although respondents were interested in physical activities, they

often lack discipline in simple works. It also showed that indoor games are their

choice rather than outdoor games. Although they often eat protein-rich foods

such as meats and fish, they become obese. It also revealed that he respondents

eat snacks and heavy meals every day.

During the interview, most of the respondents were fast to eat and gets

easily hungry. Most of the cases of obesity of the respondents were inherited

because of their family background.

3. Family center dietary practices of the respondents to prevent obesity among

children.

Based on the result of the study, practices concerning the prevention of

childhood obesity are being recommended: Health monitoring program, Weekly

exercise program, Health awareness education for the parents and the child and

Anti- obesity Advocacy through social media.

Conclusions

In light of the findings, the following conclusions are drawn:

 155

1. Most of the obese children were 6 years old, majority were females. Most of

them have the average weight of 28.1 kg- 32.0 kg, average height of 95.1 cm

100 cm, average arm circumference of 17.5 cm- 19 cm and average waist

circumference of 59 cm – 62 cm.

2. Concerning with the factors, all of them truly affects childhood obesity in

relation to daily activities, food intake and eating practices. All of them have

the verbal interpretation ‘often’.

3. It is best to conduct health monitoring program, weekly exercise program,

health awareness program for the parents and the child, and anti- obesity

through social media to prevent obesity among children.

Recommendations

1. Encourage the respondents to participate on different program implemented by

the Rural Health Unit that aims to lessen and prevent childhood obesity.

2. Coordinate with the Rural Health Unit to have continuous medical programs

related to obesity.

3. Encourage Barangay officials to implement more health programs concerning

childhood obesity.

4. For the Municipal Official, to continue implementing the existing health programs

and to further think of a new solution pertaining to childhood obesity.

5. For the Department of health, to look for a more health-friendly measure to

prevent obesity among children not only in the region but also in the entire
 156

nation.
 157

APPENDICES

APPENDIX A

January 11, 2017

December 17, 2016

Cristina CinetaRano
Ilaod Barangay Captain
Daet, Camarines Norte
 158

Sir/Mam:

We, the Senior High School students of Mabini Colleges are conducting a
research work regarding the Eating practices of Filipino Obese Children in selected
barangays in Daet with the aim to raise community awareness about the said topic. We
are requesting your good office to allow us to have information regarding the latest list
of obese children and their corresponding weight.

The information will be a big help to our research work. Thank you!

Very respectfully yours:

Princess Clemente
Group Representative

Noted by:

Dr. Joyce T. Relloso

Practical Research Adviser

APPENDIX B

January 11, 2017

 159

December 17, 2016

Nestor F. Dalida
Pasig Barangay Captain
Daet, Camarines Norte

Sir/Mam:

We, the Senior High School students of Mabini Colleges are conducting a
research work regarding the Eating practices of Filipino Obese Children in selected
barangays in Daet with the aim to raise community awareness about the said topic. We
are requesting your good office to allow us to have information regarding the latest list
of obese children and their corresponding weight.

The information will be a big help to our research work. Thank you!

Very respectfully yours:

Princess Clemente
Group Representative

Noted by:

Dr. Joyce T. Relloso

Practical Research Adviser
 160

APPENDIX C

January 11, 2017

December 17, 2016

Sonia K. Bermas
Mantagbac Barangay Captain
Daet, Camarines Norte

Sir/Mam:

We, the Senior High School students of Mabini Colleges are conducting a
research work regarding the Eating practices of Filipino Obese Children in selected
barangays in Daet with the aim to raise community awareness about the said topic. We
are requesting your good office to allow us to have information regarding the latest list
of obese children and their corresponding weight.

The information will be a big help to our research work. Thank you!

Very respectfully yours:

 161

Princess Clemente
Group Representative

Noted by:

Dr. Joyce T. Relloso

Practical Research Adviser

APPENDIX D

January 11, 2017

December 17, 2016

William I. Villarin
Salcedo Barangay Captain
Daet, Camarines Norte

Sir/Mam:
 162

We, the Senior High School students of Mabini Colleges are conducting a
research work regarding the Eating practices of Filipino Obese Children in selected
barangays in Daet with the aim to raise community awareness about the said topic. We
are requesting your good office to allow us to have information regarding the latest list
of obese children and their corresponding weight.

The information will be a big help to our research work. Thank you!

Very respectfully yours:

Princess Clemente
Group Representative

Noted by:

Dr. Joyce T. Relloso

Practical Research Adviser

APPENDIX E

January 11, 2017

 163

December 17, 2016

Jerry B. Nagera
Magang Barangay Captain
Daet, Camarines Norte

Sir/Mam:

We, the Senior High School students of Mabini Colleges are conducting a
research work regarding the Eating practices of Filipino Obese Children in selected
barangays in Daet with the aim to raise community awareness about the said topic. We
are requesting your good office to allow us to have information regarding the latest list
of obese children and their corresponding weight.

The information will be a big help to our research work. Thank you!

Very respectfully yours:

Princess Clemente
Group Representative

Noted by:

Dr. Joyce T. Relloso

Practical Research Adviser
 164

APPENDIX F

Eating Practices of Obese Children in Selected Barangay in Daet, Camarines

Norte

Dear Respondents,

We, the Senior High School Students, currently in STEM-Gold, of Mabini

Colleges are conducting a research study entitled, “Eating Practices of Filipino Obese
Children in Selected Barangay in Daet, Camarines Norte”.

We would like to ask your permission for your kind participation on our survey
regarding the topic of our study. We assure you that all the data that we have gathered
from you will be treated with strict confidentiality.

Thank you and God bless!

Very truly yours,

The Researchers

I. SOCIO-DEMOGRAPHIC PROFILE OF THE RESPONDENT

a.) Age of the child: _______

b.) Gender

____Male ______Female

c.) Weight (in kg): _______

d.) Height (in cm): _______

e.) Arm circumference: _________

f.) Waist circumference: ________

II. DAILY ACTIVITIES, FOOD INTAKE AND EATING PRACTICES OF THE CHILD
 165

Direction:This questionnaire isdesigned to get the needed vital information to

supplement the current study. Please put a check (√ ¿ that correspond to your answer.

5 Always It is always observed

4 Often It is often observed
3 Sometimes It is sometimes observed
2 Rarely It is rarely observed
1 Never It is never observed

A. Daily Activities of your Child

Indicators
5 4 3 2 1
1. He/ She engage to physical activities.

2. Outdoor activities are rather performed.

3. Indoor games are rather performed.

4. Interested in physical activities.

6. Lack of discipline in simple works

7. Shows interest in sports and ball games.

8. Plays computer games and consoles.

9. Habitual sleeping is always shown.

10 He/she does her/ his simple household chores.

.

B. Food Intake of your Child

Indicators 5 4 3 2 1

1. Fatty foods are always eaten.

2. Salty and junk foods are favored to eat.

 166

3. Fast foods are always eaten in heavy meals.

4. Always eats sweets and candies.

5. More nutrient-rich foods are chosen to eat rather than unhealthy

foods.
6. Sodas and soft drink than water are drunk.

7. He/she always eatfruits and vegetables.

8. Always eats nuts.

9. The meals that the child eats are in accordance to the food
pyramid guide.
10 Protein rich foods such as meats and fish are preferred to eat by
. the child.

C. Eating Practices of your Child

Indicators 5 4 3 2 1

1. Child eats snacks and heavy meals every day.

2. Taking rests after eating heavy meals is habitual.

3. Eats more than three times per day.

4. Eats fast during heavy meals.

5. He/she gets easily hungry.

6. Show habit of skipping heavy meals.

7. Gets easily distracted while eating.

8. Showing negative eating habits.

9. He/she observes proper eating discipline.

 167

10 Heavy meals during supper.

.

APPENDIX G

Checklist/ Picture Questionnaire for the Food Intake of the Child

Researcher-Made Questionnaire on the Eating Practices of Obese Children in

Selected Barangays in Daet, Camarines Norte

A. Meats and Protein Rich Foods

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B. Fruits

C. Vegetables
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C. Sweets
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D. Starchy Foods

1
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E. Snacks and Junk Foods

F. Drinks and Beverages

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APPENDIX H

Interview Guide

FOR THE CHILDREN

We, the Senior High School students of Mabini Colleges will be administering a
research study to assess the Food Intake of Filipino Obese Children in Selected
Barangays in Daet, Camarines Norte.

Researcher 1: Good Morning/Afternoon. First and foremost, we wish to introduce

ourselves. I’m _____________________.

Researcher 2: And I’m ____________________. We are Grade 11 STEM students

from Mabini Colleges.

Researcher 1: We are here with you now to conduct an interview about children
suffering from obesity and we know that you are capable of answering our questions.
Also, as part of our documentation, we will be taking a video during our interview.

Researcher 2: No harm will be done to you. This is only an interview so there is either
right or wrong answers. All we want is for you to answer the questions with full
confidentiality and honesty. Ok are you ready? Let’s start.

Researcher 1: First, we need to know each other more. So, your name is?
____________. How old are you? When is your birthday?

Researcher 2:What is your hobby? Or habit?

Researcher 1:How often?

Researcher 2:So what was your breakfast yesterday?

Researcher 1:How about your snacks and lunch yesterday?

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Researcher 2:And what was your dinner yesterday?

Researcher 1:How often do you eat these foods?

Researcher 2:Are these foods your favorite?

Researcher 1:How long do you finish eating your meals?

Researcher 2:Are you easy to get hungry?

Researcher 1:For how long do you take your next meal?

APPENDIX I

CURRICULUM VITAE

Name : Princess Chrissa Z. Clemente

Address : Poblacion 1 Basud, CamarinesNorte

Age : 17 years old

Date of Birth : June 11, 1999

Place of Birth : Buhi, Camarines Sur

Civil Status : Single

Blood type : O

Religion : Roman Catholic

Citizenship : Filipino

Parents : Vincent C. Clemente

Monette Z. Clemente

EDUCATIONAL ATTAINMENT:
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Elementary : CabatuanElementary School

Buhi, Camaries Sur

Secondary : Basud National High School

Basud, Camarines Norte

Senior High School : Mabini Colleges

Daet, Camarines Norte

CURRICULUM VITAE

Name : Stephanie S. Manalo

Address : P-2 Brgy. Lag-on Daet, Camarines Norte

Age : 16 years old

Date of Birth : March 13, 2000

Place of Birth : Brgy. Iberica, Labo

Civil Status : Single

Blood type : O

Religion : Roman Catholic

Citizenship : Filipino

Parents : Emily S. Manalo

Ronaldo E. Manalo Jr.

EDUCATIONAL ATTAINMENT:
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Elementary : Daet Elementary School

Daet, Camarines Norte

Secondary : CNSC Laboratory High School, Abaño Campus

Daet, Camarines Norte

Senior High School : Mabini Colleges

Daet, Camarines Norte

CURRICULUM VITAE

Name : Joben Urbano

Address : F. Pimentel, Daet, Camarines Norte

Age : 18 years old

Date of Birth : July 10, 1998

Place of Birth : Davao City

Civil Status : Single

Blood type : O

Religion : Roman Catholic

Citizenship : Filipino

Parents : Jose B. Urbano Jr.

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Aida M. Urbano

EDUCATIONAL ATTAINMENT:

Elementary : CNSC Laboratory Elementary School, Abaño Campus

Daet, Camarines Norte

Secondary : CNSC Laboratory High School, Abaño Campus

Daet, Camarines Norte

Senior High School : Mabini Colleges

Daet, Camarines Norte