275 © 2019 by the authors; licensee Asian Online Journal Publishing Group Asian Journal of Education and Training Vol. 5, No. 1, 275-279, 2019 ISSN(E) 2519-5387 DOI: 10.20448/journal.522.2019.51.275.279 © 2019 by the authors; licensee Asian Online Journal Publishing Group The Relationship between the Body Mass Index and Different Education Times in Secondary Schools Soner Karadeniz1 Sema Can2 ( Corresponding Author) 1Fatih Sultan Mehmet Secondary School, Sivas, Turkey 2Hitit University, Faculty of Sports Science, Çorum, Turkey Abstract The aim of this study was to investigate the relationship between body mass index (BMI) and educational periods in secondary school students. The study was conducted on 832 students, 418 girls (Mage: 12.99±.83) and 414 boys (Mage: 12.92±.85), who received dual and full-time education in the centre of Sivas Province. As data collection tool, BMI was calculated by measuring weight and height, and the percentile curve developed by Neyzi et al. (2008) in the classification of obesity and underweight was used. As the statistical analysis, the mean, standard deviation, frequency, percent values were used for descriptive statistics of all variables and Pearson Chi Square test. According to findings of the research, the underweight student rate was 11.9% (girls: 6.1%; boys: 5.8%), overweight student rate was 9.1% (girls: 5%; boys: 4.1%) and obese student rate was 8.6% (girls: 5.2%; boys: 3.4%). According to their BMI, 33.3% of underweight students receive dual education, 66.7% full-time education; 47.1% of normal weight students dual education, 52.9% full- time education; 61.8% of overweight students dual education, 38.2% of obese students full-time education; 59.2% of obese students dual education, 40.8% full-time education. A statistically significant relationship was found between the type of education and BMI (p<0.05). As a result, it can be said that the dual education system has increased the rate of obesity. However, the fact that the number of underweight students is higher than the number of overweight and obese students is important for introducing the habits of healthy eating. Keywords: Body-Mass index, Dual education, Education times, Full-time education, Obesity, Secondary school students. Citation | Soner Karadeniz; Sema Can (2019). The Relationship between the Body Mass Index and Different Education Times in Secondary Schools. Asian Journal of Education and Training, 5(1): 275-279 History: Received: 4 January 2019 Revised: 7 February 2019 Accepted: 1 March 2019 Published: 20 March 2019 Licensed: This work is licensed under a Creative Commons Attribution 3.0 License Publisher: Asian Online Journal Publishing Group Contribution/Acknowledgement: This study was produced from a Master Thesis with the title of “Investigation of relationship between nutrition, physical activity and obesity in 12-14 years-old secondary school students (Sivas Province sample)”. Funding: This study received no specific financial support. Competing Interests: The authors declare that they have no conflict of interests. Transparency: The authors confirm that the manuscript is an honest, accurate, and transparent account of the study was reported; that no vital features of the study have been omitted; and that any discrepancies from the study as planned have been explained. Ethical: This study follows all ethical practices during writing. Contents 1. Introduction .................................................................................................................................................................................... 276 2. Material and Method..................................................................................................................................................................... 276 3. Findings ........................................................................................................................................................................................... 276 4. Discussion ........................................................................................................................................................................................ 277 5. Conclusion ....................................................................................................................................................................................... 278 References ............................................................................................................................................................................................ 278 http://crossmark.crossref.org/dialog/?doi=10.20448/journal.522.2019.51.275.279&domain=pdf&date_stamp=2017-01-14 http://creativecommons.org/licenses/by/3.0/ http://creativecommons.org/licenses/by/3.0/ http://asianonlinejournals.com/index.php/EDU/article/view/415 https://orcid.org/0000-0003-3326-9383 https://orcid.org/0000-0003-1931-2226 http://asianonlinejournals.com/index.php/EDU/article/view/415 https://orcid.org/0000-0003-3326-9383 https://orcid.org/0000-0003-1931-2226 http://asianonlinejournals.com/index.php/EDU/article/view/415 https://orcid.org/0000-0003-3326-9383 https://orcid.org/0000-0003-1931-2226 http://asianonlinejournals.com/index.php/EDU/article/view/415 https://orcid.org/0000-0003-3326-9383 https://orcid.org/0000-0003-1931-2226 Asian Journal of Education and Training, 2019, 5(1): 275-279 276 © 2019 by the authors; licensee Asian Online Journal Publishing Group 1. Introduction According to the World Health Organization (WHO), obesity is defined as abnormal or excessive fat accumulation that presents a risk to health (WHO, 2000). According to the WHO 2016 data, the number of overweight and obese children under 5 is over 41 million. Over 340 million children and adolescents aged 5-19 were overweight or obese in 2016 (WHO, 2018). The childhood obesity has been considered as one of the most important social health problems of the 21st century in developed and developing countries. Obesity causes, Type 2 diabetes, cardiovascular diseases, and the social and psychological problems (Nuttall, 2015; Tarakçı et al., 2016; Sakarya et al., 2017; Glinkowska and Glinkowski, 2018). For this reason, it is seen as a public health issue requiring the measures to be taken. Among the factors that cause obesity in children, genetic and environmental factors are foremost. There are many reasons such as passive life style owing to the technology, boost of urbanization, drop in play areas, and excessive and unbalanced eating (Tarakçı et al., 2016; NCD Risk Factor Collaboration (NCD-RisC), 2017). On the other hand, the fact that little time is spared for the physical education and sports classes in our country may be a risk factor. In our country, the education system is carried out in two ways which are full-time and dual educations. Full-time education and dual education systems can vary according to the number of student, classroom, and school. The courses are given between 08:30 - 15:20 in full-time education and it is between 07:00 - 12:45 in the morning and 13:00 - 18:45 in the afternoon in dual education in Sivas. In this regard, there are many studies in our country to determine the prevalence of obesity seen in childhood (Öner et al., 2004; Semiz et al., 2008; Ozcebe et al., 2015). However, in our country, no study was found the relationship between the obesity with dual and full-time education. In this regard, the aim of this study is to examine the relationships between the different education time and BMI in 6,7,8th classes students in secondary schools. 2. Material and Method 2.1. Research Group A total of 832 secondary school students (girls: n=418; boys: n=414) who were educated in Sivas in 6,7,8th grades in full-time and dual education, voluntarily participated in the study. Among 47 secondary schools in Sivas, 11 of them without an indoor sport facility were randomly selected. Acknowledging that each school is a layer, the number of boys and girls students was determined by the proportional selection method. Acknowledging the branches of each class in the schools as a cluster, students were selected by sampling method from each class and branch and the research was conducted in May 2015-2016 educational year. Before the research, the official permission from the Sivas Provincial Directorate of National Education, dated 30.04.2015 and 92255297-605.01- E.4542785, and the committee approval from the OMU Clinical Research Ethics Committee, dated 10.12.2015 and B.30.2.ODM were taken. 2.2. Data Collection The length measurements of the participants included in the study were carried out with the Seca brand tape measure and body weights were carried out using the Tefal brand portable measurement tool, in compliance with the protocol (Gordon et al., 1988). The BMI (kg/m²) of all students was calculated using height and weight measurements. The BMI values obtained were classified according to the reference BMI values that were adapted to the age and gender specific to children of our country. According to this, below the 5th percentile was classified as underweight, 5th to 85th percentile normal, and 85th to 95th percentile overweight, whereas over 95th percentile was classified as obesity (Neyzi et al., 2008). 2.3. Statistical Method As part of the descriptive statistics of all variables, the mean, standard deviation, frequency (f), percent (%) values were given. Pearson Chi Square test was used to analyse the relationship between the categorical variables. All statistical procedures were performed in SPSS 20.0 package program under Windows and error level was taken as 0.05. 3. Findings Table-1. Descriptive characteristics of the students. Variables Girls Boys Total n = 418 n = 414 n = 832 Mean ± SD Mean ± SD Mean ± SD Age (years) 12.99 ± .83 12.92 ± .85 12.95 ± .84 Height (cm) 156.19 ± 7.53 156.29 ± 10.44 156.24 ± 9.09 Weight (kg) 49.27 ± 7.53 48.66 ± 13.64 48.97 ± 12.59 Source: This table is result of our research According to the Table 1, the mean and standard deviation values of the age, height, weight of the students included in the study, respectively were calculated as 12.95±.84; 156.24±9.09; 48.97±12.59. According to the Table 2, 33.5% of the students are in the 6th class; 34.5% 7th class; 32% 8th class student. 47.8% of the students receive dual education and 52.2% receive full-time education. According to the Table 3, 6.1% of underweight students were girls, 5.8% were boys; 33.9% of normal weight students were girls, 36.5% were boys; 5.0% of overweight students were girls, 4.1% were boys; 5.2% of obese students were girls, 3.4% were boys. No statistically significant correlation between gender and BMI was found (p>0.05). Asian Journal of Education and Training, 2019, 5(1): 275-279 277 © 2019 by the authors; licensee Asian Online Journal Publishing Group Table-2. Frequency (f) and percentage (%) distribution of variables. Gender f % Girls 418 50.2 Boys 414 49.8 Total 832 100.0 Education level 6. 279 33.5 7. 287 34.5 8. 266 32.0 Total 832 100.0 Education times Dual education 398 47.8 Full-time education 434 52.2 Total 832 100.0 Source: This table is result of our research Table-3. Frequency (f) and percentage (%) distribution of gender, education level, and education times according to BMI. Variables Underweight (<5) Normal (5-85) Overweight (85-95) Obese (>95) X2, p f % f % f % f % Gender Girls 51 6.1 282 33.9 42 5.0 43 5.2 X2=4.909 p= 0.179 Boys 48 5.8 304 36.5 34 4.1 28 3.4 Total 99 11.9 586 70.4 76 9.1 71 8.6 Education level 6. 38 38.4 197 33.6 27 35.5 17 23.9 X2 =8.711 p= 0.190 7. 39 39.4 200 34.1 22 28.9 26 36.6 8. 22 22.2 189 32.3 27 35.6 28 39.5 Education times Dual education 33 33.3 276 47.1 47 61.8 42 59.2 X2=18.092 p= .001 Full-time education 66 66.7 310 52.9 29 38.2 29 40.8 Total 99 100.0 586 100.0 76 100.0 71 100.0 Source: This table is result of our research According to the Table 3, 38.4% of the underweight students were in 6th class, 39.4% were in 7th class, 22.2% were in 8th class; 33.6% of students with ideal weight were in 6th class, 34.1% were in 7th class, 32.3% were in 8th class; 35.5% of the overweight students were in 6th class, 28.9% were in 7th class, 35.6% were in 8th class; 23.9% of obese students were in 6th class, 36.6% were in 7th class, 39.5% were in 8th class according to BMI. A statistically significant relationship between educational levels and BMI was not found (p>0.05). According to the Table 3, 33.3% of the underweight students compared with their BMI were at dual education, 66.7% of the students at full-time education; whereas, 47.1% of the students with normal weight with at dual education and 52.9% at full-time education; 61.8% of the overweight students were at dual education and 38.2% of them were at full-time education, 59.2% of the obese students were at dual education and 40.8% at full-time education. A statistically significant correlation between education and BMI was found (p<0.05). 4. Discussion The aim of this study is to examine the relationship between education times and BMI in secondary school students who receive education in 6th, 7th and 8th grades. In the present study, the rate of underweight was 11.9%, overweight rate was 9.1%, and the obesity rate was 8.6% Table 3. When the literature studies are examined, similar results are given by the data of Turkey Nutrition and Health Survey (TBSA, 2010, 2014) that indicates 14.9% of children aged 6-18 years are underweight, 14.3% are overweight and 8.2% are obese. Dündar and Öz (2012) found the obesity frequency as 10.3% in their research on secondary school students with an average age of 12.8 in Samsun. Barbiero et al. (2009) reported that the prevalence of overweight as 17.8%, and the rate of obesity as 9.8% among students aged 10-18 years in Brazil. Amin et al. (2008) reported that the prevalence of overweight in children between 10-14 years of age as 14.2% and 9.7% of obesity rate in Saudi Arabia. Ozturk and Akturk (2011) found the overweight as 12.4% and the prevalence of obesity as 6.5%. The findings of this study and the literature demonstrate that the rate of overweight in children is higher than the obesity. In addition, it has been observed that the obesity prevalence rates were similar to our results. According to these results, being overweight is considered a major problem and will form a risk factor for obesity in the future. In addition, it has been seen that the rate of the underweight is also a major problem in the study, and it shows parallelism with the data of the most comprehensive study (TBSA, 2010, 2014). In this study, when the BMI was examined by gender, 6.1% of the underweight students were girls, 5.8% were boys; 5.0% of the overweight students were girls, 4.1% were boys, and 5.2% of obese students were girls and 3.4% were boys. It is observed that being underweight and excessive weight/obesity are higher in girls Table 3. Simsek et al. (2005) reported that 55.6% of the obese children which is a higher percentage than the boys were girls, and Korkmaz (2008) stated that 66.0% of the obese students were girls. When we look at the gender distribution percentages, it is observed that it shows similarities with the results of our research Table 3. In contrast to these results, some studies (Tremblay et al., 2002) observed that the rate of being underweight and overweight in boys is higher as well. Öner et al. (2004) reported in the study conducted in Edirne between 12 to 17 years olds that reported that the prevalence of underweight, overweight and obesity among young girls between the ages of 12 and 17, was 11.1%, 10.6%, 2.1%, and the rates were 14.4%, 11.3%, and 1.6%, respectively, in boys. According to Barbiero et al. (2009) the prevalence of overweight was 19.9% in girls and 15.3% in boys, and the obesity was 8.2% in girls and 11.8% in boys. Dündar and Öz (2012) stated that the frequency of overweight and obesity in boys is higher than girls. Variables such as physical, physiological, Asian Journal of Education and Training, 2019, 5(1): 275-279 278 © 2019 by the authors; licensee Asian Online Journal Publishing Group metabolic rapid changes due to gender and age, biological differences in energy requirements in both sexes regarding growth and timing during sexual maturity period, and regional and social gender differences may be factors in obesity or overweight rates between genders (Al-Rethaiaa et al., 2010; Goyal et al., 2010; Biswas et al., 2017; Gebrie et al., 2018). In addition, it has been stated in a wide range of previous studies that the rates of obesity vary according to socio-economic level and region as well (The TOÇB, 2011; COSI-TUR, 2013). In this respect, the fact that Sivas is a city located in the Central Anatolian region may have affected the results. In the study, according to the class levels, it is seen that the overweight rate of 35.6% and obesity rate of 39.5% are seen in 8th grade; however, no statistically significant difference between the grade and the BMI was found Table 3 In our country, hours of education might vary from one region to another according to the number of schools, classrooms and students in our country. There are efforts for changing the timing of education which is seen as a major problem in the education system of our country and endeavours for full-time education continues. In line with this, this study in which the relationship between the times of education and BMI was examined, indicates that 33.3% of underweight students are at dual education, approximately 66.7% are at full-time education; 61.8% of overweight students are at dual education and 38.2% are at full-time education; it was observed that 59.2% of obese students were at dual education, 40.8% were at full-time, and there was a significant correlation between these rates and education times Table 3. In the light of these findings, it can be said that dual education increases the rate of underweight, overweight and obesity. In addition, in the formation of this situation, breakfast /eating habits and many factors such as sleep time is thought to be effective. 5. Conclusion In this study, the fact that underweight, overweight, and obesity rates are high especially in the dual education system, measures to be taken for the health of future generations. First of all, it is recommended to gain adequate- balanced eating habits for a healthy lifestyle, increase physical education and sports course hours, and establish the necessary physical environment for game and sports activities. In this respect, the high prevalence of obesity in the students who are studying in the “dual education” system shows the importance of the “full-time education” system. Besides, being the first study that examines the relationship between the time of education and BMI is the strong side of this study. A more comprehensive research might be made for different region and age groups across the country. References Al-Rethaiaa, A.S., A.-E.A. Fahmy and N.M. Al-Shwaiyat, 2010. Obesity and eating habits among college students in Saudi Arabia: A cross sectional study. Nutrition Journal, 9(1): 1-10.Available at: https://doi.org/10.1186/1475-2891-9-39. Amin, T.T., A.I. Al-Sultan and A. Ali, 2008. Overweight and obesity and their relation to dietary habits and socio-demographic characteristics among male primary school children in Al-Hassa, Kingdom of Saudi Arabia. European Journal of Nutrition, 6(47): 310-318.Available at: https://doi.org/10.1007/s00394-008-0727-6. Barbiero, S.M., L.C. Pellanda, C.C. Cesa, P. Campagnolo, F. Beltrami and C.C. Abrantes, 2009. Overweight, obesity and other risk factors for IHD in Brazilian schoolchildren. Public health nutrition, 12(5): 710-715.Available at: https://doi.org/10.1017/s1368980008003200. Biswas, T., A. Islam, M.S. Islam, S. Pervin and L.B. Rawal, 2017. Overweight and obesity among children and adolescents in Bangladesh: A systematic review and meta-analysis. Public Health, 142: 94-101.Available at: https://doi.org/10.1016/j.puhe.2016.10.010. COSI-TUR, 2013. Turkey childhood (7-8 years) obesity research (CO-ENG). Ankara, 2014: Ministry of Health, Public Health Agency of Turkey, Ministry of Education, Hacettepe University, Department of Health Publication No: 921. Dündar, C. and H. Öz, 2012. Obesity-related factors in Turkish school children. The Scientific World Journal, 2012: 1-5.Available at: https://doi.org/10.1100/2012/353485. Gebrie, A., A. Alebel, A. Zegeye, B. Tesfaye and A. Ferede, 2018. Prevalence and associated factors of overweight/obesity among chi ldren and adolescents in Ethiopia: A systematic review and meta-analysis. BMC Obesity, 5(1): 1-12.Available at: https://doi.org/10.1186/s40608-018-0198-0. Glinkowska, B. and W.M. Glinkowski, 2018. Association of sports and physical activity with obesity among teenagers in Poland. International Journal of Occupational Medicine and Environmental Health, 31(6): 771-782. Gordon, C.C., C.C. Chumlea and A.F. Roche, 1988. Stature, Recumbent Length and Weight. (Eds), Lohman, TG, Roche, AF & Marorell, R. Anthropometric Standardization Reference Manual. Illinois: Human Kinetics Books. pp: 3-8. Goyal, R.K., V.N. Shah, B.D. Saboo, S.R. Phatak, N.N. Shah, M.C. Gohel, P.B. Raval and S.S. Patel, 2010. Prevalence of overweight and obesity in Indian adolescent school going children: Its relationship with socioeconomic status and associated lifestyle factors. The Journal of the Association of Physicians of India, 58: 151-158. Korkmaz, A., 2008. The obesity frequency of the students which are in the 6.- 7. and 8. level classes of a primary school in the Gebze town of Kocaeli. Master Thesis. Selçuk University: Konya, Turkey. NCD Risk Factor Collaboration (NCD-RisC), 2017. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet, 390(10113): 2627-2642. Neyzi, O., H. Günöz, R.B. Furman and G. Gülbin, 2008. Weight, height, head circumference and body mass index references for Turkish children. Journal of Child Health and Diseases, 51: 1-14. Nuttall, F.Q., 2015. Body mass index: Obesity, BMI, and health: A critical review. Nutrition Today, 50(3): 117-128.Available at: https://doi.org/10.1097/nt.0000000000000092. Öner, N., Ü. Vatansever, A. Sari, E. Ekuklu, A. Güzel, S. Karasalihoğlu and N.W. Boris, 2004. Prevalence of underweight, overweight and obesity in Turkish adolescents. Swiss Medical Weekly, 134(35-36): 529-533. Ozcebe, H., T.B. Bosi, N. Yardim, E. Celikcan, N. Celikay, B. Keskinkilic and S. Ozkan, 2015. Owerweight and obesity among children in Turkey. TAF Preventive Medicine Bulletin, 14(2): 145-152.Available at: https://doi.org/10.5455/pmb.1-1409314914. Ozturk, A. and S. Akturk, 2011. Obesity prevalence and associated risk factors in school-aged children. TAF Preventive Medicine Bulletin, 10(1): 53-60.Available at: https://doi.org/10.5455/pmb.20101119041916. Sakarya, S., S. Kanl, H. İkiışık, I. Maral, M. Taşdemir, İ. Topçu and Ş. Çalı, 2017. Childhood obesity from the perspective of families, teachers and family physicians: A mixed method study. Journal of Turkish Family Physician, 8(2): 27-39. Semiz, S., Ö. Özdemir and A. Özdemir, 2008. The prevalence of obesity in childhood 6-15 years of age in Denizli. Pamukkale Medical Journal, 1(1): 1-4. Simsek, F., B. Ulukol, M. Berberoglu, S.B. Gulnar, P. Adiyaman and G. Ocal, 2005. Obesity in a primary school and a high school in Ankara. Ankara University Faculty of Medicine, 58(1): 163-166. Tarakçı, E., B.E. Hüseyinsinoğlu and A. Ciçek, 2016. Physical inactivity, obesity and preventive rehabilitation approaches in children: Review. Turkey Clinic Health Science Journal, 1(2): 111-118.Available at: https://doi.org/10.5336/healthsci.2015-43713. TBSA, 2010, 2014. Turkey nutrition and health survey. Evaluation of Nutritional Status and Habits. T. C. Ministry of Health Publication Number. 931. pp: 472. Asian Journal of Education and Training, 2019, 5(1): 275-279 279 © 2019 by the authors; licensee Asian Online Journal Publishing Group The TOÇB, 2011. School age in Turkey (6-10 age group) growth in children monitoring (TOÇB) project. Research Report, Ministry of Health, General Directorate of Primary Health Care Services, Hacettepe University Faculty of Health Sciences, Nutrition and Dietetics Department, Ministry of Education, Ministry of Health Publication No: 834, Ankara, 2011. Tremblay, M., P. Katzmarzyk and J. Willms, 2002. Temporal trends in overweight and obesity in Canada, 1981-1996. International Journal of Obesity, 26(4): 538-543.Available at: https://doi.org/10.1038/sj.ijo.0801923. WHO, 2000. Obesity: Preventing and managing the global epidemic. Report of a WHO Consultation on obesity; WHO Technical Report Series, Geneva: World Health Organization. pp: 894. WHO, 2018. Obesity and overweight. Available from https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight [Accessed 16.02.2019]. Asian Online Journal Publishing Group is not responsible or answerable for any loss, damage or liability, etc. caused in relation to/arising out of the use of the content. Any queries should be directed to the corresponding author of the article. http://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight