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Journal of Obesity
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Research Article
Prevalence of Overweight, Obesity, and Thinness in Cameroon
Urban Children and Adolescents
Ponce Cedric Fouejeu Wamba,1Julius Enyong Oben,1and Katherine Cianflone2
1Laboratory of Nutrition and Nutritional Biochemistry, Department of Biochemistry, Faculty of Science,
University of Yaound´
e1,P.O.Box8418,Yaound
´
e, Cameroon
2Centre de Recherche Institut Universitaire Cardiologie & Pneumologie de Qu´
ebec, Y4323, 2725 Chemin Sainte-Foy,
Qu´
ebec, QC, Canada G1V 4G5
Correspondence should be addressed to Katherine Cianone; katherine.cianone@criucpq.ulaval.ca
Received March ; Revised May ; Accepted May
Academic Editor: Yvon Chagnon
Copyright © Ponce Cedric Fouejeu Wamba et al. is is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Objective. is study examined the prevalence of thinness, overweight, and obesity in Cameroon children ranging from to years
old using several published references as evaluation tools. Methods. A stratied sample was used with eleven schools randomly
selected, and data from children (.% girls) ranging from to years were analyzed. Weight and height were recorded and
BMI was calculated. BMI cutos used to dene nutritional status grades included two international and three national published
indices which were compared to our database-derived cutos. Results. A prevalence of .% thinness and .% overweight
including .% obesity according to international references was detected. A .% low-weight-for-age, .% low-height-for-age,
and .% low-weight-for-height were identied. Overall, there were signicant dierences using calculations based on our database
versus published reference values and between boys versus girls. Conclusions. is study demonstrates that prevalence of thinness,
overweight, and obesity is similar to that of other leading-emerging countries reported within the last decade, yet it is still lower
than prevalence in developed countries. Ethnic background and social environment have impact on prevalences, highlighting the
importance of evaluating the Cameroon population based on locally derived database.
1. Introduction
Obesity has become a global health problem. According
to the World Health Organization (WHO) in about
. billion adults were aected worldwide, with about
million adults categorized as obese []. In the Cameroon
adult population, both overweight (.% men and .%
women) and obesity (.% men and .% women) are
prevalent and are increasing in both rural and urban areas
[–]. e higher sociodemographic levels, evaluated based
on education level, demonstrated a -to-.-fold risk of
being overweight or obese in men []. is data, along with
others, suggests the ongoing development of an obesogenic
environment in Cameroon, as is seen in many developing
countries undergoing rapid urbanization and social changes
[,].
In developed and developing countries, with the reduc-
tion of underweight status, there has been widespread
concern over the increase in overweight and obesity in
children [,]. is results in the simultaneous occurrence
of undernutrition and obesity at the childhood level in many
developing countries []. Childhood obesity is considered
to be a precursor of adverse health eects in adulthood, as
overweight children are more likely to become overweight
adolescents and adults; . times more likely in one study in
Chinese children [].
e denition of both overweight and obesity in children
and adolescents is still a matter of debate [–]. To date,
body mass index (BMI), calculated as weight (kg) per height
(m2), can be easily assessed at low cost and is strongly
associated with body fat and health risks in adults [].
In children and adolescents, BMI has increasingly been
Journal of Obesity
8 10121416
15
20
25
30
IOTF 30
Database 30
IOTF 25
Database 25
Boys
(kg/m2)
Age (years)
(a)
IOTF 30
Database 30
IOTF 25
Database 25
810 12 14 16
Girls
15
20
25
30
(kg/m2)
Age (years)
(b)
810 12 14 16
95th WHO 2007
85th database
85th WHO 2007
95th database
15
20
25
30
(kg/m2)
Age (years)
Boys
(c)
8 10121416
95th WHO 2007
85th database
85th WHO 2007
95th database
15
20
25
30
(kg/m2)
Age (years)
Girls
(d)
810 14
16
85th Must et al.
95th Must et al.
85th database
95th database
15
20
25
30
(kg/m2)
Age (years)
12
Boys
(e)
108 121416
85th Must et al.
95th Must et al.
85th database
95th database
15
20
25
30
(kg/m2)
Age (years)
Girls
(f)
F : Continued.
Journal of Obesity
15
20
25
30
85th CDC
95th CDC
85th database
95th database
810121416
Age (years)
(kg/m2)
Boys
(g)
85th CDC
95th CDC
85th database
95th database
810121416
Age (years)
15
20
25
30
(kg/m2)
Girls
(h)
810121416
15
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97th database
97th French
Age (years)
(kg/m2)
Boys
(i)
97th database
97th French
810121416
Age (years)
15
20
25
30
(kg/m2)
Girls
(j)
F : Comparison of age- and gender-specic body mass index (BMI) cut-o curves of our Database population of to years
old presented relative to dierent published reference groups: International Obesity Task Force (IOTF) cutos for overweight and obesity
matching, respectively, BMI of and kg/m2atyearsold(aandb),WorldHealthOrganization(WHO)thandthpercentiles
(c and d), Must et al. or “old United States” th and th percentiles (e and f), Center of Disease Control (CDC) or “new United States” th
and th percentiles (g and h), and Europe-French th percentile for overweight including obesity (i and j). In all panels, corresponding
cutos derived from our Database are presented as solid lines presented beside reference cutos with dotted lines.
accepted as a valid indirect measure of fat mass with age and
gender specic cutos proposed in various studies; but there
remains a wide array of references used, based on dierent
populations, including weight-for-height (ideal weight for
height or 𝑧-score), BMI percentile, skin fold thickness, and
waist circumference [,,,–].
Recent studies in Cameroon specically have pointed
out the association of obesity with hypertension and dia-
betes in adults [,]. However, there is a lack of data
concerning overweight and obesity assessment in childhood
and adolescence in Cameroon, although, clearly, the risk
of childhood obesity leading to adult morbidity is of great
public health signicance. Hence, this cross-sectional study
was designed to (i) estimate the prevalence of grades of
nutritional status (under- and overweight) in urban zones
in Cameroon and (ii) examine this prevalence with respect
to existing references and internationally available data on
childhood and adolescence.
2. Materials and Methods
2.1. Sample and Procedures. Subjects were recruited from a
cross-sectional school-based survey: the Douala Child and
Journal of Obesity
T : (a) Descriptive statistics for height, weight, and body mass index (BMI) of boys in our study population. (b) Descriptive statistics
for height, weight, and body mass index (BMI) of girls in our study population.
(a)
Age (years) 8 9 10 11 12 13 14 15
𝑁 106 125 130 163 194 224 203 140
Height (cm) . (.) . (.) . (.) . (.) . (.) . (.) . (.) . (.)
Weight (kg) . (.) . (.) . (.) . (.) . (.) . (.) . (.) . (.)
BMI (kg/m2) . (.) . (.) . (.) . (.) . (.) . (.) . (.) . (.)
𝑁: number, BMI: body mass index, and values are given as mean (standard error of the mean).
(b)
Age (years) 8 9 10 11 12 13 14 15
𝑁 118 133 139 173 238 229 195 179
Height (cm) . (.) . (.) . (.) . (.) . (.) . (.) . (.) . (.)
Weight (kg) . (.) . (.) . (.) . (.) . (.) . (.) . (.) . (.)
BMI (kg/m2) . (.) . (.) . (.) . (.) . (.) . (.) . (.) . (.)
𝑁: number, BMI: body mass index, and values are given as mean (standard error of the mean).
Adolescent Obesity Study in Cameroon (DCAO study). A
totalofschoolchildrenrangingfromtoyearsold
were recruited between February and May in the city of
Douala, including girls (𝑛 = 1404)andboys(𝑛 = 1285). A
stratied sampling procedure was used in selecting schools
and a quota sampling was used in each school. Data were
widelycollectedsoastoincorporateallsocialstrata,aswellas
ethnic groups, including minorities. Data from subjects aged
toyearsoldwerepooledforfurtheranalysis.isstudy
was approved by the School Administration and the National
Ethics Committee. Signed informed consent was obtained
from parents or guardians.
2.2. Measures. Anthropometric variables were measured
according to existing standards by trained enumerators.
Height was measured without shoes to the nearest . cm
using a portable stadiometer, and body weight was measured
to the nearest . kg using an indoor weighing scale with the
student’s shoes, coats, and other heavy outerwear removed.
HeightandweightwereusedtocalculateBMIasbodymass
(kg)/square of height (m2).
2.3. Choice of Reference Tools and Cutos for Grouping.
Our database-derived reference (Database) was rst built
according to various methods and second compared to other
published references for the assessment of grades of nutri-
tional status based, respectively, on BMI, weight for height,
weight for age, and height-for-age. e LMS method was used
to summarize the dataset in three smooth age specic values
of skewness (𝐿or Lamda), median (𝑀or Mu), and coecient
of variation (𝑆or Sigma); then each age and gender-specic
BMI cutos or percentiles were derived from our Database
using the formula: 𝑀(1 + 𝐿𝑆𝑧)1/𝑇,where𝑧indicates the 𝑧
score for required cuto, which corresponded to BMI values
of , , ., , and kg/m2at years (Method ), th
and th percentiles (Method ) and th BMI percentile
(Method ). Our Database was then compared to dierent
references using the same methodology.
Method 1. Database percentiles passing through BMI values
of , , ., , and kg/m2at years were compared to
Cole and IOTF similar published data [,,].
Method 2. Database-derived th and th BMI percentiles
were compared with similar cutos as the old US (Must et al.)
[], the new US (CDC) [,], and the WHO reference
[].
Method 3. e th centile from database was compared with
the Europe-French th BMI percentile reference [].
WHO reference [] and CDC references []
were used to assess the level of undernutrition including
wasting, stunting, and underweight. Wasting was dened as
weight below standard deviations (SD) from the median for
weight-for-height. Further, moderate wasting (wasting I) and
severe wasting (wasting II) are dened, respectively, as below
SD and below SD. Stunting was dened as height below
SD from the median for height-for-age. Underweight was
dened as weight below SD from the median for weight-
for-age.
2.4. Statistics. Quantitative data are presented as median with
coecient of variation and skewness or means with standard
error of the mean where stated. Dierences between boys
versus girls were tested by Student’s 𝑡-test. Frequency data
are given as percentages or ratios, frequency of overweight;
obesity and thinness were standardized by age and gender.
Comparison between genders and references used was per-
formed using the Chi-square test. e signicance level was
set at 𝑃 < 0.05.DatawereanalyzedwithSPSS.for
Windows (SPSS Inc., ) and GraphPad Prism .
Journal of Obesity
T : Age specic 𝐿,𝑀,𝑆,and𝑧-scores values for BMI (kg/m) from Cameroon study population using LMS method, with additional
𝑧-scores and percentiles: Boys.
Age (years) 𝑛𝐿𝑀𝑆 𝑧-scores th th th
−2 −1.33 −0.67 0.67 1.33 2 1.03 1.64 1.88
8 106 2.31 15.8 0.13 10.5 12.6 14.3 17.1 18.3 19.4 17.8 18.9 19.2
9 125 1.71 15.8 0.14 10.8 12.6 14.3 17.3 18.6 19.9 18.0 19.2 19.7
10 130 2.08 16.4 0.14 10.5 12.8 14.7 17.9 19.3 20.5 18.7 19.9 20.3
11 163 1.25 17.3 0.12 12.7 14.3 15.8 18.8 20.2 21.6 19.5 20.8 21.3
12 194 1.26 18 0.13 13.0 14.7 16.4 19.6 21.1 22.6 20.4 21.8 22.3
13 224 2.43 18.3 0.16 9.14 13.2 16.0 20.2 21.9 23.4 21.1 22.6 23.1
14 203 1.98 18.9 0.12 13.1 15.3 17.1 20.4 21.9 23.2 21.2 22.5 23.0
15 140 0.49 19.5 0.12 14.9 16.4 17.9 21.1 22.9 24.7 22.1 23.7 24.3
𝑛:sample size, 𝐿:skewness,𝑀:mean,and𝑆:coecientofvariation.−2,−1.33,−0.67,0.67,1.33,and2are 𝑧-scores used to calculate nd, th, th, th, st,
and th BMI percentiles, respectively.
3. Results
Table outlines the principal age and gender specic char-
acteristics of the database sample in boys (Tab l e (a)) and
girls (Tab l e (b)). Little gender dierences on anthropometric
variables (weight, height, and BMI) were observed at age ,
, and years, but all anthropometrics were signicantly
higheringirlsversusboysespeciallyat,,,andyears;
all 𝑃 < 0.01 (data not shown).
Based on the 𝐿𝑀𝑆 (Lamda, Mu, and Sigma) method,
mean (𝑀), skewness (𝐿), and coecient of variation (𝑆)used
for the determination of dierent BMI cutos and 𝑍scores
were calculated from our Database as shown in Tables and
,forboysandgirls,respectively.BMIvaluesincreasewith
age in both boys and girls, with higher values for girls at
all ages. Tab l e presents age-related BMI cut-o points for
various degrees of thinness, overweight, and obesity between
and years, designed by the 𝐿𝑀𝑆 method to match adult
cutos. Overall, cut-o values increase with age in both boys
and girls; a marked shi towards lower values was observed at
years old for girls and years old for boys, particularly with
respect to thinness cut-os, while overweight and obesity
cutos were less aected.
In Figure ((a) to (j)), ve dierent reference cut-os
are compared to our Database-derived cut-os using the
same calculation methodology. In panels ((a) and (b)), other
than the cuto for overweight boys, in general the IOTF
reference [] cut-os were higher versus our Database-
derived cut-os. In panels ((c) and (d)), WHO []and
th and th percentiles, dening, respectively, overweight
and obesity, were closer to corresponding percentiles in our
Database, especially at younger ages. In panels ((e) to (h)),
US references, based on Must et al. []andCDCforth
and th percentiles (overweight and obesity, resp.) [], were
all higher than our corresponding Database percentiles for
both boys and girls. Of note, for girls, closer values for the
th percentile were obtained in older versus younger girls
whilenosuchobservationwasmadeforboys,wheretheth
percentile was shied closer to the US th percentile. e
French reference group [] (panels (i) and (j)) dened as the
th percentile was lower than our Database th percentile,
with the dierence more evident in girls versus boys.
Table summarizes the prevalence of overweight exclud-
ing obesity and obesity in our Database, evaluated according
to the age and gender denitions used in the dierent refer-
ences. e prevalence of overweight ranges from .% to .%
in boys and from .% to .% in girls, whereas prevalence
of obesity ranges from .% to .% in boys and from .
to .% in girls. Regardless of the analysis method used, our
Database-derived prevalence was signicantly dierent from
the corresponding references used (all 𝑃 < 0.001).
Table summarizes the prevalence of undernutrition
inourstudypopulation.Prevalenceofunderweightand
stunting according to WHO reference was higher in
boys as compared to girls, .% versus .% and .% versus
.%, respectively; while wasting was about . times higher
in girls as compared to boys at .% versus .%. inness,
dened by BMI cut-os (Cole and our Database), yields
about the same prevalence in boys and girls, .% versus .%
and .% versus .%, respectively, using Cole and our
Database cutos.
4. Discussion
is study was conducted in in urban Cameroonian
children and adolescents aged to years old. According
to Cole et al. and IOTF references, we report an overall
prevalence of .% thinness and .% overweight including
.% obesity. Prevalence of thinness was comparable to that
of other developing regions [,], while prevalence of
overweight and obesity was lower than that of reported data
from Europe and US []. e overweight prevalence comes
closetothebottomendofthebracketobservedinEurope,
which is unexpectedly high for this country. ese results
then support the previously reported coexistence of both
thinness and overweight in developing countries, with the
increasing rate of obesity overtaking that of thinness [,,
].
is study has several limitations that need to be con-
sidered. First the collection of data was only in one urban
area of one region of the country, which limits the potential
conclusions to that area, and is not applicable to general
rural areas. From a total of children and adolescents
Journal of Obesity
T : Age specic 𝐿,𝑀,𝑆,and𝑧-scores values for BMI (kg/m) from Cameroon study population using LMS method, with additional
𝑧-scores and percentiles: Girls.
Age (years) 𝑛𝐿𝑀𝑆 𝑧-scores th th th
−2 −1.33 −0.67 0.67 1.33 2 1.03 1.64 1.88
8 118 1.14 15.9 0.15 10.9 12.6 14.3 17.6 19.2 20.8 18.5 19.9 20.5
9 133 1.09 15.9 0.14 11.2 12.8 14.4 17.5 19.0 20.5 18.3 19.7 20.2
10 139 0.59 16.9 0.12 12.8 14.1 15.5 18.4 19.9 21.5 19.2 20.7 21.2
11 173 1.85 17.7 0.17 10.2 13.1 15.6 19.7 21.5 23.2 20.7 22.3 22.9
12 238 1.18 18.7 0.16 12.4 14.6 16.6 20.7 22.6 24.6 21.8 23.6 24.2
13 229 1.02 19.5 0.16 12.9 15.1 17.3 21.7 23.9 26.1 22.9 24.9 25.7
14 195 1.08 20.3 0.15 13.8 16.0 18.1 22.4 24.5 26.6 23.6 25.5 26.2
15 179 0.74 21.3 0.14 15.2 17.2 19.2 23.4 25.6 27.9 24.6 26.7 27.5
𝑛:samplesize,𝐿:skewness,𝑀:mean,and𝑆: coecient of variation. −2,−1.33,−0.67,0.67,1.33,and2are 𝑧-scores used to calculate nd, th, th, th, st,
and th BMI percentiles, respectively.
T : Age- and gender-specic BMI cutos for the classication of nutritional status, obtained by using LMS method applied to our
Cameroon database.
Age (years) inness III inness II inness I Overweight Obesity
Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls
8 9.9 10.7 11.4 11.5 13.3 12.8 18.6 17.9 21.3 21.6
9 10.3 11.1 11.6 11.9 13.3 13.0 18.9 17.8 22.2 21.3
10 9.9 12.6 11.5 13.3 13.6 14.3 19.5 18.7 22.7 22.3
11 12.3 9.9 13.4 11.4 14.9 13.5 20.5 20.1 24.1 24.0
12 12.6 12.2 13.8 13.2 15.4 14.8 21.4 21.1 25.4 25.6
13 7.5 12.7 11.1 13.8 14.4 15.4 22.2 22.2 25.9 27.2
14 12.5 13.5 14.0 14.6 16.0 16.2 22.2 22.8 25.6 27.6
15 14.6 15.0 15.5 15.9 16.9 17.4 23.2 23.9 28.3 29.1
inness III, inness II, inness I, overweight, and obesity correspond, respectively, to BMI values of 16,17,18.5,25,and30kg/m2at years old.
selected, (.%) were eliminated because of missing data
or they were not within the proposed age range (below
or above years old). Nonetheless, the nal sample within
inclusion criteria included subjects comprising .%
boys (𝑛 = 1285)and.%girls(𝑛 = 1404), with at least
to subjects (mean .) per age and per gender; falling
within the criteria of a representative sample. Further, given
the known impact of sociodemographic factors on nutritional
status in children, a strength of this study was that sampling
was stratied to assess a wide range of existing social strata,
including primary and high schools, both public and private
ones. While prevalence data obtained in this study cannot
absolutelybegeneralizedtoeveryurbancityinCameroon,
as notable social dierences exists, this data from the largest
Cameroon cities is representative of the Cameroon urban
setting and can be compared to prevalence data recorded in
otherleadingurbancitiesinothercountries.
e results of this study showed that, in general, regard-
less of the reference parameter used, overweight and obesity
aect an important percentage of children and adolescents in
an area and a continent that has typically not been associated
with this problem. To our knowledge, this is the rst study
to report the prevalence of overweight, obesity, and leanness
in Cameroon children and adolescents with such a large
sample and specically the comparison of data to several
existing indices. We noted major dierences between our
Database analysis and published reports, according to the
reference used [,]. IOTF showed .% overweight
including obesity, while similar cut-os derived from our
Database yielded .%. French cut-os showed the lowest
percentage (.%), while US references showed intermediate
values of .% and .%, respectively, for Must et al. and
CDC references. Finally, WHO showed the highest
percentage (.%). Interestingly, the greatest dierences were
accounted for by obesity alone, which reached .% according
to WHO compared to only .% according to IOTF,
although the prevalence of overweight alone was apparently
the same (.% versus .%, resp.). Similar trends were
previously observed in a sample of Brazilian children, where
evaluation of relative obesity/overweight diered according
to the reference database used []. Based on this variation,
which was dependent on the reference database used and
the necessity and usefulness for clinicians evaluating weight
and height for age to have population specic information,
it is doubly important to establish a national Cameroon
reference in order to evaluate ongoing changes in population
parameters and weight change management by clinicians,
especially in children during their developmental stages. Our
current study provides a basis for this.
Gender showed a high impact on the prevalence of
overweight and obesity as prevalence in girls (IOTF, .%)
wasabouttwicethatinboys(IOTF,.%).esame
Journal of Obesity
T : Prevalence (%) of overweight and obesity in the study population according to dierent references.
References Boys (𝑛 = 1285) Girls (𝑛 = 1404) Boys+girls(𝑛 = 2689) Chi-squared test
Overweight†obese Overweight†obese Overweight†obese 𝑃value
Method 1
Database lms 6.4 2.2 17.2 3.8 12.0 3.0 —
IOTF []7.0 1.4 13.8 2.4 10.5 1.9 <.
Method 2
Database th 6.6 7.0 7.9 8.2 7.3 7.6 —
WHO[]8.2 5.5 12.9 8.6 10.7 7.2 <.
Must et al. []6.4 2.4 10.7 3.7 8.6 3.1 <.
CDC [,]6.4 3.0 12.4 4.1 9.5 3.6 <.
Method 3
Database th∗5.7 —6.2 —5.9 ——
French th∗[]6.8 —14.7 —10.9 —<.
†Overweight excluding obesity, ∗overweight including obesity, International Obesity Task force (IOTF), World Health Organization (WHO), and Center of
disease Control (CDC), dierence between database and corresponding references was calculated by Chi-squared test, and 𝑃 < 0.05 was set at signicant.
T : Prevalence of undernutrition dened as underweight (low weight for age), stunting (low height for age), wasting (low weight for
height) and thinness (low BMI for age) based on several references used: WHO , CDC, Cole et al. , and our Database.
Reference Status Range∗Boys: 𝑛/𝑁 (%) Girls: 𝑛/𝑁 (%) Boys + girls
WHO[]
Underweight < yrs 20/361 (5.5) 19/390 (4.8) 39/751 (5.2)
Stunting / yrs 119/1285 (9.2) 34/1404 (2.4) 153/2689 (5.7)
Wasting < cm 21/1256 (1.6) 36/1245 (2.9) 57/2501 (2.2)
Wasting I < cm 18/1256 (1.4) 31/1245 (2.5) 49/2501 (1.9)
Wasting II < cm 3/1256 (0.2) 5/1245 (0.4) 8/2501 (0.3)
CDC [,]
Unde rweight / yrs 77/1285 (5.9) 38/1404 (2.7) 115/2689 (4.2)
Stunting / yrs 118/1285 (9.2) 39/1404 (2.7) 157/2689 (5.8)
Wasting < cm — 2/30 (6.6) 2/71 (2.8)
Wasting I < cm — — —
Wasting II < cm — — —
Cole et al. []
in / yrs 121/1285 (9.4) 136/1404 (9.7) 257/2689 (9.5)
in I / yrs 285/1285 (7.3) 96/1404 (6.8) 190/2689 (7.1)
in II / yrs 18/1285 (1.4) 20/1404 (1.4) 38/2689 (1.4)
in III / yrs 9/1285 (0.7) 20/1404 (1.4) 29/2689 (1.1)
Our Database
in / yrs 71/1285 (5.5) 70/1285 (4.9) 141/2689 (5.2)
in I / yrs 61/1285 (4.7) 54/1285 (3.8) 115/2689 (4.2)
in II / yrs 8/1285 (0.6) 13/1285 (0.9) 21/2689 (0.8)
in III / yrs 2/1285 (0.1) 3/1285 (0.2) 5/2689 (.)
𝑛:outcome,𝑁:totalexposed,and∗range denes the limit or the subset to which the cutos were valid or available in the literature. World Health Organization
(WHO) and Center of disease Control (CDC).
trend remained, irrespective of the reference parameter used.
Similar ndings were reported in the Cameroonian adult
population []. A similar wide variation in gender eect was
noted in a South African to study [], where black
boys showed lower obesity (.%) as compared to black girls
(.%) []. By contrast, countries such as China and India
showed the inverse prole, with boys being heavier than girls
[], while in Westernized countries including the US and
France, no such dierences were noted [,]. Based on
the IOTF reference, .% of US boys fall above the cut-o
for overweight, with .% for Brazilian boys []. Here we
observed .% for boys, according to the same cut-os. For
girls, .% in the US were overweight, with .% in Brazil
[],andinourDatabase,.%ofCamerooniangirls.e
same feature was noted with other reference indices, with
boys being less overweight or obese. ese ndings were
supportedbytheoverallsignicantlyhigheranthropometric
variablesmeasured(height,weight,andBMI)ingirlsas
compared to boys. Clearly ethnic background and social
environment impact on the prevalence of overweight and
Journal of Obesity
obesity in a gender-specic manner, again highlighting the
importance of evaluating the Cameroon population based on
a Cameroon-derived database.
Previous studies have noted a progressive reduction in
thinness in developing countries facing social changes, while
overweight and obesity are increasing [,]. In the present
study, we report that thinness corresponding to the adult
cuto of . kg/m2was .% in girls and .% in boys; the
uses of BMI cuto corresponding to . kg/m2at years
rather than BMI of kg/m2at years suggested earlier
[] could explain the relative high prevalence of thinness.
ese values of thinness are still higher than reported data
in developed countries such as the United States at .% [],
France at % [], and in a transitional country such as Brazil
at .% []. Although the prevalence of thinness is similar
to data published previously in -to--year-old Cameroon
adolescents with % of thinness []orinSouthAfrica,
with % [], they point towards a shi in the population
towards increasing overweight and obesity. When taking into
consideration combined underweight, wasting, and stunting
groups, the gender dierences remained signicant, as more
boys were underweight and stunted while more girls were
within the wasting group. ese results are consistent with
the existing sex dichotomy reported in the adult population
of Cameroon with .% men and .% women, respectively,
under a BMI of kg/m2[].
5. Conclusion
In conclusion, to our knowledge, this study is among the
rst in Cameroon pointing out the prevalence of grades of
nutritional status in children and adolescents at the urban
level.Asreferenceindicesandcut-osareoenpopulation-
specic and sensitive and obesity/overweight varies widely
worldwide, this highlights the importance of establishing
a Cameroon-based reference. is study could then serve
as a baseline and contribute to ongoing evaluation of the
adverse eects of nutrition in transition. e important
ndings presented here are (i) a relatively high prevalence of
overweight and obesity, compared to what was expected in
this population, especially in girls, and (ii) yet at the same
time, maintenance of thinness which is more prevalent in
boys. Further studies are needed to follow the inuence of
socioeconomic environment on nutritional status grades in
the context of economic growth.
Disclosure
Ponce Cedric Fouejeu Wamba is a Cameroonian partici-
pant directly involved in interaction with children from an
educational and research viewpoint. Julius Enyong Oben
is a researcher in Cameroon with academic nutritional
expertise, and Katherine Cianone is a Canadian researcher,
with expertise in obesity, and has participated in several
international studies on children in dierent ethnic groups.
Conflict of Interests
e authors declare no conict of interests. e authors alone
are responsible for the content and writing of the paper.
Authors’ Contributions
Ponce Cedric Fouejeu Wamba was responsible for the design
of the project, direct collection of the data, data and statis-
tical analysis, and paper preparation. Julius Enyong Oben
contributed to the study design and paper preparation, and
Katherine Cianone contributed to the study design, data
interpretation, statistical analysis, and paper preparation.
Acknowledgments
eauthorswouldliketothankalllocalschoolauthoritiesfor
the permission to work in their respective schools and to all
parents and guardians for their collaboration in the project.
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