Associations of School-Level Factors and School Sport Facility Parameters with Overweight and Obesity among Children and Adolescents in Pakistan: An Empirical Cross-Sectional Study

Childhood overweight and obesity are increasingly prevalent in Pakistan, posing significant public health challenges. This study explores the associations of school-level factors and school sports facility parameters with overweight and obesity among children and adolescents in Pakistan. A cross-sectional study across seven random districts in Punjab province, Pakistan, was conducted using a representative multistage random cluster sample. Underweight (BMI < 5th percentile), overweight (85th ≤ BMI < 95th percentile), and obese (95th percentile ≤ BMI) were defined using the US Center for Disease Control (CDC) 2000 criteria. Statistical analyses including the Chi-square test, Pearson correlation coefficient, and linear regression were performed to investigate predictive characteristics. Logistic regression analysis assessed the simultaneous impact of several covariates on dichotomous outcomes, with 95% confidence intervals (CIs) computed and a significance level set at p < 0.05. The study included 4108 Pakistani school children aged 9 to 17 years (mean age = 13.92 years, 59.3% boys) from 62 schools. The prevalence of overweight and obesity was 19.4% and 10.7%, respectively. Findings revealed a concerning lack of physical education activities (60% reported 0 sessions per week), morning exercise (60%), and classroom exercises (66%) among school-aged children. Leadership attitudes toward physical education (β = 0.04, p = 0.006) and students' satisfaction with the playground (β = 0.05, p = 0.015) showed significant associations with body weight status. Conversely, provision of physical education facilities, effective fund utilization for physical education, meeting school sports facility requirements, and weekend opening of school sports grounds did not significantly impact weight status. Satisfaction with the playground was significantly associated with a lower risk of overweight (OR 0.81, 95% CI 0.69-0.95, p < 0.05), indicating reduced overweight likelihood among students satisfied with school playgrounds. The study underscores significant gaps in promoting physical activity within school environments and highlights the urgent need for interventions to enhance physical education resources and sports facilities, aiming to create healthier school environments and reduce overweight and obesity prevalence among students. Further research and interventions are crucial for promoting lifelong physical activity habits and improving student health and well-being.

Association of nutrition behavior and food intake with overweight and obesity among school-aged children and adolescents in Pakistan: a cross-sectional study

Purpose

This study aimed to assess the association between nutrition behavior, food intake, being overweight, and obesity among school-aged children and adolescents aged 9 to 17 years. Additionally, it sought to examine how these factors influence being overweight and obese within this population.

Methods

A population-based cross-sectional study was conducted with a representative multistage cluster sample of 4200 Pakistani school-aged children and adolescents aged 9 to 17 years from 62 schools across seven random districts in Punjab province, Pakistan. Underweight (BMI < 5th percentile), overweight (85th ≤ BMI < 95th percentile), and obese (95th percentile ≤ BMI) were defined using the US Center for Disease Control (CDC) 2000 criteria, and a Chi-square test utilized for comparison. The Pearson correlation coefficient (r) assessed any correlations, while a linear regression analysis explored the predictive power of Nutrition Behavior/Food Intake factors (independent variables) on body-weight (dependent variable). A logistic regression analysis estimated the simultaneous influence of multiple factors on the dichotomous outcomes, and the 95% confidence intervals (CI) were calculated. The statistical significance level was set at p < 0.05.

Results

The study was comprised of 4108 Pakistani school children aged 9 to 17 years (mean age = 13.92 years, 59.3% boys) from 62 schools. Among them, the prevalence of being overweight and obese individuals was 19.4% and 10.7%, respectively. Factors such as skipping breakfast (OR 2.45, 95% CI 1.53-3.93, p < 0.001), consuming vegetables less than once a week (OR 4.12, 95% CI 3.06-5.55, p < 0.001), consuming soft drinks three or more times a week (OR 4.74, 95% CI 3.73-6.04, p < 0.001), and consuming fast food three or more times a week (OR 10.56, 95% CI 8.16-13.67, p < 0.001) were associated with a higher risk of obesity.

Conclusion

Being overweight and obese pose significant concerns among school-aged children and adolescents in Pakistan, showing a troubling upward trend. Poor nutrition behaviors, including frequenting fast-food restaurants and low consumption of fruits and vegetables, contribute to these issues. It is imperative to comprehend these risk factors to formulate impactful policies and dietary interventions that target childhood obesity in Pakistan. Identifying vulnerable populations and implementing tailored intervention strategies are essential for public health efforts. While further interventions may be needed to reduce the body mass index (BMI) and manage being overweight and obese, the findings of this study provide valuable insights into addressing these critical health challenges.

Prevalence of overweight and obesity among Iranian population: a systematic review and meta-analysis

BACKGROUND

Obesity is a major risk factor for chronic diseases. Politicians and practitioners should be aware of the dramatic increase in obesity and its subsequent complications to prevent associated health risks. This systematic review aimed to provide better insight into the prevalence of overweight and obesity in the Iranian population.

METHOD

An evaluation was conducted on all published observational studies from both national (SID, Irandoc, Iranmedex) and international (Web of Knowledge, PubMed, Scopus) sources, which reported the prevalence of overweight/obesity among normal population samples, between January 2012 and December 2021.

RESULT

A total of 152 eligible studies were included in this meta-analysis. Of the 152 selected studies, 74 reported the prevalence of overweight/obesity in patients aged ≤ 18 years, and 61 studies in adults. In the rest of the articles (17 studies), the results were reported for a combination of these age groups. The prevalence of overweight and obesity in Iran was estimated at 20.1 (95% CI 17.92-22.30) and 13.44 (95% CI 11.76-15.22), respectively. This percentage (95% CI) was 11.71 (10.98-12.46) for overweight and 8.08 (7.02-9.22) for obesity in those aged ≤ 18 years, and 35.26 (32.61-37.99) for overweight and 21.38 (19.61-23.20) for obesity in those aged > 18 years. The overall prevalence of overweight and obesity in the entire population was 35.09% (95% CI 31.31-38.98).

CONCLUSION

As obesity is on the rise in Iran, we should seek both weight loss strategies and ways to control comorbidities associated with high BMI.

The Current Prevalence of Underweight, Overweight, and Obesity Associated with Demographic Factors among Pakistan School-Aged Children and Adolescents-An Empirical Cross-Sectional Study

Purpose: This study investigated the most recent estimates of underweight, overweight, and obesity prevalence in Pakistani school-aged children and adolescents. Methods: A cross-sectional study was conducted using a convenience random clustered sampling approach with 3,551 Pakistani school children aged 9 to 17 years from 52 schools throughout seven districts in central Punjab province. The CDC US 2000 was used to define underweight (BMI < 5th percentile), overweight (85th ≤ BMI < 95th percentile), and obesity (95th percentile ≤ BMI) for different school grade cohorts (primary, middle, secondary, and higher secondary schools). As a trend test, the Chi-square test was used. A Spearman correlation analysis (r) was used to determine the correlations between demographic variables and weight status. A regression analysis was conducted to explore the predictive power of demographic factors in relation to body weight. Results: In Pakistani school-aged children and adolescents, the prevalence of underweight, normal weight, overweight, and obesity was 21.9%, 66.9%, 5.8%, and 5.4%, respectively. Significant correlations with body weight status were shown for individual demographic parameters (age, gender, school type, and school grade). Children in urban areas were more likely to be underweight, overweight, or obese than those in rural areas. Boys were found to have a lower BMI than girls. Accordingly, more boys than girls were underweight (odds ratio (OR) = 1.57, 95% CI: 1.33-1.85) and more girls had a higher risk of obesity than boys (OR = 1.39, 95% CI: 1.03-1.86). Lower grades showed more underweight (OR = 1.66, 95% CI: 1.39-1.99) whereas higher grades showed a higher risk of obesity (OR = 1.91, 95% CI: 1.41-2.57). Conclusions: In Pakistani school-aged children and adolescents, underweight, overweight, and obesity were prevalent. Compared with studies from 2011, the risk of overweight and obesity in Pakistan has decreased. However, this may also be due to the fact that students in Pakistan have a lower BMI compared to other countries. This issue has also been seen in the present study and is confirmed here by the high number of cases of underweight students. Future research studies should look into additional weight status correlates and factors. To evaluate the association between weight status and behavioral and other health variables, future research should use longitudinal or interventional designs.

A cross-sectional analysis of snacking habits, eating habits, physical activity, and indicators of obesity among high school students in Jakarta, Indonesia

Background

Changes in the lifestyle and eating habits of people in large cities in Indonesia have increased the risk of obesity. In Indonesia, the prevalence of obesity in adolescents increased from 1.6% in 2013 to 4.0% in 2018; in Jakarta, it increased from 4.2% in 2013 to 8.3% in 2018. Obesity is closely related to health behavior in adolescence, and it is a risk factor for the occurrence of non-communicable diseases (NCDs). This study aimed to describe the snacking habits, eating habits, physical activity, and indicators of obesity among adolescents in Jakarta.

Design and Methods

This study used a cross-sectional design involving 170, 10^th–12^th grade public high school students in Jakarta Province, recruited using purposive sampling technique. Using standardized instruments, the following surveys were delivered online: The Beverage and Snack Questionnaire, the Eating Habits Questionnaire, and the Youth Risk Behavior Survey Questionnaire (Q78). The Chi-squared test was used to determine the correlation between the study's variables.

Results

The majority of the 170 respondents were female (81.2%). Among the respondents, 11.2% were obese and 6.5% were overweight. Of the 170 respondents 52.4% had the habit of snacking, 64.1% had healthy eating habits, 73.5% engaged in physical activity ≤3 days/week, 79.4% watched TV <3 hours/day, and 61.2% played video games and spent time on computers ≥3 hours/day. The bivariate analysis results showed that there was no significant relationship between snacking habits, eating habits, and physical activity with indicators of obesity (p>0.05).

Conclusions

In general, the respondents in our study were found to have a healthy lifestyle, thus helping to prevent the development of an NCD. However, a number of the respondents were overweight and obese.

The study of Iranian children and adolescents' physical activity: a systematic review and meta-analysis

OBJECTIVES

This systematic and meta-analysis review was conducted to determine the status of Iranian children and adolescents' physical activity.

CONTENT

All the related articles which were published in the major databases, including Pubmed, Scopus, Web of Science, Embase, Magiran, SID from the beginning of 2010 to the end of 2019, were reviewed by researchers. The Newcastle-Ottawa scale was also used to evaluate the quality of articles. Moreover, I ² index and chi-square were used to assess the heterogeneity between the results.

SUMMARY

490 articles were found as a result of the search in the selected international and local databases, where finally, 10 articles were included into the meta-analysis after the elimination of the duplicated articles and applying inclusion and exclusion criteria. The results indicated that 29.5% of the girls were considered active according to WHO criteria (16.1-42.8: 95% CI) and also 20.5% of the boys (7.3-33.7: 95% CI).

OUTLOOK

Overall, this study's findings showed that a large percentage of Iranian children and adolescents do not achieve the level of physical activity recommended by the World Health Organization. This can lead to undesirable consequences for this group of population that is considered as the human capital of any country; consequently, it seems necessary to take basic measures at the micro and macro levels in order to reduce such problems in the society.

Obesity and its associated risk factors among school-aged children in Sharjah, UAE

Background

The most prevalent nutritional disorders worldwide are childhood overweight or obesity. Various factors clearly contribute to the childhood obesity epidemic. The aim of this study is to investigate the prevalence of childhood obesity in children of primary schools, and determine the influence of eating behavior and lifestyle in such a condition.

Methods

The study based on a cross sectional survey including school children aged 6–11 years. Pupils were from different schools in Sharjah, UAE. Outcome measures used in this study covered health characteristics; child habits and lifestyle; disease status and medication.

Results

The number of pre-validated surveys distributed was 932 and those returned counted to 678, giving a response rate of 72.8%. More than half (379; 55.9%) of the participants were females and 191 (28.2%) of the children were obese or overweight. Almost one quarter (162; 23.9%) of the children was physically inactive. Additionally, candy and fast food consumption was significantly high (370; 54.6%) and (324; 47.8%) respectively. Participant’s food, age and time spent on TV were significantly associated with body mass index (BMI).

Conclusion

Prevalence of overweight and obesity in the Emirate of Sharjah is high in both genders and across all ages of the study population. Contributing factors may include; sedentary lifestyle, consumption of unhealthy food and family history. There is a need for an immediate attention and measures to reduce the prevalence of obesity and associated diseases.