Prevalence and factors associated with overweight and obesity among private kindergarten school children in Bahirdar Town, Northwest Ethiopia: cross-sectional study

Prevalence and factors associated with overweight in children under 5 years in West African countries

Background

Overweight is a risk factor for non-communicable diseases and is affecting an increasing number of children worldwide. The objective of this study was to measure the prevalence and related factors to overweight among children under 5 years in five West African countries.

Methods

This study was a secondary analysis of nationally representative cross-sectional data. These data were drawn from Demographic and Health Surveys (DHS) from five countries in the West African region (Benin, Guinea, Mali, Nigeria, and Togo) from 2015 to 2018.Continuous quantitative data were categorized and all analyses were weighted according to the probability that each participant was selected in the sample. Children under 5 years of age were the study population. Multilevel logistic regression was used with Stata 16.0 software.

Results

The total sample size for the analysis was 38,657 children. The pooled prevalence of overweight among children under 5 years of age in the five countries was 3%. Guinea had the highest prevalence (6%) compared to the other countries, which had a prevalence of 2%. The likelihood of being overweight was higher among children aged 0-6 months (adjusted odds ratio [AOR] = 3.09; 95% confidence interval [CI] [2.41-3.95]), who had a high birth height (AOR = 1.64; 95% CI [1.29-2.09]), whose mothers were overweight (AOR = 1.35; 95% CI [1.09-1.68]), who lived in households with fewer than five members (AOR = 1.19; 95% CI [1.00-1.46]), or who lived in Guinea (AOR = 2.79; 95% CI [1.62-4.79]).

Conclusion

This study showed that overweight concerns few children under 5 years of age in West Africa. However, it does exist, and its prevalence could likely increase if its modifiable factors (maternal overweight, household size, and height at birth) are not taken into account in nutritional interventions.

The coexistence of stunting and overweight or obesity in Ethiopian children: prevalence, trends and associated factors

BACKGROUND

Double burden of childhood malnutrition is a condition where undernutrition (stunting) along with overweight and obesity coexist within individuals, households, and populations. It reflects a new layer of malnutrition and an understudied phenomenon in many low-income settings. To date, the prevalence and factors that are associated with concurrent stunting and overweight or obesity (overweight/obesity) (CSO) in the same children have not been well researched in Ethiopia. Hence, this study aimed to assess the prevalence, trends, and factors associated with the coexistence of stunting and overweight or obesity among children aged 0-59 months in Ethiopia.

METHODS

Pooled data from 2005, 2011 and 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A total of 23,756 (weighted sample) children aged 0-59 months were included in the study. Height-for-age z-scores (HAZ) less than - 2 SD and weight-for-height z-scores (WHZ) above 2 SD were calculated, and children were classified as stunted and overweight/obese, respectively. A child who is simultaneously stunted and overweight/obese was considered as having HAZ below - 2 SD and WHZ above 2 SD computed into a variable named CSO, and reported as a binary outcome (yes or no). Multilevel logistic regression analysis that adjusts for sampling weights and clustering was used to identify factors associated with CSO.

RESULTS

The prevalence of stunting, overweight or obesity, and CSO among under-five children was 43.12% [95% CI: (42.50, 43.75%)], 2.62% [95% CI: (2.42, 2.83%)], and 1.33% [95% CI: (1.18, 1.48%)], respectively. The percentage of CSO children was reported to have declined from 2.36% [95% CI: (1.94-2.85)] in 2005 to 0.87% [95%CI: (0.07-1.07)] in 2011, and the same appeared to have increased slightly to 1.34% [95%CI: (1.13-1.59)] in 2016. Children who were currently breastfeeding [AOR: 1.64, 95%CI: (1.01-2.72)], born to an overweight mother [AOR: 2.65, 95%CI: (1.19-5.88)], and lived in families with 1-4 household members [AOR: 1.52, 95%CI: (1.02-2.26)] were significantly associated with CSO. At the community level the odds of having CSO were higher among children included from EDHS-2005 [AOR: 4.38, 95%CI: (2.42-7.95)].

CONCLUSION

The study revealed that less than 2% of children had CSO in Ethiopia. CSO was linked to factors at both the individual (i.e. breastfeeding status, maternal overweight, and household size) and community-levels. Overall, the study findings indicated the necessity of focused interventions to simultaneously address double burden of childhood malnutrition in Ethiopia. To further combat the double burden of malnutrition, early identification of at-risk children, including those born to overweight women and children living with multiple household members, is indispensable.

Prevalence of overweight/obesity and associated factors among under-five children in Ethiopia: A multilevel analysis of nationally representative sample

Background

Childhood overweight and obesity are emerging public health challenges of the twety-first century. There was a 24% increase in the number of overweight children under the age of 5 years in low-income countries. Despite the significant risk of childhood overweight/obesity for non-communicable diseases, premature death, disability, and reproductive disorders in their adult life, little attention has been given. Therefore, we aimed to assess the prevalence of overweight/obesity and associated factors among under-five children.

Methods

This study was conducted using data from a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The Mini EDHS was a community-based cross-sectional study that covered all the administrative regions of Ethiopia. The data collection was conducted between March 21, 2019 and June 28, 2019. Both descriptive and analytic findings were produced. The overweight/obesity was measured by the weight-for-height (WFH) index, more than two standard deviations (+2 SD) above the median of the reference population based on the BMI Z-score. To identify significantly asso.

Results

A total of 5,164 under-five children were included in this study cited factors of overweight/obesity, a multilevel binary logistic regression model was fitted to account for the hierarchical nature of the data. Adjusted odds ratio (aOR) with a corresponding 95% confidence interval (CI) was reported to show the strength of association and statistical significance. The overall prevalence of overweight/obesity was 2.14% (95% CI: 1.74-2.53). The odds of overweight/obesity was higher among children aged <6 months (aOR = 5.19; 95% CI: 2.98-9.04), 6-24 months (aOR = 1.97; 95% CI: 1.18-3.29), delivered by cesarean section (aOR = 1.75; 95% CI: 1.84-3.65), living in Addis Ababa city (aOR = 2.16; 95% CI: 1.59-7.81), Oromia region (aOR = 1.93; 95% CI: 1.71-5.24), having mothers with the age 40-49 years (aOR = 3.91; 95% CI: 1.90-16.92), uses traditional contraceptive methods (aOR = 2.63; 95% CI: 1.66-10.47) and households headed by male (aOR = 1.71; 95% CI: 1.84-3.48).

Conclusion

This study showed that the prevalence of overweight/obesity among under-five was low in Ethiopia. There were several factors that affect childhood overweight/obesity including child age, maternal age, mode of delivery, sex of head of household, contraception use, and geography of residence. Therefore, strategies to reduce childhood overweight and obesity should consider an identified multitude of contributing factors.

Nutritional status of school children in the South Tongu District, Ghana

Background

Malnutrition is a major public health problem because of the devastating consequences it has on children, their families, and society at large. Our study, therefore, sought to determine the prevalence of undernutrition and overweight/obesity and its associated factors among children aged 6–12 in the South Tongu District, Ghana.

Methods

A school-based cross-sectional study was conducted among 423 school children aged 6–12 years in the South Tongu District of Ghana. A multistage sampling method was employed to recruit the school children for the study. A semi-structured questionnaire was used to collect data from the respondents. We used a dual-purpose (height and weight) measuring scale to obtain the anthropometric data. The World Health Organization’s AnthroPlus software was used to generate the z-scores for determining the nutritional status. Percentages were used to present the results of the prevalence of undernutrition and overweight/obesity among school children. Bivariate and multivariable binary logistic regression were used to examine the factors associated with undernutrition and overweight/obesity among school children. The results were presented as crude odds ratios (CORs) and adjusted odds ratios (AORs), with their 95% confidence interval (CI). Statistical significance was set at p<0.05. Stata 16.0 was used to perform the analyses.

Results

The overall prevalence of undernutrition and overweight/obesity were 21.5% (CI = 17.7, 25.7) and 24.8% (CI = 20.8, 29.2), respectively. Specifically, the prevalence of stunting, thinness, underweight, overweight, and obesity were 10.4%, 12.1%, 3.8%, 11.1%, and 13.7%, respectively. School children whose household used water from non-portable sources were more likely to be undernourished [AOR = 2.03, 95% CI = 1.13, 3.63]. The odds of overweight/obesity was higher among school children whose mothers had attained formal education [AOR = 2.10, 95% CI = 1.09, 4.06], those who consumed beverages between meals per day [AOR = 1.87, CI = 1.08, 3.24], and those who had adequate dietary diversity score [AOR = 1.65, 95% CI = 1.02, 2.67]. School children aged 10–12 were less likely to be overweight/obese [AOR = 0.58, 95% CI = 0.35, 0.94] compared to those aged 6–9.

Conclusion

The study showed a relatively high prevalence of undernutrition and overweight/obesity among school children in the South Tongu District. The identified risk factor(s) for undernutrition was the usage of water from non-potable sources whilst those of overweight/obesity were age (10–12 years), maternal formal education, beverage consumption between meals per day, and adequate dietary diversity. The findings reaffirm that malnutrition is still prevalent among school children. Hence, there is a need for the Ministry of Health, Ghana Education Service, and other Non-Governmental Organizations to pay critical attention to these factors to achieve the Sustainable Development Goal 2, target 2.2. Nutritional behavioural change education should be carried out among parents and school children. School health service activities should be intensified with a special focus on nutritional screening.

Beliefs About Body Weight and Practices of Regulating Food and Physical Exercise Patterns of Children Among Parents in Southern Ethiopia

Background

The problem of childhood obesity is often associated with cultural values of body weight which includes the belief that voluptuous body size is a sign of good health status and better parental care. We examined the beliefs and behaviors of parents pertaining to preferred body weight of children, including practices of management of feeding and physical exercise patterns of children in southern Ethiopia.

Methods

Using cross-sectional survey study design, a structured questionnaire was distributed to randomly selected parents. Quantitative data were collected from 215 respondents, inserted into SPSS software, and analyzed by frequency and percentage distributions, charts, and multinomial logistic regression techniques.

Results

Most (59.1%) respondents want their child’s body weight to be normal/neither fat nor thin. In addition, 58.2% of the study participants held the opinion that average body size is an indication of good health status. Furthermore, 72.6% of respondents revealed that they control the amount of food their child consumes with the aim of preventing obesity/overweight. Moreover, 79.5% of respondents encourage their children to sometimes walk on foot, instead of always relying on vehicles while 87% of them replied that they regulate the amount of time their children spend watching TV. Above all, parents’ preference of voluptuous body size of children is significantly associated with age (OR=61.52.448, P < 0.001, 95%C.I: 57–66.14), educational status (OR = 35.605, P < 0.001; 95%C.I: 6.050–209.524), sex (OR = 0.237, P < 0.05; 95%C.I: 0.078-0.724) and grownup area (OR = 2.869, P < 0.05; 95%C.I: 1.062–7.749).

Conclusion

Parents not only have adequate level of awareness regarding the health risks of children’s heavy body weight but also engage in the body weight management practices of their children such as by regulating the food consumption patterns of children, encouraging them to undertake physical exercises, and by being role models while doing physical exercises for themselves.

Risk Factors for Overweight and Obesity within the Home Environment of Preschool Children in Sub-Saharan Africa: A Systematic Review

Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.

Dietary diversity score and cardio-metabolic risk factors: an updated systematic review and meta-analysis

CONTEXT

Dietary diversity score (DDS) has been known as a useful and convenient indicator of overall diet quality. Previous studies have reported the association between DDS and health problems such as diabetes, metabolic syndrome and cardiovascular disease.

OBJECTIVES

This systematic review and meta-analysis aimed to assess the association between dietary diversity score (DDS) and cardio-metabolic risk factors such as obesity and overweight, lipid profile, blood pressure, metabolic syndrome (MetS) and diabetes.

DATA SOURCES

We systematically searched PubMed and NLM Gateway, Scopus and Institute of Scientific Information (ISI) by up to October 2019.

DATA EXTRACTION

All observational studies which assessed the association of DDS with cardio-metabolic risk factors including anthropometric measures, blood pressure, lipid profile, glycemic indices and MetS without limitation in time of publication and language were included and critically reviewed by two independent experts. Random-effects meta-analysis was used to estimate the effect sizes.

DATA ANALYSIS

Among 843 documents retrieved from literature search, 23 studies met the inclusion criteria for systematic review, and 18 studies were eligible for meta-analysis. Random-effects meta-analysis showed that the association of DDS with obesity, abdominal obesity, overweight, body mass index, MetS, diabetes, blood pressure, and lipid profile (TC, LDL, HDL) was not statistically significant. On the other hand, the association of DDS and TG was statistically significant (SMD: - 0.23, 95% CI - 0.45, - 0.01).

CONCLUSIONS

Our findings revealed that there was no significant association between DDS and cardio-metabolic risk factors. Reassessment of the overall DDS tool as a criterion of diet quality and production of new and valid DDS standard tools is highly desirable. More high-quality studies are also needed to confirm the findings of this study.

STUDY REGISTRATION

This study is registered as PROSPERO CRD42020157127.

LEVEL OF EVIDENCE

Level I, systematic reviews and meta-analyses.

Factors associated with childhood overweight and obesity in Uganda: a national survey

Background

Childhood obesity is an emerging public health problem globally. Although previously a problem of high-income countries, overweight and obesity is on the rise in low- and middle-income countries. This paper explores the factors associated with childhood obesity and overweight in Uganda using data from the Uganda Demographic and Health Survey (UDHS) of 2016.

Methods

We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4338 children less than 5 years. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Overweight and obesity were combined as the primary outcome. Children whose BMI z score was over two were considered as overweight while those with a BMI z score greater than three were considered as obese. We used multivariable logistic regression to determine factors associated with obesity and overweight among children under 5 years of age in Uganda.

Results

The prevalence of overweight and obesity was 5.0% (217/4338) (95% CI: 4.3–5.6), with overweight at 3.9% (168/4338: 95% CI: 3.2–4.3) and obesity at 1.1% (49/4338: 95% CI: 0.8–1.5). Mother’s nutritional status, sex of the child, and child’s age were associated with childhood obesity and overweight. Boys were more likely to be overweight or obese (aOR = 1.81; 95% CI 1.24 to 2.64) compared to girls. Children who were younger (36 months and below) and those with mothers who were overweight or obese were more likely to have obesity or overweight compared to those aged 49–59 months and those with underweight mothers respectively. Children from the western region were more likely to be overweight or obese compared to those that were from the North.

Conclusion

The present study showed male sex, older age of the children, nutritional status of the mothers and region of residence were associated with obesity and overweight among children under 5 years of age.

Child dietary diversity and food (in)security as a potential correlate of child anthropometric indices in the context of urban food system in the cases of north-central Ethiopia

OBJECTIVE

To investigate the relation of child dietary diversity and household food insecurity along with other socio-demographic with child anthropometric indices in north-central Ethiopia, an area with a high level of food insecurity and inadequate diet quality.

DESIGN

A community-based cross-sectional study was used.

SETTINGS

The study was conducted in Dessie and Combolcha towns of north-central Ethiopia from April to May 2018.

PARTICIPANTS

Randomly selected 512 mother-child pairs with child's age range of 6-59 months.

RESULTS

The mean (± SD) scores of weight-for-height/length, height/length-for-age, weight-for-age, and BMI-for-age Z-scores were 1.35 (± 2.03), - 1.89 (± 1.79), 0.05 (± 1.54), and 1.39 (± 2.06), respectively. From all anthropometric indicators, stunting and overweight/obesity remained the severe public issues hitting 43% and 42% of the children, respectively. In the model, mothers' age and education and child's age, sex, and dietary diversity were significantly related with child height-for-age Z-score while place of residence, sex of household head, child's age, and dietary diversity score were the predictors of child BMI-for-age Z-score in the urban contexts of the study area. Nevertheless, food insecurity was not related to any of the child anthropometric indices.

CONCLUSION

The double burden of malnutrition epidemics (stunting and obesity) coexisted as severe public health concerns in urban settings. Anthropometric statuses of children were affected by multidimensional factors and seek strong integration and immediate intervention of multiple sectors.

Prevalence, incidence, and trends of childhood overweight/obesity in Sub-Saharan Africa: a systematic scoping review

Background

The growing burden of non-communicable diseases (NDC), particularly in low-and middle-income countries, poses a significant threat to global health. Obesity and overweight constitute major risk factors of NCDs such as heart diseases, diabetes, and kidney disease, and as a result, contribute significantly to the development of chronic morbidities, reduced quality of life, and increased risk of premature death. This study described evidence on the prevalence, incidence, and trends of childhood overweight and obesity in sub-Sahara Africa (SSA).

Methods

We conducted a systematic scoping review employing the Arksey and O’Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. To obtain relevant published articles for this review, we performed a comprehensive keywords search in PubMed, Google Scholar, Web of Science, and CINAHL via EBSCOhost platform for studies published between 2009 and June 2019. Guided by the eligibility criteria, title and abstracts, as well as the full-text articles were independently screened in parallel by two investigators. All relevant data were independently extracted by two investigators using a piloted form designed in Microsoft and thematic analysis conducted.

Results

Of the 81 included studies obtained from 250,148 potentially eligible articles, the majority (25) conducted in South Africa followed by 18 in Nigeria. Six studies were conducted in Ethiopia (6), Tanzania (5), Kenya (4), Cameroon (4), Ghana (3), Uganda (2), Mozambique (2), and Sudan (2). One study each was conducted in Botswana, Gambia, Lesotho, Mauritius, Seychelles, Togo, and Zimbabwe. The remaining three articles were multi-country studies. Most (81.5%) of the included studies were cross-sectional surveys and the majority (79) focused on both male and female participants. The majority (80/81) of the included studies reported on the prevalence of childhood overweight/obesity, 8 on the trends of childhood overweight/obesity, and one presented evidence on the incidence of childhood overweight and obesity in SSA.

Conclusion

This review demonstrates limited studies on childhood overweight/obesity in most SSA countries although the included studies suggest an increasing burden. Considering the consequences of childhood obesity, there is a need for more primary researches to inform policies decision and implementation to halt the rise of childhood obesity/overweight in SSA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-020-00491-2.

Risk factors and morbidities associated with childhood obesity in sub-Saharan Africa: a systematic scoping review

BACKGROUND

The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA.

METHODS

Guided by the Arksey and O'Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted.

RESULTS

A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region.

CONCLUSION

This review findings suggest a paucity of literature on the risk factors of childhood obesity and morbidities in most SSA countries. Hence, there is the need to intensify research efforts, especially experimental study designs using innovative strategies to promote healthy lifestyle choices that will prevent or minimize the risks and health consequences of childhood obesity in SSA.

Prevalence and associated factors of overweight/ obesity among children and adolescents in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Overweight and obesity can be defined as excessive and abnormal fat depositions in our body. They have become one of the emerging and serious public health concerns of the twenty-first century in low income countries like Ethiopia. Hence, the aim of this study was to determine the pooled prevalence and review associated risk factors of overweight/obesity among children and adolescents in Ethiopia.

METHOD

The articles were identified through explicit and reproducible electronic search of reputable databases (PubMed, Google scholar, Science Direct, EMBASE, Cochrane library), and the hand search of reference lists of previous prevalence studies to retrieve more related articles. The 18 studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. Since the included studies exhibited considerable heterogeneity, a random effect model was used to estimate the pooled prevalence of overweight/obesity. Moreover, the risk factors of overweight/obesity were reviewed.

RESULTS

The combined pooled prevalence of overweight and obesity among children and adolescents in Ethiopia was 11.30% (95% CI: 8.71, 13.88%). Also, the separate pooled prevalence of overweight and obesity were 8.92 and 2.39%, respectively. Subgroup analysis revealed that the highest overweight/obesity prevalence among children and adolescents was observed in Addis Ababa, 11.94 (95% CI: 9.39, 14.50). Female gender of the children: 3.23 (95% CI 2.03,5.13), high family socioeconomic status: 3.16 (95% CI 1.87,5.34), learning in private school: 3.22 (95% CI 2.36,4.40), physical inactivity: 3.36 (95% CI 1.68,6.72), sweet nutriments preference: 2.78 (95% CI 1.97,3.93) and less use of fruits/vegetables: 1.39 (95% CI 1.10,1.75) have shown a positive association with the development of overweight/obesity among children and adolescents.

CONCLUSION

The pooled prevalence of overweight/obesity among children and adolescents in Ethiopia is substantially high, and has become an emerging nutrition linked problem. Female gender, high family socioeconomic status, learning in private school, physical inactivity, sweet nutriments preference and less use of fruits/vegetables were found to be significantly associated with overweight/obesity.

Prevalence and factors associated with overweight and obesity among children from primary schools in urban areas of Lomé, Togo

Objective

Overweight and obesity in childhood are serious public health issues, both in developing and developed countries. The present study aimed to ascertain overweight and obesity prevalence rates among Togolese schoolchildren in Lomé, Togo, and their correlation with physical activity, socio-economic conditions and eating habits.

Design

Cross-sectional survey conducted in December 2015. Overweight and obesity were defined using age- and sex-specific BMI cut-off points of the International Obesity Task Force. Physical activity, socio-economic conditions and eating habits were assessed with a standardized questionnaire. Specially trained medical students interviewed children and collected the data. After bivariate regression analyses, factors associated with overweight/obesity were identified by multivariate logistic regression. Statistical significance was two-sided P<0·05.

Setting

Lomé, Togo.

Subjects

Representative sample of 634 children (288 boys, 346 girls), aged 8–17 years, who were studying in primary schools.

Results

Overweight and obesity respectively affected 5·2 and 1·9 % of children surveyed. Watching television (>4 h) on weekends (OR; 95 % CI: 3·8; 1·2, 12·0, P=0·02) and medium dietary diversity score (3·0; 1·1, 8·1, P=0·03) were independently associated with overweight/obesity in a multivariate regression model. Eating breakfast in the school cafeteria (0·2; 0·1, 0·8, P=0·03) and eating fruits (0·4; 0·1, 0·9, P=0·03) significantly reduced the risk of overweight/obesity.

Conclusions

Overweight and obesity prevalence were linked with sedentary behaviour and non-optimal food diversity. Promoting physical activity and fruit consumption should be explored as interventions to reduce and prevent overweight and obesity in Lomé schoolchildren. In addition, preventive approaches in the social environment of children should be considered.