Ubeera Memorial Research Society, Allama Iqbal Medical College, Lahore, 54000 Punjab, Pakistan.
BMC Public Health. 2011 Sep 25;11:724. doi: 10.1186/1471-2458-11-724.
Childhood obesity is becoming an equally challenging, yet under-recognized, problem in developing countries including Pakistan. Children and adolescents are worst affected with an estimated 10% of the world's school-going children being overweight and one quarter of these being obese. The study aimed to assess prevalence and socioeconomic correlates of overweight and obesity, and trend in prevalence statistics, among Pakistani primary school children.
A population-based cross-sectional study was conducted with a representative multistage cluster sample of 1860 children aged 5-12 years in Lahore, Pakistan. Overweight (> + 1SD) and obesity (> + 2SD) were defined using the World Health Organization child growth reference 2007. Chi-square test was used as the test of trend. Linear regression was used to examine the predictive power of independent variables in relation to BMI. Logistic regression was used to quantify the independent predictors for overweight and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were obtained. All regression analyses were controlled for age and gender and statistical significance was considered at P < 0.05.
Seventeen percent (95% CI 15.4-18.8) children were overweight and 7.5% (95% CI 6.5-8.7) were obese. Higher prevalence of obesity was observed among boys than girls (P = 0.028), however, there was no gender disparity in overweight prevalence. Prevalence of overweight showed a significantly increasing trend with grade (P < 0.001). Children living in the urban area with high socioeconomic status (SES) were significantly at risk for being overweight and obese (both P < 0.001) as compared to children living in the urban area with lower SES and rural children. Being in higher grade (aOR 2.39, 95% CI 1.17-4.90) and living in the urban area with higher SES (aOR 18.10, 95% CI 10.24-32.00) independently predicted the risk of being overweight.
Alarmingly rapid rise in overweight and obesity among Pakistani primary school children was observed, especially among the affluent urban population. The findings support the urgent need for National preventive strategy for childhood obesity and targeted interventions tailored to local circumstances with meaningful involvement of communities.
儿童肥胖症在包括巴基斯坦在内的发展中国家正成为一个同样具有挑战性但尚未被充分认识到的问题。儿童和青少年受影响最为严重，据估计，全世界有 10%的在校儿童超重，其中四分之一肥胖。本研究旨在评估巴基斯坦小学生超重和肥胖的流行率和社会经济相关性，以及流行率统计数据的趋势。
本研究采用基于人群的横断面研究，对巴基斯坦拉合尔市具有代表性的多阶段聚类样本中的 1860 名 5-12 岁儿童进行了研究。使用世界卫生组织儿童生长标准 2007 定义超重（>+1SD）和肥胖（>+2SD）。采用卡方检验作为趋势检验。线性回归用于检验独立变量与 BMI 的预测能力。采用 logistic 回归量化超重的独立预测因素，并获得 95%置信区间（CI）的调整比值比（aOR）。所有回归分析均控制了年龄和性别，P<0.05 为统计学意义。
17%（95%CI 15.4-18.8）的儿童超重，7.5%（95%CI 6.5-8.7）的儿童肥胖。男孩肥胖的比例高于女孩（P=0.028），但超重的性别差异并不明显。超重的流行率随着年级的增加呈现出显著的上升趋势（P<0.001）。与社会经济地位较低的城市地区和农村地区的儿童相比，居住在城市地区且社会经济地位较高的儿童超重和肥胖的风险显著增加（均 P<0.001）。较高的年级（aOR 2.39，95%CI 1.17-4.90）和居住在社会经济地位较高的城市地区（aOR 18.10，95%CI 10.24-32.00）是超重的独立预测因素。
巴基斯坦小学生超重和肥胖的比例迅速上升，尤其是在富裕的城市人口中。这些发现支持了迫切需要制定国家儿童肥胖预防战略，并根据当地情况制定有针对性的干预措施，同时让社区有意义地参与其中。
