Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Department of Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
BMC Public Health. 2019 Aug 6;19(1):1055. doi: 10.1186/s12889-019-7406-9.
Childhood overweight/obesity has become a major public health concern globally because of its adverse health consequences and escalating prevalence. The factors underlying the disease conditions manifested during adulthood commonly originate in childhood. Nepal is going through a transition where under-nutrition co-exists with obesity; however, there is a lack of well-documented information on childhood overweight or obesity in Nepal. This study was carried out to determine the prevalence and associated factors of childhood overweight/obesity among urban primary school children.
A cross-sectional survey was conducted from May to October of 2017. Behavioral data were collected using a structured self-administered questionnaire with parents of children aged 6-13 years old in grades 1-5 studying in private schools of Lalitpur district in Nepal. Study participants were selected using two-stage cluster random sampling from 10 private schools. Height and weight measurements of 575 children were taken and BMI-for-age-sex was calculated using WHO AnthroPlus. Data were analyzed using SPSS version 21. Associated factors were examined using Chi-square tests followed by multivariate logistic regression analyses.
The study found that out of 575 students, 107 (18.6%) were overweight and 41 (7.1%) were obese. Among 328 male children, 62 (19.0%) were overweight and 35 (10.6%) were obese. Likewise, among 247 female children, 45 (18.2%) were overweight and 6 (2.4%) were obese. Male children (aOR = 2.21, 95% CI: 1.38-3.53), children of mothers with a high school (aOR = 3.13, 95% CI: 1.39-7.12) or university level of education (aOR = 3.09, 95% CI: 1.23-7.70) and children of mothers in a professional field (aOR = 1.34, 95% CI: 1.02-4.05) had a greater likelihood of being overweight/obese. Likewise, students consuming energy-dense less nutrient food (aOR = 2.92, 95% CI: 1.66-5.12), lacking active travel to and from school (aOR = 2.38, 95% CI: 1.12-4.79) and those having sedentary behaviors (aOR = 3.01, 95% CI: 1.20-7.29) were likely to be overweight/obese.
More than one-quarter of the children in urban Lalitpur were found to be overweight/obese. High junk food consumption and sedentary activity were found to be significantly associated with childhood overweight/obesity. School health and awareness programs aiming to reduce the intake of energy-dense foods and promote an active lifestyle including active transportation to school among children are imperative. Future studies to objectively measure the type and amount of food intake and physical activity of students are recommended.
儿童超重/肥胖已成为全球主要的公共卫生问题，因为它会带来不良的健康后果，且其发病率呈上升趋势。成年期表现出的疾病状况的根本原因通常源于儿童期。尼泊尔正处于一个转型期，营养不良和肥胖同时存在；然而，尼泊尔缺乏有关儿童超重或肥胖的充分记录信息。本研究旨在确定城市小学生超重/肥胖的流行情况及其相关因素。
本横断面研究于 2017 年 5 月至 10 月进行。通过父母对 6-13 岁 1-5 年级就读于尼泊尔勒利德布尔区私立学校的儿童进行的结构自我管理问卷调查收集行为数据。从 10 所私立学校中采用两阶段整群随机抽样选择研究参与者。对 575 名儿童进行身高和体重测量，并使用世卫组织 AnthroPlus 计算 BMI 年龄性别。使用 SPSS 版本 21 分析数据。使用卡方检验检查相关因素，然后使用多变量逻辑回归分析。
研究发现，在 575 名学生中，107 名（18.6%）超重，41 名（7.1%）肥胖。在 328 名男童中，62 名（19.0%）超重，35 名（10.6%）肥胖。同样，在 247 名女童中，45 名（18.2%）超重，6 名（2.4%）肥胖。男童（aOR=2.21，95%CI：1.38-3.53）、母亲具有高中学历（aOR=3.13，95%CI：1.39-7.12）或大学学历（aOR=3.09，95%CI：1.23-7.70）和母亲从事专业领域工作的儿童（aOR=1.34，95%CI：1.02-4.05）更有可能超重/肥胖。同样，摄入高热量低营养食物的学生（aOR=2.92，95%CI：1.66-5.12）、缺乏往返学校的积极交通方式（aOR=2.38，95%CI：1.12-4.79）和久坐行为的学生（aOR=3.01，95%CI：1.20-7.29）更有可能超重/肥胖。
在城市勒利德布尔发现超过四分之一的儿童超重/肥胖。高垃圾食品消费和久坐不动的行为与儿童超重/肥胖显著相关。学校健康和提高认识计划旨在减少儿童摄入高热量食物，并促进积极的生活方式，包括积极的上学交通方式，这是至关重要的。建议未来的研究客观地测量学生的食物摄入量和体育活动的类型和数量。
