Dual Burden of Stunting and Obesity Among Elementary School Children on Majuro, Republic of Marshall Islands.

Limited data are available on the dual burden of under- and over-nutrition among children in the Republic of Marshall Islands (RMI). This study aimed to identify the prevalence of stunting and obesity among elementary school students on Majuro, RMI. A cross-sectional study was conducted in public and private elementary schools on Majuro in 2017 - 2018. Anthropometric data were collected for 3,271 children, 4-16 years of age. The main outcome measures were prevalence of stunting and obesity. Differences by gender, age, and school type (public or private) were assessed using chi-squared tests. Overall, 5.1% (95% CI 4.4-5.9) of children were obese, and 23.6% (95% CI 22.2-25.1) of children were stunted. Obesity prevalence was higher among boys (6.3%; girls 3.9%; P=0.002) and children attending private schools (11.8%; public schools 2.9%; P<0.001), and increased with age (4-6 years 3.3%; 10-12 years 7.1%; P<0.001),. Stunting prevalence was higher among children attending public schools (28.8%; private schools 8.0%) and increased with age (4-6 years 20.6%; 10-12 years 27.5%; P<0.001). Prevalence of stunting and obesity observed in this study support the need for interventions to improve nutrition and promote healthy lifestyles among children, both to address current undernutrition, and to intervene early to prevent the onset of obesity.