Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal.
Southeast Asia Development Actions Network (SADAN), Lalitpur, Nepal.
BMC Public Health. 2021 May 17;21(1):938. doi: 10.1186/s12889-021-10985-5.
Overweight/obesity among adolescents is an emerging public health issue worldwide. However, the evidence on the determinants of body weight status and lifestyle behaviors among Nepalese adolescents is limited. This study aims to explore the sleep characteristics, dietary habits, and physical activity and its association with body mass index (BMI) among Nepalese adolescents.
A cross-sectional study was conducted between July and November 2019 among 627 randomly selected adolescents from eight schools located in Kathmandu Metropolitan City, Nepal. A self-administrated structure questionnaire was used to collect the data. Anthropometric measurements (adolescent's BMI), sleep characteristics, dietary habits, and physical activity were assessed using validated tools. Multinomial logistic regression analyses assessed the association between covariates and BMI categories. The statistical significance was considered at p-value < 0.05 and 95% confidence intervals (CIs).
The overall prevalence of underweight and overweight/obesity among adolescents was 9.1% (95% CI: 7.1-11.6) and 23.7% (95% CI: 20.6-27.7) respectively. In multinomial logistic regression, adolescents who reported sleep problem compared to those with no such problem (Relative risk ratio (RRR) = 13.37, 95% CI: 7.14-25.05), adolescents who had obstructive sleep apnea (OSA) symptoms (RRR = 3.21, 95% CI:1.31-7.86), who consumed soft drink ≥1 time/day in past 1 months (RRR = 5.44, 95% CI: 2.93-10.10), consumed high-fat dietary ≥2 times/day (RRR = 2.17, 95% CI: 1.18-3.99), and had a habit of junk food consumptions (RRR = 5.71, 95% CI:2.55-12.82), adolescents who had 5-6 h/day sedentary behavior (RRR = 3.21, 95% CI: 1.14-9.09), adolescents from Terai/Madhesi castes (RRR = 2.81, 95% CI: 1.19-6.64) and adolescents whose father was employed (RRR = 2.04, 95% CI: 1.04-3.98) were at increased risk of being overweight/obesity. In contrast, adolescents aged 14-16 years had 71% lower (RRR = 0.29, 95% CI: 0.16-0.52), and adolescents who consumed less than five food groups had 45% lower (RRR = 0.55, 95% CI: 0.31-0.97) risk of being overweight/obesity compared to 12-14 years age groups and consumed more than five food groups respectively.
The findings of this study warrant immediate interventions to improve the lifestyle to reduce overweight/obesity among Nepalese adolescents. Creating a conducive environment, both at school and home is essential to encourage adolescents for the adoption of healthy lifestyle behaviors.
青少年超重/肥胖是全球范围内一个新出现的公共卫生问题。然而，尼泊尔青少年体重状况和生活方式行为决定因素的证据有限。本研究旨在探讨尼泊尔青少年的睡眠特征、饮食习惯、体力活动及其与体重指数（BMI）的关系。
2019 年 7 月至 11 月期间，在尼泊尔加德满都大都市的八所学校随机抽取 627 名青少年进行横断面研究。使用自填式结构问卷收集数据。使用经过验证的工具评估青少年的 BMI、睡眠特征、饮食习惯和体力活动。多变量逻辑回归分析评估协变量与 BMI 类别之间的关系。统计显著性水平设定为 p 值 < 0.05 和 95%置信区间（CI）。
青少年中体重不足和超重/肥胖的总患病率分别为 9.1%（95%CI：7.1-11.6）和 23.7%（95%CI：20.6-27.7）。在多变量逻辑回归中，与没有睡眠问题的青少年相比，报告有睡眠问题的青少年（相对风险比（RRR）= 13.37，95%CI：7.14-25.05）、有阻塞性睡眠呼吸暂停（OSA）症状的青少年（RRR = 3.21，95%CI：1.31-7.86）、过去 1 个月每天至少饮用 1 次软饮料的青少年（RRR = 5.44，95%CI：2.93-10.10）、每天食用高脂肪饮食≥2 次的青少年（RRR = 2.17，95%CI：1.18-3.99）和有垃圾食品消费习惯的青少年（RRR = 5.71，95%CI：2.55-12.82）、每天久坐行为 5-6 小时的青少年（RRR = 3.21，95%CI：1.14-9.09）、来自 Terai/Madhesi 种姓的青少年（RRR = 2.81，95%CI：1.19-6.64）和父亲有工作的青少年（RRR = 2.04，95%CI：1.04-3.98）超重/肥胖的风险增加。相比之下，14-16 岁的青少年体重不足的风险降低了 71%（RRR = 0.29，95%CI：0.16-0.52），与 12-14 岁年龄组相比，食用少于 5 组食物的青少年超重/肥胖的风险降低了 45%（RRR = 0.55，95%CI：0.31-0.97），食用超过 5 组食物的青少年。
本研究的结果表明，需要立即采取干预措施改善生活方式，以减少尼泊尔青少年的超重/肥胖。在学校和家庭中营造有利环境对于鼓励青少年采用健康的生活方式行为至关重要。
