Childhood malnutrition remains a significant public health problem impacting the physical and mental growth if school aged children, particularly in limited-resource countries.
The study objective was to assess levels of physical activity, patterns of screen time (S.T.), the relationship between physical activity and screen time patterns, and how these factors affect growth status (adjusting for socioeconomic status).
A cross-sectional study included 3,834 children between 6–14 years attending pre-selected schools. Teachers, students, and parents were invited to fill out a standardized questionnaire, and Body Mass Index (BMI) was calculated using Center for disease control (CDC) centile charts. A Chi-square was performed to see the possible association between any height and weight abnormalities and all possible risk factors. Multivariate logistic regression was applied to see the effect of variables significantly associated with univariate analysis.
Approximately 2,447 (63.8%) children were between 11–14 years old and 1,387 (36.2%) were between 4–10 years old. The mean height was 143.71 ± 16.51 centimetres, the mean weight was 36.5 ± 12.9 kilogram, and the mean BMI was 17.16 ± 3.52. Multivariate logistic regression status and junk food combined affected stunting socioeconomic status was significantly associated with being underweight p = 0.001.
Childhood obesity and stunting remain significant problems in Pakistani school-going children. These are significantly associated with poverty, a lack of physical activity opportunities, and available food quality.
Citation: Saleem Qureshi, Musarrat Iqbal, Azra Rafiq, Hamna Ahmed, Tooba Malik, Muhammad Nasir Kalam, Muhammad Abdullah, Qirtas Tauheed, Muhammad Daoud Butt. Dietary habits and physical activity patterns in relation to nutritional status among school-aged children in Pakistan: A cross-sectional study[J]. AIMS Public Health, 2023, 10(3): 553-567. doi: 10.3934/publichealth.2023039
Childhood malnutrition remains a significant public health problem impacting the physical and mental growth if school aged children, particularly in limited-resource countries.
The study objective was to assess levels of physical activity, patterns of screen time (S.T.), the relationship between physical activity and screen time patterns, and how these factors affect growth status (adjusting for socioeconomic status).
A cross-sectional study included 3,834 children between 6–14 years attending pre-selected schools. Teachers, students, and parents were invited to fill out a standardized questionnaire, and Body Mass Index (BMI) was calculated using Center for disease control (CDC) centile charts. A Chi-square was performed to see the possible association between any height and weight abnormalities and all possible risk factors. Multivariate logistic regression was applied to see the effect of variables significantly associated with univariate analysis.
Approximately 2,447 (63.8%) children were between 11–14 years old and 1,387 (36.2%) were between 4–10 years old. The mean height was 143.71 ± 16.51 centimetres, the mean weight was 36.5 ± 12.9 kilogram, and the mean BMI was 17.16 ± 3.52. Multivariate logistic regression status and junk food combined affected stunting socioeconomic status was significantly associated with being underweight p = 0.001.
Childhood obesity and stunting remain significant problems in Pakistani school-going children. These are significantly associated with poverty, a lack of physical activity opportunities, and available food quality.
[1] | (2011) World Health OrganizationGlobal atlas on cardiovascular disease prevention and control: published by the World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization. Europe: World Health Organization. Available from: https://apps.who.int/iris/handle/10665/329516 |
[2] | Sanyaolu A, Okorie C, Qi X, et al. (2019) Childhood and adolescent obesity in the United States: A public health concern. Global pediatric health 6: 2333794X19891305. https://doi.org/10.1177/2333794X19891305 |
[3] | Ghosh, S (2020) Factors responsible for childhood malnutrition: A review of the literature. Current Research in Nutrition and Food Science Journal 8: 360-370. https://doi.org/10.12944/CRNFSJ.8.2.01 |
[4] | Iqbal K, Islam N, Mehboobali N, et al. (2019) Relationship of sociodemographic factors with serum levels of vitamin D in a healthy population of Pakistan. Pak J Pharm Sci 32: 29. |
[5] | Saad RK, Al Nsour M, Khader Y, et al. (2021) Public health surveillance systems in the eastern Mediterranean region: bibliometric analysis of scientific literature. JMIR Public Health and Surveillance 7: e32639. https://doi.org/10.2196/32639 |
[6] | Ullah R, Saleem MA, Ahmad N (2022) Factors Affecting Stunting Growth of Children in Pakistan: Evidence from Pakistan Demographic Health Survey 2017–18. Human Nat J Soc Sci 3: 395-411. |
[7] | Gennetian LA, Marti M, Kennedy JL, et al. (2019) Supporting parent engagement in a school readiness program: Experimental evidence applying insights from behavioral economics. J Appl Dev Psychol 62: 1-10. https://doi.org/10.1016/j.appdev.2018.12.006 |
[8] | Keusch GT, Rosenberg IH, Denno DM, et al. (2013) Implications of acquired environmental enteric dysfunction for growth and stunting in infants and children living in low-and middle-income countries. Food and Nutr Bul 34: 357-364. https://doi.org/10.1177/156482651303400308 |
[9] | Olusanya O, Okpere EE, Ezimokhai M (1985) The importance of social class in voluntary fertility control in developing country. West Afr J Med 4: 205-212. |
[10] | Klish WJ Definition epidemiology; and etiology of obesity in children and adolescents (2007). Up To Date, 2007. Available from: https://www.uptodate.com/contents/definition-epidemiology-and-etiology-of-obesity-in-childrenand-adolescents. |
[11] | Lim HJ, Xue H, Wang Y (2020) Global trends in obesity. Handbook of Eating and Drinking: Interdisciplinary Perspectives. Germany: Springer publishers 1217-1235. https://doi.org/10.1007/978-3-030-14504-0_157 |
[12] | Jacob JF, Chakraborty L (2021) COVID-19 and Public Investment for Children: The case of Indian State of Karnataka. New Delhi: National Institute of Public Finance and Policy. Available from: https://www.nipfp.org.in/publications/working-papers/1953/ |
[13] | Alia RA, Sadia N, Shammy NP, et al. (2022) Diarrhoeal Disease in Relation to Childhood Malnutrition and Its Impact on Socio-economic Condition in Emerging Countries Like Bangladesh. J Pediatrics, Perinatol and Child Health 6: 370-379. |
[14] | Mamabolo RL, Alberts M, Steyn NP, et al. (2005) Prevalence and determinants of stunting and overweight in 3-year-old black South African children residing in the Central Region of Limpopo Province, South Africa. Public Health Nutr 8: 501-508. https://doi.org/10.1079/PHN2005786 |
[15] | Arif GM, Riaz M, Faisal N, et al. Climate, population, and vulnerability in Pakistan: Exploring evidence of linkages for adaptation (2019). Available From: https://knowledgecommons.popcouncil.org/departments_sbsr-pgy/733/ |
[16] | Aziz S, Hosain K (2014) Carbohydrate (CHO), protein and fat intake of healthy Pakistani school children in a 24 hour period. J Pak Med Assoc 64: 1255-1259. |
[17] | Kwabla MP, Gyan C, Zotor F (2018) Nutritional status of in-school children and its associated factors in Denkyembour District, eastern region, Ghana: comparing schools with feeding and non-school feeding policies. Nutr J 17: 1-8. https://doi.org/10.1186/s12937-018-0321-6 |
[18] | Abdullah NF, Teo PS, Foo LH (2016) Ethnic differences in the food intake patterns and its associated factors of adolescents in Kelantan, Malaysia. Nutrients 8: 551. https://doi.org/10.3390/nu8090551 |
[19] | Yalew BM (2014) Prevalence and factors associated with stunting, underweight and wasting: a community based cross sectional study among children age 6–59 months at Lalibela Town, Northern Ethiopia. J Nutr Disorders Ther 4: 2161. https://doi.org/10.4172/2161-0509.1000147 |
[20] | Kapoor A, Channa NA, Soomro AM, et al. (2018) Malnutrition and clinical manifestations in school going children at district Tharparkar, Sindh, Pakistan. Rawal Medical Journal 43: 115-115. |
[21] | Timsina SK Assessing the factor associated with nutritional status of Sukumbasi CHILDREN aged 6–59 months in Kanakai municipality, Jhapa (2018). Available From: http://202.45.146.37:8080/jspui/handle/123456789/56 |
[22] | Tremblay MS, LeBlanc AG, Kho ME, et al. (2011) Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act 8: 1-22. https://doi.org/10.1186/1479-5868-8-98 |
[23] | Rhodes RE, Janssen I, Bredin SSD, et al. (2017) Physical activity: Health impact, Prevalence, correlates and interventions. Psychol Health 32: 942-975. https://doi.org/10.1080/08870446.2017.1325486 |
[24] | Colley RC, Garriguet D, Adamo KB, et al. (2013) Physical activity and sedentary behavior during the early years in Canada: a cross-sectional study. Int J Behav Nutr Phys Act 10: 1-9. https://doi.org/10.1186/1479-5868-10-54 |
[25] | Jafar TH, Qadri Z, Islam M, et al. (2008) Rise in childhood obesity with persistently high rates of undernutrition among urban school-aged Indo-Asian children. Arch Dis Child 93: 373-378. https://doi.org/10.1136/adc.2007.125641 |
[26] | He M, Evans A (2007) Are parents aware that their children are overweight or obese?. Canadian Family Physician 53: 1493-1499. |
[27] | Ellis A, McClintic EE, Awino EO, et al. (2020) Practices and perspectives on Latrine use, child feces disposal, and clean play environments in Western Kenya. Am J Trop Med Hyg 102: 1094. https://doi.org/10.4269/ajtmh.19-0389 |
[28] | Paniagua APC Cross-national Comparison Examining Breastfeeding and Child Malnutrition Among Mexicans. Boston College (2019). |
[29] | Kimani Murage EW, Kahn K, Pettifor JM, et al. (2010) The Prevalence of stunting, overweight and obesity, and metabolic disease risk in rural South African children. BMC Public Health 10: 1-13. https://doi.org/10.1186/1471-2458-10-158 |
[30] | Vollmer S, Harttgen K, Subramanyam MA, et al. (2014) Association between economic growth and early childhood undernutrition: evidence from 121 Demographic and Health Surveys from 36 low-income and middle-income countries. Lancet Glob Health 2: e225-e234. https://doi.org/10.1016/S2214-109X(14)70025-7 |
[31] | Black RE, Victora CG, Walker SP, et al. (2013) Maternal and child undernutrition and overweight in low-income and middle-income countries. The lancet 382: 427-451. https://doi.org/10.1016/S0140-6736(13)60937-X |
[32] | Warraich HJ, Javed F, Faraz-Ul-Haq M, et al. (2009) Prevalence of obesity in school-going children of Karachi. Plos one 4: e4816. https://doi.org/10.1371/journal.pone.0004816 |
[33] | Tanveer M, Hohmann A, Roy N, et al. (2022) The Current Prevalence of Underweight, Overweight, and Obesity Associated with Demographic Factors among Pakistan School-Aged Children and Adolescents—An Empirical Cross-Sectional Study. Int J Environ Res Public Health 19: 11619. https://doi.org/10.3390/ijerph191811619 |
[34] | Sadiq S, Qureshi MFH, Farooq L, et al. (2019) Reference percentile for height, weight and BMI among children/adolescents of Karachi Pakistan. Res J Food Sci Nutr 4: 90-96. https://doi.org/10.31248/RJFSN2019.081 |
[35] | Temsutola M, Varte LR (2012) Nutritional status of children as indicated by z-scores of the Hmars: a tribe of NE India. Antrocom Online J Anthropol 8: 213-227. |
[36] | Safa F, Anjum A, Hossain S, et al. (2021) Immediate psychological responses during the initial period of the COVID-19 pandemic among Bangladeshi medical students. Child Youth Serv Rev 122: 105912. https://doi.org/10.1016/j.childyouth.2020.105912 |
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