Associations of 24-h movement behaviour with overweight and obesity among school-aged children and adolescents in Pakistan: An empirical cross-sectional study

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity Pub Date : 2025-02-23 DOI:10.1111/ijpo.13208

Moazzam Tanveer, Yujun Cai, Georgian Badicu, Ejaz Asghar, Alexios Batrakoulis, Luca Paolo Ardigò, Serge Brand

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引用次数: 0

Abstract

Background

Overweight and obesity among children and adolescents poses a significant public health challenge. In Pakistan, the prevalence of childhood overweight and obesity continues to rise, leading to long-term adverse effects on health. Various external influences shape children's health behaviours and outcomes, with parents, peers, schools, and communities playing crucial roles, particularly during formative years.

Objectives

This cross-sectional study aimed to investigate the associations between 24-h movement behaviour and overweight/obesity among school-aged children and adolescents, focusing on the intrapersonal, interpersonal, community, and school levels from a Social-Ecological Perspective.

Methods

A population-based cross-sectional study was conducted from 15 January to 15 March 2023, using a representative multistage random cluster sampling method. The study enrolled 4200 participants aged 9–17 years and 3371 parents from 62 schools in central Punjab, Pakistan. Participants' body mass index (BMI) was classified based on CDC US 2000 BMI percentiles. Socio-ecological factors were analyzed using chi-square tests, binary logistic regression, and stepwise logistic regression to examine their associations with overweight and obesity.

Results

The results of this study revealed that boys had 18.7% overweight and 9% obesity, while girls had 20.5% overweight and 13.2% obesity. Gender exhibited a significant association with weight status. A considerable proportion of participants did not meet recommended guidelines for junk food consumption (31.5% boys, 33.3% girls), physical activity (70% boys, 83.8% girls), screen time (37.7% boys, 41.1% girls), and sleep (55.7% boys, 54% girls). Individuals engaging in certain 24-h movement behaviours exhibited higher odds of obesity. Specifically, consuming fast food three or more days per week was associated with higher odds of obesity (odds ratio: 9.95, p < 0.01). Engaging in physical activity for less than 60 min per day, twice a week or less, was associated with higher odds of obesity (odds ratio: 3.47, p < 0.01). Spending three or more hours per day on screen time was linked to higher odds of obesity (odds ratio: 2.50, p < 0.01). Furthermore, being a short sleeper was associated with higher odds of overweight (odds ratio: 3.54, p < 0.01).

Conclusions

Children failing to meet none or only one guideline faced increased overweight/obesity risk compared to those meeting all recommendations. Individual-level factors such as eating habits, physical activity, sedentary behaviour, sleep patterns, and unhealthy lifestyle choices significantly influenced body weight status. Urgent interventions are needed to enhance physical education resources and sports facilities in schools to create healthier environments and reduce overweight/obesity prevalence among students, promoting lifelong habits of physical activity and improving health and well-being.

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巴基斯坦学龄儿童和青少年24小时运动行为与超重和肥胖的关联：一项实证横断面研究。

背景：儿童和青少年超重和肥胖是一个重大的公共卫生挑战。在巴基斯坦，儿童超重和肥胖的流行率继续上升，对健康造成长期不利影响。各种外部影响塑造了儿童的健康行为和结果，父母、同伴、学校和社区发挥着关键作用，特别是在成长期。目的：本横断面研究旨在从社会生态学角度探讨学龄儿童和青少年24小时运动行为与超重/肥胖之间的关系，重点关注个人、人际、社区和学校层面。方法：采用有代表性的多阶段随机整群抽样方法，于2023年1月15日至3月15日进行以人群为基础的横断面研究。该研究招募了来自巴基斯坦旁遮普省中部62所学校的4200名9-17岁的参与者和3371名家长。参与者的身体质量指数（BMI）根据美国疾病控制与预防中心2000年BMI百分位数进行分类。采用卡方检验、二元逻辑回归和逐步逻辑回归分析社会生态因素与超重和肥胖的关系。结果：本次研究结果显示，男生超重18.7%，肥胖9%，女生超重20.5%，肥胖13.2%。性别表现出与体重状况的显著关联。相当大比例的参与者在垃圾食品消费（31.5%的男孩，33.3%的女孩）、体育活动（70%的男孩，83.8%的女孩）、屏幕时间（37.7%的男孩，41.1%的女孩）和睡眠（55.7%的男孩，54%的女孩）方面没有达到建议的标准。从事某些24小时运动行为的个体显示出更高的肥胖几率。具体来说，每周吃三天或更多的快餐与更高的肥胖几率相关（优势比：9.95,p）。结论：与满足所有建议的儿童相比，不符合任何一项或仅符合一项指南的儿童超重/肥胖风险增加。个人层面的因素，如饮食习惯、身体活动、久坐行为、睡眠模式和不健康的生活方式选择，对体重状况有显著影响。需要采取紧急干预措施，增加学校的体育教育资源和体育设施，以创造更健康的环境，减少学生中超重/肥胖的患病率，促进终生的体育活动习惯，改善健康和福祉。

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.