OVERWEIGHT AMONG TUNISIAN SCHOOL-AGED CHILDREN: PREVALENCE AND ASSOCIATED FACTORS.

Abstract

Aim: To estimate the prevalence of overweight among school-aged children in Tunisia and to identify factors associated with overweight.

Materials and methods: We conducted a cross-sectional descriptive study between January and April 2025 among children aged 6-11 years attending a Maternal and Child Protection Center in Tunis. Anthropometric measurements were collected, and dietary intake was assessed using a 24-hour dietary recall. Body mass index (BMI) categories were defined according to International Obesity Task Force (IOTF) references. Sociodemographic, perinatal, behavioral, and nutritional variables were analyzed. Multivariable logistic regression was used to identify factors associated with overweight.

Results: A total of 225 children aged 6 to 11 years (mean age 9.18±1.73 years; 58% girls). The mean BMI was 18.05±3.6 kg/m². Based on French and IOTF growth references, 26.7% of participants were overweight, including 11.6% classified as obese, and 16.9% showed visceral fat excess. Multivariate analysis identified early adiposity rebound (OR=1.43; p<0.001), grade retention (OR=3.28; p=0.039), maternal obesity (OR=1.5; p=0.035), breastfeeding duration under 6 months (OR=2.61; p=0.003), introduction of cow's milk before 6 months (OR=1.78; p=0.003), hyperphagia (OR=2.03; p=0.001), snacking (OR=4.45; p=0.019), lack of physical activity (OR=4.02; p=0.019), low vitamin A intake (OR=1.02; p=0.029), and high sodium intake (OR=1.15; p=0.043) as independent factors associated with overweight.

Conclusion: These findings highlight the importance of early identification and intervention on modifiable behaviors and dietary habits to reduce the burden of childhood overweight.