Factors Associated With Childhood Overweight And Obesity In School Children In Sekondi- Takoradi Metropolis

Abstract

Background: Childhood overweight and obesity is being noted as a serious public health concern and contributes to 2.6 million deaths globally. Overweight and obesity once established in infancy persist through childhood and adulthood leading to an increase in the risk of Non-communicable diseases. The study was conducted to determine and compare the prevalence and factors associated with overweight and obesity among private and public primary school children in the Sekondi-Takoradi Metropolis. Methods: A cross-sectional study was conducted from April-July 2017 in the Sekondi-Takoradi metropolis of Ghana. Using a multi-stage random sampling, 497 school children between the ages 8-16 years were recruited from 8 primary schools (4 private, 4 public). Data collection involved interviews using a structured questionnaire, including the Food Frequency Questionnaire (FFQ), Physical activity questionnaire for children and Anthropometric measurements (weight, height and BMI). Data obtained from structured questionnaires and FFQ were analyzed using STATA version 13 to generate frequencies and percentage distributions. Anthropometric measurements, i.e. weight (kg) and height (cm) with other required variables were exported into the WHO AnthroPlus software where BMI for age was calculated and used to classify the age and sex-specific nutritional status of the pupils. Associations between demographic and socio-economic characteristics, dietary-related factors, physical activity levels and overweight/obesity were tested using bivariate and multiple logistic regressions respectively at < 0.05 significant level. Results: Combined prevalence of overweight and obesity among primary school children in Sekondi-Takoradi metropolis was 29.4%. The study revealed an overall overweight prevalence of 13.7%, obesity prevalence of 15.7% and underweight prevalence of 16.5%. Combined overweight and obesity prevalence was higher in private schools compared to public schools (44.5% vs. 13.9%, p < 0.001). Overweight was found significantly higher in children less than 12 years of age. School type (being in the private school), pupils with mothers with formal education, mothers with tertiary level of education, being in the middle socio-economic status and having lunch from the school feeding programme were significantly associated with the BMI after controlling for age, sex, physical activity levels, area of residence and other dietary-related factors. Conclusions: Overnutrition and undernutrition co-exists among primary school children in the Sekondi-Takoradi metropolis, therefore public health interventions with collaboration from the Ghana Health Service and Ghana Education should incorporate measures to avert the burden of both.