Abstract
AbstarctAim: This study explored the association between the diet diversity score (DDS) and overweight among Tunisian children. Methods: A representative sample of children living in Greater Tunis was selected based on a two-stage clustered sampling design. A total of 1200 children (3–9 years) were recruited. Dietary assessment was realized using a 24 h dietary recall. Anthropometric measurements were realized, and overweight was defined according to the World Health Organization standards. Logistic regression was used for the association between DDS with overweight. Results: A quarter of children were found to be overweight. Overweight prevalence was found to decrease with the increase of mother education level (p = 0.010) among children <6 years. Crude DDS score was higher among non-overweight children irrespective of the age class (p = 0.002). Tunisian children appeared to consume much more than six food groups, corresponding to a more than recommended intake of most nutrients. Intriguingly, DDS was positively associated with the occurrence of overweight children <6 years, adjusted odd ratio = 1.37, 95% CI (1.03–1.82). Conclusion: Overweight is a public health problem among Tunisian children. A high DDS signifies adequate nutrient intake. An increase of DDS was found to be a positive predictor of overweight only in pre-school children.
Highlights
Obesity constitutes a global public health concern, as it affected 107.7 million (98.7–118.4) children during 2015
According to non-communicable diseases (NCDs) workgroup estimates, the overweight prevalence among Tunisian children and adolescents shifted from 3.2% in 1973 to 24% in 2016 for boys and from 6.2% in 1973 to 25.9% in 2016 for girls, respectively [5]
The non-participation rate was 3%, which refers to the participants that were absent on the day of the survey
Summary
Obesity constitutes a global public health concern, as it affected 107.7 million (98.7–118.4) children during 2015. The death attributed to obesity was found to reach an alarming rate of four million people [1]. According to non-communicable diseases (NCDs) workgroup estimates, the overweight prevalence among Tunisian children and adolescents shifted from 3.2% in 1973 to 24% in 2016 for boys and from 6.2% in 1973 to 25.9% in 2016 for girls, respectively [5]. A regional study found that overweight and obesity prevail among 9.1% and 11.6% of pre-school children, respectively [6]. Diet quality (including the nutrients intake) is crucial for children’s physical and mental growth [8]. A meta-analysis conducted by Liberali et al [9] mapped dietary patterns associated with an increased risk of obesity and found that children (aged 1 to 6 years) adhering to ‘snack’, ‘westernized’ and ‘traditional’ diets are more likely to be obese
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