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Abstract
BackgroundA sizable proportion of school-going children from developing countries has abnormal growth parameters, often not standardized with international reference values. We aimed to assess the prevalence of underweight, overweight, and obesity in the schoolgirls of Punjab according to international and local references.MethodsIn this population-based cross-sectional study, 10,050 school-going girls aged 8–16 years from 12 districts of northern, central, and southern Punjab were recruited. Estimates of normal weight, underweight, overweight and obesity were calculated in the girls according to three international BMI references including centers for disease control (CDC) 2000, the international obesity task force (IOTF) 2012 and world health organisation (WHO) 2007 in addition to a local reference for the population under study. We used Cohen’s kappa statistics to analyse the agreement of our data with reference values.ResultsThere was marked overestimation of underweight (23.9%, 14.5%, 15.2% and 4.37%), slight underestimation of overweight (5.3%, 7.3%, 7.9% and 8.97%) and moderate underestimation of obesity (1.9%, 1.5%, 2.2% and 5.67%) according to CDC, IOTF, WHO and local reference, respectively. When the weight status of the study cohort was compared with the local data, we found comparable results in all four weight categories.ConclusionWe recommend population-wide further studies to estimate the prevalence of weight status in school-age girls for devising appropriate references and for planning strategies for public health policy and management.
Highlights
A sizable proportion of school-going children from developing countries has abnormal growth parameters, often not standardized with international reference values
Overweight and obesity may be attributed to lifestyle transitions, whereby a switch to a sedentary lifestyle leads to a weight gain in populations that previously had a trend of underweight
The overall prevalence of normal weight, underweight, overweight, and obesity was measured in the study population (n = 10,050) using three references and the study population cut-offs (Fig. 1)
Summary
A sizable proportion of school-going children from developing countries has abnormal growth parameters, often not standardized with international reference values. There is an increasing prevalence of abnormal growth including weight gain and underweight in Southeast Asia [1]. Pakistan faces a dual burden of overweight/obesity and underweight due to abnormalities in nutritional status in childhood and adolescence. Adolescence in girls is considered high-risk to weight gain due to changes in body composition, insulin sensitivity, eating habits, and physical activity [9, 10]. Weight gain during adolescence in girls places them at an increased risk of accumulating high body fat stores during the childbearing age. Due to the ill impacts of this dual burden of abnormal nutrition on population health, it is imperative to understand its prevalence in school-aged girls
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