Association between Primary School Children’s Unhealthful Behaviors and Overweight/Obesity: A Cross-Sectional Analysis in Urban Kenya

Author(s): Constance Awuor Gewa, Agatha Christine Onyango, Rose Okoyo Opiyo, Joel Gittelsohn, Lawrence J Cheskin

We examined patterns of unhealthful dietary, PA and sleep behaviors among primary school children of different socio-economic status (SES) in two urban settings in Kenya and explored the association between these behaviors and overweight/obesity among the children. Data was collected on 390 children, aged 10-12 years, who attended public primary schools in two cities. Children’s anthropometric measurements were taken and parents, with the help of their children, completed questionnaires on children’s dietary, physical activity, and sleep behaviors. Body-mass-index-for-age z-scores, waist-circumference-to-height ratio, and the sum of skinfold measures were calculated. We utilized prevalence ratio analysis to examine the association between socio-economic/demographic characteristics, unhealthful behaviors and overweight/obesity. Overall, 21% of the children were overweight or obese and 9% had abdominal obesity. Prevalence of unhealthful behaviors varied significantly by child’s age, gender, school income levels, city, and frequency of consumption of restaurant foods. Children who consumed less than recommended amount of fruit servings had 1.68 times the risk of being overweight/obese, 2.49 times the risk of having abdominal obesity and 1.47 times the risk of having high total skinfold values compared to children with adequate fruit intake. Children with high frequency of consumption of red/processed meats had 1.50 times the risk of being overweight/obesity compared to children with less-frequent consumption. We found rather high prevalence of unhealthful behaviors among primary school children in Kenya, identified their determinants, and the association between specific behaviors and overweight/obesity. These results can guide childhood obesity prevention measures in Kenya and neighboring countries.