title: Is high-altitude environment a risk factor for childhood overweight and obesity in Saudi Arabia?
abstract: OBJECTIVE
  To describe the prevalence of childhood overweight and obesity in rural high- and low-altitude populations of southwestern Saudi Arabia and to identify specific at-risk groups within these populations.
  
  
  METHODS
  A cross-sectional study was conducted on 912 school children and adolescents aged 6-15 years born and living permanently at high altitudes (2800-3150 m) and 972 children and adolescents of comparable ages born and living permanently at low altitudes (< or =500 m). Height and weight were measured. For children <10 years, the weight-to-height index according to World Health Organization (WHO) standards was used for assessing overweight and obesity. For adolescents 10-15 years, overweight and obesity were assessed by age and gender-specific percentiles for body mass index based on the WHO/National Centre for Health Statistics reference population. A questionnaire was used for measuring parents' socioeconomic status.
  
  
  RESULTS
  The overall prevalence of overweight and obesity at high and low altitudes was 10%. The study showed that some school children and adolescents were at a significantly higher risk of developing overweight and obesity. Significant risk factors included moderate-to-high parental income, age > or =10 years, high-altitude birth and residence, and female sex (crude odds ratio 3.2 [95% CI, 1.8- 5.5], 2.3 [95% CI, 1.6-3.2], 2.1 [95% CI, 1.5-2.9], and 1.9 [95% CI, 1.4-2.6], respectively). A multivariate analysis using the direct binary logistic regression model revealed that moderate-to-high parental income, age > or =10 years, female sex, and high-altitude birth and residence were significant independent predictors of childhood overweight and obesity. (adjusted OR 3.2 [95% CI, 1.6-2.6], 2.6 [95% CI, 1.8-3.8], 2.0 [95% CI, 1.6-2.9], and 1.8 [95% CI, 1.3-2.6]), respectively.
  
  
  CONCLUSIONS
  The present study identified risk factors for childhood overweight and obesity in Saudi Arabia. Among these, high altitude was a significant and independent factor. Future research is warranted to evaluate the exact mechanism by which a high-altitude environment may contribute to childhood overweight and obesity.
authors: Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia. mhkhalid999@yahoo.com
authors: Mohammed El-Habib
authors: Mel-H
authors: Khalid
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000531:Altitude; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology* / Q000209:etiology; D010101:Oxygen Consumption / Q000502:physiology*; D015995:Prevalence; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires