title: Prevalence and socioeconomic correlates of overweight and obesity among Pakistani primary school children.
abstract: BACKGROUND
  Childhood obesity is becoming an equally challenging, yet under-recognized, problem in developing countries including Pakistan. Children and adolescents are worst affected with an estimated 10% of the world's school-going children being overweight and one quarter of these being obese. The study aimed to assess prevalence and socioeconomic correlates of overweight and obesity, and trend in prevalence statistics, among Pakistani primary school children.
  
  
  METHODS
  A population-based cross-sectional study was conducted with a representative multistage cluster sample of 1860 children aged 5-12 years in Lahore, Pakistan. Overweight (> + 1SD) and obesity (> + 2SD) were defined using the World Health Organization child growth reference 2007. Chi-square test was used as the test of trend. Linear regression was used to examine the predictive power of independent variables in relation to BMI. Logistic regression was used to quantify the independent predictors for overweight and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were obtained. All regression analyses were controlled for age and gender and statistical significance was considered at P < 0.05.
  
  
  RESULTS
  Seventeen percent (95% CI 15.4-18.8) children were overweight and 7.5% (95% CI 6.5-8.7) were obese. Higher prevalence of obesity was observed among boys than girls (P = 0.028), however, there was no gender disparity in overweight prevalence. Prevalence of overweight showed a significantly increasing trend with grade (P < 0.001). Children living in the urban area with high socioeconomic status (SES) were significantly at risk for being overweight and obese (both P < 0.001) as compared to children living in the urban area with lower SES and rural children. Being in higher grade (aOR 2.39, 95% CI 1.17-4.90) and living in the urban area with higher SES (aOR 18.10, 95% CI 10.24-32.00) independently predicted the risk of being overweight.
  
  
  CONCLUSIONS
  Alarmingly rapid rise in overweight and obesity among Pakistani primary school children was observed, especially among the affluent urban population. The findings support the urgent need for National preventive strategy for childhood obesity and targeted interventions tailored to local circumstances with meaningful involvement of communities.
authors.affiliation: Ubeera Memorial Research Society, Allama Iqbal Medical College, Lahore, 54000 Punjab, Pakistan. mushtaqmu@gmail.com
authors.forename: Muhammad Umair
authors.initials: MU
authors.lastname: Mushtaq
authors.forename: Sibgha
authors.initials: S
authors.lastname: Gull
authors.forename: Hussain Muhammad
authors.initials: HM
authors.lastname: Abdullah
authors.forename: Ubeera
authors.initials: U
authors.lastname: Shahid
authors.forename: Mushtaq Ahmad
authors.initials: MA
authors.lastname: Shad
authors.forename: Javed
authors.initials: J
authors.lastname: Akram
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000191:economics / Q000453:epidemiology*; D050177:Overweight / Q000191:economics / Q000453:epidemiology*; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012574:Schools; D012923:Social Class