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Rise in Childhood Obesity with Persistently High Rates of Under-nutrition among Urban School Aged Indo-Asian Children
  1. Tazeen Jafar (tazeen.jafar{at}
  1. Aga Khan university, Pakistan
    1. Zeeshan Qadri
    1. Aga Khan University, Pakistan
      1. Mohammad Islam
      1. Aga Khan University, Pakistan
        1. Juanita Hatcher
        1. Aga Khan University, Pakistan
          1. Nish Chaturvedi
          1. Imperial College London, United Kingdom



            Childhood obesity is an emerging global public health challenge. However, evidence on nutritional transitioning from Indo-Asian developing countries is lacking. We conducted these analyses to determine trends in nutritional status of school aged children in urban Pakistan.


            Data on nutritional status on children aged 5 to 14 years from two independent population-based representative surveys-the urban component of National Health survey of Pakistan (NHSP) (1990-1994) and the Karachi survey (2004-2005) were analysed. Using normative data in children in the US as reference, trends in age and gender standardized prevalence (95% CI) of underweight (weight-for-age less than - 2 SD), stunting (height-for-age less than - 2 SD), and overweight and obesity (body mass index 85th percentile or greater) were compared. Association between physical activity with overweight and obesity was analyzed in the Karachi survey using logistic regression analysis.


            A total of 2074 children were included in urban NHSP and 1675 in the Karachi survey. The prevalence of underweight was 29.7% vs 27.3% (p=0.12), stunting was 16.7% vs 14.3% (p=0.05), and overweight and obesity was 3.0 vs 5.7 (p<0.001) in the two surveys, respectively. Physical activity was inversely correlated with overweight or obesity (odds ratio, 95% CI, 0.51, 0.32 -0.80 for those engaged in 30 minutes or more versus less of physical activity).


            Our study highlights the unique challenge faced by Pakistani school aged children, experiencing a rapid rise in overweight and obesity and a persistently high burden of under-nutrition. Focus on prevention of obesity in children must include strategies for promoting physical activity. (Words=256)

            • Asian
            • childhood obesity
            • malnutrition
            • physical activity

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