Association between dietary Intake, eating behavior, and childhood obesity among children and adolescents in Ethiopia

Sibhatu Biadgilign; Tennyson Mgutshini; Bereket Gebremichael; Lioul Berhanu; Courtney Cook; Amare Deribew; Betemariam Gebre; Peter Memiah

doi:10.1136/bmjnph-2021-000415

Association between dietary Intake, eating behavior, and childhood obesity among children and adolescents in Ethiopia

BMJ Nutr Prev Health. 2023 Nov 15;6(2):203-211. doi: 10.1136/bmjnph-2021-000415. eCollection 2023.

Authors

Sibhatu Biadgilign¹, Tennyson Mgutshini², Bereket Gebremichael³, Lioul Berhanu⁴, Courtney Cook⁵, Amare Deribew^{6

7}, Betemariam Gebre⁸, Peter Memiah⁹

Affiliations

¹ Department of Health Studies, College of Human Sciences, University of South Africa, Addis Ababa, Ethiopia.
² Department of Health Studies, UNISA, Pretoria, South Africa.
³ Pediatrics and Child Health, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
⁴ Nutrition Unit, Save the Children International, Addis Ababa, Ethiopia.
⁵ Department of Nursing, Fortis Institute - Pensacola, Pensacola, Florida, USA.
⁶ School of Public Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
⁷ Nutrition International, Addis Ababa, Ethiopia.
⁸ Public Health Unit, International Medical Corps, Khartoum, Sudan.
⁹ Graduate School, University of Maryland, Baltimore, Maryland, USA.

Abstract

Introduction: The upsurge of overweight/obesity (OW/OB) among children and adolescents is as a result of complex interactions between lifestyle behaviours and socioeconomic factors. The objective of this study was to determine socioeconomic and sociodemographic factors, dietary intake and eating behaviours of children and adolescents in Ethiopia and their association with OW/OB.

Methods: A cross-sectional study was conducted among 632 children and adolescents-parent dyads. To identify overweight/obese among children and adolescents, body mass index-for-age Z-scores by sex and age relative to WHO 2007 reference was calculated using WHO AnthroPlus software. A multivariable logistic regression model fitted to determine the adjusted associations between the outcome and the predictors selected from the bivariate analyses. Data analysis was carried out using STATA V.15.0.

Results: The proportion of participants with low, medium and high dietary diversity scores was 7.28%, 22.5%, and 70.2%, respectively. Participants aged 13-18 years were less likely to be overweight or obese [adjusted OR (aOR) = 0.40; 95%CI: 0.26, 0.64] to those aged 5-12 years. Children in a family with the richest or highest socioeconomic status (SES) were more likely to be overweight or obese than those in families with the poorest or lowest status. Children and adolescents who consumed soft drinks (sugar-sweetened beverages) four or more times per week [aOR = 3.24; 95%CI: 1.13, 7.95] were more likely to be overweight or obese to those who did not consume soft drinks.

Conclusions: The study identified factors such as younger age (<12 years), high SES and consumption of soft drinks as key contributors to overweight and obesity among children and adolescents. Therefore, interventions targeting behavioural prevention and reduction of overweight and obesity among children and adolescents should be cognizant of the above factors during implementation in order to achieve desired outcomes, further guided by exploratory qualitative studies to identify public perceptions and attitudes affecting dietary practices.

Keywords: Dietary patterns; Metabolic syndrome; Nutrition assessment; Weight management.