Lifestyle Practices Predictors of Nutritional Status among Basic Public-School Children in Aden, Yemen

Abstract

Introduction: Since March 2015, children's nutrition in Yemen is increasingly threatened and acute malnutrition is now at serious levels across the country. This study aimed to determine the association between nutritional status and lifestyle practices of basic-public school children in Aden-Yemen. Methods: A cross-sectional study was conducted in January 2022 on a randomly selected basic public schools’ children aged 6-10 years. Lifestyle practices including breakfast consumption at home, physical activity, screen time and sleeping time were assessed by a self-administered questionnaire filled by the parents. Measurement of Z-score was done for height-for-age, weight-for-age and body-mass-index for-age to define stunting, underweight, thinness, overweight and obesity respectively. The data were processed and analyzed using SPSS-25 and World Health Organization’s (WHO) Anthro plus program. Results: The study involved 930 students having the following prevalence: 26.9% for stunting; 32.5% for underweight and 23.1% for thinness. In addition, 1.2% were obese and 3.2% were overweight. According to the binary logistic regression, children aged >8-10 years were more likely to be stunted (AOR=5.269; 95% CI:3.339-8.313), underweight (AOR=9.156; 95% CI: 5.631-14.890) and thin (AOR=3.901; 95% CI: 2.400-6.339) compared to younger age. Male children were more likely to be stunted (AOR= 1.496; 95% CI: 11.091-2.053), underweight (AOR=3.026; 95% CI: 2.195-4.172) and thin (AOR=8.001; 95% CI: 5.313-12.048) compared to female children. Less than daily consumption of breakfast increased the risk of stunting (AOR=1.505; 95% CI:1.109-2.042), underweight (AOR=4.724; 95% CI:3.421-6.524) and thinness (AOR=6.053; 95% CI:4.033-9.084) compared to daily breakfast consumption. Children sleeping < 9 hours was associated with increased risk of stunting (AOR=1.479; 95% CI:1.093-2.001) and thinness (AOR=1.548; 95%CI:1.102-2.176) than sleeping ≥ 9 hours. Additionally, increasing likelihood of overweight (AOR= 50.848 ;95% CI: 6.211-416.301) and obesity (AOR= 8.977;95% CI: 1.098-73.422) was observed among children play outside < 1 hour compared to playing ≥ 1 hour. Furthermore, increasing risk of overweight was associated with children’s screen time ≥ 2 hours compared to < 1 hours (AOR=12.034 ;95% CI: 2.311-62.668). Conclusion: Stunting, underweight and thinness are major nutritional problems among basic public-school children in Aden. Unhealthy dietary and bad lifestyle practices associated with malnutrition indicators. This calls for attention by policymakers to address the challenges of malnutrition and implementing urgent intervention for awareness raising to maintain healthy lifestyle among school children.