This population-based cross-sectional study investigated the associations of sleep, nutrition, and physical activity with overweight and obesity among 4,108 school-aged children and adolescents (9-17 years) in Punjab, Pakistan, alongside 3,371 parental responses. Body mass index was calculated using anthropometric measurements, and weight status was classified according to the 2007 World Health Organization growth reference. Socioeconomic status was determined through parental education, occupation, and household income, while lifestyle behaviours were assessed via validated questionnaires. Multivariate logistic regression analyses were conducted, adjusting for gender, grade, and socioeconomic variables. The prevalence of overweight and obesity was 19.4% and 10.7%, respectively. Girls had a higher obesity prevalence than boys (12.3% vs. 8.9%), whereas boys showed a higher combined prevalence of overweight and obesity. Among boys, obesity was significantly associated with urban residence (AOR 1.37; 95% CI 1.13-1.83), being an only child (AOR 2.74; 95% CI 1.92-3.92), frequent fast-food consumption (≥3 times/week; AOR 1.56; 95% CI 1.23-1.97), and lower parental education (AOR 1.22; 95% CI 1.05-1.41). Among girls, long weekend sleep duration increased obesity risk (AOR 1.38; 95% CI 1.14-1.67), while being an only child (AOR 0.36; 95% CI 0.25-0.52), frequent fast-food consumption (AOR 0.64; 95% CI 0.50-0.80), and lower parental education (AOR 0.81; 95% CI 0.70-0.94) were linked to lower odds. Physical activity and soft drink intake were not significant after adjustment. These findings underscore complex, gender-specific relationships between lifestyle and socioeconomic factors, highlighting the need for targeted interventions promoting healthy sleep, nutrition, and equity-focused strategies.
Tanveer et al. (Fri,) studied this question.