Background
Methods
Study design and sample
Measures and response coding
Survey question/variable | Coding (value coded)* | Variable |
---|---|---|
How old are you?
| <12– 16 years (coded categorically) | Age |
What is your sex?
| Male (1) | Sex |
Female (0) | ||
How tall are you without your shoes on?
| Used to calculate BMI | |
How much do your weight without your shoes on?
| Used to calculate BMI | |
During the past 30 days, how often did you go hungry because there was not enough food in your home?
| Most of the time/always (1) | Food insecurity |
Never/rarely/sometimes (0) | ||
During the past 30 days, how many times per day did you usually eat fruit? (examples of fruit provided)
| 2+ times a day (1) | Fruit consumption |
Less than 2 times a day (0) | ||
During the past 30 days, how many times per day did you usually eat vegetables? (examples of vegetables provided)
| 3+ times a day (1) | Vegetable consumption |
Less than 3 times a day (0) | ||
Students who were physically active for a total of at least 60 minutes per day on five or more days during the past seven days
| Yes (1) | Consistently active |
No (0) | ||
Students who went to physical education (PE) class on three or more days each week during this school year
| Yes (1) | PE class |
No (0) | ||
Students who did not walk or ride a bicycle to or from school during the past seven days
| Yes (1) | No walking/biking to school |
No (0) | ||
During the past 30 days, how many times per day did you usually drink carbonated soft drinks, such as Coca-Cola, Sprite, Fanta, Fizzi, Moka, Youki, or tonic?
| 1+ times a day (1) Less than 1 per day (0) | Soft drink |
During the past 7 days, on how many days did you eat food from a fast food restaurant, such as [country specific examples]?
| 3+ days (1) Less than 3 days (0) | Fast food |
How much time do you spend during a typical or usual day sitting and watching television, playing computer games, talking with friends, or doing other sitting activities such as [country specific examples]?
| 3+ hours per day (1) Less than 3 hours per day (0) | Sitting 3+ hours |
Parental Support Index: created by adding the results of the coding below | Parental support | |
During the past 30 days, how often did you parents or guardians check to see if your homework was done?
| Most of the time/always (1) | Parental homework checking |
Never/rarely/sometimes (0) | ||
During the past 30 days, how often did your parents or guardians understand your problems and worries?
| Most of the time/always (1) | Parental understanding |
Never/rarely/sometimes (0) | ||
During the past 30 days, how often did you parents or guardians really know what you were doing with your free time?
| Most of the time/always (1) | Parental knowledge of activity |
Never/rarely/sometimes (0) |
Variable | Benin | Djibouti | Egypt | Ghana | Malawi | Mauritania | Morocco | |
---|---|---|---|---|---|---|---|---|
Code | Proportion | |||||||
Food insecurity | 0 | 0.823 | 0.806 | 0.948 | 0.781 | 0.815 | 0.896 | 0.893 |
1 | 0.177 | 0.194 | 0.052 | 0.219 | 0.185 | 0.104 | 0.107 | |
Fruit consumption | 0 | 0.668 | 0.343 | 0.301 | 0.266 | 0.476 | 0.682 | 0.472 |
1 | 0.332 | 0.657 | 0.699 | 0.734 | 0.524 | 0.319 | 0.528 | |
Vegetable consumption | 0 | 0.827 | 0.392 | 0.151 | 0.254 | 0.763 | 0.724 | 0.593 |
1 | 0.173 | 0.608 | 0.849 | 0.746 | 0.237 | 0.277 | 0.407 | |
Consistently active | 0 | 0.678 | * | * | 0.842 | * | 0.829 | 0.818 |
1 | 0.322 | * | * | 0.158 | * | 0.171 | 0.182 | |
PE class | 0 | 0.743 | * | * | * | * | 0.700 | 0.676 |
1 | 0.257 | * | * | * | * | 0.300 | 0.324 | |
No walking/biking to school | 0 | 0.894 | * | 0.504 | 0.647 | * | 0.683 | 0.696 |
1 | 0.106 | * | 0.496 | 0.353 | * | 0.317 | 0.304 | |
Soft drink | 0 | 0.720 | * | * | * | * | 0.495 | 0.536 |
1 | 0.280 | * | * | * | * | 0.505 | 0.464 | |
Fast food | 0 | 0.824 | * | 0.882 | * | * | 0.714 | 0.850 |
1 | 0.176 | * | 0.118 | * | * | 0.286 | 0.150 | |
Sitting 3+ hours | 0 | 0.810 | * | * | 0.730 | * | 0.629 | 0.740 |
1 | 0.190 | * | * | 0.270 | * | 0.371 | 0.260 | |
Parental support index | 0 | 0.291 | 0.350 | 0.350 | 0.310 | * | 0.368 | 0.378 |
1 | 0.260 | 0.298 | 0.264 | 0.268 | * | 0.263 | 0.276 | |
2 | 0.222 | 0.213 | 0.209 | 0.234 | * | 0.190 | 0.200 | |
3 | 0.227 | 0.140 | 0.177 | 0.188 | * | 0.179 | 0.146 |
Statistical analysis
Ethics statement
Results
Sample
Benin | Djibouti | Egypt | Ghana | Malawi | Mauritania | Morocco | |
---|---|---|---|---|---|---|---|
Survey year | 2009 | 2007 | 2006 | 2007 | 2009 | 2010 | 2010 |
N (% missing BMI) | 2681 (2.2%) | 1711 (9.7%) | 5179 (13.3%) | 6155 (5.8%) | 2305 (13.3%) | 2028 (34.6%) | 5756 (6.9%) |
Male | 65.1% | 57.1% | 52.8% | 52.4% | 46.6% | 47.4% | 52.4% |
Age: 12 or under | 4.3% | 4.1% | 22.3% | 10.7% | 5.8% | 6.1% | 14.4% |
13 | 7.0% | 6.6% | 45.3% | 16.3% | 26.6% | 9.5% | 22.2% |
14 | 14.8% | 18.2% | 22.8% | 21.8% | 38.6% | 20.0% | 26.8% |
15 | 24.6% | 27.8% | 7.3% | 26.9% | 28.4% | 28.9% | 20.8% |
16+ | 49.3% | 43.2% | 2.3% | 24.3% | 0.7% | 35.6% | 15.9% |
Underweight | 17.5% | 31.9% | 12.6% | 25.7% | 21.1% | 22.3% | 24.0% |
Normal weight | 71.3% | 49.4% | 56.0% | 65.6% | 68.9% | 53.4% | 59.4% |
Overweight* | 11.2% | 18.8% | 31.4% | 8.7% | 10.0% | 24.3% | 16.6% |
Obese | 0.6% | 5.2% | 9.3% | 1.0% | 0.8% | 3.4% | 3.6% |
Adjusted rates of underweight, overweight and obesity
Prevalence | ||||
---|---|---|---|---|
Country | Sex | Underweight% (95% CI)* | Overweight**% (95% CI)* | Obesity% (95% CI)* |
Benin | Female | 14.0 (8-20) | 21.6 (16-27) | 2.9 (0-1) |
Male | 19.9 (15-24) | 16.1 (13-19) | 0.3 (0-1) | |
Djibouti | Female | 20.1 (14-26) | 29.6 (24-35) | 9.4 (6-13) |
Male | 30.8 (24-38) | 20.1 (16-24) | 5.5 (3-8) | |
Egypt | Female | 9.9 (8-12) | 28.2 (23-34) | 7.6 (5-10) |
Male | 15.7 (13-19) | 28.2 (23-33) | 8.6 (6-11) | |
Ghana | Female | 18.3 (16-20) | 13.3 (12-15) | 1.5 (1-2) |
Male | 33.8 (31-36) | 6.7 (5-8) | 0.8 (0-1) | |
Malawi | Female | 12.4 (8-17) | 14.4 (10-19) | 1.1 (0-3) |
Male | 24.4 (18-31) | 15.9 (9-22) | 1.6 (0-4) | |
Mauritania | Female | 17.9 (11-24) | 35.9 (27-45) | 5.1 (2-9) |
Male | 23.5 (17-30) | 22.0 (16-28) | 2.7 (1-4) | |
Morocco | Female | 17.1 (12-22) | 19.3 (17-22) | 3.9 (3-5) |
Male | 29.3 (23-35) | 15.6 (11-20) | 3.6 (2-5) |
Risk factors for unhealthy weight
Underweight | Overweight | Obese | ||
---|---|---|---|---|
Multivariable model* | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
Male sex |
2.03 (1.75-2.36)
|
0.76 (0.63-0.93)
| 1.00 (0.76-1.34) | |
Age (ref = ≤12) | 13 | 1.14 (0.90-1.45) |
0.76 (0.64-0.90)
|
0.69 (0.52-0.92)
|
14 | 1.21 (0.97-1.51) |
0.61 (0.48-0.77)
|
0.66 (0.48-0.90)
| |
15 | 1.14 (0.90-1.45) |
0.48 (0.37-0.61)
|
0.43 (0.24-0.75)
| |
16+ | 0.89 (0.68-1.17) |
0.50 (0.37-0.68)
|
0.41 (0.24-0.69)
| |
Food insecurity | 0.93 (0.78-1.10) | 1.06 (0.86-1.31) | 1.02 (0.71-1.46) | |
Vegetables | 0.97 (0.85-1.11) | 0.97 (0.85-1.11) | 0.95 (0.68-1.31) | |
Fruit | 0.96 (0.83-1.09) |
1.15 (1.01-1.31)
| 1.20 (0.94-1.53) | |
Risk factors with only partial data**
| ||||
Soft drinks | 0.95 (0.80-1.13) | 0.99 (0.77-1.27) | 1.30 (0.88-1.92) | |
Fast food | 1.09 (0.87-1.35) | 1.12 (0.90-1.40) | 1.28 (0.85-1.95) | |
Consistently active | 0.93 (0.80-1.08) | 1.23 (0.97-1.56) | 1.13 (0.66-1.96) | |
Phys. Ed. 3+ days a week | 0.97 (0.80-1.18) | 1.20 (0.96-1.49) |
1.51 (1.02-2.24)
| |
Sitting 3+ hours a day | 1.02 (0.88-1.19) | 1.23 (0.97-1.56) | 1.50 (0.94-2.40) | |
Does not walk/bike to school | 0.94 (0.82-1.07) | 0.98 (0.86-1.11) | 1.00 (0.77-1.28) | |
Parental involvement index | ||||
1 | 0.95 (0.79-1.15) | 1.17 (0.98-1.41) | 1.05 (0.75-1.45) | |
2 | 1.03 (0.87-1.23) | 1.20 (0.99-1.45) | 0.95 (0.72-1.26) | |
3 | 0.97 (0.79-1.19) |
1.25 (1.01-1.56)
| 1.14 (0.85-1.53) |