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Updated: May 22, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
[Risk factors of children overweight and obesity]
Afifa Abdelkafi Koubaa1, Kawthar Younes, Zvinemira Gabsi
1Groupement des Soins de Santé de Base de Monastir.
Insights
Childhood obesity is rising in Tunisia. Parental obesity, artificial feeding, and early food diversification are key risk factors. Exclusive breastfeeding for over six months may protect against obesity.
Area of Science:
- Pediatric Endocrinology
- Public Health Nutrition
- Childhood Obesity Research
Context:
- Rising prevalence of childhood obesity in Tunisia necessitates understanding local risk factors.
- Early identification and management are crucial for preventing long-term health consequences.
Purpose:
- To determine the prevalence of overweight and obesity in 4-6-year-old children in Monastir, Tunisia.
- To investigate the association between childhood overweight/obesity and potential risk factors.
Summary:
- A cross-sectional study of 121 children (aged 4-6) in Monastir found overweight and obesity prevalence of 9.1% and 11.6%, respectively.
- Risk factors identified include parental obesity (OR=3.65), artificial feeding (OR=4.25), and early food diversification (OR=3.84).
- Exclusive breastfeeding for ≥6 months showed a protective effect (OR=0).
Impact:
- Findings highlight the need for targeted preventive strategies in Tunisia, including weight supervision and nutritional education.
- Promoting physical activity and reducing sedentary behavior (e.g., television time) are essential components of a comprehensive strategy.
- Understanding these specific risk factors can inform public health policies and interventions to combat childhood obesity in the region.
Background:
The increase of the prevalence of children obesity in some countries as Tunisia, necessitate to welling known risk factors for obesity, to prevent and early management.
Aims:
To determine the prevalence of overweight and of obesity in a group of 4-6 year-old school children in Monastir and to investigate the association with possible risk factors.
Methods:
A descriptive transversal study including 121 children aged 4-6 years old (637 males, 698 females), was conducted in 10 Kindergartens in Monastir, in 2011. Personal data such as age, sex, birth weight, breastfeeding history and parental data including parental weights and heights, parental education level and occupation were collected by questionnaires completed by parents. Height and weight were measured with a weighing-scale and body mass index (BMI; kg/m²) was calculated. The prevalence of overweight and obesity was defined based according to the curves of the french reference of Rolland Cachera.
Results:
Prevalence of overweight and obesity was 9.1% and 11.6% respectively. Parental factors associated with overweight were: parental obesity: 44% vs 17% (p=0.005) (OR = 3.65: 1.27-10.57), artificial feeding: 68% vs 33% (p=0.0016) (OR= 4.25: 1.51-12.27), and the early diversification of food before the age of 6 months: 88% vs 65% (p=0.029) (OR= 3.84: 0.98 - 17.66). Exclusive breast feeding duration ≥ 6mois is probably protector factor against obesity: 0% vs 21% (p=0. 01) (OR=0: 0.00 < OR < 0.78). We found no significant difference between overweight and non-overweight schoolchildren in frequency of high degree educated mother and father, birth weight, breakfast intake, eating habits and exercise. However overweight children intake high-caloric food, low in fiber, with troubles of nutritional comportment, and a sedentary lifestyle.
Conclusions:
Risk factors for obesity, well known in most industrialized countries, necessitate to be more understood in Tunisia, to place a preventive strategy included supervision of children weight, nutritional education and promote physical activity and reducing the time spent watching television.
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