Prevalence and Factors Associated with Thinness and Overweight/Obesity Among Secondary School Adolescents. A Cross-sectional Study

Globally unhealthy lifestyle behaviors among adolescents have become a public health concern, contributing to the obesity epidemic in many parts of the world. In The Gambia, underweight has previously been considered as a significant health problem. However, in recent decades, the prevalence of overweight and obesity has been a growing concern. Thus, we aimed to investigate the prevalence and risk factors for both thinness and overweight/obesity among school going adolescence in The Gambia. Using a cross-sectional study design, 805 students (268 males, 537 females) aged 13 to 19 from schools in Western Region, The Gambia ware selected using a multi-stage sampling design. BMI-for-age z-scores were used to determine nutritional status. Multinomial logistic regressions models were used to assess the association between multiple factors and BMI-for-age status of adolescents. Our findings show that thinness and overweight/obesity were 13.69% and 7.77% respectively. Factors such as sex (female: adjusted odds ratio [aOR]=3.15, 95% confidence interval [CI]=1.43 – 6.93), mother’s education (secondary: aOR=2.86, 95% CI=1.16 – 7.07), physical activity level (sufficiently active: aOR=0.48, 95% CI=0.24 – 0.95) and nighttime sleep duration (<6 hours: aOR=2.53, 95% CI=1.07 – 5.99) were significantly associated with overweight/obesity. In addition, sex (female: aOR=0.34, 95% CI=0.19–0.59) and nighttime sleep duration (<6 hours: aOR=2.92, 95% CI=1.24–6.86) were associated with thinness. The results suggest that the double burden of malnutrition exist in The Gambia and remains a major public health issue among adolescents. This, therefore, underlined the need for nutritional interventions targeting adolescents. Further research involving the entire country may be required to show the national burden.