Fast Food, Carbonated Drinks, and Socioeconomic Status Predict BMI among School Children in Benghazi: A Cross-Sectional Study

Abstract

Background

The effect of fast food, carbonated drinks, and socioeconomic status on BMI among school children in Benghazi.

Aim

This article determines the prevalence of obesity and overweight and their relationship with environmental factors among children aged 7 to 12 years at a primary school in Benghazi, Libya.

Methods

This cross-sectional study was conducted from October to November 2023 across primary schools in Benghazi, Libya, involving children aged 7 to 12 years (n = 384). Data were collected via a structured questionnaire: researcher staff recorded demographics and anthropometrics (height and weight using standardized protocols), while parents reported lifestyle factors (diet, physical activity, socioeconomic status). Body mass index (BMI) was calculated (kg/m²), and associations were analyzed using chi-square tests (SPSS v23; p < 0.05). Ethical approval was obtained, with written parental consent and anonymized data.

Results

This study revealed comparable obesity rates between genders, with 28.1% of boys (54/192) and 27.2% of girls (52/191) classified as obese, with no significant association between gender and BMI (chi-square = 0.18, p = 0.981). Significant relationships were found between obesity and key modifiable risk factors: frequent fast food consumption (chi-square = 56.32, p < 0.001), high carbonated beverage intake (chi-square = 142.07, p < 0.001), physical inactivity (chi-square = 23.4, p = 0.001), and higher family financial status (chi-square = 23.41, p < 0.001). Obese children exhibited extreme patterns of sedentary behavior (90.6% inactive) and sugary drink consumption (90.6% ≥ 3 times/week). A socioeconomic paradox emerged, with obesity prevalence highest in wealthier families while underweight status was associated with poorer economic conditions.

Conclusion

The high prevalence of childhood obesity in Benghazi, surpassing rates reported internationally, underscores an urgent public health crisis driven by modifiable dietary and lifestyle factors. These include eating too much fast food and sugary drinks, not getting enough exercise, and unhealthy eating habits in wealthier families. These problems can be fixed through limiting junk food, making sure that kids are active every day, and teaching healthy eating habits. If we take these steps now, we can help children in Benghazi grow up healthier.

Keywords

obesity - primary school students - prevalence - Benghazi - cross-sectional study

Publication History

Received: 17 April 2025

Accepted: 19 April 2025

Article published online:
17 June 2025

• References

• 1 WHO. Obesity. Accessed April 10, 2025 at: https://www.who.int/health-topics/obesity
• 2 WHO Child growth standards. Accessed April 10, 2025 at: https://www.who.int/tools/child-growth-standards
• 3 Jebeile H, Kelly AS, O'Malley G, Baur LA. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol 2022; 10 (05) 351-365
• 4 Ogden CL, Fryar CD, Martin CB. et al. Trends in obesity prevalence by race and Hispanic origin-1999-2000 to 2017-2018. JAMA 2020; 324 (12) 1208-1210
• 5 Schwarz S. Obesity in Children: Background, Etiology and Pathophysiology, Epidemiology. eMedicine. Published online June 30, 2023. Accessed April 28, 2025 at: https://emedicine.medscape.com/article/985333-overview?form=fpf
• 6 Abarca-Gómez L, Abdeen ZA, Hamid ZA. et al; NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017; 390 (10113): 2627-2642
• 7 Brophy S, Cooksey R, Gravenor MB. et al. Risk factors for childhood obesity at age 5: analysis of the millennium cohort study. BMC Public Health 2009; 9 (01) 467
• 8 Wilson AC, Forsyth JS, Greene SA, Irvine L, Hau C, Howie PW. Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study. BMJ 1998; 316 (7124): 21-25
• 9 Balasundarad P, Krishna S. Obesity effects on child health. 2023 Apr 10. In : StatPearls [Internet]. Treasure Island (FL): StatPerarls Publishing; 2025
• 10 Horesh A, Tsur AM, Bardugo A, Twig G. Adolescent and childhood obesity and excess morbidity and mortality in young adulthood-a systematic review. Curr Obes Rep 2021; 10 (03) 301-310
• 11 Kalarchian MA, Levine MD, Arslanian SA. et al. Family-based treatment of severe pediatric obesity: randomized, controlled trial. Pediatrics 2009; 124 (04) 1060-1068
• 12 Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet 2002; 360 (9331): 473-482
• 13 Elsaid AM, Tajoury O, Meidan T. Obesity in children attending school health in Elkish Polyclinic Benghazi 2017. Int J Res Publ Rev 2023; 4 (06) 2920-2929
• 14 Spinelli A, Buoncristiano M, Kovacs VA. et al. Prevalence of severe obesity among primary school children in 21 European countries. Obes Facts 2019; 12 (02) 244-258
• 15 Badawi NES, Barakat AA, El Sherbini SA, Fawzy HM. Prevalence of overweight and obesity in primary school children in Port Said city. Egypt Pediatr Assoc Gazette 2013; 61 (01) 31-36
• 16 Zhang X, Zhang F, Yang J. et al. Prevalence of overweight and obesity among primary school-aged children in Jiangsu Province, China, 2014–2017. PLOS ONE. 2018; 13 (08) e0202681
• 17 Pangani IN, Kiplamai FK, Kamau JW, Onywera VO. Prevalence of overweight and obesity among primary school children aged 8-13 years in Dar es Salaam City, Tanzania. Adv Prev Med 2016; 2016: 1345017
• 18 Djordjic V, Radisavljevic S, Milanovic I. et al. WHO European Childhood Obesity Surveillance Initiative in Serbia: a prevalence of overweight and obesity among 6-9-year-old school children. J Pediatr Endocrinol Metab 2016; 29 (09) 1025-1030
• 19 Emamian MH, Hashemi H, Fotouhi A. Obesity and underweight: serious health problems in Iranian primary school children. Pediatr Int 2019; 61 (10) 1030-1035
• 20 Kamal A. Growth patterns of Qatari school children and adolescent aged 6–18 years. J Health Popul Nutr 2015; 23: 250-258
• 21 Garrido-Miguel M, Oliveira A, Cavero-Redondo I. et al. Prevalence of overweight and obesity among European preschool children: a systematic review and meta-regression by food group consumption. Nutrients 2019; 11 (07) 1698
• 22 Kelishadi R, Haghdoost AA, Sadeghirad B, Khajehkazemi R. Trend in the prevalence of obesity and overweight among Iranian children and adolescents: a systematic review and meta-analysis. Nutrition 2014; 30 (04) 393-400
• 23 Vazquez CE, Cubbin C. Socioeconomic status and childhood obesity: a review of literature from the past decade to inform intervention research. Curr Obes Rep 2020; 9 (04) 562-570
• 24 Ranjani H, Mehreen TS, Pradeepa R. et al. Epidemiology of childhood overweight & obesity in India: a systematic review. Indian J Med Res 2016; 143 (02) 160-174
• 25 Hills AP, Andersen LB, Byrne NM. Physical activity and obesity in children. Br J Sports Med 2011; 45 (11) 866-870