The Association between Green Space and the Prevalence of Overweight/ Obesity among Primary School Children

Background: Childhood overweight and obesity is a major health problem in many low-and middle-income countries such as Nepal. There is evidence indicating a significant association between health and access to green space. Objective: To estimate the prevalence of childhood overweight and obesity, and to identify its association with green space among primary school children in Kathmandu metropolitan city, Nepal. Methods: A cross-sectional study was conducted on 440 (195 male and 245 female) students studying in selected primary schools of Kathmandu metropolitan city. Mothers/caretakers of the participating children were also studied. Results: Of the 440 children, 13.2% were overweight; 6.8% were obese. 4 of 16 studied variables that had significant associations with overweight/obesity in bivariate analyses, were found independent predictors of overweight/obesity after being adjusted for confounders. They included mode of transportation to school (aOR 2.08, 95% CI 1.12 to 3.88), consumption of sugary snack (aOR 2.57, 95% CI 1.12 to 5.91) and salty/savory snack (aOR 4.13, 95% CI 1.71 to 9.96), and the distance of a green space from child's residence (aOR 27.46, 95% CI 6.10 to 123.54). Conclusion: One-fifth of the children in urban schools were found to be overweight or obese. The distance to a green space was identified as the most significant factor influencing childhood overweight/obesity.