Abstract

Objectives: To estimate prevalence rates of overweight and obesity among children aged 6 to 12 in urban and rural Iraqi communities, and to identify independent risk factors for pediatric obesity by parental surveys.
Methods: The weight status of children in Iraq was examined in this research through a cross-sectional survey that took place from February to April 2025. The survey was directed to parents of children aged 6-12 years. Out of 170 initial invitations, 150 parents (75 from urban areas and 75 from rural areas) eventually participated after 20 respondents were dismissed for incomplete responses or non-provision of anthropometric data. The children's Body Mass Index (BMI) was determined and classified according to the height and weight given by their parents. Besides that, we collected thorough information particularly on age, gender, and various risk factors like screen time, physical activity, and weekly intake of fast food, soft drinks, fruits, and vegetables, family history and sleep duration. The processing and analysis of the data were done using SPSS version 28 and included descriptive statistics, chi-square tests, independent t-tests, and multivariate logistic regression. Significance was set at p<0.05.
Results: In general, 18.7% of the sample were obese while 21.3% of them were at the overweight level. There was a significant obesity prevalence in urban children (24.0% urban vs. 13.3% rural; χ² p=0.04). Urban children had higher BMIs (mean±SD 19.2±3.8 vs. 17.1±3.2; p<0.001), more screen time per day (3.1±1.2 h vs. 2.0±1.0 h; p<0.001), and less physical activity hours weekly (3.2±1.6 h vs. 5.1±2.0 h; p<0.001). In multivariate logistic regression adjusting for income and parental education, obesity was independently predicted by increased screen time (aOR per 1 h/day = 1.38, 95% CI 1.05–1.82, p=0.02), decreased physical activity (aOR per 1 h/week = 0.85, 95% CI 0.75–0.97, p=0.015), positive family history (aOR = 2.12, 95% CI 1.05–4.28, p=0.036), and living in an urban area (aOR = 1.89, 95% CI 1.01–3.54, p=0.047).
Conclusion: The greater part of Iraqi school-age children is weighed above normal or can be classified as obese, with urban children having a greater burden. Modifiable lifestyle factors, particularly time spent on screens, inactivity, and poor nutrition, along with family history, must be targeted. This situation calls for the application of public health programs designed for the urban types of environment and families.