Comparison of Obesity Prevalence and Dietary Intake in School-Aged Children Living in Rural and Urban Area of Croatia

Abstract

The aim of this study was to explore the differences in nutritional status and dietary intakes in 12~17 year-old children living in urban (Zagreb) and the rural (Sinj and Drniš) area of Croatia. A validated food frequency questionnaire was used to assess dietary intake. For each participant, body weight and body height were measured and bioelectrical impedance was used to estimate the body fat percentage. There was an overall of 310 children included: 105 (33.9%) from urban area and 205 (66.1%) from rural area; 191 (61.6%) were female with a mean age 14.9 (range 12~17) years. When adjusted for age and gender, there was no statistically significant difference in body mass index for age Z-scores between urban and rural parts (0.23±0.07 vs. 0.30±1.15; P=0.650) or in average daily energy intake (2,479.2±1,111.2 kcal vs. 2,338.2±920.2 kcal; P=0.702). There was a statistically significant difference in nutritional status between genders, with a higher percentage of boys being overweight or obese compared to girls. When combined, ‘Fast food’ and ‘Snacks’ were major contributors to the total energy intake for both areas. The mean contribution of ‘Fast food’ to total energy intake was significantly higher in the urban area. The prevalence of obesity among Croatian children is high and unrelated to the urban/rural setting, which could be partially explained by the high intake of ‘Fast food’ and ‘Snacks’.

Metabolic and Vascular Effect of the Mediterranean Diet

“…This study, which was conducted in school aged children, reported that the prevalence of obesity among Croatian children was high and unrelated to an urban/rural setting. It is necessary to coordinate the role of family together with educational institutions and health professionals in order to interrupt this raising negative trend [22].…”

Investigation of obesity, eating behaviors and physical activity levels living in rural and urban areas during the covid-19 pandemic era: a study of Turkish adolescent

“…On the contrary, other study found differences in body composition, with rural children being less weight than urban children [ 28 ]. However, in a different study, no significant difference was found between girls and boys in the height ( p = 0.01) and weight ( p = 0.07) variables between those living in urban and rural areas [ 50 ]. Furthermore, adolescent girls were more likely to be overweight and obese than boys [ 51 , 52 ].…”

“…In a similar study, prevalence rates of overweight and obesity were also higher in urban populations compared to rural populations living in Bangladesh [ 52 ]. In a study of dietary habits, the average contribution of 'fast food' to total energy intake was significantly higher in the urban area [ 50 ]. Prevalence of obesity among Croatian children was high and relevance to the urban/rural environment has not been established [ 50 ].…”

Urban and rural differences in frequency of fruit, vegetable, and soft drink consumption among 6–9‐year‐old children from 19 countries from the WHO European region

“…While Coli c-Bari c et al 24 have observed that energy and nutrient intakes were more adequate among urban than rural 12-year-old Croatian children, another study conducted in a sample of Croatian adolescents aged 12-17 years did not observe differences in total daily energy intake and other nutritional characteristics, except for fat intake. 25 In addition, those from rural areas consumed significantly less fast food and more fruits than those from urban areas. 25 Similarly, Lazarou and Kalavana 26 found that Cypriot children aged 9-13 years from rural areas consumed more traditional foods and were less likely to eat fast food.…”

“…25 In addition, those from rural areas consumed significantly less fast food and more fruits than those from urban areas. 25 Similarly, Lazarou and Kalavana 26 found that Cypriot children aged 9-13 years from rural areas consumed more traditional foods and were less likely to eat fast food. Finally, a study among Italian 8-year-olds did not observe any difference by urbanization level for fruit and vegetable consumption.…”