Third of children in Maltese primary schools are overweight or obese, study finds

A third of children in Maltese primary schools are already overweight or obese by the time they start primary education, a study has shown.

The alarming numbers were made public following a parliamentary question by PN spokesperson for lifelong learning, Charles Azzopardi addressed to youths minister Clifton Grima, as the latter tabled the 2022 study in parliament.

The study measured the body mass index (BMI) of 4-5-year olds attending kindergarten 2 in Malta, as well as the BMI of 5-16-year-olds in primary, middle and secondary schools in Malta and Gozo. The study also examined the diet, physical activity and other lifestyle behaviours of kindergarten children.

According to the WHO Child Growth Standards, 2.1% of children aged 4–5 years in KG2 (60 months or less) were classified as either overweight or obese, with 3.7% classified as obese.

When applying the WHO Growth Reference, the figures for children in KG2 aged 61 months and above were higher, with 33.0% being either overweight or obese, and 11.8% specifically categorised as obese.

Additionally, for children and adolescents in the age range of Y1-11, 39.4% were identified as either overweight or obese, and 17.3% were specifically classified as obese. 

Overall, the distribution of body composition was seen undergoing changes throughout the various school phases, exhibiting a rise in overweight and obesity rates from KG2 to middle school. However, there is a slight decline observed in secondary school. The research also indicated that boys were more likely to be obese than girls.

Lifestyle behaviours

The study examined certain lifestyle behaviours in children in Malta, one of which includes breastfeeding.

Describing breastfeeding as the “gold standard of infant nutrition,” the study shows that although breastfeeding rates in Malta seem to be on the rise, parent-reported data suggests that 22.2% of children were never breastfed. 

Additionally, 40.0% of children were breastfed for less than six months, while 37.8% were breastfed for more than six months.

Looking at children’s breakfast habits, the findings show that among children attending kindergarten 2, 43.2% of children consumed breakfast daily. On the measurement day, breakfast consumption among children and adolescents in between kindergarten 2 and year 11 was just below 60%. 

Notably, breakfast intake appears to be more prevalent among boys, with overall declining rates observed in both boys and girls across the various school phases.

Taking a look at children’s diets, 48.5% of children in kindergarten 2 were found to consume fresh fruit daily, while 14.5% consume vegetables daily. Snacking habits, which may contribute to overall energy intake and overweight/obesity, are notable, with both savoury and sweet snacks being popular choices. 

Specifically, 4.6% of kindergarten 2 children consume savoury snacks daily, and 14.8% consume sweet snacks daily. In kindergarten 2, 4.4% of children consume sugar-containing soft drinks daily, while 9.8% consume fruit juices, smoothies, or squashes daily, all of which are linked to weight gain.

The study also looked at children’s regular physical activity, citing its health benefits, including reducing the risk of noncommunicable diseases like heart disease, stroke, diabetes, and certain cancers.

Kindergarten 2 children’s parents reported that their child spent at least 2 hours per week on extracurricular sports or physical activities (65.9%), and at least 1 hour per day playing actively or vigorously (90.4%). 

Additionally, more than half (52.3%) of the children participating in the study claimed to engage in organised extracurricular sports or physical activities at least once a week. Notably, sports participation appears to be more common among boys, with increasing rates in both boys and girls throughout primary school, followed by a decline and stabilisation in middle and secondary school.

With regard to screen time, a significant majority of children (76.8%), exceeded the WHO recommendation of no more than one hour of sedentary screen time per day. In the case of the children in the study, 27.3% spent at least 2 hours per day watching TV or using electronic devices.