Comparative Study of Physical Health and Dietary Behavior of School-Going Children from Peshawar and Murree

Abstract

Background: Childhood malnutrition and poor dietary behaviors stay major public health concerns in Pakistan; however, comparative evidence from distinct geographic settings like Peshawar and Murree is limited. Objective: This study aimed to comparatively assess physical health indicators (weight-for-age, height-for-age, BMI-for-age Z-scores) and dietary behaviors among school-going children from Peshawar and Murree to find potential nutritional disparities and influencing factors. Methods: A comparative cross-sectional observational study was conducted on school-going children (n=360; aged 5-12 years; without metabolic or chronic diseases). Anthropometric assessments (weight, height, BMI, MUAC), dietary behavior questionnaires, and socioeconomic surveys were conducted using validated instruments. Ethical approval (IRB No. AUP/IRB-2023/102) was secured following the Helsinki Declaration. Data were analyzed using SPSS v27, employing descriptive statistics, independent t-tests, chi-square, Pearson correlations, and ANCOVA. Results: Children from Murree had significantly lower weight-for-age (-1.27±0.87 vs. -0.93±1.11; p<0.001), height-for-age (-1.66±1.99 vs. -1.09±2.14; p=0.012), and BMI-for-age Z-scores (-1.44±1.36 vs. -1.01±1.42; p=0.004) than those from Peshawar. Stunting (40% vs. 36%; p=0.027) and poor nutritional status (21.1% vs. 12.8%; p=0.031) were higher in Murree. Conclusion: Significant regional disparities in nutritional status and dietary behavior highlight the need for targeted, context-specific nutritional interventions to address malnutrition, particularly in Murree, emphasizing clinical relevance and public health applicability.