Dietary Habits and Lifestyle Associated with Excess Weight and Comorbidities among Schoolchildren in Cartago, Costa Rica 2023–2024: A Cross-sectional Study

Abstract

Childhood overweight and obesity, driven by an imbalance between energy intake and expenditure, are linked to increased cardiometabolic risk.
Objective: To examine the relationship between dietary habits, lifestyle factors, and the presence of excess weight, obesity, and comorbidities among schoolchildren.
Methods: Cross-sectional, quantitative study of 80 students (48 girls, 32 boys) aged 6–12 years from the educational circuit of the Central Canton of Cartago, Costa Rica (2023–2024). A structured questionnaire collected sociodemographic data, personal and family medical history, dietary practices, physical activity, and screen time.
Results: The prevalence of overweight/obesity was 28%; 29% had elevated cardiometabolic risk by waist-to-height ratio (WHtR), and 37% showed some degree of stunting. Frequent consumption of red meat, sweets, and snacks was positively associated with comorbidities, whereas regular vegetable intake and habitual breakfast consumption showed inverse associations. Weekly physical activity was protective against excess weight and comorbidities, while greater screen time was associated with sedentary behaviors and higher cardiometabolic risk.
Conclusions: Findings support school- and family-based interventions to improve diet quality, promote physical activity, and regulate screen time to reduce cardiometabolic risk in school-aged children.