Description of the sample.

Background
During the 1990s, global eating habits changed, affecting poorer and middle-income nations, as well as richer countries. This shift, known as the "obesity transition," led to more people becoming overweight or obese worldwide. In Ecuador, this change is happening, and now, one in three children is affected by overweight or obesity (OW/OB). This study explores the links between social, economic, and demographic factors and childhood obesity in Ecuador, seeking to provide insights for shaping future health policies in response to this intricate shift.
Methods
A cross-sectional study using 2018 National Health and Nutrition Survey data from Ecuador. Weighted percentages were computed, and odds ratios for OW/OB unadjusted and adjusted for each category of explanatory variables were estimated using multilevel multivariate logistic regression models.
Results
Among 10,807 Ecuadorian school children aged 5 to 11, the prevalence of OW/OB was 36.0%. Males exhibited 1.26 times higher odds than females (95% CI: 1.20 to 1.33), and each additional year of age increased the odds by 1.10 times (95% CI: 1.09 to 1.10). Economic quintiles indicated increased odds (1.17 to 1.39) from the 2nd to 5th quintile (the richest) compared with the first quintile (the poorest). Larger household size slightly reduced odds of OW/OB (adjusted odds ratio [aOR] = 0.93, 95% CI: 0.91 to 0.95), while regular physical activity decreased odds ([aOR] = 0.79, 95% CI: 0.75 to 0.82). The consumption of school-provided meals showed a non-significant reduction (aOR: 0.93, 95% CI: 0.82 to 1.06). Children from families recognizing and using processed food labels had a higher likelihood of being overweight or obese (aOR = 1.14, 95% CI: 1.02 to 1.26).
Conclusion
Age, male gender, and higher economic quintile increase OW/OB in Ecuadorian school children. Larger households and physical activity slightly decrease risks. Ecuador needs policies for healthy schools and homes, focusing on health, protection, and good eating habits.

背景
20世纪90年代，全球饮食模式发生转变，这一变化波及低收入、中等收入国家与高收入国家。这一被称为「肥胖转型（obesity transition）」的趋势，使得全球范围内超重或肥胖人群数量持续增加。在厄瓜多尔，这一变化同样正在上演，目前每三名儿童中就有一名受到超重或肥胖（overweight/obese, OW/OB）的影响。本研究旨在探究厄瓜多尔社会、经济与人口统计学因素与儿童肥胖之间的关联，以期为制定应对这一复杂变化的未来卫生政策提供参考依据。

方法
本研究采用横断面研究设计，使用厄瓜多尔2018年全国健康与营养调查（National Health and Nutrition Survey）数据。研究计算了加权百分比，并采用多水平多因素logistic回归模型，估算了OW/OB在未校正与校正各分类解释变量后的比值比（odds ratio, OR）。

结果
在10807名5至11岁的厄瓜多尔学龄儿童中，OW/OB的患病率为36.0%。男性儿童的超重/肥胖风险较女性高1.26倍（95%置信区间（95% confidence interval, 95% CI）：1.20~1.33），每增加1岁，该风险升高1.10倍（95% CI：1.09~1.10）。与第一五分位组（最贫困组）相比，从第二至第五五分位组（最富裕组）的超重/肥胖风险比值比呈升高趋势（1.17~1.39）。家庭规模越大，儿童OW/OB的风险轻度降低（校正后比值比（adjusted odds ratio, aOR）=0.93，95% CI：0.91~0.95）；规律体力活动可降低该风险（aOR=0.79，95% CI：0.75~0.82）。食用学校供餐的儿童其OW/OB风险无显著降低（aOR=0.93，95% CI：0.82~1.06）。能够识别并使用加工食品标签的家庭的儿童，其超重或肥胖的风险更高（aOR=1.14，95% CI：1.02~1.26）。

结论
年龄、男性性别与更高的经济五分位分组是厄瓜多尔学龄儿童OW/OB的危险因素；大家庭规模与规律体力活动则可轻度降低该风险。厄瓜多尔需制定针对健康校园与健康家庭的政策，重点关注健康防护与良好饮食习惯的培养。