{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:21:30Z","timestamp":1787595690811,"version":"build-2736575974"},"reference-count":72,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"\n Overweight and obesity remain major global public health challenges, particularly among children under five years of age in low- and middle-income countries (LMICs). This study aimed to assess the pooled prevalence of overweight\/obesity and its associated factors among children aged 6\u201359 months in 46 LMICs. We used the most recent nationally representative demographic and health surveys (2015\u20132024) from forty-six LMICs. A total of 393,638 weighted samples of children aged 6\u201359 months were included. Childhood overweight and obesity were defined as weight-for-height greater than two and three standard deviations above the WHO reference population median, respectively. Multilevel log-binomial regression models were employed. An adjusted risk ratio (\n \n \n \n \n \n \n R<\/mml:mi>\n <\/mml:mrow>\n \n R<\/mml:mi>\n <\/mml:mrow>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula>\n ) with a 95% confidence interval (CI) was used to select variables that had a significant association with childhood overweight\/obesity. A p value\u2009<\u20090.05 was used to declare statistical significance. The data were analyzed with R software (version 4.5.1). The pooled prevalence of overweight\/obesity was 3% (95% CI: 2.44, 3.58), with significant regional variation ranging from 1.62% in West Africa to 10% in the Europe and Central Asia (95% CI: 5.26, 17.84). Male sex (RR\u2009=\u20091.07, 95% CI: 1.03, 1.11), larger-than-average birth size (RR\u2009=\u20091.66, 95% CI: 1.54, 1.78), facility delivery (RR\u2009=\u20091.20, 95% CI: 1.13, 1.27), maternal smoking (RR\u2009=\u20091.61, 95% CI: 1.38, 1.87), maternal overweighed\/obesity (RR\u2009=\u20092.37, 95% CI: 2.19-2.56), media exposure (RR\u2009=\u20091.05, 95% CI: 1.01, 1.10), and rich (RR\u2009=\u20091.10, 95% CI: 1.04, 1.16) household wealth were factors associated with increased risk. Children aged 24\u201359 months had lower risk compared to those aged 6\u201323 months. Protective factors included current breastfeeding (RR\u2009=\u20090.91, 95% CI: 0.87, 0.95), interpregnancy intervals 18\u201323 months (RR\u2009=\u20090.77, 95% CI: 0.71, 0.83), and \u2265 24 months (RR\u2009=\u20090.87 95% CI: 0.83, 0.91), and multiple births (RR\u2009=\u20090.67, 95% CI: 0.57, 0.79). Contextually, children in medium\u2013human development index (HDI) (RR\u2009=\u20091.80, 95% CI: 1.62, 2.00) and higher\u2013HDI countries (RR\u2009=\u20093.57, 95% CI: 3.00, 4.24) had elevated risk. Compared to West Africa, all other regions showed significantly higher risk, with Europe & Central Asia demonstrated the strongest association (RR\u2009=\u20093.37, 95% CI: 2.90, 3.91). The pooled prevalence of overweight\/obesity among under-five children in LMICs is relatively low compared to high-income nations, yet substantial regional variation exists. Male sex, larger size at birth, maternal smoking, maternal overweight\/obesity, higher household wealth quantiles and higher-HDI were associated with increased risk of childhood overweight\/obesity, whereas current breastfeeding and longer interpregnancy intervals were protective. These findings highlight the importance of close monitoring of the problem and region-specific interventions targeting modifiable risk factors.\n <\/jats:p>","DOI":"10.1371\/journal.pgph.0006575","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:22:41Z","timestamp":1787592161000},"page":"e0006575","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pooled prevalence and associated factors of overweight\/obesity among under-five children in 46 low- and middle-income countries: A cross-sectional analysis of Demographic and Health Surveys data (2015\u20132024)"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5777-1269","authenticated-orcid":true,"given":"Dejen Kahsay","family":"Asgedom","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6350-7085","authenticated-orcid":true,"given":"Fentahun Bikale","family":"Kebede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2692-7394","authenticated-orcid":true,"given":"Simachew Getaneh","family":"Endalamew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bewuketu","family":"Terefe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon Keflie","family":"Assefa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsay Woldu","family":"Anbesu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"issue":"12","key":"pgph.0006575.ref001","article-title":"Prevalence and determinants of underweight and overweight\/obesity among Ghanaian children: a cross-sectional study using DHS data in Ghana","volume":"15","author":"KM Dam","year":"2025","journal-title":"BMJ Open"},{"key":"pgph.0006575.ref002","unstructured":"WHO. 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