Objective To investigate the nutritional status and influencing factors among primary and secondary school students in Karamay District, Karamay City, Xinjiang in 2022, and to provide basis for improving their nutritional status.

Methods A stratified random cluster sampling method was used to monitor the nutritional status of students from two primary schools, two middle schools and two high schools in Karamay District. Data collected included age, gender, height and weight. A questionnaire survey was conducted among 1 529 students in grade 4 and above to investigate the influencing factors related to their nutritional status, such as boarding status, dietary habits, and behavioral patterns.

Results Among the 1 529 students, the detection rate of malnutrition was 3.31%, among which the detection rates of growth retardation, moderate to severe emaciation and mild emaciation were 0.52%, 0.72%, and 2.09%, respectively. The detection rate of over nutrition was 45.91%, with overweight and obesity rates of 20.80% and 25.11%, respectively. The results of univariate analyses showed that statistically significant differences were observed in the detection rates of mild emaciation, overweight, obesity and over nutrition across different genders (all P<0.05). Statistically significant differences were also exhibited in the detection rates of moderate to severe emaciation, obesity and over nutrition across different age groups (all P<0.05). In addition, statistically significant differences were also found in the detection rates of obesity and over nutrition across boarding status and the frequency of consuming fish, poultry, meat, and eggs at breakfast (all P<0.05). Students with different vegetable consumption frequencies showed significant differences in obesity prevalence (χ²=8.826, P=0.032), while those with varying fried food intake frequencies differed significantly in growth retardation prevalence (χ²=4.511, P=0.034). The results of logistic regression analyses revealed that the risks of overweight and obesity for boys were 1.55 and 2.32 times higher than that for girls, respectively (all P<0.05). Students within 13‒<16 years age group had 1.43 and 1.38 times higher risks of malnutrition and obesity compared to those with 6‒<13 years age group, respectively (all P<0.05). Boarding students had 0.49, 1.12, and 1.13 times higher risks of malnutrition, overweight, and obesity, respectively, compared to non-boarding students (all P<0.05).Students with breakfast including meat,fish and eggs daily had 0.58, 0.80, and 0.40 times lower the risk of malnutrition, overweight, and obesity, respectively, compared to those whose breakfast didn’t include meat, fish and eggs (all P<0.05). Students with low consumption of sugar-sweetened beverages and fried foods had 0.63 and 0.64 times lower the risk of overweight, respectively, compared to those with high consumption. Students with low fresh fruit intake frequency had 1.31 and 1.39 times higher the risk of malnutrition and overweight, respectively, compared to those with high intake frequency (all P<0.05). Students with less vegetable consumption had 1.45 and 1.40 times higher the risk of malnutrition and obesity, respectively, compared to those with more consumption of vegetables (all P<0.05). Students who engaged in moderate to vigorous physical activity (MVPA) ≥60 min/day for 1‒3 days/week and those who did not engage in MVPA had 1.11 and 1.17 times higher the risk of obesity, respectively, compared to those who engaged in MVPA ≥60 min/day for 4‒7 days/week (all P<0.05). Students who met daily sleep duration recommendations had 0.78, 0.67, and 0.72 times lower the risk of malnutrition, overweight, and obesity, respectively, compared to those who did not.

Conclusion Overweight and obesity are prominent nutritional issues among primary and secondary school students in Karamay District. Age and dietary habits are strongly associated with overweight and obesity. Boys and non-boarding students need particular attention. Targeted interventions focusing on balanced diets and physical activity should be implemented promptly, along with enhanced nutrition education to promote healthy lifestyles. Personalized intervention strategies should be developed based on age and gender to improve the nutritional status of primary and secondary school students in Karamay District.