Dietary Habits and Nutritional Status of School-Aged Children (6–12 Years): A School-Based Cross-Sectional Study from Sialkot, Pakistan

Background: School age is a critical period in which diet, physical activity and sleep shape growth and lifelong health behaviours. Few Pakistani studies have examined these domains together with nutritional status in the same school-aged sample. Objective: To assess dietary habits and nutritional status among children aged 6–12 years and to examine associations between nutritional status and selected demographic, dietary, physical-activity and sedentary-behaviour variables. Methods: This school-based cross-sectional study included 300 children from urban and rural schools in Punjab, Pakistan. A structured questionnaire adapted from validated tools, including the WHO Global School-based Student Health Survey, was used. Body mass index (BMI) was calculated from height and weight, and the recorded BMI category was used for categorical analyses. Data were analyzed with descriptive statistics, t tests, ANOVA, Pearson correlation, chi-square tests and binary logistic regression (significance, p < 0.05). Results: Of 300 children, 192 (64.0%) were girls; mean age was 9.11 ± 1.96 years and mean calculated BMI was 16.86 ± 2.37 kg/m². By recorded category, 155 (51.7%) children were under weight, 117 (39.0%) normal weight, 17 (5.7%) over weight and 11 (3.7%) obese. Daily breakfast was reported by 70.7% of children, whereas fast food and sugary snacks or drinks were eaten at least weekly by 66.0% and 74.3%, respectively. Only 3.7% played outdoors for 6–10 hours per week, and 62.7% slept fewer than eight hours daily. No categorical variable was significantly associated with BMI category, although fast-food frequency was borderline (χ² = 16.778, p = 0.052). Calculated BMI differed by school type (p = 0.045; 17 public-school children) but not by gender, residence, age group or lifestyle variables. Age correlated strongly with height (r = 0.908) and weight (r = 0.699) but not with BMI (r = −0.033). Conclusion: Recorded under weight was common and over weight/obesity less so, alongside frequent fast-food and sugary snack consumption, little outdoor play and short sleep. These findings support school-based nutrition programmes that address under nutrition and unhealthy food environments together rather than obesity alone. Nutritional-status categories should be confirmed against WHO BMI-for-age z-scores.