Journals / Güncel Hemşirelik Araştırmaları Dergisi / 2026 / Cilt: 6 Sayı: 2

Association Between Body Mass Index, Visual Acuity, and Scoliosis among Fourth-Grade Primary School Children: A School-Based Cross-Sectional Study

Dördüncü Sınıf İlkokul Çocuklarında Vücut Kitle İndeksi, Görme Keskinliği ve Skolyoz Arasındaki İlişki: Okul Tabanlı Kesitsel Bir Çalışma

Beyza Gül Yildirim(SELÇUK ÜNİVERSİTESİ)0009-0003-2036-1698
Sultan Demirbağ(SELÇUK ÜNİVERSİTESİ)
Hatice Koç(SELÇUK ÜNİVERSİTESİ)
Zeynep Efe(SELÇUK ÜNİVERSİTESİ)0009-0001-0019-4963
Yusuf Emre Eyiol(SELÇUK ÜNİVERSİTESİ)0009-0002-9918-2686
Pages
118–126
Publication Date
2026-08-29
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Integrating routine anthropometric and musculoskeletal assessments into school health services may support early intervention and prevention strategies.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Childhood obesity is an important public health problem that may have significant implications not only for metabolic health but also for visual and musculoskeletal health.
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Key Findings & Data:Methods: This cross-sectional, school-based health screening study was conducted with 1,017 primary school students attending four schools in the Selçuklu district of Konya Province, Türkiye.
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Conclusion & Impact:Integrating routine anthropometric and musculoskeletal assessments into school health services may support early intervention and prevention strategies.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Çocukluk Çağı Obezitesi · Okul Sağlığı · Skolyoz

Abstract

Objective: Childhood obesity is an important public health problem that may have significant implications not only for metabolic health but also for visual and musculoskeletal health. Early identification of these health problems in school-aged children is important for planning appropriate follow-up and interventions. This study aimed to investigate the relationship between body mass index (BMI), visual acuity, and scoliosis screening outcomes among primary school children. Methods: This cross-sectional, school-based health screening study was conducted with 1,017 primary school students attending four schools in the Selçuklu district of Konya Province, Türkiye. BMI was calculated from anthropometric measurements. Visual acuity was assessed using standard vision screening tests, whereas scoliosis was evaluated using the Adams forward bend test. Data were analyzed using descriptive statistics, Pearson’s chi-square test, the likelihood-ratio chi-square test, and the independent-samples t-test. Results: The prevalence of low visual acuity significantly increased with higher BMI categories (p < 0.001). Positive scoliosis screening findings were observed in 9.8% of children with obesity, and this proportion was significantly higher than that among normal-weight peers (p < 0.001). Obese children were found to have higher proportions of low visual acuity and positive scoliosis screening findings compared with non-obese students. Conclusion: Higher BMI categories were associated with less favorable visual acuity and scoliosis screening findings. School-based screening programs may play a critical role in the early detection of obesity-related health problems. Integrating routine anthropometric and musculoskeletal assessments into school health services may support early intervention and prevention strategies.

Özet

Amaç: Çocukluk çağı obezitesi, yalnızca metabolik sağlık açısından değil, görme ve kas-iskelet sistemi sağlığı açısından da önemli sonuçlarla ilişkili olabilen önemli bir halk sağlığı sorunudur. Okul çağı çocuklarında bu sağlık sorunlarının erken dönemde belirlenmesi, uygun izlem ve müdahalelerin planlanması açısından önem taşımaktadır. Bu çalışma, ilkokul çocuklarında vücut kitle indeksi (VKİ), görme keskinliği ve skolyoz tarama sonuçları arasındaki ilişkiyi araştırmayı amaçlamıştır. Yöntem: Bu kesitsel, okul tabanlı sağlık tarama çalışması, Türkiye'nin Konya ili Selçuklu ilçesindeki dört okulda öğrenim gören 1.017 ilkokul öğrencisi ile gerçekleştirilmiştir. VKİ hesaplaması için antropometrik ölçümler yapılmış, görme keskinliği standart görme tarama testleri ile, skolyoz ise Adams öne eğilme testi ile değerlendirilmiştir. Veriler, tanımlayıcı istatistikler, Pearson ki-kare testi, olabilirlik oranı ki-kare testi ve bağımsız örneklem t-testi kullanılarak analiz edilmiştir. Bulgular: Düşük görme keskinliği prevalansı, VKİ kategorileri yükseldikçe anlamlı olarak artmıştır (p<0,001). Obez çocukların %9,8'inde pozitif skolyoz tarama bulguları gözlemlenmiş olup, bu oran normal kilolu akranlarına kıyasla anlamlı düzeyde daha yüksek bulunmuştur (p<0,001). Obez çocuklarda düşük görme keskinliği ve pozitif skolyoz tarama bulgularının, obez olmayan öğrencilere kıyasla daha yüksek oranda görüldüğü belirlenmiştir . Sonuç: Daha yüksek VKİ kategorileri, daha düşük görme keskinliği ve daha olumsuz skolyoz tarama bulguları ile ilişkili bulunmuştur. Okul temelli tarama programları, obeziteyle ilişkili sağlık sorunlarının erken teşhisinde kritik bir rol oynayabilir. Rutin antropometrik ve kas-iskelet sistemi değerlendirmelerinin okul sağlığı hizmetlerine entegre edilmesi, erken müdahale ve önleme stratejilerini destekleyebilir.

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Cite This Article

Şekerci, Y. G., Yildirim, B. G., Demirbağ, S., Koç, H., Efe, Z., Eyiol, Y. E. (2026). Association Between Body Mass Index, Visual Acuity, and Scoliosis among Fourth-Grade Primary School Children: A School-Based Cross-Sectional Study. Güncel Hemşirelik Araştırmaları Dergisi, Cilt: 6 Sayı: 2, 118–126. https://doi.org/10.65673/jcnr.1903446

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References (39)

  1. Alijanzadeh, M., Griffiths, M. D., Abbasi, M., Kakavand, E., Khaleghi, A.,. Alimoradi, Z. (2025). Prevalence of vision problems among school-entering children and association with socio-demographic characteristics: An Iranian population-based cross-sectional study. Ophthalmic Epidemiol, 32(6), 616–623. DOI:10.1080/09286586.2025.2484757.
  2. American Academy of Ophthalmology. (2016). Pediatric eye evaluations: Screening. https://www.aao.org/clinical-statement/pediatric-eye-evaluations-screening
  3. Ay-Akdoğan, S., Başpınar, M. M., & Basat, O. (2021). The frequency of obesity, hypertension, and anemia in school-aged children: A retrospective cross-sectional study from a family health center. Turk J Fam Pract, 25(3), 69–75. DOI:10.5222/tahd.2021.63935.
  4. Ayaz, S. T., Canleblebici, M., Yalçın, N., Korkmaz, M., & Yıldırım, A. (2025). Evaluation of vision problems in primary school students. Anatolian Clin J Med Sci, 30(2), 170–177. DOI:10.21673/anadoluklin.1471326.
  5. Bayartai, M. E., Schaer, C. E., Luomajoki, H., Tringali, G., & De Micheli, R. (2022). Differences in spinal posture and mobility between children/adolescents with obesity and age-matched normal-weight individuals. Sci Rep, 12(1), 15570. DOI:10.1038/s41598-022-19823-z.
  6. Bayır, B., Açıkel, B. N., Kesek, Y., & Güneş, N. (2021). Evaluation of health screening results for primary school students and determination of the effect of health education given to students on screening results. Göbeklitepe Int J Med Sci, 4(5), 51–61.
  7. Buluş, D., Aycan, Z., & Vidinlisan, S. (2017). Socioeconomic status and nutrition of childhood obesity and hypertension among primary school children. Abant Med J, 6(3), 100–106. DOI:10.5505/abantmedj.2017.80090.
  8. Buzdağlı, Y., & Tamer, K. (2022). Assessment of physical fitness of primary school students. J Natl Educ, 51(235), 2163–2178.
  9. Cetin, E., Yaman, A., & Berk, A. T. (2004). Etiology of childhood blindness in Izmir, Turkey. Eur J Ophthalmol, 14(6), 531–537. DOI:10.1177/112067210401400613.
  10. Chang, Y. C., Hsieh, W. H., Huang, S. F., Hsiao, H., Wang, Y. W., Chu, C. H.,. Wen, S. H. (2021). Sex-specific temporal trends in overweight and obesity among schoolchildren from 2009 to 2018: An age-period cohort analysis. Front Pediatr, 9, 615483. DOI:10.3389/fped.2021.615483.
  11. Demir, F. G. Ü. (2023). Scoliosis classification. J Anatol Med Res, 8(1), 1–13.
  12. Dezor-Garus, J., Niechciał, E., Kędzia, A., & Gotz-Wieckowska, A. (2023). Obesity-induced ocular changes in children and adolescents: A review. Front Pediatr, 11, 1133965. DOI:10.3389/fped.2023.1133965.
  13. De Oliveira, L. N., Costa, M. G. R., Pereira, I. O. S., Tokumoto, I. C., Leal Moreira, J. L. M., Freitas, M. C. L.,. de Oliveira Neto, H. L. (2024). Prevalence of low visual acuity in children from public schools in Northeast of Brazil. MedRxiv. (Preprints). DOI:10.1101/2024.08.01.24311293v2.
  14. Dığrak, E., Eyimaya, A. Ö., Zengin, H., & Tezel, A. (2020). Evaluation of health screening results of two public primary school students. Turk J Fam Med Prim Care, 14(2), 289–298. DOI:10.21763/tjfmpc.640069.
  15. GBD 2019 Blindness and Vision Impairment Collaborators, Vision Loss Expert Group of the Global Burden of Disease Study. (2021). Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study. Lancet Glob Health, 9(2), 130–143.
  16. Greco, E., Meo, F., & Cedrone, F. (2020). Gender differences in childhood BMI z-score, alimentary behaviour and lifestyle in a sample of 9–11 children. Clin Ther, 171(5), e425–e430. DOI:10.7417/CT.2020.2240.
  17. Irmak, A. Y., & Çelikkalp, Ü. (2022). School based adolescent health screening program results. Turk J Fam Med Prim Care, 16(2), 255–264. DOI:10.21763/tjfmpc.996975.
  18. Kaya, F., Paçacı, S., & Gunay, M. (2023). The prevalence of overweight in preschool children in Erzincan province and the cut-off values of some growth-related parameters: A cross-sectional study. Mediterr J Sport Sci, 6(Special Issue 1), 726–744. DOI:10.38021asbid.1356467.
  19. Kırağ, N., & Temel, A. B. (2016). Primary school age children determination of eye health problems with vision screening. FNJN, 24(1), 10–15. DOI:10.17672/fnhd.04425.
  20. Kozan, B. D., & Çağlayan, M. S. (2025). Evaluation of the effectiveness of the national vision screening program in school-age children. Trends Surg Sci, 4(1), 18–22.
  21. Krul, M., van der Wouden, J. C., Schellevis, F. G., van Suijlekom-Smit, L. W. A., & Koes, B. W. (2009). Musculoskeletal problems in overweight and obese children. Ann Fam Med, 7(4), 352–356. DOI:10.1370/afm.1005.
  22. Li, M., Nie, Q., Liu, J., & Jiang, Z. (2024). Prevalence of scoliosis in children and adolescents: A systematic review and meta-analysis. Front Pediatr, 12, 1399049. DOI: 10.3389/fped.2024.1399049.
  23. Neyzi, O., Bundak, R., Gökçay, G., Günöz, H., Furman, A., Darendeliler, F., et al. (2015). Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol, 7(4), 280–293. DOI:10.4274/jcrpe.2183.
  24. Oktay, G., Ceylan, E. E., Kuyucu, Y. E., Unlu, U., & Celtek, N. Y. (2025). Health screening of secondary school students in Tokat Province. HK J Paediatr, 30, 61–68.
  25. Özcan, G. H., Özcan, S., & Özer, M. K. (2024). Modeling of body mass index reference values in Turkish boys aged 5–18. Res Sports Sci, 14(1), 12–19. DOI:10.5152/rss.2024.23022.
  26. Prvulović, N., Djordjević, M., & Pantelić, S. (2023). Gender differences and climate zones in overweight and obesity prevalence in European elementary school children from 2000 to 2020: A systematic review and meta-analysis. Front Public Health, 11, 1198877. DOI:10.3389/fpubh.2023.1198877.
  27. Tezeren, H. C., & Pekyavaş, N. Ö. (2024). Does an increase in academic success affect the presence of scoliosis? A cross-sectional study on university students. Baskent Univ Fac Health Sci J, 9(3), 319–330.
  28. Tsai, C. L., Wang, J. S., Huang, C. H., & Lee, H. C. (2020). The influence of visual impairment on postural control: A pilot study in children with refractive errors. Children, 7(12), 252. DOI:10.3390/children7120252.
  29. Turkey Childhood Obesity Survey – COSI TUR 2022. (2024). Republic of Türkiye Ministry of Health, Ministry of National Education & WHO Regional Office for Europe. Health Ministry Publication No: 1295, Ankara.
  30. Turkish Ophthalmology Association. (2020). School-Age Vision Screening Guide. TOD Pediatric Ophthalmology and Strabismus Unit. https://www.todnet.org
  31. World Health Organization. (WHO). (2025). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  32. Yang, F., Yang, C., Liu, Y., Peng, S., Liu, B., Gao, X.,. Tan, X. (2016). Associations between body mass index and visual impairment of school students in Central China. Int J Environ Res Public Health, 13(10), 1024. DOI:10.3390/ijerph13101024.
  33. Zhang, J., Li, R., Zhang, Y., Li, C., Xu, B., & Qi, X. (2024). Associations between body size and visual impairment of first-year university students in Chongqing: A cross-sectional study. Medicine (Baltimore), 103(2), e35763. DOI:10.1097/MD.0000000000035763.
  34. Zhou, H. (2024). Understanding scoliosis and its impact on spinal pain and function. J Pain Manag Ther, 8(4), 218. DOI:10.35841/aapmt-8.4.218.
  35. Zou, Y., Lin, Y., Meng, J., Li, J., Gu, F., & Zhang, R. (2021). The prevalence of scoliosis screening positive and its influencing factors: A school-based cross-sectional study in Zhejiang Province, China. Res Square (Preprints). DOI: 10.21203/rs.3.rs-900481.
  36. Alijanzadeh, M., Griffiths, M. D., Abbasi, M., Kakavand, E., Khaleghi, A.,. Alimoradi, Z. (2025). Prevalence of vision problems among school-entering children and association with socio-demographic characteristics: An Iranian population-based cross-sectional study. Ophthalmic Epidemiol, 32(6), 616–623. DOI:10.1080/09286586.2025.2484757.
  37. Chang, Y. C., Hsieh, W. H., Huang, S. F., Hsiao, H., Wang, Y. W., Chu, C. H.,. Wen, S. H. (2021). Sex-specific temporal trends in overweight and obesity among schoolchildren from 2009 to 2018: An age-period cohort analysis. Front Pediatr, 9, 615483. DOI:10.3389/fped.2021.615483.
  38. De Oliveira, L. N., Costa, M. G. R., Pereira, I. O. S., Tokumoto, I. C., Leal Moreira, J. L. M., Freitas, M. C. L.,. de Oliveira Neto, H. L. (2024). Prevalence of low visual acuity in children from public schools in Northeast of Brazil. MedRxiv. (Preprints). DOI:10.1101/2024.08.01.24311293v2.
  39. Yang, F., Yang, C., Liu, Y., Peng, S., Liu, B., Gao, X.,. Tan, X. (2016). Associations between body mass index and visual impairment of school students in Central China. Int J Environ Res Public Health, 13(10), 1024. DOI:10.3390/ijerph13101024.