Regional and Urban–Rural Differences in Nutritional Status of First-Grade Children in Montenegro

Background: Childhood nutritional status is a key indicator of growth and development and is influenced by biological, environmental, and behavioral factors. Understanding regional and urban–rural differences is crucial for targeted public health interventions. Aim: This study aimed to examine regional and urban–rural differences in the nutritional status of first-grade children in Montenegro, using Body Mass Index (BMI) and Waist-toHeight Ratio (WHtR) as primary indicators. Methods: A cross-sectional study was conducted among 286 first-grade children aged 6–7 years from northern and central regions of Montenegro. Anthropometric measurements, including body height, body mass, and waist circumference, were collected following ISAK standards. Methods: Body Mass Index (BMI) and Waist-to-Height Ratio (WHtR) were evaluated in 286 first-grade schoolchildren (135 boys, 151 girls) from Northern and Central Montenegro, stratified by region and urban-rural environment. Data were analyzed using descriptive statistics and the Chi-square test (p<0.05). Results: No significant regional or urban-rural differences were found in BMI distribution (p>0.05). However, boys showed a high combined overweight/obesity prevalence in Northern (36.6%) and Central (30.2%) regions. For WHtR, a highly significant regional divergence was found among girls (p<0.001); girls from the Central region demonstrated a critically higher prevalence of abdominal obesity (32.8%) compared to Northern peers (8.3%). Urban-rural environment had no significant impact (p>0.05). Conclusions: These findings suggest relatively homogeneous patterns of nutritional status among first-grade children in Montenegro, regardless of region or settlement type. Nevertheless, the presence of overweight and obesity highlights the importance of early monitoring and preventive interventions. School- and community-based programs promoting healthy nutrition and physical activity are essential to mitigate childhood obesity and support long-term health outcomes.