The study was carried out from May 01 to July 20, 2023 at University of Hargeisa. It is a government owned University located in Hargeisa capital city of Somaliland .

The study used an institutional based cross-sectional study design to aassess fast food consumption and its association with overweight /obesity among undergraduate students of University Hargeisa, Somaliland.

The required sample size for this study was determined by using a single population proportion formula n= with the assumptions of = 95%, P = 30.7%, d=5%P = 50%, q=1-p, 1-0.307=0.693, d=0.05, and our final sample size was 260 students.

The study participants were selected using a simple random sampling technique.

For data collection, structured questionnaire was prepared based on review literatures and dig out from related studies. It was prepared by English than translated in to local language (Somali). Translated version questionnaire was pre-tested prior to the actual data collection on 5% of sample size. The questionnaire has several sections and it has separate component for the measurement of individual anthropometric data. The anthropometric data was taken by data collectors to measure weight and height using a stadiometer. Weight was measured with minimum clothing and no shoes. Each height and weight measurement was taken twice.

Detail training for data collectors and supervisor was given for one days by the principal investigator. Furthermore, the principal investigator and supervisor were supervising the data collectors daily and make frequent checks on the data collection process and data were submitted `15 on daily basis to ensure the completeness and consistency of the gathered information. Any errors, ambiguity, incompleteness encountered were addressed on the following day before starting next day activities. Consistency was checked by re-translating the Somali version back to English by another individual who is expertise in both languages.

Data was entered and checked for errors using EPI-info version 7.1.5.0 and then, data were exported to statistical package for social sciences (SPSS) software version 21 and STATA software version 14 for data processing and analysis. The data was cleaned and edited before analysis. Data exploration was undertaken to saw if there codes or items that was not be logical and then subsequent editing was made. Descriptive statistics such as; frequencies, means and proportion was used for present the findings. A bivariable and multivariable logistic regression analysis was conducted. Variables with P-values of less than 0.25 in the binary logistic regression analysis was entered into a multivariable logistic regression analysis to identify the independent predictors of fast food consumption. Both COR and AOR with corresponding 95% CI was computed to show the strength of the association. Finally, variable at P-value less than 0.05 in multivariable logistic regression analysis was considered as a statistically significant variable.

The finding of this study showed that majority of the study participants (59.6%) who had taken fast food consumption were ranged from 21-25 years old, compared to (40.4%) those whose age between 26-42 years old. The results of this study indicates that majority of respondents (60.4%)%) who had taken fast food consumption were females, compared to (36.2%)who were male. This findings show that the most of respondents (32.8%) who had taken fast food consumptions were first year level, compared to more than above four years (20.0%). student in the 1st year group responded to the study indicates are highest consumers for fast food, there is statistical association between educational level of the respondents and having fast food consumption (p 0.020) (Table 1).

In this study, the majority 235 (90.4%, CI: 86.5- 93.8) of the study participants was fast food consumers. Only 25 (9.6%) of them haven’t use fast foods (Figure 1).

Of the total study participants 111(47%),62(26.4%),18(7.7%), 18(7.7%) of students consumed fast food, sometimes, always, mostly , and often, respectively. Regarding with number of days fast food consumed per week, 70 (29.8%),91 (38.7%) , 42 (17.9%) and 18(7.7%) were consumed fast food on an average for 1-2 days, 2-3 days, 3-4 days and more than 4 days per week respectively. Related with reason to ate fast food, 22(9.4%),130(55.3%),12 (5.1%),63(26.8%),123(52%) frequently eat fast food because it is simpler and quicker to prepare , better tastes, a less expensive cost, easier accessibility, and do not have a source of fast food at home respectively (Table 2).

In this study anthropometric measurements (height and weight) were taken to assess the student’s nutritional status. Body mass index (BMI) was calculated as weight divided by height square. Based on BMI, obesity is divided into different classes; normal range (18.5 24.9), below normal range (< 18.5), pre-obesity (25-29.9), obesity class I (30-34.9), obesity class II (35-39.9), obesity class III (above 40). Hence, the study revealed that, from the total study participants 46(17.7%),127(48.8%),84(32.3%), 3(1.2%) were underweight, normal, overweight and obese respectively (Table 3).

A chi-square test was performed to assess if there is an association between categories of BMI and fast food consumption. The result revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa (Table 4).

The bi-variable logistic regression analysis result revealed that the student’s educational level (p = 0.02), student’s pocket money (p = 0.011), where the students consume fast foods (p ≤ 0.001), family members eating fast foods (p = 0.009), fruit and vegetable consumption (p = 0.002), nutritional problem managements (p = 0.038), community knowledge about nutrition (p = 0.011) were significantly associated (p-value<0.25) with fast food consumption. On multi-variable logistic regression model educational level of the students and frequency of fruit and vegetable consumptions were found to be significantly associated with fast food consumptions (p < 0.05).

It was observed that student’s educational level was positively associated with fast food consumption. For the student of the third year were 12 times more likely to consume fast foods compared to postgraduate level students ^{AOR = 12.45 (95% CI: 1.7 14.6)}. The study also revealed that, frequency of fast food consumption was negatively associated fast food consumption. In contrast, consumption of moderate and often fruit and vegetables per week increases the likelihood of fast food consumption by 24% and 49% respectively, ^{AOR = 0.76 95% CI (0.7 0.8)}, ^{AOR = 0.51 95% CI (0.47 0.575)} (Table 5).

The University of Hargeisa's Graduate Studies School provided ethical clearance. Each participant received a brief explanation of the study's objectives before to enrollment, and they all verbally consented to participating. At every stage of data collection and processing, anonymity and confidentiality were maintained.