Prevalence of overweight and obesity among school children and adolescents in Chennai

Correlation of anthropometric measurements with body mass index and estimation of the proportion of metabolic syndrome among overweight and obese children: a hospital-based cross-sectional study

BACKGROUND

Early identification of overweight and obesity with the help of simple anthropometric tests can prevent from development of metabolic complications in these children. Body mass index (BMI) is the most commonly used parameter but, measurements such as waist circumference (WC), waist-to-height ratio (WHtR) and wrist circumference (WrC) have also been studied and found to have a better correlation with visceral fat.

OBJECTIVE

To correlate WC, WHtR and WrC with BMI among overweight and obese children. The secondary objective was to estimate the proportion of metabolic syndrome among obese and overweight children.

METHODS

A single-centre, cross-sectional study involving 80 overweight and obese children aged 3-15 years. Anthropometric measures such as WC, WHtR and WrC of the study subjects were correlated with BMI and investigated for metabolic syndrome.

RESULTS

Statistically significant and moderate positive correlation was found between BMI and WC, r (80)=0.45 and p<0.001 with WC explaining 20% of the variation of BMI. There was a statistically significant, moderate positive correlation between WHtR and BMI r (80)=0.34 and p<0.001 with 11% of the variation in BMI. There was a statistically significant strong positive correlation between WC and WrC (80)=0.61 and p<0.001, and WrC explains 37.2% of the variation in WC. However, there was no statistically significant correlation between BMI and WrC. Metabolic syndrome was found in 13 (16.25%) children.

CONCLUSION

Alternative anthropometric measurements such as WC and WHtR have a significant correlation with BMI and may be of help in defining overweight and obesity in children. There was a statistically significant strong positive correlation between WC and WrC among obese children. Metabolic syndrome is common in these children.

Social and Demographic Factors Associated With Obese Children in the Age Group of 6-12 Years Attending a Tertiary Care Institute in Central India and the Prevalence of Depression in These Children: An Observational Study

INTRODUCTION

Childhood obesity in India is on the rise and is rarely raised as a concern. In the central Indian states, focus is largely on undernutrition. Thus, studies related to risk factors for being overweight and obese and the impact of obesity on the psychology of children are lacking. Hence, a hospital-based study with objectives to identify social and demographic factors associated with obesity and the estimation of the prevalence of depression among these children was conducted.

METHODS

This observational study was conducted in a tertiary care institute in the state of Chhattisgarh from July 2020 to October 2021. Children with obesity as per the WHO (> 95th percentile for the BMI) in the age group of 6-12 years were included after due consent. A proforma was administered targeting the objectives of the study and the Childhood Depression Rating Scale (CDR-S) and clinical evaluation identified the depressed.

RESULTS

Among the 5,019 children screened during the study period, 54 met the inclusion criteria (1.07%). Fifty percent of children were from the upper middle class as per the Kuppuswamy scale. Seventy percent consumed junk food more than three times a week. Twenty-three children (42.6%) engaged in physical activity of > 1 hour and 49(90.7%) had a screen time of > 2 hours. The prevalence of depression among these children stood at 5.6% with the mean age being 11.67 years. Multiple logistic regression showed an inverse association of depression with physical activity.

CONCLUSION

Obesity is prevalent in higher socioeconomic groups. Many risk factors like screen time, junk food consumption, and physical activity are modifiable. The prevalence of depression increased with age. Physical activity showed an inverse relation to depression in obese children.

Effectiveness of Health Promotion Curriculum in Enhancing Non-communicable Diseases Health Literacy in Indian Youth

Background

There is a theory-praxis gap related to health literacy interventions focused on non-communicable diseases (NCDs) among young people. We designed an NCD curriculum and investigated its’ effect on health literacy in non-medical, non-nursing college students in India. We deliberately selected non-medical and non-nursing college students (age 17 to 22 years) as we hypothesized, they would have a minimum baseline knowledge of NCDs.

Methods

We initially carried out a pilot study on 85 students in a four-day-long workshop (32 teaching hours) using empirically developed health literacy instrument. We administered the curriculum to 120 randomly selected students in four colleges, while 50 students were assigned to the comparison group. The curriculum was given over four days for a total of 32 hours. Approval was sought to give four credits for completion of the course. Each lecture comprised didactics, followed by discussion, and skills testing of measuring blood pressure and blood sugar. Health literacy was measured using a specifically designed tool at baseline and endline. The difference in health literacy scores between the two time-points (timepoint 1: before delivering the curriculum, time-point 2: at the end of four days of training) was analyzed using the t-test. Multiple linear and Poisson regression models were used to account for covariates.

Results

The average difference between the intervention and the control group in baseline scores was 0.05% points (unpaired t-test statistics: -1.36, degrees of freedom 103.15, p>0.05). The same at endline was 20.59% points (unpaired t-test statistics: -11.31, degrees of freedom 138.14, p<0.001). The endline to baseline difference in health literacy scores was 18.54% points higher in the intervention group versus the control group (unpaired t-test statistics: -10.88, degrees of freedom 161.32, p<0.001). The difference-in-difference scores remained significant after accounting for college setting and baseline score (Multivariable linear regression model, β: 19.62% points, p<0.001). None of the socio-economic characteristics were significantly associated with the difference in the difference scores, independent of the intervention effect. The proportion of participants scoring 40% or above on the health literacy measure at endline was significantly higher in the intervention versus the control group (p<0.001).

Conclusions

We provide empirical data to support the incorporation of NCDs as a credit course in college curricula in low- and middle-income countries. Our findings showed that a theory-driven skills-focused curriculum may be a tool for enhancing NCD health literacy in Indian youth from diverse academic and socio-economic backgrounds.

Management of Obesity and Its Complications in Children and Adolescents

Pediatric overweight/obesity has assumed epidemic proportions in India. It is associated with several significant complications and tracks into adulthood. The mainstay of management is a holistic lifestyle modification that must be adopted by the family as a whole. It involves dietary changes, regular physical activity, and behavioral changes that favor a healthy way of life. Regular follow-up, and attention to keeping up the motivation of the child and family achieves good results. In the present paper, a stepwise approach to prevention and management of childhood obesity is presented along with the recommendations for screening and management of associated complications and the role of pharmacotherapy and bariatric surgery.

Impact of a behaviourally focused nutrition education intervention on attitudes and practices related to eating habits and activity levels in Indian adolescents

OBJECTIVE

To evaluate the effectiveness of a behaviourally focused nutrition education (NE) intervention based on the Health Belief Model (HBM) to improve knowledge, attitudes and practices (KAP) related to eating habits and activity levels in 10–12-year-old adolescents in Mumbai, India.

DESIGN

School-based cluster randomised controlled trial. The experimental group (EG) received weekly NE and three parent sessions over 12 weeks; no sessions were conducted for the control group (CG). The theoretical framework of HBM and focus group discussion results guided the development of behaviour change communication strategies and NE aids. KAP were measured using a validated survey instrument, administered at baseline and endline in EG and CG. Paired and independent t tests determined within-group and between-group changes in pre–post scores.

SETTING

Two aided and two private schools that were randomly allocated to either an EG or CG.

PARTICIPANTS

Adolescent boys and girls (n 498; EG n 292 and CG n 206).

RESULTS

EG reported improvements in mean knowledge (39·3%), attitude (7·3 %), diet (9·6 %) and activity practice (9·4%) scores from pre to post intervention. No significant changes were observed in CG. Significant improvements in scores associated with perceived benefits, barriers and self-efficacy, breakfast and vegetable consumption, and moderate-to-vigorous activities were observed in EG.

CONCLUSIONS

Integrating NE into the academic curriculum and adopting evidence-based lessons that entail targeted information delivery and participatory activities can improve knowledge, foster right attitudes and facilitate better eating and activity-related practices in Indian adolescents.

Magnitude of Overweight and Obesity and Associated Factors Among Public and Private Secondary School Adolescent Students in Mekelle City, Tigray Region, Ethiopia, 2019: Comparative Cross-Sectional Study

BACKGROUND

Overweight and obesity emerged as one of the most serious public health concerns in adolescents. Overweight and obesity are problems of not only high income but also low-middle income countries. Therefore, this study aimed to assess the magnitude and associated factors of overweight and obesity among public and private secondary school adolescents in Mekelle city, Tigray, Ethiopia, 2019.

MATERIALS AND METHODS

A school-based comparative cross-sectional study was conducted in Mekelle city, from April to May 2019. A multi-stage sampling technique was used to select 858 participants. Chi-square test was checked before bivariate logistic regression analyses. All variables at a p-value <0.25 in bivariate logistic regression were entered into a multivariable logistic regression to determine the association between a set of independent variables with the dependent variable. Finally, statistical significance was declared at a p-value <0.05.

RESULTS

The magnitude of overweight and obesity in private and public schools were 11.8% and 3.9%, respectively. Consuming dinner not daily [AOR=5.3:95% CI=1.93-14.6] and working moderate-intensity sports at least 10 minutes/day continuously [AOR=0.19:95% CI=0.04-0.9] were associated factors of overweight and obesity in public school adolescent students. Being female [AOR=2.03:95% CI=1.08-3.8], time taken from home to public physical activities ≤15 minutes [AOR=3.6:95% CI=1.13-11.51], using transport from school to home [AOR=2.2:95% CI=1.06-4.18] and good knowledgeable adolescents [AOR=0.5:95% CI=0.27-0.9] were associated factors of overweight and obesity in private schools.

CONCLUSION

The magnitude of overweight and obesity was higher among private schools. Consuming dinner not daily and working moderate-intensity sports at least 10 minutes/day continuously were the associated factors for the occurrence of overweight and obesity in public school adolescent students. Being female, time taken from home to public physical activity facilities ≤15 minutes, using transport from school to home, and nutritional knowledge status of adolescents were associated factors for overweight and obesity in private school adolescent students.

Double burden of malnutrition among adolescents in rural West Bengal, India

OBJECTIVES

The aims of this study were to investigate the prevalence of underweight, stunting, and overweight among adolescents in rural West Bengal, India, and identify factors contributing to these forms of malnutrition.

METHODS

This was a cross-sectional study conducted within the Birbhum Health and Demographic Surveillance System in West Bengal, India. Participants were male and female adolescents 10 to 19 y of age (N = 5521). Body mass index (BMI) was calculated using measured heights and weights and z-scores based on the 2007 World Health Organization growth standards. Information on demographic characteristics, diet, and health behaviors was collected through face-to-face interviews using a standardized questionnaire. Modified Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between each risk factor and outcome.

RESULTS

The proportion of underweight was 26.6% overall: 31.1% among boys, and 21.1% among girls. The proportion of stunting was 25% overall: 23.3% among boys and 26.9% among girls. Of the participants, 4.6% were overweight or obese: 4.1% boys and 5.2% girls. Compared with boys, girls had a reduced likelihood of being underweight (adjusted PR, 0.67; 95% CI, 0.59-0.75). Multivariate models also showed that socioeconomic status was strongly associated with all nutritional outcomes. Not having a toilet facility in one's household and poor hand hygiene were also associated with a greater likelihood of stunting.

CONCLUSION

The present results suggested that adolescents in Birbhum, India are substantially affected by the double burden of malnutrition. Nutritional interventions should incorporate efforts to reduce socioeconomic inequality.

Rural Childhood Obesity - An Emerging Health Concern

BACKGROUND

Childhood obesity is growing globally as an epidemic. It is the most common metabolic disease identified in children.

OBJECTIVE

To assess the nutritional status of school going children in Poonamallee, Tamil Nadu and to compare the nutritional status between urban and rural school children.

METHODS

A retrospective review of the school health records over a period of 9 months was done with Institutional Ethics Committee (IEC) approval for a total of 1,803 children aged 5 to 18 years (916- rural, 887-urban). Revised IAP growth charts (2015) were used to classify their nutrition status.

RESULTS

The overall prevalence of overweight/obesity and thinness/severe thinness in our study was 20% and 9.4%, respectively. In the rural schools, the prevalence of overweight/obesity and thinness was 16.2% and 12.2%, respectively, whereas in the urban schools, it was 24% and 6.4%, respectively. The rural school children had lower mean Z scores of weight for age, height for age, and BMI for age compared to urban children (P < 0.001).

CONCLUSION

Among rural school children overweight/obesity is more prevalent than undernutrition. There is an urgent need for nutrition education for the school children and community.

Childhood Obesity and Its Associated Factors among School Children in Udupi, Karnataka, India

Background

Childhood obesity has become a serious public health problem in many low-and-middle income countries. This study aims to determine the prevalence and assess the factors associated with obesity among school children.

Methods

A cross-sectional school-based study was conducted among the 1185 secondary school students in Udupi, India. Data were collected using self-administered questionnaires. Weight and height were measured and Body Mass Index (BMI) was calculated. The z-score was calculated, and BMI was categorized based on its distribution by gender and age according to the World Health Organization (WHO). The BMI categories were reported as frequencies and percentages. Chi-square tests, followed by multiple logistic regressions, were used at 5% level of significance to identify factors associated with overweight and obese children.

Results

The overall prevalence of overweight and obese children was found to be 10.8% and 6.2%, respectively. Both ‘overweight’ and ‘obese’ were found more frequently among males (11.0% and 7.1%, respectively) than females (10.6% and 5.4%, respectively). Attending private schools, (AOR: 2.87, CI: 1.55–5.31), identifying as Muslim (AOR: 2.26, CI: 1.39–3.67), and having a father with a business occupation (AOR: 2.43, CI: 1.05–5.62) were found to be significantly associated with overweight/obese status.

Conclusion

We found a high prevalence of overweight and obese children in our study. Since obesity in adulthood has its onset in childhood, it is important to have effective implementation of school health activities to reduce and curb the burden of childhood obesity.

Sodium Glucose Co-transporter-2 Inhibitor: Benefits beyond Glycemic Control

Type 2 diabetes mellitus (T2DM) is a family of metabolic disorders characterized by hyperglycemia as a consequence of abnormalities in insulin secretion and insulin sensitivity. It affects hundreds of millions of people worldwide and leads to increased morbidity, compromised quality of life, higher mortality sodium glucose co-transporter 2 (SGLT2) inhibitors, a new class of oral antidiabetic drugs, have garnered considerable attention in the recent past and are considered potential first-line candidates for the management of T2DM. This review outlines the evidence-based therapeutic efficacy, safety, limitations, and advantages of SGLT2 inhibitors in the management of T2DM. SGLT2 inhibitors work by preventing the kidneys from reabsorbing glucose back into the blood, leading to increase in excretion of glucose through urine, thereby lowering hyperglycemia. Treatment with SGLT2 inhibitors improves A1C levels, reduces blood pressure and body weight, and is overall well tolerated by patients with T2DM. However, additional data on long-term cardiovascular safety are still needed. Characteristic adverse events include mild genital - urinary tract infection more commonly seen in women than in men, but serious infection is uncommon. Their use should be exercised with extra caution in patients suffering from renal impairment. Further, advancing to dual/triple combinational therapies with SGLT2 inhibitors and existing oral antidiabetic options may prove to be a breakthrough in the management of T2DM.

Socioeconomic differences in prevalence of biochemical, physiological, and metabolic risk factors for non-communicable diseases among urban youth in Delhi, India

This study examined whether the distribution of biochemical, physiological, and metabolic risk factors for non-communicable diseases (NCDs) among children and youth in urban India vary by socioeconomic status (SES). Data were derived from a cross-sectional survey of students enrolled in the 2nd and 11th grades in 19 randomly selected schools in Delhi (N = 1329) in 2014-15. Mixed-effect regression models were used to determine the prevalence of risk factors for NCDs among private (higher SES) and government (lower SES) school students. After adjusting for age, gender, and grade we found the percentage of overweight (13.16% vs. 3.1%, p value < 0.01) and obese (8.7% vs. 0.3%, p value < 0.01) students was significantly higher among private relative to government school students. Similarly, significantly higher percentage of private school students had higher waist circumference values (7.72% vs. 0.58%, p value < 0.01) than government school students. Furthermore, similar trend was observed across schools in the distribution of other NCD risk factors: raised blood pressure, raised total cholesterol, and low-density lipoprotein. Surprisingly, despite a higher prevalence of all risk factors, significantly higher percentage of private school students had adequate/ideal levels of high-density lipoprotein. Overall, the risk profile of private school students suggests they are more vulnerable to future NCDs.

Prevalence of childhood and adolescent overweight and obesity in Asian countries: a systematic review and meta-analysis

INTRODUCTION

We conducted a systematic review and meta-analysis to estimate the prevalence of overweight and obesity in children (aged 5-12 years) and adolescents (aged 12-19 years) in Asian countries. Study design: Systematic review and meta-analysis.

MATERIAL AND METHODS

We comprehensively searched specialised databases for relevant studies conducted in Asian countries between January 1, 1999, and May 30, 2017. Random effects models (using the DerSimonian-Laird method) and generic inverse variance methods were used for quantitative data synthesis. Sensitivity analysis was conducted using the 'leave-one-out' method. Heterogeneity was quantitatively assessed using the I² index. Systematic review registration: CRD42016033061.

RESULTS

Among 22,286 identified citations, 41 studies met the inclusion criteria with n = 71,998 and n = 353,513 for children and adolescents. The pooled prevalence (overall, boys and girls) was 5.8% (n = 4175), 7.0% (n = 2631) and 4.8% (n = 1651) for obesity in children aged 5-11 years; 8.6% (n = 30,402), 10.1% (n = 17,990) and 6.2% (n = 10,874) for obesity in adolescents age 12-19 years. For overweight in children the values for overall, boys and girls were 11.2% (n = 7900), 11.7% (n = 4280) and 10.9% (n = 3698) respectively; and for overweight in adolescents, 14.6% (n = 46,886), 15.9% (27,183), and 13.7% (20,574). These findings were robust in sensitivity analyses. In children and adolescents a higher percentage of boys than girls are obese (children = 7.0 vs. 4.8%, adolescents = 10.1 vs. 6.2%, p < 0.001, respectively). Furthermore, in children and adolescents a higher percentage of boys than girls are overweight (children = 11.7 vs. 10.9%, adolescents = 15.9 vs. 13.7%, p < 0.001, respectively).

CONCLUSIONS

In view of the number of children who are overweight or obese, the associated detrimental effects on health, and the cost to health-care systems, implementation of programmes to monitor and prevent unhealthy weight gain in children and adolescents is needed throughout Asian countries.

Prevalence and associated factors of overweight/ obesity among children and adolescents in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Overweight and obesity can be defined as excessive and abnormal fat depositions in our body. They have become one of the emerging and serious public health concerns of the twenty-first century in low income countries like Ethiopia. Hence, the aim of this study was to determine the pooled prevalence and review associated risk factors of overweight/obesity among children and adolescents in Ethiopia.

METHOD

The articles were identified through explicit and reproducible electronic search of reputable databases (PubMed, Google scholar, Science Direct, EMBASE, Cochrane library), and the hand search of reference lists of previous prevalence studies to retrieve more related articles. The 18 studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. Since the included studies exhibited considerable heterogeneity, a random effect model was used to estimate the pooled prevalence of overweight/obesity. Moreover, the risk factors of overweight/obesity were reviewed.

RESULTS

The combined pooled prevalence of overweight and obesity among children and adolescents in Ethiopia was 11.30% (95% CI: 8.71, 13.88%). Also, the separate pooled prevalence of overweight and obesity were 8.92 and 2.39%, respectively. Subgroup analysis revealed that the highest overweight/obesity prevalence among children and adolescents was observed in Addis Ababa, 11.94 (95% CI: 9.39, 14.50). Female gender of the children: 3.23 (95% CI 2.03,5.13), high family socioeconomic status: 3.16 (95% CI 1.87,5.34), learning in private school: 3.22 (95% CI 2.36,4.40), physical inactivity: 3.36 (95% CI 1.68,6.72), sweet nutriments preference: 2.78 (95% CI 1.97,3.93) and less use of fruits/vegetables: 1.39 (95% CI 1.10,1.75) have shown a positive association with the development of overweight/obesity among children and adolescents.

CONCLUSION

The pooled prevalence of overweight/obesity among children and adolescents in Ethiopia is substantially high, and has become an emerging nutrition linked problem. Female gender, high family socioeconomic status, learning in private school, physical inactivity, sweet nutriments preference and less use of fruits/vegetables were found to be significantly associated with overweight/obesity.

Prevalence of cardiometabolic risk factors in a nationally representative sample of Iranian children and adolescents: the CASPIAN-V Study

Introduction: This study presents the prevalence of cardiometabolic risk factors in a nationally representative sample of Iranian children and adolescents. Methods: This multi-centric study was conducted in 2015 among 4200 students aged 7-18 years. They were selected by multistage cluster sampling from 30 provinces of Iran. Anthropometric indices, biochemical and clinical parameters were measured. Results: The mean of weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG) was higher in boys than in girls (P < 0.05). The mean of triglyceride (TG), total cholesterol (TC) and low-density lipoprotein (LDL) levels were higher in girls than in boys (P < 0.05). The mean of weight, height, WC, SBP, DBP, alanine transaminase (ALT) and body mass index (BMI) was higher in urban than in rural residents (P < 0.05). Overall, 16.1%, 9.4% and 11.4% were underweight, overweight and obese. Abdominal obesity was documented in 21.6% of boys and 20.5% of girls. Low HDL-C was the most prevalent abnormality of lipid profile (29.5%) followed by high serum TGs (27.7%). Low HDL-C was more prevalent in boys than in girls (32.7% vs. 26%, respectively, P < 0.05). Prevalence of obesity and overweight were higher in girls than in boys (P < 0.05). The prevalence of obesity and overweight, abdominal obesity, and low HDL-C were higher in urban than in rural residents (P < 0.05). Conclusion: We found considerably high prevalence of some cardiometabolic risk factors including overweight and obesity, low HDL-C and hypertriglyceridemia in Iranian children and adolescents. The current findings underscore the necessity of intensifying health interventions for primordial and primary prevention of non-communicable diseases from early life.

Estimation of Dental and Bone Age in Obese Children of South India

Aim:

Determination of skeletal and dental age is very essential for Pediatric dentist and orthodontist to formulate a treatment plan, and it is a source of supplemental information for Pediatrics, Orthopedics, and Forensics. There are no available studies in the literature about the comparison of dental and bone age with chronological age in obese children of south India. Accordingly, the aim of this study was to evaluate and compare dental age, bone age, and chronological age in obese children of south India.

Materials and Methods:

Ethical approval was obtained from the ethical committee of college, and informed consent was obtained from parents of the study participants. A total of 100 obese study participants were selected between 8 to 14 years age group. Date of birth was considered to obtain chronological age. Demirjian's method was used to assess dental age. Bjork, Grave, and Brown's method was followed to detect bone age using hand-wrist radiograph. The comparison of three ages was done using the unpaired Student's t-test and Pearson's correlation coefficient.

Results:

Dental age and bone age were advanced in comparison to chronological age in both sexes and its statistically significant (P < 0.001). There was a positive correlationship between three ages in both sexes.

Conclusion:

As per our study, dental age and bone age were advanced in obese children, but dental age was more advanced. Dental age and bone age can be considered as variables for diagnosing the impact of growth in obese children. In the future, further studies are required to support our findings.

Comparison of structured and unstructured physical activity training on predicted VO2max and heart rate variability in adolescents - a randomized control trial

BACKGROUND

Physical inactivity contributes to many health issues. The WHO-recommended physical activity for adolescents encompasses aerobic, resistance, and bone strengthening exercises aimed at achieving health-related physical fitness. Heart rate variability (HRV) and maximal aerobic capacity (VO2max) are considered as noninvasive measures of cardiovascular health. The objective of this study is to compare the effect of structured and unstructured physical training on maximal aerobic capacity and HRV among adolescents.

METHODS

We designed a single blinded, parallel, randomized active-controlled trial (Registration No. CTRI/2013/08/003897) to compare the physiological effects of 6 months of globally recommended structured physical activity (SPA), with that of unstructured physical activity (USPA) in healthy school-going adolescents. We recruited 439 healthy student volunteers (boys: 250, girls: 189) in the age group of 12-17 years. Randomization across the groups was done using age and gender stratified randomization method, and the participants were divided into two groups: SPA (n=219, boys: 117, girls: 102) and USPA (n=220, boys: 119, girls: 101). Depending on their training status and gender the participants in both SPA and USPA groups were further subdivided into the following four sub-groups: SPA athlete boys (n=22) and girls (n=17), SPA nonathlete boys (n=95) and girls (n=85), USPA athlete boys (n=23) and girls (n=17), and USPA nonathlete boys (n=96) and girls (n=84).

RESULTS

We recorded HRV, body fat%, and VO2 max using Rockport Walk Fitness test before and after the intervention. Maximum aerobic capacity and heart rate variability increased significantly while heart rate, systolic blood pressure, diastolic blood pressure, and body fat percentage decreased significantly after both SPA and USPA intervention. However, the improvement was more in SPA as compared to USPA.

CONCLUSIONS

SPA is more beneficial for improving cardiorespiratory fitness, HRV, and reducing body fat percentage in terms of magnitude than USPA in adolescent individuals irrespective of their gender and sports activities.

Overweight and Obesity in Schoolchildren: Hierarchical Analysis of Associated Demographic, Behavioral, and Biological Factors

Studies focused on the mechanisms involved in the development of obesity in children and adolescents have reported associations between this condition and birth weight, sedentary lifestyle, and hereditary conditions. However, few studies have simultaneously evaluated these factors. This cross-sectional study aims to identify demographic, behavioral, and biological factors associated with overweight/obesity in children and adolescents. 381 schoolchildren aged seven to 17 years were included in the study to evaluate the associations between overweight/obesity and biological factors (including family history of obesity, birth weight, and the fat mass and obesity-associated (FTO) rs9939609 polymorphism), demographic variables (including gender and age), and behavioral variables (including physical activity and/or sports participation). The results of this study showed that there was a lower prevalence of obesity in schoolchildren aged 11-17 years (PR: 0.89; p=0.004). Obesity was more prevalent in children whose father (PR: 1.24; p < 0.001) and maternal grandmother (PR: 1.16; p=0.019) were obese. Higher prevalence rates of obesity were also identified in schoolchildren who were overweight at birth (PR: 1.18; p=0.002) and carriers of the obesity risk genotype (PR: 1.13; p=0.016). Biological factors, such as family history of obesity, overweight at birth, and the presence of the fat mass and obesity-associated rs9939609 polymorphism were associated with the prevalence of obesity in children and adolescents.

A Prospective Study of Homocysteine and its relation to Body Mass Index and Lipid Profile in School Children

OBJECTIVE

To study the serum Homocysteine levels in children and its relation with body mass index (BMI), lipid profile and plasma glucose.

Methods

138 children (age 5-15 y) were enrolled and categorized into normal, overweight and obese group. Blood homocysteine, lipid profile and plasma glucose were estimated.

RESULTS

Out of 138 children, 46 (33%) were normal, 40 (29%) were overweight and 52 (38%) were obese. Hyper-homocysteinemia was found in 34 (24.6%) of children. None of the normal children had hyperhomocysteinemia in contrast to 15 (37.5%) in overweight and 19 (36.5%) in obese group (P=0.001).The median homocysteine levels in obese and overweight children was significantly higher compared to normal children (P=0.001).There was a positive correlation between BMI and homocysteine levels. There was no significant correlation between lipid profile and plasma glucose with homocysteine levels.

CONCLUSION

Serum homocysteine levels are significantly higher in both overweight and obese children compared to normal children.

A Cross-sectional Prospective Study of Asymptomatic Urinary Abnormalities, Blood Pressure, and Body Mass Index in Healthy School Children

Introduction

Screening school children for urinary abnormalities is an inexpensive task but is not commonly undertaken in India. Although debated in western countries, its utility in early diagnosis of kidney disorders has been proved by studies from Asia. We examined the prevalence of asymptomatic urinary abnormalities (AUA), obesity, and hypertension in school children and analyzed data to identify potential risk factors among those detected with such abnormalities.

Methods

Children and adolescents 8 to 18 years of age of either gender, attending 14 public schools in West Bengal, were screened prospectively from July 2013 to July 2016 for detecting asymptomatic urinary abnormalities by a spot urine test using a dipstick. Sociodemographic profile, medical examination (weight, height, and blood pressure), and questionnaire-based data were recorded.

Results

A total of 11,000 children were screened. Of these, data from 9306 children were available for AUA, obesity, and hypertension. The prevalence rate was 7.44% (95% confidence interval [CI] = 6.91%−7.97%) for at least 1 AUA. Isolated hematuria was present in 5.2% (95% CI 4.75%−5.65%), whereas isolated proteinuria was present in 1.9% (95% CI = 1.62%−2.18%). The prevalence of prehypertension was 13.43% (95% CI = 12.74%−14.12%) and that of hypertension and abnormal body mass index was 4.05% (95% CI = 6.43%−7.47%) and 38.67 (95% CI = 37.68%−39.66%) respectively.

Discussion

The prevalence rates of AUA were comparable with those in some Asian countries but higher than in most developed countries. Of children and adolescents 8 to 18 years of age, those 13 to 18 years had significantly more high risk factors such as AUA, hypertension, and obesity.

Prevalence of obesity in elementary school children and its association with dental caries

Objectives

To investigate the prevalence of obesity among elementary school children and to examine the association between obesity and caries activity in the mixed dentition stage.

Methods

This cross-sectional study was conducted in King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between September 2014 and June 2015 using a multi-stage stratified sample of 915 elementary school children (482 boys, 433 girls) in Jeddah, Saudi Arabia. Anthropometric measurements, consisting of height, weight, body mass index (BMI), and waist circumference (WC), were obtained. Children were classified as underweight/healthy, overweight, or obese and as non-obese or obese according to their BMI and WC, respectively. Each child’s caries experience was assessed using the decay score in the primary and permanent teeth.

Results

Based on BMI, 18% of children were obese, 18% were overweight, and 64% were underweight/normal. Based on WC, 16% of children were obese, and 84% were non-obese. Girls had a significantly higher prevalence of obesity based on WC measurements (p<0.001), but not BMI. Children enrolled in private schools had a significantly higher prevalence of obesity (p<0.05) than those in public schools. For primary and permanent teeth combined, children with higher BMI and WC had a lower prevalence of caries (p<0.05).

Conclusion

The prevalence of obesity was high among male and female elementary school children. Overall caries activity was inversely proportional to BMI and WC.

Influence of Socioeconomic Status on Knowledge of Obesity and Diabetes among Adolescents in Chennai, South India

The Obesity Reduction and Awareness of Non-communicable disease through Group Education (ORANGE) Phase II program, is a school-based intervention aimed at healthy lifestyle practices for sixth and seventh grade adolescents (n = 2345) attending private (n = 1811) and government (n = 534) schools in Chennai. The objectives of this paper are (a) to describe the intervention activities and their outcomes qualitatively and (b) to report changes in body mass index (BMI) of the intervention group participants. This intervention strategy used a teacher-peer-training model in each school for long-term sustainability of the lessons learned from this program. During each intervention session, teachers led a classroom discussion on the health topic of interest, and peers facilitated small-group learning activities. Anthropometric measurements of participants were assessed pre- and post-intervention. We found government school students perceived hygienic actions (e.g., drinking clean water, taking baths daily) as healthy habits for preventing diabetes, whereas private school students associated an expensive lifestyle (e.g., eating at restaurants, riding a car) with diabetes prevention. Overall, the mean post-intervention BMI (18.3 kg/m²) was in the normal range compared to the pre-intervention BMI (17.7 kg/m²) (p < 0.0001). These results suggest that future interventions should be tailored for adolescents from different socio-economic groups while acknowledging their varied perceptions.

The Emerging Nutritional Problems of School Adolescents: Overweight/Obesity and Associated Factors in Jimma Town, Ethiopia

BACKGROUND

Globally, overweight is rapidly becoming one of the most important medical and public health problems. Adolescent obesity is a multisystem disease with potentially devastating consequences that persist into adulthood. However, there is a paucity of available information regarding the adolescent overweight and obesity in Ethiopia, particularly in the study area.

METHODS

A school-based cross-sectional study was conducted from March to April/2015 among 546 adolescents. Study participants were selected using a multi-stage, stratified random sampling method. An interviewer administered questionnaire was used to collect data. Multivariable logistic regression analysis was used to identify independent predictors of overweight and obesity at 95% confidence intervals.

RESULTS

The mean dietary diversity score of school adolescents was 6.97±1.15. Cereal based diets (99.6%) and vegetables (73.9%) are the two common foods of adolescents. The prevalence of overweight/obesity was 13.3%. Overweight/Obesity was significantly associated with being a female (AOR=3.57 [95% CI:1.28-9.9]), attending private schools (AOR=7.53 [2.51-22.3]), lack of paternal education (AOR=5.57 [95% CI:1.53-20.26]), wealthy households (AOR=3 [95% CI:1.09-8.26]) and not being a vegetarian (AOR=9.23 [95% CI:1.68-50.8]). Adolescents who are physically inactive (AOR=3.7 [95% CI:1.06-13.02]) and those with sedentary lifestyles (AOR=3.64 [95% CI:1.39-9.5]) were more obese compared to their counter peers.

CONCLUSIONS

The proportion of overweight/obesity among school adolescent was considerably high. Being a female, learning in private school, high household economic status, not being a vegetarian and having a sedentary life were significantly associated with overweight/obesity.

PRACTICE IMPLICATIONS

Findings of this study can be used to guide the development of programs aimed at preventing overweight/obesity in Ethiopia by informing policymakers and other stakeholders about this emerging nutrition-related problem among school adolescents.

Childhood overweight, obesity and associated factors among primary school children in dire dawa, eastern Ethiopia; a cross-sectional study

Background

Obesity in children is increasing worldwide. Malnutrition has become a double burden challenge of public health concern in developing countries. Childhood obesity increases the risk of chronic disease in childhood as well as adulthood. However, information is very scarce about childhood obesity in developing countries specifically in Ethiopia. Therefore, we aimed to assess childhood overweight, obesity and associated factors among primary school children at Dire Dawa, Eastern Ethiopia.

Methods

A school based cross-sectional study was conducted in Dire Dawa from 1^st to 30^th March, 2016. Study participants were selected using multistage sampling method. Pre-tested self-administered questionnaire, face to face interview technique and anthropometric measurements were used to collect data by eight well trained data collectors. Data were coded, cleaned and entered into EpiData software version 3.5.1, and exported into SPSS (version 21.0) statistical software, for data analysis. Bivariate and multivariate logistic regression were carried out to identify associated factors with childhood overweight and obesity. Statistical significance was declared using Adjusted Odds Ratio (AOR) at 95% CI and p-value less than 0.05.

Results

The prevalence of overweight and obesity were 14.7% (95% CI: 11.7, 18.0) and 5.8% (95% CI: 3.6, 8.0), respectively. Children who were from private school (AOR = 3.4, 95% CI: 1.4, 8.5), from families belonged to high socioeconomic class (AOR = 16.9, 95% CI: 6.5, 23.9), preferred sweetened foods (AOR = 2.3, 95% CI: 1.1, 5.1), had not engaged in regular physical exercise (AOR = 3.8, 95% CI: 1.5, 9.8), had experienced sedentary life style like spent their free time watching TV (AOR = 3.6, 95% CI: 1.6, 7.9), play computer game (AOR = 4.6, 95% CI:1.4,15.4), and were not having close friends (AOR = 2.9, 95% CI: 1.4, 6.2) were significantly associated with overweight/obesity risk.

Conclusion

Overweight/obesity in children is on alarming stage in the study area. Therefore, more attention should be given to creating awareness about healthy diet and improving life style through school and public media in collaboration with concerned bodies.

Overweight and Obesity among Adolescents, A Comparative Study Between Government and Private Schools

OBJECTIVE

To compare prevalence of overweight/obesity among adolescent school children of government and private schools.

METHODS

A school-based cross-sectional study was conducted in 1800 children aged 10-16 years. Body mass index (BMI), Waist circumference (WC), Hip circumference (HC), and Neck circumference (NC) were measured using standard guidelines.

RESULTS

The prevalence of overweight obesity was 27.8% (private schools 45.2%, government schools 10.5%). BMI, WC, NC, and Waist-hip ratio were significantly higher among private school students.

CONCLUSION

A differential strategic plan may be needed to prevent and control obesity among adolescent school children.

Correlation of Insulin Resistance with Anthropometric Measures and Blood Pressure in Adolescents

BACKGROUND

Blood pressure is directly related to body mass index, and individuals with increased waist circumference have higher risk of developing hypertension, insulin resistance, and other metabolic changes, since adolescence.

OBJECTIVE

to evaluate the correlation of blood pressure with insulin resistance, waist circumference and body mass index in adolescents.

METHODS

Cross-section study on a representative sample of adolescent students. One group of adolescents with altered blood pressure detected by casual blood pressure and/or home blood pressure monitoring (blood pressure > 90th percentile) and one group of normotensive adolescents were studied. Body mass index, waist circumference were measured, and fasting glucose and plasma insulin levels were determined, using the HOMA-IR index to identify insulin resistance.

RESULTS

A total of 162 adolescents (35 with normal blood pressure and 127 with altered blood pressure) were studied; 61% (n = 99) of them were boys and the mean age was 14.9 ± 1.62 years. Thirty-eight (23.5%) adolescents had altered HOMA-IR. The group with altered blood pressure had higher values of waist circumference, body mass index and HOMA-IR (p<0.05). Waist circumference was higher among boys in both groups (p<0.05) and girls with altered blood pressure had higher HOMA-IR than boys (p<0.05). There was a significant moderate correlation between body mass index and HOMA-IR in the group with altered blood pressure (ρ = 0.394; p < 0.001), and such correlation was stronger than in the normotensive group. There was also a significant moderate correlation between waist circumference and HOMA-IR in both groups (ρ = 0.345; p < 0.05). Logistic regression showed that HOMA-IR was as predictor of altered blood pressure (odds ratio - OR = 2.0; p = 0.001).

CONCLUSION

There was a significant association of insulin resistance with blood pressure and the impact of insulin resistance on blood pressure since childhood. The correlation and association between markers of cardiovascular diseases was more pronounced in adolescents with altered blood pressure, suggesting that primary prevention strategies for cardiovascular risk factors should be early implemented in childhood and adolescence.

Prevalence of Overweight and Obesity in 4 Schools of South Mumbai

INTRODUCTION

The paediatric obesity is on the rise so as the complications of obesity like cardiovascular diseases, liver diseases, dyslipidaemia are increasing. The changing dietary habits and less of outdoor activities are risk factors for obesity.

AIM

The study was conducted to find out prevalence of overweight and obesity among students in four schools of the Mumbai and compare with studies from rest of the country.

MATERIALS AND METHODS

It is school based, cross-sectional study conducted in four Schools from class of 5(th) to 10(th). The anthropometric measurements of height, weight were taken of each student. The body mass index was calculated based on the age based Cole et al., criteria (International) as well as Khadilkar et al., criteria which are specially develop for Indian children. The data was analysed with chi-square test.

RESULTS

Total 1828 students were screened from 4 schools. Out of which 590 were girls and 1238 were boys. The prevalence of overweight and obesity by Cole et al., criteria were 11.3% and 3.3% and by Khadilkar et al., criteria were 17.5% and 7.8 % respectively.

CONCLUSION

It shows significant difference in obesity between boys and girls and also between government and private schools. There is overall decrease in prevalence of overweight and obesity as age increases. The overweight and obesity among these schools in Mumbai is comparable with the rest of the studies from India.

Prevalence of hypertension in a sample of schoolchildren in the Belgrade district

OBJECTIVE

The aim of this study was to estimate the prevalence of hypertension in a sample of schoolchildren in the district of Vozdovac (Belgrade).

METHODS

This study included 780 pupils from I, III, V and VII classes of a primary school and I and III classes of a high school in the district of Vozdovac (Belgrade). The anthropometric data were obtained from medical records of a regular health survey in 2014-2015. Blood pressure (BP) was measured three times using a mercury sphygmomanometer with a cuff of appropriate size at a 5 min interval. BP values at or above the 95th percentile for age, sex, and height were considered indicative of hypertension. Statistical analysis included descriptive statistics, χ-test, t-test, and correlation analysis.

RESULTS

Of the participating students, 15.0% were overweight and 6.7% were obese. A significant negative correlation was observed between BMI categories and age (ρ=-0.126; P<0.01). The average systolic blood pressure values in boys and girls were 105.0±14.1 (range 80.0-150.0) and 102.5±12.3 (range 80-155) mmHg, respectively. The average diastolic blood pressure values in boys and girls were 67.6±8.8 (range 50-100) and 66.2±7.7 (range 50-95) mmHg, respectively. The prevalence of hypertension was 10.5%. A significant positive association was found between the presence of hypertension and age (ρ=0.150, P<0.01) and higher BMI level (ρ=0.115, P<0.01).

CONCLUSION

In our sample of schoolchildren, a high prevalence of hypertension was found. Moreover, elevated BP values correlated strongly with age and BMI.

Epidemiology of childhood overweight & obesity in India: A systematic review

BACKGROUND & OBJECTIVES

Childhood obesity is a known precursor to obesity and other non-communicable diseases (NCDs) in adulthood. However, the magnitude of the problem among children and adolescents in India is unclear due to paucity of well-conducted nationwide studies and lack of uniformity in the cut-points used to define childhood overweight and obesity. Hence an attempt was made to review the data on trends in childhood overweight and obesity reported from India during 1981 to 2013.

METHODS

Literature search was done in various scientific public domains from the last three decades using key words such as childhood and adolescent obesity, overweight, prevalence, trends, etc. Additional studies were also identified through cross-references and websites of official agencies.

RESULTS

Prevalence data from 52 studies conducted in 16 of the 28 States in India were included in analysis. The median value for the combined prevalence of childhood and adolescent obesity showed that it was higher in north, compared to south India. The pooled data after 2010 estimated a combined prevalence of 19.3 per cent of childhood overweight and obesity which was a significant increase from the earlier prevalence of 16.3 per cent reported in 2001-2005.

INTERPRETATION & CONCLUSIONS

Our review shows that overweight and obesity rates in children and adolescents are increasing not just among the higher socio-economic groups but also in the lower income groups where underweight still remains a major concern.

Predictors of overweight and obesity among school going adolescents of Vadodara city in Western India

BACKGROUND

Obesity among adolescents is escalating as a global epidemic which is associated with various lifestyle disorders in later life.

OBJECTIVE

To assess the factors influencing overweight and obesity among school going adolescents of Vadodara city in Western India.

METHODS

The study was carried out among 1050 school going adolescents from 15 schools selected by systematic random sampling after taking written informed consent from the participants. A predefined pretested semi-structured questionnaire was used to collect dietary information and physical activity. Anthropometric measurements such as height, weight, triceps skin fold thickness, waist and hip circumferences was measured using standard techniques. Adolescents were classified as overweight (>+1SD) and obese (>+2SD) with respect to their age and sex by using WHO reference charts. Factors found to be statistically significant in bivariate analysis were considered in the multiple logistic regression model.

RESULTS

Among 1050 school going adolescents, 7.8% were overweight and 2.7% were obese, making the combined prevalence of overweight and obesity as 10.5%. Among socio-demographic predictors: early and mid adolescence, male gender, English medium of instruction, positive family history of obesity were found to be the significantly associated with overweight/obesity among the study population. Whereas consumption of outside food, meal skipping habit, infrequent consumption of staple healthy food items were found to be significant diet related predictor variables for overweight/obesity. Among the physical activity predictors: sedentary activities, less outdoor games and sleep deprivation were also found to be significant predictors of overweight/obesity.

CONCLUSION

Adolescents should be motivated to take adequate amount of healthy staple food like dal-rice at home and to engage in outdoor sports related activity to prevent overweight and obesity.

Revised Indian Academy of Pediatrics 2015 growth charts for height, weight and body mass index for 5-18-year-old Indian children

Growth chart committee of Indian Academy of Pediatrics (IAP) has revised growth charts for 5-18-year-old Indian children in Jan 2015. The last IAP growth charts (2007) were based on data collected in 1989-92 which is now >2 decades old. India is in an economic and nutrition transition and hence growth pattern of Indian children has changed over last few years. Thus, it was necessary to produce contemporary, updated growth references for Indian children. The new IAP charts were prepared by collating data from nine groups who had published studies in indexed journals on growth from India in the last decade. Growth charts were constructed from a total of 87022 middle and upper socioeconomic class children (m 54086, f 32936) from all five zones of India. Data from middle and upper socioeconomic class children are likely to have higher prevalence of overweight and obesity and hence growth charts produced on such populations are likely to "normalize" obesity. To remove such unhealthy weights form the data, method suggested by World Health Organization was used to produce weight charts. Thus, the new IAP weight charts are much lower than the recently published studies on affluent Indian children. Since Indian's are at a higher risk of obesity-related cardiometabolic complications at lower body mass index (BMI), BMI charts adjusted for 23, and 27 adult equivalent cut-offs as per International obesity task force guidelines were constructed. IAP now recommends use of these new charts to replace the 2007 IAP charts.

Determinants, consequences and prevention of childhood overweight and obesity: An Indian context

The prevalence of obesity in adolescents and children has risen to alarming levels globally, and this has serious public health consequences. Sedentary lifestyle and consumption of calorie-dense foods of low nutritional value are speculated to be two of the most important etiological factors responsible for escalating rate of childhood overweight in developing nations. To tackle the childhood obesity epidemic we require comprehensive multidisciplinary evidence-based interventions. Some suggested strategies for childhood obesity prevention and management include increasing physical activity, reducing sedentary time including television viewing, personalized nutrition plans for very obese kids, co-curriculum health education which should be implemented in schools and counseling for children and their parents. In developing countries like India we will need practical and cost-effective community-based strategies with appropriate policy changes in order to curb the escalating epidemic of childhood obesity.