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Sahoo H, Dhillon P, Anand E, Srivastava A, Usman M, Agrawal PK, Johnston R, Unisa S. Status and correlates of non-communicable diseases among children and adolescents in slum and non-slum areas of India's four metropolitan cities. J Biosoc Sci 2023; 55:1064-1085. [PMID: 36698328 DOI: 10.1017/s0021932022000530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The emergence of non-communicable diseases (NCDs) in childhood poses a serious risk to a healthy adult life. The present study aimed to estimate the prevalence of NCDs among children and adolescents in slums and non-slums areas of four metropolitan cities of India, and in rural areas of the respective states The study further, investigated the effect of the place residence as slum vs. non-slum and other risk factors of the NCDs. Nationally representative data from the Comprehensive National Nutrition Survey (CNNS) was used.. Estimates were based on children (5-9 years) and adolescents (10-19 years) for whom biomarkers predicting diabetes, high total cholesterol, high triglycerides and hypertension were determined. Weight, height and age data were used to calculate z-scores of the body mass index. Overweight and obesity was higher in urban areas than in rural areas among children and adolescents. Regional differences in the prevalence of diseases were observed; children in Delhi and Chennai had a higher likelihood of being diabetic while children in Kolkata were at a greater risk of high total cholesterol and high triglycerides. The risk of hypertension was strikingly high among non-slum children in Delhi. Children from slums were at a higher risk of diabetes compared to the children from non-slums, while children and adolecents from non-slums were at a greater risk of high triglycerides and hypertension respectively than their counterparts from slums. Male children and adolecents had a higher risk of diabetes and high cholesterol. Screening of children for early detection of NCDs should be integrated with the already existing child and adolescent development schemes in schools and the community can help in prevention and control of NCDs in childhood.
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Affiliation(s)
- Harihar Sahoo
- Department of Family and Generations, International Institute for Population Sciences, (IIPS)Mumbai, India
| | - Preeti Dhillon
- Department of Survey Research and Data Analytics, IIPS, Mumbai, India
| | - Enu Anand
- Doctoral Fellow, IIPS, Mumbai, India
| | | | | | | | | | - Sayeed Unisa
- Department of Biostatistics and Epidemiology, IIPS, Mumbai, India
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Predictors of Metabolic Complications in Obese Indian Children and Adolescents. Indian J Pediatr 2021; 88:252-256. [PMID: 33047255 DOI: 10.1007/s12098-020-03515-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To identify predictors of metabolic complications in obese Indian children and adolescents. METHODS This cross-sectional study included 282 obese children and adolescents [188 boys, mean (SD) age of 11.7 (3.1) y, body mass index standard deviation score (BMI SDS) 2.4 (0.6)] who underwent metabolic work-up (oral glucose tolerance test, SGPT, lipid profile) and adiposity assessment (waist circumference and Dual energy X-ray absorptiometry). RESULTS One hundred and fifteen subjects (40.8%) had no metabolic complication (metabolic healthy obesity) with similar prevalence across BMI SDS categories (38.8% for BMI SDS below 2, 42.1% for 2-3 and 40.4% for those above 3). Normal birth weight (odds ratio 3.2, 95% confidence interval 1.0-10.1, p = 0.04), negative family history of type 2 diabetes (odds ratio 1.81, 95% confidence interval 1.0-3.3, p = 0.04) and younger age [11.3 (3.1) y as against 12.1 (3.1) y, p = 0.03] were associated with metabolically healthy obesity. No difference in BMI SDS [2.4 (0.6) as against 2.4 (0.6), p = 0.7], waist circumference SDS [2.0 (0.7) as against 2.2 (0.9), p = 0.07], waist to height ratio [0.6 (0.05) as against 0.6 (0.05), p = 0.1], DXA derived fat percentage [48.6 (5.4)% as against 47.8% (5.2), p = 0.2], android to gynoid ratio [1.05 (0.1) as against 1.06 (0.1), p = 0.08] and fat mass index [13.8 (3.5) as against 13.8 (3.3), p = 0.9] was observed in the two groups. CONCLUSIONS A substantial proportion of obese children and adolescents do not develop metabolic complications. Birth weight and family history of type 2 diabetes are the only predictors of complications. Further exploration is needed to identify interventional targets.
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Das RR, Mangaraj M, Nayak S, Satapathy AK, Mahapatro S, Goyal JP. Prevalence of Insulin Resistance in Urban Indian School Children Who Are Overweight/Obese: A Cross-Sectional Study. Front Med (Lausanne) 2021; 8:613594. [PMID: 33644095 PMCID: PMC7907002 DOI: 10.3389/fmed.2021.613594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
Background: Limited data are available for insulin resistance (IR) in over-weight/obese children from the Indian subcontinent. Identifying predictors of IR in this population is important, as they may be used as a screening tool for future metabolic complications. Materials and Methods: This school-based cross-sectional study was conducted in an Eastern Indian city. Anthropometry and blood pressure measurements were carried out as per the published guidelines. Venous blood samples were taken in a fasting state to measure plasma glucose, insulin, and lipid profile. IR was measured quantitatively by a homeostatic model of assessment (HOMA-IR). Results: A total of 545 (28.2%) children who were overweight or obese were included. The male:female ratio was 1:1.27. The overall prevalence of metabolic syndrome (MS) in these children was 21.8%. Around 32.3% of children had HOMA-IR of ≥2.5, and 22.2% had HOMA-IR of ≥3.16. The mean HOMA-IR in children with MS was 5.46 compared to 2.18 in those without MS. An increased risk of IR with low HDL, high triglyceride, increased waist circumference, and increased BP (both systolic and diastolic) was found. This means that insulin resistance was more common in children who were overweight or obesity and had underlying MS. Conclusions: The present school-based study found a high prevalence of insulin resistance among children who were overweight or obese. This could predict an increased risk of future adverse cardio-vascular events in the studied children. The findings of this study would help in planning and implementing primary prevention programs targeting weight management and lifestyle change in schoolchildren.
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Affiliation(s)
- Rashmi Ranjan Das
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Manaswini Mangaraj
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Saurav Nayak
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Amit Kumar Satapathy
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Samarendra Mahapatro
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Jagdish Prasad Goyal
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
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Arora M, Mathur C, Rawal T, Bassi S, Lakshmy R, Nazar G, Gupta V, Park M, Kinra S. Socioeconomic differences in prevalence of biochemical, physiological, and metabolic risk factors for non-communicable diseases among urban youth in Delhi, India. Prev Med Rep 2018; 12:33-39. [PMID: 30155404 PMCID: PMC6111063 DOI: 10.1016/j.pmedr.2018.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/15/2018] [Accepted: 08/07/2018] [Indexed: 11/19/2022] Open
Abstract
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.
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Affiliation(s)
- M. Arora
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - C. Mathur
- Indian Institute of Health Management and Research University, Jaipur, Rajasthan 302029, India
| | - T. Rawal
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - S. Bassi
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - R. Lakshmy
- Department of Bio-chemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - G.P. Nazar
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - V.K. Gupta
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - M.H. Park
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK
| | - S. Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Farsi DJ, Elkhodary HM, Merdad LA, Farsi NMA, Alaki SM, Alamoudi NM, Bakhaidar HA, Alolayyan MA. Prevalence of obesity in elementary school children and its association with dental caries. Saudi Med J 2017; 37:1387-1394. [PMID: 27874156 PMCID: PMC5303779 DOI: 10.15537/smj.2016.12.15904] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
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.
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Affiliation(s)
- Deema J Farsi
- Department of Pediatric Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
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Farsi DJ, Elkhodary HM. The prevalence of overweight/obesity in high school adolescents in Jeddah and the association of obesity association with dental caries. Ann Saudi Med 2017; 37:114-121. [PMID: 28377540 PMCID: PMC6150552 DOI: 10.5144/0256-4947.2017.114] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The prevalence of overweight/obesity in children in Saudi Arabia is among the highest in the world. The prevalence of dental caries is also high in Saudi children. Studies on the relationship between caries and obesity in Saudi adolescents are lacking. OBJECTIVES To study the prevalence of overweight/obesity in adolescents, and determine any association between obesity and caries. DESIGN An analytical cross-sectional study. SETTING Private and public schools in Jeddah. PATIENTS AND METHODS The study sample comprised high school children from public and private schools selected by multistage stratified random sampling. Height, weight, waist circumference (WC), and body mass index (BMI) were measured for all children, who were then classified as underweight/normal, overweight, or obese according to their BMI values, and nonobese or obese according to their WC values. The presence of caries was assessed using the Association of State and Territorial Dental Directors criteria. MAIN OUTCOME MEASURE(S) The prevalence of overweight/obesity and the association of obesity with the number of decayed permanent teeth. RESULTS 801 high school children (48% boys, 49% from public schools) with a mean (SD) age of 16.5 (0.9) years. When the BMI classification was used, 24%, 16%, and 60% adolescents were obese, overweight, and underweight/normal, respectively. When the WC classification was used, 19% and 81% were obese and nonobese, respectively. Obesity was more prevalent in boys and in students attending private schools (P < .05). The number of decayed permanent teeth showed a very weak and insignificant correlation with BMI and WC. CONCLUSION One in every four adolescents residing in Jeddah was obese, with a high obesity prevalence in boys and in children attending private schools. The prevalence of caries in the permanent dentition was not associated with BMI or WC. LIMITATIONS It was difficult to establish temporality in this cross-sectional study. Data on common risk factors were not adjusted for in the analyses.
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Affiliation(s)
- Deema Jamil Farsi
- Dr. Deema Farsi, Department of Pediatric Dentistry,, King Abdulaziz University,, PO Box 17848, Jeddah 21494,, Saudi Arabia, T: +966126402000 Ext 20388, , http://orcid.org/0000-0003-1371-913X
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Heba E, Deema F, Leena M, Najat F, Sumer A, Najlaa A, Dania B, Hammam B. Prevalence of obesity among preschool children and its relation with dental caries. ACTA ACUST UNITED AC 2017. [DOI: 10.5897/jdoh2016.0216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Silva CS, da Silva Junior CT, Ferreira BS, da Silva FDM, Silva PS, Xavier AR. Prevalence of underweight, overweight, and obesity among 2, 162 Brazilian school adolescents. Indian J Endocrinol Metab 2016; 20:228-232. [PMID: 27042420 PMCID: PMC4792025 DOI: 10.4103/2230-8210.176364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The nutritional profile of the Brazilian population has changed in recent years. Therefore, this study aimed to assess the prevalence of nutritional status among Brazilian school adolescents during the period from January 2014 to December 2014. METHODS This study employed an observational design with a cohort of school adolescents. Anthropometric measurement was assessed by nutritionists in government schools. The cut-off points for body mass index according to Brazilian criteria for adolescents of both sexes between 10 years and 19 years old were underweight (≤17.5 kg/m(2)), overweigh (≥25.0 kg/m(2)), and obesity (≥30.0 kg/m(2)). RESULTS The number of students included in the analysis was 2162, of which 71.0% were males and 29% were females (P = 0.00001). The mean age (years) was 13.14 ± 2.17 for boys and 12.66 ± 1.85 for girls (P = 0.0001). The prevalence of underweight, overweight, and obesity observed in our population of school adolescents according to the Brazilian criteria was 2.8%, 8.1%, and 2.4% for males, respectively, and 23.0%, 10.7%, and 3.6% for females, respectively. For both sexes, there was no statistically significant difference between overweight (P = 0.5469) and obesity (P = 0.7863), but there was for underweight (P = 0.001). CONCLUSIONS The occurrence of excess weight among Brazilian school adolescents is similar to the international prevalence, but the prevalence of underweight was very high among girls. The nutritional status of adolescents must be considered a public health problem in Brazil.
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Affiliation(s)
- Clarice Siqueira Silva
- Secretary of Education, Armação de Búzios, Estrada da Usina 600, Rio de Janeiro, 28950-000, State of Rio de Janeiro, Brazil
- Department of Maternal Child, Faculty of Medicine, Professional Master's Program in Mother and Child Health, Universidade Federal Fluminense, Rua Marquês do Paraná, 303, Niterói, State of Rio de Janeiro, 24030-215, Brazil
| | - Cyro Teixeira da Silva Junior
- Department of Maternal Child, Faculty of Medicine, Professional Master's Program in Mother and Child Health, Universidade Federal Fluminense, Rua Marquês do Paraná, 303, Niterói, State of Rio de Janeiro, 24030-215, Brazil
| | - Bruna Soares Ferreira
- Secretary of Education, Armação de Búzios, Estrada da Usina 600, Rio de Janeiro, 28950-000, State of Rio de Janeiro, Brazil
| | - Francielle Dal Mora da Silva
- Secretary of Education, Armação de Búzios, Estrada da Usina 600, Rio de Janeiro, 28950-000, State of Rio de Janeiro, Brazil
| | - Patricia Siqueira Silva
- Department of Maternal Child, Faculty of Medicine, Professional Master's Program in Mother and Child Health, Universidade Federal Fluminense, Rua Marquês do Paraná, 303, Niterói, State of Rio de Janeiro, 24030-215, Brazil
| | - Analúcia Rampazzo Xavier
- Department of Maternal Child, Faculty of Medicine, Professional Master's Program in Mother and Child Health, Universidade Federal Fluminense, Rua Marquês do Paraná, 303, Niterói, State of Rio de Janeiro, 24030-215, Brazil
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