Secular trends in prevalence of overweight and obesity from 2006 to 2009 in urban asian Indian adolescents aged 14-17 years

Circulatory levels of lysophosphatidylcholine species in obese adolescents: Findings from cross-sectional and prospective lipidomics analyses

BACKGROUND AND AIMS

Obesity has reached epidemic proportions, emphasizing the importance of reliable biomarkers for detecting early metabolic alterations and enabling early preventative interventions. However, our understanding of the molecular mechanisms and specific lipid species associated with childhood obesity remains limited. Therefore, the aim of this study was to investigate plasma lipidomic signatures as potential biomarkers for adolescent obesity.

METHODS AND RESULTS

A total of 103 individuals comprising overweight/obese (n = 46) and normal weight (n = 57) were randomly chosen from the baseline ORANGE (Obesity Reduction and Noncommunicable Disease Awareness through Group Education) cohort, having been followed up for a median of 7.1 years. Plasma lipidomic profiling was performed using the UHPLC-HRMS method. We used three different models adjusted for clinical covariates to analyze the data. Clustering methods were used to define metabotypes, which allowed for the stratification of subjects into subgroups with similar clinical and metabolic profiles. We observed that lysophosphatidylcholine (LPC) species like LPC.16.0, LPC.18.3, LPC.18.1, and LPC.20.3 were significantly (p < 0.05) associated with baseline and follow-up BMI in adolescent obesity. The association of LPC species with BMI remained consistently significant even after adjusting for potential confounders. Moreover, applying metabotyping using hierarchical clustering provided insights into the metabolic heterogeneity within the normal and obese groups, distinguishing metabolically healthy individuals from those with unhealthy metabolic profiles.

CONCLUSION

The specific LPC levels were found to be altered and increased in childhood obesity, particularly during the follow-up. These findings suggest that LPC species hold promise as potential biomarkers of obesity in adolescents, including healthy and unhealthy metabolic profiles.

Abnormal High Body Mass Index among Adolescents of Secondary Schools

Introduction

The rapid increase in the cases of childhood obesity and overweight and its potential to pose other non-communicable diseases has made it a global public health issue. Urbanisation and changing lifestyles also pose a threat to disease in Nepal, but the prevalence of such diseases in Nepal is still not known according to the method recommended by World Health Organization for children's obesity and overweight. This study aimed to find out the prevalence of abnormal high body mass index among adolescents of secondary schools.

Methods

A descriptive cross-sectional study was conducted among children aged 5-19 years at two secondary schools from 7 June to 14 June 2023 after getting ethical approval from the Institutional Review Committee. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval.

Results

Out of 157 children, 29 (18.47%) (12.40-24.54, 95% Confidence Interval) had abnormal high body mass index. Out of 29 children, 19 (65.51%) were male.

Conclusions

The prevalence of abnormal high body mass index among adolescents was found to be higher than other studies done in similar settings.

Keywords

children; obesity; overweight; prevalence; schools.

Patients' perception about polycystic ovarian syndrome (PCOS) in Sub-Himalayan region of India-A facility-based cross-sectional study

Background

In modern times, metabolic disorders are most common and one of them is polycystic ovarian syndrome (PCOS) in women, which causes high morbidity and complications. PCOS has largely been a neglected and less researched area; however, it is gaining importance in recent times as PCOS is increasing as well as it can be prevented to a considerable extent.

Methods

A cross-sectional study was conducted to assess knowledge among females in government hospitals in Northern India. Data were collected using a pretested structured questionnaire on 300 women (completed 270), selected by proportionate sampling technique, and admitted in government hospitals. Data were analyzed by SPSS version 23.

Results

The results showed that the mean age of respondents was 33.02 ± 9.039 years, the mean age at menarche was 12.33 ± 2.13 years, and the mean of gravida status was 1.82 ± 0.78 years. Only half of the respondents had good knowledge about PCOS.

Conclusion

This study suggests that efforts are needed to reinforce women's knowledge through setting-based awareness campaigns and health education in this context to enable them to identify and seek timely treatment and improve their quality of life.

Prevalence of Overweight and Obesity Among Students of Government and Private High Schools in an Indian State With Significant Tribal Population: A Cross-Sectional Analytical Study

BACKGROUND

Overweight and obesity among school-going children is an emerging public health problem in the country. The information available on the true extent of obesity and overweight among school-aged children is limited. Hence, the present study has been conducted to determine the prevalence of overweight and obesity among high school students in Jharkhand, India.

METHODOLOGY

This was a cross-sectional study conducted among 1162 students of government and private schools of Ormanjhi block, Ranchi district, from July 2022 to December 2022. A predesigned, semi-structured, pre-tested questionnaire containing different sections namely sociodemographic characteristics, and health parameters were used for the study subjects. Clinical examination and anthropometric measurements of height, weight, and waist and hip circumferences were taken using standard equipment to calculate body mass index (BMI) and central obesity (waist-hip ratio).

RESULTS

The prevalence of overweight and obesity was more at 14 years of age (30.2%), among boys (18.1%), and among students practicing the Islam religion (51.1%). Moreover, the prevalence of overweight and obesity was found to be highest in private schools (66.2%), and that was statistically significant (p<0.001).

CONCLUSION

The prevalence of overweight and obesity was found to be significant with respect to age, gender, and religion. The findings from this study would be helpful in raising awareness among students, parents, teachers, and health professionals about the influence of overweight and obesity on a child's physical, social, and psychological well-being, and this, in turn, would facilitate parents, students, and teachers in the adoption of a healthy lifestyle.

Correlation of dental caries status with BMI in school children of age 3-16 years- An institutional study

Aim

The study investigates the correlation of dental caries status with body mass index (BMI) in school children of age 3 to 16 years.

Background

Obesity is a rising global health epidemic. Dental caries has been the predominant disorder in modern society. Obesity and dental caries are major health problems with multifactorial characteristics and similar risk factors, such as diet, lack of physical activity, unhealthy eating pattern, not enough sleep, and high amount of stress etc. Various studies have documented diverse outcomes linked to BMI and dental caries.

Material and Methods

A cross-sectional study was implemented on 756 participants. Among the study participants, 475 (62.8%) were boys and 281 (37.2%) were girls. The decayed, missing and filled teeth (DMFT) index has been used to assess the prevalence of dental caries. Information of the study participant's height and weight was reported using a standardized measuring scale and weighing machine; after that, the BMI was measured. SPSS version 22 was used to analyze the data.

Results

The mean DMFT of the study participants in normal-weight children was 2.3. There was a positive correlation between the dental caries status and BMI, with a significant value of 0.27.

Conclusion

Diet counselling and regular dental check-ups should be prescribed to prevent dental caries from occurring and monitor children's healthy weight. Balanced nutrition needs to be provided to children by school authorities and parents.

Early-Life Antibiotics and Childhood Obesity: Yeast Probiotics as a Strategy to Modulate Gut Microbiota

This study aimed to review the existing literature to investigate the potential link between early-life antibiotic use and being overweight or obese in children. PubMed, Web of Science, Embase, Google Scholar, and Cochrane Library were searched to identify studies published until August 2021 that assessed the relationship between early-childhood antibiotic use and measures of body mass index. The studies included children aged 0-18 years. Only cohort studies were taken into consideration. Studies published in languages other than English were excluded. Antibiotic usage in early life may increase the risk of obesity in children and the addition of yeast probiotics, such as Saccharomyces boulardii CNCM I 745, to antibiotic prescription can serve as a potential option to mitigate this risk.

Associations of anthropometric cardiometabolic risk factors and leg fat accumulation in children and adolescents from Poland

OBJECTIVES

To analyze the correlation between anthropometric cardiometabolic risk factors with calf adiposity in 4-16-year-olds from Poland.

METHODS

Three thousand seventy-six persons (1568 girls and 1508 boys) were examined. Analyzed characteristics included body height, waist, hips and neck circumferences, body weight, six skinfolds. The following were calculated: body mass index (BMI), waist-to-hips ratio (WHR), the sum of all skinfolds, and the sum of skinfolds on the waist area.

RESULTS

The relationship between the calf skinfold and the rest of the characteristics was estimated using multiple regression. There was a negative relationship between calf adiposity and fat tissue accumulated around the waist and the BMI (in some groups). This suggests that participants with greater calf adiposity had lower waist adiposity and BMI than those with less fat tissue on the lower limb.

CONCLUSION

Persons with higher calf adiposity may have a lower cardiometabolic risk. This observation is significant because cardiovascular risk factors can persist from childhood into adulthood. Additionally, cardiovascular issues have numerous medical consequences but also socio-economic ones, thus they can affect individuals and be a burden on public health.

Diagnostic test accuracy of waist-to-height ratio as a screening tool for cardiovascular risk in children and adolescents: a meta-analysis

CONTEXT

Waist-to-height ratio (WHtR) is a controversial evaluation index of cardiovascular risk factors (CVRFs) in children and adolescents.

OBJECTIVE

To assess the accuracy of WHtR as a measure to screen for clusters of at least one CVRF (CVRF₁), two CVRFs (CVRF₂), and three CVRFs (CVRF₃) in different ages, sexes, regions and cut-offs.

METHODS

The PubMed, Web of Science, EBSCOhost, Springer, Taylor & Francis Online, Wiley Online Library, Wanfang, and CNKI databases were searched for eligible publications up to June 2021. The QUADAS-2 checklist was used to assess the methodology of the included studies.

RESULTS

Twenty-two studies that evaluated 85281 children and adolescents aged 5-19 years were included in the meta-analysis. The AUSROC values were 0.56 (95% CI: 0.54-0.57), 0.82 (95% CI: 0.81-0.83), and 0.89 (95% CI: 0.89-0.90) for CVRF₁, CVRF₂, and CVRF₃, respectively. Higher AUSROC values were found for adolescents (12-19 years), that is, 0.91 (95% CI: 0.88-0.93), 0.90 (95% CI: 0.87-0.92) for males, and 0.91 (95% CI: 0.90-0.91) for a cut-off of ≥ 0.51 in the identification of CVRF₃.

CONCLUSION

WHtR can be used as an accurate screening tool for CVRF₃ and CVRF₂ in children and adolescents, and it is recommended to select different cut-offs according to different ages, sexes, and regions.

Secular trends in prevalence of overweight and obesity over a decade in urban and rural South Indian children integrated with geographic information system

Context

The globalization in the process most of the rural sectors are also upgrading technically with digitalization with more availability of smart phones and gaming along with the refined food influences on the present-day children is causing a trend of overweight among the children.

Aims

To arrive at the prevalence of overweight and obesity considering the Indian Academy of Pediatrics (IAP) cut-offs for growth standards among children aged 12 years from the rural and urban areas of Mysuru District.

Methods and Material

The present program was the third large scale community intervention project carried out including the 7 talukas of Mysuru District which focused on the measurement of the Body mass index (BMI). In this phase between the year 2019 and 2020 anthropometric measurements were undertaken in 1602 urban and rural children aged 12 years from government-funded and privately-funded schools of Mysuru District.

Statistical Analysis Used

The results were analysed statistically using SPSS for Windows (version 23.0) and the t-test, Chi-square test and proportion tests, P value were reported. Results: As per the IAP reference ranges the prevalence of obesity was 5.5% and overweight was 7.1% among children of Mysuru District.

Conclusions

We report that this increase was significantly higher in girls than boys. There was an increasing trend in rural sectors; however, the obese children were more predominantly distributed among the urban sectors. This calls for a precise preventive measure to fulfil the goal of the World Health Organization (WHO) to control prevalence of childhood obesity by the year 2022.

Socioeconomic, intrapersonal and food environmental correlates of unhealthy snack consumption in school-going adolescents in Mumbai

Background

Unhealthy snacking habits in adolescents are typically triggered by obesogenic food environments and possibly perpetuated through interactions between socio-environmental factors and personal perceptions, attitudes, and motivations to change eating behaviors. This study attempted to address the knowledge gap regarding the association of intrapersonal, socioeconomic, and food environmental characteristics with unhealthy snack consumption in Indian adolescents, presenting several targets for effective interventions.

Methods

A representative sample of 10–12 years old adolescents (n 712) completed a cross-sectional survey including eating habits, characteristics of school and home food environments, and perceptions related to affordability, convenience, and barriers within the food environments. The frequency of unhealthy snack consumption was assessed using a validated qualitative food frequency questionnaire. Multivariate regression analyses determined the associated factors of unhealthy snack consumption in adolescents attending private and public schools.

Results

The mean age of adolescents was 10.9 (1.1) years, 48.2% were girls and 53.9% attended private schools. The most frequently consumed unhealthy snacks were biscuits/ cookies (5.2d/wk) followed by wafers (3.4d/wk) and Indian fried snacks- samosa/ vada pav (2.8 d/wk). Among the public-school adolescents, the odds of unhealthy snack consumption were 0.89 times lower when meals were had frequently at the dinner table and 4.97 times higher when the perceived barriers related to the affordability of healthy snacks were greater. Maternal education (OR 0.78, 95% CI 0.66–0.82, p < 0.001), family income (OR 2.15, 95% CI 1.98–2.32, p < 0.001), availability of unhealthy snacks (OR 2.98, 95% CI 1.36–3.46, p < 0.001) and fruits (OR 0.57, 95% CI 0.49–0.69, p < 0.001) at home, having evening meals together (OR 0.71, 95% CI 0.63–0.81, p 0.031), and perceived parental control during mealtimes (OR 0.67, 95% CI 0.62–0.72, p < 0.001) were associated with unhealthy snack consumption in adolescents attending private schools.

Conclusions

The results highlighted a pervasiveness of unhealthy snacks in adolescents’ food environments. Improving provisions and affordability of fruits and healthy snacks at schools, encouraging family mealtimes, and limiting the availability of unhealthy snacks at home whilst addressing the perceived barriers within food environments, and inculcating self-efficacy skills can improve snacking habits in Indian adolescents, irrespective of socioeconomic backgrounds.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13449-6.

Changes in the adiposity level and prevalence of overweight/obesity among children from Kraków (Poland) within the last decade (from 2010 to 2020)

The aim of this study was to assess the changes in the prevalence of overweight, obesity and high adiposity in children and adolescents from Krakow (Poland), between the years 2010 and 2020. Two cross-sectional series of anthropometric measurements were carried out in 2010 and 2020. Analysed characteristics included: body height and weight, BMI (Body Mass Index), body adiposity (%BF). The subjects were categorised according to their BMI (underweight, normal weight, overweight, obesity), as well as %BF (low, normal, high body fat).The research was conducted in randomly selected primary schools in Krakow (Poland). Studied cohorts (8-15 years of age), which represented four of the traditional residential districts: Śródmieście, Podgórze, Krowodrza and Nowa Huta. Among the girls, there was a negative secular trend regarding the prevalence of underweight and obesity. On the other hand, there also was a positive trend concerning the prevalence of overweight and low and high body fat. In boys, there was a negative secular trend regarding the prevalence of underweight and low adiposity. There was also a generally positive secular trend regarding the prevalence of overweight, obesity as well as high adiposity in boys. The findings of this study are particularly significant because detailed knowledge of the prevalence of overweight/obesity in childhood and adolescence is crucial for the future health of entire populations. Further studies should also take into account the levels of physical fitness and activity of the examined population.

Optimizing the impact of health and related programmes / policies to address the issue of Childhood Obesity in India----A narrative review

Non-communicable diseases are already acknowledged as a double burden, and now childhood obesity is putting extra strain on our health system. The current paper aimed to analyze the ongoing health and related programmes/policies in India, and we discussed the existing opportunities in the programmes to address the issue of childhood obesity in India. We searched the "MEDLINE," "PsycINFO," "Scopus," "Web of Science," and "Google Scholar" databases using the following keywords: ("overweight") and ("obesity"), ("childhood obesity"), ("nutritional programmes in India"), ("Health policies in India"), ("malnourished children in India") in combination with each other and in truncated form. All the relevant articles and policy documents (MOHFW, INDIA) available in the public domain were included to support the argument for this narrative review. We found that we have programme gaps like guidelines issues by Food Safety Standards Authority of India to tackle childhood obesity and it has not been strictly implemented due to multiple reasons. School health programme has an opportunity to address the issue of childhood obesity, but at the ground level the outcomes are not very promising. The National Nutrition Mission have only focussed on undernutrition and anemia problem, ignoring the overweight/childhood obesity. Primary care physicians are key players in the treatment of childhood obesity, yet rates of obesity management in the primary care setting are low. National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & stroke is dealing with health promotion and prevention, early diagnosis, and management of all ages, except children. Diet provided in Integrated Child Development Scheme is calculated based on calories, not by the quality which is a concern to us. The breastfeeding promotion programme named Mothers Absolute Affection programme has not been implemented with letter and spirit. Other than health programmes, we assume that Ministry of Urban Planning, Foreign Direct Investment policy, Advertisement Council of India and many more sector/policy/programme are indirectly responsible for the increasing burden of childhood obesity in India. Lack of awareness and wrong perception also responsible for the development of childhood obesity. We have multiple National Health Programmes and Policies to address the childhood malnutrition, but are focussing the undernutrition component only, ignoring overnutrition problem in the children, which is emerging as quadruple burden to our health system. Appropriate actions and inclusion of suggestions provided in this study for the improvement of the programmes at the practical level needs to be considered by the policy makers to halt the ever-rising trend of childhood obesity and primary care physicians should play a leadership role.

Dietary factors associated with being overweight and obese among school-going adolescents in Region One, The Gambia

BACKGROUND

The purpose of this study was to determine the dietary factors associated with being overweight and obese among school-going adolescents in Region One, The Gambia.

METHOD

This was a school-based cross-sectional study and 1008 students from eight Senior Secondary Schools in Region one of The Gambia participated in it. Data were collected through questionnaire self-administered method, and weight and height measurements. Using the age and gender-specific cutoff points proposed by World Health Organization, body mass index (BMI) was calculated using the weight and height measures. The data were analyzed using frequencies for underweight, overweight, and obesity, and the association between dietary factors and weight status of participants was determined using the Chi-square test.

FINDINGS

Out of the 1008 students recruited in the study, 981 of them completed and returned the questionnaires, resulting in a total response rate of 97%. The mean age of the participants was 17.3 years (SD = 1.9) and 385 of them (39.2%) were from grade 10. There were 627 (63.9%) females. The mean BMI for all the students was 20.0 ± 3.4 kg/m2. Most of the students (n = 672; 68.5 %) had normal body weight, but 226 (23%), 76 (7.7 %) and 7 (0.7%) of them were underweight, overweight and obese respectively. There was a significantly higher number of female students who were overweight (n = 64, 10.2%) than their male counterparts (χ2 = 72.336, p < 0.001). The frequency of drinking sugar added juices and full cream milk, eating fish, shrimps, oysters, lobsters, and snacks such as cakes and biscuits were significantly associated with overweight and obesity among the participants (p < 0.05). In conclusion, the problem of under-nutrition and over-nutrition co-existed among the students which were associated with poor eating habits.

Diabetes and cardiometabolic risk in South Asian youth: A review

South Asians are at increased risk for developing type 2 diabetes and cardiovascular disease at lower body mass index compared to other ancestral groups. Many factors contribute to this increased risk, including genetics, maternal-fetal factors, diet, fitness, body composition, and unique pathophysiology. Increased cardiometabolic risk is also seen at younger ages in South Asian individuals as compared to their White counterparts. This risk persists in migrant communities outside of South Asia. With the growing prevalence of obesity, diabetes, and cardiovascular disease in the South Asian population, it is imperative that we had better understand the mechanisms underlying this increased risk and implement strategies to address this growing public health problem during childhood and adolescence.

Prevalence and Associated Factors of Overweight and Obesity among High School Adolescents in Bahir Dar City, Northwest, Ethiopia: A Cross-Sectional Study

BACKGROUND

Overweight and obesity can be defined as excessive and abnormal fat deposition in our bodies. A body mass index for age of Z scores +2 to +3 was classified as overweight, whereas BMI for age >+3 Z-score was considered as obesity. Overweight and obesity in adolescents are a major health problem in low-income countries like Ethiopia. However, there is not well-established data on adolescents' overweight and obesity. Therefore, this study assessed the prevalence and associated factors of overweight and obesity among high school adolescents in Bahir Dar city, northwest of Ethiopia.

METHODS

An institution-based cross-sectional study was conducted from October 30 to November 30/2019 among 551 high school adolescents. Data were collected using a self-administrative questionnaire. Weight and height were measured by trained health professionals. World Health Organization AnthroPlus software was used to analyze anthropometric data into body mass index for age with z-score to ascertained overweight and obesity. Data were entered using Epi Info version 3.5.3 and transferred to SPSS version 22 for further analysis. Frequency and percentage were presented using tables and figures. A bivariable and multivariable logistic regression analysis was performed to determine the association between the dependent and independent variables. Adjusted odds ratio with 95% CI and p < 0.05 were used to dictate statistical significance for overweight and obesity.

RESULT

In this study, 522 high school adolescents aged 10-19 years were selected using a simple random sampling technique with a response rate of 94.74%. The mean age of the respondents was 17 years with SD ± 1.41. The overall prevalence of overweight and obesity was 12.5% (95% CI: 9.6, 15.2). Males (13.3%) were more than females (11.5%), being overweight and obese. Having self-employed mothers (AOR: 4.57; 95% CI: 1.06, 19.78), having government-employed mothers (AOR: 6.49; 95% CI: 1.96, 21.54), and having school feeding habit (AOR: 0.44; 95% CI: 0.26, 0.76) were factors associated with overweight/obesity among high school adolescents.

CONCLUSION

The prevalence of overweight/obesity in the current study was high. Adolescents having self-employed mothers, adolescents having government-employed mothers, and students having school feeding habits were significant factors of overweight and obesity. Therefore, more emphasis will be given to adolescents having self- and government-employed mothers and adolescents having school feeding habit.

Age and sex specific variations in body composition in Indian urban Bengali Hindu children, adolescents and young adults aged 7–21 years

Childhood and adolescent obesity is a public health concern worldwide. However, little attention has been paid on status of overweight and body composition of Indian Bengali urban middle and high SES population. The objective was to determine the prevalence of overweight and body composition status by age and sex in children, adolescents and young adults. This cross-sectional study was carried out among 4194 unmarried school and college students (1999 males and 2195 females) aged 7–21 years belonging to the Bengali Hindu Population in Kolkata, India. The survey period was from 1999 to 2011. Anthropometry of participants were measured. Age and sex specific ≥85 percentile of body mass index (BMI) for children (<18 years of age) and BMI ≥23 kg/m2 (≥18 years of age) for adults were used to define overweight. Fat percent, upper arm fat area (UAFA) and upper arm muscle area (UAMA) were estimated. Simple linear regression was performed to check trend of changes with age. The overall prevalence of overweight was 14.8% in both sexes. Mean fat percent was higher in females than males (23.5% vs 13.5% respectively; p<0.001) and it increased by 0.18% (0.02) in males and 0.56% (0.02) in females per year (both p<0.001). UAMA gradually increased with age in both sexes and increasing rate per year was by 2.07 (0.04) cm2 in males and 1.19 (0.04) cm2 in females (both p<0.001). However, UAFA increased by 0.41 (0.03) cm2 and 0.90 (0.03) cm2 every year in males and females respectively (both p<0.001). Sum of biceps, triceps, subscapular and suprailliac skinfolds increased by 1.66 (0.06) mm and 0.5 (0.07) mm per year in females and males respectively (both p<0.001). Overall prevalence of overweight was the same in both sexes but adipose tissue was higher and muscularly was lower in females than males.

Forecasting the prevalence of overweight and obesity in India to 2040

Background

In India, the prevalence of overweight and obesity has increased rapidly in recent decades. Given the association between overweight and obesity with many non-communicable diseases, forecasts of the future prevalence of overweight and obesity can help inform policy in a country where around one sixth of the world’s population resides.

Methods

We used a system of multi-state life tables to forecast overweight and obesity prevalence among Indians aged 20–69 years by age, sex and urban/rural residence to 2040. We estimated the incidence and initial prevalence of overweight using nationally representative data from the National Family Health Surveys 3 and 4, and the Study on global AGEing and adult health, waves 0 and 1. We forecasted future mortality, using the Lee-Carter model fitted life tables reported by the Sample Registration System, and adjusted the mortality rates for Body Mass Index using relative risks from the literature.

Results

The prevalence of overweight will more than double among Indian adults aged 20–69 years between 2010 and 2040, while the prevalence of obesity will triple. Specifically, the prevalence of overweight and obesity will reach 30.5% (27.4%-34.4%) and 9.5% (5.4%-13.3%) among men, and 27.4% (24.5%-30.6%) and 13.9% (10.1%-16.9%) among women, respectively, by 2040. The largest increases in the prevalence of overweight and obesity between 2010 and 2040 is expected to be in older ages, and we found a larger relative increase in overweight and obesity in rural areas compared to urban areas. The largest relative increase in overweight and obesity prevalence was forecast to occur at older age groups.

Conclusion

The overall prevalence of overweight and obesity is expected to increase considerably in India by 2040, with substantial increases particularly among rural residents and older Indians. Detailed predictions of excess weight are crucial in estimating future non-communicable disease burdens and their economic impact.

Change in overweight and obesity over a decade according to sociodemographic factors in Brazilian adolescents

The aims were to examine changes in the prevalence of overweight and obesity among students from 2001 to 2011, and to verify if these changes differ according to age group, area of residence, and family income. We analyzed two cross-sectional surveys conducted in 2001 and 2011 with brazilian adolescents. Sociodemographic and anthropometric characteristics were self-reported using a questionnaire. Multinomial logistic regression was used to analyze changes in overweight and obesity between the two surveys. The nutritional status was the outcome of the present study and the surveys (2001 and 2011) were the exposure. The odds of being overweight and obese were higher among boys and girls in urban areas in the 2011 survey compared to the 2001. Boys and girls with higher income were also more likely to present overweight and obesity in the second survey compared to the first. An increase of overweight and obesity was observed over a decade. We suggest that future interventions consider the area of residence and the family income to strengthen the effectiveness of actions developed to prevent and control these indicators among adolescents.

Trends of Obesity in 10-Years of Follow-up among Tehranian Children and Adolescents: Tehran Lipid and Glucose Study (TLGS)

BACKGROUND

We aimed to investigate the trend of childhood obesity in Tehranian population during a median follow-up of 10 years.

METHODS

Within a prospective cohort study, using data collected from Tehran Lipid and Glucose Study (TLGS), 1406 participants, aged 3-11 yr were selected and monitored in 4 phases: phase I (1999-2001), phase II (2002-2005), phase III (2006-2008) and phase IV (2009-2011).

RESULTS

Total prevalence of obesity in children increased from 5.5% to 9.4% from phase I to IV. Performing GEE (Generalized Estimating Equation) analysis, relative risk of obesity was calculated, comparing each phase to its previous phase: phase II in reference to phase I (RR=1.06, CI=1.04-1.08), phase III in reference to phase II (RR=1.01, CI=1.00-1.03) and phase IV in reference to phase III (RR=0.96, CI=0.94-0.98). Between group difference was significant in all subgroups (age, gender, parental obesity) except parental education. Test of interaction for effect of time was insignificant in all subgroups except for the age group. For children younger than 7 yr old at phase I, trend of obesity throughout the study was higher compared to those with 7 yr of age and older at phase I.

CONCLUSION

During a decade of follow-up, trend of obesity was rising in this Tehranian children in both genders, especially in younger children. Any preventive interventions for stopping this trend should focus on early stages of childhood.

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.

Gallbladder cancer incidence in Delhi urban: A 25-year trend analysis

INTRODUCTION

Gallbladder cancer (GBC) falls into the top ten leading cancer sites in urban Delhi. The incidence of GBC in females is more than that among males worldwide. The present study evaluates the temporal variation of GBC incidence in an urban Delhi population.

MATERIALS AND METHODS

The 25-year GBC incidence data were obtained from Population-Based Cancer Registry (PBCR) of Delhi which covered nearly 97.5% of the population and 75% of Delhi. We applied joinpoint regression method to determine the trend of GBC incidence from 1988 to 2012. The estimated cumulative risk (0-74) and lifetime risk of developing GBC were also calculated.

RESULTS

GBC contributed 6% of total cancer cases in Delhi during the year 2012. In the past 25 years, 12,410 GBC cases (4010 males and 8400 females) were registered and contributed approximately 3% of male cancer cases and 6.5% of female cancer cases. The median age at diagnosis of GBC was 60.13 years and 57.22 years in males and females, respectively. Joinpoint analysis showed an overall increasing trend of age-adjusted rates of GBC incidence over 25 years. In females, a downward trend was observed during 1992-2004, whereas in males, the trend remained consistent during 1991-2005; however, thereafter, it started significant increasing for both the genders. Age-specific trend of GBC also reflects an increasing trend among males and females after 2004.

CONCLUSION

The total and age-specific GBC cases have show an increasing trend in the past 25 years in urban Delhi. Stringent steps are required to control the modifiable risk factors for reducing the incidence of GBC in Delhi. In addition, individuals should also practice a healthy lifestyle to reduce the likelihood of GBC as well as other diseases.

Secular trends in overweight and obesity among urban children and adolescents, 2003-2012: A serial cross-sectional study in Guangzhou, China

Childhood and adolescent overweight and obesity are increasing in China, but limited information is available on its secular trends in Guangzhou. In this cross-sectional study, ten-wave successive data were obtained from the physical fitness surveillance for students in Guangzhou from 2003 to 2012. A total of 2,619,154 urban students aged 7–18 years were included. The age-standardized prevalence of overweight and obesity increased significantly over the period: overweight rose from 10.15% to 14.07% in boys and 6.39% to 8.11% in girls, while obesity increased from 5.65% to 8.31% for boys and 3.43% to 4.12% for girls, respectively (P < 0.05). The increasing trend was significant across almost all age-sex-specific groups (P < 0.05), especially in the last five years. The prevalence of overweight and obesity grew continuously in both sexes, but the pace of change for boys were faster than that for girls. The highest prevalence of overweight was found among 10- to 12-year-old boys, that of obesity among 7- to 9-year-old boys and girls. In conclusion, overweight and obesity have increased significantly among urban children and adolescents in Guangzhou during 2003–2012. Further analysis of influencing factors and comprehensive interventions are urgently needed to combat the obesity epidemic among urban children and adolescents in Guangzhou.

Efficacy of Health Education using Facebook to Promote Healthy Lifestyle among Medical Students in Puducherry, India: A Non-Randomized Controlled Trial

INTRODUCTION

Increasing burden of overweight and obesity among young adults is mainly due to unhealthy lifestyle especially with respect to diet and physical activity. At the same time, younger generations are spending more time with social network sites. Therefore, this study was intended to explore the role of social networking sites in promoting healthy lifestyle.

AIM

To measure the efficacy of health education using social networking sites in promoting healthy lifestyle among medical students in Puducherry, India.

MATERIALS AND METHODS

A non-randomized controlled trial was conducted in a private medical college located in Puducherry. The study participants were overweight/obese individuals with (intervention arm) and without Facebook account (control arm). Following a baseline survey, both the groups received health education from dietician and physical trainer using Audiovisual (AV) aids. Intervention group received health education through Facebook in the forms of messages, pictures and videos for six weeks. Then, follow up survey was done to assess the change in dietary pattern, physical activity and body weight. Data of those who attended baseline, intervention and follow up surveys (23- control and 22- intervention) were analysed. Means and proportions were calculated. Paired t-test and Chi-square test were used to calculate the p-value. The p-value<0.05 was considered as statistically significant.

RESULTS

Mean number of days of junk food intake per week was reduced in both control and intervention groups from 2.91 days/week and 3.27 days/week at baseline to 2.65 days/week to two days/week at follow up respectively. A significant decrease in the Body Mass Index (BMI) (p<0.05) was found among the control group (baseline: 25.57, follow up: 25.15). No significant changes were found with respect to physical activity and intake of fruits and vegetables.

CONCLUSION

Except for the decrease in junk food intake, use of Facebook as an effective tool to promote healthy lifestyle could not be proved with confidence.

Prevalence, risk factors and consequences of overweight and obesity among schoolchildren: a cross-sectional study in Kashmir, India

BACKGROUND

Obesity among children and adolescents is a growing public health problem. The objective of this study was to evaluate the prevalence, risk factors and metabolic consequences of obesity among schoolchildren from Kashmir, India.

METHODS

The study subjects (n=2024) included 870 boys and 1154 girls, aged between 6 and 18 years. Data were collected by interviewer-administered questionnaires. Information was obtained about different lifestyles, anthropometric parameters and dietary habits. Obesity was defined as body mass index (BMI) percentile as per the guidelines of Centers for Disease Control, 2000. For the evaluation of different clinical parameters, blood samples were collected from the subjects in the fasting state at 8 to 9 am after an overnight (10-12 h) fast.

RESULTS

The highest representation of subjects was from fee-paying private schools. Out of the total subjects, 6.69% were overweight and 4.64% were obese. The hip circumference, abdominal circumference, BMI, blood pressure (BP), use of ready-made foods as well as the clinical parameters like glucose, phosphorous, cholesterol and triglycerides were found significantly higher among girls than boys (p<0.05). Boys were taller and were physically more active than girls (p<0.01). Compared to the boys (3.33%), the girls were found to be more obese (5.63%). Rural dwelling subjects (4.22%) exhibited a lower percentage of obesity than urban population (5.00%). The difference in obesity among the different age groups was found statistically significant (p<0.05). Additionally, children with active lives in the form of vigorous (10.59%) or moderate (10.34%) exercise decreased their chances of gaining weight substantially.

CONCLUSIONS

Results from the present study have shown that prevalence of obesity among children was high in our population.

Nutritional status among primary school children in rural Sri Lanka; a public health challenge for a country with high child health standards

Background

Nutritional status of pre adolescent children is not widely studied in Sri Lanka. The purpose of this study was to determine the nutritional status among pre-adolescent school children in a rural province of Sri Lanka.

Methods

A school based cross sectional study was carried out in North Central Province in 100 rural schools, selected using multi stage cluster sampling with probability proportionate to size. Children in grade one to five were enrolled with a maximum cluster size of fifty. Anthropometric measurements were done by trained data collectors and venesection was done at site by trained nurses. WHO AnthoPlus was used to calculate the BMI, height for age and weight for age Z scores. Survey design adjusted prevalence estimates with linearized standard errors were generated using svy function of STATA. Mean haemoglobin concentration (Hb) was calculated using methaeamoglobin method. Screening for iron deficiency and thalassemia trait was done using peripheral blood films.

Results

Height and weight measurements were done for 4469 of children and the Hb data was available for 4398 children. Based on the survey design adjusted estimates, prevalence of severe thinness, thinness, overweight and obesity in this population was 8.60% (SE 0.94), 2.91%(SE 0.74), 2.95%(0.26) and 2.43%(SE 0.92) respectively. Similarly, survey design adjusted prevalence of underweight and stunting were, 25.93% (95% CI 24.07–27.89%) and 43.92%(95% CI 40.55–47.56%). Adjusted mean estimates for hemoglobin was 12.20 (95% CI 12.16–12.24) g/dL. Prevalence of anemia was 17.3% (n = 749). Prevalence of mild and moderate anemia was 9.4 and 7.6% respectively.

Conclusion

This study confirms that malnutrition is still a major problem in North Central Province, Sri Lanka.

Secular trends in weight status and weight-related behaviors in Korean adolescents from 2006 to 2013

The purpose of this study was to examine the secular trends in weight status and weight-related behaviors in adolescents in Korea from 2006 to 2013. Using a repeated cross-sectional design, we analyzed raw data from the 2006 and 2013 Korea Youth Risk Behavior Web-based Survey, which included 69,500 adolescents in 2006 and 70,354 adolescents in 2013. Subjects were 12- to 18-year-old boys and girls from the first grade of middle school through the third grade of high school. The data was collected by using an anonymous self-administered online survey. From 2006 to 2013, the prevalence of obesity increased by 0.7 (percent point; %p) (p < 0.001) in boys and 1.0%p (p < 0.001) in girls. At the same time, the prevalence of obesity increased by 1.0%p (p < 0.001) in middle-school students and decreased by 0.7%p (p < 0.001) in high-school students. Healthy, unhealthy, and extreme weight-control behaviors decreased in all adolescents (all p < 0.001). Obesity and unhealthy weight control behaviors in Korean adolescents remain major public concerns, and programs to encourage healthy weight control behaviors are required.

Obese children are thin in parents' eyes: A psychologically, socially, or culturally driven bias?

Although obesity presents a serious health problem in children, parents often underestimate their children's overweight and obesity status. Therefore, scientific literature was systematically screened through PubMed and PsycINFO to demonstrate the psychological, social, and cultural processes that underlie this evaluation bias. A total of 37 papers that focused on research conducted in different geopolitical contexts were taken into account. Furthermore, a lexicometric analysis of the papers' conclusions was performed. The findings showed that education plays a key role in promoting parents' awareness and their realistic recognition of their children's weight. Accordingly, adequate educational support for parents should be implemented in all healthcare policies addressing childhood obesity.

Preventing childhood obesity in Asia: an overview of intervention programmes

The rapid economic growth in Asia in the past few decades has contributed to the global increase in childhood obesity prevalence. Yet, little is known about obesity prevention efforts in this region. This systematic review provides an overview of child obesity prevention programmes in Asia. Searches were performed in six electronic databases. Out of 4,234 studies, 17 were included, among them 11 controlled trials (of which five were randomized). Only one study was published before 2007. Identified studies were predominantly conducted in China and Thailand and targeted primary school children in a school setting. Most studies implemented different programmes, frequently targeting behavioural modification through nutrition/health education lectures and/or physical activity sessions. Programme effects related to obesity outcome measures were mixed. Most substantial effects were found for outcomes such as improved health knowledge and/or favourable lifestyle practices. The relatively small number of relevant publications in Asia highlights the need for scientific evaluations of existing and future programmes. This will help ensure the implementation and dissemination of evidence-based approaches that have been proven to be effective in the Asian context. Targeting preschool settings and applying a comprehensive multisectoral approach may increase the effectiveness and sustainability of childhood obesity prevention programmes.

A 'snapshot' of physical activity and food habits among private school children in India

Concerns about increasing obesity in poorer parts of the world, including India, have often been premised in terms of global shifts in activity levels and caloric consumption. Lifestyle changes have been documented in large cities, but we do not know whether these changes are reaching young people in less urban locations. This study used photo journals to explore children's perceptions of their food and activity habits in a remote Indian city. Children expressed interest in active pastimes, learning, and health, and indicated traditional, modern, local, and global influences in their lives. Findings offer context for research and interventions.

25-year trends in gender disparity for obesity and overweight by using WHO and IOTF definitions among Chinese school-aged children: a multiple cross-sectional study

OBJECTIVES

We sought to explore 25-year trends of gender disparity in the prevalence of obesity and overweight both in urban and rural areas among Chinese children from 1985 to 2010.

METHODS

Data included 1 280 239 children aged 7-18 years enrolled in the Chinese National Survey on Students's Constitution and Health (CNSSCH), which is the largest nationally representative sample of school-aged children in China. Obesity and overweight were defined according to both WHO and the International Obesity Task Force (IOTF) definitions. Logistic regression was used to estimate the prevalence OR (POR) of gender for obesity and overweight prevalence in different surveys.

RESULTS

The prevalence of obesity increased (WHO definition: from 0.10% to 4.3%; IOTF definition: from 0.03% to 2.2%) over the past 25 years in urban and rural areas among Chinese children and it was much higher among boys than girls at each survey point (p<0.01). The increasing trend was significant in all age subgroups (p<0.01). Although the prevalence of obesity continuously increased in boys and girls, the changing pace was more rapid in boys than in girls. PORs of boys versus girls for obesity also increased over time, and the estimates of PORs were higher in urban areas than in rural areas at each survey point.

CONCLUSIONS

The gradually increasing gender disparity in urban and rural areas suggests that the prevalence of obesity and overweight in boys, and especially in urban boys, contributes to a large and growing proportion of obese and overweight children.

A study on nutritional status of school-going adolescents in Aligarh, India

Adolescence is a highly vulnerable period for malnutrition. This study was based on a Global School Health Survey methodology in the 13-15-year age group; employing WHO AnthroPlus to evaluate the nutritional status, find the prevalence of both extremes of malnutrition, compare with the growth curves and to find its sociodemographic correlates. A total of 1456 students were sampled and the mean BMI for age Z score was found to be -0.11. The prevalence of overweight and obese were 11.95% and 2.27%, respectively, whereas 2.75% suffered from thinness, defined as BMI for age <2 standard deviations. The prevalence of being overweight and obese was associated with a higher standard of living, a higher education of father or mother, working mothers and father's occupation being service/business. The evident double burden of malnutrition presages a large public health burden in future, requiring interventional attention.

Toward Food Policy for the Dual Burden of Malnutrition: An Exploratory Policy Space Analysis in India

BACKGROUND

There is global consensus that a strong policy response is essential for addressing the dual burden of malnutrition. However, policy makers in low- and middle-income countries may perceive a conflict between food supply policies to combat persistent undernutrition and more recent recommendations for policies addressing rising rates of diet-related noncommunicable diseases (NCDs).

OBJECTIVE

This article explores the potential to use policy space analysis to identify food supply policy opportunities for addressing both undernutrition and diet-related NCDs and to support improved policy coherence.

METHODS

We conducted an exploratory policy space analysis to identify opportunities and constraints for integrated nutrition policy with respect to the food supply in India, where a dual burden of malnutrition has been well documented. We conducted a review of food supply policies and 27 key informant interviews (16 with stakeholders active in India's national nutrition policy space, and 11 with policy makers and experts in food supply policy).

RESULTS

The analysis suggests several opportunities for an integrated food supply policy agenda, including targeting common foods of concern (such as highly processed foods) and foods that present common benefits (such as fruits and vegetables), and scaling up existing small-scale policy initiatives that support the availability of nutrient-rich foods. Challenges include policy inertia and competing priorities within the economic sector.

CONCLUSION

This scoping study indicates that the policy space analysis framework used here can help to identify specific, contextually appropriate policy options and strategies for strengthening public health nutrition policy within sectors responsible for food supply policy.

Overweight and Obesity in School Children of a Hill State in North India: Is the Dichotomy Urban-Rural or Socio-Economic? Results from a Cross-Sectional Survey

INTRODUCTION

Overweight and obesity are a public health problem in India not only in adults but also in children. The authors sought to estimate the prevalence of overweight and obesity in school-going children of 6-17 years of age and examine its demographic and dietary correlates in context of their urban-rural status and socio-economic status.

METHODS

In this cross-sectional survey height and weight were measured in 1266 school children in government and private schools of urban and rural areas. Dietary assessment was done using single day 24-hour dietary recall method. The data were analyzed using SPSS (IBM SPSS Statistics Version 19) and WHO AnthroPlus Software. Factorial ANOVA was used for testing interaction within and between subgroups for continuous variables and Chi-square test was used for categorical variables.

RESULTS

It was found that the overall prevalence of overweight was 15.6% of which 5.4% were obese, with maximum prevalence in boys attending urban private schools. The mean caloric intake in the study population with 24-hour dietary recall method was 1558.2 kilocalories (SD: 428 kilocalories).

CONCLUSION

Overweight and obesity is a significant problem in school-going children. Higher socio-economic status continues to remain an important driver of this epidemic in the younger generation and affects demographic and dietary determinants of this problem.

Overweight and its associated risk factors among urban school adolescents in Nepal: a cross-sectional study

OBJECTIVES

The prevalence of non-communicable diseases is increasing in Nepal. Overweight and obesity are the major risk factors of many non-communicable diseases. Adolescence is a critical phase for development of overweight and obesity. Risk factors associated with overweight and obesity are not well understood in Nepal. The objective of the study was to identify the factors associated with overweight and obesity among adolescent students.

SETTING

A cross-sectional descriptive study was carried out on higher secondary school students in the Lalitpur sub-metropolitan city, Nepal.

PARTICIPANTS

A random sample of 360 students aged 16-19 years from eight schools was included in the study.

RESULTS

The prevalence of overweight among adolescent students was 12.2% (95% CI 8.9 to 15.5). Factors associated with being overweight included being male (adjusted OR (AOR) 2.64, 95% CI 1.18 to 4.88), studying in private school (AOR 2.10, 95% CI 1.03 to 4.28), high socioeconomic status family (AOR 4.77, 95% CI 1.36 to 16.72), watching television for more than 2 h per day (AOR 8.86, 95% CI 3.90 to 20.11), and consuming fruit four times or less per week (AOR 3.13, 95% CI 1.39 to 7.01). There was no statistically significant association between adolescent overweight and age, ethnicity, mother's education level, mother's occupation, number of siblings or family type.

CONCLUSIONS

Socioeconomic status, watching television for a longer time and consuming less fruit are major risk factors for overweight among adolescents in Nepal. Interventions are needed to increase awareness about the risk factors of adolescent overweight and obesity to decrease prevalence of overweight-associated non-communicable diseases.

Temporal trend in overweight among adolescents in northeastern Brazil

OBJECTIVE

This study aimed to determine the prevalence and the temporal trend in overweight, as well as their relationship with sociodemographic factors in adolescents from northeastern Brazil.

SUBJECTS AND METHODS

We analyzed data from two similar school-based, cross-sectional epidemiological studies conducted in 2005 (n = 2,768) and 2009 (n = 2,776), with public and private high school students of both sexes, aged 14 to 18 years, in João Pessoa, state of Paraiba, Brazil. Sociodemographic information (sex, age and economic class), body weight (kg) and height (cm) were self-reported by the students. Body mass index was classified according to International Obesity Task Force criteria.

RESULTS

There was a significant increase of three percentage points in overweight prevalence from 2005 (10.1%; CI95%: 8.9-11.3) to 2009 (13.1%; CI95%: 11.4-15.5), which was of greater magnitude in males (5.0%; p < 0.001) than in females (1.8%; p = 0.085). Adjusted analysis showed that the Odds Ratio for an adolescent to show overweight in 2009 compared with 2005 was 1.34 (CI95%: 1.13-1.60), which was also greater in males (OR = 1.45; CI95%: 1.15-1.83), in adolescents aged 16 years (females - OR = 3.01; CI95%: 1.62-5.55), and in those from the middle economic class (males: OR = 1.47; CI95%: 1.03-2.23; females: OR = 1.59; CI95%: 1.01-2.53).

CONCLUSIONS

Prevalence of overweight in adolescents was high, and showed an increasing trend, particularly in males who belonged to the middle economic class.

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.

Overweight trends among Polish schoolchildren before and after the transition from communism to capitalism

This study aims to reveal the secular trends in body mass index (BMI) and the prevalence of overweight and obesity among Polish schoolchildren between the years 1966-2012, during which intense socio-political changes took place. Four surveys were conducted in several districts of Poland looking at 69,746 schoolchildren aged 7-18. Significant increase in mean BMI as well as in the prevalence of overweight and obesity was observed. During this time the highest increase in both mean BMI and excess weight was observed between 1988 and 2012, i.e. after the political transformation, resulting in the improvement of living conditions. However, with respect to girls in late adolescence, between these years, the mean BMI as well as the prevalence of overweight were leveling off, while the percentage of boys with excess body fat in the same developmental category significantly increased in 2012. In the years 1966-1978 and 1978-1988 the pattern of changes in the prevalence of overweight and obesity reflected the social and economic circumstances, i.e. temporary economic improvements, or deepening political crises and food shortage. In conclusion, the weight status of schoolchildren strongly reflects socio-political changes that took place in Poland, as well as in most of the Central European countries in the last half century.

Assessing Differences in Risk Perceptions About Obesity Among "Normal-Weight" and "Overweight" Adolescents--A Qualitative Study

OBJECTIVES

To assess the differences in risk perceptions of overweight/obese and normal-weight adolescents about obesity and associated risk factors.

DESIGN

Qualitative study using focus group discussions (FGDs).

SETTINGS

Five randomly selected schools from the South Indian city of Hyderabad.

PARTICIPANTS

Seventy-nine adolescents (ages 11-14 years) participated in 10 FGDs (5 each with overweight/obese and normal-weight groups).

PHENOMENON OF INTEREST

Whether obesity-related risk perceptions differ with actual weight status or not.

ANALYSIS

FGDs were recorded, transcribed, and manually coded for thematic analysis. Results were presented according to 6 themes. At each stage of coding and analysis, reports were read independently by 2-3 researchers and the inter-coder reliability was high (ratio of number of agreements against the sum of agreements plus disagreements was over 90%).

RESULTS

Adolescents across the groups had limited understanding of nutrition during adolescence as well as causes and consequences of obesity. The optimistic bias that they were less vulnerable compared to others to the risks of obesity was evident from perceptions of overweight groups. While overweight adolescents argued that obesity was hereditary, the normal-weight participants perceived "faulty food habits" and laziness as the reasons. Adolescents across the groups considered fruits and vegetables as healthy foods.

CONCLUSIONS AND IMPLICATIONS

There were clear differences in perceptions of adolescents of different weight status. Employing the risk perception analysis framework, this study identified the following adolescent traits: responsive, avoidance, and indifference, which may be useful for developing nutrition communication programs.

Overweight status in Indian children: prevalence and psychosocial correlates

OBJECTIVE

To examine the association between overweight status and psycho-social risk factors in Indian children.

METHODS

Data from India's nationally-representative Global School-based Student Health Survey were analyzed using SPSS for all participating students (n=8130, 58% males).

RESULTS

The likelihood of being overweight was significantly higher for children with fewer friends (OR=1.16, 95%CI=1.13-1.18) or friends who were not kind or helpful, children with symptoms of depression (OR=1.20, 95%CI=1.03-1.39) and anxiety (OR=1.09, 95%CI=1.07-1.15), children with little parental involvement (OR=1.06, 95%CI=1.02-1.10), and children who felt lonely or missed school days without permission.

CONCLUSIONS

Psychosocial distress in overweight Indian children warrants comprehensive interventions for screening and treatment of pediatric obesity.

Type 2 diabetes in youth in South Asia

People of South Asian origin are at a high risk of developing diabetes compared to that of other ethnic groups. Recent evidence suggests an emerging epidemic of youth-onset type 2 diabetes (T2DM) in the region, in parallel with the childhood obesity epidemic. Many risk factors such as foetal and early-life influences, the South Asian phenotype, family history of diabetes and environment factors are responsible for the early occurrence of T2DM in South Asia. The high risk supports the need for the opportunistic screening of children and adolescents for diabetes in South Asian countries. Early detection, lifestyle modification, weight reduction and drugs are central to the care of children with T2DM. Both population-based preventive strategies and interventions targeting children and adolescents with obesity and impaired glucose tolerance are required to combat the epidemic of youth-onset T2DM in South Asia.

Investigating correlations in the altered metabolic profiles of obese and diabetic subjects in a South Indian Asian population using an NMR-based metabolomic approach

It is well known that obesity/high body mass index (BMI) plays a key role in the evolution of insulin resistance and type-2 diabetes mellitus (T2DM). However, the exact mechanism underlying its contribution is still not fully understood. This work focuses on an NMR-based metabolomic investigation of the serum profiles of diabetic, obese South Indian Asian subjects. (1)H 1D and 2D NMR experiments were performed to profile the altered metabolic patterns of obese diabetic subjects and multivariate statistical methods were used to identify metabolites that contributed significantly to the differences in the samples of four different subject groups: diabetic and non-diabetic with low and high BMIs. Our analysis revealed that the T2DM-high BMI group has higher concentrations of saturated fatty acids, certain amino acids (leucine, isoleucine, lysine, proline, threonine, valine, glutamine, phenylalanine, histidine), lactic acid, 3-hydroxybutyric acid, choline, 3,7-dimethyluric acid, pantothenic acid, myoinositol, sorbitol, glycerol, and glucose, as compared to the non-diabetic-low BMI (control) group. Of these 19 identified significant metabolites, the levels of saturated fatty acids, lactate, valine, isoleucine, and phenylalanine are also higher in obese non-diabetic subjects as compared to control subjects, implying that this set of metabolites could be identified as potential biomarkers for the onset of diabetes in subjects with a high BMI. Our work validates the utility of NMR-based metabolomics in conjunction with multivariate statistical analysis to provide insights into the underlying metabolic pathways that are perturbed in diabetic subjects with a high BMI.

Empirical change in the prevalence of overweight and obesity in adolescents from 2007 to 2011 in Guangzhou, China

There is a strong evidence of an increasing secular trend in obesity in adolescents in most of the world over the past 10 years. However, no studies have been reported on this trend in Guangzhou, one of the most urbanized areas in China. This study assessed the empirical changes in body mass index (BMI) and the prevalence of overweight and obesity of adolescents in Guangzhou from 2007 to 2011. The data were derived from the surveys on students' constitution and health carried out by government in 2007, 2009, and 2011 in Guangzhou. Randomly, 17,157 students in 2007, 26,381 students in 2009, and 36,328 students in 2011, aged 12 to 18, from schools in the four urban districts were examined. Anthropometric parameters were measured in all students. Adiposity status was estimated using BMI according to the Working Group on Obesity in China criteria. The total prevalence of overweight and obesity increased from 8.1 % and 3.1 % in 2007 to 10.0 % and 4.2 % in 2011, respectively (P < 0.05). However, the total prevalence of obesity decreased significantly from 4.5 % in 2009 to 4.2 % in 2011 (P < 0.05). The prevalence of overweight and obesity in males was significantly higher than that in females in each year among the 4 years (P < 0.05).

CONCLUSION

Although the prevalence of adolescent overweight and obesity in Guangzhou in 2011 is still lower than the average values of Chinese large coastal cities, a significant increase was still found in their prevalence from 2007 to 2011. However, the adolescent obesity, but not the overweight prevalence, starts to decrease from 2009 to 2011.

Contribution of food sources to the vitamin B12 status of South Indian children from a birth cohort recruited in the city of Mysore

OBJECTIVE

There is evidence that subclinical vitamin B12 (B12) deficiency is common in India. Vegetarianism is prevalent and therefore meat consumption is low. Our objective was to explore the contribution of B12-source foods and maternal B12 status during pregnancy to plasma B12 concentrations.

DESIGN

Maternal plasma B12 concentrations were measured during pregnancy. Children's dietary intakes and plasma B12 concentrations were measured at age 9.5 years; B12 and total energy intakes were calculated using food composition databases. We used linear regression to examine associations between maternal B12 status and children's intakes of B12 and B12-source foods, and children's plasma B12 concentrations.

SETTING

South Indian city of Mysore and surrounding rural areas.

SUBJECTS

Children from the Mysore Parthenon Birth Cohort (n 512, 47.1 % male).

RESULTS

Three per cent of children were B12 deficient (<150 pmol/l). A further 14 % had 'marginal' B12 concentrations (150-221 pmol/l). Children's total daily B12 intake and consumption frequencies of meat and fish, and micronutrient-enriched beverages were positively associated with plasma B12 concentrations (P=0.006, P=0.01 and P=0.04, respectively, adjusted for socio-economic indicators and maternal B12 status). Maternal pregnancy plasma B12 was associated with children's plasma B12 concentrations, independent of current B12 intakes (P<0.001). Milk and curd (yoghurt) intakes were unrelated to B12 status.

CONCLUSIONS

Meat and fish are important B12 sources in this population. Micronutrient-enriched beverages appear to be important sources in our cohort, but their high sugar content necessitates care in their recommendation. Improving maternal B12 status in pregnancy may improve Indian children's status.

Are the current Indian growth charts really representative? Analysis of anthropometric assessment of school children in a South Indian district

BACKGROUND

India currently is posed by the double threat of thinness and overweight/obesity among children. Different growth charts have taken different population and give different cut-off points to assess these conditions.

OBJECTIVE

The objective of this study is to assess the anthropometry of school children, 5-18 years of age and thereby estimate the prevalence of childhood thinness, overweight and obesity. To analyze how the study population compares with that of Agarwal's growth chart.

MATERIALS AND METHODS

The anthropometric measurements of all the students who were studying from 1(st) to 12(th) standards were taken from 27 randomly selected Government and private schools. Prevalence of thinness, overweight and obesity were assessed using two standards - Indian standard given by Agarwal and International Standards given by International Obesity Task Force (IOTF).

RESULTS

The prevalence of thinness, overweight and obesity among 18,001 students enrolled as per Indian standard were 12.2%, 9.5% and 3% and as per International standard were 15.3%, 8.1% and 2.6% respectively. The mean and the 95(th) percentile values of body mass index for both boys and girls at all ages in this study are falling short of Agarwal's and IOTF values. Using international cut-offs as well as Indian cut-offs given by Agarwal, underestimate the prevalence of obesity among boys and girls of all age groups.

CONCLUSION

This study shows that under and over-nutrition among school children is in almost equal proportions. There is an underestimation of obesity among children whenever an Indian or an International growth chart is used. Thus, this study brings out the need for a really representative growth chart.

Eliciting a policy response for the rising epidemic of overweight-obesity in India

India is experiencing multiple transitions with respect to nutrition patterns, epidemiology and demography. Along with staggering childhood undernutrition, a rapid rise in chronic diseases and their risk factors including overweight-obesity (O-O), among all sections of society, is compounding India's health challenges. We present an overview of the O-O scenario (prevalence, determinants) and profile existing initiatives to address this modifiable risk factor in India. Urgent attention from all sectors, committed resources, policy support and targeted actions are warranted to combat the dual burden of malnutrition. The health systems should be reoriented and strengthened, in addition to enabling actions in other sectors, to address prevention and control of non-communicable diseases and associated risk factors like O-O.