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

Prevalence of overweight and obesity and associated demographic and health factors in India: Findings from Comprehensive National Nutrition Survey (CNNS)

BACKGROUND

Childhood obesity (5-9 years) in India is likely to contribute 11% to the global burden by 2030.

METHODS

Data from India's Comprehensive National Nutrition Survey (CNNS, 2016-2018) was used to assess the prevalence and key associated factors of overweight and obesity. Multivariable logistic regression models were applied to identify potential determinants associated with being overweight and obese.

RESULTS

Overweight prevalence (including obesity) varied from 1.6% (0-4 years) to 4.8% (10-19 years). The majority of states reported a higher proportion of adolescents overweight and obese, than younger age group 5-9 years. A significantly higher prevalence of children and adolescents with obesity was reported in higher wealth quintiles and residents of urban areas. The prevalence of overweight and obesity and associated demographic and health factors in India included: the presence of NCD risk factor (adolescents: 1.68, 95% CI [1.31-2.14]), micronutrient deficiency (5-9 years children: 1.72, 95% CI [1.30-2.28]), mother's education (5-9 years children: 4.84, 95% CI [2.92-8.03]; adolescents: 2.17, 95% CI [1.42-3.32]), wealth (adolescents: 1.92, 95% CI [1.16-3.19]), place of residence (5-9 years children: 1.68, 95% CI [1.39-2.03]; adolescents: 1.39, 95% CI [1.16-1.66]), child age (5-9 years children: 1.64, 95% CI [1.40-1.93], and screen-time (adolescents: 1.63, 95% CI [1.22-2.19].

CONCLUSION

The findings set out policy and research recommendations to pave the path for curtailing the increasing prevalence of overweight and obesity and achieving the World Health Assembly's Global Nutrition target of 'no increase in childhood overweight (Target 4) by 2025'.

Effect of aerobic exercise on anthropometric parameters among Indian primary school children

Childhood obesity is a global public health concern with significant implications for long-term health. This study addresses the rising rates of obesity among school-age children (10-12 years) and investigates the effectiveness of aerobic exercise interventions in improving anthropometric parameters, specifically focusing on BMI and mid-arm circumference (MAC). The study emphasizes the role of schools in shaping children's behaviors and aims to contribute empirical evidence to inform health promotion strategies for this demographic. The research employs a quasi-experimental design, involving 60 school-age children in Visnagar, Gujarat, India. The 12-week aerobic exercise intervention, conducted three times a week, comprises activities like running, jumping jacks, and dance routines. Data collection includes sociodemographic information, BMI, and MAC measurements. The study design, participant criteria, and intervention details are carefully outlined. Socio-demographic variables such as age and monthly family income significantly influence BMI, highlighting the importance of considering these factors in interventions. Pretest results show 80% of children classified as overweight, reducing to 58.3% post-intervention. The mean BMI significantly decreases from 24.41 to 22.84 (p < 0.05), indicating the positive impact of aerobic exercise. The study also explores the association between BMI, MAC, and socio-demographic variables through chi-square tests. Data shows the prevalence of overweight and obesity among school-age children and demonstrates the effectiveness of a 12-week aerobic exercise program in improving BMI. Findings align with existing literature on the positive impact of physical activity on weight management in children.

A Systematic Review of School-Based Nutrition Interventions for Promoting Healthy Dietary Practices and Lifestyle Among School Children and Adolescents

Childhood malnutrition is one of the foremost community health problems in the world, particularly in developing countries like India. This current review was conducted to evaluate the effectiveness of various school-centered nutrition interventions/intervention programs developed in recent years, and their impact on the nutritional status, dietary habits, food preferences, lifestyle, and dietary behaviors in relation to diet, as well as physical activities for school children, especially adolescents. This review included studies found in the PubMed/Medline, SCOPUS, and Web of Science (WOS) databases, published from July 2017 to 2023. They were analyzed for eligibility criteria defined for this study, including school children and adolescents, school-based nutrition interventions/strategies/policies/initiatives, nutritional status, physical activity, dietary habits, and lifestyle. The Risk of Bias assessment was conducted using Review Manager version 5.4. Among 1776 potentially related studies, 108 met the eligibility criteria. Following this review, 62 studies were identified as eligible for this study, in which 38 intervention programs were discussed. A total of 13 studies were considered comprehensive and multi-component, 15 were nutrition education interventions, six were identified as physical activity interventions, and four focused on lifestyle and dietary behavior-related interventions. Another 24 of the 62 studies reviewed (approximately 39%) were either original articles, review articles, or articles pertaining to nutritional program guidelines, protocols, and/or reports. These studies uncovered a possible relationship between a decrease in BMI and school children's engagement in diet and/or physical activity. Results also suggest that these programs can be effective, although evidence for the long-term sustainability of changes in BMI was less evident and not fully substantiated/supported. Most of these findings are based on self-reported program data and may consist of biases linked to recall, selection of participants, and the desire to report favorable final measures (physical activity, lifestyle, and dietary habits). This study has the potential for use in public health programs devoted to healthy nutrition behavior and lifestyle practices. This research was primarily conducted by clinical researchers and did not receive any standardized institutional or organization-derived grant funding and support.

Comparative Assessment of the Periodontal Findings in Child Subjects With a Normal Body Mass Index and in Obese Subjects

BACKGROUND

Obesity in children is a concerning issue affecting a large population globally. Obesity and overweight are risk factors for various medical conditions, including periodontal diseases, hypertension, cerebrovascular disease, cardiovascular disease, and/or diabetes.

AIM

The study aimed to comparatively assess the periodontal findings in child subjects with a normal BMI and in obese subjects.

METHODS

The present observational study aimed to comparatively assess 216 school-going child subjects that were divided into two groups: non-obese (BMI<25) and obese, with BMI≥25 having equal gender distribution. In both groups, clinical attachment loss (CAL), probing depth (PD), and bleeding on probing (BOP) were assessed along with a questionnaire on oral hygiene and dietary habits. The data gathered were statistically analysed.

RESULTS

The study results showed that in obese subjects, significantly higher values were seen for probing depth, bleeding on probing, and plaque index compared to non-obese subjects with p<0.05. However, no significant difference was noted in the CAL of obese and non-obese subjects (p>0.05).

CONCLUSION

The periodontal status is compromised in obese subjects with higher values of probing depth, bleeding on probing, and plaque index compared to child subjects with normal weight. The level of CAL does not differ significantly between obese and non-obese child subjects.

The incidence, prevalence, and contributing factors of overweight and obesity among adolescent population of India: A scoping review protocol

Introduction

Overweight and obesity among the adolescent population are emerging as worldwide epidemics. Its increasing occurrence in India is highly concerning. Amidst the burden of malnutrition, where undernutrition is a long-standing health problem, the rising concerns around childhood overweight/obesity has several repercussions for this population. The aim of this scoping review is to map the evidence of the prevalence and contributing factors of overweight and obesity among adolescents (10 to 19 years) in the Indian population.

Methods

The study will be conducted according to the Arksey and O’Malley scoping review framework and the Joanna Briggs institute Reviewers’ manual. The Population, Concept and Context strategy (PCC) will ensure the review questions, eligibility criteria, and search strategy. The Systematic Review and Meta-analysis: Extension for Scoping Review (PRISMA-ScR) will be used for the findings of the study of Scoping Review. The Mixed Methods Appraisal Tool (MMAT), Version- 2018 will be used to assess the methodological quality of all relevant studies. Literature search will be done using electronic databases: PubMed, Google Scholar, SCOPUS, EMBASE, and Cochrane library by specific keywords such as “prevalence”; “overweight”; “obesity”; “obese”; “malnutrition”; “BMI”; “adolescent”; “teenager”; and “youth” etc. Additional studies will be considered using cross-references.

Why The Knowledge of Indian School-Going Adolescents Regarding NCDs is Not Transforming into Lifestyle Changes?

Background

There is a paucity of research to demonstrate the quantification of adolescents' risk behavior toward Non-Communicable Diseases (NCD) in India. This study aims to explain the knowledge of school-aged adolescents about NCD and whether their knowledge is truly translating into lifestyle changes and if not, what are the potential underlying factors responsible for that.

Methodology

A school-based cross-sectional study was conducted on adolescents in Jodhpur district, India, in grades 6 to 12. The data was gathered via a semi-structured questionnaire. The participant's weight and height were assessed using a digital weighing machine and a stadiometer, respectively. SPSS v.23 was used to analyze the data. Univariate (chi-square) and multivariate (logistic regression) analysis were used to quantify knowledge and risk factors, and inferences were derived.

Results

A total of 1010 students participated in the study. The mean scores of knowledge and risk behavior were 32.82±6.43 (out of 40) and 9.23+2.63 (out of 30), respectively. Adolescent risk behavior and knowledge were not found to be significantly related. Physical activity, spending fewer hours sitting, not skipping breakfast, and habit of fruit and vegetable consumption were significant factors for a healthy lifestyle among them.

Conclusion

Due to differences in underlying predictors, adolescents' understanding of NCDs did not translate into healthy lifestyle modifications. These findings highlight the importance of developing tailored interventions for adolescents that target identified risk domains.

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.

Prevalence of overweight and obesity among school children in Mysuru, Karnataka

Childhood obesity has become a major public health challenge in developing countries including India due to the changes in the lifestyle and food habits of children owing to the influence of urban culture and technological growth. The present study is a cross-sectional, school-based study conducted to assess the prevalence of obesity and to determine the demographic variables influencing the obesity among school children.

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.

The socio-ecological model as a framework for understanding junk food consumption among schoolchildren in Nepal

BACKGROUND

The consumption of industrially processed food, popularly known as junk food, is a growing public health concern worldwide, including in Nepal. Schoolchildren are a vulnerable group and they consume junk food at school.

AIM

The aim of this study was to examine multi-level determinants of junk food consumption among basic schoolchildren using the socio-ecological model as a framework.

METHODS

A cross-sectional study was conducted among students (n = 404), and a self-reported questionnaire was used to collect the data. The chi-square test and logistic regression were applied to analyse the results using SPSS version 26.

RESULTS

Nearly half (47%) of the students reported that they consumed junk foods at snack time. Important variables for explaining junk food consumption were knowledge of food and nutrition-a micro-level determinant; sharing knowledge of food and nutrition with classmates at school-a meso-level determinant; grade of student-an exo-level determinant; and occupation of parents-a macro-level determinant. However, multivariate analysis found that knowledge of food and nutrition (p < 0.05), and sharing knowledge of food and nutrition with classmates at school (p < 0.05) were the significant predictors of junk food consumption.

CONCLUSIONS

Junk food consumption is common among basic-level students in the study schools. Multi-level determinants explain the factors associated with this behaviour, extending from micro to macro as the socio-ecological model asserts. This study points to the need for comprehensive school-based nutrition education that targets multiple levels of influence, focusing on active learning approaches to promote healthy dietary behaviour in students.

Prevalence of Obesity and Overweight among School-Aged Children in Saudi Arabia and Its Association with Vitamin D Status

BACKGROUND

Childhood obesity is a significant global public health problem. Worldwide data showed an increasing trend over the years. We aimed to explore the prevalence of obesity, and its association with vitamin D status.

METHODS

This cross-sectional study was conducted during the period from 2016 to 2017. The study included 3613 schoolchildren aged 6-19 years in the western, central, and eastern regions in Saudi Arabia. Anthropometric data including age, sex and body mass index (BMI) was collected and the serum 25OH- vitamin D (25OHD) was measured. Age-sex standardized BMI Z-scores using the 2007 World Health Organization growth standards were applied.

RESULTS

Data from 3613 school-aged children (females = 51.8%), with equal percentage of participants from each region were analyzed. Prevalence of obesity and overweight was estimated at 7.1% and 14.4% respectively. An increasing trend was detected with age (p: 0.006). Obesity started to increase at the age of 10 years and continued to increase until 19 years. Most of the obese children (64.2%) had deficient vitamin D levels, compared to 33.7% of them with suboptimal levels and only 2.0% with optimal levels (p: <0.001).

CONCLUSIONS

This large cohort study revealed a high prevalence (21.5%) of obesity and overweight in school children aged between 6-19 years with increasing trend with age.  Children with high BMI showed extremely high prevalence of VDD and VDI. These findings are alarming and point to the need for effective national interventions that include improving and encouraging access to physical activity and exposure to sunlight, educational activities for students, parents, and schoolteachers and possible enrichment of staple food with vitamin D.