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SHORT COMMUNICATION
Year : 2010  |  Volume : 54  |  Issue : 3  |  Page : 158-160  

Obesity among adolescents of affluent public schools in Meerut


1 Assistant Professor, L.L.R.M. Medical College, Meerut, India
2 Associate Professor,Subharti Medical College, Meerut, India
3 Professor, L.L.R.M. Medical College, Meerut, India
4 Statistician Cum Lecturer, Subharti Medical College, Meerut, India

Date of Web Publication18-Jan-2011

Correspondence Address:
Seema Jain
Assistant Professor, L.L.R.M. Medical College, Meerut, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-557X.75740

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   Abstract 

The prevalence of obesity has increased worldwide in all segments of the population due to increased industrialization, urbanization, mechanization, and associated changes in diet and lifestyles. Change in diet habit of consuming more high energy fast foods and shifting to sedentary lifestyle has affected our children and also increased the risk of chronic diseases among adolescents. Childhood obesity has association with increased risk of coronary heart disease, stroke, and cancer in later life. Therefore, its control and prevention is one of the major concerns for all developing nations. The present school-based cross-sectional study was carried out among 2785 affluent adolescents of six public schools in Meerut during the period October 2003 to March 2004. The objective is to assess the magnitude of overweight and obesity in adolescents and associated risk factors, with the help of the ELIZ health pathway based on body mass index criteria. Prevalence of overweight and obesity was found to be 19.7% and 5.3% in girls and 18.36% and 10.82% in boys. Obesity was found to be significantly associated with high intake of junk foods (P < 0.05), binge eating, high calorie intake (P < 0.05), lower physical activity (P < 0.05), and prolonged TV watching (P < 0.05).

Keywords: Lifestyle factors, Obesity, Overweight, School health


How to cite this article:
Jain S, Pant B, Chopra H, Tiwari R. Obesity among adolescents of affluent public schools in Meerut. Indian J Public Health 2010;54:158-60

How to cite this URL:
Jain S, Pant B, Chopra H, Tiwari R. Obesity among adolescents of affluent public schools in Meerut. Indian J Public Health [serial online] 2010 [cited 2019 May 19];54:158-60. Available from: http://www.ijph.in/text.asp?2010/54/3/158/75740

Obesity is considered to be a global epidemic, has spread its major roots in our children and adolescents. Overweight children have double chances to become obese adult than normal children. [1] Adolescence is characterized by an exceptionally rapid rate of growth and is often variable in individuals due to its dependence on genetic hormonal and nutritional factors. [2] More than 60% of overweight children have at least one additional risk factor for cardiovascular disease, such as raised blood pressure, hyperlipidemia, or hyperinsulinemia, and more than 20% obese children have two or more risk factors.

During the past 20 years, prevalence of obesity among children and adolescents has doubled in America. The United States National Center for Health Statistics suggests that nearly 15% adolescents are overweight or obese. [1] Obesity is harder to treat in adults than in children. [3],[4] Sedentary lifestyle, strange food habits, binge eating, and prolonged TV viewing have probably given rise to this health catastrophe. [5],[6] Every day our adolescents are becoming over conscious about their body images and are often misguided to inculcate unhealthy habits. It is often felt that health of an adolescent is often neglected due to lack of awareness, busy work schedule, and poor compliance from teens. Considering the depth of this issue, this study was planned to find out the prevalence of overweight and obesity among affluent adolescents and the different factors responsible for the obesity in children.

It was a cross-sectional study conducted among adolescents of six affluent public schools in Meerut district having similar fee structure, from October 2003 to March 2004. The schools were selected by simple random sampling within 10 km of coverage area of medical college. Consent was obtained from the principals of schools. A sample size of 2785 was calculated by taking 15% relative error for qualitative data on prevalence of 6% in affluent adolescents. [7] All students aged 10-16 years from class 5 to 11 were selected.

A detailed proforma comprising of complete information about their personal habits, dietary intake (by the 24 h recall method), and family history was distributed among participants. Parent teacher sensitization meetings were held in the schools, and data were collected after 2 days of sensitization. Weight and height were measured by electronic weighing scale to nearest 100 g and height measuring stand to nearest 0.1 cm, respectively. Altogether 2570 students could be covered with a dropout of 7.7%. From each school, 519, 434, 441, 509, 458, and 424 students were included in the study.

Overweight and obesity were assessed by the ELIZ health pathway for adolescents, [2] and other contributory factors such as sex, socioeconomic, family profile, dietary habits, and personal habits were studied in relation to prevalence of obesity. Data were collected, complied, and analyzed accordingly by the Microsoft excel worksheet.

The ELIZ Health Path for Adolescents and Adults (EHPA) approach [2] is used to assess health of adolescents, and it shows underweight adolescents as well as overweight. By this method, body mass index (BMI) is directly read from the chart by marking weight and height on the same chart which is not possible by other methods. [7],[8] The ELIZ health pathway for adolescents and adults was designed and validated as a simple tool to assess the nutritional status applicable for both sexes whether under nourished or overnourished [Figure 1].
Figure 1 :ELIZ Health Path for Adolescents and Adults (EHPA)-Growth Assessment Chart. Lower most black area, under nutrition (BMI < 15.0); Dark grey, normal (BMI 15– 22); light grey above, overweight (BMI 22– 25); uppermost black area, obesity (BMI > 25)

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The prevalence of obesity in adolescents of public schools in Meerut was found to be 8.6% by the ELIZ health pathway which is comparable to findings by Gupta and Ahmed, [5] Kapil et al., [6] and Vedavati et al. [9] The ELIZ health pathway for adolescents also shows a high prevalence of under nourished adolescent girls (7.7%) and boys (9.4%) along with normal, overweight, and obese adolescents [Table 1].
Table 1 :Distribution of adolescent boys and girls according to nutritional status by EHPA

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The prevalence of obesity was higher in males than in females when compared to the study of Kapil et al., [6] but Vedavati et al. [9] showed higher prevalence in males. Maximum obesity was seen in 10-12 year of age group in both the sexes which is comparable to studies of Kapil et al. [5] and Gupta and Ahmed.[6] At this stage, growth potential is high and this is very important to screen them for such nutritional problems and guide them timely to inculcate healthy habits.

Introduction of sedentary lifestyle, media, and junk food eating has shown contributions toward causation of obesity in adolescents [Table 2]. In this study, consumption of high energy fried food and junk food have shown significant association with the prevalence of adolescent obesity comparable to findings of Sinhababu, [10] Singh et al., [11] and WHO Expert Committee. [12] Reduced physical and sports activity and prolonged T.V watching for more than 2 h were found to be significantly associated with the obesity in adolescents, comparable to recommendations by Shetty. [4] Shetty recommended that excessive TV watching and playing video and computer games have a direct impact on the childhood obesity due to decline in physical activity. [4] This study did not reveal any statistical significance of obesity in relation to sibling order, family history, parent's education, and father's occupation.
Table 2 :Distribution of various factors associated with obesity in adolescents

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This study recommends that the ELIZ health pathway for adolescents is the appropriate, easy, and acceptable method to screen obesity as well as under nutrition, as it can be used easily by school authorities as a part of health checkups. It can give alarming signals in early stage that can easily be conveyed to the parents, so that preventive strategies could be implied at the household and school level simultaneously and synergistically. School authorities can arrange some activities such as group discussion on nutrition and balanced diet, regular sports with involvement of all students from time to time, and knowledge will be imparted to home to limit television viewing, restrict the intake of energy dense foods and soft drinks. School libraries can display standard charts of weight and height, waist-to-hip ratio, or ELIZ health pathway for adolescents, in order to make our future generations aware about their fitness.

 
   References Top

1.International Life Sciences Institutes, Preventing Childhood Obesity is a Current Research Focus: Initiatives Cooperate to Share Information and Stem Epidemic. The PAN Report: Physical Activity and Nutrition, USA, International Life Science Institute, Vol. 2. 2000. p. 5.   Back to cited text no. 1
    
2.Elizabeth KE. A novel growth assesment chart for adolescent. Indian Pediatr 2001;38:1061-4.   Back to cited text no. 2
[PUBMED]    
3.Styne DM. Childhood obesity and Adolescent obesity, prevalence and significance. Pediatr Clin North Am 2001;48:823-47.  Back to cited text no. 3
[PUBMED]    
4.Shetty PS. Childhood obesity in Developing societies. Nutr Found India Bull 1999;20:4.  Back to cited text no. 4
    
5.Gupta AK, Ahmed AJ. Childhood obesity and hypertension. Indian Pediatr 1990;27:333-7.  Back to cited text no. 5
    
6.Kapil U, Singh P, Pathak P. Prevalence of obesity among affluent adolescent school children in Delhi. Indian Pediatr 2002;39:450-2.   Back to cited text no. 6
    
7.Cole TJ, Bellizzi MC, Flegal KM, Diez WH. Establishing standard definition for child overweight and obesity worldwide: International survey. Br Med J 2002;320:1-6.  Back to cited text no. 7
    
8.Must A, Dallal GE, Dietz WH. Reference data for obesity, 85th Percentile and 95th Percentile of Body Mass Index and Triceps skin fold thickness. Am J Clin Nutr 1991;53-54,839-46, 773.  Back to cited text no. 8
    
9.Vedavati S, Jay Shree S, Mohammad R. Prevalence of overweight and obesity in affluent adolescent girls in Chennai in 1981 and 1998. Indian Pediatr 2003;40:775-9.  Back to cited text no. 9
    
10.Sinhababu A. Body Mass Index status and some obesity promoting dietary factors among nursing students of nursing training school, Bankura. Indian J Community Med 2006;31:78-9.   Back to cited text no. 10
  Medknow Journal  
11.Singh AK. Maheshwari A, Shankla N, Anad K. Life style associated risk factors in adolescents. Indian J Pediatr 2006;73:901-6.   Back to cited text no. 11
    
12.WHO. Report of Joint WHO/FAO Expert Consultation, Diet, Nutrition and the prevention of chronic disease, WHO technical report series 2005;916:2.  Back to cited text no. 12
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]


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