With social-economic development,India moved away from childhood malnutrition and towards the better health and food security, this resulted in reduced number of underweight, malnourished, and stunted-wasted children. With changing lifestyle and food habits there is a spike in overweight and obesity not onlyin adults but also among children. With high prevalence India ranked third in the childhood obesity after the USA and China. 1, 2
Abnormal or excessive fat accumulation results in to overweight and obesity. This present a greater risk to health. Obesity can be measured using body mass index (BMI) which is calculated using person’s weight in kilograms divided by square of his or her height in meters. BMI of more or equal to 30 kg/m2is considered as obese whereas BMI of more or equal to 25 is defined as overweight. 1, 2
Both overweight and obesity are the risk factors for the development of chronic diseases including diabetes mellitus, cardiovascular diseases (CVD) and cancer. Initially obesity was considered the problem of developed countries, but now due to changing the life style, it has become the problem of low- and middle-income countries mainly in the urban populations. 1
Several programs are running to combat malnutrition in India, however India has developed another problem as obesity. Previous data by National Family Health Survey (NFHS-4) have documented the doubling of the obese people in India. This also highlighted the point of increasing the obesity among the urban population as compared to rural settings. 2
In India nutritional status varies significantly from region to region and childhood malnutrition varies between 20 to 80 % region to region but interestingly there is a rising of prevalence of childhood overweight and obesity in some parts.3 In present study we tried to find out the prevalence of overweight and obesity of school going children of Chandimandir area.
Three hundred and ninety six school going children having age between 12-14 years from a school of Chandimandir were studied.To capture the demographic and lifestyle data a pre-designed questionnaire based on Global school-based student health survey4was used. It was a cross-sectional single centre study conductedon January 2019.
A prior permission to conduct this study was secured from the Govt. Education Dept. and the school authorities. An informed and written consent was also secured from the participating students and their parents. For this study only the children in the age group of 12 to 14 years were taken and students withsevere and chronic illness and who were unwilling toparticipatewere excluded.
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To calculate the body mass index (BMI) height and weight of the subjects was recorded using the digital weighing machine and meter tape.All the subjects were interviewed to record theage, sex, food habits, skipping breakfast, TV watching time, time spent on videogames and social media, time spent on physical activities and games.
Based on the recorded subjects were classified as regularly eating or not eating breakfast, skipping breakfast or average breakfast in a week. Children indulge in physical activity for sixty minutes (moderate to vigorous) per day classified as physically active. Moderate activity included brisk walking, dancing, household chores and vigorous exercise includes running, fast cycling, fast swimming, moving heavy load, playing football etc. 5
BMI was calculated according to the WHO child growth reference and a set of thresholds based on single standard deviation spacing was used in the study. BMI = Weight (Kg)/Height2 (m2) (weight in kilograms is divided by square of weight in meter)
Subjects were grouped as Underweight (18.5), Normal (18.5 and 24.9), Overweight (25 and 29.9) and Obese (30 and 39.9). Recorded data was analyzed using IBM SPSS ver. 20 software and Microsoft Excel. Data is expressed as number and percentage. The risk factors were assessed by using Chi-square test. P value of We included 396 subject of either sex between 12 to 14 years of age. Subjects weredivided in to four groups as normal, underweight, overweight and obese based on their BMI. Results showed that prevalence of obesity and overweight was 5% and 8% respectively which shows over all prevalence of 13%.
Similar reports were generated by the Vairagade et al6 and Tapnikar et al7; as per these studies among school children of Aurangabad combined prevalence was 10% (overweight:7%; obesity:3%) which was closer to ours and slightly higher in a study in Nagpur i.e. a combined prevalence of 14% (overweight:12%; obesity:2%). Our results resonate with the study by Jcob et al in which WHO growth reference charts, 2007 was used like ours but sample size was only 150. In Kerala it was 10.7% (overweight: 7.56%; obesity: 3.10%) respectively though the school children belonged to rural area of Kerala unlike ours. 8Bhargava et al concluded that in the hill states of India prevalence of overall overweight and obesity was 15.6 % which is higher than our result. 9
On analysis of age wise distribution of BMI in our study prevalence of 12 % overweight and 8 % obesity was found to be highest in 14 year of school children and similar findings were observed by Kavitha et al in their study at Gulbarga where prevalence of overweight and obesity were more among 15 years students followed by 14 year age group of children.10
We also found that there is higher prevalence of overweight and obesity i.e. 9% and 6% respectively among girls than those of boys i.e. 7% and 4% respectively. Which is in agreement to finding of Jacobet al, among rural children of Kerala where more girls were found to be overweight (9.09%) than boys (5.96%). But in terms of obesity unlike our findings boys were more obese (3.35%) than girls (2.85%).8Jagadesan et al also conclude that prevalence of overweight and obesity were more among females with 17.74% and 6.45% respectively compared to males (4.55% and 1.44% respectively) and gender was significantly associated with overweight and obesity unlike in current study. 11
Major factors and behaviors responsible for overweight and obesity are unhealthy food habits and lack of physical activity. These risk behaviors among overweight and obese children were compared with non-obese children. In our study we found the association between fast food eating and obesity significant (pAnother common observation among obese subjects was skipping of breakfast, our findings are similar to Thompson et al who observed a high prevalence of both overweight (41%, including 15% who were obese) and breakfast skipping (68%) and on multivariate analysis found that more frequent breakfast skipping was associated with greater odds of overweight. 13With easy availability of modern electronic media and gadgets, children spends more time around them instead of actual physical activity, which are now regarded as the most modifiable risk factors of childhood obesity. We also observed that around 55% of both obese and non-obese children were used to TV watching and videogames and association of TV viewing and obesity was not found significant. (P=0.0956, P>0.05). Similar findings were reported by Saha from Mehsana, Gujarat.
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