Abstract
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.
Acknowledgments
The authors of this study would like to thank the State Department of Science and Technology, Government of Jammu and Kashmir for their financial assistance (Grant/Award Number: ‘32ST2011’). The authors are also thankful to all the children for their voluntary participation in the study.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted article and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. WHO. Report of a WHO consultation on obesity. Preventing and managing the global epidemic, 1998.Search in Google Scholar
2. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization technical report series, 2000;894:i-xii, 1–253.Search in Google Scholar
3. Gupta N, Shah P, Nayyar S, Misra A. Childhood obesity and the metabolic syndrome in developing countries. Indian J Pediatr 2013;80(Suppl 1):S28–37.10.1007/s12098-012-0923-5Search in Google Scholar
4. Martin L, Oepen J, Reinehr T, Wabitsch M, Claussnitzer G, et al. Ethnicity and cardiovascular risk factors: evaluation of 40,921 normal-weight, overweight or obese children and adolescents living in Central Europe. Int J Obes (Lond) 2015;39:45–51.10.1038/ijo.2014.167Search in Google Scholar
5. Perez-Escamilla R, Hospedales J, Contreras A, Kac G. Education for childhood obesity prevention across the life-course: workshop conclusions. Int J Obes Suppl 2013;3(Suppl 1):S18–S9.10.1038/ijosup.2013.7Search in Google Scholar
6. Reilly JJ. Obesity in childhood and adolescence: evidence based clinical and public health perspectives. Postgrad Med J 2006;82:429–37.10.1136/pgmj.2005.043836Search in Google Scholar
7. Stevens GA, Singh GM, Lu Y, Danaei G, Lin JK, et al. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index). National, regional, and global trends in adult overweight and obesity prevalences. Popul Health Metr 2012;10:22.10.1186/1478-7954-10-22Search in Google Scholar
8. Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet 2002;360:473–82.10.1016/S0140-6736(02)09678-2Search in Google Scholar
9. Hakala P, Rissanen A, Koskenvuo M, Kaprio J, Ronnemaa T. Environmental factors in the development of obesity in identical twins. Int J Obes Relat Metab Disord 1999;23:746–53.10.1038/sj.ijo.0800923Search in Google Scholar PubMed
10. Allamani A. Addiction, risk, and resources. Subst Use Misuse 2007;42:421–39.10.1080/10826080601142287Search in Google Scholar PubMed
11. Fister K. Junk food advertising contributes to young Americans’ obesity. Br Med J 2005;331:1426.10.1136/bmj.331.7530.1426-cSearch in Google Scholar PubMed PubMed Central
12. Printice AM, Jebb SA. Fast foods, energy density and obesity: a possible mechanistic link. Obesity Rev 2003;4:187–94.10.1046/j.1467-789X.2003.00117.xSearch in Google Scholar
13. Qi Z, Ding S. Obesity-associated sympathetic overactivity in children and adolescents: the role of catecholamine resistance in lipid metabolism. J Pediatr Endocrinol Metab 2016;29:113–25.10.1515/jpem-2015-0182Search in Google Scholar PubMed
14. Kalra S, Unnikrishnan A. Obesity in India: the weight of the nation. J Med Nutr Nutraceut 2012;1:37–41.10.4103/2278-019X.94634Search in Google Scholar
15. Masse LC, de Niet-Fitzgerald JE, Watts AW, Naylor PJ, Saewyc EM. Associations between the school food environment, student consumption and body mass index of Canadian adolescents. Int J Behav Nutr Phys Act 2014;11:29.10.1186/1479-5868-11-29Search in Google Scholar PubMed PubMed Central
16. Kotecha PV, Patel SV, Baxi RK, Mazumdar VS, Shobha M, et al. Dietary pattern of schoolgoing adolescents in urban Baroda, India. J Health Popul Nutr 2013;31:490–6.10.3329/jhpn.v31i4.20047Search in Google Scholar PubMed PubMed Central
17. Bridges KG, Jarrett T, Thorpe A, Baus A, Cochran J. Use of the triglyceride to HDL cholesterol ratio for assessing insulin sensitivity in overweight and obese children in rural Appalachia. J Pediatr Endocrinol Metab 2016;29:153–6.10.1515/jpem-2015-0158Search in Google Scholar PubMed PubMed Central
18. Caminiti C, Armeno M, Mazza CS. Waist-to-height ratio as a marker of low-grade inflammation in obese children and adolescents. J Pediatr Endocrinol Metab 2016;29:543–51.10.1515/jpem-2014-0526Search in Google Scholar PubMed
19. BM P. The nutrition transition and obesity in the developing world. J Nutr 2001;131:871S-3.10.1093/jn/131.3.871SSearch in Google Scholar PubMed
20. Sanders T, Feng X, Fahey PP, Lonsdale C, Astell-Burt T. Green space and child weight status: does outcome measurement matter? Evidence from an Australian Longitudinal Study. J Obes 2015;2015:194838.10.1155/2015/194838Search in Google Scholar PubMed PubMed Central
21. Goyal RK, Shah V, Saboo BD, Phatak SR, Shah NN, et al. Prevalence of overweight and obesity in indian adolescent school going children: its relationship with socioeconomic status and associated lifestyle factors. J Assoc Physicians India 2010;58:151–8.Search in Google Scholar
22. Mistry SK, Puthussery S. Risk factors of overweight and obesity in childhood and adolescence in South Asian countries: a systematic review of the evidence. Public Health 2015;129:200–9.10.1016/j.puhe.2014.12.004Search in Google Scholar PubMed
23. Casonatto J, Fernandes RA, Batista MB, Cyrino ES, Coelho ESMJ, et al. Association between health-related physical fitness and body mass index status in children. J Child Health Care 2016;20:294–303.10.1177/1367493515598645Search in Google Scholar PubMed
24. Mohan V, Jaydip R, Deepa R. Type 2 diabetes in Asian Indian youth. Pediatr Diabetes 2007;8(Suppl 9):28–34.10.1111/j.1399-5448.2007.00328.xSearch in Google Scholar
25. Velasquez-Mieyer P, Perez-Faustinelli S, Cowan PA. Identifying children at risk for obesity, type 2 diabetes, and cardiovascular disease. Diabetes Spectrum 2005;18:213–20.10.2337/diaspect.18.4.213Search in Google Scholar
26. Chatterjee P. India sees parallel rise in malnutrition and obesity. Lancet 2002;360:1948.10.1016/S0140-6736(02)11943-XSearch in Google Scholar
27. Caballero B. A nutrition paradox–underweight and obesity in developing countries. N Engl J Med 2005;352:1514–6.10.1056/NEJMp048310Search in Google Scholar
28. Wright CM. Which threshold should India use to define childhood obesity and how much does it matter? Indian Pediatr 2011;48:103–4.10.1007/s13312-011-0030-0Search in Google Scholar
29. Ahmad QI, Ahmad CB, Ahmad SM. Childhood obesity. Indian J Endocrinol Metab 2010;14:19–25.Search in Google Scholar
30. Andrabi SM, Bhat MH, Andrabi SR, Kamili MM, Imran A, et al. Prevalence of metabolic syndrome in 8–18-year-old school-going children of Srinagar city of Kashmir India. Indian J Endocrinol Metab 2013;17:95–100.10.4103/2230-8210.107812Search in Google Scholar
31. Eston R, Reilly T. Kinanthropometry and exercise physiology laboratory manual: anthropometry, Volume 1: London and New York: Taylor & Francis, 2009.10.4324/9780203868744Search in Google Scholar
32. Dudala SR, Arlappa N. An updated Prasad’s socio economic status classification for 2013. Int J Res Dev Health 2013;1:26–8.Search in Google Scholar
33. Gonzalez-Casanova I, Sarmiento OL, Gazmararian JA, Cunningham SA, Martorell R, et al. Comparing three body mass index classification systems to assess overweight and obesity in children and adolescents. Rev Panam Salud Publica 2013;33:349–55.10.1590/S1020-49892013000500006Search in Google Scholar
34. The International Association for the Study of Obesity and the International Obesity TF. The Asia-Pacific perspective: redefining obesity and its treatment. Australia: IASO and IOTF, 2000.Search in Google Scholar
35. Chhatwal J, Verma M, Riar SK. Obesity among pre-adolescent and adolescents of a developing country (India). Asia Pac J Clin Nutr 2004;13:231–5.Search in Google Scholar
36. Kapil U, Singh P, Pathak P, Dwivedi SN, Bhasin S. Prevalence of obesity amongst affluent adolescent school children in delhi. Indian Pediatr 2002;39:449–52.Search in Google Scholar
37. Khadilkar VV, Khadilkar AV. Prevalence of obesity in affluent school boys in Pune. Indian Pediatr 2004;41:857–8.Search in Google Scholar
38. Marwaha RK, Tandon N, Singh Y, Aggarwal R, Grewal K, Mani K. A study of growth parameters and prevalence of overweight and obesity in school children from delhi. Indian Pediatr 2006;43:943–52.Search in Google Scholar
39. Ramachandran A, Snehalatha C, Vinitha R, Thayyil M, Kumar CK, et al. Prevalence of overweight in urban Indian adolescent school children. Diabetes Res Clin Pract 2002;57:185–90.10.1016/S0168-8227(02)00056-6Search in Google Scholar
40. Vohra R, Bhardwaj P, Srivastava JP, Srivastava S, Vohra A. Overweight and obesity among school-going children of Lucknow city. J Family Community Med 2011;18:59–62.10.4103/2230-8229.83369Search in Google Scholar PubMed PubMed Central
41. Gupta DK, Shah P, Misra A, Bharadwaj S, Gulati S, et al. Secular trends in prevalence of overweight and obesity from 2006 to 2009 in urban Asian Indian adolescents aged 14–17 years. PLoS One 2011;6:17221.10.1371/journal.pone.0017221Search in Google Scholar PubMed PubMed Central
42. Deoke A, Hajare S, Saoji A. Prevalence of overweight in high school students with special reference to cardiovascular efficiency. Glob J Health Sci 2012;4:147–52.10.5539/gjhs.v4n2p147Search in Google Scholar PubMed PubMed Central
43. Ranjani H, Pradeepa R, Mehreen TS, Anjana RM, Anand K, et al. Determinants, consequences and prevention of childhood overweight and obesity: an Indian context. Indian J Endocrinol Metab 2014;18:S17–25.10.4103/2230-8210.145049Search in Google Scholar PubMed PubMed Central
44. Oduwole AA, Ladapo TA, Fajolu IB, Ekure EN, Adeniyi OF. Obesity and elevated blood pressure among adolescents in Lagos, Nigeria: a cross-sectional study. BMC Public Health 2012;12:616.10.1186/1471-2458-12-616Search in Google Scholar PubMed PubMed Central
45. Rao S, Kanade A, Kelkar R. Blood pressure among overweight adolescents from urban school children in Pune, India. Eur J Clin Nutr 2007;61:633–41.10.1038/sj.ejcn.1602555Search in Google Scholar PubMed
46. Fraser LK, Clarke G, Cade JE, Edwards KL. Fast food and obesity: a spatial analysis in a large United Kingdom population of children aged 13–15. Am J Prev Med 2012;4:77–85.10.1016/j.amepre.2012.02.007Search in Google Scholar PubMed
47. Maher C, Olds T, Eisenmann JC, Dollman J. Screen time is more strongly associated than physical activity with overweight and obesity in 9- to 16-year-old Australians. Acta Paediatr 2012;101:1170–4.10.1111/j.1651-2227.2012.02804.xSearch in Google Scholar PubMed
48. Shan XY, Xi B, Cheng H, Hou DQ, Wang Y, et al. Prevalence and behavioral risk factors of overweight and obesity among children aged 2–18 in Beijing, China. Int J Pediatr Obes 2010;5:383–9.10.3109/17477160903572001Search in Google Scholar PubMed
49. Babinska K, Kovacs L, Janko V, Dallos T, Feber J. Association between obesity and the severity of ambulatory hypertension in children and adolescents. J Am Soc Hypertens 2012;6:356–63.10.1016/j.jash.2012.08.002Search in Google Scholar PubMed
50. Buch N, Goyal J, Kumar N, Parmar I, Shah VB, et al. Prevalence of hypertension in school going children of Surat city, Western India. J Cardiovasc Dis Res 2011;2:228–32.10.4103/0975-3583.89807Search in Google Scholar PubMed PubMed Central
51. Chakraborty P, Dey S, Pal R, Kar S, Zaman FA, et al. Obesity in Kolkata children: magnitude in relationship to hypertension. J Nat Sci Biol Med 2011;2:101–6.10.4103/0976-9668.82310Search in Google Scholar PubMed PubMed Central
52. Jain S, Pant B, Chopra H, Tiwari R. Obesity among adolescents of affluent public schools in Meerut. Indian J Public Health 2010;54:158–60.10.4103/0019-557X.75740Search in Google Scholar PubMed
53. Lu X, Shi P, Luo CY, Zhou YF, Yu HT, et al. Prevalence of hypertension in overweight and obese children from a large schoolbased population in Shanghai, China. BMC Public Health 2013:13:24.10.1186/1471-2458-13-24Search in Google Scholar PubMed PubMed Central
54. Musaiger AO, Al-Mannai M, Zagzoog N. Association between food intake frequency and obesity among adolescent girls in Saudi Arabia. Int J Adolesc Med Health 2014;26:145–7.10.1515/ijamh-2012-0115Search in Google Scholar PubMed
55. Fareed M, Afzal M. Estimating the inbreeding depression on cognitive behavior: a population based study of child cohort. PLoS One 2014;9:e109585.10.1371/journal.pone.0109585Search in Google Scholar PubMed PubMed Central
56. Fareed M, Afzal M. Evidence of inbreeding depression on height, weight, and body mass index: a population-based child cohort study. Am J Hum Biol 2014;26:784–95.10.1002/ajhb.22599Search in Google Scholar PubMed
57. Bhat GA, Shah IA, Rafiq R, Nabi S, Iqbal B, et al. Family history of cancer and the risk of squamous cell carcinoma of oesophagus: a case-control study in Kashmir, India. Br J Cancer 2015;113:524–32.10.1038/bjc.2015.218Search in Google Scholar PubMed PubMed Central
58. Wu M, Zhang ZF, Kampman E, Zhou JY, Han RQ, et al. Does family history of cancer modify the effects of lifestyle risk factors on esophageal cancer? A population-based case-control study in China. Int J Cancer 2011;128:2147–57.10.1002/ijc.25532Search in Google Scholar PubMed
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