 |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
 |
Home| Journals | Statistics Online Expert | About Us | Contact Us |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
 |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| About this Journal | Table of Contents | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
[Abstract] [PDF] [HTML] [Linked References]
Prevalence and Epidemiology of Overweight and Obesity among Upper Primary School Children in Latur City
Soniya V. Ashtekar1*, Sarita B. Mantri2, Atul V. Wadagale3 1Assistant Professor, 2Principal and Professor, Department of Community Medicine, MIMSR Medical College, Latur, Maharashtra, INDIA. 3Assistant Professor in Biostatistics, Department of Community Medicine, Government Medical College, Latur, Maharashtra, INDIA. *Corresponding Address: Research Article
Abstract: Background: Obesity is increasing at an alarming rate throughout the world. Obesity in children is a marker of overweight in adult age, and it shows an association with the chronic non communicable disease. Hence study was undertaken to find out the prevalence of overweight and obesity. Objectives: 1.To determines prevalence of overweight and obesity among upper primary school children. 2. To identify factors influencing overweight and obesity. Material and methods: A cross sectional study was conducted. 1182 school children studying in 5th to 7th standard were studied. Sociodemiographic, anthropometric and dietary data was collected using a pre-tested questionnaire. Results: prevalence of overweight and obesity was 8.44% and 1.54% respectively. Higher socioeconomic status, Daily Calorie intake Above RDA, mix type of food and less Physical Activity time were the significant factors for overweight and obesity. Conclusion: Increased junk food frequency, low physical activity should be avoided by children. Health education to teachers, parentsand students will help for reducing the prevalence of obesity. Keywords: Obesity, Epidemiology, Latur.
Introduction The prevalence of child obesity is increasing rapidly worldwide. obesity has become a colossal epidemic causing serious public health concern and contributes to 2.6 million deaths worldwide every year.1 initially prevalence of obesity was more in developed countries but now higher prevalence is seen in developing countries also. National representative data for childhood obesity in India is unavailable, however available studies of Delhi and Chennai has shown the prevalence of 7.4% and 6.2% respectively.2,3 Obesity is a consequence of an energy imbalance; energy intake exceeds energy expenditure over a considerable period. Lifestyle changes and worldwide nutrition transition are important factors for obesity epidemic. Economic growth, modernization, urbanization (increased use of automated transport, technology at home) and globalization of food markets are important factors for increased prevalence of obesity. Obesity is associated with an increased risk of morbidity and mortality as well as reduced life expectancy. 50-80% of obese children will continue as obese adults.4 Due to difficulty in the treatment of obesity in adults and the many long-term adverse effects of childhood obesity, prevention of childhood obesity has now been recognized as a public health priority.5 With this background in mind, the present study was undertaken to know the prevalence of overweight and obesity and its influencing factors in upper primary school children(children studying in 5th to 7th std.)
Aim and Objectives
Methodology The study was done in 4 schools, which were selected randomly from the list of all schools in an urban area during June 2011-May 2012. Pilot study showed 8% prevalence of obesity among the children. Sample size was estimated at 5% level of significance with an allowable error of 20%, using the following formula . It was 1150 children. The total number of children in all four schools was 1230. Out of these, 48 were excluded from the study as they were absent on the day of examination. Thus, finally the total numbers of children studied were 1182. The study was approved by the Ethical Committee of the Medical College. Permission was obtained from the authorities of local school. Teaching and administrative staff and students underwent prior orientation about the study. The questionnaire was pre-tested and validated during the pilot study. The questionnaire used to record the data regarding the various socio-demographic variables, various influencing factors with respect to obesity. The data collection from the study subjects consisted of two steps -the personal interview and the anthropometric measurements. The time selected for undertaking the measurements was during the school working hours. Anthropometric measurements included Weight, Height. The sociodemiographic data was filled by the parents. School children were sent to home with parental form one day prior to their interview and measurements. Parental form included sociodemiographic data. This parental form was attached with consent form.
Data analysis Children were classified into according to their BMI as obese, overweight, normal and underweight. IOTF (International Obesity Task Force) cutoff points were used for classifying children into different classes 6. Data was analyzed using SPSS. As overweight and obesity are having same epidemiology and overweight is a step before obesity, during analysis both the groups i.e. overweight and obesity were merged and statistical tests were applied.
Results Table 1: Distribution of Children According to their standards
Figure 1: Distribution of Children According to their Body Mass Index Table 2: Distribution of Children According to their Age and Sex Composition
Table 3: Risk factors for overweight and obesity in children
Table 4: Multivariate Regression Analysis of Obesity and Overweight in Children
Total no of children in the study were 1182. Total no. of students studying in standard 5th, 6th and 7th were 393,409 and 380 respectively. Mean age was11.2 ± 0.92 years. Range was 9-14 years. Mean age of males and females was 11.21±0.9 years and 11.20±0.85 years respectively. Out of 1182 children 654 (55.32%) were males and 528 (44.68%) were females(Table 2). Among these 1182 school children studied, 101 (8.54%) were overweight, 17(1.44%) were obese and 476(40.28%) were underweight (fig 1). Overall, it was also found that the prevalence of obesity was more among male population (1.53%) as compared to that in females (1.33%). though the difference was not significant. The prevalence of obesity was found to be highest among 9-11 years age group (1.57%) and overweight was maximum in 12-14 year age group (9.47%). Mean weight of obese male was 45.84 ± 9.54kg. and that of obese female was 43.49 ± 7.29 kg. Univariate analysis showed following factors to be associated with overweight and obesity - higher socioeconomic status (p<), working status of mother(p<0.005), use of motor vehicle for commuting to school(p<0.000), less physical activity (p<0.05), intake of extra calories than RDA(p< 0.05), junk food > 2 times a week(p<0.00) and mix type of diet(p< 0.05).(Table 3) Multiple Logistic Regression Analysis was applied and found that higher socioeconomic status, Daily Calorie intake Above RDA, mix type of food and less Physical Activity time were the significant factors for overweight and obesity.(Table 4) Discussion Out of 1182 children 654 (55.32%) were males and 528 (44.68%) were females. These findings were consistent with the study done by Premanath et al. 7 in Mysore, there were 54.5% were males and 46.1% were females. In present study prevalence of overweight was found to be 8.54%. Similar results were found by Kotian et al.8 (9.9%), Kapil et al.2 (7.4%), Avula Laxmaiah et al.9 (7.2%), Kumar et al.10 (5.74%). Prevalence of obesity in our study was 1.44%, similar results were seen by Mishra A et al.11 (2.8%),Avula Laxmaiah et al.9(1.6%), Mahajan et al.118(2.12%), Kotian et al.8 (4.4%) and Bharati et al.12(1.2%) In our study the prevalence of obesity was more among male population (1.53%) as compared to that in females (1.33%). It was also comparable with a study by Kapil et al.2 males were more (8.3%) as compared to female (5.5%). In contrast to our study Kumar et al.10 found that percentage of obese females (8.82%) was more than males (5.59%). In a study by Kotian et al.8 from south Karnataka it was found that prevalence of overweight and obesity was more in girls(10.5%) than boys(9.3%) and this difference was not significant (p =0.72). Combined prevalence of overweight and obese children was slightly more in the age group of 12-14 yrs (10.74%) as compared to 9-11 yrs (9.48%). In a study by Kapil et al.2 maximum prevalence of obesity was in the pubertal age group 10-12 years. In other studies like S. Kumar et al.10 and Unnithan et al.13 it was observed that prevalence was higher among children of higher age group as compared to younger ones. The prevalence of obesity was found to be significantly associated with children of Upper Socio Economic Status and they were more likely to get obese and overweight as compared to those of other class. Comparable findings were found in study by Marwah et al.14 and Shabana et al.15 Children of working mother were more likely to get obese and overweight as compared to that of non-working mother. It may be due to 1)Readymade(obesogenic ) food is served due to lack of time. 2)working mother has higher socioeconomic status 3)no control over food intake of children. Similar findings were revealed in the study conducted by Tarek Tawfik Amin et al.16 that the prevalence of obesity and overweight was 32.1% in children of working mothers as compared to 22 % in children of non –working mothers.(p<0.05). Use of motor vehicle was statistically associated with the prevalence of overweight and obesity. Similar results were found in a study by Avula Laxmaiah9 in Hyderabad. Less or absent physical activity had more risk of falling in obese group as compared to those who had more physical activity. Similar findings were seen in S.Kumar et al. 10( OR: 2 , P< 0.001) andKotian et al.8 (OR: 21.09 95% CI : 2.77-166.8). Those who watch TV for more duration had more chance of getting obese or overweight as compared the other group. This may also be important because apart from being a sedentary habit, watching television also involve munching in between snacks and also influence of advertisements of junk food, chocolates, soft drinks which increase tendency of the child to eat these items frequently.The findings are comparable to that of study done by Shabana et al.15 (OR -2.5, p< 0.0001), Kuriyan et al.17 (OR :19.6 p < 0.001) and Kotian et al.8 (OR 7.3, 95% CI = 3.6-14.66). Children who ate extra calories had more chances of getting obese and overweight as compared to those who ate less calories.These findings were similar to that of study done by Seema Jain et al.18(p<0.05) and Kapil et al.2 In present study it was found that junk foods do have a significant role to play in the development of obesity(p<0.005). Study conducted by S Kumar et al.10 in Davengere showed that eating junk food for >2 times per week to be associated significantly with obesity( OR ; 5.6 p<.001) and Rajaaat Vohra et al.19 showed similar results (OR=9.17 95%CI=1.28-1.86). Present study revealed that vegetarian or mix diet significantly determine obesity (p<0.005). In a study conducted by Tarek Amin16 in Saudi Arabia, it was found that obese and overweight children frequently consumed meat and alternatives as compared to non-overweight, non-obese group.(48.9%vs 39.8%) a study by Gillis and Bar reported that obese children consume significantly more servings of meat and alternatives than that in the non-obese one16.
Conclusion Hence concluded that prevalence of overweight and obesity in study area was 8.54% and1.44% respectively. Higher socioeconomic status, Daily Calorie intake Above RDA, mix type of food, less Physical Activity time and sedentary time for TV computer were the significant factors for overweight and obesity in children.
References
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
