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ORIGINAL ARTICLE
Year : 2014  |  Volume : 3  |  Issue : 1  |  Page : 30-35

Assessment of obesity in school children


Department of Community Medicine, Government Medical College, Aurangabad, Maharashtra, India

Date of Web Publication24-Dec-2013

Correspondence Address:
Subhash S Dhole
Department of Community Medicine, Government Medical College, Aurangabad - 431 001, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-019X.123444

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  Abstract 

Background : Traditionally, a fat child is considered as an 'attractive' child and is often referred to as a 'healthy' child, one who is likely to survive the rigors of undernourishment and infection. The obesity has been defined as a condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health may be impaired. Obesity can be seen as the first wave of a defined cluster of non communicable diseases called "New World Syndrome" creating an enormous socioeconomic and public health burden in poorer countries.
Objective : To study the prevalence of childhood obesity in study area.
Materials and Methods : The present cross-sectional study was carried out in Municipal Corporation area among school going children during the period of 1 st Sept 2009 to 31 st August 2010. We prepared the list of children, roll number wise from selected school. Four hundred school children were included in study (286 from government school and 114 from private school). Selection was done by systematic sampling method. First we selected 10 th roll number and then every 10 th roll number children was included in the study. Those children who were absent on the day of survey were not included. The weight and height was measurement by the investigator himself to avoid possible observer's bias. Shoes, Chapels were removed before taking the weight and weight.
Results and Conclusion : The study conducted among a sample of 400 school children of Municipal corporation area revealed that 30 (7.5%) of the children were overweight, 25 (6.3%) were obese and 345 (86.3%) of them were normal. Out of a total of 400 children screened, 206 (51.5%) were girls and 194 (48.5%) were boys. Among the total girls, 10.2% were overweight and 6.3% were obese, 83.5% were normal. Similarly, among total boys 4.6% were overweight and 6.2% were obese, 89.2% were normal. The prevalence of overweight and obesity were higher in girls than boys. Difference in the distribution of children according to sex was not statistically significant. The age group of 13-14 years showed highest prevalence in overweight (18%) and obesity (9%).

Keywords: Body mass index, diabetes mellitus, ischemic heart disease, non communicable diseases


How to cite this article:
Dhole SS, Mundada VD. Assessment of obesity in school children. J Med Nutr Nutraceut 2014;3:30-5

How to cite this URL:
Dhole SS, Mundada VD. Assessment of obesity in school children. J Med Nutr Nutraceut [serial online] 2014 [cited 2020 Oct 29];3:30-5. Available from: https://www.jmnn.org/text.asp?2014/3/1/30/123444


  Introduction Top


Traditionally, a fat child is considered as an 'attractive' child and is often referred to as a 'healthy' child, one who is likely to survive the rigors of undernourishment and infection. The obesity has been defined as a condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health may be impaired. [1] The terms "obese" and "overweight" often are used interchangeably. Technically, "obesity" is the upper end of "overweight." Obesity is clinically diagnosed as body mass index (BMI) greater than 25 and overweight in between 23 to25 in children. [2] At least 30% of obesity begins in childhood. Obese children from 50-80% will continue as obese adult [3] and fall into risk group of Diabetes, Hypertension, Coronary Heart Disease and many more obesity related diseases. Complication of adult obesity are made worse if the obesity begins in childhood. Obesity is harder to treat in adults than in children. [4] Effective prevention of adult obesity will require the prevention and management of childhood obesity. Obesity can be seen as the first wave of a defined cluster of non communicable diseases called "New World Syndrome" creating an enormous socioeconomic and public health burden in poorer countries. With the increase in obesity prevalence there is a parallel increase in obesity associated chronic diseases and their clinical onset at ever younger ages. The obesity has reached an epidemic proportion in urban Indian population. If we allow this epidemic to continue we will top the world in Diabetes and CHD earlier than estimated. The cost of treating diabetes mellitus and associated disorders alone will consume a major chunk of our national resources, which is affordable. Only community-based approaches can address such large numbers of affected children.


  Materials and Methods Top


The present cross-sectional study was carried out in Municipal Corporation area among school going children during the period of 1 st Sept 2009 to 31 st August 2010.

Sample size

The prevalence of childhood obesity in India was 7.6% in previously published study. By considering, 7.6% to 8% as the prevalence, sample size was calculated with the help of practical manual for sample size determination by Wanga and Lemeshow [5] as follows.

  • Anticipated Prevalence 8%
  • Confidence Level 95%
  • Absolute precision 5%.


The resultant sample size was 114 children but we had concluded 400 children from 57 schools in the study.

Selection of schools

For the selection of schools, the list of all schools (577) belonging to different categories (262 Government school and 315 Private school) was obtained from the school authorities of the local government. From the list of school by systematic random sampling method, we selected 10% schools. i.e., 26 government's school, 31 private schools and total 57 schools were selected for study. First we selected 10 th number school and then every 10 th school was included in the study.

Inclusion criteria

  • Children studying in 5 th -7 th standards
  • School from Municipal corporation area.


Exclusion criteria

  • Children below 5 th and above 7 th standards
  • Schools outside Municipal corporation area.


We prepared the list of children roll number wise from selected school. From the list of children by systematic random sampling method, we selected 10% children i.e., 286 government's school children, 114 private schools children and total 400 school children were selected for study. First we selected 10 th roll number and then every 10 th roll number children was included in the study. Those children who were absent on the day of survey, they were not included. The weight and height was measurement by the investigator himself to avoid possible observer's bias. The weight was measured by circular, string type portable new weighing machine, which is designated to weigh the weight between 1 to 130 kg. Before taking the weight the indicator of weighing machine was ensured to 'Zero' mark and then individual was asked to stand over machine and then appropriate weighing reading was noted on the study proforma. Shoes, Chapels were removed before taking the weight.

The tailors measuring tape, having markings up to 0 to 150 cm, was used for measuring the height of children. The children were made to stand erect by facing his back to plane wall/pillar with his heel touching to wall/pillar, with head erect and touching to wall/pillar. Shoes, Chapels were removed before taking the height. The instruments required in the study are as follows:

  • An electronic weighing machine
  • Height measuring scale
  • Measuring tape
  • Scale.


Data on weight and height were collected for each through direct physical examinations. Height and weight were measured using standard procedure and BMI (kg/m 2 ) was calculated.

Data analysis

Data were collected and Analysis was done with statistical package for social sciences (SPSS) version 18.0, by using statistical method like minimum, maximum, mean, standard deviation and chi square test data were analyzed.


  Results and Observations Top


Out of 400 children, 345 (86.3%) children had normal BMI, 30 (7.5%) children were overweight and 25 (6.3%) children were obese.

In the 9-10 years age group, all 36 (100%) children had normal BMI. In the 11-12 years age group, out of 264 (66%), 236 (89.4) children had had normal BMI, 12 (4.5%) children were overweight and 16 (6.1%) children were obese. In the 13-14 years age group, out of 100 (25%), 73 (73%) children had normal BMI, 18 (18%) children were overweight and 9 (9%) children were obese. The maximum number of prevalence of obesity (18.1%) was found in the age group of 13-14 and overweight were (9%). The proportion of overweight/obesity was higher (18%) in the age group of 13-14 yrs than in 9-10 yrs and11-12 yrs.

Out of 400 children, 345 (86.3%) children had normal BMI, 30 (7.5%) children were overweight and 25 (6.3%) children were obese.

In the male, out of the 194 (48.5%), 173 (89.2%) children had normal BMI, 9 (4.6%) were overweight and 12 (6.2%) were obese. In the female, out of 206 (51.5%), 172 (83.5%) children had normal BMI, 21 (10.2%) children were overweight and 13 (6.3%) children were obese. The prevalence of overweight and obesity were higher in girls than boys. The difference found between sex was not statistically significant (P > 0.05).

Out of 400 children, 173 (43.25%) boys, 172 (43%) girls in the 5 th class children had normal BMI. 9 (2.25%) boys, 21 (5.25%) female in the 6 th class children were overweight and 12 (3%) boys, 13 (3.25%) female children in the 7 th class were obese.

In the 5 th class out of 66 (16.5%), 29 (43.93%) boys, 35 (53%) girls children had normal BMI and 2 (3%) boys children were obese.

In the 6 th class out of 130 (32.5%), 66 (50.76%) boys, 59 (45.38%) girls children had normal BMI, 2 (1.5%) boys. 1 (0.7%) girls children were overweight and 1 (0.7%) boys, 1 (0.7%) girls children were obese.

In the 7 th class out of 204 (51%), 78 (38.23%) boys, 78 (38.23%) girls children had normal BMI, 7 (3.4%) boys. Twenty (9.8%) girls' children were overweight and 9 (4.4%) boys, 12 (5.8%) girls' children were obese.

The higher prevalence of overweight, obesity was found in the seventh class 13.2%, 10.3% respectively. The maximum number normal children (96.3%) were found in the sixth standards and minimum obesity (1.5%). The difference found between classes was statistically significant (P < 0.05).

Out of 400 children, 345 (86.3%) children had normal BMI, 30 (7.5%) children were overweight and 25 (6.3%) children were obese. In the government school out of the 286 (71.5%) children, 251 (87.8%) had normal BMI, 19 (6.6%) were overweight and 16 (5.6%) were obese. In the private school out of 114 (28.5%), 94 (82.5%) children had normal BMI, 11 (9.6%) children were overweight and 9 (7.9%) children were obese. The prevalence of overweight was 9.6%, obesity 7.9% in the private school and in the government school were 6.6% and 5.6, which was higher in the private school than government school. The difference found between type of school was not statistically significant (P > 0.05).

Out of 194 boys in the age group of 10-14 years, the minimum height were 107, maximum160 and mean height 131.80 ± 12.32 SD. The minimum weight were 18, maximun 45 and mean weight 29.98 ± 6.213 SD. The minimum BMI were 11, maximum 27 and mean BMI 16.93 ± 4.325 SD. The minimum Mid arm circumference were 15, maximum 27 and mean Mid arm circumference 18.97 ± 2.542 SD. The minimum waist circumference were 23, maximum 78 and mean waist circumference 52.51 ± 8.87 SD. The minimum hip circumference were 29, maximum 84 and mean waist circumference 64.60 ± 7.862 SD.

Table showing that the out of 206 girls the minimum height were 108, maximum 153 and mean height 130.69 ± 11.231 SD. The minimum weight was 18, maximun 45 and mean weight 30.01 ± 6.279 SD. The minimum BMI were 10, maximum 28 and mean BMI 17.88 ± 4.567 SD. The minimum Mid arm circumference were 14, maximum 25 and mean Mid arm circumference 18.72 ± 2.282 SD. The minimum waist circumference were 40, maximum 80 and mean waist circumference 54.40 ± 10.245 SD. The minimum hip circumference were 56, maximum 84 and mean waist circumference 66.49 ± 7.785 SD.


  Discussion Top


Laxmaiah et al., ( 2007 ) [6] in their study at Hyderabad found that the prevalence of overweight among girls tended to increase from 6.2% at 12 years to 10.8% at the age of 15 years and gradually decreased at 17 years (9.2%), whereas in boys, it was the highest at the age of 14 years (9.2%) and decreased to 5.3% at the age of 17 years [Table 1].
Table 1: Distribution of children according to age-group

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Bharati et al., ( 2008 ) [7] in their study at Wardha, central part of India found that the Overall, 79 (3.1%) children were overweight while 32 (1.2%) were obese. The proportion of overweight/obesity was higher (5.0%) in late adolescence (>15 year of age) than in early adolescence (<15 year of age). But the difference was not statistically significant.

Kumar et al., ( 2007 ) [8] in their study observed that a total of 1496 children studied (975 boys, 521 girls). Prevalence of obesity was 5.74%. Prevalence of obesity was more in girls (8.82%) than boys (4.10%). The difference observed in prevalence of obesity between boys' and girls' was highly significant.

Bharati et al., ( 2008 ) [9] in their study observed that the proportion of overweight/obesity was 4.4 and 4.3% among boys and girls respectively.

Patnaik et al., ( 2011 ) [10] in their study observed that, out of total 468 school children, 41.9% were boys and 58.1% were girls Out of 468 students examined for the study, 28.68% were either overweight or obese. Overweight and obesity was 33.65% in boys and 25.73% in girls [Table 2].
Table 2: Distribution of children according to sex

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Kumar et al., ( 2007 ) [11] in their study observed that, A total of 1496 children studied (975 boys, 521 girls), the maximum number of boys from the 6 th class and girls from the 5 th class.

Warraich et al., ( 2009 ) [12] in their study observed that, out of total 104 children in the sixth class, 67 were male and 37 female. Total children in seventh class were 89 out of that, 54 were male and female 35. Total children in eighth class total were 91 out of that 54 were male and 37 female. The maximum numbers of children was from the sixth class and overall more male (175) involved than girl (109). The overall prevalence of overweight was 8% and obese 6% [Table 3].
Table 3: Distribution of children according to class of study

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Premanath et al., ( 2008 ) [13] in their study observed that, there were 23527 boys (54.5%) and 19625 girls (45.5%), 36354 (84.2%) children were from private schools and 6798 (15.8%) were from Government schools. Children from private schools were significantly overweight when compared to those from government schools, (9.1% vs 5.9%; P < 0.05), while prevalence of obesity was not different between the two groups (3.6% vs 2.1%) [Table 4].
Table 4: Distribution of children according to type of school

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Raj et al., ( 2007 ) [14] from their study reported that in the age of 10 yrs total boys were 1109, the mean height 137.1 ± 6.48 SD, mean weight 29.3 ± 6.50 SD and mean BMI 15.4 ± 2.48 SD. In the age of 11 years total boys were 1126, the mean height 141.9 ± 7.24 SD, mean weight 23.6 ± 7.94 SD and mean BMI 16.1 ± 2.83 SD. In the age of 12 years total boys were 1125, the mean height 146.7 ± 7.87, mean weight 35.9 ± 9.13 SD and mean BMI 16.5 ± 2.96 SD. In the age of 13 years total boys were 1024, the mean height 153.7 ± 8.83 SD, mean weight 40.9 ± 9.71 SD and mean BMI 17.2 ± 2.99 SD. In the age of 14 years total boys were 1088, the mean height 159.9 ± 8.36 SD, mean weight 45.1 ± 9.6 SD and mean BMI 17.5 ± 2.79 SD. Goyal et al., ( 2009 ) [15] from their study reported that in the age of 12 years total boys were 86%, the mean height 154.4 ± 0.7 SD, mean weight 46.7 ± 0.2 SD and mean BMI 19.9 ± 0.2 SD. In the age of 13 years total boys were 57%, the mean height 151.6 ± 0.4 SD, mean weight 44.9 ± 0.4 SD and mean BMI 19.5 ± 0.1 SD. In the age of 14 years total boys were 63%, the mean height 154.6 ± 0.3 SD, mean weight 46.8 ± 0.3 SD and mean BMI 19.6 ± 0.1 SD [Table 5].
Table 5: Anthropometric measurements of boys

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Raj et al., ( 2007 ) [14] from their study reported that in the age of 10 years total girls were 1178, the mean height 137.6 ± 7.08 SD, mean weight 29.9 ± 7.10 SD and mean BMI 15.7 ± 2.62 SD. In the age of 11 years total girls were 1301, the mean height 142.8 ± 7.33 SD, mean weight 33.7 ± 8.01 SD and mean BMI 16.3 ± 2.77 SD. In the age of 12 years total girls were 1269, the mean height 148.6 ± 6.68 SD, mean weight 38.2 ± 8.07 SD and mean BMI 17.2 ± 2.83 SD. In the age of 13 years total girls were 1388, the mean height 152.1 ± 6.24 SD, mean weight 41.5 ± 7.82 SD and mean BMI 17.9 ± 2.84 SD. In the age of 14 years total girls were 1481, the mean height 154.2 ± 5.99 SD, mean weight 44 ± 8.53 SD and mean BMI 18.5 ± 3.08 SD.

Goyal et al., ( 2009 ) [15] from their study reported that in the age of 12 years total girls were 86%, the mean height 150.1 ± 1.1 SD, mean weight 44.6 ± 1.1 SD and mean BMI 19.8 ± 0.5 SD. In the age of 13 years total girls were 43%, the mean height 149.1 ± 0.4 SD, mean weight 43.4 ± 0.4 SD and mean BMI 19.5 ± 0.2 SD. In the age of 14 years total girls were 37%, the mean height 151.6 ± 0.3 SD, mean weight 44 ± 0.4 SD and mean BMI 19.2 ± 0.2 SD [Table 6].
Table 6: Anthropometric measurements of girls

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  Conclusion Top


The study conducted among a sample of 400 school children of Municipal corporation area revealed that 30 (7.5%) of the children were overweight, 25 (6.3%) were obese and 345 (86.3%) of them were normal.

Recommendation

(1) There should be regular class hours on healthy food habits, nutritive values of different food items, lifestyle and behavioral modification. (2) Every student should take part in outdoor games and sports. (3) Each student should monitor his/her anthropometric parameters in their health dairy, at least once in a month.

 
  References Top

1.Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. Geneva: World Health Organization; 2000 (WHO Technical Report Series, No. 894).  Back to cited text no. 1
    
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3.Styne DM. Childhood and adolescent obesity. Prevalence and significance. Pediatr Clin North Am 2001;48:823-54.  Back to cited text no. 3
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5.Langa SK, Lemeshow S. Sample size determination in health studies: A practical manual. Geneva: World Health Organization; 1966. p. 132.  Back to cited text no. 5
    
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7.Bharati DR, Deshmukh PR, Garg BS. Correlates of overweight and obesity among school going children of Wardha city, Central India. Indian J Med Res 2008;127:539-43.  Back to cited text no. 7
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8.Kumar S, Mahabalaraju DK, Anuroopa MS. Prevalence of obesity and its influencing factor among affluent school children of Davangere city. Indian J Community Med 2007;32:15-7.  Back to cited text no. 8
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10.Warraich HJ, Javed F, Faraz-Ul-Haq M, Khawaja FB, Saleem S. Prevalence of obesity in school-going children of Karachi. PLoS One 2009;4:e4816.  Back to cited text no. 10
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13.Goyal RK, Shah VN, Saboo BD, Phatak SR, Shah NN, Gohel MC, 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.  Back to cited text no. 13
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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