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| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 31
| Issue : 3 | Page : 169-173 |
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Factors influencing obesity among school-going children in Sambalpur district of Odisha
Amit Kumar Mishra1, Himansu Prasad Acharya2
1 Department of Community Medicine, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India
2 Department of Community Medicine, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, Odisha, India
| Date of Web Publication | 17-Aug-2017 |
Correspondence Address:
Amit Kumar Mishra
Department of Community Medicine, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jms.jms_73_16
Background: Overweight and obesity are the resultant of excess consumption and less utilization of calorie resulting in storage of fat in the body. Obesity may have an adverse effect on health, leading to increased health problems and/or reduced life expectancy. It is the precursor of large number of fatal noncommunicable diseases such as diabetes, coronary heart disease, cancers, and osteoarthritis in later stages of life.
Materials and Methods: The objectives were to estimate the prevalence and determinants of overweight and obesity among schoolchildren aged 10–12 years. The study was conducted in the year 2012–2013. It was a cross-sectional study among 300 school-going children of 10–12 years. A stratified multistage random sampling method was used to select students for the study, and a pretested predesigned questionnaire was used to collect data from the students.
Results: The prevalence of overweight and obesity was 6.3% and 3.3%, respectively. The prevalence of overweight and obesity among boys was 5.6% and 3.4%, respectively, and among girls, the prevalence was 7.4% and 3.3%, respectively. The outdoor activities, cycling, activities after school hours and mode of transportation to school, hours of television viewing, or computer use, all are significantly associated with body mass index status of schoolchildren.
Conclusion and Recommendations: The present study shows that overweight and obesity among schoolchildren aged 10–12 years are an emerging health problems in this part of Odisha. The overnutrition problem (overweight/obesity) was reported higher among female students than male students. Health education to students regarding the ill effects of overweight and obesity is the most important step in the prevention of overnutrition. A well-designed, well-implemented school program can effectively promote physical activity and healthy eating behavior among children.
Keywords: Body mass index, obesity, overweight, physical activity, prevalence
How to cite this article:
Mishra AK, Acharya HP. Factors influencing obesity among school-going children in Sambalpur district of Odisha. J Med Soc 2017;31:169-73 |
| Introduction | |  |
Overweight and obesity are defined as abnormal or excessive accumulation of fat; it may be due to increase in number of fat cells (hyperplasia) or due to increase in size (hypertrophy). Obesity may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.[1] The World Health Organization (WHO) describes overweight and obesity as one of the today's most important public health problems, which is escalating as a global epidemic.[2] Obesity has become a major epidemic causing serious public health concern and contributes to 2.6 million deaths worldwide every year.[3] In the past two decades, the burden of overweight and obesity among children and adolescents has increased significantly in the developed countries,[4] and similar trends are being observed even in the developing world.[5] India is always ahead in noncommunicable disease burden as compared to other developing countries; now, childhood obesity is a major noncommunicable disease problem in this country.
In recent years, our dietary habits have changed from eating fresh vegetables, fruits, milk, and products, whole grain preparation to caloric dense (loaded with fat and sugar) highly processed foods and soft drinks which just have calories and of no nutrition in proportion to the same. Developing countries are undergoing nutrition transition due to increased economic development and marketed globalization leading to rapid changes in lifestyle and dietary habits.[6]
Obesity in childhood appears to increase the risk of subsequent morbidity and mortality, whether or not obesity persists into adulthood.[7] More than 60% of overweight children have at least one additional risk factor for cardiovascular disease and more than 20% of obese children have two or more risk factors.[8] It is believed that 50%–80% of obese children will continue to be obese as adults.[2] Children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems.[9]
In this context, the present research work has been conducted with the objective to estimate the burden and determinants of overweight and obesity among schoolchildren aged 10–12 years in Sambalpur town.
| Materials and Methods | | |
A cross-sectional study was planned to conduct in Sambalpur district of Odisha among school students of 10–12 years as the information collected from them are reliable, and early intervention in this age group can prevent the development and consequences of overweight and obesity in later life.
The sample size was calculated as 300 by assuming the prevalence of overweight and obesity as 25% and relative precision 20% with 95% confidence interval. The study was conducted in the year 2012–2013. The students were selected by stratified multistage random sampling method. Initially, a list of all government schools and private schools present in Sambalpur town was prepared; from each category, randomly five schools were chosen. In the selected school out of the total number of sections for each age group, randomly one section was selected. Students were selected by systematic random sampling procedure from the attendance register. By this procedure, 15 students from each age group irrespective of sex were selected and thirty students from each school were selected for the study. If any student from the selected roll number was absent on the day of visit, then the next present roll number was included in the study. The birth date of study individuals was checked from their admission registered, and the students qualifying the study criteria were included in the study.
For the interest of the students, all the students of a selected section were interviewed and examined, but the data for the study were considered and entered for previously selected roll numbers only. A semi-structured, closed-ended, pretested, predesigned questionnaire was used to collect information from students.
The tool used here to measure the overweight and obesity was body mass index (BMI). The collected data were entered in Excel sheet and after data cleaning; analysis was performed in Statistical Package in the Social Sciences (SPSS), version 19 software developed by IBM.
Ethical approval for the research was obtained from the Institute Ethics Committee of a tertiary care teaching hospital. The approval for the research to conduct in Sambalpur was also obtained from Director of School Education, Sambalpur, Odisha, India.
The WHO classification for overweight/obesity [Table 1] underestimates the burden in the Asian population. The International Obesity Task Force has proposed the standards for overweight/obesity in Asia and India,[6] as shown in [Table 2]; this classification was used here to estimate the burden of overweight/obesity in the study area. | Table 1: The World Health Organization classification of body mass index
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 | Table 2: The International Obesity Task Force classification of body mass index
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| Results | | |
A total of 300 students were included in the study. From each school thirty students, 15 students from each age group irrespective of sex were selected. Out of the 300 students, male comprises 178 (59.3%) and female 122 (40.7%). The prevalence of overweight and obesity observed was 6.3% and 3.3%, respectively. The overall combined prevalence overweight and obesity was 9.6%. The prevalence of overweight and obesity among boys was 5.6% and 3.4%, respectively, and among girls was 7.4% and 3.3%, respectively. The overall prevalence of overweight/obesity was marginally higher among girls (10.7%) than boys (9%) [Table 3]. The prevalence of overweight and obesity among 10–11 years' age group was 6% and 1.3%, respectively, and among 11–12 years' age group was 6.7% and 5.3%, respectively. The overall prevalence of overweight and obesity among 10–11 years' and 11–12 years' age group was 7.3% and 12.0%, respectively [Table 4]. [Table 5] shows the relationship between the father's occupation and BMI status of children. In the case of death of father (in three participants), the occupation of the earning head of the family was taken into consideration. There was a significant association between father's occupation and BMI status of child. | Table 5: Distribution of body mass index according to occupation of fathers
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[Table 6] shows higher prevalence of overweight/obesity in children with no outdoor activities. The prevalence of overweight and obesity (4.8% + 1.2%) was significantly lower among the students who participated in outdoor games than among the nonparticipants (8.2% + 5.9%). The mode of transportation to school was significantly associated with BMI. In the present study, 55.2% of overweight and obesity students have no activities in game periods; they spend their time just sitting in their classroom, watching others playing, or in the computer room. The BMI was significantly associated with activities in game periods. In students with BMI <23, 77.1% have cycling activity after school hours. The cycling activity after school hours was significantly associated with BMI of students [Table 7]. In the present study, 54.67% of students watch television or use computer for more than 2 h/day. The prevalence of overweight and obesity significantly increases with increase in a number of hours of television viewing/computer use per day [Table 8]. [Table 9] shows that in the case of overweight/obese students, 68.9% of them have the habit to eat something during television viewing or computer use. It also shows that 58.6% of overweight/obese students have fast-food eating habits of >3 times/week. The fast-food eating habits were significantly associated with BMI. | Table 6: Distribution of body mass index according to outdoor activities of study participants
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 | Table 7: Distribution of body mass index of study participants according to their different physical activities
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 | Table 8: Distribution of body mass index according to television viewing/computer use
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 | Table 9: Distribution of body mass index of study population according to their food habits
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| Discussion | | |
The prevalence of overweight was high in girls than boys, but the difference of obesity among boys and girls was negligible. In the present study, the prevalence of overweight and obesity was much lower as compared to the studies by Mandal and Mandal, Amin et al., and Sood et al.[10],[11],[12] The higher combined prevalence in girls than boys was supported by Shah et al. study with combined prevalence of overweight and obesity 16.66% among girls and 12.48% among boys.[13]
The prevalence of obesity was much lower as compare to the study by Kumar et al. with the prevalence of obesity 5.74% and the prevalence of obesity was more in girls (8.82%) than boys (4.10%) which was not the case in the present study.[14] In a similar study in Puducherry by Mohanty, the prevalence of combined overweight and obesity in school-going children in urban study population was 7.4%, which was less than the present study.[15] Padez et al., in their study, observed girls with higher percentages of overweight than boys, which was similar to the findings of the present study but also showed a higher percentage of obesity than boys, not so in this study.[16]
The prevalence of overweight and obesity was higher in 11–12 years' age group than 10–11 years' age group students. This may be explained by higher exposure to adverse environmental factors, as they spend more time outside, more time spend on tuitions and thus less physical activities, and more fast-food eating habits than the lower age group students. The prevalence was lower than the study by Aggarwal et al. in Ludhiana, 12.7% overweight and 3.4% obesity.[17]
In the present study, there is a significant association between father's occupation and BMI status of the student. Here, a more number of overweight/obese cases were reported from family with father working in high-income group profession, and this finding was supported by the studies conducted by Mohanty[15] and Bharati et al.[18]
The prevalence of overweight and obesity was high among the students with sedentary lifestyles, i.e., less physical activity. Mohanty in their study found significantly higher prevalence of overweight/obesity in children with no outdoor activities.[15] Saraswathi et al. found higher prevalence of overweight and obesity in children with only indoor activities such as television viewing, computer and video game, indoor games, sleeping, and long school hours.[19] A study by Patnaik et al. found a higher prevalence of overweight and obesity in children with not playing outdoor games, not doing regular exercise, watching television, and computer for more than 2 h daily.[20] The present study finding of significant association between physical activity and BMI status of schoolchildren was supported by the studies of Jain et al., Laxmaiah et al., and Bracale et al.[8],[21],[22] In the present study, the significant association between television watching/computer use and overweight/obesity was supported by many studies like Jain et al., Saraswathi et al., and Patnaik et al.[8],[19],[20]
Aggarwal et al., in their study, found a significant association between type of diet and BMI, but in the present study, it was not associated with BMI, and these findings are supported by Jain et al. study.[17],[23] According to the study by Kumar et al., the high-energy food consumption and obesity were significantly associated.[14] The high prevalence of overweight/obesity among students with higher frequency of fast-food habits in the present study is supported by Jain et al. and Amin et al. studies.[8],[11]
| Conclusion | | |
The overnutrition (overweight/obesity) was reported higher among girls than boys. The overweight/obesity problem was found more among 11–12 years' age group than 10–11 years' age group. The outdoor activities, cycling, activities after school hours, and mode of transportation to school, all were significantly associated with BMI of students. The prevalence of overweight/obesity significantly increases with increase in hours of television viewing and computer use. The eating pattern during television viewing and the fast-food eating frequency was significantly associated with the BMI of students.
| Recommendations | | |
Health education to students regarding the ill effects of overweight/obesity is the most important step of preventive measures. Other preventive measures are like changing the eating pattern from low-nutritive, energy-dense food to high-nutritive, low-energy-dense food, restriction of packed food eating habits during television viewing/computer use, reducing the junk food, and fast-food eating frequency; periodic screening for overweight/obesity should be done in schools. A well-designed, well-implemented school programs can effectively promote physical activity and healthy eating behavior among children.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]
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