|Year : 2019 | Volume
| Issue : 1 | Page : 41-45
Study of the anthropometry and prevalence of overweight in school boys in an Urban Area
Sukhmeet Minhas1, Rajesh Kunwar2, Harinder Sekhon3, Pijush Jaiswal4
1 Department of Community Medicine, Officer Commanding, Station Health Organisation, Kirkee, Pune, Maharashtra, India
2 Department of Community Medicine, TS Misra Medical College, Lucknow, Uttar Pradesh, India
3 Consultant Psychiatry, Central Reserve Police Force, India
4 Department of Community Medicine, Senior Registrar 158 Base Hospital, India
|Date of Submission||05-Oct-2018|
|Date of Acceptance||17-Feb-2019|
|Date of Web Publication||19-Jun-2019|
Lt Col Sukhmeet Minhas
Department of Community Medicine, Officer Commanding, Station Health Organisation, Kirkee, Pune - 411 003, Maharashtra
Source of Support: None, Conflict of Interest: None
Context: Overweight and obesity has been found to increase among children over the last few decades. Not only are more children becoming overweight, but they are also becoming so at a relatively younger age. Aims: This study of anthropometry of boys in a school in an urban area calculates the prevalence of overweight and thereafter suggests appropriate measures for improvement in lifestyle. Besides, secondary objectives were to determine the association of overweight and obesity with demographic factors. Settings and Design: A school-based, descriptive, cross-sectional study, in an urban area. Subjects and Methods: A sample size of 1537 was calculated. Anthropometric measurements of the participants were recorded including height, body weight, mid-upper arm circumference, and waist and hip circumference. Status of overweight and obesity was determined using body mass index. A structured questionnaire was used to record the personal particulars and sociocultural factors. Statistical Analysis Used: Data were analyzed using the software Epi Info™ version 7, developed by the Division of Health Informatics and Surveillance of the Centers for Disease Control, Atlanta. Results: Most participants ranged in age from 6 to 15 years, while 17.2% were overweight and 3.7% were found to be obese. Conclusions: As the main causes of excess weight include individual behavior and dietary patterns, children must be exposed and habituated to a healthy lifestyle as a preventive measure.
Keywords: Children, obesity, overweight, prevalence, school
|How to cite this article:|
Minhas S, Kunwar R, Sekhon H, Jaiswal P. Study of the anthropometry and prevalence of overweight in school boys in an Urban Area. J Mar Med Soc 2019;21:41-5
| Introduction|| |
Based on estimates of the World Health Organization (WHO), over 1.9 billion people worldwide are overweight, whereas almost 600 million are obese. This condition is of concern more so because obesity is amenable to prevention. There are many different definitions for overweight and obesity. In general, individuals who have their body mass index (BMI) that exceeds the 95th percentile of age- and gender- specific values are considered overweight. Ones who have a BMI ranging 85th–95th percentiles have a risk of becoming overweight. Excessive accumulation of or abnormal fat leads to impairment of health.,, Childhood overweight has not been researched into a lot, but available evidence based on surveys conducted worldwide indicate the rise in overweight and obesity in children, which is very similar to the condition among adults. Children these days are becoming overweight at comparatively a much younger age. In India, it has been observed in a study that the prevalence of overweight in school-going children in urban areas has increased from 16% to 24% over 10 years. Another study showed the prevalence to be 16.75% (overweight) and 5.59% (obese) in boys, while it was 19.01% and 5.03%, respectively, in girls. Similar results were found in another study, where the prevalence of overweight was 11.1% and that of obesity was 14.2%. The phenomenon of “tracking” has been well recognized in the context with childhood obesity, that is, obesity during childhood has also been observed to “track” into the adulthood., Overweight children are likely to have health-related consequences during their young age. A secular trend has been observed from childhood obesity to adulthood. Nearly 41% of adults who are presently obese were found so in childhood also., As reports on the prevalence of childhood overweight in most of the developing countries including India are scarce, this study was undertaken. The aim was to study the anthropometry of boys in a school in an urban area. The objectives of the research included studying the anthropometry of the boys studying in that school, calculation of prevalence of overweight, and thereafter to suggest appropriate measures for improvement in lifestyle with respect to overweight. Besides, the secondary objectives were to determine the association of demographic factors with overweight and obesity.
| Subjects and Methods|| |
This study complies with the Declaration of Helsinki guidelines as revised in 2000. Clearance of the Institutional Ethics Committee was obtained. Informed consent of the parents of the participants was taken, and their anonymity was maintained.
This was a school-based study conducted on boys studying in an urban school. It was a cross-sectional survey undertaken from August 2014 to February 2015. From previous studies, overweight prevalence was known to be 15.6% among the boys, with another 5.4% at risk of overweight from a previously conducted research. With a 95% confidence interval, with finite correction, the sample size calculated was 1537. However, all the boys who were enrolled and studying in the school were potential participants for the study after taking informed consent. Anthropometric measurements were recorded, and a questionnaire was used to record the personal particulars and sociocultural factors.
Various instruments that were used in the present study included a portable-type digital weighing machine of Omron™, portable anthropometric rod, that is, stadiometer of Seca™ and nonstretchable measuring tape of Seca™. Anthropometric measurements that were recorded included height, body weight, BMI, mid-upper arm circumference (MUAC), waist circumference (WC), hip circumference (HC), and the waist/hip ratio (WHR).
Weight of the child was measured after placing the digital weight scales on firm flooring. The child was made to stand on the center of the scales after removal of shoes and heavy clothing such as sweater or blazer. It was recorded to the nearest half kilogram.
Measurement of height was done using a portable stadiometer after placing it against a wall. Children were made to remove their shoes and bulky clothing. The stadiometer was placed on a flat, hard, and noncarpeted floor. Each child was made to stand with feet together, flat, and against a wall. It was made sure that legs were straight, arms were at the sides, the shoulders were level while the child looked straight ahead, and that the line of sight was parallel with the floor. Measurement of height was taken making the child stand with head, shoulders, buttocks, and heels touching the flat surface of the stadiometer. The flat headpiece was used to form a right angle with the vertical rod and lowered until it firmly touched the crown of the head. Measurer's eyes were kept at the same level as that of the headpiece. The point where the bottom of headpiece met the rod was marked and recorded to get the height measurement up to 0.1 cm.
BMI was calculated as follows: BMI = weight (in kg)/height2 (in m).
MUAC was measured to the nearest 0.1 cm by using a nonstretchable measuring tape. It was measured round the left upper limb and at its midpoint. To measure, the left arm of the child was bent, and the mid-point between the olecranon process and acromium was found and marked with a pen. Then, with the arm hanging straight down, the MUAC tape was wrapped around the arm at the midpoint mark and recording taken to the nearest 1 mm.
Percentiles were used as an indicator for assessing the size and the growth patterns of individual children. The growth charts showed the categories of weight status and depicted underweight, healthy weight, at risk of overweight, and overweight, as shown in [Table 1].
|Table 1: Center for Disease Control classification of weight status according to the percentile range|
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BMI was used to determine the status of overweight and obesity as shown in [Table 1]. Since, for children, BMI is specific for age and sex, it is referred to as BMI-for-age., Before the commencement of the study, the aim and objectives of the study were discussed with the school authorities and they were briefed about the scope of study so as to solicit their cooperation. Age was recorded to the nearest completed year as per the official records of the school. Record of educational status of the child was restricted to the class in which he was studying at the time of data collection. For the record of data related to sociocultural factors, a pretested and validated questionnaire was used. Data thus collected were stored in a suitable database. Thereafter, it was analyzed by using the software Epi Info™ version 7 (Centres for Disease Control (CDC) Atlanta, USA), developed by the Division of Health Informatics and Surveillance of the Centers for Disease Control, Atlanta.
| Results|| |
It was observed that, out of 1550 participants examined, age ranged from 5 years to 18 years. Distribution of the frequency of participants with respect to age is shown in [Table 2]. Calculation of BMI of the participants showed that mean and median BMI increased with the increase in age, especially from 11 years to 16 years of age. The distribution of mean and median BMI with respect to age is shown in [Table 2]. Based on the criteria laid down, none of the participants were found to be underweight, 79.1% were of normal or healthy weight, and 17.2% were overweight, while 3.7% were obese. Calculation of WHR of the participants showed that the mean and median WHR increased with the increase in age till about 14 years to 15 years as shown in [Table 2].
|Table 2: Distribution of frequency, mean and median body mass index, waist/hip ratio, and mid-upper arm circumference of participants with respect to age|
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Distribution of mean and median MUAC with respect to age [Table 2] shows that both increased with increasing age, especially from 12 years to 17 years.
The sociodemographic profile of the study population showed that only 2% hailed from rural background, while the remaining 98% were from an urban background. While 97% of the participants lived in nuclear families, 2% were from a joint family and the remaining 1% lived in a three-generation family. Of all the participants, 68% had fathers who were at least graduate, while fathers of the remaining participants had some postgraduate degree. The total income of the family ranged from Rs. 24,500/month to Rs. 256,000/month. The total number of children in each family ranged from only one to five children, with 37% having only one sibling. Among the sociodemographic factors, type of family of the participants was not found to have any significant bearing on the anthropometry of the participant, as did the educational status of the parents, rural or urban background of family, total family income, or the total number of children in the family.
| Discussion|| |
Comparison of median height of participants is shown in [Table 3]. Median height of the participants in the present study was found to be generally higher than that of CDC, WHO, and Indian Academy of Pediatrics (IAP), at the ages of 5 years, 6 years, 16 years, 17 years, and 18 years, while it was comparatively lower in the other age groups. Comparison of median weight of participants is shown in [Table 4]. The median weight of participants in the present study was lower at all ages than that of the CDC, WHO, and IAP. Comparison of BMI of the participants to the findings in other studies is shown in [Table 5]. Based on the laid-down criteria, 79.1% of the participants were of normal or healthy weight, 17.2% were overweight, and 3.7% were obese, while none were found to be underweight. BMI of the participants in the present study was comparatively lower than that of the CDC, WHO, and IAP till the age of 9 years, after which it was recorded to be higher. On the whole, it was observed that the median height, weight, and BMI of participants in the present study were comparable to those of other studies.,,
Mean and median WC, in the present study, was found to increase with increase in age, correlating with growth of the participants, as was found on comparison with other studies. It has been observed through research that children who are obese and have WC ≥90th percentile are at a relatively higher risk for having dyslipidemia as well as insulin resistance as compared to those obese children who have a normal WC. These results indicate that evaluation of WC in obese participants on a routine basis may be helpful in identifying those obese participants who are at a greater risk of developing diabetes and Cardio-vascular diseases (CVDs). WC is an established predictor of insulin resistance syndrome. Therefore, it could be considered as a tool to help clinically identify those children who are at risk for developing these conditions. HC and WHR were found to be increasing with increase in age of the participants, thus correlating with their growth as was found in other studies., MUAC in the present study was also found to be comparative to other studies. In fact, MUAC has also been proposed as an additional indicator to measure obesity in children. It can be used as an inexpensive but accurate screening tool for overweight and obesity among children living in resource-poor settings.,,,
| Conclusion|| |
In the present study, 1550 participants were studied in total. Based on the criteria laid down, none of the participants were found to be underweight, 79.1% were of normal or healthy weight, and 17.2% were overweight, while 3.7% were obese. In accordance with the physiological growth of children of this age, the body weight, height, BMI, WC, and HC were found to be increasing with the age, especially during the years of the growth spurt. As the main causes of excess weight in children are similar to those in adults, children of this age are likely to benefit from a healthy lifestyle. Primary preventions may have to be aimed at primary schoolchildren. School curricula already include periods for games and physical activity which should be enforced strictly and not merely for attendance. Because patterns of physical activity established in childhood are likely to persist into adulthood, physically active children will most likely become active adults. Therefore, it is imperative to initiate children into a physically active lifestyle at an early age. Besides, it would be worthwhile if the school authorities become strict about the type of eatables made available in school canteens and permit only healthy choices for students. Such practical and cost-effective community-based strategies will help curb the escalating epidemic of childhood obesity.
We would like to thank the staff and students of the Army Public School, Pune, for their participation in this study.
Financial support and sponsorship
This study was financially supported by the Office of the Director General Armed Forces Medical Services, Indian Army, and Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
Conflicts of interest
This study is based on the research work done as part of Armed Forces Medical Research Committee project sanctioned by the Office of the Director General Armed Forces Medical Services.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]