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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 3  |  Page : 96-102

Prevalence and risk factors of overweight and obesity among college-going adolescents in Siddipet district


Primary Health Care Center, Ibra, Oman

Date of Submission05-Feb-2021
Date of Decision14-Apr-2021
Date of Acceptance01-May-2021
Date of Web Publication25-Sep-2021

Correspondence Address:
Dr. Shaik Riyaz Ameer
Primary Health Care Center, Wadi al-Tayeen, Ibra
Oman
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjhs.mjhs_9_21

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  Abstract 


Background: Obesity among children is a major public health problem in industrialized world and also in the developing countries such as India. The prevalence is increasing at an alarming rate worldwide. India is going to become fourth country in terms of the greatest number of children with obesity.
Objective: To study the prevalence and risk factors of overweight and obesity among college-going adolescents.
Methods: Present cross-sectional study was carried out among 600 adolescents of 15–19 years. Pretested questionnaires were used to collect personal information, socioeconomic particulars, lifestyle patterns, and dietary habits. Body mass index (BMI) was calculated by formula weight (kg)/height (m2). Based on the BMI charts developed by IAP, percentile for BMI was taken as a standard. Underweight students were excluded from the analysis. First correlation was carried out among BMI and all other variables. Significantly correlated variables were entered in the multiple linear regression model. Significant variables (P < 0.1) on Chi-square were entered in multiple logistic regression (MLR) model. Adjusted odds-ratio (OR) were compared with the crude odds ratio for each variable. P < 0.05 was considered statistically significance.
Results: The prevalence of overweight and obesity in both the sexes was found to be 17.7% in the present study. On crude analysis, being female (OR = 1.957 [1.272–3.01]), father being skilled or professional (OR = 8.184 [4.539–14.76]), father being educated at intermediate or higher (OR = 6.567 [4.132–10.44]), belonging to Social Class I and II (OR = 6.29 [3.362–11.77]), being nonvegetarian (OR = 1.663 [1.035–2.671]), and eating four times/day (OR = 1.717 [1.045–2.823]) were found to be significant risk factors for being overweight and obese among adolescents. However, final model of MLR showed that being female, father being highly educated, and belonging to higher social class were significant predictors of overweight and obesity.
Conclusion: The prevalence of overweight and obesity among these college-going adolescents was high. Being female, father being highly educated and belonging to higher social class were the significant predictors of overweight and obesity.

Keywords: Adolescents, obesity, overweight, predictors, prevalence, risk factors


How to cite this article:
Ameer SR. Prevalence and risk factors of overweight and obesity among college-going adolescents in Siddipet district. MRIMS J Health Sci 2021;9:96-102

How to cite this URL:
Ameer SR. Prevalence and risk factors of overweight and obesity among college-going adolescents in Siddipet district. MRIMS J Health Sci [serial online] 2021 [cited 2021 Oct 25];9:96-102. Available from: http://www.mrimsjournal.com/text.asp?2021/9/3/96/326736




  Introduction Top


The Latin word “adolescere” was used to derive the “adolescence” term and the meaning is to “grow up.”[1] They constitute about 25% of the total population of India. Its period can be divided into early, middle, and late adolescence. Early constitutes the age group of 10–13 years; middle constitutes the age group of 14–16 years; and late constitutes the age group of 17–19 years. A lot of changes take place as the adolescent grows up which include not only body size but also mental and psychological changes including adoption of thought process and a change in the attitude and other social aspects is also seen. This is a true period of great transition.[2]

Obesity is one form of malnutrition and overweight is precursor to it and its presence during this period affects the health of adult life.[3] The sequelae of this period overweight and obesity are many which includes diabetes, heart disease, hypertension, and many other problems. Premature death risk is increased in those with a history of childhood obesity. There is increased risk of fractures, hypertension, resistance to insulin, and other psychological effects among those with a history of childhood and adolescent life obesity.[4]

Many Asian countries are experiencing the steadily increasing burden of overweight and obesity among children and adolescent age groups. India is no more an exception to this problem. The significant factors contributing to this rise are the economic transition taking place in developing countries like India. Lack of physical activity and improper dietary habits are contributing to this pandemic. Foods rich in energy, sugars, and high fat diet are in trend. Physical activity is decreasing due to more amount of mechanization at each and every level and increasing income is contributing to affordability of the cost of this mechanization.[5]

Healthy home-based foods are replaced by junk food and fast food very rapidly worldwide. The reasons may be many including lack of time, increased affordability, and change in the attitude, for example, more tendency toward partying. Lack of physical activity among children can be due to many reasons such as overtime schooling hours, tuitions, increasing use of gazettes, and lack of motivation for outdoor games. Thus, many factors contribute to the childhood and adolescent overweight and obesity. In summary, improper eating habits and lack of physical exercise are important risk factors.[6]

Obesity among children and adolescent is a serious public health problem. It has been declared as epidemic worldwide by the World Health Organization. The International Obesity Task Force (IOTF) found that the prevalence of obesity among children is about 10% worldwide on an average.[7] The National Health and Nutrition Examination Surveys (NHANES) II study reported that the prevalence of overweight among adolescents in the age group of 12–19 years as 15% in the years 1966–80 which was found to be 21% in 1988–91 NHANES cycle III Study.[8]

Obesity among children is a major public health problem in the industrialized world which are naturally rich and affluent. The present rates of prevalence in America are more than 30%, while it is more than 20% in Australia and in the UK and Saudi Arabia, it is more than 15%.[9] A prevalence rate of 10%–15% has been reported from other countries such as China, Italy, and Malta. Present studies show an increasing trend in the obesity among children at a dangerous rate. This is true for almost all countries in the world.[10] India is going to become the fourth country in terms of the greatest number of children with obesity.[10]

Hence, the present study was carried out to study the prevalence and associated factors of overweight and obesity among college-going adolescents.


  Methods Top


Study area

Siddipet city was chosen as the study area. Students from both government and private intermediate (11th and 12th) were selected.

Study design

A cross-sectional study design was selected for the present study.

Duration of study

The present study was conducted during the period of October 2017 and March 2018.

Sample size

Taking prevalence of overweight and obesity both as 15% (based on a pilot survey in the local college) and precision of 20% at 95% confidence interval with 10% of nonresponse rate sample size was 600.

Selection of subjects

From each college, 100 students were taken using the systematic sampling method. Prior consent was taken from the participants.

Selection of schools

The present study was approved by the Ethical Committee of RVM Institute of Medical Sciences, Mulugu, Siddipet (District). The list of colleges with the number of students in each college was obtained. Colleges were selected from the college list using the simple random sampling technique till the desired number of sample size is met. Before a college was taken for the study, head of the institution was contacted, purpose of the study was explained and permission was obtained. Consent was also taken from parents through college authority. Sampled colleges were visited on a date given by college authority.

Inclusion criteria

Children in the age group of 15–19 years present in college. Students without any significant past history of chronic illness for 3 months.

Exclusion criteria

Children below the age of 15 years and above age 19 years. Children those who remain absent on survey day those who did not get the consent from the parents were not included in study population. Children with chronic illness, endocrinal problems, and physical and mental defects.

Methodology

The pilot study was done on 100 children and questionnaire, and data collection technique was refined accordingly. Pretested questionnaires were used to collect personal information, socioeconomic particulars, lifestyle patterns, and dietary habits. Body mass index (BMI) was calculated by formula weight (kg)/height (m2).[11] Based on the BMI charts developed by Indian Academy of Pediatrics (IAP), Percentile for BMI was taken as a standard for the present study.[12] Vegetarians were those who eat only vegetables and do not eat meat, chicken, and egg at all and nonvegetarians were those who eat meat, chicken, and egg along with vegetables. Pizza, samosa, chips, burgers, noodles, and other fast foods were considered fatty foods. Biscuits, cakes and pastries were considered baked food. As it was found difficult to measure the quantity of snaking in the pilot study; hence, the frequency of snaking is taken into account. Playing outdoor games, physical exercise, walking, cycling, swimming, and physical training in school were considered physical activities and attending schools, tuitions, reading, homework, watching television, playing computer games, and sleep were considered as sedentary activity.

Research tools

A predesigned and pretested schedule Standardized OMRON digital weighing scale and Portable digital height rod (Door mounted design) were used.

Statistical analysis

The data were entered in excel spreadsheets and analyzed using the SPSS Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. Chicago: SPSS Inc.. Students having underweight were excluded from the statistical analysis. Odds ratio and Chi-square test were used to measure the strength of association. First correlation was carried out among BMI and all other variables. Significantly correlated variables were entered in the multiple linear regression model. Multi-Collinearity was tested using tolerance and variance inflation factor. Significant variables (P < 0.1) on Chi-square analysis were entered in the multiple logistic regression (MLR) analysis. Adjusted odds ratio was compared with the crude odds ratio (OR) for each variable. P = 0.05 or less was considered for statistical significance.


  Results Top


[Table 1] shows the distribution of study participants as per age and sex. Majority of the study participants were in the age group of 16 years (51.2%) followed by 17 years (26.2%). Males and females were almost equal.
Table 1: Distribution of study participants as per age and sex

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[Table 2] shows the distribution of study participants as per father's literacy status and socioeconomic status. Only 3.5% of the fathers were illiterate. Majority belonged to the upper middle class.
Table 2: Distribution of study participants as per mother's literacy status and socioeconomic status

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[Table 3] shows the distribution of study participants as per diet and exercise. Majority (65.7%) were nonvegetarian. 81.8% ate three times a day. 58.3% were not doing any kind of exercise. 71.5% had sedentary lifestyle.
Table 3: Distribution of study participants as per diet and exercise

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[Table 4] shows the prevalence of overweight and obesity among college-going adolescents in Siddipet district. The overall prevalence of overweight and obesity in both the sexes was found to be 17.7% in the present study.
Table 4: Prevalence of overweight and obesity among college-going adolescents in Siddipet district

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[Table 5] shows age- and sex-wise prevalence of overweight and obesity. The prevalence of overweight among adolescent girls was 11.9% while not a single boy was found to be overweight. The prevalence of obesity among girls was 10.9% as compared to 12.9% among boys. No one was either overweight or obese at the age of 15 years. At 16 years of age, 8.5% of the girls were overweight but boys were not, and the prevalence of obesity at this age was more in boys (22.7%) as compared to girls (17.6%). At 17 years of age, the prevalence of overweight among girls was 19.6% while not a single boy was found to be overweight, and the prevalence of obesity at this age was more in boys (8.3%) compared to girls (5.2%). At 18 years of age, the prevalence of overweight among girls was 25% while not a single boy was found to be overweight and no one was obese. At 19 years of age, the prevalence of overweight among girls was 14.3% while not a single boy was found to be overweight and no one was obese.
Table 5: Age- and sex-wise prevalence of overweight and obesity

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[Table 6] shows the association of various factors with overweight and obesity combined. First a crude analysis between BMI categories (normal and overweight + obesity) was carried out using Chi-square and odds ratio. It was found that being female (22.6% vs. 12.9%; OR = 1.957 [1.272–3.01]); father being skilled or professional (29.5% vs. 4.9%; OR = 8.184 [4.539–14.76]), father being educated at intermediate or higher (36.1% vs. 7.9%; OR = 6.567 [4.132–10.44]), belonging to Social Class I and II (25.5% vs. 5.2%; OR = 6.29 [3.362–11.77]), being nonvegetarian (20.1% vs. 15.1%; OR = 1.663 [1.035–2.671]), and eating four times a day (24.8% vs. 16.1%; OR = 1.717 [1.045–2.823]) were found to be significant risk factors for being overweight and obese among adolescents.
Table 6: Association of various factors with overweight and obesity combined

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[Table 7] shows the correlation of BMI with variables. Among the variables correlated, sex, father occupation, father literacy, family income, socioeconomic status, and diet type were found to be significantly correlated with body mass index.
Table 7: Correlation of body mass index with variables

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[Table 8] shows the results of multiple linear regression analysis. Variables which were significantly correlated with BMI were entered in the multiple linear regression model. The model was found to explain 20.9% of variation in the BMI (r2 = 0.209), and it was statistically significant (f = 27.394; P = 0.000). Among these variables, sex, father occupation, father literacy, socioeconomic status, and diet type were found to be significant in the model, and family income was not significant.
Table 8: Results of multiple linear regression analysis

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[Table 9] shows the results of MLR analysis. Dependent variable was body mass index categorized as normal versus overweight and obesity. Variables found significant in the multiple linear regression model (total five) and significant on Chi-square analysis which met the eligibility criteria for MLR model (total six) were entered in the MLR model. It was found that the predictive accuracy of null model which was 82.3% increased marginally to 84.5% after all variables were entered. Omnibus test was significant (0.000) and Hosmer and Lemeshow test was not significant (0.171) which meant that the model was good to predict the model and the model can be used. Negelkerke r square was 0.292 which meant that 29.2% of variation in the model was explained by the variables entered in the model. Final model showed that being female, father being highly educated, and belonging to higher social class were the significant predictors of overweight and obesity adolescents.
Table 9: Results of multiple logistic regression analysis

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  Discussion Top


Majority of the study participants were in the age group of 16 years (51.2%) followed by 17 years (26.2%). Males and females were almost equal.

Only 3.5% of the fathers were illiterate. Majority belonged to upper middle class.

Majority (65.7%) were nonvegetarian. 81.8% ate three times a day. 58.3% were not doing any kind of exercise. 71.5% had sedentary lifestyle.

The overall prevalence of overweight and obesity in both the sexes was found to be 17.7% in the present study.

The prevalence of overweight among adolescent girls was 11.9% while not a single boy was found to be overweight. The prevalence of obesity among girls was 10.9% as compared to 12.9% among boys. No one was either overweight or obese at the age of 15 years. At 16 years of age, 8.5% of the girls were overweight but boys were not, and the prevalence of obesity at this age was more in boys (22.7%) as compared to girls (17.6%). At 17 years of age, the prevalence of overweight among girls was 19.6% while not a single boy was found to be overweight, and the prevalence of obesity at this age was more in boys (8.3%) as compared to girls (5.2%). At 18 years of age, the prevalence of overweight among girls was 25% while not a single boy was found to be overweight, and no one was obese. At 19 years of age, the prevalence of overweight among girls was 14.3% while not a single boy was found to be overweight, and no one was obese.

First a crude analysis between BMI categories (normal and overweight + obesity) was carried out using Chi-square and odds ratio. It was found that being female (22.6% vs. 12.9%; OR = 1.957 [1.272–3.01]); father being skilled or professional (29.5% vs. 4.9%; OR = 8.184 [4.539–14.76]); father being educated at intermediate or higher (36.1% vs. 7.9%; OR = 6.567 [4.132–10.44]); belonging to social Class I and II (25.5% vs. 5.2%; OR = 6.29 [3.362–11.77]); being nonvegetarian (20.1% vs. 15.1%; OR = 1.663 [1.035–2.671]); and eating four times a day (24.8% vs. 16.1%; OR = 1.717 [1.045–2.823]) were found to be significant risk factors for being overweight and obese among adolescents.

Among the variables correlated, sex, father occupation, father literacy, family income, socioeconomic status, and diet type were found to be significantly correlated with body mass index.

Variables which were significantly correlated with BMI were entered in the multiple linear regression model. The model was found to explain 20.9% of variation in the BMI (r2 = 0.209), and it was statistically significant (f = 27.394; P = 0.000). Among these variables, sex, father occupation, father literacy, socioeconomic status, and diet type were found to be significant in the model and family income was not significant.

Dependent variable was body mass index categorized as normal versus overweight and obesity. Variables found significant in the multiple linear regression model (total five) and significant on Chi-square analysis which met the eligibility criteria for MLR model (total six) were entered in the MLR model. It was found that the predictive accuracy of null model which was 82.3% increased marginally to 84.5% after all variables were entered. Omnibus test was significant (0.000) and Hosmer and Lemeshow test was not significant (0.171) which meant that the model was good to predict the model and the model can be used. Negelkerke r2 = 0.292 which meant that 29.2% of variation in the model was explained by the variables entered in the model. Final model showed that being female, father being highly educated and belonging to higher social class were the risk factors for overweight and obesity.

Gautam and Jeong[13] carried out a study among 1185 secondary school students in Udupi. 10.8% were overweight and 6.2% were obese. The prevalence was more in males as compared to females (11% vs. 7.1% for overweight and 10.6% vs. 5.4% for obesity) but we found that it was more in females. They reported that private school children, being Muslim and professional father were the significant predictors of overweight and obesity. We found that father being highly educated was one of the significant predictors of overweight and obesity but not the occupation.

Cherian et al.[14] examined the prevalence of overweight and obesity among urban school children in Kerala. The prevalence was more among girls (5.3%) as compared to boys (3%). Children belonging to higher income group showed significantly more prevalence of overweight and obesity compared to those belonging to lower socioeconomic groups.

Ranjani et al.[15] carried out a systematic review of “52 studies conducted in 16 of the 28 States in India”. They found that the obesity prevalence among children and adolescents was more in the North India as compared to South India. They also reported that the prevalence of overweight and obesity among children increased from 16.3% in 2001 to 2005 to 19.3% in 2010.

Rohilla et al.[16] found that weight, height, and body mass index increased with increase in the age. On binary logistic regression analysis, they observed that being female, using bus for going to school, single sibling and not playing games were the significant predictor of overweight. We also found that being female was an independent predictor of overweight and obesity in the present study.

Maiti et al.[17] used three reference values to compare the prevalence of obesity among children and found that the prevalence of highest using the World Health Organization criteria (10.62%) as compared to only 7.64% using the Center for Disease Control Criteria and still reduced to 7.49% using the IOTF criteria.


  Conclusion Top


The prevalence of overweight and obesity among these college-going adolescents was high. Being female, father being highly educated, and belonging to higher social class were the significant predictors of overweight and obesity.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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Cherian AT, Cherian SS, Subbiah S. Prevalence of obesity and overweight in urban school children in Kerala, India. Indian Pediatr 2012;49:475-7.  Back to cited text no. 14
    
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Ranjani H, Mehreen TS, Pradeepa R, Anjana RM, Garg R, Anand K, et al. Epidemiology of childhood overweight and obesity in India: A systematic review. Indian J Med Res 2016;143:160-74.  Back to cited text no. 15
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Rohilla R, Rajput M, Rohilla J, Malik M, Garg D, Verma M. Prevalence and correlates of overweight/obesity among adolescents in an Urban city of North India. J Family Med Prim Care 2014;3:404-8.  Back to cited text no. 16
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]



 

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