Association of contributing factors of over-weight and obesity among urban school going adolescent girls of Cooch Behar district, West Bengal, India

INTRODUCTION

Developing countries are experiencing remarkable changes in child and adolescent nutrition because of the nutritional changes, demographic and epidemiological conversion during last two decades. These situation makes impact on changes in lifestyle patterns, food consumption pattern and economic changes.^1-4 In India, the probable cause of the nutritional changes are quick socio-economic changes, demographic and epidemiologic transformations, changes in nutritional habit and a more lazy and inactive lifestyle in Indian populations.^1,2,4.5 Infact, Some studies concluded that risk factors such as unhealthy eating habits, spending long hours watching TV, and high socio-economic status was associated with the prevalence of overweight-obesity.^6,7 So, monitoring the prevalence of overweight and obesity in children and adolescents is very much needed. Excess body adiposity deposited in Human body and causes overweight and obesity. Studies significantly found that prevalence of overweight-obesity elevated risk of several non-communicable lifestyle disorders such as hypertension, metabolic syndrome, type-2 diabetes mellitus (T2DM), hypertension, insulin resistance, polycystic ovarian syndrome (PCOS) and coronary heart disease (CHD) and also social problems among both children and adolescents.^2-4,8-11

After an exclusive literature review, no studies were found on adolescent Bengalee Hindu girls, in the present study area. Bengalee Hindu is the majority of West Bengal. The present study was an attempt to survey current status of prevalence of overweight-obesity among urban Bengalee Hindu adolescent girls of Cooch Behar district, West Bengal, India.

METHODS

A community based cross sectional study was conducted from April to October, 2023 among urban (n=232) Bengalee Hindu (15-18) years old adolescent school going girls of Urban municipal areas of Cooch Behar district, West Bengal, India. Cooch Behar is situated in northern part of West Bengal. According to the census 2011, Bengalee Hindu population in Cooch Behar district is 74.05%. The studied population was selected using simple random sampling technique. For ethical consideration, Helsinki Declaration (2007) was followed.¹² Nature and purpose of the present study was explained to school authorities, students and their parents and written consent was taken from school authorities before data collection. Students were interviewed and measured during school hours. Total 232 Bengalee Hindu girls were joined and cooperated during data collection. Data was collected using pre-tested and pre designed schedule. Age was recorded on the basis of their birth certificates. Anthropometric measurement height (cm), weight (kg) was recorded by following standard procedures.¹³

Derived variable, Body Mass Index (BMI) were calculated using following formula: BMI=Weight (kg)/Height²(m²). The values of body mass index were plotted on age specific WHO Charts for height and BMI.^14,15 The BMI values were classified on the basis of the position of the plot, between the major standard deviation lines and named as, -3SD, -2SD, -1SD, 1SD, 2SD, 3SD. In the purpose of calculating BMI-for –age z-score, 2SD and above were categorized as overweight-obese, between -1SD to 2SD were categorized as normal, between -2SD to -3SD were categorized ad moderate thinness and values below -3SD were categorized as severe thinness.^14-17 All statistical analysis was done using Statistical package for social science (SPSS Inc., Chicago, IL, version 20.0) and WHO Anthro Plus software. Descriptive statistics of anthropometric variable height, weight and BMI was done in terms of mean and standard deviation (±SD). One-way ANOVA was used to assess age specific mean differences of anthropometric variables. Statistical analysis was done using Chi-square (χ2) test to find out categorical association. The p value <0.05 was considered as significant.

RESULTS

Table 1, showing mean±standard deviation of Anthropometric variables. The mean height (cm), weight (kg) and BMI (kg/m²) among the studied population were 151.97 cm, 57.10cm and 24.61kg/m² respectively. One-Way ANOVA were done and values showed statistically insignificant differences between age and anthropometric variables.

ns-Non-significant

Table 2, showing prevalence of overweight-obesity in the studied urban population. Prevalence of overweight-obesity among 15years, 16years, 17 years and 18 years were 33.9%, 18.9%, 21.9% and 33.9% respectively. Higher prevalence of overweight-obesity was found among 18years girls. However, prevalence of severe thinness and moderate thinness among the studied population were 0.86% and 3.4% respectively. Overall 68.96% girls found normal in the present study. However, only 0.86% girls found severely thin and 3.4% girls found moderately thin.

*Values are parenthesis indicates percentage, ns-Non-significant

Table 3 showing association between overweight-obesity and contributing factors. In the present study, only 3.44% girls were vegetarian while, 96.56% girls liked mixed diet. No vegetarian girl found overweight-obese in the present study and the difference was statistically significant (p<0.05). 52.59% girls consumed fast food less than three times per week and 39.65% girls consumed fast foods 3-7 times. Only 7.76% girls never consume fast foods. overweight-obesity increased with the frequency of fast foods consumption and the difference was statistically significant (p<0.05). 53.02% girls have carbonated drink less than 3 times per week and 36.21% girls have carbonated drink 3 to 7 times per week. The prevalence of overweight-obesity increased with the frequency of having carbonated drink and the difference was statistically significant (p<0.05). 21.55% girls used mobile up to two hours per day while majority were used mobile for two or more hours per day. The prevalence of overweight-obesity increased with the frequency mobile uses and the difference was statistically significant (p<0.05). 90.51% girls watched T.V. up to one hours per day. Only 9.49% girls watched T.V. more than one hours per day. The difference was statistically insignificant (p=0.010). 37.93% girls participated daily physical activities in school or home. While, 62.07% girls were almost inactive and not interested in physical activities. The prevalence of overweight-obesity increased with physical inactivity and the difference was statistically significant (p<0.05). 39.22% girls came school either walking or cycling. 60.78% girls used motorized vehicles for transportation to school. The difference was statistically insignificant (p=0.024).

*Values are parenthesis indicates percentage

DISCUSSION

The adolescence period i.e. 10years-19years, generally, denoted by prompt growth, development and conversion from childhood to adulthood.^18-20 That’s why, adolescents require right and perfect nutrition for growth. Generally, adolescent can achieve 15% of their adult height and half of the adult weight during these phase.^21,22,4 While rural India is fighting with the prevalence of undernutrition, urban India are tussling with prevalence of overweight-obesity because of switching sedentary life style and earning much more than rural population.^{2,3,9,10,23-25}

In the present study, prevalence of overweight-obesity among the studied population was 26.72%. Similar result was reported by Jain et al, Jain et al in Meerut.^26,27 Another study reported that 7.60% urban adolescents found overweight-obese in Madhya Pradesh.²⁸ A study conducted on diet and nutritional status among adolescents and revealed that 11.97% adolescents found overweight-obese in Lucknow^2.9 Bibi et al revealed that 14.92% adolescent found overweight –obese in Kamrup district, Assam.³⁰

Sedentary life style is the contributing factor for overweight-obesity. In the present study, diet, fast food consumption, having carbonated drink, use of mobile and physical inactivity was significantly associated overweight-obesity (p<0.05) (Table 3).

78.97% girls used mobile for more than two or more hours in the present study. Among them, 31.86% girls were overweight- obese. 90% girls were watching T.V. up to one hour or less. Infact, girls revealed that they were more interested in mobile rather watching T.V. (Table 3).

Less physical activity or completely inactive life style could increase the risk of overweight obesity. 62.07% girls did not participate any physical activity in school or home. Few studies were reported that less physical activity responsible for high adiposity and subcutaneous fat.^32,7,31 Fast food consumption and having carbonated drink increases the prevalence of overweight-obesity. More than 50% girls consume fast food and have carbonated drink for 3-7 times per week, found obese. Several studies significantly found that consumption of high calorie carbohydrate rich food, inactive life style causes weight gaining.^2,9,10,3,4

One of the major limitation of the present study was, it was a cross sectional study with limited sample size. Longitudinal study with more sample size can describe the impacts of some determinants of overweight-obesity well. Moreover, only urban adolescent girls were included in this study. If the rural adolescent girls were also included, then, this study properly described that the determinants of overweight-obesity, impacts on urban adolescent girls, were responsible for rural adolescent population or not.

CONCLUSION

Present study assessed prevalence of overweight-obesity using WHO growth reference 2007.In the present study, prevalence of overweight-obesity among Bengalee Hindu girls was 26.72%. Sedentary life style is found as the leading factor for overweight-obesity. Contributing factors, like, diet, fast food consumption, having carbonated drink, use of mobile and physical inactivity was significantly associated overweight-obesity.

ACKNOWLEDGEMENTS

We would like to thank the school authorities, participants and the University of North Bengal for their help and support.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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