International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 04 Issue 24, December, 2012

Pages: 38-42

Date of Publication: 30-Nov--0001


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OVERWEIGHT AND OBESITY IN YOUNG ADULTS: FOOD FOR THOUGHT

Author: Kavita Vasudevan P., Umamaheswari K., Vedapriya D.R., Palanivel Chinnakali

Category: Healthcare

Abstract:Research question: What is the magnitude of overweight and obesity among young adult students of a medical college? Setting: All undergraduate medical college students of a private medical college in Pondicherry. Design: Facility based cross-sectional study. Using a pre-tested semi-structured questionnaire all subjects were interviewed after taking informed consent. Weight, height, waist circumference and hip circumference were measured. Overweight, obesity and central obesity was estimated by using standard criteria. Results: prevalence of overweight or obese was 26.7 % & 35.2% resp. using the standards for Asian Indians and 29.1% and 3.8% resp. using the WHO cut-offs. About 23.3 5%and 10.9% of the subjects had larger waist circumferences and higher waist-hip ratios The prevalence was significantly more in males when compared to females. Conclusion: Overweight and obesity is a problem in this study group which calls for primary preventive measures like health education, dietary modification, physical activity and periodic screening.

Keywords: overweight, obesity, young adults, primary prevention

Full Text:

INTRODUCTION
The global epidemic of overweight and obesity – ‘globesity’ is becoming a public health problem in many parts of the world. Rapidly changing diet and lifestyles is fueling this global obesity epidemic. It is associated with an increased risk of developing various non-communicable diseases including hypertension, coronary heart disease, diabetes, stroke and some forms of cancers.(1) The National Family Health Survey-3 (NFHS-3) has reported that nutrition transition is underway in India with high proportion of overweight co-existing with high rates of malnutrition.(2) The age-group from 18-21 years is an important phase in life; physically, mentally and emotionally. This is the period of transition from adolescence to adulthood. Proximity to biological maturity at this time may provide final opportunities for primordial and primary prevention of health problems. Overweight and obesity during this period are associated with development of risk factors for obesity related diseases. Studies using anthropometric measurements to assess nutritional status have been focused more on under-five children and school children. But the emergence of obesity and its sequelae as public health problems has renewed interest in the adolescent anthropometry.(3) Medical students joining Medical Colleges represent this group. There are very few studies on the health and nutritional status for this group in our country. This study aims to assess the prevalence of overweight and obesity in medical students.

METHODOLOGY
This study was conducted in a private medical college in Pondicherry wherein 100 students are admitted every year. Institute Ethical committee clearance was obtained before starting the study. The purpose of the study, and the procedure was explained to each student in detail. All students currently studying in the college, willing to participate, were enrolled for the study. Informed consent was obtained from each student. The height, weight, waist circumference and hip circumference were measured. The weight was taken on a weighing scale with standard minimum clothing to the nearest 0.5kg. Height was measured on a vertical scale with the heel, buttocks and occiput against the wall and the head in the frankfurt plane to the nearest 0.5cm. Waist circumference (WC) was measured at the level of the highest point of the iliac crest and hip circumference was the largest diameter around the buttocks. The cut-off for WC to quantify abdominal obesity indicating high risk was taken as 90 cm for men and 80cm for women. Waisthip ratio was calculated by using the formula WHR= (waist circumference in cm)/ (Hip circumference in cm). WHR of more than 0.85 in women and 0.95 in man was considered as abdominal obesity. Body mass index (BMI) was calculated by the formula BMI= (weight in kg)/ (height in mts) 2 . BMI was used to categorise the nutritional status of the subjects as per the recommended cut-offs for Asian Indians. (Normal BMI: 18.0-22.9 kg/m2 ; Overweight: 23.0-24.9 kg/ m2 ; Obesity: >25 kg/m2 ).(4,5) It was also compared with the WHO cut-offs.

STATISTICAL ANALYSIS
Data was entered in MS Excel and analyzed by using SPSS software v17.0. Students’ t test was used to compare means and Chi-square test was used to compare proportions between groups. A pvalue of 0.05 or less was considered statistically significant.

RESULTS
A total of 471 students were included in this study of which 59.7% were males. The mean age for girls was 21.2 ± 2.1 (range 18-36yrs ) and for boys was 21.7 ± 2.2 (range 18-31yrs ). Only 5(1.1%)of them, all girls; were married. Socioeconomic status was assessed by using the Prasad’s classification based on per capita income. About 95.4% of the respondents belonged to class II or above. Table 1 shows the distribution of the study population based on their gender and semester of study. The biggest proportion of female and male subjects was in V semester and I semester respectively. Table 2 shows the mean anthropometric parameter of the study population. The male subjects were found to be significantly taller, heavier, had larger waist circumferences and higher body mass index compared to female subjects. Figure 1 shows the distribution of body mass index of the study subjects based on south-asian cut-offs and WHO cut-offs. Using the south-asian cut-offs majority of the subjects were found to overweight or obese (26.7 % & 35.2% resp.) with sub-optimal BMI. The WHO classification which has higher BMI cut offs for overweight and obesity shows that majority have normal BMI(60.3%). The proportion of overweight and obesity was 29.1% and 3.8% resp. About 23.3 5%and 10.9% of the subjects had larger waist circumferences and higher waist-hip ratios(table 3)indicating abdominal obesity.

DISCUSSION
The risk factors of today are the diseases of tomorrow. Identifying the risk factors in populations occupies a central place in the surveillance system because of the importance of the lag time between exposure and disease. Therefore, public health strategies have to be driven by the motive of identifying risk factors in populations in different settings.(6)Obesity is an important risk factor in the pathogenesis of hypertension, dyslipidemias, diabetes mellitus and cardio-vascular diseases. Identifying overweight and obesity early and managing it with rational approaches is crucial in control of cardio-vascular diseases. This study has found a prevalence of overweight and obesity in this group of medical students as 26.7% and 35.2% respectively using the BMI cutoffs for Asian Indians. Using the WHO BMI cutoffs the prevalence of overweight or obesity was found to be 32.9%. This prevalence is higher than that reported by studies in medical college students in Delhi and West Bengal.(3,7) This difference may be due to the differences in sample size of the studies, age of the subjects and dietary practices. In this study most of the students belonged to the upper socio-economic class indicating the effect and quality of the feeding practices in their childhood and adolescence. The National Family Health Survey-3 (NFHS-3) has reported a prevalence of overweight in women as 14.8% and in men 12.1% with an higher prevalence in urban areas when compared to rural areas. This is lower than the present study as the population studied in NFHS-3 was adults in the age group 15-45yrs(2). Studies from Kerala and gujrat(6,8) among adults in the age-group 15- 60 yrs have reported a prevalence similar to this study. All the above mentioned studies from India have used BMI cut-offs as stated by WHO for assessing obesity. This would make international comparisons possible but may underestimate the true burden. It would be advisable to use the criteria relevant to Asians Indians as suggested in various publications by the government of India with respect to body mass index, waist circumference and waist-hip ratio.(4,5) The prevalence of overweight, obesity and central obesity was more in males than in females. This is different from that reported by some other studies (6, 9). Shah et al reported that overweight, obesity and central obesity is higher in women, whereas Mehan et al have reported higher abdominal obesity in women based on waist circumference and waist-hip ratio. But in both the studies the age group of the subjects(15-45yrs) was different from that of the current study. This study has shown that overweight and obesity is a health problem in the group studied. Belonging to higher socio-economic status, changing diets and lifestyles may have contributed to this high prevalence. This requires planning of strategies, focusing on the young adults to prevent obesity-related sequelae.

CONCLUSION
Overweight and obesity is a problem in this study group which calls for primary preventive measures like health education, dietary modification, physical activity and periodic screening. Physical activities like sports, yoga, periodic screening of students, maintaining health cards for students could be made essential during medical training course. Further studies in similar groups, across the country are needed to substantiate the findings of this study.

ACKNOWLEGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in the references of this manuscript. The authors are also grateful to authors/ editors/ publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

References:

1. Vedapriya D R, Mittal A, Mahajan P, Kavita V, Balamuruganvelu S, Umamaheswari K. Prevalence Of Overweight Among Adults In Arural Area Of Tamil Nadu. Ind. J Nutr Dietet.2010; 47:404-8

2. Fact sheet: National Family Health Survey NFHS-III 2005-06. Ministry of Health and Family Welfare. Govt. of India 

3. Chabra V, Grover VL, Agrawal K, Kanan AT. Nutritonal status ans blood pressure of medical students in Delhi. IJCM.2006;31(4):248-51.

4. National Programme for Prevention and Control of Diabetes, Cardio-vascular diseases and Stroke. A manual for Medical Officer. Government of India-WHO collaborative programme 2008-09.

5. Mishra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D et al. Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management. JAPI 2009; 57(2):163-70.

6. Mehan MB, Surabhi S, Solanki GT. Risk factor profile of non-communicable diseases among middle income (18-65 years) freeliving urban population of India. Int J Diab Dev Ctries 2006; 26(4): 169-76.

7. Gupta S, Ray TG, Saha I. Overweight, obesity and influence of stress on body weight among undergraduate medical students. IJCM 2009; 34(3): 255-57.

8. Thankappan KR, Shah B, Mathur P, Sarma PS, Srinivas G, Mini GK et al. Risk factor profile of non-communicable diseases: results of a community-based study in Kerala, India. Ind J Med Res 2010; 131:53-63.

9. Shah B, Mathur P. Surveillance of cardiovascular disease risk factors in India: The need & scope. Ind J Med Res 2010; 131:53-63.



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A Study by Amr Y. Zakaria et al. entitled "Single Nucleotide Polymorphisms of ATP-Binding Cassette Gene(ABCC3 rs4793665) affect High Dose Methotrexate-Induced Nephrotoxicity in Children with Osteosarcoma" is awarded Best Article for Vol 13 issue 19
A Study by Kholis Ernawati et al. entitled "The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review" is awarded Best Article for Vol 13 issue 18
A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
A Study by Chandran Anand et al. entitled "A Prospective Study on Assessment of Quality of Life of Patients Receiving Sorafenib for Hepatocellular Carcinoma" is awarded Best article for Vol 13 issue 15
A Study by Rosa PS et al. entitled "Emotional State Due to the Covid – 19 Pandemic in People Residing in a Vulnerable Area in North Lima" is awarded Best Article for Vol 13 issue 14
A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13
A Study by Mona Isam Eldin Osman et al. entitled "Psychological Impact and Risk Factors of Sexual Abuse on Sudanese Children in Khartoum State" is awarded Best Article for Vol 13 issue 12
A Study by Khaw Ming Sheng & Sathiapriya Ramiah entitled "Web Based Suicide Prevention Application for Patients Suffering from Depression" is awarded Best Article for Vol 13 issue 11
A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10
A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
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A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
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A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
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A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
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A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
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A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma situs slot entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
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A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
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A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09
Late to bed everyday? You may die early, get depression situs slot
Egg a day tied to lower risk of heart disease situs slot
88 Percent Of Delhi Population Has Vitamin D situs slot  Deficiency: ASSOCHAM Report

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A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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