Scientific studies
Track 1 - Stemming the tide: innovations in prevention and screening
Risk factors
2016WCC/SS-1928
Over-nutrition among school children in India: A Meta-analysis
Pratap K. Jena* 1, 2, 3, Sudhir K. Satpathy3, B.P. Jeena4
1Health Systems Research India Initiative, Bangalore, 2Premier Research Group, 3KIIT School of Public Health, Bhubaneswar, 4Nitte University, Mangalore, India
Background: Obesity, one of the most important cancer risk factor, continues to be a significant public health concern in developed nations and gradually afflicting other nations. As half of overweight adults were overweight during their childhood, meta-analysis of overweight/obesity burden among Indian school children would help to assess the obesity epidemic situation in India. There is only one meta-analysis of obesity burden among Indian school children was done using three studies only.
Aim: To estimate pooled prevalence of over nutrition among school children in India by meta-analysis of studies published during last 10 years.
Methods: Studies conducted during 2005 and 2015, using WHO cut-off points to assess over-nutrition (overweight and obesity) among Indian school children were included in this meta-analysis. Twenty one studies involving both boys and girls in the age group of 6-19 years from rural or urban schools were included in the meta-analysis. Studies using other (IOTF & CDC) criteria for defining obesity or overweight, studies on specific subgroups like gender, and schools having affluent children were excluded in the analysis. MetaXL (V 2.2) software was used to conduct meta-analysis. Considering heterogeneity of the studies, Random Effect Model and Inverse Variance Heterogeneity model used for estimating pooled prevalence.
Results: The prevalence of obesity ranged between 1.5% to 32.2% in the included 21 studies covering 81,716 school children of 6 to 19 years old, and 11 Indian states. The pooled prevalence estimate in Random Effect model and Inverse Variance Heterogeneity model were 11.15% (95% CI: 8.98% -13.51%) and 10.56% (95% CI: 5.09% - 16.74%) respectively. In sub group analysis boys and urban students had higher burden of over nutrition, than their counterparts. However, gender difference in over nutrition prevalence was lower than urban-rural difference. Most of the studies included were of moderate quality and there was heterogeneity among studies.
Conclusions: One in 10 school children are suffering from over nutrition in India. Dual burden of under nutrition and over nutrition, is of concern. Over nutrition epidemic is concentrated in urban school children, and it is spreading to rural students. As urban students are more exposed to other cancer risk factors, there may be increase in urban incidence of obesity related carcinoma in future. The gender gap of over nutrition is narrowing. Limited rural studies, use of different criteria to define obesity, makes it difficult to synthesize results in pooled analysis and international comprision, which warrants use of standard tool for assessment of over nutrition across the globe.
Disclosure of Interest: None Declared
Keywords: Children, Epidemiology, Obesity