See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/300082191

Prevalence of overweight and obesity among adolescent students in

Pondicherry, South India

Article in International journal of Nutrition Pharmacology Neurological Diseases · April 2016

DOI: 10.4103/2231-0738.179966

CITATIONS READS
27 545

3 authors, including:

Vishnu Prasad R Zile Singh

Government of India 163 PUBLICATIONS 1,434 CITATIONS
33 PUBLICATIONS 166 CITATIONS
SEE PROFILE
SEE PROFILE

All content following this page was uploaded by Vishnu Prasad R on 11 April 2016.

The user has requested enhancement of the downloaded file.

[Downloaded free from http://www.ijnpnd.com on Monday, April 11, 2016, IP: 27.251.28.61]

O r i g i n al A r t icle

Prevalence of overweight and obesity among

adolescent students in Pondicherry, South India
Vishnu Prasad R, Joy Bazroy, Zile Singh

Department of Community ABSTRACT

Medicine, Pondicherry Institute
of Medical Sciences, Puducherry,
India
Address for correspondence:
Dr. Vishnu Prasad R,
Department of Community
Medicine, Pondicherry Institute of
Medical Sciences, Kalapet ‑ 605 014,
Puducherry, India.
E‑mail: vishnuprasath2@gmail.com
Context: The adolescent period of human life is one of the vital times when most of the
body growth and development occur. Nearly 35% of the global burden of disease has
its root emergence in adolescence. Overweight and obesity are defined as “abnormal
or excessive fat accumulation that presents a risk to health.” Aims: The present
study aims to measure the prevalence of overweight and obesity among adolescent
students (aged 10–18 years) in Pondicherry. Settings and Design: The study was
conducted as a cross‑sectional study among 10–18‑year‑old students in Pondicherry. The
study was conducted among 2,465 students from 5 schools and 2 polytechnic colleges.
Materials and Methods: The students were classified as “overweight” or “obese”
based on the Indian Academy of Pediatrics (IAP) age‑ and gender‑specific body mass
index (BMI) guidelines. Statistical Analysis Used: Data entry was done in MS Excel 2013
and Statistical Package for the Social Sciences (SPSS) version 21 was used for the statistical
analysis. Chi‑square test was used to identify statistical difference in proportions.
Results: The study results showed that the prevalence of overweight and obesity in our
study population was 9.7% and 4.3%, respectively. There was no difference in prevalence
between males and females. The prevalence of overweight/obesity increased as the age
advanced. Conclusions: The prevalence of overweight and obesity was predominant
among the students of private schools in the urban region in our study population.

Key words: Adolescent, obesity, overweight, prevalence, students

INTRODUCTION that presents a risk to health.”[2] Energy imbalance

The adolescent period of human life is one of the
vital times when most of the body growth and
development occur. Preparation for adulthood takes
place in this period in the form of physical, sexual,
and psychological growth and development. Nearly
35% of the global burden of disease has its root
emergence in adolescence.[1] Overweight and obesity
are defined as “abnormal or excessive fat accumulation
Access this article online
Quick Response Code:
Website:
www.ijnpnd.com
DOI:
10.4103/2231-0738.179966
between consumed and expended constitute the
primary etiology behind overweight and obesity.
Changing dietary pattern and sedentary lifestyle
are said to have led to the increasing prevalence of
overweight and obesity. South Asia is found to have
the highest prevalence of obesity and it was found to
increase every year.[3] Obesity in adolescents is found
This is an open access article distributed under the terms of the Creative
Commons Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows
others to remix, tweak, and build upon the work non‑commercially, as long as the
author is credited and the new creations are licensed under the identical terms.
For reprints contact: reprints@medknow.com
How to cite this article: Prasad RV, Bazroy J, Singh Z. Prevalence
of overweight and obesity among adolescent students in Pondicherry,
South India. Int J Nutr Pharmacol Neurol Dis 2016;6:72-5.
Received: 24-10-2015, Accepted: 20-11-2015

72 © 2016 International Journal of Nutrition, Pharmacology, Neurological Diseases | Published by Wolters Kluwer - Medknow
[Downloaded free from http://www.ijnpnd.com on Monday, April 11, 2016, IP: 27.251.28.61]

Prasad, et al.: Overweight and obesity among adolescent students

to have association with the occurrence of various
lifestyle diseases such as diabetes, hypertension,
dyslipidemia, osteoarthritis. during adulthood. It
is essential to know the prevalence of overweight
and obesity among adolescents so that appropriate
preventive measures can be taken. The present study
aims to measure the prevalence of overweight and
obesity among adolescent students (aged 10–18 years)
in Pondicherry.
MATERIALS AND METHODS
The study was carried out as an institute‑based
(schools + polytechnic college) cross‑sectional study
among adolescents (aged 10–18 years). The study was
carried out from June 2014 to December 2014. Five
schools (1 urban private school, 1 urban government
school, 1 rural private school, 2 rural government
schools) were selected randomly to have equal
distribution of students from the urban and rural
regions, both government and private schools. Since
the number of students in the rural government
schools is less, two schools were included in order
to have equal distribution of students among various
school types for comparison. In case of polytechnic
colleges (two), the students studying in each of
the colleges were from the urban and as well as
rural regions. Hence, one private college and one
government college were selected. Minimum required
sample size was calculated to be 2,458 based on the
prevalence of 14% from a study done in Karnataka,
South India.[4] The sample size was calculated with
a relative precision to 10% of prevalence, using the
formula Z2 PQ/d2. All the students of both genders
available during the time of examination in the
schools and institutions were included in the study.
The total number of students included in the study
was 2,465, of which 1,882 were from the schools
was done in MS Excel 2013 and Statistical Package
for the Social Sciences (SPSS) version 21 (SPSS‑Inc.,
Chicago, IL) was used for the statistical analysis.
Written informed consent was obtained from the
parents and assent was obtained from the students
wherever applicable.
RESULTS
The age‑ and gender‑wise distribution of the students
who participated in the study based on their height and
weight are found to follow standard normal growth
curves in adolescents [Table 1]. The overall prevalence
of overweight was 9.7% (240) and obesity was
4.3% (105) among our study population (not presented
in table). The overall prevalence of overweight/obesity
was 14% (345). There was no significant difference in
prevalence of overweight/obesity among males and
females. In both males and females, the prevalence
was high among those who are in the age group of
16–18 years when compared to the adolescents in the
age group of 10–15 years [Table 2].
Table 1: Height and weight distribution of students
based on gender
Age Mean (SD)
(in years) Male (N=1,310) Female (N=1,155)
Height Weight Height Weight
(in cm) (in kg) (in cm) (in Kg)
10 139.17 (7.6) 29.13 (6.7) 137.76 (7.3) 31.05 (8.0)
11 139.37 (7.9) 29.68 (7.8) 138.79 (7.9) 30.50 (9.2)
12 143.68 (8.3) 33.18 (9.6) 145.67 (8.3) 34.68 (9.0)
13 149.54 (8.6) 36.50 (11.0) 150.56 (7.5) 39.94 (9.6)
14 156.22 (9.3) 42.77 (11.0) 153.17 (6.5) 42.44 (9.3)
15 162.99 (8.6) 50.32 (13.7) 155.36 (7.3) 46.45 (11.6)
16 167.19 (6.9) 53.67 (12.7) 157.71 (5.6) 50.83 (12.9)
17 169.71 (6.6) 56.51 (12.4) 157.88 (5.2) 50.86 (11.1)
18 169.86 (7.2) 56.50 (11.8) 157.86 (5.9) 51.43 (14.6)
SD: Standard deviation

and the remaining 583 were from the polytechnic

institutions. There were 1,310 (53.1%) male students Table 2: Distribution of children with overweight/
and 1,155 (46.9%) female students. Students who could obesity based on age and gender (N=2,465)
not be contacted after two visits to the institution were Age Overweight N (%) Obese N (%) Total overweight
planned to be excluded from the study; however, (in years) Boys Girls Boys Girls and obese
N (%)
we could recruit all the enrolled students with a
10 11 (7.7) 14 (10.6) 4 (2.8) 3 (2.3) 32 (11.7)
100% response rate. The heights of the students
11 14 (8.2) 8 (5.2) 8 (4.7) 3 (2.0) 33 (10.2)
were measured and rounded off to the nearest 12 28 (12.4) 15 (9) 5 (2.2) 3 (1.8) 51 (13)
centimeter and the weights of the students were 13 18 (9.0) 11 (5.9) 10 (5.0) 3 (1.6) 42 (10.9)
measured to the nearest 100 gm by the investigators. 14 22 (11.5) 15 (8.5) 10 (5.2) 3 (1.7) 50 (13.6)
Age‑ and gender‑specific body mass index (BMI) was 15 13 (12.0) 10 (16.9) 3 (2.8) 4 (6.8) 30 (18)
calculated using WHO Anthroplus software.[5] The 16 7 (16.7) 10 (19.6) 2 (4.8) 5 (9.8) 24 (25.8)
students were classified as “overweight” or “obese” 17 8 (8.6) 7 (6.8) 5 (5.4) 13 (12.6) 33 (16.8)
based on the Indian Academy of Pediatrics (IAP) 18 11 (8) 18 (14) 5 (3.6) 16 (12.4) 50 (18.8)
age‑ and gender‑specific BMI guidelines.[6] Data entry Total 345 (14)

International Journal of Nutrition, Pharmacology, Neurological Diseases | April‑June 2016 | Vol 6 | Issue 2 73
[Downloaded free from http://www.ijnpnd.com on Monday, April 11, 2016, IP: 27.251.28.61]

Prasad, et al.: Overweight and obesity among adolescent students

The prevalence of overweight and obesity were high adolescents (aged 12–18 years). It was also reported
among student who belonged to the schools of the in the same study that the prevalence of overweight
urban region (14.8%) and private schools (18.7%) was high among adolescent children who belonged
when compared to the students of the schools in the to higher socioeconomic class compared to those who
rural regions and government schools, respectively. belonged to the lower socioeconomic class. Laxmaiah
The overall prevalence of overweight and obesity et al., in a similar study conducted among adolescents
among early adolescents (aged 10–15 years) was in the age group of 12–17 years, reported a prevalence
observed to be 12.3% [Table 3]. as low as 7% during the year 2007.[8] It was observed by
George et al.[9] in a study done in Kerala among rural
The maximum prevalence of overweight and obesity adolescent children in the age group of 13–18 years
was observed in the urban private school (20%), that the  rates of prevalence of overweight and obesity
while the minimum prevalence of overweight and were 16% and 7%, respectively. The results of the
obesity was observed in the rural government studies discussed above show a higher prevalence
school (5.2%) [Figure 1]. when compared to our study. A higher prevalence
of about 15.8% was also reported from another study
The prevalence of overweight and obesity was by Ramachandran et al.[10] among urban adolescent
found to high among males in the younger age school children. Recent studies have shown increasing
group (10–14 years) when compared to females, trend of prevalence of overweight and obesity among
whereas among the students of older age group (15– adolescents.[11‑13] Goyal et al.[14] in a study among
18 years) the prevalence was observed to be higher adolescents in Surat city observed a prevalence
among female students as compared to their male of overweight and obesity as 6.55% and 13.9%
counterparts [Table 4]. respectively. Some of the determinants of overweight
and obesity found in the previous study were low
DISCUSSION physical activity, TV watching/computer games,
and junk foods. Similar association was also seen in a
The overall prevalence of overweight and obesity was
study done by Prasad et al.[15] in Hyderabad city among
found to be 14% among adolescents (aged 10–‑18 years)
adolescents. Also obesity and overweight is found to
from the present study. Also we observed a higher
be associated with body shape dissatisfaction among
prevalence of obesity among urban and private
adolescents that may further lead to low self‑esteem.[16]
school students. Goyal et al.[7] reported a similar
A multicomponent approach‑based intervention that
prevalence (12%) of overweight and obesity among
involves both school and home environments for the
prevention of obesity is advised.[17] In the present study,
Prevalence of Overweight/Obesity
it was observed that prevalence of overweight/obesity
25
20
20
17.2
was high among males in the younger age group,
Percentage

15 whereas in the older age group it was high among

10
9.8
females, this could possibly be explained by the
5.2
5 hormonal changes influencing growth during
0
Urban Private Rural Private Urban Government Rural Government
adolescence and puberty. Some of the strengths of
the present study are that it included students from
Figure 1: Distribution of overweight/obesity prevalence among both urban and rural region and students of private
students based on school type* (N = 1,882) *The difference in prevalence
of overweight/obesity among various school types was found to be and government institutions are included, hence
statistically significant (P < 0.001) the study results can be generalized. Also, standard

Table 3: Distribution of overweight and obese students based on type and location of schools (N=1,882)
Type and location Overweight/obesity N (%) Total P* Odds ratio
of school Present Absent N (%) (95% CI)
School location
Urban school 138 (14.8) 794 (85.2) 932 (100) 0.001 1.6 (1.12-2.1)
Rural school 94 (9.9) 856 (90.1) 950 (100)
Type of school
Private 154 (18.7) 668 (81.3) 822 (100) <0.001 2.9 (2.2-3.9)
Government 78 (7.4) 982 (92.6) 1,060 (100)
Total 232 (12.3) 1,650 (87.7) 1,882 (100)
*Chi‑square test was used to identify statistically significant difference in proportion and a P value of <0.05 was considered significant

74 International Journal of Nutrition, Pharmacology, Neurological Diseases | April‑June 2016 | Vol 6 | Issue 2
[Downloaded free from http://www.ijnpnd.com on Monday, April 11, 2016, IP: 27.251.28.61]
Prasad, et al.: Overweight and obesity among adolescent students
Table 4: Association between gender and
overweight with respect to age group (N=2,465)
Age group Gender Overweight/obesity
Present Absent
10-14 years Male 130 (14.0) 800 (86.0)
Female 78 (9.6) 735 (90.4)
15-18 years Male 54 (14.2) 326 (85.8)
Female 83 (24.3) 259 (75.7)
*Chi‑square test was used to identify statistically significant difference in
proportion and a P value of <0.05 was considered significant
procedures were followed in classifying the students
as overweight and obese. Some of the possible
limitations of the study are as follows: The relatively
small sample size and cross‑sectional design, which
is inadequate to study various possible determinants
of overweight and obesity. Also, the exact place of
residence (urban or rural) to which the students
belong could not be ascertained since the information
regarding this when collected from younger student
was not found to be of good validity, although an
attempt was made. In case of urban schools, from the
school student records it was observed that most of
the students (>90%) were from urban areas. Whereas
most of the students (>95%) in the rural schools were
from rural areas as reported by the school officials.
Similarly, socioeconomic status of the students cannot
be studied directly since most of the children may not
give relevant details, hence a private–government
stratification was done.
CONCLUSION
The prevalence rate of overweight and obesity were
9.7% and 4.3%, respectively, in our study population.
The study results show that overweight and obesity
is predominant among adolescent students belonging
to the private schools in urban Pondicherry.
Acknowledgment
The authors would like to acknowledge the support
of all the students who participated in the study and
the head of the institutions for permitting the study.
Financial support and sponsorship
Nil.
International Journal of Nutrition, Pharmacology, Neurological Diseases | April‑June 2016 | Vol 6 | Issue 2
View publication stats
Conflicts of interest
There are no conflicts of interest.
P*
REFERENCES
0.005
1. Karthikeyan A, Shanthi V, Nagasathaya A. Preliminary phytochemical
<0.0001 and antibacterial screening of crude extract of the leaf of Adhatoda vasica.
L. Int J Green Pharm 2009;3:78‑80.
2. Ilango K, Chitra V. Wound healing and anti‑oxidant activities of the
fruit pulp of Limonia acidissima Linn (Rutaceae) in rats. Trop J Pharm
Res 2010;9:223‑30.
3. Jaacks LM, Slining MM, Popkin BM. Recent trends in the prevalence
of under‑ and overweight among adolescent girls in low‑ and
middle‑income countries. Pediatr Obes 2015. [Epub ahead of print].
4. Kotian MS, S GK, Kotian SS. Prevalence and determinants of
overweight and obesity among adolescent school children of
South Karnataka, India. Indian J Community Med 2010;35:176‑8.
5. Growth Reference 5‑19 years. WHO AnthroPlus Software. WHO.
2015. Available from: http://www.who.int/growthref/tools/en/.
[Last accessed on 2014 Aug 01].
6. Khadilkar VV, Khadilkar AV, Borade AB, Chiplonkar SA. Body mass
index cut‑offs for screening for childhood overweight and obesity in
Indian children. Indian Pediatr 2012;49:29‑34.
7. Goyal RK, Shah VN, Saboo BD, Phatak SR, Shah NN, Gohel MC,
et al. Prevalence of overweight and obesity in Indian adolescent
school going children: Its relationship with socioeconomic
status and associated lifestyle factors. J Assoc Physicians India
2010;58:151‑8.
8. Laxmaiah A, Nagalla B, Vijayaraghavan K, Nair M. Factors affecting
prevalence of overweight among 12‑ to 17‑year‑old urban adolescents
in Hyderabad, India. Obesity (Silver Spring) 2007;15:1384‑90.
9. George S, Binu J, Joseph BB. A study on the prevalence of overweight
and obesity and its influencing factors in rural adolescent school going
children in Kerala, India. Int J Curr Res Rev 2012;4:89‑99.
10. Ramachandran A, Snehalatha C, Vinitha R, Thayyil M, Kumar CK,
Sheeba L, et al. Prevalence of overweight in urban Indian adolescent
school children. Diabetes Res Clin Pract 2002;57:185‑90.
11. 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.
12. Niranjan N, Hiremath S, Kapoor A, Berwal PK. Prevalence of
overweight and obesity and factors affecting it in affluent adolescents
of Raichur city. Int J Contemp Pediatr 2015;2:21‑4.
13. Jagadesan S, Harish R, Miranda P, Unnikrishnan R, Anjana RM,
Mohan V. Prevalence of overweight and obesity among school children
and adolescents in Chennai. Indian Pediatr 2014;51:544‑9.
14. Goyal JP, Kumar N, Parmar I, Shah VB, Patel B. Determinants of
overweight and obesity in affluent adolescent in Surat City, South
Gujarat region, India. Indian J Community Med 2011;36:296‑300.
15. Prasad VG, Katta H, Malhotra V. Risk Factors associated with obesity
among adolescent students: A case control study. Int J Health Sci Res
2015;5:1‑5.
16. Prasad VR, Kanimozhy K, Venkatachalam J, Madhanraj K, Singh Z.
Body shape dissatisfaction and overweight noesis among polytechnic
college students in Puducherry‑A cross sectional study. Int J Indian
Psychol 2015;2:44‑52.
17. Sreevatsava M, Narayan KM, Cunningham SA. Evidence for
interventions to prevent and control obesity among children
and adolescents: Its applicability to India. Indian J Pediatr
2013;80(Suppl 1):S115‑22.
75