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Study of life style determinants of overweight and obesity among school going
adolescents in urban Jabalpur, Madhya Pradesh, India

Article in International Journal of Community Medicine and Public Health · January 2017
DOI: 10.18203/2394-6040.ijcmph20170290

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International Journal of Community Medicine and Public Health
Tomar SP et al. Int J Community Med Public Health. 2017 Feb;4(2):554-559
http://www.ijcmph.com pISSN 2394-6032 | eISSN 2394-6040

DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20170290
Original Research Article

Study of life style determinants of overweight and obesity among school

going adolescents in urban Jabalpur, Madhya Pradesh, India
Shashi Prabha Tomar*, Pradeep Kumar Kasar, Rajesh Tiwari

Department of Community Medicine, NSCBMC, Jabalpur, Madhya Pradesh, India

Received: 15 October 2016

Revised: 11 December 2016
Accepted: 20 December 2016

*Correspondence:
Dr. Shashi Prabha Tomar,
E-mail: tomarshashi9@gmail.com

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: Obesity has become a colossal epidemic causing serious public health concern and contributes to 2.6
million deaths worldwide every year. Indian data regarding current trends in childhood obesity are emerging.
Considering the fact that India has rapidly growing middle class easily habituated for enormous lifestyle changes in
recent decades responsible for developing potential platform for obesity among youths. Accordingly, the objective of
the present study was to evaluate the associations between overweight, obesity and several lifestyle factors, including
physical activity, sedentary behaviours among adolescents aged 10-17 years.
Methods: A cross-sectional study was carried out in two schools of Jabalpur located around medical college area ,
184 students effectively interviewed by predesigned questionnaire regarding Socio-demographic profile ie current
residence, age, mothers educational and occupational status and family size and life style practices like the physical
activity questions designed to asses typical time spent per day on games and outdoor activity, on sedentary activities,
including television (TV) viewing, video games, and computer and internet use. Data entry and data processing were
carried out using the SPSS version 17 software and data analyses were applied using the appropriate statistical tests of
significance.
Results: Prevalence of obesity and overweight: Of the 184 adolescents studied, 7.6% were obese and 2.2% were pre-
obese.
Conclusions: Among all of the lifestyle factors assessed, overweight and obesity exhibited associations with less
frequent physical activity, and more television and internet use.

Keywords: Adolescents, Life style, Obesity, Overweight

INTRODUCTION of school-age children affected will almost double by

2010 compared with the most recently available surveys
Obesity has become a colossal epidemic causing serious from the late 1990s up to 2003.3 Current evidence
public health concern and contributes to 2.6 million indicates that obesity is a multi-factorial condition
deaths worldwide every year.1 Indian data regarding influenced by many variables, including genetic,
current trends in childhood obesity are emerging. A demographic and lifestyle factors.4 Genetic and
recent study conducted among 24,000 school children in demographic variables such as family history of obesity,
south India showed that the proportion of overweight age, ethnicity and sex can not be modified. However,
children increased from 4.94 per cent of the total students obesity-associated lifestyle factors are often modifiable.
in 2003 to 6.57 per cent in 2005 demonstrating the time In fact, previous research has shown that childhood
trend of this rapidly growing epidemic.2 The proportion obesity is associated with many lifestyle factors,

International Journal of Community Medicine and Public Health | February 2017 | Vol 4 | Issue 2 Page 554
 Tomar SP et al. Int J Community Med Public Health. 2017 Feb;4(2):554-559

including sedentary behaviours, physical inactivity and A predesigned questionnaire regarding Socio-
unhealthy dietary choices.5-10 demographic profile ie current residence, age, mothers
educational and occupational status and family size , and
Information on lifestyle factors associated with obesity in life style practices like addiction habit, the physical
adolescents in India are currently limited and the activity questions designed to asses typical time spent per
available data indicated that unhealthy lifestyle practices day on games and outdoor activity, on sedentary
were generally correlated with BMI in Indian children activities, including television (TV) viewing, video
and adolescents in fewer studies Considering the fact that games, and computer and internet use were utilized as
in India has experienced enormous lifestyle changes in study instrument:
recent decades, rapidly growing middle class and rise of
obesity among youths.11 Therefore, a better Assessment instrument was developed in a group
understanding of the relationships between obesity and discussion among students and faculty of department of
lifestyle factors is necessary for effective prevention and community medicine further approved with pretesting the
management of obesity in youth. Also, local studies using questionnaire in schools.
a representative sample and validated instruments to
assess lifestyle factors are particularly scarce. Data management and data processing
Accordingly, the objective of the present study was to
evaluate the associations between overweight, obesity Data entry and data processing were carried out using the
and several lifestyle factors, including physical activity, SPSS version 17 software (SPSS Inc.). Both the
sedentary behaviours among adolescents aged 10– descriptive and inferential data analyses were applied
17 years. Institutional ethical clearance was obtained using the appropriate statistical tests of significance (chi-
prior to the study. square), A multivariate binary logistic regression model
was generated by including study variables Confidence
METHODS interval of 95% and significant difference of ≤0.05 was
found to be valid and convenient.
Research setting and study design
RESULTS
A cross-sectional study was carried out in two, schools of
Jabalpur located around medical college area. 100 A total of 184 school children were included with their
students from each school were purposely selected for age ranging from 10 to 17 year (mean age, 15.64±1.42
study .Out of these 16 students not cooperated ,were not years) and mean weight 49.39±12.27 and mean height
willing to pacipate so 184 students effectively 161.53±10.60.
interviewed .The total 184 students included in our study
from the 5th to 12th grades were of age 10-17 years. Prevalence of obesity and overweight: Of the 184
children studied, 18 (9.7%) were obese and pre-obese.
Data collection tools and techniques Among total14 (7.6%) were obese and 4 (2.2%) were
pre-obese. With regard to gender-specific BMI 8.7%,
After a brief orientation, selected school children were males whereas 12.3% females were obese and
subjected to the following experiments overweight. Over-weight and obese were higher in
children of illiterate mothers, female students, among the
Anthropometric measurements older age group 14-17 years students. Obese and
overweight were more who skip breakfast (20%) it was
The weight was measured using a commercial scale with found statistically significant with p value <0.05,
an accuracy of ±100 g. The subjects asked to remove surprisingly obesity and overweighs were found higher
their footwear and wear minimal clothes before weighing among Tiffin user 12.3% as compared to canteen.
them. The standing body height was measured to the
nearest 0.5 cm by using a commercial stadiometer with Participation in cultural activities is also a significant
the shoulder in a relaxed position and arms hanging predictor and surprisingly obese and overweighs were
freely and without shoes. The scales were recalibrated participate frequently in cultural events as compared to
after each measurement. All measurements were carried non-obese group. Obese and overweighs were more
out outside the class- room on individual after an (19.9%) among those who don’t do exercise and don’t
interview with food frequency questionnaire. play outdoor games as compare to those who regularly
exercise and play outdoor games (7.5%) and it was
Adolescents, overweight and obesity are defined using found statistically significant with p value <0.05.
age and sex specific normograms for body mass index
(BMI). Adolescents with BMI equal to or exceeding the Binary logistic regression was applied for life style
age-gender-specific 95th percentile are defined obese with factors and dietary habits, by using the dependent
≥85 percentiles were considered overweight, while those variables overweight and obesity revealed that change in
with <85 percentiles were considered desirable or lean.13 eating habits(routine consumption of tea and coffee)
during exams (OR: 2.75) were positively associated with

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 Tomar SP et al. Int J Community Med Public Health. 2017 Feb;4(2):554-559

obesity and overweight while having breakfast regularly The odds of adolescents spending >5hrs per day on
(OR=0.32), and negative family history of obesity playing video games/whatsapp/surfing net (OR=5.99),
(OR=0.35) were negatively associated with obesity and watching television while having meals (OR=1.64),
overweight indicating its protective effect on obesity and change in routine consumption of tea or coffee
overweight among adolescents students. Also, it was (OR=2.27) of being obese or overweight were more as
found in our study family history of diabetes was compared to the other counterparts, though these were
significantly associate with obesity and overweight (OR not found to be statistically significant.
5.152).
Table 1: Anthropometric sample characteristics in relation to the BMI classification.

Attribute BMI Number Mean Std. deviation Std. Error Mean Significance
Non obese 166 161.2994 10.5163 0.8162 0.337
Height
Pre obese and obese 18 163.8333 11.3979 2.6865 0.377
Non obese 166 46.82 9.15 0.71 0.000**
Weight
Pre obese and obese 18 73.22 12.42 2.93 0.000**
BMI Non obese 166 17.8864 2.4824 0.1927 0.000**
Pre obese and obese 18 27.1231 2.3045 0.5432 0.000**

Table 2: Association with obesity and overweight with socio-demographic, life style determinants
(N=184).

Variables Normal Obesity and overweight Total p value

Age
10-13 38 (90.5%) 4 (9.5%) 42 (22.83) 0.949
14-17 128 (90.1%) 14 (9.9) 172 (77.17)
Sex
Male 116 (91.3%) 11 (8.7%) 127 (69.02) 0.545
Female 50 (87.7%) 7 (12.3%) 57 (30.98)
Mothers education
Illiterate 66 (89.2%) 8 (10.8%) 74 (40.22) 0.442
Literate 100 (90.9%) 10 (9.1%) 110 (59.78)
Socioeconomic status
Upper 133 (90.5%) 14 (9.5%) 147 (79.89) 0.784
Middle 30 (88.2%) 4 (11.8%) 34 (18.48)
Lower 3 (00.0%) 0 (0) 3 (1.63)
Participation in cultural activities
Yes 94 (86.2) 15 (13.8) 109 (59.54)
0.04*
No 72 (96) 3 (4) 75 (40.76)
Outing for Dinner or lunch
Weekly 16 (72.7) 6 (27.3) 22 (11.96)
Monthly 42 (95.5) 2 (4.5) 44 (23.91)
0.021*
More than a month duration 57 (93.4) 4 (6.6)4 61 (33.15)
Never 51 (89.5) 6 (10.5) 57 (30.98)
Party with friends
Frequently 78 (86.7) 12 (13.3) 90 (48.91)
0.4
Occasionally 20 (90.2) 5 (7.5) 25 (13.59)
Out door Game and exercise
Regular (>5times/week) 136 (92.5) 11 (7.5) 147 (79.89)
0.036*
Not regular (<5times/week) 30 (81.1) 7 (19.9) 37 (20.11)
Addiction (tobacco/smoking)
Yes 10 (83.3) 2 (16.7) 12 (6.522)
0.406
No 156 (90.7) 16 (9.3) 172 (93.48)
Total 166 (90.22) 18 (9.78)

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 Tomar SP et al. Int J Community Med Public Health. 2017 Feb;4(2):554-559

Table 3: Logistic regression model for life style factors and their risk association with obesity and overweight.

Life style factors Adjusted odds ratio 95% CI p-value

Hours spend playing video games/whats app/ surfing net
0-2 hrs per day 1.422 0.17-11.7 0.744
3-5 0.824 0.05-14.4 0.894
>5 5.998 1.5-8.6 0.150
Never - - -
Watching T.V while taking meal
Yes 1.641 0.52-5.25 0.402
No - - -
Breakfast everyday
Regularly 0.319 0.11-.89 0.465
Not regularly - - -
Change in eating habits during exam
Yes 1.5 1.67-4.9 0.03*
No - -
Change in routine consumption of tea, coffee
Yes 2.247 0.87-5.8 0.09
No - - -
Change in sleep during exams
Yes 1.029 0.37-2.8 0.405
No - - -
History of obesity
No 0.347 0.124-35 0.04*
Yes - - -
Family history of diseases
Diabetes Mellitus 5.152 1.619-16.39 0.006*
Hypertension 1.232 0.23-6.51 0.806
Endocrinal dysfunction 0.004 0-3.91 0.822
Others 0.944 0.1814.93 0.946
Absent - - -
*Significant with p value<0.05.

DISCUSSION Deheeger M et al mentioned Boys appear to engage in

higher levels of physical activity, report more
Lifestyle practices is an important determinants of health participation in sports, and have higher levels of aerobic
as Economic development of India has changed lifestyle fitness than females.21 Further gender differences in
habits.14 Modern life style practices coupled with activity energy expenditure and reported physical activity
physical inactivity have likely contributed to the increase become more apparent approaching puberty, because of
in the prevalence of overweight and obesity in the the reported decline in physical activity in girls prior to
children.15 Overall prevalence obesity and overweight puberty.22
adolescents in our study was found to be 9.7%. Among
total 184 adolescents surveyed 7.6% were obese and In our study sedentary habits less exercise and less
2.2% were pre-obese which was consistent with study outdoor activities were more among obese and
done in Delhi showed prevalence of obesity among overweight, the difference were found statistically
affluent class students 7.4%.16 Similar studies are significant and odds of being obese or overweight
conducted India for prevalence of obesity and results are among adolescents spending >5 hrs per day on playing
comparable to our study with respect to obesity video games/whatsapp/surfing net was 5.99. In a similar
prevalence.17-20 study by Laxmaiah et al logistic regression analysis
revealed that the prevalence of overweight was 3 times
With regard to gender-specific BMI, among males 8. 7% higher in those not participating in outdoor games (OR:
whereas 12.3% among girls were obese and overweight 2.75; CI: 1.56, 4.72), and 1.92 times higher in those
showing higher prevalence among girls. One of the watching television >or =3 h/d (OR: 1.92; CI: 1.16,
reasons being boys are more physically active than girls. 3.18).23

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 Tomar SP et al. Int J Community Med Public Health. 2017 Feb;4(2):554-559

Owen N et al mentioned in their study showed an inverse relationship with hypertension. Natl Med J India.
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