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      Epidemiology of childhood overweight & obesity in India: A systematic review

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          Abstract

          Background & objectives:

          Childhood obesity is a known precursor to obesity and other non-communicable diseases (NCDs) in adulthood. However, the magnitude of the problem among children and adolescents in India is unclear due to paucity of well-conducted nationwide studies and lack of uniformity in the cut-points used to define childhood overweight and obesity. Hence an attempt was made to review the data on trends in childhood overweight and obesity reported from India during 1981 to 2013.

          Methods:

          Literature search was done in various scientific public domains from the last three decades using key words such as childhood and adolescent obesity, overweight, prevalence, trends, etc. Additional studies were also identified through cross-references and websites of official agencies.

          Results:

          Prevalence data from 52 studies conducted in 16 of the 28 States in India were included in analysis. The median value for the combined prevalence of childhood and adolescent obesity showed that it was higher in north, compared to south India. The pooled data after 2010 estimated a combined prevalence of 19.3 per cent of childhood overweight and obesity which was a significant increase from the earlier prevalence of 16.3 per cent reported in 2001-2005.

          Interpretation & conclusions:

          Our review shows that overweight and obesity rates in children and adolescents are increasing not just among the higher socio-economic groups but also in the lower income groups where underweight still remains a major concern.

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          Most cited references74

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          Worldwide trends in childhood overweight and obesity.

          Obesity has become a global epidemic but our understanding of the problem in children is limited due to lack of comparable representative data from different countries, and varying criteria for defining obesity. This paper summarises the available information on recent trends in child overweight and obesity prevalence. PubMed was searched for data relating to trends over time, in papers published between January 1980 and October 2005. Additional studies identified by citations in retrieved papers and by consultation with experts were included. Data for trends over time were found for school-age populations in 25 countries and for pre-school populations in 42 countries. Using these reports, and data collected for the World Health Organization's Burden of Disease Program, we estimated the global prevalence of overweight and obesity among school-age children for 2006 and likely prevalence levels for 2010. The prevalence of childhood overweight has increased in almost all countries for which data are available. Exceptions are found among school-age children in Russia and to some extent Poland during the 1990s. Exceptions are also found among infant and pre-school children in some lower-income countries. Obesity and overweight has increased more dramatically in economically developed countries and in urbanized populations. There is a growing global childhood obesity epidemic, with a large variation in secular trends across countries. Effective programs and policies are needed at global, regional and national levels to limit the problem among children.
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            Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness.

            Body mass index (BMI) and triceps skinfold thickness (TSF) are commonly used measures of adiposity in clinical and epidemiologic studies. The 85th and 95th percentiles of BMI and TSF are often used operationally to define obesity and superobesity, respectively. Race-specific and population-based 85th and 95th percentiles of BMI and TSF for people aged 6-74 y were generated from anthropometric data gathered in the National Health and Nutrition Examination Survey 1 (NHANES I). The complex sample design of the survey is reflected in the reference values presented. Racial differences in these extremes of the distribution do not emerge until adulthood. Researchers may choose population-based, race-specific, or age-specific criteria for obesity on the basis of assumptions underlying their specific research questions.
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              Percentiles for body mass index in U.S. children 5 to 17 years of age.

              It has been recommended that body mass index (BMI) (weight in kilograms/height in meter2) be used routinely to evaluate obesity in children and adolescents. This report describes the distribution of BMI in children and adolescents in the United States. Standardized measurements of height and weight from 9 large epidemiologic studies including 66,772 children age 5 to 17 years were used to develop tables for the distributions of BMI that are age, race, and gender specific. The mean BMI increases with age and is slightly higher for girls than boys. Mean BMI for black and Hispanic girls was noticeably higher than for white girls. The percentiles of BMI are consistently higher than those based on the NHANES I measures, particularly for the 95th percentile. The proportion of obese children compared with NHANES I standards is higher and is highest for Hispanic boys and black and Hispanic girls. The tables and figures will allow pediatricians to determine the relative ranking of BMI for patients compared with values derived from a large sample of healthy children and adolescents. The identified gender and ethnic differences may be guides to understanding the cause and prevention of obesity.
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                Author and article information

                Journal
                Indian J Med Res
                Indian J. Med. Res
                IJMR
                The Indian Journal of Medical Research
                Medknow Publications & Media Pvt Ltd (India )
                0971-5916
                February 2016
                : 143
                : 2
                : 160-174
                Affiliations
                [1] Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non Communicable Diseases Prevention & Control, IDF Centre for Education, Chennai, India
                [* ] All India Institute of Medical Sciences, WHO Collaborating Centre for Capacity Development & Research in Community based NCDPC, New Delhi, India
                [** ] WHO Regional Office for South-East Asia (SEARO), New Delhi, India
                Author notes
                Reprint requests: Dr V. Mohan, Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention & Control & IDF Centre for Education, 4, Conran Smith Road, Gopalapuram, Chennai 600 086, Tamil Nadu, India e-mail: drmohans@ 123456diabetes.ind.in
                Article
                IJMR-143-160
                10.4103/0971-5916.180203
                4859125
                27121514
                bbe5ba4f-5f52-4b92-ab68-a4c006877986
                Copyright: © Indian Journal of Medical Research

                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.

                History
                : 23 June 2014
                Categories
                Systematic Review

                Medicine
                childhood,cut-points,india,obesity,overweight,prevalence
                Medicine
                childhood, cut-points, india, obesity, overweight, prevalence

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