ECHO…for a change!!

The childhood obesity is increased more than three folds in last two decades in developed world. There is nutritional transition seen in the developing world including India. The westernization in diet of the Indian population along with prosperity brings the brunt of overweight and obesity. This has future implications of liver diseases, heart diseases, hypertension, hyperlipidaemia, insulin resistance; malignancies. Mumbai is the prosperous city and an economical capital of India. Also, the rampant use junk food, common outdoor eating’s, no grounds to play for children make the high likelihood that the prevalence of obesity to be higher than rest of the country.

It can profoundly affect children’s physical health, social, and emotional well-being and self-esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child.

One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits of the entire family. Treating and preventing childhood obesity helps protect the child’s health and has tremendous impact on child’s Physical and academic performance.

And hence we at Aastha Bariatrics took initiative and launched ECHO... for a change (‘E’radicating ‘C’Hild ‘H’ood ‘O’besity), a pan Mumbai campaign against childhood obesity.

This campaign was done in 15 high schools across Mumbai, which covered in total of 9000 students.

Body composition analysis

This cross-sectional study carried out for 3 months. The permission from the principal, parents and assent from the students were taken prior the screening.

This study incorporated primary analysis of anthropometric measurements (Height, weight, BMI, body fat) of total 9000 children in the age group of 11 to 15 years, studying in class 6^th to 9^th standard, from all 3 regions of Mumbai i.e. Central region from Thane to Dadar, Western region from Andheri to Bandra, and South region from Chhatrapati Shivaji Maharaj Terminus to Dadar (Table 1).

BMI percentile for children are:

Children were categorized into three groups: obese (> 95^th percentile), overweight (≥ 85^th percentile) and normal (< 85^th percentile, > 5^th percentile) using age- and sex-specific percentiles of BMI.

The prevalence of overweight and obesity were calculated by calibrated scales and using BMI for age/gender percentiles derived through child and teen BMI calculator developed by CDC. Structured questionnaires were designed for detailed diet recalls, assessment of physical activity patterns. Data collection was done by nutritionist with assistance of two trained interns.

Nutrition assessment

Detailed diet recall questionnaire was circulated to each and every student. Interaction with parents and teachers were done regarding the food patterns, school lunches, snacking patterns, family eating habits, outings, their likes and dislikes were studied in detail.

Students were asked to fill 24-hour diet recall form and submit it to their respective class teachers

Habitual activity assessment

The physical activity pattern was assessed through interaction with parents and teachers both. Child’s socialising, active participation in curriculum was discussed with parents and teachers. Even the frequency of screening time i.e the time children are spending on TV/laptop/mobile phones and time for outdoor activity were noted down with the help of structured questionnaire.

Physical evaluation

Each student was evaluated for any present medical conditions and physical appearance like:

• Breathlessness

• Lethargy

• Double chin

• Excessive sweating

• Tiredness after even little activity

• Dark patches around neck

• Excess weight in abdomen and waist

Data of around 9000 students was collected from 15 schools across Mumbai, out of which 53.4% (4806) were boys and 46.6% (4194) were girls.

Table 2 shows, out of 4806 male students, 1028 (21.6%) were overweight and 817 (16.8%) were obese [BMI between 85^th-95^th percentile and > 95^th percentile respectively]. Whereas out of 4194 female students, 805 (18.8%) were overweight and 612 (14.3%) were obese.