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 Table of Contents  
COMMENTARY
Year : 2014  |  Volume : 1  |  Issue : 1  |  Page : 46-48

Obesity among Indian adolescents: Some emerging trends


Department of Food and Nutrition, Lakshmibai College, University of Delhi, New Delhi, India

Date of Submission24-Oct-2013
Date of Decision01-Nov-2013
Date of Acceptance08-Nov-2013
Date of Web Publication30-Dec-2013

Correspondence Address:
Anita Malhotra
Department of Food and Nutrition, Lakshmibai College, University of Delhi, New Delhi
India
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Source of Support: None, Conflict of Interest: None


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  Abstract 

An epidemic of obesity has engulfed children and adolescents across the developed and the developing world in recent years and India is not unscathed by this crisis in public health. This article underscores some emerging trends in obesity among Indian adolescents.

Keywords: Adolescent obesity, food marketing, India, obesity prevention


How to cite this article:
Malhotra A. Obesity among Indian adolescents: Some emerging trends. J Obes Metab Res 2014;1:46-8

How to cite this URL:
Malhotra A. Obesity among Indian adolescents: Some emerging trends. J Obes Metab Res [serial online] 2014 [cited 2018 Dec 18];1:46-8. Available from: http://www.jomrjournal.org/text.asp?2014/1/1/46/123909

World-wide, obesity among children and adolescents has acquired endemic proportions and is being perceived as a crisis in public health. [1],[2] The prevalence is increasing at a fast rate and presently, about 200 million school-aged children are estimated to be overweight at the global level. [3],[4]

School surveys in Indian cities indicate that an increasing number of adolescents from the affluent population are either overweight or obese. [5],[6],[7],[8] A recent study carried out on 13-17 years old adolescents reveals that the prevalence of overweight in Private schools was 27% - 6 times higher than the prevalence in the Government schools catering to lower socio-economic groups. [9] Another multicentric study covering 38,296 students, aged 8-18 years, also found that higher socio-economic status was significantly associated with overweight and abdominal obesity; the overall prevalence of overweight and obesity was 24%. [8]

The repercussions of child and adolescent obesity are many. Obese children have a higher tendency to become obese adults. [10],[11] Overweight children who grow into obese adults have higher risks of non-communicable disease such as type 2 diabetes mellitus, coronary heart disease and cancer. [12],[13],[14] Besides, the obese youth face social stigma, which is pervasive and can have far reaching implications for their emotional and physical well-being. [15]


  Toxic Environment Top


Obesity is a complex disorder that results from a combination of biological, social, environmental and behavioural factors. [16] However, the dramatically increasing prevalence of obesity cannot be attributed to genetics or failure of responsibility in the individuals. [17] The food and activity choices of individuals are influenced convincingly by the toxic and obesogenic environment in which they live. Ceaseless marketing of unhealthy food, paucity of safe areas for physical activity and easy availability of junk food make it difficult for them to opt for healthy choices. [18]

With globalisation, adolescent lifestyles have undergone a drastic change in terms higher consumption of energy-dense food, lower physical activity and more sedentariness. It is increasingly being emphasised that these lifestyle changes are driven by powerful factors that are intricately woven into business, politics and economics. [19] Food industry uses lobbying, financial contribution, public relations and advertising among other means to influence the governments, nutrition and health professionals and the public. Wherefore, it plays a pivotal role in determining what the individuals eat. [20]


  Marketing of Energy-Dense Foods Top


Marketing is as an important contributing factor that affects consumption of unhealthy food among children. Adolescents being more receptive to change and new ideas are easily affected by exposure to media such as television, mobile phones and advertisements. A recent study carried out in Delhi reveals that the marketing campaigns promoting Western food products in Indian ways are able to reach out effectively to the affluent school-going adolescents. The food choices, purchasing behaviour and consumption pattern of the youth are influenced by advertisements particularly the ones that use local language and endorsement from local celebrities. The favourite food advertisements reported by the adolescents under study were found to promote energy-dense and nutrient-poor products that were non-Indian in origin. [21]


  Weight Concerns and Unhealthy Weight Control Behaviour Top


Another trend being observed among Indian adolescents is the increasing weight related concern. Recently, a study investigated specific weight related concerns among 1818 school going adolescents in Delhi and found that weight control was important for almost all the youth irrespective of their weight status. Fasting, skipping meals and food restricting were among the common unhealthy weight control behaviours stated; the girls, reportedly, indulged more in these practices. A trend of distorted body image and eating disturbances such as self-induced vomiting and taking dieting pills was also reported. Alarmingly, it was at par with data from similar studies in the United States and Australia. [9]


  Public Health Approach for Addressing Obesity Top


The 'personal responsibility frame' that blames obese individuals for overeating and being inactive has not met any success in addressing the problem of obesity during the last three decades. In the current context, there is a 'need for bold action to prevent adolescent obesity' and a public health approach is required to make positive changes in the environment in which adolescents live. [19]

Since, schools provide continuous and rigorous contact with children, effective and low-cost school-based interventions can be planned and implemented to target a large number of adolescents simultaneously. A pioneering controlled trial assessed the effectiveness of a multi-component model of nutrition and life-style education on the behaviour modification as well as risk profile of urban Asian Indian adolescents belonging to middle socio-economic strata. Findings indicate that the comprehensive school-based intervention led to an imrpovement of nutrition-related knowledge, dietary and lifestyle practices as well as the anthropometric and biochemical profiles of Indian adolescents. Post-intervention, significantly lower proportion of subjects reported consuming aerated drinks and energy-dense junk food such as pizza, burger and french fries while a higher proportion of them reported consuming fruits and vegetables as well as whole grain cereals. [22]


  Regulatory Action Top


World Health Organisation has acknowledged the role of food marketing in the aetiology of child obesity and the development of diet related non-communicable diseases. A set of recommendations on the marketing of food and non-alcoholic beverages to children and a recent report on marketing of foods high in fat, salt and sugar to children are some regulatory steps in this direction. [23],[24]

At the national level, clause 24 of the recently formulated Food Safety and Standards Act, 2006 describes restrictions on advertisements and prohibition of unfair practices, but it does not specifically address the marketing of high fat, salt and sugar products to children and adolescents. [25]

The trends suggest that the prevalence of obesity among the affluent Indian adolescents is catching up fast with that in many parts of the developed world. The lifestyle changes exhibited by higher consumption of unhealthy foods, lower physical activity and increasing sedentariness, driven by strong environmental factors, must be researched scientifically. Multiple strategies including generation of awareness, school health programs and regulation of junk food marketing are needed to address the emerging problem of obesity among affluent adolescents in India.

 
  References Top

1.WHO. Obesity-Preventing and managing the global epidemic. WHO Technical Report Series 894. Switzerland: World Health Organization; 2000.  Back to cited text no. 1
    
2.Lobstein T, Baur L, Uauy R, IASO International Obesity Task Force. Obesity in children and young people: A crisis in public health. Obes Rev 2004;5 Suppl 1:4-104.  Back to cited text no. 2
    
3.de Onis M, Blössner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010;92:1257-64.  Back to cited text no. 3
    
4.IOTF. International Obesity Task Force [homepage on the internet]. United Kingdom: International Obesity Task Force [about 1 screen]. Available from: http://wwwiasoorg/iotf/obesity/obesitytheglobalepidemic/ [Cited 2013 Oct 25].  Back to cited text no. 4
    
5.Kapil U, Singh P, Pathak P, Dwivedi SN, Bhasin S. Prevalence of obesity amongst affluent adolescent school children in Delhi. Indian Pediatr 2002;39:449-52.  Back to cited text no. 5
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6.Bhardwaj S, Misra A, Khurana L, Gulati S, Shah P, Vikram NK. Childhood obesity in Asian Indians: A burgeoning cause of insulin resistance, diabetes and sub-clinical inflammation. Asia Pac J Clin Nutr 2008;17 Suppl 1:172-5.  Back to cited text no. 6
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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.  Back to cited text no. 7
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8.Misra A, Shah P, Goel K, Hazra DK, Gupta R, Seth P, et al. The high burden of obesity and abdominal obesity in urban Indian schoolchildren: A multicentric study of 38,296 children. Ann Nutr Metab 2011;58:203-11.  Back to cited text no. 8
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9.Stigler MH, Arora M, Dhavan P, Shrivastav R, Reddy KS, Perry CL. Weight-related concerns and weight-control behaviors among overweight adolescents in Delhi, India: A cross-sectional study. Int J Behav Nutr Phys Act 2011;8:9.  Back to cited text no. 9
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10.Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;337:869-73.  Back to cited text no. 10
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11.Styne DM. Childhood and adolescent obesity. Prevalence and significance. Pediatr Clin North Am 2001;48:823-54, vii.  Back to cited text no. 11
    
12.Dietz WH. Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics 1998;101 (3 Pt 2):518-25.  Back to cited text no. 12
    
13.Shetty P. Childhood obesity in developing societies. Bull Nutr Found India 1999;20:1-4.  Back to cited text no. 13
    
14.Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 2011;365:1876-85.  Back to cited text no. 14
    
15.Puhl RM, Latner JD. Stigma, obesity, and the health of the nation's children. Psychol Bull 2007;133:557-80.  Back to cited text no. 15
    
16.Insel P, Turner RE, Ross D. Nutrition. 3 rd ed. Boston: Jones and Barlett Publishers; 2007.  Back to cited text no. 16
    
17.Harris JL, Pomeranz JL, Lobstein T, Brownell KD. A crisis in the marketplace: How food marketing contributes to childhood obesity and what can be done. Annu Rev Public Health 2009;30:211-25.  Back to cited text no. 17
    
18.HSPH. Harvard School of Public Health [homepage on the internet]. Boston: Harvard School of Public Health [about 1 screen]. Available from: http://www.hsph.harvard.edu/obesity-prevention-source/?page_id=111350557014. [Last accessed on 2013 Oct 25].  Back to cited text no. 18
    
19.Brownell KD, Schwartz MB, Puhl RM, Henderson KE, Harris JL. The need for bold action to prevent adolescent obesity. J Adolesc Health 2009;45 Suppl 3: S8-17.  Back to cited text no. 19
    
20.Nestle M. Food politics-How the food industry influences nutrition and health. London: University of California Press; 2007.  Back to cited text no. 20
    
21.Stigler MH, Medina J, Arora M, Nazar G, Rodrigues L, Reddy KS, et al. Adolescents' response to food marketing in Delhi, India. In: Williams JD, Pasch KE, Collins CA, editors. Advancing communication strategies to prevent childhood obesity. New York: Springer; 2013. p. 269-84.  Back to cited text no. 21
    
22.Singhal N, Misra A, Shah P, Gulati S. Effects of controlled school-based multi-component model of nutrition and lifestyle interventions on behavior modification, anthropometry and metabolic risk profile of urban Asian Indian adolescents in North India. Eur J Clin Nutr 2010;64:364-73.  Back to cited text no. 22
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23.WHO. Set of recommendations on marketing of foods and non-alcoholic beverages to children. Switzerland: World Health Organization; 2010.  Back to cited text no. 23
    
24.WHO. Marketing of foods high in fat, salt and sugar to children. Denmark: World Health Organization Regional Office for Europe; 2013.  Back to cited text no. 24
    
25.FSSA. The Food Safety and Standards Act, 2011. Delhi: Commercial Law Publishers (India) Pvt. Ltd.; 2011. p. 22.  Back to cited text no. 25
    




 

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Toxic Environment
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