In India, it was basically under nutrition, which attracted the focus of health workers. Childhood obesity was rarely seen. But over the past few years this entity is increasingly being observed. The changing life style of families in the so called modernized India with increased purchasing power, easy availability, more comfortable and luxurious living, thanks to improved technology has all attributed to this problem. Increased hours of inactivity due to increasing academic pressure, television, video games and computer have all replaced outdoor games and other social activities. The incidence of obesity in children attending the O.P.D. of the PGI was increasingly being observed. An attempt was hence made to identify such obese children and determine the contributing risk factors. A total of 120 children were observed over a period of one year (2000-01). Body mass index (BMI) >85th percentile and >95th percentile was taken as the criteria to identify overweight and obesity respectively(1).

Patients with obesity due to secondary causes were excluded from the study. Detailed anthropometry was recorded and dietary assessment done by interviewing the mothers, using 24 hour recall method and the food frequency consumption questionnaire. Details of family history and life style patterns were also recorded. Intake of food calories, proteins, fats and carbohydrates were calculated using the ICMR standards(2).

Other details like family history, activity levels of each child and number of hours of television viewing were also recorded.

A total of 120 children presenting to the OPD for primary obesity were studied out of which 79 were obese and 41 were overweight.

4-7 

1690

1996.8 ± 564.6

31.97 ± 11.5
P <0.01

55.48 ± 11.6
NS

12.53 ± 1.57 
P<0.01 

7-10

1950

2076.5 ± 427.59

28.64 ± 6. 47
NS

61.1 ± 7.12
NS

11.35 ± 1.63
P<0.01 

10-12

2190

2260.3 ± 475.4

28.03 ± 7.63
NS 

61.03 ± 7.39
NS 

11.67 ± 1.67 
P<0.01

10-12
Girls 

1970 

1979.2 ± 413.81

27.76 ± 3.47
NS

60.75 ± 3.75
NS

11.56 ± 1.52
P<0.01 

* Denotes desired values.

As seen in Table I an interesting feature noted in this study was that the mean total caloric value intake of all these children was not significantly high but the calories derived from fats did seem to be more than the desired 25%, which was especially significant in the 4-7 year age group. Similar observations have been made by Rolland Cachera(3) where he states that obese and non-obese individuals have similar energy intakes implying that obesity results from small imbalances of energy intake & expenditure. Moreover diets high in fats are likely to be energy dense and highly palatable. This combination leads to increased energy intake and to increased body mass index(4). Moreover the calories taken from proteins did seem to be significantly below the recommended 20% of the total caloric intake.

Various other factors contributing to obesity were analyzed. It was found that lack of physical activity, watching television or video for more than one hour daily and a positive family history of obesity all contributed significantly to child obesity. Several authors have noted the role of physical activity in the obese children. Exercise showed beneficial effects when added to a reduced energy intake program(4). Robinson in his school-based trial targeted the reduction of media as a way of influencing adiposity, physical activity and dietary intake. His results showed that although increased activity may not be as effective in weight reduction as diet modifications, physical activity patterns seem to play a crucial role in weight maintenance(5).

Meenu Singh,
Madhu Sharma,
Department of Pediatrics,
Advanced Pediatric Center,
Postgraduate Institute of Medical Education
and Research,
Chandigarh 160 012,
India.