International Surgery Journal | December 2019 | Vol 6 | Issue 12 Page 4522
International Surgery Journal
Panchal SN et al. Int Surg J. 2019 Dec;6(12):4522-4526
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Original Research Article
Prevalence and determinants of obesity and overweight among
college students of Gujarat, India: a cross sectional study
Saurabh Naranbhai Panchal
1
, Akash Virendrabhai Agrawal
2
*, Nilesh Thakor
3
INTRODUCTION
Worldwide, disease profile are transforming at a rapid
pace catching the attention of medical professionals and
policy makers alike. This is particularly true in low and
middle-income countries that form the major chunk of
global population. The emerging epidemics of obesity,
cardiovascular disease and diabetes form the crux of this
phenomenal change. Among these entities, obesity has
become a colossal epidemic causing serious public health
concern and contributes to 2.6 million deaths worldwide
every year.
1,2
The prevalence of obesity has increased
worldwide in almost every country in all the age groups.
The steep increase has prompted this development to be
called an epidemic and because it is worldwide, a
pandemic.
3
It has been estimated that worldwide over 22 million
students under the age of 20 are obese, and one in 10
students is overweight. Globally the prevalence of early
adulthood obesity varies from over 30% in USA to less
than 2% in Sub-Saharan Africa. Currently the prevalence
ABSTRACT
Background:
Early adulthood obesity itself is a predictor of adult obesity and of higher than expected adult
morbidity and mortality. The objective of this study was to know the prevalence and determinants of obesity in
college students of Vadodara and Patan city of Gujarat, India.
Methods:
The present cross sectional study was undertaken during April 2017 to March 2018 in randomly selected 5
Colleges of Vadodara city and Patan City of Gujarat. Total 1330 students between the age group of 18 to 23 years
were examined and BMI were calculated. The prevalence of overweight and obesity were determined based on the
International Obesity Task Force criteria. Various determinants of obesity and overweight were studied by
interviewing students. Thus collected data was analyzed using SPSS 17 (Trial version).
Results:
Out of 1330 students, males were 49.6% Prevalence of obesity and overweight was 6.1% and 11.0%
respectively. The prevalence of obesity and overweight was higher amongst less active group (6.5% and 13.4%
respectively). Prevalence of obesity and overweight was significantly higher in the group of students who spent >2
hours daily in front of television or computers. The prevalence of obesity and overweight was significantly higher
amongst group of students who took daily calories above recommended dietary allowance (21.5% and 22.8%
respectively). The prevalence of obesity and overweight was significantly higher who took junk food (9.3% and
14.8% respectively).
Conclusions:
High prevalence of obesity and overweight in college students indicate an urgent need to increase
awareness via education and motivation of all stakeholders.
Keywords: Obesity, Overweight, Prevalence, Determinant, College students
Department of Surgery, GMERS Medical College,
1
Gotri-Vadodara,
2
Dharpur-Patan, Gujarat, India
3
Department of Community Medicine, GMERS Medical College, Vadnagar, Gujarat, India
Received: 21 October 2019
Revised: 07 November 2019
Accepted: 08 November 2019
*Correspondence:
Dr. Akash Virendrabhai Agrawal,
E-mail: drakashag[email protected]m
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.
DOI: http://dx.doi.org/10.18203/2349-2902.isj20195195
Panchal SN et al. Int Surg J. 2019 Dec;6(12):4522-4526
International Surgery Journal | December 2019 | Vol 6 | Issue 12 Page 4523
of obese college students is 20% in UK and Australia,
15.8% in Saudi Arabia, 15.6% in Thailand, 10% in Japan
and 7.8% in Iran. In China, the prevalence of obesity
among students aged 7-9 years increased from 1-2% in
1985 to 17% among girls and 25% among boys in 2000.
4
Indian data regarding current trends in early adulthood
obesity are emerging. Available studies of Delhi and
Chennai has shown the prevalence of 7.4% and 6.2%
respectively. A study conducted among adolescent
college students in South Karnataka has shown the
prevalence of overweight and obesity to be 9.9% and
4.8% respectively.
5
Aetiopathogenesis of early adulthood obesity is multi
factorial. Interactions between genetic, neuro endocrine,
metabolic, psychological, environmental and socio-
cultural factors are clearly evident in early adulthood
obesity. Early adulthood obesity affects self-esteem and
has negative consequences on the cognitive and social
development. Conditions such as type 2 diabetes mellitus,
hypertension and hypercholesterolemia, which were
noted primarily in adults, are becoming more common
among students with the increase in the prevalence of
obesity. Early adulthood obesity itself is a predictor of
adult obesity and of higher than expected adult morbidity
and mortality. Due to difficulty in the treatment of
obesity in adults and the many long-term adverse effects
of early adulthood obesity, prevention of early adulthood
obesity has now been recognized as a public health
priority.
5
With this background in mind, the present
study was undertaken to know the prevalence and
determinants of obesity in college students of Vadodara
and Patan city.
METHODS
The present study was a cross sectional study undertaken
in 5 colleges, which were selected randomly from list of
all colleges from Vadodara and Patan city during April
2017 to March 2018. All students between the age group
of 18-23 years were included after written informed
consent. The sample size was calculated based on an
estimated prevalence of obesity of 8% by pilot study,
with 80% power, 95% confidence and 5% level of
significance with an allowable error of 10% to obtain an
age and gender-specific representative sample of
students. 1300 college going students of age group 10- 15
years were the calculated sample size of the study but
since all the students, studying in all classes selected
colleges, belonging to the 18-23 years age group were
included in the study population, the final study
population was 1330 students. These students were
examined and interviewed using pre-designed, pre-tested,
semi-structured Performa. Height was measured in
centimeters (cm) using a stadiometer. Weight was
measured in kilograms (kg) using a standardized
weighing machine. Body mass index (BMI) was
calculated using the formula weight (kg) divided by
height in square meters. Waist circumference was
measured in centimeters using a non-stretchable fiber
measuring tape. The prevalence of overweight and
obesity were determined based on the IOTF
(International Obesity Task Force) criteria. Before
conducting the study approval was obtained from
institutional ethical committee for human research. Data
safety and confidentiality was also given due
consideration. The file containing identity related details
was kept password protected and the filled Performa were
kept in lock with key accessible only to researcher.
Various determinants of obesity and overweight were
studied by interviewing students. Thus collected data was
analyzed using SPSS 17 (trial version).
RESULTS
Out of 1330 students males were 49.6% and females were
50.4%. Overall, the total number of obese students
identified in whole study population was 81 (6.1%) and
numbers of overweight students were 146 (11.0%).
Overall prevalence of obesity was more among male
population (6.4%) as compared to that in females (5.8%).
Though the prevalence of overweight was more among
males (11.3%). Different categories of BMI and gender
of the students were not significantly associated (Table
1).
The prevalence of obesity was found to be highest among
23 years age group (9.1%). The prevalence of overweight
was maximum in 21 year age group (15.8%). The Chi
square test applied between different age groups and BMI
category (Obese and Overweight taken together and
Normal) was found to be significant, indicating thereby
the statistical association of increasing age with the
prevalence of obesity and overweight (Table 2).
The numbers of students with total sports-physical
activity time per week ≤2 hour were only 382. The
prevalence of obesity and overweight was higher
amongst less active group (6.5% and 13.4% respectively)
as compared to more active group. Though the
association was not significant (Table 3). The number of
students, who spent above 2 hours in front of television
or computers for any purpose, was 277. The prevalence
of obesity and overweight was significantly higher
(17.7% and 21.3%) amongst those who spent greater time
in front of television, mobiles and computers as
compared to the other group who spent ≤2 hours in front
of television or computers per day (Table 4).
The number of students with daily calorie intake >RDA
(Recommended Dietary Allowance) was 241. The
prevalence of obesity and overweight was significantly
higher amongst group who took daily calories above
RDA (21.5% and 22.8% respectively) as compared to the
other group as shown in Table 5. The numbers of
students taking junk foods more than twice a week were
696. The prevalence of obesity and overweight was
significantly higher in them (9.3% and 14.8%) as
compared to those who took junk food less than or equal
to 2 times per week (2.5% and 6.8% respectively) as
shown in Table 6. The number of students taking
Panchal SN et al. Int Surg J. 2019 Dec;6(12):4522-4526
International Surgery Journal | December 2019 | Vol 6 | Issue 12 Page 4524
vegetarian diet was 765 as compared to those who took
mix diet who were 565. The prevalence of obesity and
overweight was significantly higher amongst those who
took mix diet (8.1% and 13.1%, respectively) as
compared to vegetarians as in Table 7. The number of
students with either parents having history of obesity was
98. The prevalence of obesity and overweight among
students having parents with history of obesity was
225.5% and 23.4%, respectively which was significantly
higher than those without parental history of obesity
(4.5% and 9.9%) as in Table 8.
Table 1: Gender wise distribution of the students according their BMI category.
Sex
Obese
Normal
Total
N
%
N
%
N
%
N
%
Male
42
6.4
75
11.3
544
82.3
661
100
Female
39
5.8
71
10.6
559
83.6
669
100
Total
81
6.1
146
11.0
1103
82.9
1330
100
χ² value=0.37; D.F.=2; p=0.82.
Table 2: Distribution of students according their age and BMI category.
Age group (years)
Obese
Overweight
Normal
Total
N
%
N
%
N
%
N
%
18
9
4.6
13
6.6
175
88.8
197
100
19
11
5.2
16
7.5
186
87.3
213
100
20
12
5.2
21
9.2
196
85.6
229
100
21
14
5.8
38
15.8
189
78.4
241
100
22
14
6.4
29
13.2
176
80.4
219
100
23
21
9.1
29
12.6
181
78.4
231
100
Total
81
6.1
146
11.0
1103
82.9
1330
100
χ² value=20.7; D.F.=10; p<0.05.
Table 3: Distribution of students according to their total sports-physical activity per week and their BMI category.
Total sports physical
activity time per week
Obese
Overweight
Normal
Total
N
%
N
%
N
%
N
%
≤2 hours
25
6.5
51
13.4
330
86.4
382
100.00
>2 hours
56
5.9
95
10.0
773
81.5
948
100.00
Total
81
6.1
146
11.0
1103
82.9
1330
100.00
χ² value=1.533; D.F.=2; p=0.4.
Table 4: Distribution of students according to their total sedentary time before TV/computers daily and their BMI
category.
Total sedentary time for
TV/computers/mobiles daily
Obese
Overweight
Normal
Total
N
%
N
%
N
%
N
%
>2 hours
49
17.7
59
21.3
169
61.0
277
100
≤2 hours
32
3.0
87
8.3
934
88.7
1053
100
Total
81
6.1
146
11.0
1103
82.9
1330
100.00
χ² value=131.52; D.F.=2; p<0.0001.
Table 5: Distribution of students according to their daily total calorie intake in terms of recommended dietary
allowance and BMI category.
Recommended dietary allowance
Obese
Overweight
Normal
Total
N
%
N
%
N
%
N
%
>RDA
52
21.5
55
22.8
134
55.6
241
100
≤RDA
29
2.6
91
8.3
969
89.0
1089
100
Total
81
6.1
146
11.0
1103
82.9
1330
100.00
χ² value=115.19; D.F.=2; p<0.0001.
Panchal SN et al. Int Surg J. 2019 Dec;6(12):4522-4526
International Surgery Journal | December 2019 | Vol 6 | Issue 12 Page 4525
Table 6: Distribution of students according to their junk food intake frequency per week and their BMI category.
Junk food frequency per week
Obese
Overweight
Normal
Total
N
%
N
%
N
%
N
%
>2 times
65
9.3
103
14.8
528
75.9
696
100
≤2 times
16
2.5
43
6.8
575
90.7
634
100
Total
81
6.1
146
11.0
1103
82.9
1330
100.00
χ² value=53.528; D.F.=2; p<0.0001.
Table 7: Distribution of students according to the type of their diet and BMI category.
Type of diet
Obese
Overweight
Normal
Total
N
%
N
%
N
%
N
%
Vegetarian
35
4.5
72
9.4
658
86.0
765
100
Mix
46
8.1
74
13.1
445
78.8
565
100
Total
81
6.1
146
11.0
1103
82.9
1330
100.00
χ² value=12.869; D.F.=2; p<0.01.
Table 8: Distribution of students according to history of obesity in either parents and their BMI category.
History of obesity in either parent
Obese
Overweight
Normal
Total
N
%
N
%
N
%
N
%
Present
25
25.5
23
23.4
50
51.0
98
100
Absent
56
4.5
123
9.9
1053
85.5
1232
100
Total
81
6.1
146
11.0
1103
82.9
1330
100.00
χ² value=93.544; D.F.=2; p< 0.0001.
DISCUSSION
In our study the prevalence of obesity was more in males
(6.4%) as compared to females (5.8%) and also the
prevalence of overweight was slightly higher in males
(11.3%) as compared to females (10.6%). In the study by
Thaddanne et al the prevalence of obesity was more in
females (6.8%) as compared to males (4.62%), but the
prevalence of overweight was slightly higher in males
(10.25%) as compared to females (9.69%).
2
In the study
done by Ghonge et al and Kumar et al in Davangere,
prevalence of obesity among females (8.82%) was more
than that among males (4.10%).
3,6
In Agarwal et al
prevalence of obesity among girls was (6.7%) higher as
compared to that amongst boys (5.4%).
7
In our study overall prevalence of obesity and overweight
was 6.1% and 11.0% respectively. In Thaddanne et al
overall prevalence of obesity and overweight was 5.62%
and 9.99% respectively.
1
Similar prevalence of obesity
and overweight in college students were found in studies
done by Ghonge et al, Kapil et al, Kotian et al, Premnath
et al and Kadilkar et al.
4,8-11
In our study the prevalence of
obesity and overweight was higher amongst less active
group (6.5 % and 13.4% respectively) as compared to
more active group. In Thaddanne et al the prevalence of
obesity and overweight was significantly higher amongst
less active group (9.3 % and 13.95% respectively) as
compared to more active group.
1
Similar results were
obtained in the study done by Ghonge et al
and Kotian et
al.
4,9
They showed that obesity was 21 times higher
among those students participating less than two hours/
week in any type of physical activity. In a study done by
Kumar et al in Davengere showed that those with absent
physical activity had 2 times more risk of falling in obese
group as compared to those who had more physical
activity.
6
In our study prevalence of obesity and overweight was
significantly higher in the group who spent >2 hours
daily in front of television or computers. In Thaddanne et
al prevalence of obesity and overweight was significantly
higher in the group who spent >2hours daily in front of
television or computers. The findings are comparable to
that of study done by Ghonge et al and Shabana et al in
Chennai which showed that greater than 2 hours
television watching (or -2.5, p<0.0001) was associated
with obesity.
4,12
The study done by Kuriyan et al in South
India also found that the adjusted odds of being
overweight for students who viewed television for greater
than or equal to 2 hours/day was 19.6 (p = 0.001), when
compared to students who viewed television for less than
or equal to 45 minutes/day.
13
In our study the prevalence of obesity and overweight
was significantly higher amongst group of students who
took daily calories above RDA (21.5% and 22.8%
respectively) as compared to the other group. In
Thaddanne et al the prevalence of obesity and overweight
was significantly higher amongst group of students who
took daily calories above RDA (18.57% and 15.19%
respectively) as compared to the other group.
1
It is
comparable to the findings of Ghonge et al and Kapil et
al which showed increased total calorie among obese and
Panchal SN et al. Int Surg J. 2019 Dec;6(12):4522-4526
International Surgery Journal | December 2019 | Vol 6 | Issue 12 Page 4526
overweight group as compared to normal students.
4,8
These findings were also similar to that of study done by
Ghonge et al
and Seema Jain et al.
4,14
In our study
significant association was found between junk food
consumption and obesity. Similar findings were also
obtained in the studies done by Thaddanne et al, Ghonge
et al, Kumar et al, Kotian et al, and Jain et al.
1,4,6,9,14
In our study the prevalence of obesity and overweight
among students having parents with history of obesity
was 25.5% and 23.4% respectively which was
significantly higher than those without parental history of
obesity (4.5% and 9.9%). In Thaddanne et al the
prevalence of obesity and overweight among students
having parents with history of obesity was 46.15% and
17.94% respectively which was significantly higher than
those without parental history of obesity (4.34% and
9.74%).
1
These findings are consistent with another study
done by Thaddanne et al,
Ghonge et al and Kumar et al in
Davengere parental history of obesity was present for
32.7% of obese students.
1,3,5
Students with parental
history of obesity showed 25.2 times more chances of
developing obesity than normal students. 33.8% of the
obese girls and 31.6% of the obese boys had history of
parental obesity. The findings are in contrast with the
study done by Jain et al who found no significant
association with family history of obesity.
14
CONCLUSION
The prevalence of obesity and overweight was
significantly higher in students with sedentary lifestyle,
high consumption of junk food and high calorie diet with
positive family history of obesity. High prevalence of
obesity and overweight in college students indicate an
urgent need to increase awareness via education and
motivation of all stakeholders. This will go a long way in
preventing early adulthood obesity and thus ultimately
stemming the rising tide of non-communicable diseases
such as diabetes and cardio vascular disease in India.
There is definitely a need for well-planned, large-scale
studies using standardized methodologies to estimate the
prevalence and determinants of obesity and overweight in
college students.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: The study was approved by the
Institutional Ethics Committee
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Cite this article as: Panchal SN, Agrawal AV, Thakor
N. Prevalence and determinants of obesity and
overweight among college students of Gujarat, India: a
cross sectional study. Int Surg J 2019;6:4522-6.