|
The present study revealed the existence of dual burden of underweight (35.5%) and overweight (5.1%) among the GNM students with mean body mass index of 20.14 and no obesity. The prevalence of faulty weight perception was 38.6% and was found to be weighted towards feeling higher weight. This accounted for the relatively lower prevalence of perceived underweight (24.4%) perceived normal weight (50%) and higher prevalence of perceived overweight (25.6%) compared to actual weight status based on body mass index. [J Indian Med Assoc 2007; 105: 85-7]
|
|
Key words : Body mass index, underweight, overweight, faulty weight perception.
Obesogenic changes in dietary pattern and physical activity level are spreading across the world like an
infectious disease – first in the developed and then in the developing countries, first in affluent then in poorer sections1. Almost all countries (high income and low income alike) are now experiencing an obesity epidemic2. Heavy marketing of energy dense, fatty, salty and sugary foods and beverages on the one hand, and of labour saving devices for use at home, work place and leisure time on the other, are making healthy choices much more difficult.
Side by side, changes in body image ideal towards thinness and the resulting slimming tendency thereof, though not so pronounced among males, are particularly noticeable among young girls1. This may be somewhat advantageous in population where the risk of undernutrition does not exist. But in countries like India where the problem of obesity coexists with the problem of chronic energy deficiency (CED), this trend might result in aggravating CED, the implications of which are likely to be far more serious in young girls who will have to bear the future generation. Educational institutions, especially the residential ones, which house large number of young girls, can play an important role in reversing this trend3. Against this background the present study was undertaken with the following objectives: (1) To find out the prevalence of underweight, overweight and faulty weight perception among study subjects. (2) To compare the actual and perceived weight status.
Material and Method
An institution-based cross-sectional study was carried out in the month of July, 2004 among all the 176 GNM students of a Nursing Training Centre (NTC), Bankura, located in the campus of BS Medical College. Height and weight of the study subjects were measured using the standard procedure suggested by Jellife4. WHO grading1,2 of body mass index (BMI) was used for determination of actual weight status as underweight (BMI <18.5), normal weight (BMI 18.5-24.9) and overweight (BMI 25 and above). Perceived weight status was correspondingly classified into thin, normal and fat respectively. The relevant information were collected by a self administered questionnaire prepared for this purpose and put to the respondents in a class room. Absentees were covered on subsequent dates to ensure complete coverage.
Observations and Discussion A total of 176 GNM students were studied, of whom the perceived weight status was normal in 50% cases, thin in 24.4% cases and fat in 25.6% cases.
The study revealed the prevalence of underweight and overweight (based on BMI) among study subjects as 33.5% and 5.1% respectively, with no one having obesity (BMI 30 and above). Mean BMI was 20.14. Various studies1,2,5,6 have shown wide variation in the prevalence of underweight, overweight and obesity. Kapil et al5 had obtained 7.4% prevalence of obesity among affluent adolescents in Delhi. Augustine and Poojara6 in their study on urban college girls of Ernaculun had found the prevalence of underweight and overweight as 21.5% and 10.5% respectively. The relative proportion of underweight, overweight and obesity depend on the stage of development reached in a transitional society1, and the rapidity with which modern marketing practices displace traditional diet and lifestyle2. In the first stage of transition, high BMI remained confined to the wealthier section of society since the obesogenic influences affect them first. It is only in the later phase of transition when poorer sections start showing increase in the prevalence of high BMI. Studies have shown a strong positive correlation between mean population BMI and the prevalence of high BMI. A WHO expert committee1 has observed ‘when the mean BMI is 23 or below, there are few, if any, individuals with BMI 30 and above. The probability of an increasing prevalence of obesity rises markedly above a mean BMI of 23. Rose found a 4.66% increase in the prevalence of obesity for every single unit increase in the mean population BMI above 23’. The mean BMI of 20.14 in the present study was well below 23 and thus consistent with the low prevalence of overweight and non-existence of obesity in this study population. Relatively higher prevalence of underweight (33.5%) in the present study was indicative of poor socio-economic background of the study population. In fact it was the admission policy of the NTC to select its students from a few peripheral districts which happen to be relatively backward.
As shown in Table 1, the prevalence of perceived underweight (24.4%) was less than the prevalence of actual underweight (33.5%) but the difference was not statistically significant with Z-score of less than 2 (Z=1.89). The prevalence of perceived normal weight (50%) was less than the prevalence of actual normal weight (61.4%) and here the difference was statistically significant with Z-score a little more than 2 (Z=2.16). By contrast, the prevalence of perceived overweight (25.6%) was significantly higher than the prevalence of actual overweight (5.1%) [Z=5.57]. Thus feeling fat was seemingly the dominant perception. The girls feeling overweight are more likely to engage in unhealthy weight control practices6 than those feeling normal or underweight. Table 1 also revealed that majority (86.0%) of the girls who were feeling thin were actually underweight. Similarly, majority (72.7%) of those feeling normal were actually normal weight. In sharp contrast, most (84.4%) of the girls who were feeling fat belonged to normal weight category. Therefore, the weight related perception seemed to be weighted towards feeling higher weight. This was also evident from the prevalence of faulty weight perception among underweight and normal weight categories (based on BMI). Prevalence of faulty weight perception among underweight was 37.3% and attributable entirely to feeling higher weight. Prevalence of faulty weight perception tilted heavily (35.2%) towards feeling higher weight. Overall prevalence of faulty weight perception needed correction. Higher prevalence was reported by Maloney7 as 75% and Augustine and Poojara6 as 48%. The prevailing fault perception, if not corrected in time, may lead to adoption of faulty weight control practices, development of eating disorders, and, above all, may end up in aggravating the already existing high level of undernutrition. The later can have adverse long term impact on the health and well being of the offspring born to these ‘would be mothers’.
The dual burden of underweight and overweight among the GNM students of NTC, Bankura, calls for appropriate modification of their diet and physical activity level GNM students of NTC, Bankura, calls for appropriate modification of their diet and physical activity level coupled with regular monitoring of their weight status. Since all the girls stay in the hostel provided by the NTC, the institution can play a crucial role by making necessary facilities available to its students. The prevailing faulty weight perception can be corrected by educating the girls about the importance of weight as the basis for determining and monitoring their weight status instead of any subjective feeling. The institution can play a pivotal role in this regard through appropriate IEC activities and help create a supportive environment, which, in turn, would enable the students to achieve and maintain a healthy body weight.
Acknowledgment
The author wishes to thank the Principal Nursing Officer, NTC, Bankura for giving permission and administrative help for carrying out the study. He is also grateful to the students of NTC who co-operated to carry on this work.
References
1 WHO — Preventing and managing the global epidemic: report of a WHO Consultation on Obesity. World Health Organ Tech Rep Ser 2000; 894: 1-72.
2 WHO — Diet, nutrition and the prevention of chronic diseases: report of a Joint WHO/FAO Expert Consultation. World Health Organ Tech Rep Ser 2003; 916: 1-83.
3 Prabhakaran S — Nutritional status of adolescent girls residing in a university hostel. Indian J Nutr Dietetics 2003; 40: 274-7.
4 Jelliffee BD — The Assessment of the Nutritional Status of the Community. Geneva: WHO, 1966: 63-78.
5 Kapil U, Singh P, Pathak P, Dwibedi SN, Bhasin S — Prevalence of obesity among affluent adolescent school children in Delhi. Indian Pediatr 2002; 39: 449-52.
6 Auguestine LF, Poojara RH — Prevalence of obesity, weight perception and weight control practices among urban college going girls. Indian J Commun Med 2003; 28: 187-90.
7 Maloney MJ — Eating disorders during adolescence. Ann Nestle 1995; 53: 101-5.
*MD (SPM), Associate Professor, Department of Community Medicine, BS Medical College, Bankura 722102
Home
Copyright : JIMA
|
