Journal of Family Medicine and Primary Care

LETTER TO EDITOR
Year
: 2016  |  Volume : 5  |  Issue : 1  |  Page : 194-

Comment on "correlates of overweight and obesity among urban adolescents in Bihar, India"


Madhavi Bhargava1, Anurag Bhargava2,  
1 Department of Community Medicine, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, India
2 Department of General Medicine, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, India

Correspondence Address:
Madhavi Bhargava
Department of Community Medicine, Yenepoya Medical College, University Road, Deralakatte, Mangalore - 575 018, Karnataka
India




How to cite this article:
Bhargava M, Bhargava A. Comment on "correlates of overweight and obesity among urban adolescents in Bihar, India".J Family Med Prim Care 2016;5:194-194


How to cite this URL:
Bhargava M, Bhargava A. Comment on "correlates of overweight and obesity among urban adolescents in Bihar, India". J Family Med Prim Care [serial online] 2016 [cited 2020 Aug 8 ];5:194-194
Available from: http://www.jfmpc.com/text.asp?2016/5/1/194/184668


Full Text

Dear Editor,

We read the article by Ghosh et al., "correlates of overweight and obesity among urban adolescents in Bihar, India" with interest. [1] The authors have done a commendable job of highlighting an issue of public health importance in adolescents of Bihar. However, some issues need to be addressed.

First, the reference for sample size calculation (prevalence = 20%) is a review article which quotes overweight and obesity in Indian studies ranging from 4.7% to 29%. [2] An original and nationally representative study or a meta-analysis is preferable in calculating a sample size. [3] Moreover, authors mention the lack of data regarding overweight/obesity in National Family Health Survey (NFHS). It is important to point out that NFHS-3 does report overweight and obesity in the age group of 15-19 years which is 3.5% at national level. For Bihar, it is 1.3% in females and 0.7% in males of 15-19 years of age. [4]

Authors have used reference data from the Center for Disease Control and Prevention 2000 dataset for body mass index cut-offs. It would have been preferable to use standardized World Health Organization cut-offs for the age group of 5-19 years which are applicable for developed as well as developing countries. [5] Moreover, the population is classified in dichotomous categories (overweight and not-overweight) which groups together participants who are normal and thin. According to NFHS-3, the age group of 15-19 has the highest prevalence of thinness, 52% in females and 61.6% in males in this age group in Bihar. [4] It will be interesting to see the burden of thinness in the 79% reported as not overweight in this study (where participants of 15 years of age are in majority). In addition, the methodology used for the determination of socio-economic status is unclear, and physical activity due to household chores remains undocumented (which is significant in India).

Finally, the analysis shows a significant association between nonconsumption of vegetables and fruits with overweight/obesity. However, socio-economic status is an important confounder in case of intake of vegetables and fruits.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Ghosh A, Sarkar D, Pal R, Mukherjee B. Correlates of overweight and obesity among urban adolescents in Bihar, India. J Family Med Prim Care 2015;4:84-8.
2Kaur S, Kapil U, Singh P. Pattern of chronic diseases amongst adolescent obese children in developing countries. Curr Sci 2006;88:152-4.
3Khadilkar VV, Khadilkar AV, Cole TJ, Chiplonkar SA, Pandit D. Overweight and obesity prevalence and body mass index trends in Indian children. Int J Pediatr Obes 2011;6:e216-24.
4International Institute for Population Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3), India, 2005-06. Bihar, Mumbai: IIPS; 2008.
5de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007;85:660-7.