Obesity Reduction and Awareness of NCD

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ORANGE
PROJECT
Obesity Reduction and Awareness of NCDs through
Group Education in children
Dr.V.Mohan, MD., FRCP (London, Edinburgh, Glasgow
Ireland), Ph.D., DSc., FNASc.
Dr.Ranjani Harish, CDE, Ph.D
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INTRODUCTION

• Childhood obesity is a forerunner of obesity in
  adulthood, which in turn has a strong association
  with NCDs such as type 2 diabetes and
  cardiovascular disease
• In developing countries including India,
  overnutrition co - exists with undernutrition.
• Children belonging to the lower socioeconomic
  group are undernourished whereas the higher and
  middle income children are overnourished.
• There is an urgent need for accurate data on
  nutritional status of children adolescents and
  also need for spreading messages about the rising
  obesity epidemic among them.

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WHY DO WE NEED THIS STUDY?

• Most of the earlier studies in children and
  adolescents in India have been done either on
  small numbers or in selected schools in India.
• This study plans to undertake large scale
  screening of children to obtain accurate
  prevalence estimates of childhood obesity and
  glucose intolerance in children and adolescents.
• A massive awareness program targeting the
  prevention/reduction of obesity in children at
  the school community level is also planned.

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AIM

• To estimate the prevalence of obesity, glucose
  intolerance, hypertension, dyslipidemia and
  metabolic syndrome among urban children and
  adolescents aged 6-19 years and to raise
  awareness about Non-Communicable Diseases (NCDS)
  among them in Chennai city in South India.

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MAP OF CHENNAI CITY
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METHODOLOGY
ORANGE PROJECT
COLONY COMPONENT
SCHOOL COMPONENT
Main difference between the components is that
blood testing will be done only in the colonies
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METHODOLOGY
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Demographic Information Collected in Schools and
Colonies
School component n 20, 000
Colony component n 2,000
Phase I
Screening for anthropometrical and clinical
parameters
Screening for anthropometrical, clinical
biochemical parameters
METHODOLOGY
Facilitate WHO Health Promoting Schools (HPS)
Phase II
Planned Interventions In Schools Colonies
Follow up of all colony children based on consent
Follow up of children from selected cooperative
schools determined by consent
Phase III
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METHODOLOGY

• Specific objectives of the School component
• To collect anthropometric data of school going
  children ranging from the age group of 6 to 19
  years to develop standardised age specific cut
  points for height, weight, waist circumference,
  BMI, body fat and blood pressure in children
  and adolescents as such data is not available in
  India.
• To study the prevalence of overnutrition and
  undernutrition in school going children from
  private and government schools
• To promote the concept of health promoting
  schools (HPS) in Chennai

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METHODOLOGY

• Corporation Government aided schools Group 1
• Private Management run schools Group 2
• Schools in Tamil Nadu have been divided into four
  major categories primary (age group 6-10 yrs),
  upper primary or middle (age group 6 13 yrs),
  secondary (age group 6 15 yrs) and upper
  secondary (age group 6 17 yrs).
• 10 Corporation zones in Chennai. Based on the
  proportion of schools in each zone, a total of 50
  schools will be selected by systematic random
  sampling.
• The number of children to be selected from each
  school is around 400 and number from each age
  group 150 to achieve a proportionate sample of
  all age groups .

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METHODOLOGY

• Specific objectives of the Community component
• To study the prevalence of obesity, glucose
  intolerance, metabolic syndrome in a
  representative sample of children and adolescents
  ranging from the age group of 6 19 years in
  Chennai.
• To develop a risk score which will help to
  identify diabetes/ pre-diabetes in children and
  adolescents.
• To create awareness about non-communicable
  diseases among the children, adolescents and
  their family members.

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METHODOLOGY

• The list of zones and the areas under each
  corporation zone was obtained from the
  Corporation of Chennai website
• The residential colonies were randomly selected
  from the areas covered under each zone ensuring
  that the colonies selected were representative of
  Chennai city.
• Permission was obtained from the Colony Welfare
  Association President and Secretary of every
  colony before conducting the screening and
  awareness.
• Every family in the colony was approached and the
  children fitting the age criteria were included
  in the study only after obtaining the informed
  consent of the parent and the assent of the
  child.

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AWARENESS MESSAGES

• What are NCDs?
• Health implications of under nutrition, obesity
  and diabetes among children and adults
• Importance of increased physical activity and
  reduced TV viewing
• Importance of weight reduction
• Importance of following a traditional diet
  pattern and healthy eating
• Understanding the fast food culture and how to
  reduce consumption of fast foods
• Increasing fruits and vegetables consumption
• Need for cutting down on calorie, fat and sugar
  intake wherever appropriate
• Ill effects of smoking, use of smokeless tobacco,
  alcohol etc.
• Spotting the hidden messages in junk food
  advertisements, and
• The need to understand food labeling

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EXPECTED OUTCOMES

• Data on prevalence of obesity (abdominal and
  general), underweight, blood pressure, clinical
  markers of diabetes will be collected from 20,000
  school children.
• In addition data on prevalence of glucose
  intolerance, dyslipidemias, metabolic syndrome
  will be collected from 2000 children residing in
  middle income colonies.
• By increasing awareness about various NCDs among
  children the health care burden due to NCDs can
  be reduced in the future.
• This project could serve as a role model to study
  the feasibility and viability for NCD prevention
  programmes for children in India and other
  developing countries.
• This project will launch the WHO - HPS initiative
  in atleast 50 schools in urban Chennai. This in
  effect can create awareness and improvement of
  basic health and hygiene facilities in these
  schools.
• This project is expected to positively change the
  health of 22, 000 children and through them
  atleast reach out to 1, 00,000 adults who can
  bring out healthy behavior changes in their own
  lives.

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FOR MORE DETAILS CONTACT Dr. V Mohan or Dr.
Ranjani Harish Contact Nos. 91 - 44 4386
8888 E-mail drmohans_at_vsnl.net Website
www.drmohansdiabetes.com