Evidence for Interventions to Prevent and Control Obesity Among Children and Adolescents: Its Applicability to India

Abstract

Childhood obesity is on the rise worldwide and its increasing prevalence in low and middle income countries is well-known. Obesity interventions have the potential to prevent adverse health outcomes; however, large gaps in research and knowledge about the efficacy and sustainability of such interventions remain. The objectives of this article were to review the evidence for interventions to prevent and control obesity among children and adolescents, evaluate their applicability in India, and discuss the challenges to sustain such interventions. The authors reviewed published research focusing on childhood obesity interventions, especially in India and other lower-resource countries. Nine observational and 10 interventional studies were reviewed. Most studies identified were from developed countries and took place at day-care settings, schools, and after school programs. Nineteen reported studies were grouped into categories: diet (2), physical activity (4), childcare programs (2), media-based programs (2), parental involvement (2), multi-component studies (1), and screen time (6). Most interventions were effective in reducing BMI, decreasing sedentary behaviors, and increasing physical activity. Sustainability of these interventions was not evaluated. While there is no one method or simple intervention to address obesity, multi-component approaches involving home and school environments are promising and warrant evaluation in India. Literature on obesity prevention and control in India and in lower-resource countries, however, is sparse. Existing gaps in knowledge about obesity should be addressed by conducting research in India and carrying out interventions to determine what strategies will be successful and sustainable locally.

An evaluation of outdoor school environments to promote physical activity in Delhi, India

“…To our knowledge, no previous study thus far has evaluated the school built environment as a potential target to promote physical activity in children in resource-limited settings. However, a recent review of 19 interventions to prevent obesity in low-income countries, including some that aimed to increase physical activity, found that the majority were effective in reducing body mass index, decreasing sedentary behaviors, and increasing physical activity [52]. Another study compared physical activity and sedentary behavior among school children from 34 countries and found that few engaged in sufficient physical activity according to country standards and recommendations.…”

Determinants, consequences and prevention of childhood overweight and obesity: An Indian context

“…The variety of convenience foods available in the market and the role of media in sensitizing the parents and children to these changes could have also undoubtedly contributed to childhood obesity. [ 8 ] One of the factors that could significantly affect children's energy intake is the increasing availability of energy-dense, high-calorie foods/snacks and drinks in school canteens. Working mothers or single-parent families may also increase the demand for take away foods or increase the frequency of eating out and cause reliance on pre-prepared foods.…”

“…[ 12 ] Studies on prevention of childhood obesity focus primarily on this important issue as these sedentary activities are seen to have a direct correlation to increased body weight. [ 8 13 14 ] The Central Board of Secondary Education (CBSE) 2007 fact sheet[ 15 ] reported that only 30% of adolescents played regularly for at least 1 hour a day. Aggarwal et al .…”

Training in Dietary Practices and Physical Activity to Improve Health among South Asian Medical Students

“…A recent review of evidence of interventions for obesity that may be applied in Indian settings had very few studies from India, and it concluded that there are large gaps in knowledge about prevention and management of obesity. This review brings out the fact that there may be many interventions that are possible which need to be studied in India, while giving careful consideration to the various issues in study design such as feasibility and composition of interventions [ 10 ].…”