A cross-sectional study on burden and predictors of obesity and anemia in school-going adolescents from Northern India
DOI:
https://doi.org/10.18203/2349-3291.ijcp20253487Keywords:
Adolescent health, Anemia, Obesity, Body mass index, Cross sectional studies, Dietary habits, Nutritional status, Public health, Socioeconomic status, Waist hip ratioAbstract
Background: Adolescence, a period of rapid growth and high nutritional demand, faces a dual burden of malnutrition. This study assessed anemia and obesity prevalence and their demographic, dietary and anthropometric associations among school-going adolescents in India.
Methods: A cross-sectional study was conducted from August 2023 to January 2025 in selected schools in Sitapur, India, enrolling 386 adolescents via multistage random sampling. Data on sociodemographic, dietary habits and clinical history were collected through structured interviews. Anthropometry (weight, height, body mass index (BMI), waist-hip ratio (WHR), mid-upper arm circumference (MUAC)) and hemoglobin levels (automated hematology analyser) were measured. Anemia and obesity were classified using WHO guidelines and CDC BMI percentiles/WHR cut-offs, respectively. Data were analyzed using SPSS v26.0; p<0.05 was considered significant.
Results: The mean age was 14.19±2.63 years. Overweight and obesity prevalence were 7.8% and 30.8%, respectively, with 10.6% underweight. Central obesity was present in 45.6% (WHR). Anemia affected 32.4% and was associated with female gender (OR=2.77, p<0.001), nuclear family (B=-0.900, OR=0.41, p=0.005), vegetarian diet (B=-1.903, OR=0.15, p<0.001) and low socioeconomic status (OR=10.26, p<0.001). Obesity was linked to non-vegetarian diet (OR=2.467, p=0.009), daily fast-food intake (OR=3.323, p=0.005) and inversely associated with lower SES (B=-2.083, OR=0.124, p<0.001). No significant association was observed between BMI and anemia (p=0.591).
Conclusions: High prevalence of overweight/obesity (38.6%) and anemia (32.4%), with notable coexistence, highlights the dual burden of malnutrition. Integrated school-based interventions focusing on screening, nutrition education and early management are essential to improve adolescent health in India.
Metrics
References
Guan KW, Adlung C, Keijsers L, Smit CR, Vreeker A, Thalassinou E, et al. Just-in-time adaptive interventions for adolescent and young adult health and well-being: protocol for a systematic review. BMJ open. 2024;1;14(7):e083870. DOI: https://doi.org/10.1136/bmjopen-2024-083870
Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC. The age of adolescence. The lancet child & adolescent health. 2018;1;2(3):223-8. DOI: https://doi.org/10.1016/S2352-4642(18)30022-1
Ragelienė T, Grønhøj A. The influence of peers′ and siblings′ on children's and adolescents′ healthy eating behavior. A systematic literature review. Appetite. 2020;1;148:104592. DOI: https://doi.org/10.1016/j.appet.2020.104592
Kumari G, Rathoria E, Khan FA, Singh SK, Lahari R, Rathoria R, et al. Prevalence of stunting, thinness and anaemia among adolescents and their association with demographics and dietary habits. Int J Contemp Pediatr. 2024;11(12):1711. DOI: https://doi.org/10.18203/2349-3291.ijcp20243466
Chouraqui JP. Dietary approaches to iron deficiency prevention in childhood-a critical public health issue. Nutrients. 2022;12;14(8):1604. DOI: https://doi.org/10.3390/nu14081604
World Health Organization. Anaemia. Who.int (Internet). (cited 2025 Jul 5). Available from: https://www.who.int/health-topics/anaemia
Scott S, Lahiri A, Sethi V, de Wagt A, Menon P, Yadav K, et al. Anaemia in Indians aged 10-19 years: Prevalence, burden and associated factors at national and regional levels. Maternal & child nutrition. 2022;18(4):e13391. DOI: https://doi.org/10.1111/mcn.13391
Singh A, Rathoria E, Singh SK, Rathoria R, Yadav SK, Bansal U. Prevalence of overweight and obesity and associations with socio-demographic and etiological factors. Int J Contemp Pediatr. 2024;11(10):1400-5. DOI: https://doi.org/10.18203/2349-3291.ijcp20242735
Bansal U, Raja A, Agarwal P. The influence of family history of cardiovascular disease on blood pressure, waist hip ratio and body mass index in adolescents. International J Contemp Pediat. 2020;7(4):733. DOI: https://doi.org/10.18203/2349-3291.ijcp20200855
Sharma N, Sanjeevi RR, Balasubramanian K, Chahal A, Sharma A, Sidiq M. A systematic review on prevalence of overweight and obesity among school children and adolescents in Indian population. Indian J Endocrinol Metabol. 2024;1;28(2):104-16. DOI: https://doi.org/10.4103/ijem.ijem_365_23
Fatima S, Bansal U, Suryavanshi P. Complementary feeding practices in India and improvement strategies. International J Sci Res. 2021;10(3):29-32. DOI: https://doi.org/10.36106/2844774
Singh A, Rathoria E, Khan FA. Clinical profile and co-morbidities in children with moderate and severe acute malnutrition. International J Contemp Pediat. 2025;12(2):266. DOI: https://doi.org/10.18203/2349-3291.ijcp20250095
Davis JN, Oaks BM, Engle-Stone R. The double burden of malnutrition: a systematic review of operational definitions. Current Dev Nut. 2020;1;4(9):127. DOI: https://doi.org/10.1093/cdn/nzaa127
Jeong J, Cho Y, Cho IY. Association between obesity and anemia in a nationally representative sample of South Korean adolescents: a cross-sectional study. In Healthcare. 2022;10(6):1055. DOI: https://doi.org/10.3390/healthcare10061055
Panichsillaphakit E, Suteerojntrakool O, Pancharoen C. The Association between hepcidin and iron status in children and adolescents with obesity. J Nutrit Metabol. 2021;21(1):9944035. DOI: https://doi.org/10.1155/2021/9944035
Dalvi T, Kalghatgi S. A 2023 Update of Kuppuswamy Socioeconomic Status Classification Scale for the Indian Population. J Indian Assoc Publ Heal Dentistr. 2023;21(3):282-3. DOI: https://doi.org/10.4103/jiaphd.jiaphd_173_23
Sommer I, Teufer B, Szelag M, Nussbaumer-Streit B, Titscher V, Klerings I, et al. The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis. Scientific Reports. 2020;29;10(1):12699. DOI: https://doi.org/10.1038/s41598-020-69498-7
Sisay BG, Hassen HY, Jima BR, Atlantis E, Gebreyesus SH. The performance of mid-upper arm circumference for identifying children and adolescents with overweight and obesity: a systematic review and meta-analysis. Public Health Nutrition. 2022;25(3):607-16. DOI: https://doi.org/10.1017/S1368980022000143
Nogueira-de-Almeida CA, Ruffo P, Martinez EZ. Cutoff points of mid-upper arm circumference (MUAC) for diagnosis of adolescent obesity: A systematic review with metanalysis and MOSTA tape proposal: MUAC cutoff for diagnosis of adolescent obesity. Global Pediat. 2024;1;8:100135. DOI: https://doi.org/10.1016/j.gpeds.2024.100135
World Health Organization. Guideline on hemoglobin cutoffs to define anaemia in individuals and populations. 2024. Available at: https://www.who.int/publications. Accessed on 21 August 2025.
Jeevan J, Karun KM, Puranik A, Deepa C, Mk L, Barvaliya M. Prevalence of anemia in India: a systematic review, meta-analysis and geospatial analysis. BMC Public Health. 2025;5(1):1270. DOI: https://doi.org/10.1186/s12889-025-22439-3
Salis VM, Kini PS, Devi NB, Devi TD, Padashetti SI. Effectiveness of Self-Instructional Module on Knowledge Regarding Prevention of Iron Deficiency Anemia Among Adolescent Girls at Selected Pre-University Colleges of Moodbidri. International J Immunol Nurs. 2024;10(2):1-7. DOI: https://doi.org/10.33545/26630427.2024.v7.i2a.165
George L, Kiran A, Nalini N, Kujur M, Kumar A. Prevalence of malnutrition among adolescent tribal girls in India: a systematic review and meta-analysis. Indian J Publ Heal. 2025;69(2):197-202. DOI: https://doi.org/10.4103/ijph.ijph_34_24
POSHAN abhiyaan - PM’s overarching scheme for holistic nourishment. Available at: https://www.india.gov.in/spotlight/poshan-abhiyaan-pms-overarching-scheme-holistic-nourishment. Accessed on 21 August 2025.
Eat Right India. Available at: https://eatrightindia.gov.in/eatrightindia.jsp. Accessed on 21 August 2025.
World Health Organization; 2023. WHO acceleration plan to stop obesity. Available at: https://www.who.int/publications. Accessed on 21 July 2025.
Anaemia Action Alliance. Available at: https://www.who.int/teams/nutrition-and-food-safety/anaemia-action-alliance. Accessed on 21 August 2025.
Rathoria R, Rathoria E. Effect of maternal anemia on cord blood haemoglobin of newborn. Int J Reprod Contrac Obst Gynecol. 2021;11(1):64. DOI: https://doi.org/10.18203/2320-1770.ijrcog20215076
Downloads
Published
How to Cite
Issue
Section
