Eat well Program in Obesity. Non-communicable diseases co

Eat Well Program in Obesity: A study on obesity and eating well program outcomes among professional college students in Kanpur District.

INTRODUCTION

Non-communicable diseases continue to be important public health problems in the world, being responsible for sizeable mortality and morbidity—non-communicable diseases (NCDs). Obesity is the leading cause of death and disability worldwide. In 2005, NCDs caused an estimated 35 million deaths, 60% of all deaths globally, with 80% in low-income and middle-income countries and approximately 16 million deaths in people less than 70 years of age. Total deaths from NCDs are projected to increase by a further 17% over the next 10 years. The changing pattern of lifestyle leads to the development of obesity, stress, atherosclerosis, cancer, and other NCDs. According to the WHO criteria, there are three steps in screening NCDs. Step 1: Estimating population needs through assessing the current risk profile and advocating for action. Step 2: Formulate and adopt the NCD policy. Step 3: Identify policy implementation steps. Management of NCDs should increase awareness among the public regarding the signs and symptoms of the disease and its complications. Health promotion strategies, with a strong focus on disease prevention, are needed to empower people to act individually and collectively to prevent risky behavior and create economic, political, and environmental conditions that prevent NCDs and their risks.[1]

Obesity is now so common within the world’s population that it is beginning to replace undernutrition and infectious diseases as the most significant contributors to ill health. In particular, obesity is associated with diabetes mellitus, coronary heart disease, certain forms of cancer, and sleep-breathing disorders. Obesity is defined by a body-mass index (weight divided by the square of the height) of 30 kg m⁻² or greater. However, this does not consider the morbidity and mortality associated with more modest degrees of overweight nor the detrimental effect of intra-abdominal fat. The global epidemic of obesity results from a combination of genetic susceptibility, increased availability of high-energy foods, and decreased requirement for physical activity in modern society. Obesity should no longer be regarded simply as a cosmetic problem affecting certain individuals but as an epidemic that threatens global well-being.[2]

Obesity, which broadly refers to excess body fat, has become an important public health problem. Its prevalence continues to increase worldwide. As the prevalence of obesity increases, so does the burden of its associated co-morbidities. However, not only does the total body fat matter, but so does the distribution pattern. Excess visceral fat, also referred to as central obeObesityas a stronger association with cardiovascular disease than subcutaneous fat, which is deposited mainly around the hips and buttocks. Central obeObesityoduces a characteristic body shape which resembles an apple and thus is also referred to as “apple-shaped” beObesity op “used “paper-shaped “eObesity wh “ch fat is deposited on the hips and buttocks circumference and Waist: Hip ratio (WHR), i.e. t, the ratio of the hip circumference to waist circumference.

Morbidities related to obesity -Impaired glucose tolerance test and diabetes mellitus, heart diseases, dyslcerebrovascularo vascular diseases, metabolic syndrome, pulmonary abnormalities, osteoarthritis, gastrointestinal abnormalitiesphysicaleand r, physical and social problems, etc.

Obesity, a multifaceted and prevalent health concern, arises from the intricate interplay of various risk factors that span genetic, environmental, and lifestyle domains. As societies undergo rapid transformations in diet, physical activity patterns, and overall living conditions, the prevPrevalenceobeObesitys surged, constituting a significant global public health challenge. The etiology of the obesity complex, with numerous factors converging to influence body weight regulation and adipose tissue accumulation. This thesis aims to delve into the diverse risk factors contributing to obeObesitynraveling the connections between genetics, environmental influences, lifestyle choices, and their collective impact on the escalating obesity rates worldwide. Understanding the intricate web of contributors is imperative for developing targeted interventions and public health strategies to mitigate the burden of obesity and its associated health consequences.

To improve public health in India and to combat negative nutritional trends to fight

lifestyle diseases, the Food Safety and Standards Authority of India (FSSAI) launched ‘The Eat

Right ‘movement’ on 1 Jul 10’2018. The food industry, public health professionals, civil

society and consumer organizations, influencers, and celebrities came together on a common

platform and pledged to take concrete steps to amplify ‘The Eat Right’ movement, the

country This movement is aligned with the government’s programs such as POSHAN Abhiyaan, Anemia Mukt Bharat, Ayushman Bharat Yojana, and Swachh

Bharat Mission.

‘The Eat Right ‘ovement’ is built on t’o broad pillars of ‘Eat Healthy’ a’d ‘Eat Safe’. It’s a

cocollectiveffort to make both the demand and supply side interventions through engagement

of key stakeholders.

The study’s main objectives were to integrate the “Eat Right Move” campaign into “the school environment and to improve the students’ awareness of nutrition and health. The sub-objectives of the study are i) to assess the nutritional status of the school students, ii) to study the knowledge of school students about nutrition, iii) to improve the eating habits of students through teaching nutrition, and iv) to sensitize the parents about the “Eat Right Move “ent”..

“Review of literature

Global overview

Plotnikoff RC et al. (2015et al.) descriptively studied the effectiveness of interventions targeting physical activity, nutrition, and healthy weight for university and college students.

To examine the effectiveness of interior improvement in improving physical activity, diet, and weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative, and synthesis and meta-analyses were conducted when appropriate.

Forty-one studies were included; of these, 34 significantly improved one of the key outcomes. Of the studies examining physical activity, 18/29 yielded substantial results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control groups. Of the studies investigating nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction.

Overall, 41 studies targeting improvements in student health outcomes (physical activity, diet, weight loss) within tertiary education settings met the inclusion/exclusion criteria. Study characteristics (i.e., country, targ,, et sample and size, age, duration, int,,ervention and retention) and risk of bias scores are summarized. Risk of bias assessment indicated eight studies had a negative rating (high risk of bias), 30 were considered neutral, and the remaining four had a positive rating (low risk of bias).[10]

Indian overview

Ameena RN et al;(2020) conducted ‘Eat Right Move’ent Campaign ‘into the schoo’ environment, study sample consisted of 100 adolescents of age 11-13 years among them 50 each were from a government school and a private school. It aimed to provide nutritional knowledge and attitudes to standards and to teach and inculcate good eating practices amongst school-going students to enhance their quality of life. The study results showed that age-appropriate-appropriatee-appropriates could facilitate knowledge and positive changes in attitudes and practices. They created positive nutritional awareness amongst the adolescents and their parents. Thus, this study proved that the Eat Right Movement can be successfully integrated across the schools of the State and Nation.

PENGPID S et al. (2014 NOV) conducted a study on PrevPrevalenceoverweight/obeObesityd central obeObesityd its associated factors among a sample of university students in India—obesity research & clinical practice.

The study found a high prevalence of overweight/obeObesityd central obeObesityeveral gender-specific health risk practices were identified, including lack of dietary risk knowledge, shorter sleep duration, living away from parents or guardians, tobacco use, and lack of social support and religiousness that can be utilized in health promotion programs.

37.5% were overweight or obese, 26.8% were overweight (≥23–27.4 BMI), 10.7% were obese (≥27.5 kg/m2), 11.7% were underweight (<18.5 kg/m2) and 16.4% central obesity (WC ≥90 cm for men and ≥80 cm for women). In multivariate analysis among men lack of non-organized religious activity (odds ratio = OR 0.85, confidence interval = CI 0.77–0.95), lower dietary risk knowledge (OR = 0.64, CI = 0.41–0.99), tobacco use (OR = 2.23, CI = 1.14–4.38), and suffering from depression (OR = 1.59, CI = 1.00–2.47) were associated with overweight/obeObesitynd younger age (OR = 0.32, CI = 0.12–0.90), lives away from parents or guardians (OR = 1.79, CI = 1.04–3.07), healthy dietary practices (OR = 1.95, CI = 1.02–3.72) and 9 or more hours sleep duration (OR = 0.28, CI = 0.09–0.96) were associated with central obeObesityn bivariate analysis among women, lack of social support, lower dietary risk knowledge, tobacco use, and 9 or more hours sleep duration were associated with overweight/obeObesityd lives away from parents or guardians and abstinence from alcohol associated with central obeObesityangwar V et al; (2019 Jan) conducted study on Study of Overweight and Obesity and Associated Factors among Undergraduate Medical Students in North India.

The study showed a high prevalence of overweight (30.2%) and obesity 9%). Obesity was significantly associated with a non-nonvegetarian (p0.05). The importance of healthy eating habits and a healthy life, a healthy lifestyle. We cra wagerwonra ing tWeldonwelnon ess for healthy living among medical sturiistartingcted on 129 medical student students of50. Were males, and 64 (49.6%) were females. Out of total students, 85 (65.9%) were normal weight, 39 (30.2%) were overweight, and 5 (3.9%) were obese according to BMI. Nobody was underweight in our study group. 87 (67.4%) students a ts had normal waist-hi, p ratio, and 42 (32.6%) were obese. The waist-hip ratioThe waist-hipificantly higher in male students than in female students (p0.05). We also observed that 45 (34.9%) students were vegetarian, and the rest were nonvegnonvegetariangnonvegetarianalence of obeObesitys significannonvegetarian nonveg nonvegetarian vegetarian students (p< 0.05)

33.3% of students were off of exercising regularly while 66.7% were not exercising at all (table history of endocrine diswaswasrs were only in 7 (5.4%) s, students and history of menstrual disorders were present in 6.3% (n= 4) female subjects only. 13.2% of students had a family history of being overweight/obese, while 34.9% had a family history of diabetes mellitus. There was no significant difference in the prevalence of obesity/ overweight and family history of diabetes/ obesity. 76% of students had normal sleep duration. 16% of students slept for 8 hours. There was no significant difference between sleep duration and BMI (P> 0.05). There was no significant difference between the previous prevalence of obesity and sleep duration. Prevalence of overweight and obesity is highest in students with blood group B (12.4%) and least in blood group AB (0%). Prevalence of obeObesitys 1.6% in students with blood groups A and B [7]

State overview

Tiwari HC et al. (2014) conducted a cross-sectional study in 2014 Jan on Overweight & obesity and its correlates among school-going adolescents of district Allahabad. The magnitude of overweight/obesity among school-going adolescents of Allahabad was 7.7%. Regular participation in household activities &outdoor games, and health habits should be emphasized at the individual level, family level & school level to curb this problem. A total of 940 students were included in this study. Am,ong these 50.5% belonged to urban & 49.5% belonged areasural area. Males were 53.7% while 46.3% were females with a mean age of 15.5 years ±1.25 SD—overall prevPrevalenceoverweight & obeObesitys found to be 6.6% & 1.1%, respectively. The prevalence of being overweight was highest in late adolescence (8.3%). The prevalence of overweight was found to be higher among female students (7.4 %) than among male students (5.9%) (Table 1). The prevalence of overbought is significantly higher among urban students (10.1% and 1. among 7%) than among rural students (3.0% and 0.4%) respect, respectively. Among urban students, the prevalence of overweight and obesity was found to be 13.0% & 2.1% among female students and 8.2% and 1.4% among male students. Among rural students, 3.1% of males were overweight and overweight and fo. The prevPrevalenceoverweight and obesity among female students were 2.9% and 0.8%, respectively. Prevalence of overweight & obeObesitys Socioeconomic status belonging to Socioeconomic status I (11.7% & 2.2%) followed by Socioeconomic status II (overweight 7.4% & obeObesityThe majority (45.3%) had participated in outdoor games hours>6 hour/week. In comparison (32.0%) did not participate at all. Only 14.6% participated in household activity for >3 hrs./day, while 52.7% participated in 1-3 hrs. Most students (67%) did not go for it, and only 10.8% walked regularly for more than 1hr/day.

The prevalence of overweight/obesity was significantly higher among the students who did not participate in various physical activities like outdoor games and household activities and watched television daily for longer durations. The prevalence of overweight/obesity was also significantly higher among those students who consumed fast foods and junk drinks frequently (≥3 times/week).

The final model of binary logistic regression analysis revealed that the risk of being overweight and obese4is times that of socioesocioeconomics in adolescents who belonged to socioesocioeconomics class I, compared to those in socioesocioeconomics III and below. The risk of overweight and obeObesitys 2.6 times higher among adolescents who either did not participate in any household activity or participated for less than 1 hour/day compared to those who participated for more than 3 hours/day, 2.3 times higher among adolescents who did not participate in outdoor games and sports as compared to those who participated for >6 hour/week. It was 2.6 times higher among adolescents who watched television ≥ 3 hours/day than those who either did not watch or watched it for less than 1 hour. The risk of being overweight & obeObesitys 1.8 times higher among adolescents who consume fast foods frequently

Alpana Saxena (2015) conducted a study on 260 college students. The information included name, age, gender, present, and weight and height (sub-subjects subjected to BMI, which was calculated by dividing a person’s body by a person’s height (weight [kg] / height [m²]).

Obesity is increasing in students. The most common reasons are frequent use of fast food, alcoholic drink,s drinks, and a lack of exercise.

Subjects underweight were (males- 15, females- 20), normal weight (males- 50, females- 74), overweight (males- 17, females- 22), pre- obese (males- 20, females- 22) and obese (males- 8, females- 11). The difference was non-significant (P > 0.05)—the prevPrevalenceobeObesitys 7.27% in males and 7.33% in females, fafactorsrink soft drinks, fast food, and alcoholism.

Rationale of Study

Oba Obesity is a public health problem in India, and it leads to many non-communicable diseases like Cancer, Diabetes; it is important to know the factors (Dietary, physical activity, substance abuse, etc.)
This study is an attempt to be healthy among college students.
The study will examine the knowledgeable group of students and their practices of encouraging them to improve their nutritional awareness.
A standardized questionnaire method was developed and used to collect the socioesocioeconomics of the students, including socio-socioeconomic heart health h profile, diet profile,e, and lifestyle particulars data (N=380).
To collect information regarding demographic characteristics.
To evaluate sugar, salt, and fat consumption data among coldata college students.

Lacunae in existing knowledge

No recent studyThere is more norm Kanpur Regthe ion.
the Eat Right campaign finding was not done in the Kanpur region

Limitation of study

It can be done generally by highlighting the whole Indian population.
This is a longitudinal study, which has limitations. A further multicentric study is needed to determine the exact quantum of the problem so that obesity can be prevented immediately.

Research question and hypothesis

What is the prevPrevalenceoverweight in college students?
What is the risk factor associated (junk food, inactivity, smoking, what effect
Effthe Eat program in them after 6 months?

Aim: To find ObeObesity “Eating well pr “gram” outcome in pr “fessional college.

Objectives:

1) To study the prevPrevalenceobeObesityoverweight in the college of Kanpur.

2)To study risk factors related to obeObesityoverweight.

3) To measure the outcome of the eating well program among students.

MATERIAL AND METHODS

Study Design: Longitudinal study
Study setting: ITI College, Sarvodaya Nagar, Kanpur
Study population: Students 18 years to 22 years of age
Study Period:2 years from March 2024 to February 2026
Study tool: Predesigned questionnaire
Inclusion: –
1) 18-22 years age group.
2) Students Found at that time of two visit
Exclusion Criteria: –

Students not willing to participate in the study

Sample Size Estimation:

Based on the prevalence rate of morbidity (38%) as per a study done by Gangwar V et al. (2019 Jan) [7], the required sample size has been calculated by using the formula;

[n= z²pq/d²]

Where ‘n’ is the miminimumample size; ‘z’ denotes the level of confidence according to the normal standard distribution that corresponds to the 95% confidence interval (z= 1.96); ‘p’ stands for ‘h’ prevPrevalence’ is the component p (q= 1-p); and ‘d’ pertains totoedesired degree of accuracy or tolerated margin of error/ absolute error.

Based on the prevPrevalencerate of morbidity (38%)

The required sample size is:

As p= 38%, z= 1.96, q= 100-38= 62,

d=absolute error= 5%

n= (1.96) ² x 38 x62/ 2²

n= 362

Taking into consideration non-response of 5%,

Estimated sample size, n= 380. The definition used for study purposeObesity– Obesity can be defined as an excessive amount of fat that increases the risk of medical illness and premature death.

Body Mass Index (BMI)- Methods of estimating body composition include measuring weight and weight for height, body mass index (BMI), and circumference. Of these, perhaps the most convenient is BMI, which can be calculated according to the following formula: BMI = weight (kg)/(height) (m2) Body Mass Index (BMI), a measurement that compares weight and height, defines people as underweight, normal weight, overweight (pre-obese) and obese. The WHO regards a BMI of less Underweight: BMI less than 18.5

WHO Guidelines for Asian

Normal weight: BMI 18.5 to 22.9 Asian

Overweight: BMI 23 to 25

Obesity: BMI >25 or greater.

The measurement of height, a fundamental anthropometric parameter, follows standardized procedures outlined by the World Health Organization (WHO) to ensure consistency and accuracy. The following steps are employed:

1. Equipment: Utilize a calibrated stadiometer, a vertical measurement device with a flat base and a sliding headpiece. Ensure the stadiometer is positioned on a level and flat surface.

2. Preparation: Request the participant to remove shoes and any headgear that might interfere with the measurement. The participant should stand erect with heels together, feet flat on the ground, and the back straight against the stadiometer.

3. Measurement Process: The participant, with the heels, buttocks, and the back of the head, makes firm contact. Lower the headpiece gently until it touches the crown of the head without compressing the hair. Ensure the eyes are in the Frankfurt horizontal plane, maintaining a natural posture without leaning.

4. Reading the Measurement: Record the height measurement to the nearest completed millimeter.

Overweight-Overweight is a body mass index (BMI) of 23 or higher. Obesity is defined as a BMI of 25 or higher.

Waist Circumference >=80 for Female and >=90 cm for Male

METHODOLOGY

Sampling methlongitudinal

A longitudinal study will be done among students of ITI College in Kanpur.
b. Study participants will be using aging elected by simple random technique.
c. Predesigned questionnaire will be used to gather information (General information, anthropometry)

Study tools: –

Demographic characteristics.Obesity-related characteristics.
Behavior related characteristics

Outcome Measures

To find out prevPrevalenceobeObesityo identify the cause of obeObesityd overweight in college students.
To educate the Eat WellWell Eat Well program.
To encourage overweight students to improve their eating habits, the lifestyle program measures changes in weight after six months of the program.

Statistical Methods

Descriptive statistics will be generated to determine the distribution

of socio-demographic variables.

Frequencies and percentages will be shown for categorical

variables.

Mean and SD values will be used for quantitative parameters

Appropriate statistical tests will be used for data analysis.

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