Effects of controlled school-based multi-component model of nutrition and lifestyle interventions on behavior modification, anthropometry and metabolic risk profile of urban Asian Indian adolescents in North India

• Published in: European journal of clinical nutrition Vol. 64; no. 4; pp. 364 - 373
• Main Authors: Singhal, N, Misra, A, Shah, P, Gulati, S
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.04.2010; Nature Publishing Group
• Subjects: 692/699/1702/393; 692/699/2743/137; 692/700/459/284; 692/700/478/174; Adolescent; Adolescent Behavior; adolescent nutrition; Adolescent Nutritional Physiological Phenomena; Adolescents; Aeration; anthropometric measurements; Anthropometry; Asian Continental Ancestry Group; Asian Indians; Asian People; attitudes and opinions; Behavior modification; Beverages; Bioelectricity; Biological and medical sciences; Blood; blood glucose; Blood Glucose - metabolism; Body Composition; Body fat; Body image; Body measurements; Body Weights and Measures; boys; Children; Clinical Nutrition; Complications and side effects; Confidence intervals; Diabetes; Diabetes mellitus; Diabetes. Impaired glucose tolerance; Diameters; Diet; Disease prevention; Eating behavior; eating habits; Education; Electrodes; Elementary school students; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Energy Intake; Epidemiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Females; Food; Food and nutrition; food intake; foods; Fruits; Fundamental and applied biological sciences. Psychology; gender differences; girls; Health aspects; Health Behavior; Health Education; Health Knowledge, Attitudes, Practice; Humans; Impedance; Impedance method; India; India - epidemiology; Insulin resistance; Internal Medicine; Intervention; Life Style; lifestyle; Lifestyles; Lipids; Lipids - blood; Male; Males; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolism; Methods; Nutrition; Nutrition education; nutrition knowledge; Nutrition research; nutritional intervention; nutritional status; Obesity; Obesity in children; Obesity, Abdominal; Obesity, Abdominal - blood; Obesity, Abdominal - epidemiology; Obesity, Abdominal - therapy; original-article; Prevention; Public Health; Risk assessment; Risk Factors; Schools; Socioeconomics; Students; Surveys and Questionnaires; Teenagers; therapy; Urban Health; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Asia; India; adolescents; diabetes; Asian Indians; obesity; prevention; Endocrinopathy; Anthropometry; Risk; Urban area; Prevention; School; Behavior; Nutritional status; Human; Obesity; Urban environment; Nutrition; Diabetes mellitus; Nutrition disorder; Metabolic diseases; School environment; Feeding; Adolescent; Risk factor; Indian; Models; Life style
• ISSN: 0954-3007; 1476-5640; 1476-5640
• DOI: 10.1038/ejcn.2009.150

Background/Objectives: To study the effectiveness of a multi-component intervention model of nutrition and lifestyle education on behavior modification, anthropometry and metabolic risk profile of urban Asian-Indian adolescents in North India. Subjects/Methods: Two schools matched for student strength and middle socioeconomic strata were randomly allocated to intervention and control group. Changes in nutrition-related knowledge, attitude, lifestyle practices, food frequency and body image of eleventh-grade students (15–17 years) in both schools were tested using a validated questionnaire. Anthropometric and biochemical measurements were made using standard methods. Segmental body composition analysis was carried out using an 8-electrode multifrequency bioelectrical impedance method of body fat estimation. Results: At 6 months follow-up, significant improvement in several domains of knowledge was observed in intervention children ( n =99; males=60; females=39) as compared with control school children ( n =102; males=61; females=41). In the intervention group, significantly lower proportion of children consumed aerated drinks (15.1%; P <0.001) and energy-dense unhealthy foods (8.9%; P =0.03), whereas significantly higher proportion brought tiffin (packed lunch) to school (14.9%; P =0.004) and brought a fruit in their tiffin (30.7%; P <0.001) as compared with the control group. Significant decrease in mean waist circumference ( P =0.02, 95% confidence interval (CI)=−2.43,−0.17), sagittal abdominal diameter ( P <0.001, 95% CI=−0.82,−0.09), waist-to-hip ratio ( P =0.02, 95% CI=−0.03,−0.004) and fasting blood glucose ( P =0.05, 95% CI=−0.09, 5.00) was seen in intervention as compared with control school children. Conclusions: Multi-component model of nutrition and lifestyle education was successful in improving the nutrition-related knowledge, eating habits and lifestyle practices, and resulted in beneficial changes in anthropometric and biochemical profiles of the Asian Indian adolescents. This model should be applied on countrywide basis to prevent obesity and diabetes.