Risk Factors and Complications of Childhood Obesity and Overweight in an Urban Setting of a Lower Middle-Income Country

Abstract

In contrast to several high-income nations, childhood obesity prevalence is rising in low/middle-income countries. Our objective was to study risk factors and complications of childhood overweight/obesity in an urban lower middle-income country setting. This was an observational study. Children aged 2-18 years at a pediatric clinic in Chennai, India were enrolled over a 12-month period. The definition of overweight was >23rd and obesity >27th adult equivalent percentile Body Mass Index. Parents and children completed a risk-factor questionnaire. Children with obesity/overweight were evaluated for complications. Of 103 children enrolled, 61% were obese/overweight and 39% healthy weight. Independent predictors of absence of overweight/obesity were as follows: never/rarely consuming sugar-sweetened beverages, never/rarely eating out, and sleep duration > 11 h. Exercise performed rarely/never independently predicted overweight/obesity. No significant difference was observed with screen time or a vegetarian diet. Complications in 54 obese/overweight children included prediabetes (15%), hypertension (11%), dyslipidemia (22%), nonalcoholic fatty liver disease (22%), acanthosis nigricans (24%), and anxiety/depression (17%). In conclusion, differences were observed in behaviors associated with childhood obesity in an urban lower middle-income environment compared to those in high-income nations. Behaviors associated with childhood obesity in an urban lower middle-income environment are similar to those reported from high-income nations, with some differences. Complications of overweight/obesity are common in this setting.

Keywords: cardiovascular risk factors; childhood obesity; childhood overweight; developing nations; risk factors.

Figure 1

Complications of childhood obesity present among 54 children with obesity/overweight (24 male, 30 female) who underwent systematic evaluation. NAFLD = nonalcoholic fatty liver disease. PCOS = polycystic ovarian syndrome. OSA = obstructive sleep apnea.