Overnutrition among schoolchildren in India: a review and meta-analysis

Background: Obesity continues to be a significant public health concern in India. As half of overweight adults were also overweight during their childhood, estimates of the burden of overweight or obesity among Indian schoolchildren would help to forecast the obesity epidemic among adults. In this context, we did a review and meta-analysis of studies published during past 10 years. Methods: Studies done during 2005–15 that used WHO cut-off points to assess overnutrition (overweight and obesity) among Indian children aged 6–19 years from rural or urban schools were included. Studies that used other diagnostic criteria, focused on specific subgroups such as males, or were done in affluent schools were excluded. Considering the heterogeneity of the studies, random effects and inverse variance heterogeneity models were used for estimating pooled prevalence using MetaXL (version 2.2) software. Findings: 21 studies involving both boys and girls, covering 81 716 schoolchildren and 11 Indian states, were included. The prevalence of overnutrition in the individual studies ranged between 1·5% and 32·2%. The pooled prevalence estimates of overnutrition in the random effects and inverse variance heterogeneity models were 11·15% (95% CI 8·98–13·51) and 10·56% (5·09–16·74), respectively. In subgroup analysis, boys and urban students had a higher burden of overnutrition than their counterparts. However, the difference in overnutrition prevalence across gender groups was lower than the urban–rural difference. Most of the studies included were of moderate quality and there was heterogeneity among studies. Interpretation: One in nine schoolchildren suffering from overnutrition is a concern as India suffers a dual burden of undernutrition and overnutrition, representing the inequitable distribution of health. Interventions to reduce overnutrition burden and monitoring of overnutrition with the use of a country-specific standard tool is warranted. Funding: None