Prevalence of risk factors for obesity, diabetes mellitus and hypertension in high school children and screening of high-risk children for glycosuria: A cross-sectional study in Dharwad District, India [version 1; peer review: 2 approved with reservations]

Background: India is currently undergoing a demographic and epidemiological transition leading to the occurrence of hypertension and type 2 diabetes, which were once considered as disease of the elderly among the adolescents. Methods: A cross-sectional study was conducted in Dharwad district, Karnataka, including 1600 students between 11-17 years age group, across both private and government schools located in both rural and urban areas; information on socio-demographic variables, physical activity, dietary habits, substance abuse, and family history of hypertension, diabetes mellitus and level of stress among participants was collected. Anthropometric measurements were taken, blood pressure was measured, general physical examination was done to look for signs of insulin resistance. Urine was examined for the presence of glucose using urine glucose strips in overweight children with ≥2 risk factors (American Diabetes Association criteria for children). Results: Prevalence of overweight/obesity was 4.6% and hypertension was 14.8%. Multivariate logistic regression done for variables found significant in univariate analysis on comparison of risk factors between overweight and normal children showed higher odds for family h/o diabetes (OR = 1.14, CI: 0.58-2.23), private school (OR = 1.5, CI: 0.75-2.96), high socio-economic status (OR = 2.0, CI: 0.95-4.30), hypertension (OR = 2.0, CI: 0.95-4.30) and acanthosis nigricans (OR = 219, CI: 71.49-672.42) among overweight and for variables found significant in univariate analysis on comparison of risk factors between hypertensives and normotensives showed higher odds for inadequate sleep (OR = 1.4, CI: 1.00-1.87), private school (OR = 1.32, CI: 0.96-1.81), high SES (OR = 1.43, CI: 0.95-2.14), psychological stress (OR = 1.97, CI: 1.42-2.73) and obesity (OR = 6.98, CI: 3.75-12.98). Conclusions: Health education on healthy diet consumption and physical activity, BMI calculation and tracking of blood pressure should be integrated into school health programs.