THE RISK FACTORS IN DEVELOPING

METABOLIC SYNDROME AMONG

BOYS AND GIRLS AGED 18-24YEARS IN

MUMBAI CITYBy- JULIET D’SOUZA

M.sc. CND-PART II

Guide: MRS. ANURADHA

SHEKAR

INTRODUCTION

Metabolic syndrome is highly age dependent. Young adults are at increased risk of developing it due :• family history• irregular eating habits• childhood obesity• lifestyle habits like excessive smoking, drinking, sedentary lifestyle• less of physical activity. Young adults are building block of the country’s economy as well as health. As the present generation is showing signs of developing metabolic syndrome it

would be interesting to find out the factors leading to it.

OBJECTIVES To identify the risk factors in developing metabolic syndrome. To determine the prevalence of obesity and overweight in developing metabolic

syndrome among the young adults in Mumbai city. To assess the nutritional status using anthropometric measurements. To establish the neck circumference measurements as markers of obesity. To evaluate the eating habits as a major factor for developing metabolic

syndrome using a food frequency questionnaire. To evaluate the nutritional status and eating patterns of youths of Mumbai city

using a 3 day dietary recall. To evaluate physical activity level and lifestyle pattern and medical history in

developing metabolic syndrome. To correlate the eating habits of youth’s to their parents eating habits

METHODOLOGYSample size: 200

Samples taken from different areas of MUMBAI CITY(Byculla, Dadar, Andheri, Vasai ,Thane, Dombivli and Ulhasnagar)

AGE, HEIGHT, WEIGHT, BMI, IBW, WAIST CIRCUMFERENCE, NECK CIRCUMFERENCE and BLOOD PRESSURE

(Will be measured of all the participants) 

QUESTIONNAIRE (Questions regarding the physical activity and lifestyle pattern as well as dietary practices)

 

A 1 DAY DIETARY RECALL AND FOOD FREQUENCY table (To know the food patterns and choices of food eaten)

RESULTS WERE TALLYED USING STATISTICAL TECHNIQUE

RESULTS AND DISCUSSIONS BACKGROUND INFORMATION AGE-:18-24years both boys and girls. RELIGION: major samples belong to catholic community followed by

Maharashtrians, Muslims, Guajarati's, South Indians and Jains. AREAS OF SAMPLING: major samples were from Thane followed by

Andheri, Ulhasnagar, Dadar, Dombivli, byculla etc. TYPE OF FAMILY: most of the participants belonged to nuclear families as

compared to joint families. OCCUPATIONAL STATUS: major samples in the study were students

followed by employed. Very few samples were unemployed and students + employed.

MONTHLY INCOME: majority of the samples belonged to middle class group of the society.

FAMILY HISTORY: obesity is related to family history at P=0.00, followed by diabetes and hypertension.

FOOD CHOICES: most of the obese samples were found to eating non-vegetarian food as compared to vegetarian .

CONTD……..

ANTHROPOMETRIC MEASUREMENTS. OVERALL ANTHROPOMETRIC MEASUREMENTS: the mean age of

boys and girls was 21years. the mean weight for boys was found to be 75kg and for girls 63kg. The mean height for boys was found to be 171cm and for girls 159cm. The mean ideal body weight for boys was found to be 71kg and for girls 54 kg. The mean waist circumference for boys and girls was found to be 87cm. The mean neck circumference for boys was found to be 37cm and girls 33.8cm The difference in the anthropometric measurements between boys and girls was

found to be significant at P=<0.05 The overall neck circumference to predict obesity was found to be 34.5cm at

0.900sensitivity and 0.167specificity.

CONTD…….. Yang l. in his study to correlate the neck circumference with visceral adiposity

and insulin resistance . Value of 37cm and more strongly correlate to them. Yang GR et al in their study found out neck circumference value: >35cm for

boys and 33cm for girls.

Yang l. Clin Endocrinol (Oxf) 2010; 73:197–200.Yang GR et al. Diabetes Care. 2010 Nov;33(11):2465-7.doi:10.2337/dc100798.

Epub 2010 Aug 19.

CONTD…….. BODY MAS INDEX

BMI in kg/m2 Classification

<16 Severely underweight

16-16.9 Moderately underweight

17-18.4 Underweight

18-22.9 Normal/ healthy

23-24.9 Overweight

25-30 Obese

30-34.9 Obese grade I

40> Obese grade II

normal overweight obese obese grade Iobese grade IIunderweight

CONTD…….. The guidelines were released jointly by the Health Ministry, the Diabetes

Foundation of India, the All-India Institute of Medical Science (Aiims), Indian Council of Medical Research, the National Institute of Nutrition and 20 other health organizations.A person with a body mass index of 23 kg/m2 will now be considered overweight and below that as one with normal BMI—unlike the cut-off limit of 25 kg/m2 earlier. 

Those with BMI of 25 kg/m2 will be clinically termed obese (as opposed to 30 kg/m2 at the international level) and those with BMI of 32.5 kg/m2 will require bariatric surgery to eliminate excess flab.  According to guidelines, cut-offs for waist circumstances will now be 90 cm for Indian men (as opposed to 102 cm globally) and 80 cm for Indian women (as opposed to 88 cm at the international level).

India reworks obesity guidelines, BMI lowered: The Health Ministry has reduced the diagnostic cut-offs for body mass index (BMI) to 23 kg/m2 and the standard waist circumference to deal obesity. Submitted on Wed, 11/26/2008 - 18:10.

CONTD…….. DIETARY HABBITS1. DAIRY PRODUCTS: CHEESE, PANEER AND CURD.

daily

1/wee

k

1/15d

ays

1/mon

thrar

elynev

er0

1020304050607080

not obeseobese

daily 1/week 1/15days1/month rarely never0

102030405060

not obeseobese

daily

1/week

1/15d

ays

1/mon

thrar

elynev

er

010203040506070

not obese

not obeseobese

CONTD……..2. VEGETABLES AND FRUITS

daily

1/wee

k

1/15d

ays

1/mon

thrar

elynev

er0

102030405060708090

100

not obese

not obeseobese

daily

1/wee

k

1/15d

ays

1/mon

thrar

ely

0102030405060708090

not obeseobese

not obeseobese

CONTD……..3. FAST FOODS: SAMOSA, VADA, WAFERS, POPCORN, PIZZA

daily

1/wee

k

1/15d

ays

1/mon

thrar

elynev

er

05

1015202530354045

not obese

not obeseobese

daily

1/wee

k

1/15d

ays

1/mon

thrar

elynev

er0

10

20

30

40

50

60

70

80

obesenot obese

daily 1/week 1/15days1/month rarely never0%

10%20%30%40%50%60%70%80%90%

100%

obesenot obese

daily 1/week 1/15days 1/month rarely never0%

10%20%30%40%50%60%70%80%90%

100%

obesenot obese

daily 1/week 1/15days 1/month rarely never0%

10%20%30%40%50%60%70%80%90%

100%

obesenot obese

CONTD……..4. COFFEE AND MEAT AND MEAT PRODUCTS

daily 1/week 1/15days 1/month rarely never0%

10%20%30%40%50%60%70%80%90%

100%

obesenot obese

daily 1/week 1/15days 1/month never05

10152025303540

not obeseobese

not obeseobese

CONTD…….. PHYSICAL ACTIVITY

none walking sit ups crunches0

10

20

30

40

50

60

70

80

femalesmales

treadm

ill

cyclin

g

push u

ps

pull u

ps

dumbel

lsyog

a

aerobi

csnon

e0

102030405060708090

malesfemales

CONTD…….. LIFESTYLE HABBITS: SMOKING AND DRINKING

female male 0

10

20

30

40

50

60

70

80

90

yes

no

yes no0

10

20

30

40

50

60

70

80

malesfemales

CONTD…….. AGE OF ATTAING PUBERTY AND SYMPTOMS EXPERIENCED BY

GIRLS

age

01020304050

1012131415161718

menstrual symptoms

nonepainabdominal bloatingcrampswhole body painheadache

CONTD…….. CORRELATIONS OF BMI AMD MENSES

FACIAL HAIR, ACNE AND WHITE DISCHARGE FOR PCOD IN GIRLS

norm

al

overw

eight

obese

M. obe

se

H. obe

se

unde

rweig

ht0

20

40

irregularregular

facial hairacne

020406080

100

yes

no

yesno

normal excess less0

102030405060708090

SUMMARY AND CONCLUSION A significant difference was found in the anthropometric measurements of

boys and girls. boys had higher values as compared to girls. The difference was significant at P=0.05.

Obesity was found to be more prevalent in medical history followed by diabetes and hypertension at P=0.00.

More non-vegetarians were found to be obese as compared to vegetarians at P=0.046.

Dietary patterns were also related to increase the risk of obesity. More of obese boys and girls were found to more involved in playing game

as compared to non-obese boys and girls at P=0.05. More of boys were seen to be involved in lifestyle patterns like smoking and

drinking alcohol as compared to girls. Significant factors were found which may lead to development of metabolic

syndrome among boys and girls aged 18-24years in Mumbai city.

RECOMMENDATIONS The study can be done in different cities to find out the at risk groups. A wider range of age groups can be selected. The study can be done varied populations like adolescents, old age, specific sex

and specific religion and region. Various dietary tool like food dairy, 3 day dietary recall, weighment method and

be used to calculate the dietary intake more specifically. Detailed anthropometric assessment including body composition can be done. Nutrition education program can be conducted to educate samples on them on

effect of nutrition and pre and post data can be collected. Sessions can be conducted on physical activity and various beneficial exercises

can be demonstrated that can be done for better and healthy lifestyle.