Improvement in nutrition-related knowledge and behaviour of urban Asian Indian school children: findings from the ‘Medical education for children/Adolescents for Realistic prevention of obesity and diabetes and for healthy aGeing’ (MARG) intervention study

Abstract

Increasing prevalence of childhood obesity calls for comprehensive and cost-effective educative measures in developing countries such as India. School-based educative programmes greatly influence children's behaviour towards healthy living. We aimed to evaluate the impact of a schoolbased health and nutritional education programme on knowledge and behaviour of urban Asian Indian school children. Benchmark assessment of parents and teachers was also done. We educated 40 196 children (aged 8 -18 years), 25 000 parents and 1500 teachers about health, nutrition, physical activity, non-communicable diseases and healthy cooking practices in three cities of North India. A pre-tested questionnaire was used to assess randomly selected 3128 children, 2241 parents and 841 teachers before intervention and 2329 children after intervention. Low baseline knowledge and behaviour scores were reported in 75 -94 % government and 48-78 % private school children, across all age groups. A small proportion of government school children gave correct answers about protein (14-17 %), carbohydrates (25 -27 %) and saturated fats (18-32 %). Private school children, parents and teachers performed significantly better than government school subjects (P,0·05). Following the intervention, scores improved in all children irrespective of the type of school (P, 0·001). A significantly higher improvement was observed in younger children (aged 8-11 years) as compared with those aged 12-18 years, in females compared with males and in government schools compared with private schools (P,0·05 for all). Major gaps exist in health and nutrition-related knowledge and behaviour of urban Asian Indian children, parents and teachers. This successful and comprehensive educative intervention could be incorporated in future school-based health and nutritional education programmes.

The High Burden of Obesity and Abdominal Obesity in Urban Indian Schoolchildren: A Multicentric Study of 38,296 Children

“…Data were collected as part of a school- and community-based intervention survey, the Medical Education for Children/Adolescents for the Realistic Prevention of Obesity and Diabetes and for Healthy Ageing (MARG, which is Hindi for ‘path’) involving schoolchildren aged 8–18 years [15]. This was a multicentric study conducted from August 2006 to December 2008, in schools located across 5 Indian cities: New Delhi, Jaipur, Agra (north), Allahabad (central) and Mumbai (west).…”

“…Private schools were run by private management and catered mainly to children of upper-middle and high SES. This sampling design ensured proportional representation of all SES, details of which have been previously described [15]. …”

Impact of actions of food and nutrition education program in a population of adolescents

“…The researchers reported a significant impact on students' food knowledge and eating behavior, emphasizing lower intake of high-sodium and high-sugar foods 23,24 .…”

Rising Incidence of Overweight and Obesity among Children and Adolescents in India

“…Significant improvement in the nutrition related knowledge was observed among the experimental group after the education intervention (in two forms via traditional media and via audio-visual CD's) as compared to the baseline data. In a school based program conducted by Shah et al [35] children and adolescents (8-18 years) were educated about health, nutrition, physical activity, non-communicable diseases and healthy cooking practices in three cities of North India. Baseline data revealed low nutrition knowledge scores in government (75-94%) and private (48-78%) schools.…”