Nutrition Education and Meal Replacement : A Combined Intervention Strategy among Obese Adolescent Girls with Metabolic Syndrome

Abstract

IntroductionMetabolic Syndrome has become one of the most world‐renowned severe health problems of the 21st century. India alone has 105 million adolescent girls and among them the overall prevalence of metabolic syndrome is 4.2% in 16–18 year olds. Metabolic syndrome is caused by an unhealthy lifestyle that includes eating too many calories, being inactive and gaining weight, which leads to diabetes and heart diseases. Diets of adolescents are low in fruits, vegetables, dairy products, whole grains, and high in total fats, saturated fats and added sugars.HypothesisWe hypothesize that by providing interventional strategies and increasing awareness among adolescent girls, we might promote healthy lifestyle and thereby control the obesity epidemic and its metabolic consequences.MethodsA total of 2766 adolescent girls (18–21 years old) were screened for obesity. Information on their socio‐economic background including social status, age, occupation of the head of the family, birth order and hereditary disease with a specially designed interview schedule and details on food intake were collected by a 24‐hour recall method. Three intervention strategies namely nutrition education, a physical activity package and meal replacement with Kodomillet (Paspalum scrobiculatum) recipes were developed and implemented. Sixty obese adolescent girls were divided into four groups of 15 each. They are nutrition education and physical activity(Group I), nutrition education and meal replacement (Group II), nutrition education (Group III) and the normal control(Group IV). The selected obese adolescent girls were evaluated after a period of four months by recording the changes in weight, BMI, WHR and body fat percentage and their nutritional knowledge.ResultsThe prevalence of obesity among 18, 19, 20 and 21 years old was found to be 18%, 22%, 38% and 21.7% respectively. Ninety seven per cent of the obese adolescents had higher degree of waist circumference. Among the study population, an elevated systolic blood pressure (12%) and diastolic blood pressure (11%), and an elevated glucose concentration (40%) confirmed the presence of metabolic syndrome. The mean weight of obese adolescent girls in experimental group II was reduced from 62.8kg to 60.8kg and their body fat reduced from 36.3% to 34.5% after intervention. The waist‐to‐hip ratio also significantly reduced in experimental group II in comparison with the other groups. Although the mean High Sensitivity C – Reactive Protein (HsCRP) level of experimental group II which was 2.5 reduced to 2.2 after intervention, it still remained higher than the normal range. Overall, a significant (1%level) increase in nutritional knowledge among all the experimental groups was observed after intervention.ConclusionTaken together, for the first time, these findings revealed that a combined nutrition education and meal replacement interventional strategy provides beneficial effects by increasing awareness and promoting a healthy lifestyle among adolescent girls thereby controlling the obesity epidemic and its metabolic consequences.Support or Funding InformationScience and Engineering Research Board, Dept of Science and Technology, Govt of India