Nutritional and blood pressure screening in school children in rural South India: a cross-sectional study

Dhanya Roy, Sundar Singh, Lenikumar Joseph


Background: Screening for diseases is not very popular in Indian populace in general, and receive little attention from heath care policy makers, administrators or even health care providers, who concentrate on curative services. Health and nutritional screening of school children and adolescents, remains virtually a neglected field. So we conceived this study to look at the feasibility of large scale health screening of adolescents at school by a simple and inexpensive way by looking into the nutritional status (survey of anthropometry) and blood pressure readings among adolescents.

Methods: Students from 5 rural school in South India from age group of 10 to 18 years (fifth to twelfth standard) were assessed for their height, weight, BMI and blood pressure. Data was entered in WHO EpidataTM (version 3.0) and transferred to SPSS 12.0 version for analytical studies.

Results: In current study of 2201 students, wasting (35.5%), stunting (24.5%), high BMI (7.6%) were found. Prevalence of wasting is 1.63 times higher in males (p<0.001). There is significant relationship with high BMI and severe stunting (p<0.001, OR 2.54; 1.58%, 4.1%; 95% CI). Prevalence of pre-hypertension is 14.1% and hypertension is 9.5%. There is a linear trend in the prevalence of hypertension and BMI (p<0.001). As the BMI increases, blood pressure also increases.

Conclusions: Even with all advances in health care, undernutrition is highly prevalent. Obesity is on a rise in rural population and high proportions of overweight children are stunted also. High BMI is a risk factor for hypertension.


Anthropometry, Blood pressure, Obesity, Stunting, BMI

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Biswas T. India launches programme for child-health screening. Lancet. 2013;381(9869):e8.

Adolescent health. Available at: https://www.nhp. Accessed on 20 March 2021.

Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904.

Patil AD, Shejul S, Bhandarkar P, Kattimani A, Mudassir A, Bantwal K. A study of adolescent obesity and hypertension in urban school in Mumbai. Int J Commu Med Public Health. 2018;5(2):790-4.

UNICEF India: the children-Nutrition. Available at: Accessed on 20 March 2021.

India national family health survey (NFHS-3) 2005-06. Available at: publications/publication-frind3-dhs-final-reports.cfm. Accessed on 20 March 2021.

Mukhopadhyay A, Bhadra M, Bose K. Anthropometric assessment of nutritional status of adolescents of Kolkata, West Bengal. J Hum Ecol. 2005;18(3):213-6.

De Onis M, Dasgupta P, Saha S, Sengupta D, Blössner M. The National center for health statistics reference and the growth of Indian adolescent boys. Am J Clin Nutr. 2001;74(2):248-53.

Ahmad QI, Ahmad CB, Ahmad SM. Childhood obesity. Indian J Endocrinol Metab. 2010;14(1):19-25.

Venkaiah K, Damayanti K, Nayak MU, Vijayaraghavan K. Diet and nutritional status of rural adolescents in India. Eur J Clin Nutr. 2002;56(11): 1119-25.

Haboubi GJ, Shaikh RB. A comparison of the nutritional status of adolescents from selected schools of South India and UAE : A cross-sectional study. Indian J Commu Med. 2009;34(2):108-111.

Nitish M, Sen J. Prevalence of stunting and thinness among rural adolescents of Darjeeling district, West Bengal, India. Ital J Public Health. 2010;7:54-61.

Bhargava M, Bhargava A, Ghate SD, Rao RSP. Nutritional status of Indian adolescents (15-19 years) from National family health surveys 3 and 4: revised estimates using WHO 2007 Growth reference. PLoS One. 2020;15(6):e0234570.

Bose K, Bisai S. Prevalence of undernutrition among rural adolescents of West Bengal, India. J Trop Pediatr. 2008;54(6):422-3.

Hoffman DJ, Sawaya AL, Verreschi I, Tucker KL, Roberts SB. Why are nutritionally stunted children at increased risk of obesity? Studies of metabolic rate and fat oxidation in shantytown children from São Paulo, Brazil. Am J Clin Nutr. 2000;72(3):702-7.

Raj M, Sundaram KR, Paul M, Deepa AS, Kumar RK. Obesity in Indian children: time trends and relationship with hypertension. Natl Med J India. 2007;20(6):288-93.

Monyeki KD, Kemper HCG, Makgae PJ. Relationship between fat patterns, physical fitness and blood pressure of rural South African children: Ellisras longitudinal growth and health study. J Hum Hypertens. 2008;22(5):311-9.

Anand NK, Tandon L. Prevalence of hypertension in schoolgoing children. Indian Pediatr. 1996;33(5):377-81.

Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904.