ESPE Abstracts (2018) 89 P-P3-165

Hidden Hunger in Overweight/obese Indian Adolescents

Vandana Jain, Babita Upadhyaya & Anuja Agarwala

All India Institute of Medical Sciences, New Delhi, India

Background and Objective: Overweight/obese children may have unrecognized deficiency of several essential micronutrients owing to their faulty dietary habits. These may impair their physical and mental development. Deficiency of specific minerals and vitamins that co-factors in metabolic and signalling pathways, such as choline, zinc, magnesium, vitamins D and B12 may also predispose to insulin resistance, fatty liver and metabolic syndrome. This study was undertaken to assess the macro- and micronutrient intakes of overweight/obese Indian adolescents.

Methods: This was a cross-sectional hospital based study. Dietary assessment was done using 24 hours recall and quantitative food frequency questionnaires in 214 overweight/ obese adolescents aged 10 to 16 years. Daily intakes of fat, protein, carbohydrates, fibre, iron, calcium, magnesium, zinc, choline, folic acid, vitamin B12 and vitamin C were calculated and compared to the age and gender-specific recommended dietary allowances (RDA) for Indian adolescents. Intake <90% of RDA was considered low and >110% as high. Serum 25 hydroxyvitamin D was measured in a subset (n=66) by electrochemiluminiscence, <20 ng/ml was considered as deficiency.

Results: The daily intake of energy, fat and proteins exceeded the RDA but that of fibre and several micronutrients was low. Intake of choline, vitamin B12, zinc, iron and calcium was low in 76.6, 72.9, 60.8, 59.8, and 31.8%, of the adolescents, respectively. Biochemical vitamin D deficiency was present in 74.3%.

Table 1
Dietary ComponentDaily intake Mean ± SDIntake in comparison to recommended daily allowance
High N (%) As per RDA N (%) Low N (%)
Energy (Kcal)2922.3±837.5148 (69.2)46 (21.5)20 (9.3)
Protein (g)82.5±25.1200 (93.5)10 (4.6)4 (1.9)
Fat (g)88.6±32.0209 (97.7)2 (0.9)3 (1.4)
Fibre (g)8.6±3.801 (0.5)213 (99.5)
Iron (mg)22.7±8.947 (22.0)39 (18.2)128 (59.8)
Calcium (mg)973.3±493.4109 (51.0)37 (17.2)68 (31.8)
Magnesium (mg)591.6±235.3213 (99.5)1 (0.5)0
Zinc (mg)9.0±3.753 (24.7)31 (14.5)130 (60.8)
Choline (mg)262.8±223.335 (16.4)15 (7.0)164 (76.6)
Folic Acid (μg)288.8±119.3192 (89.8)11 (5.1)11 (5.1)
Vitamin B12 (μg)0.82±1.039 (18.2)19 (8.9)156 (72.9)
Vitamin C (mg)91.3±67.3175 (81.8)19 (8.9)20 (9.3)

Conclusion: Hidden hunger is common in obese adolescents. This should be identified and rectified by appropriate nutritional advice.

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