Primary prevention in Indian schools

Producing posters about healthy lifestyles is part of the project, and will hopefully change the way schoolchildren eat and exercise in India. “MARG”( Hindi for Path) programme, aiming to create awareness about diabetes, obesity, lipid disorders and heart disease in children and adolescents is enjoying overwhelming success and support in North India. The programme aims to teach school children aged 9-18 years optimal dietary and lifestyle practices for prevention of lifestyle diseases, which will enable them to disseminate messages regarding healthy living to peers and family. In the programme, more than 50,000 school children of three major cities in North India; Delhi, Jaipur, and Agra, will be educated over a period of three years. Surveys conducted at the beginning and end of the project, recording the children’s level of knowledge about healthy lifestyle as well as physical data, will provide evidence of the impact. An increasingly obese generation Research studies conducted by Prof. Anoop Misra, has shown that every second adult in Delhi fulfils the criteria of obesity. Prof. Anoop Misra former professor of Medicine at the premier, All India Institute of Medical Sciences is now Director at the Department of Diabetes and Metabolic Diseases, at Fortis Hospitals, Delhi and NOIDA (UP) and member of the WHO Expert Committee and ICMR Task Force on Childhood Obesity. Further research by his team showed that 16%-18% of children were overweight or obese in 2004, but it has strikingly increased to 29% in 2007. Obesity causes Syndrome X, which is present in 26% schoolchildren, and is a precursor of youth-onset diabetes. Nearly 50-70% of the obese children will become obese adults, and would suffer from not only diabetes, but also stroke, liver disease, infertility, hypertension, arthritis, and cancers. The project is initiated by the Diabetes Foundation, India, and is supported financially by World Diabetes Foundation. The activities began in Delhi in January 2007 and have been effectively running for three months in ten designated schools in Delhi. Ten schools in Agra and ten in Jaipur will also run similar activities. A total of 30 schools were originally meant to be included in the awareness programme, but an unexpectedly high interest for this healthy lifestyle education program means that additional fifty schools in Delhi are eager to roll out the intervention. The programme seems to be a success even before the pilot period of three years has ended. Prof. Misra says “In developing countries like India, such primary prevention measures for obesity and diabetes are the most cost-effective strategy to curb the epidemic of diabetes. We have started well, established a nucleus, and would provide a module based on our experiences which can be used by others all over India. Finally, it is our firm resolve and hope that this movement should cover not only all regions of India but the whole of South Asia.”   Young and eager cooking competition participants in one of the Delhi schools involved in the MARG project. Involving the children Innovative and locally appropriate education strategies are used for the intervention, such as school plays, debates and poster and cooking competitions. The schools, teachers and student educators work with the project on a voluntary basis, all showing a great interest in participating. In all three cities, 120 students and 60 physical education teachers are being trained as volunteers to help in dissemination of the nutrition and health messages and nearly 10,000 parents will also be educated in health issues. WDF Programme coordinator, Mr Ulrik Uldall Nielsen visited the project activities in July 2007. He was very pleased to see how the program activities are conducted, in an interactive manner, by integrating education in sports classes or in other extra curricular student activities. He became actively involved as a jury in the the cooking competition in one of the participating schools in New Delhi, the St. Paul’s School, Safdarjung Development Area. In another school, Kendriya Vidyalaya, RK Puram Sector 8, Shift II, ten year old children presented healthy home cooked meals, drinks and desserts; ”the children showed true enthusiasm, illustrating that they had in fact understood the key messages about a healthy diet”. “During the cooking competition, a boy explained to me how to cook a special fruit curd dessert in every detail, even underlining the importance of turning off the stove when the cooking was done.“ says Ulrik with a smile as he reminisces his trip. “The exercise certainly has made this boy show interest in the food preparation at home, in the future he will hopefully engage in more conversations with his family about healthy foods”,. The knowledge the children receive at school will be disseminated by them to their parents, family and friends, hopefully creating a movement for healthy living and slowing down the development of obesity in the Indian society, which is the long term goal of the project. Primary prevention, which means preventing a disease to develop in the population, is one of the focus areas of the World Diabetes Foundation. The MARG programme is the first project which focuses 100% on primary prevention of not only diabetes but on NCDs in general. Other projects are underway in South Africa and the Caribbean, and several other WDF supported projects have primary prevention as part of their activities.

MARG: “Medical education for children/Adolescents for Realistic prevention of obesity and diabetes and for healthy aGeing”. MARG means “the path” in Hindi.