The Silent Epidemic : Non Communicable Diseases in Students

Background: Non-communicable diseases (NCDs) are increasingly being identified in adolescents and young adults globally, driven by lifestyle transitions, unhealthy dietary patterns, physical inactivity, psychosocial stress, and sleep disruption. Early adulthood represents a critical window for the identification of cardiometabolic risk factors, allowing for timely preventive interventions before progression to established disease.

Methods: A large, multi-year cross-sectional screening program was conducted among college students, with complete data available for 101,087 of 178,834 students screened (55.7%). Assessments included anthropometric measurements, blood pressure, random blood sugar, waist circumference, hemoglobin levels, and HbA1c estimation. A focused analysis was conducted in a subgroup of more than 10,000 high-risk students. Non-fasting lipid profiles were obtained in a subset of participants. Lifestyle behaviours, dietary patterns, physical activity, and mental health indicators were assessed using structured questionnaires.

Results: Overall, only 38.6% of students had a normal body mass index, while 43% were overweight or obese, including 19.7% with class I obesity, 9.6% with class II obesity, and 0.6% with morbid obesity. An additional 18.4% were underweight, reflecting a dual burden of malnutrition.
In the high-risk subgroup (n≈10,000), the prevalence of cardiometabolic abnormalities was substantial: 40% were overweight or obese; 30% had increased waist circumference; and 30% had low haemoglobin levels consistent with anaemia. One in eight students was diabetic or at high risk for diabetes, one in six had abnormal lipid profiles, and one in fifty met criteria for stage II hypertension (>130/85 mmHg). Elevated triglycerides were common and were frequently associated with high LDL, low HDL, elevated VLDL, and abnormal cholesterol-to-HDL ratios.
Sex-specific differences were observed: females had a higher prevalence of central obesity, anaemia, and elevated HbA1c, whereas males had higher rates of elevated blood pressure; both sexes showed similarly high risks of obesity and dyslipidemia.
Mental health concerns were frequently reported, with 40.8% experiencing anxiety or nervousness, 35.8% reporting sleep disturbances, and 25.2% considering professional mental health support. Only 16.3% of students met recommended physical activity levels.

Conclusions: This large-scale study provides compelling evidence that the foundations of NCDs are being laid alarmingly early in life. The coexistence of obesity, dysglycemia, dyslipidemia, metabolic dysfunction, anaemia, hypertension, and mental health concerns at such an early age, in asymptomatic youth, represents a global public health warning. Without early detection, today’s young adults risk progressing to premature cardiovascular disease, diabetes, and chronic disability. Public awareness, systematic screening and early preventive interventions embedded within educational institutions offer a scalable, cost-effective strategy to identify risk early and decisively nip NCDs in the bud, protecting the health of future generations.

Dr (Professor) Indira Jayakumar is Senior consultant and Lead Pediatric Intensivist at Apollo Speciality Hospital, Chennai with 35 years experience in pediatrics. She is also the Medical Director of Apollo SHINE Foundation, a not for profit organisation, focussing on campus student health at schools and colleges across India. The large scale screening for the study was conducted through the Apollo SHINE organisation.