Long-term health and lifestyle outcomes in young adults seven years after school-based interventions: a cross-sectional study

The largest disease burden among 10–24-year-olds is attributed to the non-communicable diseases (NCDs) contributing to 56% of global disability-adjusted life-years (DALYs). While lifestyle interventions show modest short-term health benefits, long-term adoption and their broader impact on overall health remain underexplored, particularly in India. The study aimed to explore the health and lifestyle status of young adults who were part of a cohort of a school-based interventional study conducted between 2005 and 2011. A cross-sectional study was conducted in two schools in Pune and Nashik, Maharashtra, on cohorts who were enrolled in the SYMKEM study (2005–2011). It explored the adiposity, dietary patterns, and physical fitness of the same group after seven years. Participants, aged 20–23, participated between 2018 and 2020. Information on selected sociodemographic, anthropometric indicators, blood pressure, food frequency, and physical activity was collected. The participants were from one school each from Pune (n = 181) and Nashik (n = 81), aged 20–22 years (93.5%), and half were males (48.5%). Females were shorter (Pune—63.4% vs. 83.8%; p = 0.000) and lighter (Pune—15.1% vs. Nashik 3.0%; p = 0.032), and a higher proportion of Pune females were underweight. Overweight and obesity were prevalent among females (Pune—37.6%, Nashik—54.6%), with 30% of the participants from both locations having central adiposity. Males had higher overweight and obesity rates (Pune—56.8%, Nashik—56.3%) and were less likely to be underweight. Significant height differences were found between participants from the two sites (p = 0.048). A significant gender-wise difference in height, weight, waist circumference, and BMI (p = 0.004) was observed. Half of the males (50%) and one-quarter of the females from Pune (28%) were in the hypertension I and II (Pune—6.8% and 2.2%) categories, respectively. Males were more physically active than females (66.4% vs. 36.2%); however, they were in poor (42.2%) or very poor (24.4%) VO2 max categories. The present study identified a double burden of malnutrition (coexisting underweight and obesity) among female participants, gender-wise association with anthropometric indices, a higher proportion of male participants in hypertension stages I & II, and > 50% of males performing high physical activity levels but in poor or very poor VO₂ max categories.