Introduction

Project Y-SMilES (Young – Stronger India through a Million Health Educated Students) is a comprehensive, school-based health initiative spearheaded by the Institute of Liver and Biliary Sciences (ILBS) in collaboration with NTPC as part of its CSR initiatives. The program aims to tackle the rising prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) and associated lifestyle disorders by targeting children aged 11 to 17 years (Classes VI to XII). The project is grounded in the belief that early education and screening can empower children to adopt healthier lifestyles and become catalysts of change within their communities.

Need for the Project

India is witnessing an alarming rise in lifestyle diseases, including diabetes, cardiovascular conditions, and especially NAFLD. NAFLD, which is characterized by fat accumulation in the liver unrelated to alcohol consumption, affects over 38% of the Indian population. With risk factors beginning to develop during adolescence, timely intervention in schools becomes crucial. Building on the success of the previous SMilES project, which screened over 16,000 college students and identified 11% in the high-risk category, Y-SMilES extends the outreach to a younger demographic to facilitate early detection and lifestyle modification.

Rapid urbanization, changes in dietary habits, and increasingly sedentary lifestyles have contributed significantly to the surge of non-communicable diseases in India. Children and adolescents, who are often overlooked in public health strategies, are particularly vulnerable as these habits are solidified during school years. By addressing these issues early through structured awareness and diagnostic efforts, we can significantly reduce the long-term healthcare burden.

NAFLD is especially concerning due to its asymptomatic progression in early stages, often remaining undetected until it leads to more severe liver conditions. Screening and education in schools offer a unique preventive opportunity by reaching students in a structured and supportive environment. Through early identification and lifestyle correction, students can be guided toward making health-positive decisions for life.

Moreover, involving schools in public health initiatives fosters a culture of collective responsibility and health awareness that extends to families and communities. Teachers play a vital role in reinforcing health messages, while students serve as peer influencers, making schools powerful platforms for health promotion and behavioural change.

The Y-SMilES project is structured around the following core aims:
– To evaluate the prevalence, risk factors, and predictors of fatty liver disease among students aged 11–17 years (Classes VI to XII).
– To educate students about the causes, consequences, and preventive strategies for fatty liver disease.
– To empower students as ‘health-educated ambassadors’ who will disseminate knowledge to their peers, families, and communities.
– To enhance students’ understanding of non-communicable diseases (NCDs) and promote sustained healthy practices.

-Educate Students on Fatty liver Disease

Project Scope

The project envisions screening and educating approximately 67,500 students across 18 states and 50 cities in India. This nationwide campaign is being executed in a phased manner.

Phase 1: Screening Phase
– Students and parents fill out a validated offline questionnaire.
-Based on their responses, students are classified into three risk zones:

1. Red (High Risk)

2. Yellow (Moderate Risk) 

3. Green (Low Risk)

Phase 2: Intervention Phase
  – All students participate in the ‘Exit NCDs’ module aimed at promoting healthy lifestyle behaviors.
  Intervention is tailored by risk group:
  1. Green: General health awareness. Students in the Green zone are at low immediate   risk, but health education is crucial to help them maintain their well-being and prevent future complications.    

• Awareness sessions on balanced nutrition, exercise, and liver health
• Interactive modules on early prevention of lifestyle diseases
• Resources to become peer motivators and health-conscious Students.

 2. Yellow: Targeted awareness programs. The Yellow zone represents students who exhibit moderate risk factors for Non-Alcoholic Fatty Liver Disease (NAFLD)—such as early signs of unhealthy weight gain, sedentary behavior, or poor dietary habits—but do not yet require clinical intervention.

•  Focused workshops on nutrition, exercise, and liver health
•  Behavioural guidance on managing screen time, sugar intake, and sleep patterns
•  Follow-up support to track improvements and reinforce healthy changes
•  Engagement with families to ensure a supportive home environment

  3. Red: Detailed health testing and structured lifestyle guidance. The Red zone includes students identified as high risk for developing or already having early signs of Non-Alcoholic Fatty Liver Disease (NAFLD). These students show multiple warning indicators such as high BMI, poor diet, low physical activity, family history of metabolic disorders, or concerning responses in the health questionnaire. 

• Structured lifestyle counselling focusing on nutrition, physical activity, and behavioural change
• Personalized health action plans developed in collaboration with families and school authorities
• On-going follow-up to monitor progress and reinforce interventions.
• Free clinical evaluations, including blood tests and Fibro Scan (a non-invasive liver health scan)

(High-risk students undergo blood and biochemical tests, along with Fibro Scan to detect liver abnormalities.
All diagnostics are provided free of cost to the high-risk group)