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Year : 2015 | Volume : 3 | Issue : 3 | Page : 228 - 231  


Original Articles
Nutritional status of adolescents at a rural health centre of Dakshina kannada district of Karnataka

Sagar Borker1, Jahnavi Pare2, Anitha C3, Shruthi Bhat4

1Associate Professor Community Medicine KVG Medical College Sullia Karnataka India

2MSc student Department of food science and nutrition Karnataka state Open University Mysore India

3Department of food science and nutrition Karnataka state Open University Mysore India

4Assistant Professor in Anatomy KVG Medical College Sullia Karnataka India

Corresponding Author:

Dr. Sagar Borker

Email: sagarborker@gmail.com

Abstract:

Background: There are about 1.2 billion adolescents, a fifth of the world’s population and

their numbers are increasing. Hence it is essential to assess their nutritional status.

Objectives: To study the nutritional status of rural adolescents, to determine the type of malnutrition among them.

Methods: The study was conducted among 100 adolescents (12-18 years) of both the sexes in the rural primary health centre Guttigar, Sullia Taluk of Dakshina Kannada district, Karnataka between April - June 2014.

Results: Study found that 64% had chronic energy deficiency, 19% - underweight, 16% - normal and only 1% was overweight. it was observed that there was a significant association between BMI and sex; BMI and Age.

Conclusion: Findings of the present study indicate that under nutrition is the major problem of adolescents than overweight or obesity. Therefore the study suggests a need to adapt a strong nutritional intervention programme.

Keywords: Nutritional status, anthropometry, adolescents

INTRODUCTION:

Adolescence is the phase marked by distinct physical, psychological , mental and emotional changes the consequence of which might be tragic sometimes.[1] WHO defines adolescence  within age 10-19 years.[2] One in every 5 people are in an adolescent age. Today 1.2 billion adolescents stand at the crossroads between childhood and the adult world. Around 243 million of them live in India.[3]

Diet and nutrition plays a remarkable role in shaping ones physique. The practice of early marriage (23%) and conceiving early leads to greater risk of morbidity and mortality among adolescent girls.[2] If the adolescent girls nutritional needs are not met they are likely to give birth to undernourished children. Thus transmitting under nutrition to next generation.[1] Hence an attempt was made to understand and study the nutritional status of adolescents in the rural PHC of a village called Guttigar in Dakshina Kannada District of Karnataka.

METHODS:

The study was conducted among 100 adolescents (12-18 years) of both the sexes in the rural primary health centre Guttigar, Sullia Taluk of Dakshina Kannada district, Karnataka in the month of April - June 2014. The subjects were selected randomly among adolescents who came to PHC as Out patients, patient’s relatives and some were from the surrounding locality. A prior permission was obtained from the Medical Officer of the Primary health centre for the study. The growth velocity is maximum for boys between 12-15 years and for girls 10-13 years was found from one study. 4Therefore the age groups between 12-18 years were taken. The required sample size of 69 was obtained by a crude prevalence of malnutrition (59.2% by referring to the Banerjee et al5 study) and allowable error (20% of crude prevalence). Finally 100 subjects were chosen for simplicity. The data collection was done as per the WHO reference standards (1983).6 The study variables were bio-data which included the socio-demographic characters like age, sex, school Standard (studying/completed), religion, economic status, marital status, caste. Anthropometric data which included the waist circumference, hip circumference, arm circumference, height and weight respectively. Finally data was entered in Microsoft excel 2007 and was analyzed statistically using SPSS software with appropriate statistical tests and statistical significance was set at  p < 0.05 level.

RESULTS:

In the present study out of the total 100 adolescents, the maximum number i.e. 66% were in the age group of 12-14 years. The females (58%) were higher in number than males (42%). Hindus constituted 93% of the study population. There was one Christian boy. All the subjects were unmarried as they are expected to be. The majority of them belonged to low income group (68%). The caste category of the studied samples includes- GM – 3%(Brahmin),  I – 1%(Maniyani), IIA- 7%(Poojari, malayali, devadiga), IIB – 9%(Muslim), IIIA – 47%(Gowda, Hegdae), IIIB -16%( Christian, Lingayath, Bants, Marathi), and SC/ST- 17%  respectively.

By using Chi-square test, it was observed that there is no statistically significant difference between both the sexes in each age group. There is an equal representation of both the sexes in all the age group. (Chi-square(x2) =5.10, df =2, and p=0.07).

The females were taller and heavier (145cm, 35kgs) than males (143cm, 33kgs) in 12-14 years;  males were taller and heavier (159cm, 46kgs) in 15-16 years;17-18 yrs. in both the sexes there was decrease in weight more in females.

Waist circumference of females in 12-14 years was higher (65cm) than males (63cm). But in 15-16 years it was higher in males (73) and there was a decrease in waist circumference in both the sexes at 17-18 yrs. This trend may be perhaps due to a sudden growth spurt where in later years the height goes on increasing and the waist circumference decreases proportionately. The females (83) have higher hip circumference than males (81) in 15-16 years. At 17-18years, it remained the same in males (81) but there was a slight decrease in females (79).

Females had alower waist hip ratio in all the age groups (0.85, 0.86, 0.86) than males (0.90, 0.89, 0.84). Body Mass Index was higher in females (16.56) at 12-14 years and at 15-16 yrs in males it increased (18.41). But in 17-18 years it was found to be on a lower side in both the sexes. The hip/height and waist/height is more in females as compared to males. But it remained low in 17-18 years in both the sexes. Weight/ height was found to be more in females (0.24) up to 12-14 years and thereafter it increased in males (0.29). But it remained low in 17-18 years in both the sexes. Table 1

Pie chart 1 shows that 83% of adolescents were undernourished (64% CED +19% underweight). The BMI criteria were taken to define the malnutrition. Any adolescent of BMI < 16.5 as considered as CED, <18.5 was considered as underweight, 18.5-24.9 as normal, 24.9-29.9 as overweight and >30 as obese. Among girls, 30% had chronic energy deficiency (CED), 15% - underweight, 13% - normal.4 thus male adolescents were found to be more malnourished than female adolescents.

The BMI was compared with different socio-demographic characteristics to find any association with malnutrition. By applying Chi-square test, it was observed that there was a significant association between BMI and sex. (p < 0.01) and BMI and age. (p< 0.05). In case of religion, economic status, marital status, school (Standard studying/completed) no significant association was found.

By using Pearson’s correlation coefficient high correlation was found between Body Mass Index and Waist Hip Ratio. (p < 0.01).

DISCUSSION:

In the present study the females were taller and heavier than males in 12-14 yrs age; then males overtook them in 15-16Y; further on it slight decreased in both the sexes. Similar findings i.e. girls being slightly taller and heavier than boys in the age group 8–12 years, whereas boys being taller and heavier than girls in the age group 13–18 years were reported by Singh SM et al.[7]  Yusuf M et al, reported that females in his study tended to have more height and weight for age band 13; while males had more height and weight for age band 16 and 17, and statistically significant higher height than females for age band 18 years, which may be explained by the fact that puberty tends to occur earlier in females, with the males catching up later on in life.[8]

The present study showed 83% of subjects had under nutrition. Males (90.5%) were more undernourished than females (77.6%). The various studies carried out in different parts of country have shown variation in the degree of under-nutrition.[9] Das et al, reported the overall prevalence of under nutrition to be 28.60%. The rates were significantly higher among boys (37.59%) as compared to girls (19.43%). [10] Deshmukh et al, reported 54% adolescents as thin (< 5th percentile) in rural area of Wardha.  The above studies show a higher degree of under-nutrition among adolescents than the present study. Variation in the extent of under-nutrition among adolescents could be due to differences in various assessment criteria, socio-cultural practices, geographical variations, level of socioeconomic development & prevailing dietary practices in that area. [9]

The prevalence of underweight from the present study was found to be 19% which was more in females (15%) than males (4%). But Banerjee et al., reported that one-third of adolescents were underweight; more boys than girls.[6]Singh SM found that the overall prevalence of underweight was 28.29% which was equal among boys and girls.[7] These results are dependent on the classification used, socioeconomic status of adolescents in the area and several other known and unknown factors.

The government has started various nutritional interventional programmes like mid day meal programme and Ksheera Bhagya Yojana for primary and high school children, which helps in getting full attendance in school and  to improve the nutritional status as well as hunger of many poor class children.

CONCLUSION:

Overall the study found 83% of adolescents were undernourished. Therefore changes in the food habits are needed to improve the nutritional status of adolescents.

RECOMMENDATIONS:

Therefore the study suggests that nutritional intervention programs should be given in every school, PHC, and college. So it will be more effective for maintaining desired nutritional status of the adolescents.

REFERENCES:

 

  1. Patanwar P, Sharma KKN. Nutritional status of kurmi adolescent girls of Raipur city, Chhattisgarh. International Journal of Scientific and Research Publications 2013; 3(11):1-6.
  2. Guduri GB, Avvaru K, Naidu SA. Assessment of Nutritional Status among Early Adolescent Girls (11-14 Years) Attending Government Schools of Visakhapatnam City. IOSR Journal of Dental and Medical Sciences Apr.2014;13(4): 31-3.
  3. Shah AT, Bhatt JR, Patel M, Patel GP. Body Mass Index, dietary habits and physical exercise among school going adolescents: A cross- sectional study in Ahmadabad. National Journal of Community Medicine Apr – June 2013; 4(2): 314-7.
  4. Srilakshmi B. Dietetics, 7th edn. New Delhi: New Age International (p) limited Publishers; 2014.p.103.
  5. Banerjee S, Das A, Shinkere R, Patel V. Under-nutrition among adolescents: A survey in five secondary schools in rural Goa. Natl Med J India 2011; 24 (1); 8–11.
  6. Bamji MS, Krishnaswamy K,Brahman GNV.Editors,Text Book of Huan Nutrition. Oxford and IBH Publishing Co. Pvt .Ltd,New Delhi.142-153.
  7. Singh MS,  Devi RKN. Nutritional Status among the Urban Meitei Children and Adolescents of Manipur, Northeast India Journal of Anthropology 2013; 1-5.
  8. Yusuf SM, Mijinyawa MS, Musa BM, Gezawa ID, Uloko AE.Overweight and Obesity among Adolescents in Kano, Nigeria. J Metabolic Synd 2013; 2 (1)1-5.
  9. Mankar M, Joshi S, Velankar D, Mankar J, Anjenaya S. Nutritional status of Adolescents in Rural Area of Panvel. International Journal of Medicine and Allied Health Sciences. 2014; 1(1):8-13.
  10. Das B, Bisai S.Prevalence of under nutrition among Telaga adolescents: An endogamous population of India. The Internet Journal of Biological Anthropology. 2008; 2(2):1-7.

                                                              

 Table 1: Overall data for male and female

 

Males

 

           Mean

          SD

                                           Range

 

                         Age  group

                                        Age group

Anthrop-

Ometric

data

12-14Y

15-16Y

17-18Y

12-14Y

15-16Y

17-18Y

12-14Y

 Min-       Max.

       15-16Y

  Min-       Max

      17-18Y

 Min-       Max

Waist/hip

0.90

0.89

0.84

0.19

0.33

0.05

0.79      -  0.97

0.83    -   0.92

0.78  -    0.90

BMI

15.84

18.41

17.03

2.85

3.88

0.84

12.91    -  27.71

15.76    -   24.57

16.01  -   17.94

Waist/ht

0.44

0.46

0.43

0.04

0.48

0.02

0.38      -  0.62

0.42   -    0.54

0.40    -    0.46

Weight/ht

0.23

0.29

0.27

0.05

0.06

0.02

0.17      -  0.44

0.25   -    0.40

0.24    -   0.29

Hip/ht

0.49

0.51

0.51

0.05

0.04

0.005

0.32     -   0.58

0.49   -   0.59

0.51    -    0.52

Females

 

           Mean

          SD

                                           Range

 

                         Age group

                                        Age group

Anthrop-

Ometric

data

12-14Y

15-16Y

17-18Y

12-14Y

15-16Y

17-18Y

12-14Y

 Min-       Max.

       15-16Y

  Min-       Max

      17-18Y

 Min-       Max

Waist/hip

0.85

 0.86

 0.86

0.04

  0.05

0.06

0.75      -   0.94

0.79    -  0.96

0.79   -   1.03

BMI

16.56

18.23

16.91

2.06

2.51

2.07

13.74     -  21.98

14.95   - 23.13

13.76  -  21.08

Waist/ht

0.45

0.47

0.45

0.03

0.04

0.04

0.39       -   0.52

0.41   -   0.54

0.37  -  0.53

Weight/ht

0.24

0.28

0.25

0.04

0.04

0.04

0.18       -  0.32

0.22    -  0.36

0.20  -   0.33

Hip/ht

0.52

0.54

0.52

0.03

0.03

 0.04

0.47       -   0.58

0.49  -   0.61

0.46   -   0.59

 

Figure 1: Pie chart – showing degree of malnutrition

 

 





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