|Year : 2012 | Volume
| Issue : 3 | Page : 233-236
Nutritional status assessment of school children in Mangalore city using the multicenter growth reference study WHO 2007 Z-scores
Ramachandra Kamath1, Manish Kumar1, Sanjay Pattanshetty1, Asha Kamath2
1 Department of Public Health, Manipal University, Manipal, Karnataka, India
2 Department of Community Medicine, Manipal University, Manipal, Karnataka, India
|Date of Web Publication||8-Aug-2012|
Department of Public Health, Manipal University, Manipal, Karnataka
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Context: One of the the United Nation's Millennium Development Goals (MDGs) is the reduction of maternal and child mortality. The 'green revolution' has increased food supply in Asia, and hunger and under nutrition have been decreasing since 1981. However, instead of having to deal with surplus food grain, South Asia and India are still facing high levels of hunger. Although some south Indian cities are witnessing a technology boom, one in every 11 children die within the first 5 years of their lives either due to malnutrition or due to non availability of even simple technology and health care. Aim: To assess the nutritional status of schoolchildrenin Mangalore city. Settings and Design: A cross-sectional study. Materials and Methods: A total 1630 students from 11 schools were enrolled for the study. The sample size was calculated assuming the prevalence of undernourished in Mangalore city as 20% and a relative precision of 10%. Statistical Analysis: The BMI (body mass index), Z-scores, and World Health Organization (WHO) Multicentric Growth Reference Study (MGRS) growth chart was used for analysis. Results: Our study population of 1630 students comprised 830 (50.9%) males and 800 (49.1%) females. On analysis, 82 children (5.03%) were found to be undernourished, 37 (2.3%) were overweight, and 16 (1%) were obese. Undernourishment was more prevalent in boys (6.87%) than in girls (3.12%).Obesity was marginally higher among males (1.2%) as compared to females (0.8%) (P=0.003). A total of 15 boys (1.8%) and 22 girls (2.8%) were found to be overweight. Conclusions: The nutritional status of the students in our study is better than has been found in other studies. However, there are cases of under nourishment that need attention. At the same time, there is a need to deal with obesity and overweight in schoolchildren in order to prevent the impending epidemic of noncommunicable disease.
Keywords: Mangalore, obesity, schoolchildren, undernourishment
|How to cite this article:|
Kamath R, Kumar M, Pattanshetty S, Kamath A. Nutritional status assessment of school children in Mangalore city using the multicenter growth reference study WHO 2007 Z-scores. Int J Nutr Pharmacol Neurol Dis 2012;2:233-6
|How to cite this URL:|
Kamath R, Kumar M, Pattanshetty S, Kamath A. Nutritional status assessment of school children in Mangalore city using the multicenter growth reference study WHO 2007 Z-scores. Int J Nutr Pharmacol Neurol Dis [serial online] 2012 [cited 2021 Jan 15];2:233-6. Available from: https://www.ijnpnd.com/text.asp?2012/2/3/233/99476
| Introduction|| |
The total number of undernourished in the world was 1023 million in 2009 and the numbers were expected to decline by 9.6% to 925 million in 2010. Developing countries alone account for 98% of the world's undernourished people. The prevalence of undernourishment in the developing world is 16%, slightlyless than the 18% in 2009. Two-thirds of the developing countries' undernourished people live in just seven countries: Bangladesh, China, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, and Pakistan; more than 40%livein China and India alone. 
Reduction of maternal and child mortality is one of the United Nation's Millennium Development Goals (MDG). Factors such as low income, relatively higher prices, bad healthcare, and neglect of basic education all play their roles in causing under nutrition in India. The 'green revolution' has boosted food production in Asia and because of it hunger and under nutrition have been decreasing since 1981. However, instead of having surplus food grains, South Asia and India still face high levels of hunger.  Some south Indian cities are in the midst of a technology boom but one in every 11 children die in the first 5 years of their lives either due to malnutrition, non availability of low-cost technology, or due to absence of low-cost intervention. 
Food insecurity can negatively affect educational attainment in many ways. A known pathway is through high rates of school absenteeism: children from food-insecure households are pulled out of school to engage in productive activities in order to earn money. In the concerned environment of caregivers to provide proper food children might also suffer from a significant amount of psychological and emotional stress. These events often affect their cognitive and behavioral performances as adolescents. Such behaviors are incompatible with their school attendance.  Nutritional deficiency anemia leads to decreased working capability by affecting the physical and mental development of an individual and thus affects the development of a country. 
The present study was undertaken to assess the nutritional status of schoolchildren in Mangalore City.
| Materials and Methods|| |
This cross-sectional study was conducted among schoolchildren in Mangalore city. A sample size of 1537 was calculated to be necessary to detect an assumed prevalence of undernourished of 20% with a relative precision of 10%. This nutritional and health status assessment among schoolchildren in Mangalore city involved a total of 11 randomly selected schools. All students from classes III to VII present on the day of our visit were enrolled for the study. The schools were informed well in advance and were provided with all the information about the study and consent was taken from the respective school principals and the parents of the children. Weight was measured using a Seca™ 703 electronic scale accurate to ±0.15%/±100g, and height was recorded using a measuring rod with 1-mm graduations
For analysis the Statistical Package for the Social Sciences (SPSS® 16.0) and World Health Organization (WHO) Multicentric Growth Reference Study (MGRS) growth chart was used. Data was entered into Microsoft® Excel® and body mass index (BMI) was calculated. Then the Z scores were calculated for each individual, using the formula:
The median BMI used in the above formula was taken from the WHO 2007 Multicenter Growth Reference Study Charts. Nutritional grading was done using percentages.
| Results|| |
A total of 1630 students from 11 schools of Mangalore comprised the study sample. There were1501 males (49.1%) and 1554 (50.9%) females [Table 1]. The maximum number of students were from class VII (398; 24.4%), and the least number of students were from in class III (259; 15.9%). Undernourishment was seen in 82 (5.03%) children, while overweight and obesity were seen in 37(2.3%) and 16 (1%) of the students, respectively [Table 2]. Undernourishment was more common in boys (6.87%) than in girls (3.12%). Obesity was also seen more often in males (1.2%) than in female (0.8%) (P=0.003). A total of 15 boys (1.8%) and 22 girls (2.8%) were found to be overweight. The age-wise distribution of nutritional status is depicted in [Table 3].
|Table 2: Anthropometric measurements expressed asmean and standard deviation|
Click here to view
| Discussion|| |
The prevalence of undernourishment in the study was found to be 5.03%, which is less than that found by a similar study conducted by Francis et al,  in Jos North Local Government Area of Plateau State, Nigeria. Another study conducted by Chandra et al,  in the villages of Dharwad and Haliyaltaluks reported 44.4% of children as underweight, which is more than that found in our study. A study done among Jenukuruba tribal children by Prabhakar et al, also revealed high prevalence of mild (41.5%) and severe (6.7%) stunting andhigh prevalence of mild (40%) and severe (3.7%) wasting; they also reported 45.2% of children as having moderate underweight and 14.8% as having severe underweight. These figures indicate a higher prevalence of under nutrition than in our study population.
Undernourishment was observed among 6.87% boys and 3.12% girls in our study. In a similar study conducted by Raja et al, in the primary schools of Nandigram area of Purba Medinipur district, West Bengal, they found an overall (age combined) prevalence of thinness of 62.9% and 61.6% in boys and girls, respectively. Another study conducted by Banerjee et al. in the mining belt in northern rural Goa reportedthat 37.8% of the boys and 27.5% of the girls in their sample were underweight. A similar study done by Hassan et al, in the government schools in Azad Nagar area of Bangalore reported the prevalence of malnutrition in males and females as 57.94% and 42.06%, respectively. In the present study, among schoolchildren in Mangalore city, the prevalence of thinness and severe thinness was observed to be 0.24% and 4.78%, respectively. In a study by Bisai et al, among Lodha tribal children in a village of Paschim Medinipur, 9.1%, 9.7%, and 3.6% children were found to be severely underweight, stunted, and wasted, respectively.
limitation of our study is that data on the socioeconomic status of the students were not collected. In order to get details of the socioeconomic status a community-based study needs to be done.
| References|| |
|1.||The State of Food Insecurity in the World: Addressing food insecurity in protracted crises, Food and Agriculture Organization Report 2010. Available from: http://www.fao.org/docrep/013/i1683e/i1683e.pdf [Last accessed on 2011 June 11]. |
|2.||Antony GM, Laxmaiah A. Human development, poverty, health and nutrition situation in India. Indian J Med Res 2008;128:198-205. |
|3.||Antony GM, VisweswaraRao K, Balakrishna N. Human Development Index: It's Suitability for the Assessment of Health and Nutritional Status of Indian States, EPW, Bombay, India. 2001;36:2976-9. |
|4.||Belachew T, Hadley C, Lindstrom D, Gebremariam A, Lachat C, Kolsteren P. Food insecurity, school absenteeism and educational attainment of adolescents in Jimma Zone Southwest Ethiopia: A longitudinal study. Nutr J 2011;10:1-9. |
|5.||Sudhagandhi B, Sundaresan S, William WE, Prema A. Prevalence of anaemia in the schoolchildren of Kattankulathur, Tamil Nadu, India. Int J Nutr Pharmacol Neurol Dis 2011;1:184-8. |
|6.||Francis A, Seline O, Angela O. Nutritional Status of Newly Enrolled Primary Schoolchildren in Jos-Plateau, Nigeria. Pak J Nutr 2010;9:1166-70. |
|7.||Chandra KR, Padennavar UM, Sadashivappa T, Prabhakara GN. Nutrition Assessment Survey of Schoolchildren of Dharwad and Haliyal Taluks, Karnataka state, India. Kathmandu Univ J Sci Engg Technol 2006;2:1-19. |
|8.||Jai Prabhakar SC, Gangadhar MR. Nutritional Status of Jenukuruba Tribal Children in Mysore District, Karnataka. Anthropologist 2009;11:83-8. |
|9.||Chakraborty R, Bose K. Very high prevalence of thinness using new international body mass index cut off points among 5-10 year old schoolchildren of nandigram, west Bengal, India. J Res Med Sci 2009;14:129-33. |
|10.||Banerjee S, Dias A, Shinkre R, Patel V. Under-nutrition among adolescents: A survey in five secondary schools in rural Goa. Natl Med J India 2011;24:8-11. |
|11.||Hasan I, Zulkifle M. A Study of prevalence of malnutrition in government Schoolchildren in the field area of Azad nagar Bangalore, India. India. Glob JSci Front Res2010;10(7: 43-46 |
|12.||Bisai S, Bose K, Ghosh A. Nutritional Status of Lodha Children in a Village of Paschim Medinipur District, West Bengal. Indian J Public Health 2008;52:203-6. |
[Table 1], [Table 2], [Table 3]