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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 5  |  Issue : 2  |  Page : 165-168

Assessment of the Nutritional Status of Female Adolescents across Rural and Urban Areas of Belagavi – A School-based Comparative Study


Departments of Physiology and Public Health, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India

Date of Submission23-Dec-2019
Date of Decision06-Mar-2020
Date of Acceptance25-May-2020
Date of Web Publication18-Dec-2020

Correspondence Address:
Harpreet Kour
Department of Physiology, JN Medical College, KLE Academy of Higher Education and Research, Nehru Nagar, Belagavi - 590 010, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bjhs.bjhs_81_19

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  Abstract 


BACKGROUND: The present-day adolescent females will constitute to be important pillars of India in the near future. Adolescence is a phase for a high requirement of macro and micronutrients.
OBJECTIVE: The objective of the study was to assess and compare the nutritional status among the female adolescent population of the rural and urban areas of Belagavi.
MATERIALS AND METHODS: A school-based comparative study was carried out at five rural and five urban schools of Belagavi. A total of 110 female adolescents of age 10–16 years were randomly enrolled for the study. The study was conducted from March 2018 to December 2018. Variables included were age, height, weight, body mass index, waist circumference, hip circumference, waist–hip ratio, and dietary intake patterns by a 24-h dietary recall method. Data were analyzed using SPSS version 20.0 statistical software.
RESULTS: In the urban population, nearly half of the study population, i.e., 26 (47.27%) subjects, were underweight, whereas in the rural population, 39 (70.90%) were underweight. The mean energy intake was 2194.32 ± 140.79 Kcal and 1993.49 ± 146.14 Kcal in the urban and rural populations, respectively.
CONCLUSION: Most of the female adolescents from the rural areas were underweight and had less calorie consumption as compared to their counterparts from urban areas.

Keywords: 24-h dietary recall, adolescent females, nutritional status


How to cite this article:
Hiremath M, Kour H, Angolkar M. Assessment of the Nutritional Status of Female Adolescents across Rural and Urban Areas of Belagavi – A School-based Comparative Study. BLDE Univ J Health Sci 2020;5:165-8

How to cite this URL:
Hiremath M, Kour H, Angolkar M. Assessment of the Nutritional Status of Female Adolescents across Rural and Urban Areas of Belagavi – A School-based Comparative Study. BLDE Univ J Health Sci [serial online] 2020 [cited 2021 Jan 19];5:165-8. Available from: https://www.bldeujournalhs.in/text.asp?2020/5/2/165/303979



Adolescence is a period of rapid transition from childhood to adulthood in terms of growth and development. This is accompanied by changes in various dimensions of health like physiological, psychological, and behavioral.[1] During adolescence, the nutrient requirements are at a peak and in absolute terms are the highest than at any other stage of life. About 21% of the Indian population are adolescents and are the future adult population of India and their health and well-being is decisive. The World Health Organization (WHO) defines adolescence as a period of life between the ages of 10 and 19 years.[1],[2] There is a high demand of macronutrients like carbohydrates, protein, fat, and micronutrients like vitamins and minerals during the adolescent period as compared to any other time in the lifespan of an individual.[3] Studies have reported that adolescent growth and development is closely related to the dietary intake and nutritional status.[4],[5] Physiologically, during the adolescent period, there is a 50% gain of their adult weight, 20% or more than that of their adult height, and 50% of their adult skeletal mass.[6]

Most developing countries including India are facing the dual burden of either undernutrition or overnutrition occurring simultaneously within a population.[7] Although very little evidence on the mortality rate among adolescents is reported, very less importance is given to this period.[8],[9]

Anthropometry is a simple method for assessing the nutritional status and growth in adolescent females. It is not only an important health indicator but also a predictor of various morbidities in the community.[10] However, there is a little information about the nutritional status comparing female adolescents from rural and urban parts of India. Given the above facts, an attempt was made to compare the nutritional status of urban and rural adolescent females of the age group 10–16 years in Belagavi district.


  Materials and Methods Top


This 1-year comparative study was undertaken at five urban and five rural private schools of Belagavi (a district in the southern state of Karnataka, India). The schools were selected by simple random sampling method. Adolescent females of the age group 10–16 years studying in these schools from 6th to 10th standard were randomly selected. The study was conducted from March 2018 to December 31, 2018. Adolescent females who were willing to participate and were present during the data collection days were randomly selected as participants. All the participants and the school officials were requested to provide written consent to participate in the study. Proportionate samples were selected and the lottery method was used to select the sample from each class. From each school, a total of 11 females were enrolled.

The sample size was calculated using the below mentioned formula for conditional probability:



Where n = number of subjects required, Z = 1.96, 10% alteration rate, 1.1 at 95% CI with 20% change in standard deviation (SD); hence the sample size = =100 was obtained.

Ethical clearance was obtained from the Institutional Ethical Committee.

Study parameters

  1. Age was recorded in completed years [Table 1]
  2. Height was measured by a commercial stadiometer to the nearest 0.5 cm
  3. Weight was recorded by a digital scale with an accuracy of +100 gm
  4. Body mass index (BMI) was calculated using Quetelet's equation, i.e., BMI = body weight (in Kg)/height (in meters). The respondents were divided into four categories based on their BMI according to the BMI cutoffs points as follows: underweight (BMI <18.49), normal weight (18.5–22.99), overweight (23–24.99), obese Class I (25-29.9), and obese Class II (BMI =30) (WHO 2008)[11]
  5. Waist circumference was measured by a measuring tape placed at the level parallel to the floor, midpoint between the top of the iliac crest and the lower margin of the last palpable rib in the midaxillary line. The data were analyzed using cutoffs points for Asians (more than 80 cm in women). This is a measure of central obesity[11]
  6. Waist–hip ratio was calculated with the corresponding values of waist circumference divided by the hip circumference. The waist–hip ratio of =0.85 for females is considered as truncal obesity, whereas hip circumference was measured by placing the measuring tape at the maximum extension of buttocks to find the hip circumference[11]
  7. 24-h dietary recall: Modified American Dietetic Society Questionnaire considering regional food habits was used to collect the 24-h dietary intake. The previous day's dietary intake of the individuals was taken using the household types of equipment. This method was used to estimate the average calories (Kcal/d) protein (g/d), and iron (mg/d) consumption. The observed values were compared with the guidelines given by the ICMR.[12]
Table 1: Age wise distribution of the study participants

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Statistical analysis

Data entry and analyses were done using the IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, Version 20.0. IBM Corp. Released 2011. Armonk, NY, USA: IBM Corp. Data were expressed as mean ± SD and Chi-square test was used to evaluate the correlation between the groups.


  Results Top


The mean height of the urban and rural study participants was comparable, whereas the female adolescents in urban schools had a significantly more weight as compared to the adolescent females in the rural schools.

Among the urban study population, 26 (47.27%) participants were underweight, 24 (43.63%) were of normal weight, 3 (5.454%) were overweight, and 2 (3.636%) participants were obese. Among the rural study population, 39 (70.90%) students were underweight, 15 (27.27%) were with normal weight, and 1 (1.818%) was overweight [Table 2].
Table 2: Comparison of the anthropometric variables between the study groups

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The mean dietary intake or energy consumption was significantly higher in the urban population as compared to the rural population. The mean intake of protein and iron content was also higher among the urban population but did not differ statistically when compared to the rural participants [Table 3].
Table 3: Comparison of dietary intake as per 24-h dietary recall method

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  Discussion Top


Adolescents constitute one-fourth of the Indian population, representing an effervescent human resource. The female adolescent population, in the years to follow, will play an important role not only as the work force but also the biological role of birthing children and raising them; hence, it is important to identify the nutritional status of the adolescent female population. The present study included the female adolescent population from both the rural and urban schools of Belagavi district with a mean age group of 14 + 1.43 years. The nutritional status of the study subjects was assessed by measuring anthropometric variables and by calculating the calorie consumption per day by the 24-h dietary recall method.

In the present study, it was observed that the mean weight of the study participants from the urban population was higher (44.36 ± 6.91 kg) as compared to the rural population (37.73 ± 6.5 kg). These findings of the study are concomitant with the findings of Sachan et al.,[13] Shakya et al.,[14] Begum et al.[15] Kankana.[16]

As per the WHO on BMI classification, in the rural study population, about 70.9% were underweight, 27.25% were in the normal range, 1% were overweight, while in contrast in the urban population, only 47.27% were underweight, 24% were normal weight, and 3% were overweight. Based on the BMI index, a high prevalence of undernutrition has been reported by many researchers from different cities.[17],[18],[19] A few studies have also reported a high prevalence of overweight adolescents in both the rural and urban populations as compared to this study among the adolescent girls owing to affluent backgrounds.[20],[21],[22]

In the present study, most of the urban participants were observed to be overweight when compared to their rural. As per the Indian Council of Medical Research (ICMR) guidelines, the normal dietary intake of calorie consumption for adolescent females of age group 10–12 years is 2010 Kcal, for 13–15 years is 2330 Kcal, and for 15–17 years is 2440 Kcal. In this study, the adolescent females from the rural population had less energy intake as mentioned in the recommend dietary allowances by the ICMR, whereas female adolescents from the urban population nearly met the energy consumption as per the guidelines. The recommended dietary allowance (RDA) for protein and iron consumption is 40.4 g/d, 51.9 g/d, 55.5 g/d, and 26–27 mg/d for the above-mentioned groups in adolescent females. The protein consumption in both the groups was almost similar and comparable to RDA. In contrast, the iron consumption for both the groups was less as compared to the RDA mentioned. This can affect their health, school performance, and physical and mental growth.[23],[24]

The need of the hour is to provide an appropriate nutritional counseling to this group of adolescent females. It is imperative to prepare them physiologically to endure the journey of gestation and motherhood and to empower them to sustain a healthy lifestyle thereafter.


  Conclusion Top


There was a significant difference among the various nutritional parameters assessed in female adolescents from rural and urban schools of Belagavi. Although the urban participants were overweight when compared to their rural counterparts, the study does indicate a need for focusing on women and child development (nutrition wise) in the rural sectors. It would be beneficial if the government initiates schemes that could monitor and improve the health of female adolescents in the country.

Future implications

To address this issue, there is a need to evaluate and provide nutritional counseling for better health outcomes for young adolescent females. This in turn can reduce the burden of maternal and infant morbidity and mortality.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Progress for Children: A Report Card on Adolescents. Socio-Demographic Profile of Adolescents; Number 10 April, 2012 UNICEF. Available from: http://www.unicef.org/publications/files/Progress_for_Children_-No._10_EN_04232012.pdf. [Last accessed on 2019 Sep 25].  Back to cited text no. 1
    
2.
Strategy Handbook. Rashtriya Kishor Swasthya Karyakram. Adolescent Health Division Ministry of Health and Family Welfare Government of India. January, 2014. https://www.dropbox.com/s/0oj4p422y7st4ku/RKSK%20Strategy%20Handbook.pdf. [Last accessed on 2019 Sep 25; Last accessed on 2014 Sep 08].  Back to cited text no. 2
    
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The World Health Report 2001. Mental Health: New Understanding, New Hope. Geneva: World Health Organization; 2001. p. 39-44. Available from: http://www. mentalhealthpromotion.net/resources/whr01_en-3.pdf. [Last accessed on 2019 Sep 25].  Back to cited text no. 3
    
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Biesalski HK, Tinz J. Micronutrients in the life cycle: Requirements and sufficient supply. NFS J 2018;11:1-11.  Back to cited text no. 4
    
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Berkey CS, Gardner JD, Frazier AL, Colditz GA. Relation of childhood diet and body size to menarche and adolescent growth in girls. Am J Epidemiol 2000;152:446-52.  Back to cited text no. 5
    
6.
Kaur TJ, Kochar GK, Agarwal T. Impact of nutrition education on nutrient adequacy of adolescent girls. Stud Home Comm Sci 2007;1:51-5.  Back to cited text no. 6
    
7.
Joshi SM, Likhar S, Agarwal SS, Mishra MK, Shukla U. A study of nutritional status of adolescent girls in rural area of Bhopal district. Natl J Community Med 2014;5:191-4.  Back to cited text no. 7
    
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The Double Burden of Malnutrition Case Studies from Six Developing Countries. Food and Agriculture Organization of the United Nations Rome; 2006. p. 1-20. Available From: http://www.fao.org/3/a0442e/a0442e00.pdf. [Last accessed on 2019 Sep 25].  Back to cited text no. 8
    
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Popkin BM, Horton S, Kim S, Mahal A, Shuigao J. Trends in diet, nutritional status and diet related communicable diseases in China and India: The economic costs of the nutrition transition. Nutr Rev 2001;59:379-90.  Back to cited text no. 9
    
10.
Woodruff BA. Assessment of the Nutritional Status of Adolescents in Emergency Affected Populations. Centres for Disease Control and Prevention, Atlanta. RNIS Supplement; 2000. p. 1-21.  Back to cited text no. 10
    
11.
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-63.  Back to cited text no. 11
    
12.
World Health Organization. Waist Circumference and Waist-Hip Ratio. Report of WHO Expert Consultation. Geneva: World Health Organization; 2008.  Back to cited text no. 12
    
13.
Sachan B, ZafarIdris M, Jain S, Kumari R, Singh A. Nutritional status of school going adolescent girls in Lucknow District. J Med Nutrit Nutraceuticals 2012;1:102-5.  Back to cited text no. 13
    
14.
Shakya T, Jha CB, Shakya N, Sharma S. Overweight and obesity among early adolescents from government and private schools of Dharan, Nepal: A comparative study. Europ J Pharm Medical Res 2017;4:315-9.  Back to cited text no. 14
    
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Begum A, Sharmin KN, Hossain MA, Yeasmin N, Ahmed T. Nutritional status of adolescent girls in a rural area of Bangladesh: A cross sectional study Bangladesh. J Sci Industrial Res 2017;52:221-28.  Back to cited text no. 15
    
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Kankana DE. A comparative study on nutritional status of adolescents girls of different rural area of West Bengal. Anthropol 2016;4:173.  Back to cited text no. 16
    
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Lamba A, Garg V. A study on the nutritional status of adolescent girls (12-14yrs) residing in rural area of Bijnor district of Uttar Pradesh. Int J Food Sci Nutrit 2017;34:53-61.  Back to cited text no. 17
    
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Goyle A. Nutritional status of girls studying in a government school in Jaipur city as determined by anthropometry. Anthropologist 2009;11:225-7.  Back to cited text no. 18
    
19.
Maiti S, Chattterjee K, Ali KM, Ghosh D, Paul S. Assessment of nutritional status of rural early adolescent schoolgirls in dantan-iiblock, paschim medinipur district, West Bengal. National J Community Med 2011;2:14-8.  Back to cited text no. 19
    
20.
Shivaramakrishna HR, Deepa AV, Sarithareddy M. NutritionalStatus of adolescent girls in rural area of kolar district-a cross-sectional study. Al Am En J Med Sci 2011;4:243-6.  Back to cited text no. 20
    
21.
Mehta M, Bhasin SK, Agrawal K, Dwivedi S. Obesity amongst affluent adolescent girls. Indian J Pediatr 2007;74:619-22.  Back to cited text no. 21
    
22.
Subramanyam V, Jayashree R, Rafi M. Prevalence of overweight and obesity in affluent adolescent girls in Chennai in 1981 and 1998. Indian Pediatr 2003;40:332-6.  Back to cited text no. 22
    
23.
Sesikeran B. Nutrient Requirements and Recommended Dietary Allowances for Indians ICMR 2010. p. 1-30 Available from: http://nutritionfoundationofindia.org/PPT-2011/Seven17-18teen/Dr-B-Sesikeran.pdf. [Last accessed on 2019 Sep 25].  Back to cited text no. 23
    
24.
Sharma AK, Shukla D, Kannan AT. Calorie and protein intake and its determinants among adolescent school girls in Delhi. Indian J Community Med 2005;30:8-10.  Back to cited text no. 24
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  [Table 1], [Table 2], [Table 3]



 

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