Nutritional status of adolescent girls from an urban slum area in South India.

Objective. To assess the nutritional status of adolescent girls in a slum community. Methods. A community-based cross-sectional study was carried out over a period of two months. 223 adolescent girls of age 10 – 18 years were selected randomly. Data was collected by interviewing the adolescent girls using predesigned, pre tested, semi-structured schedule. Parents interview was taken whenever necessary. Anthropometric measurements were recorded using standardized methodology as recommended by World Health Organization (WHO). Standard operational definitions were used. Various statistical applications like percentiles, mean, standard deviation and proportions were used for analysis of the data. Results. Overall prevalence of stunting was found to be 47% and 28.3% as per NCHS and Indian standards respectively. Prevalence of underweight was 42.6% and 22.9% as per NCHS and Indian standards respectively. Prevalence of thinness was 20.6% as per Indian standards. Conclusion. It is concluded that there is a high prevalence of under nutrition among adolescent girls in this slum community. Health education and nutrition interventions are needed on priority basis.

Effectiveness of weekly supplementation of iron to control anaemia among adolescent girls of Nashik, Maharashtra, India.

A national nutritional anaemia-control programme in India, focusing on supplementation of iron to pregnant women after the first trimester of pregnancy, failed to make an impact. It is prudent to recommend the correction of iron stores before the woman becomes pregnant. 'Efficacy' of weekly supplementation of iron has been proved to improve iron stores in adolescence in many studies abroad and in India. The objective was to study the 'effectiveness' of a weekly iron-supplementation regimen among urban-slum, rural, and tribal girls of Nashik district, Maharashtra, India. A baseline and the mid-term assessments were done using the cluster-sampling techniques. In each stratum, 30 clusters were identified. Twelve and 10 adolescent girls from each cluster were identified in the baseline and mid-term surveys respectively. The haemoglobin estimation was done using the HemoCue system. Data were analyzed using the Epi Info software (version 6.04). The overall prevalence of anaemia came down significantly to 54.3% from 65.3%. The decline was statistically significant (p<0.001) in tribal girls (48.6% from 68.9%) and among rural girls (51.6% from 62.8%). But the decline was not statistically significant among urban slum girls. Similarly, a significant rise in the mean haemoglobin levels was seen among tribal and rural girls. However, it did not increase significantly among urban slum girls. The programme had performed poorly in urban-slum areas, as the mean number of tablets consumed in urban-slum areas was only 5.6+/-3.3, as against 6.7+/-2.6 tablets in tribal girls and 7.2+/-2.2 tablets in rural girls. Considering the biological and operational feasibility and the effectiveness of the intervention, weekly supplementation of iron to adolescent girls should be universally started to correct the iron stores of a woman before she becomes pregnant.

Influencia del género y la percepción de la imagen corporal en las conductas alimentarias de riesgo en adolescentes de Mérida / Influences of gender and body image perception in risk eating disorders in adolescents in Mérida

Este estudio tuvo como objetivo analizar la influencia del género y la percepción de la imagen corporal en las conductas alimentarias de riesgo asociadas con los trastornos de la conducta alimentaria en adolescentes del primero y segundo año de educación media y diversificada en ocho instituciones educativas públicas del Municipio Libertador estado Mérida Venezuela, seleccionadas de forma intencional. Se realizó un estudio de campo, descriptivo, en el cual participaron 421 adolescentes, 56.5 por ciento varones y 43.5 por ciento hembras, el promedio de edad para los varones fue 15.75 ± 1.05 años y para las hembras 15.80 ±1.07 años. Para la recolección de los datos de imagen corporal se diseñó y se validó un instrumento donde el participante seleccionó entre cuatro alternativas la opción que más representaba su condición para el momento. El 57,5 por ciento, se percibió normal, 30.6 por ciento como delgados; y el 11,9 por ciento con sobrepeso. No se reportó percepción de imagen corporal obesa. La imagen corporal normal y delgada fueron percibidas entre los adolescentes con una frecuencia más alta en los varones (32,5 por ciento), mientras que la percepción de la imagen con sobrepeso fue más frecuente en las hembras (7,4 por ciento). El registro de la conducta alimentaria se realizó a través de un cuestionario diseñado y validado por expertos constituidos por nutricionistas, sociólogos y psicólogos clínicos en el que solicitó al entrevistado reportar la conducta alimentaria practicada para el control del peso en los últimos seis meses. Los hallazgos permiten confirmar que las mujeres cuya percepción de su imagen se caracteriza por el exceso, presentan mayor riesgo asociado con los trastornos de la conducta alimentaria (9,586 F=2 p=0,008) (12,622 F=5 p=0,027).

The object of this study was to analyze the influence of gender and body image perception in risk eating conducts associated with the upheavals of eating disorders in adolescents of first and second year of highschool in eight public institutions of the Municipio Libertador in Merida Venezuela, They were selected in an intentional form. A descriptive field, was performed, in which 421 adolescents participated, 56,5% men and 43,5% females, the average of age for the 15,75 men was ± 1,05 years and for 15,80 females ± 1.07 years. For the gathering of the corporal Image data, an instrument was designed and validated, In this the participant chose between four alternatives the option that represented more his/her condition at the moment, 57.5%, perceived themselves as normal, 30.6%, as thin; and 11.9% with overweight. The perception of obese corporal image was not reported. The normal and thin body image were perceived among the adolescents with a higher frequency in men 32.5%, whereas the perception of the image with overweight was more frequent in the females (7.4%). The registry of eating disorders was done through a questionnaire designed and validated by a group of experts constituted by dietitians, sociologists and clinical psychologists in which the interviewed was asked in person to report the eating conduct practiced for the control of weight during the previous six months. The findings allow us to confirm that women whose perception of their image is characterized by the excess present major risks associated with the upheavals of the eating disorders (9,586 F=2 p=0,008 (12,622 F=5 p=0,027).

Fatores associados ao risco de consumo insuficiente de fibra alimentar entre adolescentes / Factors associated with risk of low dietary fiber intake in adolescents

OBJETIVO: Avaliar o consumo de fibra alimentar entre adolescentes e analisar os fatores associados ao risco de consumo insuficiente desse nutriente. MÉTODOS: Estudo transversal com 722 adolescentes da cidade de São Leopoldo. O processo amostral deu-se por conglomerados por meio de sorteio sistemático de 40 setores censitários e domicílios, incluindo todos os indivíduos entre 10 e 19 anos. Foram obtidos peso e estatura dos adolescentes e dados sociodemográficos da família. Os métodos utilizados para avaliar o consumo alimentar foram o inquérito recordatório de 24 horas e o inquérito de freqüência. Para o cálculo da quantidade de fibra alimentar da dieta, foi utilizado o Programa de Apoio à Nutrição (Nutwin) do Departamento de Informática da Universidade Federal de São Paulo (UNIFESP). A análise estatística foi realizada por meio de regressão logística, utilizando modelo hierárquico. RESULTADOS: A prevalência de consumo insuficiente de fibras foi de 69 por cento nas meninas e 49,7 por cento nos meninos (p < 0,001). Entre os meninos, os fatores que determinaram essa condição foram: consumo não habitual de feijão (OR 2,65; IC95 por cento 1,05-6,68) e excessivo de lipídeo (OR 2,67; IC95 por cento 11,23-5,83). Para as meninas, maior faixa etária (OR 5,33; IC95 por cento 2,33-12,2), consumo não habitual de feijão (OR 3,01; IC95 por cento 1,44-6,53), consumo excessivo de lipídeo (OR 1,85; IC95 por cento 1,01-3,37), fazer dieta para perder peso (OR 2,50; IC95 por cento 1,10-5,70) e presença de excesso de peso (OR 2,06; IC95 por cento 1,04-4,07). CONCLUSÕES: Os resultados permitem concluir que a ingestão excessiva de gordura e o consumo não habitual de feijão estão fortemente associados ao risco de consumo insuficiente de fibra alimentar em ambos os sexos e que o sexo feminino apresenta mais fatores de risco para esse desfecho.

OBJECTIVE: To evaluate dietary fiber intake among adolescents and to analyze factors associated with the risk of insufficient consumption of this nutrient. METHODS: Cross-sectional study of 722 adolescents from the town of São Leopoldo, RS, Brazil. Sampling was by clusters, with a systematic randomization of 40 census sectors and residences, including all individuals aged 10 to 19 years. The adolescents' weight and height were measured and sociodemographic data on their families recorded. A 24-hour dietary recall and a frequency survey were used to assess dietary intakes. The quantity of dietary fiber in diets was calculated using Nutwin nutrition support software (Programa de Apoio à Nutrição), developed by the IT Department at Universidade Federal de São Paulo (UNIFESP). Statistical analysis was by means of logistic regression, employing a hierarchical model. RESULTS: The prevalence of insufficient dietary fiber intake was 69 percent among girls and 49.7 percent for boys (p < 0.001). The determinant factors of this condition among boys were non-habitual consumption of beans (OR 2.65; 95 percentCI 1.05-6.68) and excessive fat intake (OR 2.67; 95 percentCI 11.23-5.83). For girls factors were increased age (OR 5.33; 95 percentCI 2.33-12.2), non-habitual consumption of beans (OR 3.01; 95 percentCI 1.44-6.53), excessive fat intake (OR 1.85; 95 percentCI 1.01-3.37), dieting for weight loss (OR 2.50; 95 percentCI 1.10-5.70) and presence of overweight (OR 2.06; 95 percentCI 1.04-4.07). CONCLUSIONS: These results admit of the conclusion that excessive fat consumption and non-habitual consumption of beans are strongly linked with the risk of insufficient dietary fiber intake in both sexes and that females exhibit a greater number of risk factors for this outcome.

Nutrição e excesso de massa corporal: fatores de risco cardiovascular em adolescentes / Nutrition and excess body mass: cardiovascular risk factors in adolescents

OBJETIVO: Verificar a freqüência de hipertensão arterial, sedentarismo e consumo alimentar inadequado em adolescentes com excesso de massa corporal. MÉTODOS: Estudo transversal com 56 adolescentes, sendo 21 meninos e 35 meninas, entre 10 e 19 anos. As variáveis foram: sexo, idade, peso, estatura, índice de massa corporal, classificação nutricional, hipertensão arterial, atividade física e consumo alimentar de risco cardiovascular. Avaliou-se o consumo alimentar com questionário que estabelece consumo de risco cardiovascular entre adolescentes por categorias de consumo, segundo pontuações por quantidades e freqüência consumida. Do questionário originaram-se as variáveis categorias de consumo e pontuações. Aplicou-se correlação de Spearman entre índice de massa corporal, idade e pontuação de consumo. Por teste "t" de Student compararam-se entre os sexos as médias de índice de massa corporal, idade, massa corporal, estatura e pontuação de consumo, e por qui-quadrado as freqüências por presença e ausência de hipertensão arterial, prática de atividade física e categorias de consumo. Com teste Kruskal-Wallis, analisou-se a variância da pontuação de consumo entre grupos. RESULTADOS: Não houve diferenças estatísticas entre os sexos para atividade física (p=0,68), hipertensão arterial (p=0,94), excesso de massa corporal (p=0,31) e categorias de consumo (p=0,53). O índice de massa corporal não se correlacionou com a idade (r=0,20 e p=0,14) e a pontuação de consumo (r=-0,06 e p=0,60). Não houve diferença estatística (p=0,19) na pontuação do consumo por grupos. CONCLUSÃO: Os adolescentes não apresentaram distinções por sexo quanto à prevalência de hipertensão arterial, sedentarismo e consumo alimentar de risco cardiovascular, embora as meninas apresentassem maior freqüência desses fatores quando agrupados.

OBJECTIVE: To assess the frequency of arterial hypertension, inactivity and inadequate food intake related to cardiovascular risk in adolescents with excess body mass. METHODS: Cross-sectional study including 56 adolescents (21 boys and 35 girls) aged 10-19 years. Variables were: gender, age, weight, height, body mass index, nutritional classification, arterial hypertension, physical activity, and food intake categories scored in terms of cardiovascular risk. This intake was assessed through a questionnaire which established cardiovascular risk intake among adolescents by intake categories according to scored amounts and intake frequency. The questionnaire originated the variables intake categories and scores. Spearman's correlation was applied among body mass index, age and intake score. Student's test compared body mass index averages, age, body mass, stature and intake score, according to gender; and the chi-square test assessed frequencies according to presence and absence of arterial hypertension, physical exercise practice and intake categories. The Kruskal-Wallis test analyzed the variation of intake scores among the groups. RESULTS: There was no statistical difference between genders in physical activity (p=0.68), arterial hypertension (p=0.94), body mass excess (p=0.31), or intake categories (p=0.53). Body mass index did not correlate with age (r=0.20, p=0.14) or intake score (r=-0.06, p=0.60). There was no statistical difference (p=0.19) in intake scores among the groups. CONCLUSION: Adolescents showed no gender differences concerning arterial hypertension prevalence, inactivity and food intake related to cardiovascular risk, although for girls these factors were more frequent when these were grouped.

Relação entre proteína dietética e calciúria em crianças e adolescentes com nefrolitíase / Relation between diet protein and calciuria in children and adolescents with nephrolitiasis

PURPOSE: The objective was to evaluate the quality of diet and the relationship between protein diet and calciuria in children and adolescents with nephrolithiasis. METHODS: Forty-nine children and adolescents (28 male and 21 female; 10.1 +/- 3.16 years old) with nephrolithiasis were included in study. Diet evaluation was performed over a 3 day period in order to determine nutrient consumption. The analysis of diets were carried out by DietWin Clínico 3.0 software. One 24-hour urine sample was collected for the measurement of calcium. Nutritional status was also assessed by Body Mass Index (BMI). RESULTS: The diet of patients containe insufficient energy and calcium. High levels of protein (69.64 +/- 16.42 gm), mainly animal source (65.81 +/- 11.45%) and low levels of calcium (500.95 +/- 284.64 mg) was observed (95%). Analysis of 24 hour urine samples revealed that 25.0% of the patients presented hypercalciuria. A positive correlation (r = 0.26680) between animal protein intake and calciuria was found, in opposite of vegetable protein and calciuria correlation (r = -0.2675). CONCLUSIONS: Animal protein of the diet has a significant effect in urinary excretion of calcium in patients with nephrolithiasis.

Intestinal parasitoses and the nutritional status of Veddah children in Sri Lanka.

This study describes and compares the intestinal parasitoses and nutritional statuses of primary school children of Veddah (local indigenous population) and Sinhalese (more advanced society) in rural Sri Lanka. Children attending years 1-3 (age range 6-15 years) at Dambana Primary School (Veddah) and Wewatta Primary School (Sinhalese) were included in the study. Stools and blood samples were examined for evidence of intestinal parasites and anemia. The heights and weights of the children were measured and anthropometric indices calculated. There was a high prevalence of G. intestinalis and B. hominis (Giardia 7.8% and 6.2%; Blastocystis 17.2% and 17.3% at Dambana and Wewatta, respectively) in both communities, the predominant helminth being N. americanus (20.3% at Dambana and 14.8% at Wewatta; p>0.05). Other geohelminth infections were scarce in both communities. A greater proportion of boys than girls were underweight and stunted in both communities. Wasting and anemia was significantly high among the Veddah children.

Plasma vitamin A and C status of in-school adolescents and associated factors in Enugu State, Nigeria.

The study was undertaken to determine the intake of vitamin A and C and plasma concentrations of these vitamins among in-school adolescents. The factors affecting the vitamin status of these adolescents were also determined. Data for this report were obtained from a cross-sectional survey of 600 in-school adolescents in Nsukka local government area (LGA) of Enugu State, Nigeria. Ninety and 45 of the adolescents were randomly selected for determining plasma concentrations of vitamin A and C and intake of these vitamins respectively. Dietary assessment was done using a three-day weighed food intake method. Venous blood samples were collected and used for determining plasma vitamin A using the trifluoroacetic acid (TFA) method, while plasma vitamin C was determined by the thiourea method. Values obtained were matched against standards. The intake of vitamin A by all the adolescents was adequate (126-137% of recommended intake), while the intake of vitamin C was inadequate (51-91% of recommended intake). The mean intake of vitamin C was higher among males (23.7 +/- 0.71-27.3 +/- 8.0) than among females (15.3 +/- 2.8-19.5 +/- 5.1). Despite the adequate intake of vitamin A, 40% of the male and 32% of the female adolescents had low plasma concentrations of the vitamin (< 20 microg/dL). On the other hand, concentrations of plasma vitamin C were low among about 47% of these adolescents. Using multiple regression analysis, the two most important variables influencing vitamin A status were household size (b = -0.629; p < 0.0 1) and nutrition knowledge (b = -1.372; p < 0.01), while for vitamin C status, these were household size (b = -0.110; p = 0.05) and age (b = 0.226; p < 0.05). The daytime students had a significantly (p < 0.05) better vitamin A and C status than the boarders. The prevalence of vitamin A and C deficiencies among the adolescents may be more than estimated due to inadequate intake and/or poor bioavailability. This may pose a serious health risk for adolescents. There is, therefore, a need for adequate nutrition education and awareness about healthy lifestyles among Nigerian adolescents.

Nutritional status of the Indian population.

High prevalence of low birth weight, high morbidity and mortality in children and poor maternal nutrition of the mother continue to be major nutritional concerns in India. Although nationwide intervention programmes are in operation over two decades, the situation has not changed greatly. In addition, the Indian population is passing through a nutritional transition and is expected to witness higher prevalences of adult non-communicable diseases such as diabetes, hypertension and coronary heart disease according to the theory of 'fetal origin of adult disease'. Clearly, there is a need for examining several issues of nutritional significance for effective planning of interventions. In particular, maternal nutrition and fetal growth relationship, long term effects of early life undernutrition, interactions of prenatal nutritional experiences and postnatal undernutrition are some of the major issues that have been discussed in the present paper with the help of prospective data from various community nutrition studies carried out in the department.