Are our rural adolescents eating healthy?: Implications for redesigning school health interventions – A cross sectional study in rural Coimbatore

Background: Adolescence is a period of transition where independence in thinking and behavior is established and food choices that are made are followed for several years, and this can influence their health in adulthood. Hence, understanding the eating habits are necessary to plan effective nutritional interventions in adolescents. Objectives: The main objective of the study is to find out the extent of malnutrition among rural adolescents as well as evaluate their eating habits against recommended dietary food groups and to compare eating habits across gender and age groups. Methods: A cross-sectional study was done among 1425 adolescents from 13 rural schools from 2014 to 2015, and the variables considered in this study were age, sex, body mass index (BMI), and the eating habits of the adolescents. Results: Undernutrition was seen among 23% and overweight/obesity among 8% of adolescents. The habit of taking milk and milk products, fruits, and green leafy vegetables were very poor among the adolescents. Significant association was found between eating habits and BMI. Furthermore, late adolescents had better eating habits, and significant gender difference was seen in certain eating habits. Conclusions: The study shows that it is possible to understand the gaps in eating habits of adolescents, and this can be used to plan tailor-made nutritional interventions to adolescent groups as their eating habits are different and have long-term nutritional and health implications.

A tool for quickly identifying gaps in diet of school children for nutritional educational interventions

Compared to adults, assessment of dietary intake of school children has always been a great challenge in public health practice. Hence, this paper aims to share our experience in overcoming the problems in dietary assessment of large number of school children aged 6� years and the practicality of the tool for quickly identifying the broad gaps in the diet of individual Children for providing them dietary counseling. Based on the Indian Council of Medical Research/National Institute of Nutrition recommendations for balanced diet among school children, a simplified dietary gap assessment tool was developed to identify gross gaps in their diet and also a system of scoring it so as to measure effectiveness of the nutritional educational program. The simplified tool was effective in overcoming the challenge of making the children understand the concept of portion size by replacing it with inquiry of frequency of food intake in 'yes� or 搉o� terms and thereby making it easy to administer and is time efficient enough to enable a large number of students to be screened.

Life Style Interventions in the Prevention of Coronary Artery Disease.

Lifestyle diseases particularly coronary artery disease (CAD) has been noted to be the most important cause of the morbidity and mortality all over the world. India is currently passing through this epidemic so much so that it would be taking a heavy toll of Indian youth and economy to the tune of some 1.6 trillion $ during 2015-2030 . The main causative factors for CAD identified as coronary risk factors are: smoking / tobacco, physical inactivity, faulty diet, hypertension, diabetes, high level of cholesterol and stress. As most of these risk factors are lifestyle related attempt to modify them by appropriate interventions form the cornerstone of prevention of CAD epidemic. Studies done by Dean Ornish and several others prompted us to plan an interventional case control study in 640 patients of established CAD. These cases were given power point presentation regarding healthy lifestyle on one to one basis and followed up at three and six months. Primary outcomes variable were change in smoking /tobacco habits, physical activity, obesity, dietary habits, control of hypertension, diabetes and lipid profile. At the end of intervention it was possible to bring down the tobacco consumption, improve physical activity, better control of hypertension ( p< 0.03) , reduction in obesity ( p= 0. 0005) and raising HDL cholesterol ( p 0.05 ) significantly in test group. Taking cue from above study a five step innovative strategy was developed for effective implementation of healthy life style in coronary patients attending Cardiac Clinic at HAH Centenary Hospital, Jamia Hamdard. This strategy included sensitizing patients to locally developed visuals , posters and pamphlets at registration desk , concurrent counseling by attending doctor at the end of clinical examination and showing patients and their family the features of atherosclerosis during carotid ultrasound assessment. These points were again reinforced at follow up visits. Initial results of current intervention model is very encouraging in the sense that > 60% of subjects have quit smoking and close to 50% have started regular walking and taking appropriate diet following our intensive counseling. It is thus possible to modify the risk prone behavior and making such people shun smoking / tobacco consumption, resume regular physical activity and eat appropriate diet. The above interventional model merits further evaluation and extensive application.