Original ArticleASSESSMENT OF NUTRTIONAL STATUS AND DIETARY PATTERN OF ADOLESCENTS IN COASTAL AREA OF PUDUCHERRY 1 K. Kumarakuru and Sundramoorthy Haripriya 2 1 Research scholar Assistant Professor, Department of Food Science and Technology Pondicherry University, Puducherry, India 2 ABSTRACT Nutrition is a crucial factor determining health and is a very important factor in determining the health of any population. Diet is one of the prime constituent of health and nutritional status. A diet which is inadequate in both quantity and quality will mark for elevated level of malnutrition. Adolescents nutritional status has been considered as a vital tool in the assessment and promotion of health. This study assessed the nutritional status and dietary pattern of adolescent of both gender age groups. Height and weight were measured and dietary intake was recorded by 24 hour recall method. The mean intake of food stuff of fats and oils, green leafy vegetables, roots and tubers, fruits and was gruesomely inadequate varying only 28.7, 24.7, 12.3, and 34.3 per cent respectively of the suggested RDA allowances. Pulses and other vegetables were adequate meeting the allowances. The study revealed prevalence of under nutrition and decreased energy intake along with low micronutrient intake among the adolescents. The prevalence of stunting among adolescent boys and girls of fishing community was 55.5 and 63.8 per cent and thinness was 38.3 and 29.8 per cent respectively. The results of the study revealed inadequate intake of foods by the adolescent which is expressed as hidden hunger. The protein calorie inadequacy and the prevalence of stunting data strongly highlights the requirement of awareness programs for the adolescent in fishing community on importance of balanced diet and good nutrition practices to improve the nutritional status of the adolescent. INTRODUCTION A dolescents nutritional status has been considered as a vital tool in the assessment and promotion of health. Health is a key factor in entering, enduring and performing in life [1]. The nutritional status of a nation is highly reliant on the nutritional status of the adolescents as girls of this age are prospective mothers and boys form the prime work force. Interestingly, only now there are few Government health and nutrition schemes which benefits for adolescents. Maximum physical growth at Correspondence Dr. S. Haripriya Assistant Professor Department of Food Science & Technology, Pondicherry University, Pududcherry-605014, India. Email: [email protected] 03 adolescence occurs only during the adolescents phase and the maximum of it is seen in the preadolescent period. Fishermen are the special group of some grave way of life. All over India, hundreds of men and women prolong to be involved in fish related activity, mainly to continue their families. As the fisheries resource is increasingly susceptible the task of men and women gets more and more complicated. Nutritional status of the fishing community plays a vital role in the improvement of the socio economic back ground which in turns reflects on the nutrition status of their family members. Fish and fishing is an important occupation in the coastal areas of India. Puducherry being a coastal area has a large population of fishermen. Though many schemes and benefits are extended to fishermen who can be Journal of Community Nutrition & Health, Vol.4, Issue 1, 2015 The collected data were analyzed using SPSS windows version 20. Issue 1. there is an urgent need to evaluate the nutritional status of the adolescents of fishermen community which could enable the Government and policy frames to initiate strategies for the well being of the adolescents among fishermen community. A total of 227 adolescents in the age group of 10-18 years of both genders participated in the study. 70 per cent of requirement i.4. Early identification of illnesses through regular nutritional and health check-ups could help prevent complications [2]. Gaussian distribution with a coefficient variation of 15 per cent was used to predict the protein and energy requirement curves. These factors are considered to be important especially in a developing country like India. the assessment of nutritional status of the adolescent in the coastal areas of Puducherry was performed. In terms of defining the protein. Per cent adequacy of food intake was calculated based on the intake by ICMR (2010) [4]. clinical assessment and personal hygiene.energy adequacy status. requirement-2SD was used as the intercept for the different age groups of the adolescents. chronic energy deficiency and nutrient intake was tested using chi-square test. ICMR RDA 2010[4]. 2015 . 1995 [7] was assessed. Protein-calorie adequacy status of adolescents was categorized according to the age group. Using the food composition Table and RDA.e. The peak rates of growth are exceeded only for the period of the fetal life and early infancy [3]. The subject's parents were also asked details pertaining to the types of food preparations. WHO. Journal of Community Nutrition & Health. Analysis of data The average daily intake of foods by various age groups of boys and girls was computed and compared with the suggested levels of intake by ICMR RDA 2010[4]. the nutrient profile was calculated. MATERIALS AND METHODS Sampling and investigation This is a cross-sectional study on the adolescents of the fishermen community adapting stratified random sampling procedure. Therefore.. The 24 hour recall method was adopted for collecting the details of the foods consumed by the boys and girls following 04 Kumarakuru et al systematic random sampling procedure. 2007) [4 & 5]. The adolescent in the fisherman community are considered to be a weaker section of the population due to the poor income generation. The adolescent boys and girls were compared against the NCHS reference values for height and weight [6] which was used to assess under nutrition and the extent of stunting. Anthropometric measurements such as weight and height were measured on all the selected adolescent boys and girls by using standard equipment. Average nutrient intake and excess/deficit of macro nutrient intake was computed using food composition tables and Recommended Dietary Allowances (RDA) for Indians (ICMR. raw materials used for each of the preparation and total cooked amount of each preparation in terms of standardized measurement cups. Vol.jcnh. The study design was approved by the Institutional Human Ethical Committee (PU/IEC/201213/30) and informed consent was taken from who participated in the study. Association between age. RESULTS Food stuffs The frequency of the food stuffs consumed by the adolescent boys and girls was computed based on the intake per day divided by the number of respondents. The study was piloted in boys and girls of age group 10-18 years of fishing community. Height and weight measurement was used to compute the Body Mass Index (BMI) using the formula BMI= weight (kg)/ height cm2.www. Nutrition and health services focus more attention on nutritional support. An epigrammatic study of the fishing community adolescent population was done with respect to socio-demographic profile (data not included). In this study. The mean body mass index (BMI) was calculated and prevalence of thinness (<5th percentile) and overweight (≥ 85 percentile) NHANES. the real crux is on the health and nutritional status of the maritime fishers which is an unsolved issue addressed. Based on the values that were standardized in our laboratory the food consumption data of the study was converted into raw food equivalents. 2010 & Gopalan et al.in classified as Maritime and inland fishers. 05 Kumarakuru et al Protein calorie adequacy The protein calorie adequacy was calculated for the adolescent age group based on the diets consumed (Table 3). Preferences to specific types of fishes were not expressed. folic acid and Vitamin A was only half to two third of the RDA. The next group which showed protein and calorie inadequacy (15. an alarming per cent of adolescent in the fishing community were prevailing in the protein adequate and calorie deficient status which would destabilize the adequacy per cent if left unattended. vitamin C and iron. Nutrient The age wise mean nutrient intake is presented in Table 2. Consumption of leafy vegetables. The mean intake of energy was around 68.8 per cent. According to the findings from the Table it shows that significant difference was observed in height and weight in both the gender among the different age group. Except for the calcium and thiamine content the intake of all other nutrients were found to be much below the RDA and the intake of iron. This could be the reason why a higher proportion of adolescents have been reported of inadequate consumption of micronutrient including riboflavin. fruits. niacin. through the prevalence of stunting is higher but prevalence is greater in older girls. Further.. Similarly 21 per cent of the adolescent in 13-15 years had calorie adequate but protein deficient diet. protein. Anthropometry Table 4 shows the mean height and weight of the adolescent age groups in both genders. 2015 . According to a study conducted in urban slum of Dhaka. It is also noted that the cereals and millets consumed in all the age group were found to be significantly less than the RDA requirement (460 g/day). riboflavin and niacin percent) was well noted in younger age group (10-12 and 13-15 years) than in the age group of 16-18 years. The clinical Journal of Community Nutrition & Health. Inadequate quantities of protein and calorie consumption were noted in all the groups of which the highest per cent of 16. Heights and weight of genetic make-up and nutritional profile together to determine human height and weight which is only altered socioeconomic background. as the age increases the height and weight is also consequently increasing.www. The food frequency pattern of the adolescent boys and girls revealed that adequacy of the cereals consumption was considerably low in all the age group surveyed.jcnh. Similarly in this data. the consumption of fish was an integral part of the daily diet which varied from 62 to 74 per cent. it was 65 per cent of the girls fell below <3rd percentile of NCHS reference values of which ratio of stunting in older girls was greater. The pulses consumption among the adolescents was adequate when compared with the RDA (40g/day).9 per cent of the RDA and the mean intake of protein was 66. In similar data was also noted in the study where the nutrient intake of adolescents (rural) expects protein all other micro nutrient well below RDA. The cereals and millets consumed in the age group 10-12 years included 148 g/day (boys) and 149 g/day (girls) being the lowest among the adolescent groups surveyed. Whereas in the age group 13-15 years the consumption was only 178 g/day (boys) and 175 g/day (girls) for cereals and millets. Expression of nutrient gap (especially energy.in The data is presented in Table 1.3 and 69.4.8percent) was in the same age group 13-15 years boys. Most of those fishes which remained off the sales were only consumed.1 percent prevailed in the age group 13-15 years girls. The fraction of adolescent receiving adequate energy and protein from the diet was much higher in 10-12 years and 1618 years in both the gender (23-25 percent) when compared with other age groups. roots and tubers. Vol. Though adolescents surveyed fell under the protein and calorie adequacy. Around 60-68 per cent in the age group of 10-18 years had received adequate protein and insufficient calories in their diet. Issue 1. Nutritional status The prevalence of stunting (height for age < 3rd percentile) showed in Table 5 as per NCHS and Indian standards. vitamin A.7 to 63. The food intakes pattern was skewed. fats and oils and sugar and jaggery were found to be lower than the RDA among the adolescent age groups surveyed. On comparing the prevalence rate of thinness and overweight. adolescents (2001).4 448.8 19.43±3.61±0.891 NS 0.416 NS 25.526 NS 22.6±2.5 175±24.221 NS 102.9 100.24±73.30±6.9±13.31±9.5±46.780 NS 0.0±2.32±2.4 61.3 0.2 42.02 1.6 23.5 8.3±1. Vol. NNMB reported 39 per cent of adolescents in rural areas of southern region were stunted [8] while another findings school going children of northern part of India 19.731 NS 0.7 28.4±48. This survey data gives a clear picture of the prevalence of malnutrition in the adolescents group.0±18.5 0.9±4.8±60.1±3. Further the prevalence of overweight and under weight.9 445.893 NS 0.3 25.8 34±15 10.05) * significantly different (p≤0.5 pValue* 0.16±105.970 NS 0.28±84.4 p-Value* 0.2±42.6±3.69±10.944 30.6 0.0 p-Value* NS 149±46.1 pValue* 0.76±52.7±18.5 60±19.5 13.7±7.1 1395±185 44.16±0.07 2.1 0.2±0.8 370. The results are analogues to the data observed by Government of India on working group of TABLE 1: FOOD STUFFS (G/DAY) AMONG 10-19 YEAR BOYS AND GIRLS Food Stuffs 10-12 years Girls Boys Cereals Pulses GLV Other vegetables Roots &tubers Fish Fruits Fats & Oils Milk &Milk products Sugar& Jaggery 148.4 0.6±10.0 336.96±7.A (µg) Thiamin (mg) Riboflavin(mg) Niacin (mg) 1400±145 37.www.43±48.7±6.5 20.717 NS Boys 189.9 pValue* 0.1 13.4 31.345 NS Boys 1424±81 54.2 0.1±57.6 0.4 16-18 years Girls 181±18. Data reveal concomitance between over nutrition and under nutrition particularly in the age group in the age group of 12 to 14 years.05).02 1. These findings can be correlated with the food and nutrient intake.19±2.371 NS 38.0±6.560NS 0.3 28.9 0. In slum area of Dhaka 17 per cent of adolescent's girls reported the prevalence of thinness [10].05) TABLE 2: AVERAGE NUTRIENT INTAKE (G/DAY) AMONG 10-19 YEAR BOYS AND GIRLS Average Nutrient intake Boys Energy(Kcal) Protein(g) Fat(g) Calcium( mg) Iron (g) Vitamin.4±11.0±8.0±30.8±47.6±68.760 NS 0.3 441.63±113.59±0.7 15.6 0. *significantly different (p≤0.6±3.27±5.3 16.9 110.8±10.628 NS AGE GROUP 13-15 years Girls Boys pValue* 178.495 NS 0.0 16-18 years Girls 1464±105 50.628 NS 0.6±10.2 0.78±2.5 42.8 37.1 0.22±87.03 1.6±10.8±3.jcnh.7±2.5 0.990 NS 0. NS. majority of the population were in the underweight sector.31±5.6±0.4 27.4±23.4.4 16.8 18.9 403.1 to 41 percent recorded a prevalence of stunting as per NCHS and Indian standards respectively [9].4 430.412 NS 148.2 18.7±11 17.2 0.6 14.3 15.5±16.1 30.8±10.7 0.19±17.3±23.4 152.4±65.2 18.7 42.774 NS 6.5 7.2±57. 2015 .926 NS 0.891 NS 0.5 103.795 NS 0.5 0.35±2.4 0.17±11.21±5.2 472.904 NS 0.57±0.2±5.254 NS 0.in Kumarakuru et al significance of thinness categories in adolescents is still scarce (Table 6).7±6.256 NS 14.20±64.911 NS 0.06 3.822 NS 0.36±7.3±3.0±22.654 NS 0.05).48±9.730 NS 0.0±81.± standard deviation.807 NS 0.4 18.5 10-12 years Girls 1355±176 37.6 7.926 NS 23±12.345 NS Mean.766 NS 0.3 14.7 158.29±0.241 NS 0.29±4.5 1.6 0.0 29.10.0 148±53.11 &12].835 NS 0.35±10.46±49.763 NS 15.727 NS 12. prevalence of thinness was found to be more in all the age group in both the gender (P≥0.80±4.497 NS 12.345NS 0.6 0.4±16.129 NS 0.4 9.691 NS 0.87±5. (p> 0.0±30.327 NS 48.25±0.9 0.9±53.3 427.624 NS 8. stunting and increased BMI presents the increased morbidity and nutrient deficiency among these adolescents who have continuously undergone a deficient nutrient diet in their DISCUSSION Maximum nutrient requirement is the need in adolescents phase which is the final growth phase of an individual.04 1.2 10.05) 06 Journal of Community Nutrition & Health. Data on thinness among adolescents girls (14 to 50 %) have also been reported in many studies [9.9 8.5±10.8 351.7 13.9 22.225 NS 0.932 NS Mean.599 NS Boys AGE GROUP 13-15 years Girls 1411±89 45.36±16.12±5. ± standard deviation.46±2.491 NS 60.1 369.571 NS 0.3 0.4±91. This is the first data available on the nutrition status of adolescence of fishing community in India.9 0.471 NS 138±63.6 155±58.4±1.59±1.4±0.798 NS 0.251 NS 13.922 NS 0.2 28.2 28±10. Due to low intake micronutrient rich foods.8 0.3 0.7±59.2 52.175 NS 0.8 10. This could be due to particular socio-economic groups or due to the varied availability of nutrients matching to the requirement in the growth phase.313 NS 0.5±9.2 0.67±2.4 8.3±11.9 106.5±6. NS.Non Significant (p> 0.7 24.79±6. Issue 1.0 0.437 NS 105.64±3.2 0.7 377.5±16.Non Significant.648 NS 0.2±0. 992 (P<0. NS.2 54.05) TABLE 5: PREVALENCE OF STUNTING (LOW HEIGHT FOR-AGE) Age Height Boys 130. * significantly different (p<0.1 32.05) 07 0 Journal of Community Nutrition & Health.4 68.6 58.5 25.4 > > > Mean± standard deviation NS.3 47.2 10+ 11+ 12+ Mean± standard deviation NS.4±1. ± Standard deviation.1 21.7±3.www.8 42. .8 16.4 27.3 50.Non significant(p≥0.2 14.4 23.5±1.9 132.8 15.05).5 17.D) OF ADOLESCENT AGE GRO Gender BOYS Agegroup 10-12 13-15 16-18 Mean. Vol.9 7.4 136.7 60. * significantly different (p≤0.2 17. Issue 1.4 23.6 15.1 11.: Inadequate.4 8.5±2.6 127.3 23.5 17.Calorie Adequacy Status Girls Boys 13-15 years Boys 6.05).4 38.9 11.05)NS +: Adequate.Non Significant (P>0.5 16.4 9.2±2.jcnh.in Kumarakuru et al TABLE 3: DISTRIBUTION (%) OF PROTEIN .05) TABLE 6: PREVALENCE OF THINNESS AND OVERWEIGHT (BMI-FOR-AGE) Age 10+ 11+ 12+ BMI kg/m2 Boys 16. * Significantly different (p≤0.8 15.8±2.7 Thinness (BMI <5th percentile (%) Boys Girls B 21. * Significantly different (p≤0.4.1 20.05)* P-CP-C+ P+CP+C+ Chi-square test 16-18 years Girls 15.Non Significant.6 21.8 48.8 20.847 ( P≥0.05)NS Boys Girls 6.7±2.0±1.4 Girls 16.120 (P≥0.4 47.9±6.CALORIE ADEQUACY OF 10-19 YEAR AGE GROUP BOYS AND GIRLS 10-12 years Protein .6 12.05) TABLE 4: HEIGHTS AND WEIGHTS (MEAN ± S. 2015 . which might indicate the Government to undertake measures to augment capital formulation among fishing population by additional alternatives such as setting up of fish processing units and similar arrangements. Issue 1. ICMR (2010).. 1994. Kant S and Kapoor SK. C. 2015 . World Health Organization: Physical Status: The Use and Interpretation of Anthropometry. European Journal Clinical Nutrition. New Delhi: Century Publications.V. Ahmed F. Panda P. 1998. B. Health status of school children in Ludhiana city. 1995.Physical growth : National Centre for health Statistics percentiles. The study also opened avenues for indirectly assessing the food and nutritional security of lower income group who are directly dependent on PDS. 2. Report of World Expert Committee. Vol. J.S. S. on a top priority basis.in CONCLUSION Dependence on Fishing as the main source of livelihood. Ramasastry. Deosthale. Technical Report Series No. Hamill V. p. Recommended Dietary Intakes for Indians.www. 36: 810-815. Delpeuch F. Khan MR. 8.K. 48: 141-1417.. 1999. 2007. through which the adult as well as the adolescent population of fishing folks family is observed to “source” of all subsequent nutritional deficiencies.H. Benjamin AI. “Education and physical growth” Hodder and Stoughton. Nutritional status of adolescent girls and women of Reproductive age. 3. International Journal of Obesity. Indian Pediatr. Drizd T.. Kumarakuru et al 3. Government of Puducherry for financial assistant to carry out the research. 6. Massamba JP.L.M. Nutritive Value of Indian Foods. B. 1989. 10.jcnh. Validity of anthropometry in classifying youths as obese.G.B. The Government might very well take a call on reassessing and recalibrating the schemes related food security in fishermen population pockets of the Union Territory of Puducherry. REFERENCES 1. 4. Roche A.V. 5.F and Moore W. Himes. National Health Programs of India. 08 Journal of Community Nutrition & Health.1979. nutrient intake and dietary pattern of adolescent female factory workers in urban Bangladesh. the need of the hour as per the study require an immediate addressing of nutritional status of the adolescent population of the fishing community through health camps. Is body mass index sensitively related to socio-economic status and to economic adjustment? A case study from the Congo. Indian Journal of Community Medicine 2000. Expert Group of ICMR. Kishore J. 32: 607-629.Londan:1978. Geneva. The American journal of clinical Nutrition.. and Bouchard. NIN. Balasubramanyam. and Panth.441447. India: 2010. Traissac P and Maire B. Asian Pacific Journal of Clinical Nutrition 2005. 14: 1926. Tanner J. This does not mean that “Fishing Occupation” is the reason. Narasinga Rao. setting up special counseling units on nutritional awareness for adolescent population. 9. Report of Regional consultation. 12. Geneva.C. ACKNOWLEDGMENT Thanks to the Department of Science. and above all. Y.V. Technology and Environment.4. Johnson C.M. Singh S and Zachariah P. Cornu A. Reed R. supplementing the population with quality food grains and vegetables in a manner that they do not get back to the market. Hyderabad.C.. but the minimal resource generation out of fishing due to reasons that fall outside the scope of this study. World Health Organization. 11. World Health Organization. Gopalan. Physical status. 25(4):150155. 854. Anand K. Health Organization.A. Nutritional status of adolescent school children in Rural North India. 13: 183193. 7. which certainly require midcourse policy corrections but before every such initiative.