|Year : 2012 | Volume
| Issue : 2 | Page : 101-105
Nutritional status of school going adolescent girls in Lucknow District
Beena Sachan1, Mohammad Zafar Idris1, Savita Jain1, Reema Kumari1, Ashutosh Singh2
1 Upgraded Department of Community Medicine, CSM Medical University UP, Lucknow, India
2 Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India
|Date of Web Publication||22-Sep-2012|
In front of Dr. Uma Singh, Ashok Nagar, Ghatampur, Kanpur Nagar, Uttar Pradesh - 209206
Source of Support: None, Conflict of Interest: None
Objectives: To study the nutritional status of school going adolescent girls in Lucknow district, Uttar Pradesh, India.
Materials and Methods: A cross-sectional descriptive study was carried out in urban as well as rural schools of Lucknow district from October 2008 to September 2009. Multistage random sampling was used to select the requisite number of girls. A total of 847 school going adolescent girls between 10 and 19 years of age were interviewed and anthropometric measurements were recorded for assessing the nutritional status.
Results and Conclusions: The mean weight in all age groups in both urban and rural schools showed significant difference with the ICMR mean weight for respective ages except in ages 18 and 19 years in urban school girl's and in ages 10 and 19 years in rural school girls. The mean height in all age groups in both urban and rural schools showed significant difference with the ICMR mean height for respective ages except in ages 18 and 19 years in urban schools and in ages 16, 17, 18, and 19 years in rural schools. Overall prevalence of thinness was found to be 17.0% and 11.4% (BMI <5th percentile according to NCHS-CDC reference) among urban and rural school going adolescent girls respectively. Overall prevalence of overweight was found to be 5.4% and 3.9% (BMI >85th percentile according to NCHS-CDC reference) among urban and rural school going adolescent girls, respectively.
Keywords: Adolescent girls, body mass index, Lucknow, nutritional status
|How to cite this article:|
Sachan B, Idris MZ, Jain S, Kumari R, Singh A. Nutritional status of school going adolescent girls in Lucknow District. J Med Nutr Nutraceut 2012;1:101-5
|How to cite this URL:|
Sachan B, Idris MZ, Jain S, Kumari R, Singh A. Nutritional status of school going adolescent girls in Lucknow District. J Med Nutr Nutraceut [serial online] 2012 [cited 2019 Jun 20];1:101-5. Available from: http://www.jmnn.org/text.asp?2012/1/2/101/101298
| Introduction|| |
Adolescents are those between the ages of 10 and 19 years old.  Adolescence is a transitional phase between childhood and adulthood characterized by marked acceleration in growth. , Growth monitoring by anthropometric measurement during this period, is not only an important health indicator but also a predictor of various morbidity in the community, though the anthropometry is universally applicable, simple, inexpensive, and noninvasive technique, it is still an underused tool for guiding public health policy as well as individual clinical decision. 
Reports of the World Health Organization (WHO) suggest that in South East Asian Region a large number of adolescents, who constitute 20% of the population in these countries, suffer from malnutrition, which adversely impacts their health and development. 
Health and nutrition of the girls of today will affect the health and survival of the future generation. Adolescent girls are the mothers of tomorrow and no edifice can be built on a foundation which is so weak.
To study the nutritional status of school going adolescent girls in Lucknow district.
| Materials and Methods|| |
The present cross-sectional study was carried out among school going adolescent girls in Lucknow District. Overall 847 school going adolescent girls (593 urban and 254 rural) of Lucknow district, aged 10-19 years were interviewed and examined.
Multi-stage random sampling technique was used to select the requisite number of girls.
At first stage, Lucknow district was divided into urban and rural areas. Then urban Lucknow was divided into six zones. These six zones were further subdivided into Cis Gomti and Trans Gomti. From Cis Gomti two zones were randomly selected and similarly from Trans Gomti two zones were randomly selected.
At the second stage, from each zone one senior secondary school was selected randomly from the listed Government senior secondary schools. Similarly rural Lucknow was divided into eight blocks of which two blocks were randomly selected. In the next step from each block, one senior secondary school was randomly selected from listed Government senior secondary schools.
At the third stage, in a given school, students from classes VI to XII of age group 10-19 years were selected. Students within the class were selected through systematic random sampling. In some schools of rural area, the numbers of students in the classes were not enough that is why systematic random sampling was not possible and all the students of the class were invited to participate in the study.
By using this multistage random sampling technique, four schools were randomly selected in urban area and 593 adolescent girls were chosen from these schools. Similarly in rural area two schools were randomly selected and from there 254 adolescent girls were chosen.
The statistical analysis was carried out using windows version of SPSS 16.0. Mean and standard deviation of the anthropometric data, obtained on 10-19 years old adolescent girls were calculated for each age group.
For the purpose of comparison ICMR reference value for height and weight were used. Body Mass Index (BMI) was computed using the standard equation: BMI (kg/m 2 ) = Weight (kg)/Height 2 (m 2 ). The cut off value for thinness was the <5th percentile of NCHS-CDC standards and for overweight it was >85th percentile of NCHS-CDC standards.
| Results|| |
A total of 847 school going adolescent girls (100%) were included in the study drawn from six randomly selected Government schools (four schools from urban area and two schools from rural area) from the Lucknow district through multistage random sampling.
[Table 1] shows the age wise distribution of mean weight of girls and their comparison with the ICMR standards. The mean weight of adolescent girls in all age groups in both urban and rural schools was better than ICMR standards. The mean weight in all age groups in both urban and rural schools showed significant difference with the ICMR mean weight for respective ages except in ages 18 and 19 years in urban school girl's and in ages 10 and 19 years in rural school girls.
|Table 1: Distribution of mean weight (kgs) of adolescent school girls by age|
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[Table 2] shows age wise distribution of mean height of girls and their comparison with ICMR standard. The mean height of adolescent girls in all age groups in both urban and rural schools was better than ICMR standards except in age 19 years in urban schools. The mean height in all age groups in both urban and rural schools showed significant difference with the ICMR mean height for respective ages except in ages 15, 18, and 19 years in urban schools and in ages 16, 17, 18, and 19 years in rural schools.
|Table 2: Age wise distribution of mean height (Cms) of adolescent school girls|
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[Table 3] shows age wise distribution of adolescent school girls by the prevalence of thinness and overweight. In urban girls the prevalence of thinness was more, 17.0% than in rural girls, 11.4%. In urban girls the prevalence of overweight was also more, 5.4% than in rural girls, 3.9%. Highest prevalence of thinness, i.e., 38.1% was in 18 years aged girls in urban schools, while in rural schools it was maximum, i.e., 37.5% in 10 years aged girls. Highest prevalence of overweight, i.e., 15.6% was in 16 years aged girls in urban schools while in rural schools it was maximum, i.e., 29.4% in 18 years aged girls.
In rural schools, none of the girls of ages 10 to 14 years were overweight.
|Table 3: Distribution of adolescent school girls by age and body mass index|
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| Discussion|| |
Mean weight of adolescent school girls by age
In the present study, it was observed that in both urban and rural schools the mean weight of adolescent school girls was significantly higher than ICMR mean weight in all the ages except in ages 18 and 19 years in urban school girls and in ages ten and nineteen years in rural school girls.
The findings of this study are in concomitant with the findings of Tripathi, et al.  and Ahmad, et al.,  who observed similar differences in mean weight from ICMR standard for corresponding ages, except in age 19 years, where it was below ICMR standard. There were also significant differences with ICMR mean weight in all ages except 13, 14, 18, and 19 years in urban girls.
Mean height of adolescent school girls by age
Similar to the weight, in both urban and rural adolescent school girls mean height was significantly higher than ICMR mean height for respective ages except in ages 15, 18, and 19 years in urban schools and in ages 16, 17, 18, and 19 years in rural schools.
Almost similar findings were observed by Tripathi, et al.  and Ahmad, et al.,  in their study at Lucknow, who observed that mean height in all the ages were better than ICMR standards, except in the age of nineteen years. The mean height was significantly higher than ICMR mean height in ages 12, 13, 14, and 17 years in rural girls and 12 and 13 years in urban girls.
A little slowing down of growth was observed in the present study (in terms of weight and height) in late adolescent age group (17-18 years) while in early or middle adolescent age group (10-13 and 14-16 years), our parameters were higher than those of ICMR standards. The effect of improvement in both weight for age and height for age among adolescents girls is not reflected in body mass index. Bisai, et al.,  observed in their study that rate of underweight was more among late adolescence than early adolescents. In our study it was found that this late adolescent age group was more health conscious related to weight.
In the present study weight and height seems to be increasing over time, it means that adolescent girls exhibited better nutritional status. This improvement in the nutritional status may be due to Mid-day Meal Programme and increased literacy rate. Research has shown that better nourished girls have higher pre-menarcheal growth velocities and reached menarche earlier than undernourished girls. 
Furthermore, nutritional improvement through food supply may bring about some catch-up, growth, but it may also increase the risk of obesity, as seen in adolescents who have an accelerated maturation,  and as suggested by the observed association of overweight with.  Therefore, it is assumed to contribute to the pandemic of diabetes and hypertension in foreseeable future.
Prevalence of thinness and overweight
In the present study, it was observed that overall thinness (defined as BMI <5th percentile of NCHS- CDC reference) among urban girls was 17.0%, which was more than the overall thinness in rural girls (11.4%). Adolescent girls of urban area are unconstructively apprehensive about slim figure due to more media exposure. It is posing a detrimental threat to their health and nutritional status.  Almost similar findings were also observed by Das, et al.  (14.7%) in their study. Sood, et al.  and Bose, et al.  reported a prevalence of thinness 5.1% and 23.1%, respectively, while Shahabuddin et al.,  in a rural community in Bangladesh, observed that 59.0% adolescent girls were thin. This higher figure of thinness in their study may be attributed to poor socioeconomic conditions of rural Bangladesh.
The poor nutritional status of adolescent girls has important implications in terms of physical work capacity and adverse reproductive outcomes.
It was observed, that overall overweight (defined as BMI >85th percentile NCHS-CDC reference) among urban school was 5.4%, which was more than rural girls (3.9%).
Subramanyam, et al.,  in their study among adolescent girls in Chennai, observed that prevalence of overweight (BMI >85th percentile) was 9.6% in adolescent girls which is almost similar to our findings. While Mehta, et al.  and Sood, et al.  in their study, reported a prevalence of overweight 15.2% and 13.1%, respectively, which was more than our study and could be incriminated to the affluent society.
The prevalence of overweight in our study is lower in comparison to other studies. It is not towards increasing trend. So still the prevalence of under nutrition is major concern. It is seen in our study that adolescent girls of urban families are more overweight than rural families because of decreased physical activities, sedentary lifestyle, altered eating patterns, and increased fat content of the diet. The increasing prevalence of obesity in a population is an early indicator of an emerging health burden due to the increasing mortality and morbidity from noncommunicable diseases such as diabetes and hypertension in developing societies. Although diabetes and hypertension are higher in urban area it is growing fast in rural area too because of adopting urbanized lifestyle. 
Nutritional status of adolescent girls contributes to nutritional status of community. As a preventive strategy, there is a need to apply health and nutritional education program for inculcating healthy life styles.
| Acknowledgment|| |
The authors are sincerely thankful to the principals of schools wherein the study was undertaken, for their valuable help extended during the study.
| References|| |
|1.||World Health Organ. Physical status:the use and interpretation of anthropometry. Report of the WHO Expert Committee. World Health Organ Tech Rep Ser 1995;854:1-452. |
|2.||Adolescents Nutrition: A review of the situation in selected South - East Asian countries World Health Organization. Regional office of South East Asia. 29 Dec 2005. Executive Summary. |
|3.||Anand K, Kant S, Kapoor SK. Nutritional status of adolescents school children in rural north India. Indian Pediatr 1999;36:810-5. |
|4.||Tripathi S. Study of health status and effectiveness of iron folic acid prophylaxis among adolescent girls of Lucknow. Thesis for MD, K.G.M.C., Lucknow; 2002. |
|5.||Ahmad N. A study on the nutritional status of adolescent school students in Lucknow district. Thesis for MD, K.G.M.U., Lucknow; 2004. |
|6.||Bisai S, Bose K, Ghosh D, De K. Growth pattern and prevalence of underweight and stunting among rural adolescents. Nepal Paediatr Soc 2011;31:17-24. |
|7.||Post GB, Kemper HC. Nutrient intake and biological maturation during adolescence. The Amsterdam growth and health longitudinal study. Eur J Clin Nutr 1993;47:400-8. |
|8.||Popkin BM, Richards MK, Montiero CA. Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J Nutr 1996;126:3009-16. |
|9.||Dixit S, Agarwal GC, Singh JV, Kant S, Singh N. A study on consciousness of adolescent girls about their body image. Indian J Community Med 2011;36:197-202. |
|10.||Das DK, Biswas R. Nutritional status of adolescent girls in a rural area of North 24 Parganas district, West Bengal. Indian J Public Health 2005;49:18-21. |
|11.||Sood A, Sundararaj P, Sharma S, Kurpad AV, Muthayya S. BMI and body Fat percent: Affluent adolescent girls in Bangalore City. Indian Pediatr 2007;44:587-91. |
|12.||Bose K, Bisai S. Nutritional status of rural adolescent school children in Paschim Medinipur, West Bengal. Indian Pediatr 2008;45:515-6. |
|13.||Shahabuddin AK, Talukder K, Talukder MK, Hassan M, Seal A, Rahman Q, et al. Adolescent nutrition in a rural community in Bangladesh. Indian J Pediatr 2000;67:93-8. |
|14.||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. |
|15.||Mehta M, Bhasin SK, Agrawal K, Dwivedi S. Obesity amongst affluent adolescent girls. Indian J Pediatr 2007;74:619-22. |
|16.||Sayeed MA, Mahtab H, Akter Khanam P, Abdul Latif Z, Keramat Ali SM, Banu A, et al. Diabetes and impaired fasting glycemia in a rural population of Bangladesh. Diabetes Care 2003;26:1034-9. |
[Table 1], [Table 2], [Table 3]