Nutritional assessment Gujarat Ahmedabad selected by Go I

Nutritional assessment

Gujarat Ahmedabad (selected by Go. I) Ahmedabad Municipal Corporartion (10 schools) Dascroi (6 schools) Sample size (385 children) Sabarkantha (selected by Go. G) Sanand (6 schools) Himmatnagar (6 schools) Bhiloda (6 schools) Sample size (173)

� Anthropometic � Diet Assessment Pattern Survey � Clinical Survey

� Body weight � Height � Mid upper arm circumference (MUAC)

Body weight Height MUAC Anthropometric Measurement

Table-1 Anthropometric parameters and BMI of school children as per age Age (n)% Height Weight BMI MUAC 5 (10)1. 79 110. 55± 3. 72 15. 24± 2. 22 12. 48± 1. 71 15. 50± 1 6 (37)6. 63 110. 86± 4. 69 16. 53± 3. 12 13. 37± 1. 51 15. 67± 1. 56 7 (46)8. 24 115. 11± 4. 69 18. 30± 3. 12 13. 71± 1. 51 16. 19± 1. 56 8 (58)10. 39 122. 01± 6. 11 20. 67± 3. 61 13. 81± 1. 57 16. 81± 1. 55 9 (60)10. 75 127. 31± 7. 08 22. 81± 3. 79 14. 00± 1. 45 17. 36± 1. 67 10 (75)13. 44 131. 11± 7. 22 24. 64± 4. 79 14. 23± 1. 67 17. 63± 1. 92 11 (60)10. 75 137. 29± 6. 41 28. 13± 4. 42 14. 88± 1. 81 18. 64± 2. 41 12 (76)13. 62 140. 25± 7. 36 30. 52± 6. 00 15. 45± 2. 39 19. 34± 2. 61 13 (78)13. 97 145. 47± 7. 97 33. 22± 5. 80 15. 62± 1. 98 19. 77± 2. 19 14 (49)8. 78 149. 70± 6. 53 37. 30± 7. 20 16. 60± 2. 79 20. 93± 2. 71 15 (6)1. 07 154. 63± 4. 29 41. 27± 1. 13 17. 30± 1. 18 20. 64± 2. 41 16 (2)0. 35 150. 00± 2. 83 43. 40± 14. 70 19. 42± 7. 27 18. 95± 1. 48 18 (1)0. 17 163. 00± 0. 00 44. 70± 0. 00 16. 82± 0. 00 23. 00± 0. 00

Table-2 Nutritional status of school children as per age and gender Age n Height (cm) Weight (kg) BMI (kg/m 2) Male Female Male 5 4 6 16. 48± 0. 61 14. 42± 2. 58 13. 40± 0. 10 11. 86± 2. 04 15. 38± 0. 63 15. 58± 1. 24 6 18 19 7 22 24 8 24 34 9 33 27 110. 33± 4. 5 9 109. 00± 3. 0 3 114. 22± 4. 9 1 121. 59± 5. 4 7 126. 48± 6. 0 8 131. 22± 7. 0 4 137. 90± 7. 1 7 139. 59± 6. 8 2 146. 04± 8. 1 4 149. 48± 7. 0 1 153. 38± 3. 5 0 150± 2. 83 10 36 39 11 24 36 12 41 35 13 35 43 14 25 24 15 2 4 16 0 2 110. 88± 2. 4 6 113. 06± 5. 5 4 115. 43± 6. 0 7 122. 42± 7. 0 7 128. 30± 7. 6 2 131. 14± 7. 5 7 136. 17± 5. 1 0 140. 95± 7. 9 3 139. 59± 6. 8 2 149. 62± 6. 1 7 157. 45± 7. 1 4 - Female MUAC (cm) Female Male Female 17. 49± 4. 32 15. 70± 1. 34 13. 53± 2. 00 13. 22± 1. 02 15. 78± 2. 10 15. 55± 1. 03 18. 41± 3. 57 17. 82± 3. 02 13. 72± 1. 69 13. 60± 1. 67 15. 95± 1. 60 16. 20± 1. 50 20. 92± 4. 35 20. 42± 3. 06 13. 82± 1. 54 13. 79± 1. 63 16. 67± 1. 65 16. 91± 1. 51 22. 45± 3. 63 14. 04± 1. 42 13. 97± 1. 55 17. 28± 1. 83 17. 52± 1. 45 23. 22± 3. 91 24. 61± 4. 93 14. 29± 1. 79 14. 17± 1. 61 17. 49± 1. 90 17. 78± 1. 97 24. 73± 4. 76 28. 47± 3. 89 27. 64± 4. 50 15. 37± 2. 12 14. 45± 1. 35 18. 46± 2. 84 18. 58± 1. 88 31. 66± 6. 49 29. 31± 5. 34 15. 86± 2. 50 14. 99± 2. 25 19. 69± 2. 85 18. 92± 2. 32 29. 31± 5. 34 33. 83± 5. 43 14. 99± 2. 25 15. 83± 2. 16 18. 92± 2. 32 20. 04± 2. 50 35. 53± 5. 14 38. 87± 8. 67 15. 87± 2. 13 17. 30± 3. 28 20. 36± 1. 92 21. 50± 3. 35 41. 50± 0. 71 41. 50± 1. 29 16. 80± 1. 81 17. 67± 1. 12 20. 75± 0. 35 20. 25± 3. 28 - 43. 4± 14. 71 - 19. 42± 7. 27 - 18. 95± 1. 48

Table-3 Nutritional status of primary and upper primary school children as per gender Ref: WHO (2007) BMI (Z scores) Primary school Gender Normal n (%) Moderate undernutrition n (%) Severe undernutrition n (%) Overweight n (%) Total Male 89 (54. 26) 43(26. 22) 26(15. 85) 6 (3. 65) 164 Female 100(57. 47) 56(32. 18) 15(8. 62) 3(1. 72) 174 BMI Upper Primary school Male 49(49. 49) 27 (27. 27) 21(21. 21) 2 (2. 02) 99 Female 64(52. 89) 37 (30. 57) 14 (11. 57) 6 (4. 95) 121

Nutritional Status

Depigmentation 50. 00% 42. 43% 39. 07% 33. 94% 27. 30% 26. 24% 26. 88% Male Female 25. 00% Total 12. 19% 15. 13% 7. 69% 0. 00% Primary Upper Primary Total

Night Blindness 6. 79% 4. 52% 3. 94% Males Females Total 2. 69% 2. 26% 1. 78% 1. 25% 1. 19% 0. 59% Primary U. Pry Total

Bitot Spot 5. 93% 4. 75% 4. 66% 3. 58% 1. 81% Primary 0. 90% U. Pry Females Total 2. 71% 1. 19% Males 1. 08% Total

Pale Conjuctiva 25. 00% 20. 36% 13. 98% 11. 76% 12. 50% 9. 79% 8. 60% Females Total 8. 96% 7. 12% 5. 02% 2. 67% 0. 00% Primary U. Pry Males Total

Pale Skin 75. 00% 53. 85% 47. 13% 50. 00% 42. 73% Males Females Total 28. 05% 24. 04% 25. 00% 25. 79% 22. 40% 24. 73% 18. 69% 0. 00% Primary U. Pry Total

Mottled Enamel 49. 55% 48. 39% 46. 61% Males 24. 91% 26. 11% 23. 44% Primary 23. 08% 23. 53% U. Pry Females 23. 48% Total

Decaying, Mottling and Filling 35. 01% 30. 11% Males Females 22. 62% Total 18. 10% 15. 59% 16. 91% 10. 86% 11. 76% Primary U. Pry 14. 52% Total

� The quantity served per child was generally as per the requirement of primary school or upper primary school children. � In some schools more number of children were present in comparison to the number of children who consumed MDM.

Age (yrs) Weight Energy (Kcal) Protein (gm) 7 -9 25. 1 1690 29. 5 Boys 10 -12 34. 3 2190 39. 9 Girls 10 -12 35 2010 40. 4 Boys 13 -15 47. 6 2750 54. 3 Girls 13 -15 46. 6 2330 51. 9 Boys 16 -17 55. 4 3020 61. 5 Girls 16 -17 52. 1 2440 55. 5

Meal Ener gy Prote Fa Carot in t ene Thiam ine Ribofla vin Niaci Vit Folaci Vit Iro n B 12 n Calciu Vit A m Dal rice+ Brinjal potato 566 10 16 64 0. 2 4 0 38 17 1 34 192 Chana sabzi + Roti 208 6 8 37 0. 1 0 38 0 2 46 119 Khichdi 361 6 8 5 0 0 2 0 13 0 1 12 3 Pulao 7. 3 8 6. 6 0. 1 2. 3 0 10. 3 3. 3 1 16 163. 7 433

Ø It was observed that the recipes could not meet the expected amounts of energy and proteins, compared to RDAs Ø Only Dal rice and brinjal potato(566 kcal) could provide energy close to expected amounts(646 Kcal). Ø Flourosis was observed in majority of the children.

� It is desirable to have cereals and pulses along with vegetables and fruits. � Drumstick leaves should be included in recipes. � One piece of sapota or mango approximately 100 -150 g may be distributed along with rice. � 20 g of whole Bengal gram for primary and 30 g upper primary be soaked and cooked with pulao to give balance of protein and energy. � Recipes like LAPSI are not liked by children therefore a substitute for this should be thought of.

� The last 10 per cent of the children having lowest academic performance should be medically examined regularly for anaemia, IDD, hearing and eyes.