Diet and nutritional status of rural adolescents in India

Abstract

Objective: To study the current diet and nutritional status of rural adolescents in India.

Design: Cross-sectional study with household as the unit of randomization.

Setting: National Nutrition Monitoring Bureau collected information in the rural areas of the nine States.

Methods: In each State, 120 villages were selected from eight districts. From each of the selected villages, 20 households (HHs) were selected from five clusters. The information on socio-demographic profile was collected in all the 20 HHs, while anthropometric data such as weight, height and clinical signs of nutritional deficiency was collected on all the available adolescents in the selected households. In every fourth sampled household, ie five HHs, dietary information on all the members was collected using 24 h dietary recall. The outcome measures for nutritional status were proportion of underweight (<median −2 s.d. of NCHS standards of weight for age), stunted (<median −2 s.d. of NCHS standards of height for age) and body mass index. The nutrient intakes were compared with recommended dietary allowances (RDA).

Results: Anthropometric and socio-economic information on 12 124 adolescent boys and girls and dietary information on 2579 individuals in 1996–1997 was available for the analysis. The major occupation of the heads of the households surveyed was agriculture. More than a third (37.3%) of the families with adolescents did not possess any land. The per capita income per month was about Rs 250/- at 1996–1997 prices. About 23% of the adolescent girls were married before the age of 18 y. About a quarter of the married adolescent girls had short stature and 18.6% were underweight. They considered as ‘at risk’. About 39% of the adolescents were stunted (<Median −2 s.d. of NCHS height for age) irrespective of sex. The prevalence of undernutrition (<median −2 s.d. of NCHS weight for age) is higher (53.1%) in boys than in girls (39.5%). The extent of stunting was higher (42.7%) among adolescents belonging to the scheduled caste community. In the case of girls, the extent of underweight was considerably less in each age group than their male counterparts. About 70% of adolescents consumed more than 70% of RDA for energy. The intakes of micronutrients such as vitamin A and riboflavin were woefully inadequate.

Conclusions: The extent of undernutrition was high among adolescents and was higher among boys than girls. Adolescent girls in the rural areas could be at greater risk of nutritional stress because of early marriage and early conception before completion of their physical growth.