ASSESSMENT OF BODY MASS INDEX AND NUTRITIONAL MEASUREMENTS OF ADOLESCENT GIRLS ANJNA NEMA DEPARTMENT OF HOME SCIENCE, GOVT. AUTO GIRLS P.G. COLLEGE OF EXCELLENCE SAGAR (M.P.), INDIA. ABSTRACT Girls are the core of human dynamics; only healthy females can make socioeconomic upliftment of the country. College girls are in reproductive age and are the future mothers; their nutritional status is significant and should be taken care of. Nutritional status of the mother is the result of her lifetime dietary habits, had a greater influence on the outcome of pregnancy than her dietary status of her own mother will influence the outcome of her pregnancy. The present study was carried out with an objective to know the nutritional status through BMI about 1000 girls who were selected from 15 different colleges of Jabalpur city of Madhya Pradesh. 250 girls from each category, i.e. general category other backward category, schedule caste and schedule tribe were randomly selected. Girls were surveyed and necessary nutritional measurements of height, body height, sitting height and chest girth were obtained. Classification of Body Mass Index and anthropometrics measurements of college girls is reported. Values of correlation coefficients between different nutritional measurements and index are also calculated. Study reveals on the basis of BMI classification as per WHO specification that 69.1percent girls found under normal range.26.9percent girls found malnourished, 4percent girls found in grade I over weight. Category wise classification of BMI shows that 64.8 percent of general category, 74.0 percent of OBC, 57.2 percent of schedule caste and 80.4 percent of schedule tribe girls are in normal range. Category specification shows 29.2 percent General, 22.0 percent OBC, 36.8 percent of schedule caste and 19.6percent ST girls are found malnourished. On the other hand, total 4.0 percent girls found in grade I overweight category. Chest girth shows high positive correlation with weight in all the four groups. It ranged 0.66 to 0.76. BMI shows high positive correlation with body weight. The value r of weight and BMI ranges 0.81 to 0.92. Weight and height are moderately positively correlated ranged 0.32 to 0.44. Height and sitting height are also positively correlated with 0.52 to 0.81. The findings clearly indicate a positive secular trend towards an increase in the mean height, weight and circumference of college girls at Jabalpur of this study. KEY WORDS: Body mass index, Secular Trend. INTRODUCTION: The physical impact on any heavy workload assigned to women, is compounded by gender differences in access to nutrition. While both sexes may be disadvantaged by poor nutrition, women are especially more vulnerable largely because of their special needs associated with the biological processes of reproduction, which require better nutritional status of women. In spite of this fact, the health of women remains a challenge as the majority of women go through life in a state of nutritional stress, as they are malnourished.[1] 235
Girls are the core of human dynamics; only healthy females can make socioeconomic upliftment of the country. College girls are in reproductive age and are the future mothers their nutritional status is significant and should be taken care of. Nutritional status of the mother is the result of her lifetime dietary habits, had a greater influence on the outcome of pregnancy than her diet during pregnancy. [2] It may even be that the nutritional status of her own mother will influence the outcome of her pregnancy.[3] Malnutrition has emerged as a major health problem of our country. Assessment of nutritional status is, one of the most important health indicators of a population group. Various studies have confirmed that malnutrition exists among the poorest section of our country in which children are victims and women in reproductive period appear to be the worst suffers. [4] Health status of Madhya Pradesh shows IMR/1000 live births is 90 and <5 mortality/1000 is 137.6.[5] India is among slow progressing nation in child and maternal core. Madhya Pradesh is one of the states where maternal mortality rates are as high as 700 or more [6]. The report points out that these deaths can be reduced through wider use of key intervention and a Continuum of care approach for mother and child beginning before pregnancy. Therefore it is necessary to assess the nutritional status of youth, before they enter in vicious life cycle of early marriage, conception, pregnancy, abortion, parturition and lactation. Date from NNMB show that a significant percentage of Indian female in the reproduction period is at high risk due to low body weight (<38 kg) and low height (<45 cm). Such women fall into the high risk category of observing problems and low birth weight offspring [7]. In the present study classification of Body mass Index and anthropometrics measurements of college girls are reported. They are further classified in four categories of General Class other backward class, schedule caste and schedule tribe. Values of correlation coefficients between different nutritional measurements and index are also reported separately for all the four groups. Empirical data on measurement of college girls of different caste or class have been very scanty. Data on the nutritional measurements of tribal girls and schedule caste have been most scant. Time trends studies and studies related to anthropometrical measurements are very rare, especially in Madhya Pradesh and on College girls. This kind of time trend study in carried out by some researcher in South India. [8, 9, 10, 11]. Materials and Methods: A study was conducted in various colleges of Jabalpur. Data have been tabulated and analyzed by the simple percentage method. To collect relevant data from different colleges firstly all the colleges of Jabalpur city have been arranged in descending order on the basis of total number of students. Than after colleges having total number of girls students more than 50.0 percent were selected. Thus (15) colleges of Jabalpur city were selected as Sample College by stratified sampling method. 1000 Unmarried girls were selected from 15 different colleges of Jabalpur city of Madhya Pradesh, 250 girls from each class, i.e. general class other backward class, schedule caste and schedule tribe were randomly selected. The relevant data on 1000 Girls comprising 250 from each category i.e. general, other backward class (OBC), schedule tribe (ST) and schedule caste (SC) were selected by purposive sampling from selected colleges but the sample size of each college under study is different on the basis of their above said categories in order to make the sample a representative one. Girls were surveyed and necessary nutritional measurements of height, body height, sitting height and chest girth were obtained. Standardized measurements of height, body weight, sitting height and chest girth were obtained for each subject. All the measurements were 236
taken with due precautions, to minimize the errors. Body mass index is also calculated for each girl. Data was computed through the Z test and correlations between measurements have been calculated. STUDY AREA: Madhya Pradesh is one of the major states of India located in the central part of India therefore it is named so. It has 6,03,85,118 total population out of which 2,8928245 are female. Jabalpur city is heart of India, and a division of Madhya Pradesh. The population of Jabalpur is 2,167,469. ABOUT SAMPLE: College girls of General Category, Schedule Caste, Schedule Tribe and other backward class of Jabalpur city, Madhya Pradesh, are the sample for the present study. Schedule Caste, Schedule Tribe and other backward class are socially disadvantaged groups, as they still continue to lag behind the rest of the society due to their social and economic backwardness. In the specific census data, It is apparent that the majority of these class lives below the poverty line, posses no asset and engage in a low income traditional occupation. Therefore Indian Government has launched various schemes for their educational and economic upliftment SOCIO DEMOGRAPHIC PROFILE OF SAMPLES: The mean age of respondents is 20.5 years. A large number of girls i.e 49.0 percent belongs to nuclear family, followed by joint 47.2 percent, and extended 3.8 percent. 43.7 percent respondents are from lower class families, 33.2 percent respondents are from lower middle class family, 14.4 percent of middle class 8.7 percent of higher class. Regarding education of mother in the study, 11.8 percent mothers of respondents are illiterate, 38.3 percent have acquired education of primary and middle level, 39.9 percent mother were higher secondary educated and only 11 percent were educated up to college level. Result and Discussion: TABLE 1: MEAN VALUES AND STANDRED DEVITION (SD) OF ANTHROPOMETRIC MEASUREMENTS & INDICES MEASUREMENTS GENERAL OBC- 250 SCHEDULE SCHEDULE TOTAL- 250 Girls Girls CASTE- 250 Girls TRIBE- 250Girls 1000 Girls Mean SD Mean SD Mean SD Mean SD Mean SD Age 19.8 1.63 20.0 1.46 20.3 2.16 20.0 1.83 20.1 1.80 (Years) Weight (Kgs) 48.5 6.47 49.4 6.17 46.7* 6.67 47.5* 5.30 48.1 6.29 Height (Cms) 154.8 5.31 154.6 4.89 153.0* 4.87 152.8* 4.67 153.8 5.02 Chest 81.2 5.06 82.9* 6.12 81.2 6.04 80.8 3.46 82.4 5.50 (Cms) Sitting Height 78.3 3.12 70.0* 2.70 80.0* 2.91 79.3* 2.85 79.2 2.96 (Cms) Body mass 20.2 2.47 20.6* 2.36 19.9 2.67 20.3 2.05 20.3 2.43 Index 237
OBC: Other Backward Class *p<0.05 Table 1 shows the mean and SD of different measurements and age of girls. For description, purpose measurements of all the four classes are mentioned separately. General Class: Table 1 shows the mean age of the girls is 19.8 years with 1.63 SD mean height is 154.8 cms with 5.31 SD. Mean weight is 48.5 kg with 6.47 SD. Mean chest girth is 81.2 cms with 5.06 SD. Sitting height mean is 78.3 cms and 3.12 SD. BMI is 20.2 with 2.47 SD. Other Backward Class: The mean age is 20.0 years with 1.46 SD, Mean height is 154.6 cms with 4.89 SD. Mean weight is found 49.4 kg with 6.17 SD, Mean chest girth is found 82.9 cms with 6.12 SD sitting height mean is 79.0 with 2.70 SD and BMI is 20.6 with 2.36 SD. Schedule Caste: The mean age is 20.3 years with 2.16 SD mean height is 153.0 cms with 4.87 SD. Mean weight is 46.7 kgs with 6.67 SD mean chest girls is 79.1 cms with 6.42 SD. Mean sitting height is 80.0 cms with SD 2.91. Mean BMI is 19.9 with 2.67 SD. Schedule Tribe: The mean age is 20.1 years with 1.83 SD. Mean Height is 152.8 cms with 4.67 SD. Mean weight is 47.5 kgs with 5.30 SD. Mean chest girth is 80.8 cms with 3.46 SD sitting height is 82.3 cms with 2.85 SD. Mean BMI is 20.3 with 2.02 SD. It is interpreted that the mean age of the girls is approximately same and so the BMI. The mean weight and chest girth is found different in all categories. OBC girls have higher values for weight as well as chest girth. The lowest value for weight and chest girth is found in schedule caste girls. TABLE 2: DISTRIBUTION OF BODY MASS INDEX (As per the WHO, 1995 Classification) BMI (WHO) Total Girls GENERAL OBC SC ST TOTAL <16.0 Severe Malnutrition 16.0-16.99 Grade II Thinness 17.0-18.49 Grade I Thinness 18.5-24.99 Normal Range 250 3 (1.2percentt) 250 16 (6.4percent) 250 54 (21.6percent) 250 162 (64.8percent) 8 (3.2percent) 5 (2.0percent) 42 (16.8percent) 185 (74.0percent) 12 (4.8percent) 22 (8.8percent) 58 (23.2percent) 143 (57.2percent) 3 (1.2percent) 18 (7.2percent) 28 (11.2percent) 201 (80.4percent) 26 2.6percent 61 6.1percent 182 18.2percent 691 69.1percent 25.0-29.99 250 15 10 15 --- 40 Grade I (6.0percent) (4.0percent) (6.0percent) 4.0percent Overweight 30.0-39.99 250 --- --- --- --- --- Grade II Overweight TOTAL 1000 250 250 250 250 1000 OBC : Other Backward Class, SC : Schedule Caste, ST : Schedule Tribe. 238
Indices: The mean value of BMI among total 1000 girls of the present study is found 20.3 with 2.43 SD. The mean value of BMI of General class girls and schedule tribe are quite close to each other i.e. 20.2 and 20.3 respectively. But the mean value of height and weight of general class was significantly higher. This finding supports the finding of Singh (2005) that BMI is not a very sensitive index and it should be bed carefully and cautiously. BMI should not be presented alone measurements of height and weight should also be presented wherever the results of BMI are to be reported and interpreted. WHO considers BMI as an important nutritional index for detecting cases of under weight and overweight individuals. In the present study classification of BMI of the subject were done as per the WHO specification. [12] (Table-2) As per the classification 69.1 percent girls are under normal range, class specification shows 64.8 percent of general class, 74.0 percent of OBC, 57.2 percent of schedule caste and 80.4 percent of schedule tribe girls are in normal range. Further total 26.9 percent girls found malnourished, class specification shows 29.2percent General, 22.0 OBC, 36.8 percent of schedule caste and 19.6 percent ST girls are found malnourished. On the other hand total 40.0 percent girls found in grade I over weight class. Class wise specification shows equal percentage, i.e. 6.0 percent in Gen class, 4.6 percent overweight in OBCs 6.0 percent in schedule caste, no body found over weight in schedule tribe. Table 3 : Value of coefficient of correlation r between different indices and anthropometric measurements of girls. Variables General OBC Schedule caste Schedule Tribe Height: Weight +0.44 +0.42 +0.42 +0.32 Weight: Sitting Ht. +0.38 +0.37 +0.292 +0.14 Height: Sitting Ht. +0.81 +0.62 +0.60 +0.52 Chest: Weight +0.71 +0.73 +0.66 +0.76 Chest: Height +0.10 +0.33 +0.48 +0.01 Chest: Sitting Ht. +0.08 +0.28 +0.11-0.12 Weight: BMI +0.81 +0.85 +0.84 +0.92 OBC: Other Backward Class Correlation between measurements: Chest girth shows high positive correlation with weight in all the four groups. It ranged 0.66 to 0.76. BMI shows high positive correlation with body weight. The value r of weight and BMI ranges 0.81 to 0.92 this finding supports the study of Rao et.al. [13] that weight is positively correlated with all measurements. Weight and height are moderately positively correlated ranged 0.32 to 0.44. Height and sitting height are also positively correlated with 0.52 to 0.81. The study reveals that weight is a Single simple measurement can be used to assess the nutritional status which supports the study of Rao (1998) that weight is the most suitable indices and stature have low correlation with other indices. 239
Table 4 : Comparison of Anthropometric measurements for 20 years of age Height (cms) Weight (kgs) Chest (cms) Sitting height Study (cms) Mean SD Mean SD Mean SD Mean SD ICMR 1972 Present study 151.7 5.90 43.5 7.28 74.6 6.26 79.2 3.51 152.8* 4.67 47.5* 5.30 80.8* 3.46 82.3 2.85 Time Trends: ICMR study [14] reported All India data of height and weight and other measurements of Indian Children and adolescents (up to the age of 21 years) in different variables of Urban/rural, religion wise, socioeconomic status and state wise. ICMR did not report Urban and rural data separately for each state. In our study the mean age of total 1000 girls is 20.1 years. Therefore we are comparing with the age 20.0 years age of ICMR data calculated for urban girls. Mean height for 20 years of age according to ICMR is 151.7 cms with 5.90 SD. Our study shows mean height is 153.8 cms with 5.02 SD. Weight according to ICMR is 43.5 kg with 7.28 kg SD, our study shows mean weight is 48.5 kg with 6.29 kg SD. Chest circumference mean is 74.6 cms with 6.26 SD as per ICMR study, Our study shows 79.2 cms with 3.51 cms SD. Sitting height is 79.6 cms with 3.31 cms SD as per ICMR study, our study shows mean sitting height 79.2 cms with 2.96 SD.(Table 3). These findings clearly indicate a positive secular trend towards an increase in the mean height, weight and circumference of college girls at Jabalpur of this study. This positive secular trend could be due to better diet, nutrition, better health service and living conditions of girls of the present study. It may also be mentioned here that the sample of All India Urban girls included the girls of the states of north India who are in better status of body build than the girls of Madhya Pradesh, which actually comes under BIM AROU, states of India and is still far behind on account of economic and social development parameters. Despite their inclusion in the All India Urban sample college girls in Jabalpur of this study showed greater mean height, weight that All India Urban girls of 20 years age group reported by ICMR.This finding supports the finding of Bharti et. al [15]. They studied patterns of growth in height and weight of Bengali girls that the 50 th percentile value of their sample of height and weight is higher compared to ICMR (1972) Singh 2005 [11] who have studied the time trend study of different body measurements on boys at chennai and Ooty find similar results. Summary and Conclusion: This is concluded that the higher value for BMI, weight & height is observed in other backward class girls. The lowest value for BMI, weight & height is observed among schedule caste girls. The values of different body measurements and Indices are very close to each other among girls of general class and schedule tribe. Maximum number 92 (36.8 percent) girls of schedule caste found to be malnourished minimum numbers 49 (19.6 percent) girls of schedule tribe found to be malnourished. 80.4 percent girls of schedule tribe 240
are found at normal range followed by 74.0 percent of OBC, 64.8 percent of General class and 57.2 percent of schedule caste girls. Interestingly none girls from ST are found to be overweight. The reason for better nutritional status among ST girls could be their better body build (Genetic reasons) and their diet pattern. Body mass index and weight are positively correlated. References 1. Ashrit, Radha, Health Status of working women. Yojna 2006, 50; 75-78. 2. Baired, D; Variation in fertility association with change in health status. J. Chron. Dise., 1965, 18, 1109. 3. Zemeshoffs, S. Marthens E. Van and Grawell: DNA (Cell number) in neonatal brain: Second generation (F 2 ) alteration by maternal (F 0 ) dietary protein restriction science, 1971,172; 850. 4. ICMR, studies on preschools children technical report series-26, ICMR, 1984. 5. National Health Policy, Government of India 2005. 6. WHO, World Health Report 2005. World Health Organisation. 7. Kharade Pallavi, P. and Usha Anthony, Nutritional status and outcome of pregnancy in Young and Older mother in Mumbai. The Ind. J. Nutr. Dietet, 2002, 39, 26-30. 8. Rao, K. Visweswara, Rau Parvathi and Thimmayamma, B.V.S., Nutritional anthropometry of Indian adults. The Ind. J. Nutr. Dietet., 1986, 23, 239-256. 9. Rao, K. Visweswara, N. Balkrishna., P.B. Pillai and Leela Raman., Relative Utility of Various anthropometric Indices in assessing the nutritional status of lactating women man in India, 1998, 78 (1 & 2), 57-71. 10. Madhavan, S., Singh, R. and Swaminathan, M.C., Secular changes in height and weight on Indian adults, Ind. J. Med. Res. 1964, 52, 612-617. 11. Singh, R., Nutritional Measurements and Body Mass Index of college boys in Chennai and Ooty and the Badaga men at the Nilgiri hills. Phys. Anthrop. Hum. Genet. 2005, 24, 231-241. 12. WHO Expert committee, Physical status: The use and interpretation of anthropometry. Report of a WHO Expert Committee 1995. World Health Organisation Geneva. 13. Rao, K. Visweswara, N. Balkrishna., B.V.S. Thimmayamma and Parvathi Rau., Indices and critical limits of malnutrition for use among adults. Man in India 1990, 70 (4), 351-367. 14. ICMR, Growth and Physical Development of Indian Infants and Children, Indian council of Medical Research 1972, Technical Report Series no. 18. 15. Bharti, Sushmita, Mukharjee, Deepak, Bharti, Premnanda and Gupta Rajan., Pattern of growth in height and weight of Bengali girls of Howrah district West Bengal. Man in India, 1992, 72, 4, 423-43. 241