Nutritional Deficiencies of Adolescent Boys and Girls of Kashmir Valley (J&K, India)

ABSTRACT

The present study focused on nutrition deficiencies of adolescent boys and girls. The field sample for the present study was undertaken in six districts of Kashmir valley J&K (viz, Srinagar, Budgam, Anantnag, Kupwara, Pulwama and Baramulla), covering a sample of 1500 adolescents i.e. 750 boys and equal number of girls in the age group of 10-19 years, study in Government Schools. The findings of the study suggests that lifestyle including nutritional habits track from adolescent into adulthood, thereby lead to increased incidence of chronic disease e.g. cardiovascular diseases, diabetes and cancer. Exposure in childhood and adolescence to adverse life style and faulty food habits such as poor food intake, special meal preferences and patterns and above all sedentary life style may exacerbate this, thus worsening the prognosis. Hence promotion of healthy nutrition habits and physically active life style during adolescent period is a critical public health strategy.

Keywords: Nutrition, Deficiency, Adolescents, Boys, Girls

INTRODUCTION

Adolescence is a time of change to adult behavior and there by eating habits of childhood gradually change into those typical of an adult. Adolescence is, therefore, an important time that demands for health and nutrition education. Eating habits may be erratic large quantities may be eaten one day and very little next day. It has been pointed out by researchers that adolescents in different parts of the country had nutritional deficiencies. It occurs in boys as well as in girls. Adolescent girls are at special nutritional risk because of iron deficiency anemia. The requirement of iron, which is 18 mg/day, is needed not only to make losses due to menses but also to build up reserves. Calorie requirement for most adolescent is high. An adolescent may rush off to school without eating breakfast. When away from home he or she usually eats readily available meals that are acceptable to its peer groups. This means snacks in the form of fast-food (junk food). He/she eats fewer meals at home where parents can provide them nutritious diet. Adolescents may indulge in food fads, macrobiotic diets and semi starvation regimens in calories, vitamins and minerals. An adolescent protein need/unit body weight is higher than that of adult but less than a rapidly growing infant. 7 Introduction Adolescents have higher vitamin and mineral needs compared with people at most other life stages. Adolescents are mostly concern with vitamin A, calcium and iron each of which plays an important role in growth. Adolescents who do not achieve sufficient bone density have greater risk of developing osteoporosis later in life (Heald 1975; Thomas 1989). Physical changes cause an adolescent to focus attention on his body as he tries to incorporate his new appearance into his developing sense of identity. Many adolescents go through stages, which they are pre-occupied with their appearance and body functions. They may see nutrition as helpful or harmful to their developing body image. A boy may show concern about his body in relation to athletic ability. He may want to eat more to increase his weight and muscle mass. The deposition of fat which normally occurs in adolescent girls may cause her to become concerned that she is getting fat limiting calorie intake at this time may interfere with linear growth. The onset of obesity during adolescence may contribute to a number of psychological problems. It may interfere with development of positive body image (Starz 1983; Kapil 2002).

Dietary recommendations during adolescence must take into account the social and attitudinal characteristics of the individual as well as the timing and the rate of growth. Greater independence from family supervision and guidance is associated with increased peer conformity and influences of mass media. Rapid changes in body create alterations in body image and individual reactions to those changes. Emotional instability may cause intermittent stress. Physical activity may be higher among individuals who participate in competitive sports but very low in those with sedentary pursuit’s time schedule may lead to the omissions of some meals or to greater frequency of eating may be consumed more often away from home and may commonly be bought in franchised food outlets. Interest of non-traditional eating pattern may increase. Nutrient needs during adolescence are dictated by the rate of growth. Requirement increases at the outset of growth. Spirit reaches their maximum at the time of peak growth and gradually approach adult levels as growth subsides (Srilakshmi 2002).

The age of puberty has shifted gradually to earlier years and a lengthened period of education and dependence has served to expand the life of adolescence (Garg 2002). During this period of life the stress of rapid growth becomes evident and are manifest both in Physical and mental changes and in sexual maturation of the individual. If there is non acceptance of adolescent role as an individual or a male or a female, there is opt to develop a defiant loneliness, feeling of rejection, and an unbearable resentment or even hatred of oneself or of one or both parents that may transfer to all members of a particular sex or social group or to society as a whole with disastrous consequences (Bhattacharya 1985). Out of this turmoil there may develop panoply of special medical and social problems. Some are related to genetic factors and some to physiological changes within the individual where as others develop from the search for identity and purpose with concomitant rebellion against a real or apparent restraining society not infrequently the causes interrelated and mutual reinforcing such as defiance of parents, drinking alcohol, drugs, pregnancy and venereal diseases.

MATERIAL AND METHODS

The present study was carried out in Government Schools of six Districts of Kashmir Valley were Srinagar, Budgam, Anantnag, Kupwara, Pulwama and Baramulla. The study was undertaken on 1500 adolescents aged 10-19 years of age, both boys and girls. As per census of 2001-02 (Education Department, J&K) total population of J&K adolescents from 10-14 was 7.9 lakh (4.1 lakh boys and 3.8 lakh girls) and between 15 and 19 years the total population of adolescents was 5.4 lakh (2.5 lakh boys and 2.8 lakh girls). Since the size of adolescents was too large to be covered, it was decided to employ sampling method.

A. Sample Size

A total of 1500 government school students comprising nearly 1% of State’s total on roll adolescent population were chosen by Simple Random Sampling. The specific population selected for sampling in the survey was students attending schools from middle to higher secondary.

Sampling Procedure:

The study sample was selected using the following design.

B. Design: - Multi stage sampling procedure.

Thirty sites were selected as follows:

Stage I: Administratively, Kashmir valley at the time of data collection was divided into six districts. Two Tehsils from each district were selected to obtain total of 1500 adolescents aged 10-19 years. All educational Zones falling in each district were enlisted. While using the random tables to obtain total of thirty educational Zones, five Educational Zones were selected from each district

Stage II: The middle, high and higher secondary schools falling in each Tehsil was surveyed for collection of the sample. All the schools i.e. the schools in which the required age group was present were enlisted in each Educational Zone. One school (clustered) was selected in each zone by using.

C. .Random Tables

Stage III: From each District a selected sample of 125 students each both from boys as well as from girls were taken by systemic random sampling as final sampling unit.

D. Data collection

The information was collected from primary as well as secondary sources. In primary sources questionnaire cum interview technique was used. In secondary source journals, books and related literature were studied. In designing questionnaire, simple language was used but still in some schools questions had to be explained in local Kashmiri language

to obtain appropriate information from the respondents. Pre-testing was done on 2 per cent of the sample and questionnaire was modified accordingly. The questionnaire consisted of the following sections:

E. General Information

In this section name, address, age, class, parental education, parental occupation, income of the family was asked. Parental literacy is perhaps the most important factor that determines the prevailing state of ill health and under nutrition/malnutrition. It has been observed that educated mothers with inadequate health care and limited economic facilities could largely succeed in escaping ill health and malnutrition because they could utilize available meager resources optimally.

RESULTS

Table 1 Nutritional Deficiencies among Adolescent Boys

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Table No. 1 shows the symptoms of nutritional deficiency of adolescent boys. The clinical assessment of nutritional status shows that 64% of adolescent boys were without any nutritional deficiency. Among the deficiency anemia was very common and it was observed in 21% boys, 5% showed signs of Bitot’s spots, 9% angular stomatitis and 5% scurvy. The study findings are comparable to the observations of the Gupta (1973) who reported nutritional deficiencies among adolescents. Present study findings were also better than Milton (1990) who reported 40% of adolescent were anemic. Seltzer(1963) study on adolescents reported that H B level of adolescents was 12 gm/100ml and are slightly better than present studies.

Table 2: Nutritional Deficiencies among Adolescent Girls

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Table No. 2 shows the signs of symptoms of nutritional deficiency of adolescent girls. The clinical assessment of nutritional status shows that 56% of adolescent girls were without any nutritional deficiency. Among the deficiencies Anemia was very common and it was observed in 36% of adolescent girls, 5% shows signs of Bitot’s spots, 11% angular stomatitis and 16% scurvy. The findings are better than that of Kurz (1996) who reported 55% of Indian adolescents were anemic. Slemenda (1997) states that most adolescents had nutritional deficiencies like anemia and Vitamin deficiency. Pati (2004) also reported that most of the adolescents were anemic. Carrut and Golberg (1990) also reported nutritional deficiencies among adolescents.

Table 3: Menstrual History of Adolescent Girls

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Table No. 3 shows menstrual history of the sample. The investigation revealed that 60% adolescent girls had irregular period. The nature of bleeding shows that 42% girls had excessive periods, 20% had scanty periods and 32% had painful periods. The findings of the present study are comparable of Singh (2006) who reported menstrual problems among adolescents. Campbell and Macrath (1997) in his study reported use of medicine during periods by adolescent girls. It can be seen from the above table that measure complaint of adolescent girls was irregular menstrual history i.e. 60%.

Table 4: Distribution of Adolescent by Personal Hygiene

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Table No. 4 reveal that the personal hygiene of adolescents was satisfactory wherein more than half i.e. 56% of boys and 64% girls were clean. The percentage of unclean adolescent was 31% boys and 18% girls. The personal hygiene among adolescents was noticed in the form of cleanness of teeth, nails, hair and uniform, mode of brushing, hand clean, bathing and physical appearance and was graded as very clean, clean and unclean. The findings of the present study are comparable with Jalil (1993) who also noticed good personal hygiene of adolescents. Rao (1993) also reported satisfactory hygiene among adolescents.

Table 5:Distribution of Adolescent boys by Height and Weight

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Source: Food & Nutrition Board of India, National Academy of Science designed for the maintenance of good nutrition

Table No. 5 given above gives distribution of boys by height and weight. It shows mean weight of boys was 43 kgs against recommended 45 kgs and height was 157 cms against recommended 157 cms and BMI was 17.4 in the age group of 11-14 years. The mean weight of adolescent boys was 44 kgs against recommended 65 kgs and height was 157 against 176 and BMI was 18 in the age group of 15-18 years. The findings of the present study are comparable to the findings of Merchant (1975) reported that height and weight of respondents were less as compared to ICMR values. Jain (1973) also reported height and weight of adolescents were less as compared to ICMR values.

Table 6: Distribution of Adolescent girls by Height and Weight

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Source: Food & Nutrition Board of India, National Academy of Science designed for the maintenance of good nutrition

Table No. 6 given distribution of girls adolescents by height and weight. It shows mean weight of adolescent girls was 42 kgs against recommended 46 kgs and mean height was 147 against recommended 157 cms and BMI was 19.4 in the age group of 11-14 years. The mean weight of adolescent girls was 46 kgs against recommended 55 kgs and height was 153 cms against 160 cms and BMI was 19.6 in the age group of 15-18 years. The findings of the present study were better than the survey conducted by National Nutrition Bureau in which it has been revealed that comparatively a high percentage of adolescent girls in the age group of 14-15 years reported with weight 38 kgs and height 145 cms.

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