Assessment of impact of nutritional status on pubertal development in adolescent girls of two senior secondary schools of Dehradun and to correct pubertal disorders by adolescent health counseling and adequate pharmacological intervention

Abstract

Background: Adolescence is a transitional stage of physical and psychological development that occurs during the period from onset of puberty to adulthood. Adolescent nutrition is crucial for proper growth and development and a prerequisite for achieving full development potential. Aims and Objectives: The objectives of the study were as follows: (1) To find out the gross nutritional status in girl students of two senior secondary schools in Dehradun, (2) to assess the level of pubertal development in them, (3) to find out correlation of nutritional status (body mass index, BMI) with pubertal development and physical activity, and (4) to do counseling on adolescent health and pharmacological intervention as needed. Materials and Methods: A cross-sectional observational study was undertaken among 200 adolescent girls of two senior secondary schools of Dehradun. They were of 12-18 year age group studying in class VI to XII. The sample was selected by systematic random sampling Their physical examination (weight & height ) was done to calculate BMI & pubertal assessment was done by means of oral questionnaire and by showing Tanner charts. The corelation between BMI & onset of pubertal events was analyzed statistically by Chi-square test. Results: Body mass index was normal in 44%, low in 52% of students& high in 4%. On assessing pubertal events, menarche has occurred in 74% of students out of which maximum number of students attained menarche at age of 12 years followed by 13 years. Breast changes (thelarche) were present in 74.5% of students and pubic hair was present in 68% of students. A correlation was found between BMI and pubertal events. In girls with low BMI (underweight), menarche was present in 52.94% of cases, breast changes were in 52.94% of cases, regularity of periods in 42.59% of cases in girls with high BMI (overweight/obese), menarche was present in 91.66% of cases, breast changes were in 100% of cases, and regularity of periods in 36.36% of cases. Pallor was present in 37.5% of the total girls. Out of number of girls with normal weight, 80% had regular physical activity and girls with high BMI had very less regular physical activity. Conclusion: The study concluded that underweight, overweight, and anemia were the nutritional problems detected and there was a statistically significant correlation of BMI with onset of pubertal events. Those with low BMI had delayed puberty and those with high BMI had earlier onset of pubertal events. Hence, the need for correction of nutritional disorders with healthy diet, physical exercise, and clinical consultation was considered very crucial to solve the problems of early and delayed puberty. Hence, counseling the girls on adolescent’s health was encouraged in schools including imparting knowledge, nutritional education, and supplementation.