Prevalence Of Chronic Energy Deficiency Research Articles

Prevalence of Chronic Energy Deficiency in Rural-Dwelling Older Indian Adults During a Period of Severe Drought

The prevalence of chronic energy deficiency (CED = BMI < 18.5) among older adults (≥60 years) was assessed utilizing a large data set from a community-based cross-sectional study carried out in severely drought-affected rural areas of India. Anthropometric measurements (height, weight) were recorded for a total of 3,147 individuals, and a family diet survey (one day 24-hour recall) was carried out in 1,900 households (HHs) from 190 villages. As per the Body Mass Index (BMI), the prevalence of CED was 51.1% and 48.5% among older males and females, respectively. It was higher (p < 0.001) in the 70 years and older age group compared with those aged 60–69 years. In general, the prevalence of CED was higher (p < 0.001) for those belonging to the Scheduled Caste and Scheduled Tribes, for HHs of agricultural and non-agricultural labor, and for marginal or small farmers. The prevalence of CED was relatively lower (p > 0.05) among older adults during the drought period compared with the non-drought period. This could be attributed to intervention programs initiated by the government of India during the drought. These findings illustrate the value of intervention programs in drought-afflicted and drought-prone areas and underscore the importance of monitoring the nutritional status of older adults so that appropriate programs can be initiated as needed.

Mid-upper arm circumference as a measure of nutritional status among adult Bengalee male slum dwellers of Kolkata, India: relationship with self reported morbidity

This cross-sectional study was undertaken to investigate the relationship of mid-upper arm circumference (MUAC) with body mass index (BMI) and the self reported morbidity status. This was to assess the reliability of MUAC as a measure of nutritional and overall physical health status among the adult (> 18 years) Bengalee male slum dwellers of Kolkata, (India). Data on height, weight, MUAC and self reported morbidity were analysed for 474 individuals. The BMI was computed following the standard formula. Classification of chronic energy deficiency (CED) was done following the WHO guidelines. The mean (sd) age, height, weight, BMI and MUAC were 37.5 (14.2), 161.5 (6.2), 53.0 (9.5), 20.3 (kg/m2 and 25.0 cm, respectively. The mean BMI decreased significantly (F = 243.0; p < 0.001) from the highest MUAC group (22.5 kg/m2) to the lowest one (17.1 kg/m2). Overall prevalence of CED (BMI < 18.5 kg/m2) was 32.3%. The prevalence of CED also increased sharply from the highest MUAC group (3.0%) to the lowest group (84.2%) (X2 = 237.8; p < 0.001). The odds ratios (OR) for being CED is very much high in the lowest MUAC group (OR = 178.70, CI = 71.37-447.46). A significant (X2 = 19.168, p < 0.001) increase in the prevalence of self reported illness from the highest MUAC group (19%) to the lowest one (40.4%, OR = 2.78; CI = 1.68-4.62) was also observed. The mean MUAC was observed to decrease significantly (F = 7.157, p < 0.001) from non-ill group (G IV) to the group which reported to have both previous and recent illness (G I). The prevalence of undernourished (MUAC < 23.0 cm) also increased significantly (X2 = 21.54, p < 0.001) from G IV to thee G I. In conclusion, the MUAC can be used as an efficient alternative measurement in the evaluation of CED status among adult Bengalee males.

Undernutrition among adult Bengalees of Dearah, Hooghly District, West Bengal, India: Relationship with educational status and food habit

A cross-sectional study of 1203 adult (> 18 years of age) Bengalees of Dearah, Hooghly District, West Bengal, India, was undertaken to evaluate the prevalence of undernutrition and the relationship of educational level and food habit with undernutrition. Height and weight were measured and body mass index (BMI) computed following the standard equation. A BMI < 18.5 kg/m2 was classified as undernutrition or chronic energy deficiency (CED) as per World Health Organization (WHO) recommendations. The public health problem of low BMI in this population was classified according to the WHO criteria. Educational status was coded as: no formal education, 1-8 years of schooling and > 8 years of schooling. Food habit was recorded as vegetarian or non-vegetarian. The mean ages of males and females were (39.6 +/- 15.0 years) and (39.6 +/- 15.0 years), respectively. There were significant (p < 0.001) sex differences in mean height and weight; both sexes had a similar BMI. The overall (sex combined) prevalence of undernutrition was 27.7%. The frequency of undernutrition was significantly (p < 0.001) higher among females (31.7%) compared to males (23.6%). According to the WHO classification of low BMI, the prevalence of CED was high (20-39%) indicating a serious situation. There existed a significant (p < 0.001) relationship between the level of formal education and nutritional status. Overall, the frequencies of CED (43.5%) were much higher than overweight (7.0%) among subjects with no formal education. The frequencies of CED and overweight among subjects with 1-8 years of formal education were 25.7% and 9.7%, respectively. Similarly, significantly (p < 0.001) higher rates of CED were found among subjects with no formal education in both sexes (males = 39.5%; females = 45.6%) compared to the presence of overweight (males = 1.8%; females = 9.8%). Sex-combined frequency of undernutrition was significantly (p < 0.001) higher among vegetarians (48.3%) compared with non-vegetarians (25.5%). The respective frequencies of overweight were 1.7% and 12.8%. This significant (p < 0.001) trend existed in both sexes with 46.9% male and 49.3% female vegetarians having CED. The corresponding figures for overweight among vegetarians were 0.0% and 2.9%, respectively. The rates of CED were significantly (p < 0.001) lower among non-vegetarians (males = 21.5%; females = 29.6%). Non-vegetarians had significantly higher rates of overweight in both males (8.7%) and females (16.9%). Multiple regression analysis revealed that both educational status as well as food habit had significant effect on BMI in both sexes. In general, the educational status had a stronger impact (males: t = 6.356, females: t = 5.017) than food habit (males: t = 3.373; females: t = 2.763) on BMI. This significant impact remained even after controlling for the effect of age. In conclusion, this study demonstrated that adult Bengalees of Dearah were under serious nutritional stress indicating a public health problem. In addition, a strong inverse relationship existed between educational level and CED. Moreover, vegetarianism was significantly associated with CED. Urgent public health measures are required, particularly among females, to reduce the high prevalence of CED in this population. Similar studies should be conducted in other parts of West Bengal before any general conclusions can be inferred about the relationship between educational status, food habit and CED in the state.

Nutritional Parameters and Chronic Energy Deficiency in Older Adults of Desert Areas of Western Rajasthan, India

Nutritional status was assessed in 212 older individuals (≥60 years of age) in a cross - sectional study carried out in desert areas of western Rajasthan during 2003. Heights and weights were recorded and a family diet survey (one-day, 24-hour recall) was carried out in 200 households (HHs) from 20 villages. Body Mass Index (BMI) was used to classify nutritional status. The prevalence of Chronic Energy Deficiency (CED = BMI < 18.5) was ≥ 40% in desert areas of India, indicating a “very high” public health problem. It was higher among older women (52%) compared with men (42.4%) and higher in those belonging to Scheduled Caste and Scheduled Tribes and in HHs of laborers, artisans, landless individuals, marginal farmers, and below poverty line families. CED did not differ (statistically) between the desert and plain areas of Rajasthan. CED prevalence among older adults in desert areas was actually lower (p < 0.001) than that found in their rural and tribal counterparts. Intervention programs initiated by the government may explain this finding. Our findings support the conclusion that regular nutritional monitoring of older adults in desert and drought prone areas is needed and can help appropriately target the need for intervention measures.

Nutritional Status of Baiga – A Primitive Tribe of Madhya Pradesh

Baiga tribe of Baigachak area is declared as one of the primitive tribe of Madhya Pradesh, based on their pre-agricultural technology, low literacy and stagnant population. The present study was carried out to study the nutritional status of this tribe. A cross sectional study was carried out in the Baigachak area in 2002-2003 to study the nutrition profile of the Baiga Tribe. Eight villages were purposely selected from three blocks of Baigachak area. From eight villages 400 households were randomly selected for the study, and one thousand five hundred forty five individuals from four hundred households were covered for anthropometric measurements, and 80 households were covered for diet survey by 24hr recall method. The extent of malnutrition for preschool children was assessed by SD classification and the nutritional status of adults was assessed by BMI classification. About 61% of the pre-school children were under weight (<Median -2SD) out of them 24.3% children were severely under weight. Stunting and wasting were seen in 44.3% and 37% children respectively. Prevalence of chronic energy deficiency (BMI<18.5) was about 76% among adult population. Consumption of cereals was higher than recommended level (460gm), while the consumption of other foodstuff was lower than the RDA. The intake of all nutrients except calcium was significantly lower than recommended level. The present study revealed that malnutrition is widely prevalent among the Baiga tribe which is mainly due to inadequate dietary intake.

Relationship of family income and house type to body mass index and chronic energy deficiency among urban Bengalee male slum dwellers of Kolkata, India

A cross-sectional study of 469 adult (>18 years) Bengalee male slum dwellers of Dum Dum, Kolkata, India, was undertaken to study the relationships of family income and house type with body mass index (BMI) and chronic energy deficiency. The overall frequency of chronic energy deficiency was 32.0%. Based on the World Health Organization classification, the prevalence of chronic energy deficiency among this population was high and thus the situation is serious. Overall, monthly family income was significantly positively correlated with BMI. Significant differences in mean weight, BMI and monthly family income, were observed between the two house type groups. All values were found to be significantly higher in the brick household group who also earned a comparatively higher income as evident from the mean monthly family income values. The prevalence of chronic energy deficiency was also found to be significantly higher in the bamboo-fenced household group. Subjects belonging to the lowest family income group had the lowest mean BMI and the highest rate of chronic energy deficiency while those in the highest family income group had the largest mean BMI and lowest rate of chronic energy deficiency. There was a significant family income group difference in mean BMI. There existed significant differences in chronic energy deficiency rates in family income group categories. Linear regression analyses showed that monthly family income and house type had a significant impact on BMI. Subsequent multiple regression analyses revealed that both monthly family income and house type had a significant impact on BMI, even after controlling for each other.

Body form and nutritional status among adult males of different social groups in Orissa and Bihar States in India

This paper aims to carry out a biological investigation of the body form and nutritional status of the major social groups of Orissa and Bihar States in India. For this, Cormic Index (CI) and Body Mass Index (BMI) have been computed using data on height, sitting height and weight, taken from adult males of age 18–62 years of various ethnic groups in these two states. The subjects have been classified on the basis of chronic energy deficiency (CED). It is found that a substantial proportion of the people with CED are in the grade II and grade III categories. ANOVA, t-tests, correlation and regression were carried out separately. The results reveal that in Orissa, Scheduled Tribes are shorter, lighter and have lowest mean values of BMI and Cormic Index compared to other groups, but in Bihar, though the Scheduled Tribes are shorter, Scheduled Castes are lower in weight and have the lowest mean values of BMI. There are significant differences in BMI as well as in CI between Scheduled Tribes of Orissa and Bihar. Scheduled Castes and Tribes of Bihar have the highest percentage of CED with 64.71% and 57.45%, respectively. Muslims of Bihar are also affected (52.95%), but overall prevalence of CED is lower in Orissa (49.11%) than in Bihar (54.62%). BMI and CI are highly correlated for each of the social groups in Bihar and Orissa.

Anthropometric characteristics and nutritional status of adult Oraon men of Gumla District, Jharkhand, India

Background. According to the 2001 Census, India has a tribal population of over 84 million which constitutes 8.2 % of its total population. In general, the tribal populations of India are very undernourished. Objectives. To determine the anthropometric characteristics and prevalence of undernutrition, based on body mass index (BMI), of adult male Oraons, a tribal population of Gumla District, Jharkhand, India. Methods. A total of 205 adult (age=18 years and above) Oraon men of five villages, namely, Kubatoli, Rehetoli, Bhitar (inner) Serka, Bahir Serka, and Chera, in Gumla District, Jharkhand. These villages are located approximately 130 km from Ranchi, the provincial capital of Jharkhand. Anthropometric measurements included height, weight, circumferences and skinfolds. BMI was calculated by the standard equation. Chronic energy deficiency (CED) was evaluated according internationally accepted BMI cut-off points. Results. The means (SD) for height, weight and BMI were 161.8 (6.3) cm, 47.3 (5.3) kg and 18.0 (1.6), respectively. The prevalence of CED (BMI < 18.5) was 63.9 %. The rates of CED III (BMI < 16.0), CED II (BMI = 16.0 to 16.9) and CED I (BMI = 17.0 to 18.4) were 7.3 %, 17.6 % and 39.0 %, respectively. According to the WHO criterion, the prevalence of undernutrition was very high and the situation was critical. Conclusions. Adult Oraon men of Gumla, Jharkhand, are facing severe nutritional stress. The situation is critical, necessitating implementation of immediate nutritional intervention programs.

TRADITIONAL OCCUPATIONS AND NUTRITIONAL ADAPTATION AMONG CENTRAL INDIAN CASTE POPULATIONS

The socioeconomic milieu has benefits and drawbacks for determining level of nutrition. The Indian population provides an excellent example of nutrition-driven adaptation. The present paper deals with the relationship between BMI (body mass index) and traditional occupation and process of adaptation among adult males of Central India. Anthropometric data collected by the Anthropological Survey of India on stature, sitting height and weight of 6663 adult males belonging to 22 castes were used for computation of BMI and Cormic index. The caste groups earning their living as labourers are found to be shortest (157.4+/-6.5 cm), and the caste group practising priesthood are tallest (168.6+/-6.6 cm). The prevalence of chronic energy deficiency is found to be highest (72%) among castes earning their living as daily wage labourers. The ANOVA on Cormic index and BMI suggests that people within the same occupational group are more homogeneous than those from different occupational groups. The t test also supports the homogeneity of the same occupational group.

Relationship of Income with Anthropometric Indicators of Chronic Energy Deficiency among Adult Female Slum Dwellers of Midnapore Town

A cross-sectional study of 333 adult (> 18 years) female slum dwellers (mean age = 34.2 years) of Midnapore town, West Bengal, India, was undertaken to study the relationships of monthly per capita income (MPCI) with two anthropometric measures, namely body mass index (BMI) and mid-upper arm circumference (MUAC). It also investigated the association of MPCI with chronic energy deficiency (CED). Results revealed that the mean height, weight, MUAC and BMI of the subjects were 148.2 cm, 43.2 kg, 22.7 cm and 19.6 kg/m 2 , respectively. The overall frequency of CED based on BMI (BMI < 18.5 kg/m 2) and MUAC (MUAC < 22.0 cm) was 46.8 % and 43.5%, respectively. Based on the World Health Organization classification, the prevalence of CED among this population was very high (≥40%) and thus the situation is critical. Overall, MPCI was significantly (p < 0.001) positively correlated with BMI (r = 0.21) and MUAC (r = 0.25). Moreover, MUAC was very strongly correlated (r = 0.81; p < 0.0001) with BMI. Linear regression analyses showed that MPCI had significant impact (p < 0.001) on BMI (T = 3.92) and MUAC (T = 4.74). MPCI explained 4.1% and 6.1% variation in BMI and MUAC, respectively. Subjects belonging to the lowest per capita income group (PCIG) had the lowest mean BMI (18.9 kg/m 2) and mean MUAC (21.9 cm) and the highest rate of CED (BMI based CED = 52.3%; MUAC based CED = 53.5%). Those in the highest PCIG had the largest mean BMI (20.7 kg/m 2) and MUAC (23.9 cm) and lowest rate of CED (BMI based CED = 39.0 %; MUAC based CED = 35.4 %). There were significant PCIG differences in mean BMI (F = 4.115, p < 0.05) and MUAC (F = 6.995, p < 0.001). Moreover, there existed clear PCIG differences in CED rates using both BMI as well as MUAC. In conclusion, this study provided evidence that PCI was significantly associated with BMI, MUAC and the presence of CED. The relationships of PCI with BMI and MUAC were similar. The rate of CED was very high indicating a critical situation. These findings may have severe public health implications. It is recommended that immediate appropriate nutritional intervention programmes be initiated among this population along with serious efforts to increase their PCI. In this population, either BMI or MUAC can be effectively used to study the effect of PCI on nutritional status.

Chronic energy deficiency in some low socio-economic populations from South India: Relationships between body mass index, waist–hip ratio and conicity index

This paper reports the prevalence of chronic energy deficiency (CED) based on body mass index (BMI) and its relation to other adiposity measures namely, waist–hip ratio (WHR) and conicity index (CI) in some low socio-economic groups from South India. Two ethnic groups from each area type, namely, tribal, rural and urban areas, are included and samples of 646 men and 670 women belonging to six groups are selected on a multistage basis. Based on the measurements, BMI, WHR and CI are calculated. A considerable proportion of populations studied here experience CED. A higher proportion of women than men show CED. The BMI and WHR are slightly higher among men and WHR exhibits significant intersex difference. The CI is in expected ranges and all ethnic groups differ from each other in all measurements and indices. Age is strongly correlated with WHR and CI, but not with BMI. Both WHR and CI are influenced by BMI. BMI and sex are found to be significant contributors to the variation in WHR, and ethnicity also added to the variation in CI. The present study also concludes that adult malnutrition (as indicated by BMI) is spread to a considerable extent in these populations of low socio-economic status. It appears that the ethnic differences occurring in several measurements/indices reflect the economic and social conditions.

Adult Santal Males from Orissa and West Bengal: Comparison of Their Anthropometric Profile and Chronic Energy Deficiency

This study was undertaken among adult (aged > 18 years) male Santals of Orissa and West Bengal, to compare their anthropometric profile and the prevalence of chronic energy deficiency (CED), based on body mass index (BMI). Santals of Jhargram, Paschim Medinipur, West Bengal and Ananadapur, Keonjhar, Orissa were studied. Anthropometric measurements including height, weight and mid upper arm circumference (MUAC) were measured using standard protocol. The BMI was derived from height and weight. Internationally recommended BMI cut-off points were utilized to evaluate nutritional status. Results showed that there were significant differences between the means of some anthropometric characteristics of the two populations. The extent of CED (BMI < 18.5) was found to be high in both populations (Orissa = 26.2%; West Bengal = 31.5%). Using the World Health Organization criterion the prevalence of CED was high and the situation was serious in both populations. In conclusion, this study provided evidence that the nutritional status of adult Santals, in both Orissa as well as West Bengal, was not satisfactory. Immediate appropriate nutritional intervention programs are needed for implementation among Santals of both regions.

Body Mass Index and Chronic Energy Deficiency Among Urban Bengalee Male Slum Dwellers of Kolkata, India: Relationship with Family Income

A cross-sectional study of 191 adult (>18 years) Bengalee male slum dwellers of Kolkata, India, was undertaken to study the relationships of family income with body mass index (BMI) and chronic energy deficiency (CED). Results revealed that the mean height, weight, and BMI of the subjects were 162.2 cm, 54.0 kg, and 20.5 kg/m2, respectively. The overall frequency of CED (BMI < 18.5 kg/m2) was 33.5%. Based on the World Health Organization classification, the prevalence of CED among this population was high (20–39%) and thus the situation is serious. Overall, monthly family income (MFI) was significantly positively correlated (r = 0.18, p < 0.05) with BMI. Linear regression analyses showed that MFI had significant impact (p < 0.05) on BMI. The percent variation in BMI explained by MFI was 2.6%. Subjects belonging to the lowest family income group (FIG) had the lowest mean BMI (19.5 kg/m2) and the highest rate of CED (46.6%) while those in the highest FIG had the largest mean BMI (21.4 kg/m2) and lowest rate of CED (23.1%). There was a significant FIG difference (F = 2.965, p < 0.05) in mean BMI. Moreover, there existed FIG differences (χ 2 = 7.54, p < 0.06) in CED rates. In conclusion, this study provided strong evidence that FIG was significantly associated with BMI and the presence of CED. The rate of CED was high, indicating a serious situation. These findings may have severe public health implications. It is recommended that immediate nutritional intervention programs be initiated among this population along with serious efforts to increase their family income.

Diet and Nutritional Status of Tribal Population in ITDA Project Areas of Khammam District, Andhra Pradesh

Tribal populations are socio-economically disadvantaged compared to other population groups. They have different health problems owing to the variability in their geographical, socio-economic development and cultural characteristics. At the request of the project officer, a cross sectional survey was carried out to assess the diet and nutritional status of tribal population in ITDA, Bhadrachalam in Khammam district of Andhra Pradesh. A total of eight hundred households in twenty villages from five Mandals, were covered for survey. The study revealed that a majority of the households were living in kutcha houses. The major occupation of the head of the HH in a majority of the HHs was either agricultural labour or other labour. About 72% of the men and 88% of their women counterparts were illiterate. In general at household level, the average consumption of all the foods except cereals and millets were below the recommended level. The average intake of all the nutrients was lower than the RDA as well as the figures reported in NNMB tribal survey. The extent of deficit was highest with respect to vitamin A (83%), followed by riboflavin (64%), iron (59%), and total fat (47%). Protein calorie adequacy status revealed that about half of the HHs (52%) were consuming adequate amounts of both protein and energy, while about 21% were consuming inadequate amounts of both the nutrients. The prevalence of undernutrition (< Median –2SD of weight for age) among 1-5 years children were lower (65.4%) than that reported for the Tribes in the State of Andhra Pradesh (68.8%). Among the adolescents (12-17 years), about 45% of boys and 21% of girls were undernourished. The prevalence of Chronic Energy Deficiency (CED) among adults was about 51%. Breastfeeding practices revealed that majority of the mothers initiated breast-feeding with in 24hrs of delivery. About 76% of the children started receiving the complementary feeding from the age of 4-6 months. About 93% of children (12-24 months) were fully immunized and 90% received at least one dose of massive dose vitamin A during previous one year. However the study indicates the need to control the micro nutrient deficiencies through dietary diversification by promoting home gardening. Since the prevalence of morbidity was higher in this population, effort should be made to improve the environmental sanitation and personal hygiene.

Trends of under- and overweight among rural and urban poor women indicate the double burden of malnutrition in Bangladesh

Although undernutrition and communicable diseases dominate the current disease burden in resource-poor countries, the prevalence of diet related chronic diseases is increasing. This paper explores current trends of under- and overweight in Bangladeshi women. Nationally representative data on reproductive age women from rural Bangladesh (n = 242,433) and selected urban poor areas (n = 39,749) collected by the Nutritional Surveillance Project during 2000-2004 were analyzed. While the prevalence of chronic energy deficiency [CED, body mass index (BMI) < 18.5 kg/m(2)] continues to be major nutritional problem among Bangladeshi women (38.8% rural, 29.7% urban poor; P < 0.001), between 2000-2004, 9.1% of urban poor and 4.1% of rural women were overweight (BMI > or = 25 kg/m(2), P < 0.001). In addition, 9.8% of urban poor and 5.5% of rural women were found to be 'at risk of overweight' (BMI 23.0-<25 kg/m(2)). From 2000 to 2004, prevalence of CED decreased (urban poor: 33.8-29.3%; rural: 42.6-36.6%), while prevalence of overweight increased (urban poor: 6.8-9.1%; rural: 2.8-5.5%). The risk of being overweight was higher among women who were older and of higher socioeconomic status. Rural women with at least 14 years of education had a 8.1-fold increased risk of being overweight compared with non-educated women [95% confidence intervals (CI): 6.6-8.7]. Women living in houses of at least 1000 sq ft (93 m(2)) were 3.7 times more likely to be overweight compared with women living in <250 sq ft (23 m(2)) houses (95% CI: 3.2-4.3). The recent increase in overweight prevalence among both urban poor and rural women, along with high prevalence of CED, indicates the emergence of a double burden of malnutrition in Bangladesh.

Prevalence and Causes of Chronic Energy Deficiency and Obesity in Women of India

We investigate the nutritional status of women in India and its relation to the prevalence of chronic energy deficiency (CED) and obesity. To do this, we have used the data from the Indian National Family Health Survey, 1998-1999, on body mass index (BMI) of ever-married women, ages 15-49 years, along with several socioeconomic factors, such as level of education, religion or caste, occupational status, and standard of living index. The study was based on 81,712 women from 26 states and 6 zones, which were grouped according to geographic proximity of the states of India. A multiple linear regression analysis was done to see the relation between nutritional status of women and different socioeconomic factors. The data reveal that the prevalences of CED, overweight, and obesity in India are 31.2%, 9.4%, and 2.6%, respectively. The incidences of CED and obesity are negatively related. The prevalence of CED is the lowest in Arunachal Pradesh and highest in Orissa. Punjab has the highest prevalence of obesity, and Bihar has the lowest. For the zonewise distribution the Northeast zone has the lowest degree of prevalence of CED and the East zone is at the bottom of the list with the highest degree of malnutrition. We also found that the nutritional status of women goes together with the enhancement of their educational status, standard of living, and so on. There are also significant differences between rural and urban sectors and among castes, religions, and occupations. Furthermore, regression analysis shows that all the socioeconomic variables considered here significantly affect BMI in Indian women.

INTER-RELATIONSHIPS OF INCOME, CHRONIC ENERGY DEFICIENCY, MORBIDITY AND HOSPITALIZATION AMONG ADULT MALE SLUM DWELLERS OF MIDNAPORE, WEST BENGAL, INDIA

A cross-sectional study of 212 adult (>18 years) male slum dwellers (mean age=34.6+/-14.4 years) of Midnapore town, West Bengal, India, was undertaken to study the inter-relationships of chronic energy deficiency (CED), monthly family income (MFI), self-reported morbidity and hospitalization due to severe illness. The mean height, weight and body mass index (BMI) of the subjects were 160.0 cm, 50.8 kg and 19.9 kg/m2, respectively. The overall frequencies of CED (BMI<18.5 kg/m2), morbidity and hospitalization were 38.2%, 34.4% and 13.7%, respectively. Based on the WHO classification, the prevalence of CED among this population was high (20-39%), indicating a serious situation. Overall, MFI was significantly (p<0.01) positively correlated with BMI (r=0.21). Linear regression analyses showed that MFI had a significant impact (t=3.08; p<0.002) on BMI. Overall, MFI explained 3.9% variation in BMI. Subjects belonging to the lowest family income group (FIG I) had the lowest mean BMI (19.1 kg/m2) and the highest rate of CED (46.3%) and morbidity (36.6%). Those in the highest family income group (FIG III) had the largest mean BMI (20.8 kg/m2) and lowest rate of CED (30.2%) and morbidity (30.2%). The highest rate (18.9%) of hospitalization was found in this group. There were significant family income group differences in mean BMI (F=3.134, p<0.05). The frequency of morbidity (24.6%) and hospitalization (11.9%) was lowest among normal BMI individuals. Morbidity was significantly higher (chi2=11.92, p=0.0026) among CED (48.2%) subjects compared with normal BMI individuals (OR=2.85; CI=1.49-5.46). Similarly, compared with normal BMI subjects, morbidity was higher (38.5%; OR=1.92; 95% CI=0.50-7.18) among overweight subjects. Hospitalization was more common among CED subjects (16.1%; OR=1.42; CI=0.58-3.45) compared with normal BMI subjects. Similarly, the frequency of hospitalization was more among overweight individuals (15.4%; OR=1.35; 95% CI=0.0-7.59). In conclusion, this study provides evidence that the frequency of CED among this population is high, indicating a serious situation. Moreover there exists strong inter-relationships between BMI, CED, MFI and morbidity.

Anthropometric Profile and Chronic Energy Deficiency Among Adult Santal Tribals of Jhargram, West Medinipur District, West Bengal, India: Comparison With Other Tribal Populations of Eastern India

A cross-sectional study was undertaken to determine anthropometric profile and the prevalence of chronic energy deficiency (CED), based on body mass index (BMI) of adult Santals, a tribal population of Jhargram, West Medinipur District, West Bengal, India. A total of 410 adult (aged > 18 years) Santals of six villages (Jharagaria, Jamiderdanga, Jamda, Jaynagar, Chapashol, and Lukudahi) near Jhargram town of West Medinipur District, West Bengal, India, were studied. These villages are located within 15 km. (approximately) from Jhargram town and 150 km. from Kolkata, the provincial capital of West Bengal. Anthropometric measurements including height, weight, and circumferences as well as BMI were measured using standard protocol. Overall, the extent of CED (BMI < 18.5) was found to be very high (36.8%). The prevalence of CED was higher in women (41.8%) compared to men (31.5%), although this difference was statistically not significant. Using the World Health Organization criterion (WHO, 1995) the prevalence of CED was high and the situation was serious in men. Among women, CED prevalence was very high and the situation was critical. However, compared to some other tribes of eastern India, adult Santals had better anthropometric and nutritional profile. The authors would like to thank all subjects who participated in the study. In conclusion, this study provided evidence that although the anthropometric and nutritional profile of adult Santals was better than some of the other tribal populations of eastern India, immediate appropriate nutritional intervention programs are needed for implementation among Santals.

Health and Morbidity Profile of Bharias-A Primitive Tribe of Madhya Pradesh

The study was carried out to determine the health and morbidity status of Bharia tribe. A total of ten villages were surveyed, and total of 172 households and nine hundred ten individuals were covered. The major occupation of the head in the households surveyed is agriculture and agriculture labor. 66.4 percent of the population was illiterate. Acute respiratory infection and fever were the commonest morbidity found more in preschool and school going children than adult population. According to weight for age, 52.5 percent of the Pre-school children were underweight (<-2SD). Stunting was 48.1 and wasting was 33.9 percent. Prevalence of chronic energy deficiency (BMI<18.5) was about 35.6 percent in adult population. Bharia Children are suffering with more morbidity like fever, respiratory infection and malnutrition than adult population.

Excess male chronic energy deficiency among adolescents: a cross-sectional study in the context of patrilineal and matrilineal societies in Northeast India

To determine the sex differences in chronic energy deficiency (CED) among adolescents in the context of patrilineal and matrilineal societies in Northeast India. Cross-sectional, community-based study of the Hmar patrilineal society and the Khasi (War and Khynriam) matrilineal society. Mizoram and Meghalaya in Northeast India. In total, 1733 adolescent boys and girls aged 9-16 y: Khynriam Khasis (n = 1005), War Khasis (n = 305) and Hmars (n = 423). Weight, height, and socio-economic characteristics. Body mass index (weight in kg/height in m2) was used for assessing CED relative to the international reference values. The overall prevalence of CED was significantly greater in boys than in girls. The sex differences in the prevalence of CED were 5, 10 and 6% points in the Khynriam Khasis, War Khasis and Hmars, respectively. Allowing for age and socio-economic variables, the risks of CED were about 1.82 (95% CI 1.14-2.90), 1.83 (95% CI 1.19-3.33) and 1.78 (95% CI 1.10-3.25) times greater in boys than in girls among the Khynriam Khasis, War Khasis and Hmars, respectively. Using logistic regression analysis, the prevalence of CED was negatively associated with family income across study populations. No significant association was found between CED and religion. Patrilineal and matrilineal forms of society were not reflected in the prevalence of CED among adolescents. Subject to further studies of the research problems concerning the nutritional status of adolescents, girls fare better than boys with respect to the prevalence of CED.