nutritional survey in school going children

nutrition survey in school going children Pakistan

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2. Nutritional survey of school going children in rural and urban areas of district Mardan in relation to protein and energy consumption Muhammad Ihsan 2015-ag-1994 MSc(Hons) HND Supervisor: Prof. Dr. Nuzhat Huma 2

3. Road map Malnutrition Nutritional Assessment World view Situation in Pakistan Experimental case study Objectives Study plan Materials and methods Expected results and references 3

4. Malnutrition Group of conditions related to Poor quality, insufficient quantity of nutrient intake, absorption or utilization. Types of malnutrition Over nutrition - when there is an excess intake of nutrients, it results in over nutrition . Under nutrition - the condition of health of a person that results due to the lack of one or more nutrients is called under nutrition. . Protein-energy malnutrition - insufficient protein and calories Micronutrient deficiency diseases - resulting from a deficiency of specific micronutrients. Major problem in children is deficiency of protein and calories (Nazemi et al., 2015) 4

5. Malnutrition Uncontrolled in school going children Mainly 5-10 years of children Reflected by their suboptimal mental achievement ( Tiwari  et al ., 2013 ) Reduces the immune response against various infections Major causes of mental retardation Growth depends on nutritional and health condition Growth can be judged through nutritional assessment (Srivastava et al ., 2012). 5

6. Nutritional Assessment A comprehensive nutritional assessment includes Anthropometric measurements of body composition Biochemical measurements of serum Clinical assessment of altered nutritional requirements Social or psychological issues that may preclude adequate intake (Ong et al ., 2014) 6

7. World view Half of the world malnourished population In Pakistan , Bangladesh and India . Children are more affected than adults. According to an estimate in 2011 , 3.1 million children deaths per year or 45 percent due to malnutrition with other chronic diseases WFP estimated US $3.2 billion per year for combating 66 million malnourished school-age children (Black et al ., 2013) 7

8. Situation in Pakistan almost 40% of these children are underweight Over half the children are affected by stunting and about 9% by wasting Significant provincial variations in malnutrition rates lowest in Punjab highest in Balochistan Anthropometric deficits are systematically higher in rural areas due to lower socio-economic status very poor access to basic health services ( Di Cesare et al ., 2011 ) 8

9. National Nutrition Survey 2011 Micronutrients Deficiency Vit- A Deficiency ( 0-59 months) 56 58 53 81 100 37 78 82 Zinc Deficiency (0-59 months) 37 39 35 34 34 49 34 33 Vit- D Deficiency (0-59 months) 41 43 42 40 26 33 30 32 Iodine Deficient ( 6-12 years) 37 35 39 35 10 65 26 70 Indicators National Sindh Punjab Balochistan FATA AJK KPK Gilgit 9

10. Nutrients Deficiency in KPK Micronutrients Deficiency Vit- A Deficiency ( 0-59 months) 78 Zinc Deficiency ( 0-59 months) 34 Vit- D Deficiency (0-59 months) 30 Iodine Deficient (6-12 years) 26 Indicators KPK Indicators KPK Growth Severe Stunting ( 0-59months) 25 Wasting rate 18 Under weight 24 Anemia Anemia 47 Ferritin deficiency 21 Iron deficiency anemia 13 10

11. Case study A study conducted in school students of Lahore, Pakistan Students selected: 1860 Following values was compared in contrast to the global growth standards gender , age, weight, height, BMI percentiles, nutritional health Results after comparing with International Obesity Task Force ,WHO and USCDC shows that Both girls and boys had lower BMI Lower weight In younger age groups, boys had same height and girls were taller But after nine years of age both boys and girls fell short (Mushtaq et al ., 2012 ) 11

12. Why this study was conducted? Many studies on school age children of Pakistan Limited studies are available for Khyber Pakhtunkhwa (KPK) Urgent need to evaluate the nutritional health of KPK children 12

13. Objectives Nutritional status assessment of school going children ( 5-10 year) i n urban and rural areas of district Mardan Dietary , clinical, and anthropometric assessment of school going children in the study area 13

14. Study plan S ample size was of 300 students Total number of selected schools were 12 7 from rural and 5 from urban F rom both urban and rural schools 150 students were selected From each school students between age 5-10 were randomly selected 14

15. Methodology Questionnaire was designed which includes S tudent personal information A nthropometric assessment C hild activity status Demographic & socio-economic status C linical signs and symptoms H istory of previous disorders or disease Dietary history 15

16. Cont… Parameters of Anthropometric and clinical assessment MUAC, Weight, Height , Age, BMI, MUAC : Mid-point between the elbow and the shoulder Procedure Measuring tape was used and placed around the left arm the arm should be relaxed and hang down the side of the body MUAC measures while ensuring that the tape neither pinches the arm nor is left loose The MUAC value recorded to the nearest 0.1 cm or 1 mm (Rema and Vasanthamani, 2011) 16

17. Cont… Body Weight : was measured by using digital weighing scale (Kuczmarski et al. , 2000). Body Height: was measured by using stadiometer (Kuczmarski et al ., 2000) Age: From school record 17

18. Analysis and results WHO z-score system WHO Z- score system was used to classify the nutritional status of children age limit 5 to 12 years (Mushtaq et al., 2012). Dietary History Food frequency questionnaire was established to assess complete diet history and protein and energy consumption ( Rockett and Wolf, 1995 ) Data will be statistically evaluated 18

19. Expected Results and Discussion Following raw results were been found: Health of urban areas children is better than rural areas Anthropometrical measurements was 85% normal Clinical sings and symptoms shows some micronutrients deficiencies Skin colour, hair strength, nail colour, mouth, eyes, bones Further Research and data analysis is continue 19

20. References Black , R.E., C.G. Victora, S.P. Walker, Z.A. Bhutta, P. Christian, M. De Onis, M. Ezzati, S. Grantham-Mcgregor , J. Katz and R. Martorell. 2013. Maternal and child under-nutrition and overweight in low-income and middle-income countries. The Lancet . 382:427-451 . Di Cesare, M., Z. Bhatti, S. B. Soofi , L. Fortunato, M. Ezzati , and Z. A. Bhutta . 2015. Geographical and socioeconomic inequalities in women and children's nutritional status in Pakistan in 2011: an analysis of data from a nationally representative survey. The Lancet Global Health 3:229-239. Kuczmarski, M.F., R.J. Kuczmarski and M. Najjar. 2000. Descriptive anthropometric reference data for older Americans. Journal of the American Dietetic Association. 100:59-66 20

21. Cont… Mushtaq , M.U., S. Gull, K. Mushtaq, H.M. Abdullah, U. Khurshid, U. Shahid, M.A. Shad and J. Akram. 2012. Height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children. BioMed Central Pediatrics . 12:31 . Nazemi, L., I. Skoog, I. Karlsson, S. Hosseini, M. R. Mohammadi, M. Hosseini, M. J. Hosseinzade, S. A. Mesbah-Namin, and M. Baikpour. 2015. Malnutrition, prevalence and relation to some risk factors among elderly residents of nursing homes in Tehran, Iran. Iranian Journal of Public Health. 44:218 . Ong, C., W. M. Han, J. J.-M. Wong, and J. H. Lee. 2014. Nutrition biomarkers and clinical outcomes in critically ill children: A critical appraisal of the literature. Clinical Nutrition. 33:191-197. Rema , N and G. Vasanthamani. 2011. Prevalence of nutritional and lifestyle disorders among school going children in urban and rural areas of Coimbatore in Tamil Nadu, India. Indian Journal of Science and Technology. 4:131-140 . 21

22. Cont … Rockett, H.R., A.M. Wolf and G.A. Colditz. 1995. Development and reproducibility of a food frequency questionnaire to assess diets of older children and adolescents. Journal of the American Dietetic Association. 95:336-340 . Srivastava A, SE Mahmood, PM Srivastava, VP Shrotriy and Bhushan, 2003. Diet, nutrition, and the prevention of chronic diseases in Uttar Pardesh. Health and Population-perspectives and Issues. 28:17-25. Tiwari, H.C., A. Gahlot and R. Mishra. 2013. Health profile of primary school children: study from a rural health block of Kanpur. Journal of Evolution of Medical and Dental Sciences. 2:6941-6946 . Witvliet , M. 2014. World health survey: a useful yet underutilized global health data source. Austin Journal Public Health Epidemiology.1:1012. 22

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