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Use of National and International Standards in Assessing the Growth and Nutritional Status of Rural Indian Children
Jeannot, Lovemine
Jeannot, Lovemine
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Date
2015
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Public Health
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http://dx.doi.org/10.34944/dspace/3044
Abstract
This study compares anthropometry of rural Indian schoolchildren using national and international reference values, and explores association between demographic and socioeconomic variables and growth measures among rural children. A cross-sectional survey of height, weight, and BMI was conducted among schoolchildren (5-16 years) in Gujarat, where there were pre-established contacts who could facilitate access to schools and data collection for this study. Gender- and age-specific Z-scores were obtained for 519 children (234 girls, 285 boys) based on Indian reference values (Khadilkar et al., 2009) using an Excel® macro. Percentages of children stunted (height-for-age less than or equal to -2SD), underweight (weight-for-age less than or equal to -2SD), and wasted (BMI-for-age less than or equal to -2SD) were obtained (Khadilkar & Khadilkar, 2011). Children falling between adult Indian BMI levels 23 and 28 kg/m2 were considered overweight, and those above 28 kg/m2 were considered obese. Those stunted (height-for-age + 1SD), and obese (BMI > +2SD) were generated similarly using the WHO International Growth Standards (WHO, 2015). Regression analyses were conducted to model the relationship between growth measures, determined using national references, and predictor variables: age, gender, school, and caste. 21%, 23.1%, 8.9%, 2.7% and 0.2% of children were respectively stunted, underweight, wasted, overweight and obese based on Indian References and recommendations, and 27 %, 8.7%, 6.4% and 2.7 % respectively stunted, wasted, overweight and obese based on WHO Standards and recommendations. School was found to have significant interaction with all growth measures (P <.0001) and age had a significant interaction with height-for-age (P = 0.05). The current level of undernutrition, and emerging problems of overnutrition, in this study highlight a need to concentrate efforts to improve nutrition of Indian schoolchildren in rural areas.
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