Diet and nutritional status of rural adolescents in India

OBJECTIVE: To study the current diet and nutritional status of rural adolescents in India. DESIGN: Cross-sectional study with household as the unit of randomization. SETTING: National Nutrition Monitoring Bureau collected information in the rural areas of the nine States. METHODS: In each State, 120 villages were selected from eight districts. From each of the selected villages, 20 households (HHs) were selected from five clusters. The information on socio-demographic profile was collected in all the 20 HHs, while anthropometric data such as weight, height and clinical signs of nutritional deficiency was collected on all the available adolescents in the selected households. In every fourth sampled household, ie five HHs, dietary information on all the members was collected using 24 h dietary recall. The outcome measures for nutritional status were proportion of underweight (相似文献   

Energy balance of adolescent girls in rural area of Varanasi

Although several studies have been undertaken on dietary intake of adolescent girls, studies on their energy expenditure and thereby energy balance are few. In order to explore these aspects, this community based cross-sectional study was done on 270 adolescent girls of a rural area of Varanasi, selected by adopting appropriate sampling technique. Nutritional status of study subjects was assessed on the basis of BMI. Their energy intake was computed by 24 hours recall oral questionnaire method. Estimation of energy expenditure was based on physical activity which was noted by 24 hours activity recall questionnaire method. Average energy intake (1609.42 +/- 528.87 kcal/day) of the study subjects was less than their mean energy expenditure (1896.19 kcal/day). Their energy expenditure was significantly influenced by several factors (e.g. age, caste, type of family, etc.) As much as 69.63%, subjects were in negative energy balance. Majority of subjects belonging to lower (79.37%) and middle (75.19%) SES were in the negative energy balance. Negative energy balance has been significantly less in subjects belonging to high SES, having main occupation of the family as business and high per capita income groups with respect to their corresponding subcategories. In all 68.52% study subjects had BMI < 18.5 kg/m2. Majority (91.11%) of adolescent girls had rate of energy expenditure > 1.4. Under nutrition was significantly (p<0.05) more in subjects with rate of energy expenditure > 1.4 (i.e. 70.33%) than in subjects with rate of energy expenditure < or = 1.4.     

Diet and nutritional status of adolescent tribal population in nine states of India

Tribal population constitutes about 8% of the total population in India. They are particularly vulnerable to undernutrition, because of their geographical isolation, socio-economic disadvantage and inadequate health facilities. Recognizing the problem, Government of India launched different programmes for their welfare. Adolescence is a significant period of growth and maturation. The nutritional status of adolescent girls, the future mothers, contributes significantly to the nutritional status of the community. Therefore an attempt was made to assess the diet and nutritional status of adolescent population from the different tribal areas of India. The available database collected by National Nutrition Monitoring Bureau (1998-99) was utilized for this purpose. Data on a total of 12,789 adolescents (10-17 yrs) was included for the analysis. Four percent of the adolescent girls were married and less than 1% were either pregnant (0.4%) or lactating (0.7%) at the time of the survey. The mean intake of all the foodstuffs, especially the income elastic foods such as Pulses, Milk & Milk products, Oils & fats and Sugar & Jaggery were lower than the recommended levels of ICMR. The intake of all the foodstuffs except green leafy vegetables was lower than that of their rural counterparts. The intake of all the nutrients were below the recommended level, while that of micronutrients such as iron, vitamin A and riboflavin were grossly inadequate in all the age and sex groups. About 63% of adolescent boys and 42% of girls were undernourished (< 5th BMI age percentiles of NHANES). A significant association between undernutrition and socio-economic parameters like type of family, size of land holding and occupation of head of household was observed. Therefore, there is a need to evolve comprehensive programmes for the overall development of tribal population with special focus on adolescents.     

Nutritional status and birth outcomes of adolescent pregnant girls in Morogoro, Coast, and Dar es Salaam regions, Tanzania

OBJECTIVE: Studies that link adolescence pregnancies, nutritional status, and birth outcomes in Tanzania are scarce. We examined the nutritional status and birth outcomes of pregnant adolescent girls from rural and urban areas of three regions in Tanzania. METHODS: The study was carried out in the regions of Dar es Salaam (Chamazi and Gezaulole dispensaries and Round Table Maternity Home), Coast (Tumbi Regional Hospital and Mlandizi Health Center), and Morogoro (Regional Hospital, Uhuru Clinic, and Mlali Health Center). One hundred eighty pregnant adolescent girls ages 15 to 19 y were recruited and interviewed, and their nutritional status measurements were taken at the seven health facilities. Information concerning date of birth, marital status, educational status, sex education, and income status was collected with a structured questionnaire. Height, weight, and mid-upper arm circumference were measured according to standard techniques. Hemoglobin concentration was measured with a hemoglobinometer and the HemoCue technique. Nutritional status was assessed by body mass index, and hemoglobin concentration was determined by cutoff points of the World Health Organization. Suitable statistical analysis was done with SPSS 9.0. Weekly weight gain during pregnancy was measured in 123 subjects who kept their appointments and reported back after 2 wk. Fifty-seven subjects did not keep their appointments and were lost to follow-up. Records of infants' birth weights and mode of delivery were obtained from 50 subjects who delivered at the study sites. RESULTS: The height of about 54% of the subjects was shorter than 151 cm, suggestive of short maternal height. Severe wasting was observed in 27% of subjects. Mean weekly weight gain during pregnancy was 317 +/-110 g (-500 to 500 g). No significant differences were observed between rural and urban settings. Mean infant birth weight was 2600 +/- 480 g. About 48% of infants had low birth weight (<2500 g) and only 14% of infants had birth weight greater than 3000 g. About 14% of infants were born by cesarean section. Nearly 86% of the pregnant adolescent girls were anemic. A hemoglobin concentration below 7 g/dL was observed in 5% of subjects. Most subjects (55%) had hemoglobin concentrations from 7 to lower than 10 g/dL. There was a weak correlation between infant birth weight and weekly weight gain of the girls during pregnancy (r = 0.36, P < or = 0.01). However, a strong correlation was observed between birth weight and hemoglobin level of adolescent girls during pregnancy (r = 0.67, P = 0.01). Short stature was observed to contribute toward cesarean delivery (P = 0.05) because more cesarean deliveries were performed in short girls (<151 cm tall). CONCLUSIONS: The nutritional status of pregnant adolescent girls in the study areas was poor and resulted in poor pregnancy outcome. Girls should be educated about reproductive health at the primary level of education.     

Anaemia and iron deficiency anaemia among young adolescent girls from the peri urban coastal area of Indonesia

Anaemia due to iron deficiency is still a widespread problem. Among adolescent girls, it will bring negative consequences on growth, school performance, morbidity and reproductive performance. This cross sectional study aimed to identify the different nutritional and iron status characteristics of young adolescent girls 10-12 years old with iron deficiency anaemia and anaemia without iron deficiency in the rural coastal area of Indonesia. Anaemic girls (N =133) were recruited out of 1358 girls from 34 elementary schools. Haemoglobin, serum ferritin, serum transferrin receptor and zinc protophorphyrin were determined for iron status, whilst weight and height were measured for their nutritional status. General characteristics and dietary intake were assessed through interview. Out of 133 anaemic subjects, 29 (21.8%) suffered from iron deficiency anaemia, which was not significantly related to age and menarche. About 50% were underweight and stunted indicating the presence of acute and chronic malnutrition. The proportion of thinness was significantly higher (P < 0.05) among subjects who suffered from iron deficiency anaemia (51.7% vs. 29.8%). Furthermore, thin subjects had a 5 fold higher risk of suffering from iron deficiency anaemia (P< 0.05) than non-thin subjects (OR: 5.1; 95%CI 1.34-19.00). Further study was recommended to explore other factors associated with anaemia and iron deficiency anaemia, such as the thalassemia trait and vitamin A deficiency. The current iron-folate supplementation program for pregnant women should be expanded to adolescent girls.     

Body mass index and nutritional status of adult Savar tribals of Keonjhar District, Orissa, India

A cross-sectional study was undertaken to determine sex differences in mean body mass index (BMI) and nutritional status (based on BMI), as well as the effect of age on BMI and nutritional status of adult Savars, a tribal population of Orissa, India. A total of 600 adult (aged > 18 years) Savars of four villages, namely, Bonianiposi, Morabali, Panchapolli and Sailong of Keonjhar District, Orissa, India, were studied. Height and weight were measured and BMI computed. Mean ages of both sexes were similar (men: mean = 38.9 years, sd = 15.3; women: mean = 38.0, sd = 13.9). Men had significantly greater mean height (p < 0.001), weight (p < 0.001) and BMI (p < 0.05). The prevalence (sex combined) of undernutrition (BMI < 18.5) was found to be very high (43.5%). Moreover, there was a significant (chi2 = 7.39, p = 0.025) difference in the prevalence of undernutrition between men (38%) and women (49%). Age was significantly (p < 0.001) negatively correlated with BMI in both sexes (men: r = -0.20; women: r = -0.16). In general, the frequency of undernutrition increased with increasing age. In conclusion, this study demonstrated that the prevalence of adult undernutrition was very high among Savar women and high among Savar men. These rates increased with increasing age. Therefore, from the public health point of view, immediate nutritional intervention programmes are needed for implementation among Savars, especially among older individuals. Moreover, further research is needed not only among this ethnic group but also other tribal populations of India to fully understand the causes and consequences of adult undernutrition.     

Iron Status of Adolescent Girls (10-15 years) Attending a Government School in Jaipur City, Rajasthan, India

Iron deficiency anaemia is widely prevalent amongst women and children in India. The present work was designed to be an intervention study with nutrient fortified biscuits to ameliorate the micronutrient status of adolescent girls from a low socio-economic background. The baseline data on iron status of 109 adolescent girls (10-15 years) studying in a government school in Jaipur city, India are presented here. The iron status of adolescent girls was determined through haemoglobin, serum iron and serum ferritin levels. The results revealed that 96.3% of the adolescent girls suffered from anaemia, 31.2% of whom had mild deficiency and 65.1% had moderate deficiency. Anaemia was more prevalent in the older age groups. About 31% of the subjects had normal levels while the rest (69%) had low levels of serum iron. Similarly, about 75% of the subjects had low serum ferritin levels. Conclusively, anaemia was highly prevalent in the studied population and the adolescent girls had low haemoglobin, serum iron and serum ferritin levels. It is recommended that the school system be used for micronutrient supplementation to improve their nutritional status as the students are more regimented here for distribution of nutrient fortified food products.     

Growth and nutritional status in a probabilistic sample of schoolchildren from Rio de Janeiro, 1999

Growth and nutritional status were assessed in a probabilistic sample of public schoolchildren (1,705 girls and 1,682 boys) in the city of Rio de Janeiro in 1999. Nutritional status of the under-10-year group was assessed by z < -2 (undernutrition) for body mass for height and height for age and by z > +2 for body mass for height (overweight). For children over 10, the 5th and 85th percentiles of body mass index for age were used to assess underweight and overweight, respectively. Prevalence rates of overweight and obesity according to the International Obesity Task Force criteria were also calculated. Prevalence rates for undernutrition were below expected for the reference population. Prevalence of overweight was approximately 18% and 14% for girls and boys, respectively, and obesity was 5% for both sexes. The results of the present study are similar to findings from population-based surveys in Brazil: low prevalence of undernutrition and high prevalence of overnutrition.     

Status of adolescent girls in a rural south Indian population

The objectives were to assess the nutritional status of rural adolescent girls, to measure their knowledge about maternal and child nutritional needs, to measure their dietary intake, and to determine the sociocultural aspects of these girls. 47 adolescent girls aged 13-18 years attending a workshop on health and development organized by the Center of Maternal and Child Health, Vellore, India, participated. Their height and weight were measured; their hemoglobin concentration was determined; and other relevant data were collected about diet, knowledge, and nutrition by means of interviews and group discussions. 55% were agricultural laborers, while the remaining 45% worked occasionally. 14% had primary, 12% had secondary, and 10.2% had high school level education. In addition to attending school, 16.3% worked on the farm and 12% picked flowers. The mean height of all the age groups was below the expected standard for the age group. The growth of 34.7% of the subjects was very poor. The difference in height was much more significant in the younger age group (13-15 years) than in the older age group (16-18 years). Although all the subjects were normal for weight for height, only 51.2% had normal weight for their age group. The overall mean hemoglobin value was 10.0 g/dl. 73.5% of the subjects had a hemoglobin value below 12 g/dl (WHO standard) and could be classified as anemic. The mean hemoglobin level increased with increasing age, the lowest being at the age of 13 (9.8 g/dl) and the highest at the age of 17 years (11.9 g/dl). The mean age of menarche was 14.3 years. The diet was predominantly rice. Consumption of vegetables, milk, and meat was very low, which might have been responsible for the high prevalence of anemia in the girls. 91% of them were not aware that anemia could result from menstrual blood loss. 75% of them were aware of nutritional blindness and 48% of protein energy malnutrition. The girls reported sex discrimination in school and in the family.     

Anthropometric profile of children aged 0 to 5 years in the city of Niterói, Rio de Janeiro, Brazil

The Niterói-based Nutritional and Food Surveillance System (SISVAN Niteroi, RJ, Brazil) performed an anthropometric survey which included 2,248 children from zero to 60 months of age in September 1992, during a mass vaccination day program. The purpose was to determine the nutritional status of children from that city. The indexes used were Weight for Age (WA), Weight for Height (WH), and Height for Age (HA), and the reference population was that of the NCHS (National Center for Health Statistics, USA), adopted and recommended by the WHO. The indexes were analyzed using the classifications by Gomez and Z-Scores. Prevalence of undernutrition was calculated on the basis of the proportion of children with Z-scores under -2.00, using HAZ to stabilish chronic forms and WHZ for acute ones. A data base was built using Epi Info, version 5.0 1b, and a special program from CDC (Centers for Disease Control) was used to calculate anthropometric indexes. The results showed as much as 20.1 % of undernutrition, including all forms from the Gomez classification. In the city as a whole, 6.8% had HAZ under -2.00. The results indicated a serious situation of chronic undernutrition that demands continuous nutritional surveillance in Niteroi, and especially in the city's Eastern District.     

Examining Means of Reaching Adolescent Girls for Iron Supplementation in Tigray,Northern Ethiopia

Background: Iron deficiency is the most prevalent nutritional deficiency in adolescent girls from the developing world. One of the recommended interventions to improve iron status in adolescent girls is iron supplementation. Yet the provision of iron supplements to adolescent girls proved to be a challenging task for the health systems across the developing world. Objective: The objective of the study was to examine means of reaching adolescent girls for iron supplementation in Northern Ethiopia. Methodology: Analytical cross-sectional study consisting of both quantitative and qualitative approaches to data collection and analysis was used in this study. Stratified multi-stage systematic random sampling technique was adopted and primary quantitative data were collected from 828 (578 school attending and 250 non school attending) adolescent girls recruited from nine districts of Tigray. The primary quantitative data were analyzed using SPSS version 20 software. The qualitative data collected through key informant interviews and focus group discussions were transcribed verbatim and qualitatively analyzed. Results: The mean (SD) age of the girls was 16.7 (1.4) years. Four hundred forty seven (54%), 355 (42.9%) and 26 (3.1%) of the adolescent girls had low, medium and high diet diversity scores, respectively. More than half, 467 (56%), of the adolescent girls believed that adolescent girls were overloaded with household jobs everyday compared to boys from their respective communities. Key informants said that, there is no adolescent nutrition message promoted in the study area. Low community awareness, perceiving iron tablet as a contraceptive, religious and cultural influences, and lack of confidence in supplementation value of iron tablets, are some of the potential barriers mentioned by the key informant and focus group discussion participants. Schools (45%), health centers (27%) and health posts (26%) were the preferred public facilities for provision of iron supplements to student adolescent girls whereas schools (11%), health centers (47%) and health posts (41%) were the preferred public facilities for provision of iron supplements to adolescent girls who were not attending schools from the study communities. Conclusion: The health posts and health centers were the preferred health facilities for iron supplementation to adolescent girls who were not attending schools while the school was the preferred facility for iron supplementation of student adolescent girls.     

A Low Pulse Food Intake May Contribute to the Poor Nutritional Status and Low Dietary Intakes of Adolescent Girls in Rural Southern Ethiopia

Poor nutrition in adolescent girls poses critical health risks on future pregnancy and birth outcomes especially in developing countries. Our purpose was to assess nutritional status and dietary intake of rural adolescent girls and determine pulse and food intake patterns associated with poor nutritional status. A cross-sectional community-based study was conducted in a traditional pulse growing region of southern Ethiopia on 188 girls between 15 to 19 years of age, with 70% being from food insecure families. Prevalence of stunting (30.9%) and underweight (13.3%) were associated with low food and nutrient intake. Diets were cereal-based, with both animal source foods and pulses rarely consumed. Improving dietary intakes of female adolescents with nutrient dense foods would ensure better health for themselves and for the next generation.     

Overweight, stunting, and anemia are public health problems among low socioeconomic groups in school adolescents (12-15 years) in the North Gaza Strip

The objective of the study was to describe sociodemographic differences in nutritional status among school adolescents aged 12 to 15 years in north Gaza Strip. A cross-sectional survey was conducted in 2002 comprising 1022 students from 10 schools in Gaza city, Jabalia village, and Jabalia refugee camp. Height, weight, and hemoglobin levels were measured to assess nutritional status. Self-administered questionnaires were administered to students and parents to obtain data on sociodemographic characteristics. The prevalence of overweight/obesity, stunting, and anemia in the total sample was 17.9%, 9.7%, and 49.6%, respectively. More overweight/obese girls than boys were found (20.2% vs 15.4%). In girls, being from a low-income residential area, having employed fathers, and having reached puberty had highest risk of overweight/obesity, whereas in boys, those with medium socioeconomic status (SES) had the lowest risk of overweight. The mean height-for-age percentile was generally low for both sexes compared with the National Center for Health Statistics/World Health Organization reference, but stunting was more common in boys than girls (13.7% vs 6.2%). Age was positively associated with risk of stunting in boys, whereas in girls, SES and mother's education were negatively associated with stunting. Anemia prevalence was high in both girls and boys (51.3% vs 47.9%). Age and onset of puberty had an independent negative effect on anemia among boys. Girls from nuclear families and from Jabalia village had higher risk of being anemic. In conclusion, undernutrition and overnutrition coexisted in the study area. Anemia, stunting, and overweight among the adolescents are public health problems, especially among low SES groups that merit attention.     

Grip strength as an index for assessment of nutritional status of children aged 6-10 years

The purpose of this study was to evaluate the use of grip strength as an index of nutritional status in 6-10 y old children. Seven hundred and eighty seven children (364 boys and 423 girls) in the age group of 6 to 10 y were selected from private and municipal schools, orphanages and slums in the cities of Mumbai and Pune, India. Grip strength was measured using the dominant hand. Height, weight, mid-arm circumference and triceps skinfold were also measured in all subjects. A significantly high correlation (p<0.01) was observed between grip strength and age for both sexes. Boys had a higher grip strength than girls at all ages. Grip strength was significantly correlated with height, weight, mid arm circumference, triceps skinfold, arm fat and arm muscle areas (p<0.01). Stepwise multiple regression analyses showed height, weight, triceps skinfold and age to be independent variables influencing grip strength. Grip strength was found to be a specific measure of lean body mass (75 to 94%), but sensitivity was quite low (about 25%). The positive predictive value was variable, ranging from 54.6 to 21.5%. The specificity, sensitivity and positive predictive values were very high when compared with arm muscle area. Grip strength may have a potential value as an additional test for nutritional assessment in field situations and clinical settings.     

Nutrient Intake Amongst Rural Adolescent Girls of Wardha

Objective:

To assess the nutrient intake of rural adolescent girls.

Materials and Methods:

The cross-sectional study was carried in four adopted villages of the Department of Community Medicine, M.G.I.M.S., Sewagram. A household survey was carried out in the villages. A list of all the adolescent girls in the age group of 10-19 years was prepared by enumeration through house-to-house visit. All adolescent girls were included in the study. A pre-designed and pre-tested questionnaire was used to collect data on socio-demographic variables and anthropometric variables. A 24 h recall method was used to assess nutrient intake. Data generated was entered and analyzed using epi_info 2000. Nutrient intake was compared with ICMR Recommended Dietary Allowances. Nutritional status was assessed by BMI for age.

Results:

The mean height of the adolescent girls was 142.9 cm. Overall, 57% of the adolescents were thin (BMI for age <5^th percentile for CDC 2000 reference) and 43% of the adolescents were normal (BMI for age between 5^th – 85^th percentile for CDC 2000 reference). The average energy intake, which was 1239.6±176.4 kcal/day, was deficient of RDA by 39%. The average protein intake was 39.5±7 gm/day. It was deficient by 36% and the average iron intake, which was 13.2±2.5 mg/day, was deficient by 48%.

Conclusions:

The findings reiterate the dietary deficiency among adolescent girls which adversely affects the nutritional status. If the poor nutritional status is not corrected promptly before they become pregnant, it adversely affects the reproductive outcome. If we have to meet out the goals of Reproductive and Child Health Program, intervention strategies to improve the dietary intake of adolescent girls are needed so that their requirements of energy, protein, vitamins and minerals are met.     

A Study on Consciousness of Adolescent Girls About Their Body Image

Background:

Perceived body image is an important potential predictor of nutritional status. Body image misconception during adolescence is unexplored field in Indian girls.

Objectives:

To study the consciousness of adolescent girls about their body image.

Materials and Methods:

This multistage observational study was conducted on 586 adolescent girls of age 10–19 years in Lucknow district (151 from rural, 150 from slum, and 286 from urban area) of Uttar Pradesh, India. Information on desired and actual body size was collected with the help of predesigned questionnaire.

Results:

20.5% of studied girls show aspiration to become thin, who already perceived their body image as too thin. 73.4% adolescent girls were satisfied with their body image, while 26.6% were dissatisfied. The dissatisfaction was higher among girls of urban (30.2%) and slum (40.0%) areas in comparison to rural (22.5%) area. Percentage of satisfied girls was less in the 13–15 years (69.9%) age groups in comparison to 10–12 years (76.5%) and 16–19 years (76.4%). Among girls satisfied with their body image, 32.8% girls were found underweight, and 38.4% were stunted. Underweight girls (42.1%) and stunted girls (64.9%) were higher in number within satisfied girls of slum area. Among all of these adolescent girls, 32.8% of girls had overestimated their weight, while only 4.9% of girls had underestimated their weight.

Conclusions:

This study concludes that desire to become thin is higher in adolescent girls, even in those who already perceived their body image as too thin.     

Nutritional status,birth weight and breast feeding of elementary first grade Chilean students

The nutritional status was assessed of 306 1st grade students from metropolitan Santiago, Chile, equally divided between girls and boys, public and private schools, and low, medium and high socioeconomic groups. The mean age was 6.38 years. Anthropometric measurements taken were weight, height, upper segment, head circumference, arm circumference and triceps skinfold. Percent weight for age, height for age and weight for height were determined according to tables of the National Center for Health Statistics. Expressed as percentage of weight for height, there was a high incidence of obesity (8.9%), and overweight (23.9%), but a low incidence of undernutrition (1%). According to the Waterlow sample distribution, 85.0% of the subjects had adequate nutritional status, 0.3% were wasted, 14% were stunted, and 0.7% were seriously malnourished. Nutritional status was positively and significantly correlated with birth weight, but not with duration of breast feeding. No differences in the duration of breast feeding were found with regard to sex or type of school. More upper status women breast fed for durations less than 6 months, while more lower status women breast fed for more than 6 months. Those from high socioeconomic groups had higher birth weights and better nutritional status. The results indicate an improvement in nutritional status and birth weights of Chilean children, but suggest that intervention should be made to prevent obesity.     

Low folic acid status and its association with anaemia in urban adolescent girls and women of childbearing age in Sri Lanka

Folic acid deficiency is implicated in the aetiology of nutritional anaemia and adverse pregnancy outcomes for the fetus. Data on folic acid status among adolescent girls and non-pregnant, non-lactating young women are limited. We assessed folic acid status in a random sample of 552 subjects (277 adolescent girls aged 15-18.9 years and 275 women aged 19-30 years) living in Colombo, Sri Lanka. The association of low folic acid status with anaemia was evaluated. Socio-economic, food intake and anthropometric data were obtained. Hb, serum folic acid, vitamin B12 and ferritin and plasma homocysteine concentrations were measured. Forty-three per cent of subjects studied had low serum folic acid concentrations (<3 ng/ml) and 47 % had low Fe stores (serum ferritin <20 microg/l). Overall prevalence of anaemia was 12.9 %, and 43.9 % of anaemic subjects had both low folic acid status and depleted Fe stores (serum ferritin <12 microg/l). Both low folate status and depleted Fe stores were significantly associated with anaemia (odds ratio = 2.32; 95 % CI 1.34, 4.01 and odds ratio = 5.98; 95 % CI 3.36, 10.63, respectively). Serum folic acid concentration was associated (r = 0.108, P = 0.015) with folate intake as indicated by a computed folate index. Folate index was associated inversely with household size and positively with economic status and education level. In this study population low folic acid status, besides depleted Fe stores, was associated with anaemia. The high prevalence of low folic acid status observed highlights the need for nutrition education to improve intakes of folate, Fe and other micronutrients among adolescent girls and young women.     

Seasonality and nutritional status of indigenous peoples: the case of Wari' in Rondônia State, Brazil

Despite the importance of nutritional status and eating practices among Brazilian indigenous populations, the subject has received little research attention. This study examines the Wari' community in Rond?nia State, in the southwest Amazon. Two anthropometric surveys, six months apart, were carried out to characterize the group's nutritional status and investigate possible seasonal variations (n = 279 and 266; age range, 0-87 years). Prevalence rates of low height for age (61.7%) and weight for age (51.7%) in Wari' under-5 children were among the highest reported in the literature on indigenous populations in Brazil. Overweight and obesity were not common in the population, regardless of age. According to the anthropometric data, nutritional conditions are generally worse during the rainy season, when undernutrition increases in children, and both male and female adults lose weight. Seasonality is an important factor when defining nutritional surveillance protocols and discussing the nutritional status of indigenous peoples.     

Micronutrient Adequacy in the Diet of Reproductive-Aged Adolescent Girls and Adult Women in Rural Bangladesh

Micronutrient deficiencies remain a serious nutritional concern in Bangladesh, especially among rural women of reproductive age (WRA). This study assesses the diet quality of reproductive-aged adolescent girls and adult women (referred to together as WRA in this study), including socio-demographic factors associated with their diet quality. The diet quality of adolescent girls was compared with that of adult women to assess which group was most at risk. The diet quality was measured by calculating the nutrient adequacy ratio (NAR), using the preceding 24 h dietary recall method. The mean adequacy ratio (MAR) was calculated as an overall measure of diet quality using the NAR. Nearly three quarters of WRA (adolescents: 73.1–88.5%; adult women: 72.9–86.4%) had an inadequate intake of calcium, vitamin A, folic acid, and vitamin B12. The prevalence of inadequate dietary intakes of calcium, zinc, and energy was significantly higher in adolescent girls (p < 0.001) than in adult women. Overall diet quality was significantly better in adult women (0.51 ± 0.21, p < 0.001) than in adolescent girls (0.49 ± 0.22). Age, marital status, educational level, and monthly household income were important factors associated with the diet quality of WRA. Micronutrient inadequacy is widely prevalent in the diets of WRA in Bangladesh, and adolescent girls with poor socio-economic status and lower educational levels are at higher risk.