Nutritional status of tribal and non-tribal adults in rural Bangladesh: A comparative study

BACKGROUND

Nutritional status is an important indicator of health status among adults. However, to date, there exists scanty information on the nutritional status of tribal populations of Bangladesh. The aim of the study was to investigate the nutritional status of tribal (T) and non-tribal (NT) adult people living in the rural area of Rajshahi district, Bangladesh.

METHODS

A total of 420 (72 T and 348 NT) households were studied. The samples were selected using multistage stratified sampling with proportional allocation. The nutritional status of adults was measured using body mass index (BMI). Descriptive statistics, t-test, ANOVA and Z-proportional test were utilized for data analysis.

RESULTS

The study revealed that 8.3% and 9.2% of T and NT men were suffering from under nutrition respectively, while the corresponding figures in women were 12.5% and 10.1% respectively. Overall, 11.1% and 27.0% men, and 13.9% and 29.3% women T and NT were over-nourished respectively. The rate of over nutrition among T was significantly (p<0.05) higher than NT for both sexes. The mean weight and BMI of the NT men were significantly (p<0.01) higher than T men. The mean weight, height and BMI of NT women were higher (p<0.05) than T women. ANOVA demonstrated that the variation in BMI among education levels of NT men and the variation among occupation for both ethnicities were significant (p<0.01). The variation in BMI among education levels and occupation of T and NT women were significant (p<0.05), moreover ordinal logistic regression model demonstrated that hygienic toilet facilities and father's occupation were predictors of nutritional status. The interaction effects of education and occupation, and education and household monthly income on BMI were significant (p<0.01) for T men and both T and NT women (p<0.05).

CONCLUSIONS

The prevalence of over-nutrition among NT is higher than T for both sexes. Some socio-economic and demographic factors were found as predictors of malnutrition. At least 12 of the 17 Sustainable Development Goals (SDGs) contain indicators that are highly related to nutrition, our findings can help Bangladesh Government for achieving SDGs by 2030. Appropriate nutritional intervention and awareness programmes can be initiated by the Government to ameliorate the burden of malnutrition among adults in the country.

Dealing with infodemic during COVID-19 pandemic: Role of effective health communication in facilitating outbreak response & actions - An ICMR experience

Objectives

To highlight and assess the impact of intervention tools used by Indian Council of Medical Research (ICMR) against COVID19 associated infodemic in the world's largest democratic country, India.

Study design

It is a retrospective cross sectional study. The impact of ICMR's multi-pronged strategy to address the infodemic during pandemic has been assessed through analysis of print media reportage and social media engagements.

Methods

The impact of the interventions was assessed using cloud media mappers like MediaCloud and Meltwater using keywords. The data was analysed in terms of reportage, theme of reportage. A sub-section of media reportage (Feb 2020-June 2020) was analysed in details from 4 major dailies to understand the coverage and tonality of media reports. The data on COVID 19 related tweets, posts and uploads were taken from social media platforms of Indian Council of Medical Research (ICMR) particularly twitter, instagram, facebook and youtube and estimate of pre and post pandemic changes in followers or users were collected for analysis. The data was curated and analysed using MS excel.

Results

There was a surge of 3800% reportage in media during pandemic as compared to same time frame in pre-pandemic times. A surge of followers on twitter from 26,823 on Feb 2020 (before pandemic) to 3,36,098 at March 2022 (after pandemic) was observed. A drastic increase in monthly followers was observed after start of Pandemic (after Feb 2020) in comparison to before pandemic (Before Feb 2020). Similar trends were observed on other social media platforms of ICMR.

Conclusions

The Communications Unit at ICMR geared up with more robust plans and designed several interventions to mitigate the infodemic which helped in evidence based decision making towards outbreak response and action. This highlights the importance of evidence based, crisp, timely and effective communication during the epidemics/pandemics to buid trust and confidence in the community.

Old known and possible new biomarkers of ANCA-associated vasculitis

Antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) comprises a group of multisystem disorders involving severe, systemic, small-vessel vasculitis with short- and long term serious and life-threating complications. Despite the simplification of treatment, fundamental aspects concerning assessment of its efficacy and its adaptation to encountered complications or to the relapsing/remitting/subclinical disease course remain still unknown. The pathogenesis of AAV is complex and unique, and despite the progress achieved in the last years, much has not to be learnt. Foremost, there is still no accurate marker enabling us to monitoring disease and guide therapy. Therefore, the disease management relays often on clinical judgment and follows a" trial and error approach". In the recent years, an increasing number of new molecules s have been explored and used for this purpose including genomics, B- and T-cell subpopulations, complement system factors, cytokines, metabolomics, biospectroscopy and components of our microbiome. The aim of this review is to discuss both the role of known historical and clinically established biomarkers of AAV, as well as to highlight potential new ones, which could be used for timely diagnosis and monitoring of this devastating disease, with the goal to improve the effectiveness and ameliorate the complications of its demanding therapy.

Ethnic heterogeneity in body composition patterning and CVD risk factors: a multi-ethnic study of Asian Indian Tribes

BACKGROUND

Indian subcontinent exhibits considerable degree of ethnic heterogeneity in cardiovascular disease (CVD) risks. Given the importance of ethnicity, the present multi-ethnic study was conducted to find out the differences in body composition patterning and its influence on CVD risk variables.

OBJECTIVE

Owing to considerable ethnic heterogeneity among Asian Indians the study was performed to determine the association of variability between body composition and CVD risk factors at the micro-level among different tribes by sex, province, and generation.

METHODS

Nine tribes from three different states (provinces) were considered. Anthropometric measurements, body composition, adiposity, blood pressure, and fasting blood glucose was measured using standard technique. Body composition was measured using BIA method by means of body fat monitor. Mean differences of the body composition measures were analysed by ANOVA. Stepwise multiple regressions were done with CVD risk variables as dependent and body composition profiles as independent variables to find out the significant predictors. Those were then loaded for principal component factor analyses (PCFA).

RESULTS

Tribal subjects of both sexes and from both younger and older generations in Gujarat had significantly higher percentage body fat, subcutaneous fat-whole body, and subcutaneous fat-trunk as compared to tribal subjects of Odisha, and West Bengal, as well as significantly lower skeletal mass-whole body and skeletal mass-trunk. PCFA showed two components: (i) percentage body fat with muscle mass; and (ii) visceral fat with resting metabolism. These two components cumulatively explained 80-90% of the total variance associated with CVD risk variables, across the nine tribes.

CONCLUSION

Tribal subjects of Gujarat had higher CVD risks with significantly higher fat mass and lower muscle mass followed by the tribal subjects of Odisha, and West Bengal respectively. The younger generation are equally at risk as their older counterparts. The CVD risks are developing at a much faster rate resulting in a serious public health threat, even in traditional societies. Body composition measures could be considered as a better non-invasive technique for early intervention and proper risk management among the Asian Indians in general and tribal populations in particular.

Determinants of time-trends in exclusivity and continuation of breastfeeding in India: An investigation from the National Family Health Survey

Breastfeeding is an essential key factor for reducing child mortality and the risk of disease. Therefore, to ensure health and wellbeing for all (Sustainable Development Goal 03), and to reduce inequalities in child health status (SDG 10), understanding the determinants of breastfeeding is essential. Our research aims to investigate determinants of different breastfeeding practices from 2005-06 (NFHS-3) to 2015-16 (NFHS-4), and changes in different breastfeeding practices among various demographic, social, religious, and economic groups during this decade. We have used a multivariate binary logistic regression model to estimate significant determinants of different breastfeeding practices. The results show an 8.4% hike in Exclusive Breastfeeding (EBF), along with a 3.3% and 1% drop in the Continuation of Breastfeeding (CBF) up to one and two years respectively during this decade in India. Significant variation has been found in EBF, CBF1 and CBF2 among various categories of child's birth interval, place of residence, social groups, economic communities, and geographic regions. Maternal nutritional status and anemia levels had significant influence on CBF1 and CBF2, and gender of the children on EBF and CBF2 from 2005-06 to 2015-16. There was no significant variation in CBF1 and CBF2 among children born in different birth orders, whereas EBF was significantly less among higher birth orders children. A dramatic improvement in EBF was found among first birth ordered children, teenage and/or highly educated mother, rich families, and in north India, and CBF2 was significantly raised only among higher educated mothers. The estimation of determinants throughout the decade is essential for improving government policies related to supporting and encouraging breastfeeding. The study suggests more initiatives and investment for the promotion, support and improvement of CBF for one and two years, and reduction of inequality among various demographic and socio-economic groups and geographic regions.

The effect of a natural disaster on handgrip strength in prepubertal Indian children exposed to a severe cyclone during the prenatal and early postnatal growth

Natural disasters (NDs) experienced by women and their children during prenatal and infant growth may have long-lasting effects on offspring’s development. Handgrip strength (HGS) is one of the measures of muscular strength and an indicator of health status. This study compared HGS in children exposed to cyclone Aila in India during their prenatal and infant growth compared to a control group from a non-affected, adjacent area. The total sample involved 444 boys and 423 girls aged 7–9 years, categorised into 3 groups: prenatally exposed to Aila, exposed to Aila in infancy, and the control group, non-exposed to Aila. Results revealed that prenatally exposed children of both sexes had significantly lower HGS than the controls (at least, p < 0.001 in boys; p < 0.05 in girls). On the other hand, the postnatally exposed boys, but not the girls, showed lower HGS than the controls. A significant effect of a group factor (ND exposure) on HGS was observed even after controlling for confounding variables (age, height, BMI, birth weight, gestational age; at least, p < 0.05). Our findings indicate that prenatal or early postnatal experience of a ND may have association with impaired HGS in prepubertal children.

Association of body mass index and upper arm body composition with depressive symptoms in old age home and family based elderly

The following study was designed to find out the association of the mid-upper arm body composition and body mass index (BMI) with depressive symptoms among the old age home based (group 1) and family based elderly (group 2) subjects. In group 1 elderly males, 51.5% were showing mild depressive symptoms and 17% were showing moderate to severe depressive symptoms. On the other hand, among group 2 elderly males, prevalence of mild depressive symptoms was in 27% and moderate to severe depressive symptoms was in 4.5% of the subjects. Among elderly with and without depressive symptoms, BMI, waist-hip ratio (WHR), arm muscle circumference (AMC), arm muscle area (AMA), arm fat area (AFA), fat mass (FM), muscle mass and bone mass were significantly (p < 0.01) lesser among group 1 as compared to group 2. Among group 1, the AFA (R² change = 0.178), AMC (R² change = 0.035), AMA (R² change = 0.032), FM (R² change = 0.022) and muscle mass (R² change = 0.019) have highest contribution to the variance of depressive symptoms. On the other hand, BMI (R² change = 0.04) and WHR (R² change = 0.03) had the highest, though small, contribution to the variance of depressive symptoms among group 2. The upper arm body composition indices were better indicator of depressive symptoms in group 1, and BMI and WHR were better indicators of depressive symptoms in group 2. Therefore, among group 1 subjects, the upper arm body composition indices prove to be better regular health monitoring indices as compared to traditionally used BMI and WHR.

Diagnostic diversities of Clear Fluid encountered during Fine needle aspiration cytology with an analysis of various variables

Background: Incidental finding of clear fluid during fine needle aspiration (FNA) is not rare in day to day practice of cytology. Though clear in appearance, cells obtained from it may yield a diverse diagnosis ranging from an inconclusive opinion to a malignant lesion. So, clear fluid is not non-significant always; lack of proper processing and examination may prove fatal to a patient. Aim: To evaluate the diverse diagnosis of clear fluid. Materials and methods: During a period of three years, hundred and seven cases which yielded clear fluid during FNAC from different parts of the body were studied. Direct and indirect smears (wherever applicable) was prepared, stained and examined microscopically. Results: Of these 107 cases of clear fluid, Male: Female ratio was 1: 1.6. Maximum cases - 55 (51.40%) was found in the age group 21 to 40 years. Trunk held the most number of lesions - 54 cases (50.46%). FNA results were interpreted as inconclusive in 19 cases (17.76%), benign in 84 cases (78.50%), suspicious in 01 case (0.93%) and malignant in 03 cases (2.80%). Epidermal cyst was the most common benign lesion - 16 cases (14.95%). Malignant lesions found were papillary carcinoma of thyroid, carcinoma of breast and metastatic squamous cell carcinoma – one case each. Conclusion: Our study emphasizes on the importance of proper examination of clear fluid as it may prove helpful in an undiagnosed case of malignancy and it may also improvise the learning of young pathologists. Bangladesh Journal of Medical Science Vol.18(4) 2019 p.753-755

Cytology Microarray on Cell Block Preparation: A Novel Diagnostic Approach in Fluid Cytology

Background:

The cytological examination of serous body effusions to diagnose and stage malignancy is well accepted in clinical medicine. Conventional smear (CS) and cell block (CB) study has to be complemented with immunohistochemistry (IHC) for a definitive diagnosis of malignancy and also to differentiate it from reactive mesothelial cells. Cytology microarray (CMA) is a modification of tissue microarray which involves core needle biopsy of multiple cell blocks and embedding it in a single block.

Aim:

The aim of this study was to assess the effectiveness of IHC technique in CMA for rapid diagnosis of malignancy and to reduce the cost of testing.

Materials and Methods:

In this study, 82 pleural fluids were collected and subjected to CS and CB study followed by IHC in CMA blocks. Six commonly used antibodies were applied to confirm malignancy and diagnose the primary.

Results:

Nineteen cases were diagnosed as malignancy by CB method. MOC-31 confirmed adenocarcinoma deposit in 67% cases of which 44% were proved to be of lung primary by TTF1.

Conclusions:

IHC on CMA blocks of effusion fluids is a very effective technique that can significantly reduce the cost of testing by >70%.

Contribution of Calcium and Other Dietary Components to Global Variations in Bone Mineral Density in Young Adults

A research project on comparative international studies of osteoporosis using isotope techniques was organized by the International Atomic Energy Agency (IAEA) with the participation of 12 countries (Brazil, Canada, Chile, China, Croatia, Hungary, Philippines, Russia, Singapore, South Africa, Turkey, and the United Kingdom). Participating centers in 11 countries (all but the UK) made measurements and collected data on men and women aged 15 to 49 years. In addition to studies of bone mineral density (BMD) at the femoral neck and lumbar spine using DEXA, anthropometric, lifestyle, and nutritional data were also collected. The results of the nutritional studies are reviewed in this paper. Overall, about 8% of the observed variability in spine BMD could be attributed to nutritional factors in men and women; in men, no such relationship could be determined. No single nutritional component (not even calcium) stood out as being of particular importance across all participating centers.

Relationship between temperament and fatness in 11-year-old children and 17-year-old adolescents from Wrocław, Poland

Childhood obesity is increasing globally, and Poland is no exception. Studies indicate that relationship between obesity and psychological well-being is a complex issue and this needs further research. The objective of the present cross sectional study was to analyze the relationship between some temperament components and fatness among children in two developmental periods, approximately before and after adolescence. Participants included 122 children aged 11 years (57 boys and 65 girls), and 153 adolescents aged 17 years (64 boys and 89 girls) from 6 primary and 4 secondary schools in Wrocław, Poland. Height, weight, triceps-, subscapular and abdominal skinfold thicknesses were measured. Temperament was assessed by a questionnaire of Buss and Plomin (1984) in two versions: EAS-C for children completed by parents and EAS-D for youth and adults. Physical activity (PAL) was also assessed by a questionnaire. Mean, median and standard deviation (SD) were calculated and Student's t tests were performed to test for significance of differences between groups. Chi squared (χ²) statistic was used to test the significance of differences in frequencies. Analyses of covariance (ANCOVA) were performed to show the effect of the social - psychological factors on fatness. Controlling for socioeconomic status and physical activity level, activity, as a component of temperament had a significant effect on body fatness. The only component of temperament, which significantly influenced level of fatness in girls, was emotionality. These relationships differed according to sex and the two age groups concerned.

Role of Cytology in Early Diagnosis of Cerebrotendinous Xanthomas

Cerebrotendinous xanthomatosis is a rare autosomal recessive lipid storage disease characterized by widespread tissue deposition of two neutral sterols, cholestenol and cholesterol, resulting in tendinous xanthomas, juvenile cataracts, progressive neurological defects, and premature death from arteriosclerosis. Because it is a treatable cause of cerebellar ataxia and dementia, its early diagnosis is desirable. Here, we have reported the case of an 11-year-old boy with this disorder who was diagnosed based on the cytological findings of fine needle aspiration and clinical features.

Nutritional status among children and adolescents aged 6–18 years of Kolam tribe of Andhra Pradesh, India

Malnutrition has become one of the serious problems among children and adolescents internationally, especially in developing countries. India, a developing country covers 40% of undernourished children of the world. In India, tribal population is among the most deprived and undernourished people. The present study shows the prevalence of undernutrition among Kolam tribal children and adolescents by comparing different Body Mass Index (BMI) cut off points. Age and sex specific nutritional status of studied population shows 15.01% boys and 18.35% girls are in Chronic Energy Deficiency (CED) III category, 16.22% boys and 19.32% girls are in CEDII, 31.71% boys and 2.72% girls are in CEDI only 0.96% boys and 1.69% girls are in overweight category respectively. Undernutrition is not limited to young children, even adults are also severely underweight in developing countries. Health and nutrition of today’s adolescent girls may have great impact on the quality of next generation. Proper nutritional programs and health policies are needed to be implemented among tribals to solve the problem of undernutrition and similar studies should be planned in other underprivileged sections worldwide.

Socio-economic and demographic correlates of stunting among adolescents of Assam, North- east India

The prevalence of stunting (low height-for-age) is a key indicator of long-term chronic undernutrition which reflects an anthropometric failure to reach linear growth potentials due to prolonged food deprivation and/or disease or illness during the early stage of life. The present study assesses the prevalence and socio-economic and demographic correlates of stunting among adolescents of the North-east India. This cross-sectional study was undertaken among 1,818 (830 boys; 988 girls) adolescents (aged 10-18 years) belonging to ethnically heterogeneous populations of Karbi Anglong district of Assam, using stratified random sampling method. Anthropometric measurements of height and weight were recorded using standard procedures. Socio-economic and demographic variables were obtained using pre-structured schedule. The age-sex specific L, M and S reference values were used to calculate height-for-age Z-score (HAZ). According to WHO, HAZ found to be <−2SD was classified as stunting. The data were analysed using descriptive statistics, t-test, ANOVA, chi-square analyses, binary and step-wise multiple logistic regression analysis in SPSS (version, 17.0). The prevalence of stunting was observed to be significantly higher among boys (48.4%) than girls (37.8%) (p<0.01). Age-sex specific prevalence was found to be higher among boys than girls aged 14-18 years and contrary were observed among girls aged 10-14 years (p>0.05). The binary logistic regression analysis showed that several socio-economic and demographic variables were significantly associated with stunting (p<0.05). The step-wise multiple logistic regression analysis showed that sex (boys), age groups (13-15 years and 16-18 years), father’s occupation (cultivator) and Rupees ≤5000 household income was significantly associated with stunting (p<0.05). Appropriate nutritional intervention programmes and dissemination of knowledge at population level related to undernutrition are necessary to ameliorate their nutritional status.

Neck circumference as a screening measure of overweight/obesity among Indian adults

Neck circumference (NC) is an anthropometric measurement of differentiating body fat distributions and a marker of upper subcutaneous adiposity. The present study highlights the association and importance of NC as a suitable proxy screening measure of overweight/obesity as compared to the conventional anthropometric variables used among Indian adults. The present community based cross-sectional study was undertaken among 1169 Karbi adults (males: 625; females: 544) residing in Karbi Anglong district of Assam, Northeast India, who were selected through a multistage stratified random sampling method. Height, weight, waist circumference (WC), hip circumference (HC) and NC were recorded using standard procedures. The body mass index (BMI) was calculated and prevalence of overweight/obesity was assessed using standard cut-offs. The prevalence of obesity using BMI (≥25.00 kg m-2) was 15.52% and 15.26% among males and females, respectively (p≥0.05).The prevalence of obesity using NC was observed to be significantly higher among males (48.80%) than females (19.12%) (p<0.01). The binary logistic regression analysis showed that NC predicted obesity over the conventional anthropometric variables with reasonable accuracy (p<0.01). The ROC-AUC analysis showed a relatively greater significant association between BMI, WC and HC and NC for obesity (p<0.01). Thus, NC appears to be a potentially simple, easyto- use screening measure for predicting obesity among adults. Further studies are required to validate its use for screening of obesity among other ethnic populations in India.

Central obesity and coronary risk factors

A cross-sectional study of 130 Bengalee Hindu men (mean age=50.3 years; SD=10.5 years) was undertaken to investigate the relationship of body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR) with total cholesterol (TC), high density (HDL-C), low density (LDL-C) and very low-density (VLDL-C) lipoprotein cholesterol, fasting plasma glucose (FPG) and triglycerides (FTG). Correlation studies revealed that WHR was significantly correlated (r=0.245, p<0.01) with TC. WC and WHR had significant correlations with VLDL-C, FPG and FTG. All subjects were further divided into two groups based on WHR<0.95 (centrally non-obese, CNO) and WHR>0.95 (centrally obese, CO) following the US Joint National Committee (JNC) guidelines. Students’ t-test revealed that CO subjects (n=83) had a significantly higher mean TC (p<0.05), VLDL (p<0.05), FPG (p<0.01) and FTG (p<0.05) compared with CNO individuals (n=47). Results of analysis of variance (ANOVA) of central obesity status (CNO=no, CO=yes) and BMI (BMI tertiles used as a categorical variable) with these metabolic variables revealed that CO status had a significant effect (p<0.05) on TC, VLDL-C, FPG and FTG. BMI tertiles did not a have significant effect on any of these metabolic variables. There was no significant BMI tertile-central obesity status interaction. It can therefore be concluded that the JNC guidelines of WHR>0.95 to define central obesity can be used, irrespective of BMI, among this population, to identify individuals who have enhanced metabolic risk factors of coronary heart disease (CHD). Furthermore, it can be routinely used for health promotion purposes among Bengalee men.

Anthropometric and body frame size characteristics in relation to body mass index and percentage body fat among adult Bengalee male brick-kiln workers from Murshidabad, West Bengal, India

SUMMARY

Anthropometric and body frame size parameters (ABFSP) are used to interpret body mass and to evaluate nutritional status. Objective of the present study was to investigate the interrelationships between ABFSP, percentage body fat (BF%) and body mass index (BMI). The study was carried out in a sample of 141 adult Bengalee healthy male brick-kiln workers (age range 18-59 years) from Murshidabad district in West Bengal, India. Body weight was recorded; anthropometric measurements included height, breadth (elbow, wrist, hand, foot, ankle, knee), circumferences (mid-upper arm, chest, waist, hip, thigh, medial calf) and skinfolds (biceps, triceps, subscapular, suprailiac). Derived ABFSP included sum of breadth and circumferences, frame index, BMI, BF%, sum of skinfolds, ratio of central and peripheral skinfolds, arm muscle area, arm muscle circumference, arm fat area and brachial adipo-muscular ratio. Correlations (age-controlled) between ABFSP, BMI and BF% were highly significant (p < 0.001). The ABFSP and BF% varied significantly (p < 0.0001) in relation to BMI-based nutritional status (BNS). Multinomial logistic regression analysis (age-adjusted) showed ABFSP had statistically significant (p < 0.01) relationships with BNS. There were strong interrelationships between ABFSP, BMI and BF% independent of age. The ABFSP in individuals with normal BMI, suffering from undernutrition (low BMI) or overweight are different.

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.

Predictive equations for height estimation using knee height of older Bengalees of Purba Medinipur, West Bengal, India

For nutritional assessment work for older population, it is important to be able to estimate body height based on knee height. The present report describes three equations for height estimation among older Bengalees based on knee height and compares the results with knee height based formulae developed for several other populations. Anthropometric measurements were analyzed from 114 (62 men and 52 women) older subjects aged >= 55 years. The subjects were randomly selected from two blocks (Contai I and Ramnagar I), at coastal area of Purba Medinipur District in West Bengal, India. A population specific formula for height was created based on knee height of the subjects. These estimated formulae from the present study and fourteen other previously reported formulae were also applied to these older population and the mean estimation errors were statistically compared. Analysis indicated that our derived formulae gave accurate estimation of height among the subjects.

Sibling composition and household room sharing are associated with menarcheal status among rural Bengalee girls of West Bengal, India

Menarche, the first menstruation, is one of the most important events in a woman's reproductive life. The timing of menarche varies across populations and depends upon social interaction and family environment. It is also associated with several biological as well as social factors. The objective of this study was to explore the relationship between sibling composition and age at menarche (AAM) and to assess the association between the pattern of room sharing with family members of different sexes and menarcheal occurrence among rural Bengalee girls from West Bengal, India. The total sample comprised 577 Bengalee girls, 6-17 years of age, from various schools and madrasas in two blocks of the Nadia District of West Bengal State in India. The effects of room sharing on the occurrence of menarche, and of sibling composition on the menarcheal age, were assessed by analyses of covariance. The room-sharing pattern had a significant effect on menarcheal status (yes÷no): a significantly higher percentage of girls who shared a room with the mother and÷or sisters were postmenarcheal compared with those who shared a room with male family members. AAM did not differ significantly between girls having brothers or sisters. However, sibling order had a significant impact on AAM. Girls who had a younger sibling only (brother or sister) had a higher mean AAM, and girls who had both younger brothers and younger sisters had significantly higher mean AAM, than did the girls who had no younger sibling (singletons or having only elder siblings). There was no difference in AAM between the girls who had younger sister(s) and those who had younger brother(s). These differences were also independent of body mass index. In conclusion, the room sharing characteristics and the sibling sex composition, particularly their order, had significant effect on menarche in adolescent rural Bengalee girls.

Relative fat distribution in relation to menarcheal status among Bengalee Hindu girls of West Bengal, India

Background:

Menarche seems be related to the relative distribution rather than the total amount of body fat. Previous studies showed that the ratio between lower-body vs. upper-body fat was associated with the timing of menarche.

Aim:

To compare the relative distribution of subcutaneous fat among Bengali Hindu pre- and post-menarcheal girls.

Materials and Methods:

The participants were 234 Bengali Hindu girls aged 11-14 years: 111 pre-menarcheal and 123 post-menarcheal girls, randomly selected from a secondary school from a suburb of Kolkata, West Bengal, India. Triceps, abdominal, sub-scapular, and calf skinfolds were measured. For each skinfold site, ratio was calculated as follows: Log (one skinfold/sum of skinfolds). Principal components (PC) analysis was performed to derive components which express the maximum contrast among the log of ratios. T-test was employed to assess differences between individual scores of components between pre- and post-menarcheal girls.

Results:

The three identified PC suggested extremities-trunk, lower trunk-upper trunk, and an upper extremity-lower extremity contrasts, respectively. Scores for second and third components showed significant differences between pre- and post-menarcheal groups of girls.

Conclusion:

The attainment of menarche by Bengali girls aged 11-14 years was associated with characteristically more relative subcutaneous fat distribution in the upper trunk and in the lower limbs, in contrast to lower trunk and upper limbs, respectively.

Comparison of body adiposity indices in predicting blood pressure and hypertension among slum-dwelling men in Kolkata, India

INTRODUCTION

Recent findings show a high incidence of stroke among slum dwellers in Kolkata, India. This cross-sectional study aimed to compare the association of different adiposity indices to blood pressure (BP) and hypertension (HT) among slum-dwelling Bengalee men in Kolkata.

METHODS

Measurements of height, weight, waist and hip-circumferences, biceps, triceps, subscapular and suprailiac skinfolds, systolic (SBP) and diastolic (DBP) of 470 men aged 18-60 years were taken. Body mass index (BMI), body adiposity index (BAI), percent body fat, waist-height (WHtR) and waist-hip ratios (WHR) were computed. The effect of adiposity values on HT was estimated by logistic regressions, while partial correlations and linear regressions analyses of SBP and DBP with each index were performed.

RESULTS

BMI had the strongest correlation with blood pressure. The newly proposed index, BAI, had significant but considerably lower correlations with both BP compared to BMI and central adiposity. Both BMI and WHtR explained DBP with equal efficacy. Abdominal obesity, measured by WC, showed the strongest association with risk of HT, independent of age and BMI. The predictive effect of abdominal adiposity on blood pressure (SBP and DBP) appeared to be modified by age-BMI interaction.

CONCLUSION

BAI showed no advantage over other adiposity measures in the prediction of hypertension among the men in this study. Waist circumference was the best obesity measure to predict hypertension and may be preferred to BMI considering its simplicity of measurement. The simple measure of WC might help in easy screening of hypertension among the poor people in resource constrained settings such as those in urban slums.

Nutritional assessment by mid-upper arm circumference of santal adults of Purulia, West Bengal, India

The present community based cross-sectional study was undertaken to determine the prevalence of undernutrition using mid-upper arm circumference (MUAC) among adult (> 18 years) Santals of Purulia District, West Bengal, India. It was undertaken at 10 villages of the district. A total of 520 (217 males and 303 females) subjects were measured. Commonly used indicator i.e., MUAC and BMI, were used to evaluate the nutritional status of the subjects. More women (64.7%) then men (54.4%) based on MUAC and women (59.4%) then men (34.6%) based on BMI were undernourished. Significant sex difference both in MUAC (t=2.378, p<0.05) and BMI (t=4.971, p<0.001) were observed. Significant age group difference for MUAC was observed (F=8.93***, df=3) for men and (F=9.52***, df=3) for women. For BMI, these values were F=10.10*** (df=3) F=6.17*** (df=3) respectively. In conclusion, we found that adult Santals of both sexes were under critical nutritional stress, women and the oldest among them were the most.

Effect of number of rooms and sibs on nutritional status among rural Bengalee preschool children from eastern India

In developing countries including rural India, undernutrition among preschool children is one of the main barriers of the national development. However, there exists scanty information on the prevalence of underweight and stunting and their socio-demographic predictors among preschool children in India and West Bengal. The aim of the present study was to investigate the prevalence of underweight and stunting and the impact of two socio-demographic indicators, namely number of living rooms (NLR) and number of sibs (NS), on them among 1-5 year old Bengalee rural preschool children of Integrated Child Development Services (ICDS) Centres. This cross sectional study was undertaken at 30 randomly selected ICDS centre of Chapra Block, Nadia District, West Bengal, India. A total of 673 children, aged 1-5 years were studied. The overall (age and sex combined) rates of underweight and stunting were 54.40% and 39.20%, respectively. NLR was significantly associated with the prevalence of underweight (chi2 = 4.34, df = 1, p < 0.05) and stunting (chi2 = 8.98, df = 1, p < 0.01) among girls. Similarly, NS had a significant association with prevalence of underweight (chi2 = 10.29, df = 1, p < 0.001) and stunting (chi2 = 5.42, df = 1, p < 0.05) among girls. Girls with < 2 NLR had significant higher risk of being underweight (OR = 1.64, C.I = 1.30-2.62) or stunted (OR=2.23, C.I = 1.31-3.80) than those with > or = 2 NLR. Moreover, girls with > or = 3 NS had significant higher rate of underweight (OR = 2.03, CI = 1.32-3.146) or stunting (OR = 1.69, C.I = 1.09-2.63) than those with < 3 sibs. Logistic regression analyses also revealed that both NLR as well as NS were strong predictors of underweight (NLR: Wald = 4.30, p < 0.05; NS: Wald = 8.74, p < 0.001) and stunting (NLR: Wald = 10.17, p < 0.001; NS: Wald = 5.38, p < 0.05) among girls. Gender discrimination could be a likely cause for this sex difference in the impact of NRL and NS. Moreover, logistic regression were also undertaken with underweight and stunting status (yes/ no) as dependent variables and NLR and NS (combined) as independent variables to identify their effects, when considered together, on undernutrition. Results showed that NS had significant impact on underweight (Wald = 8.28, p < 0.001) rather than NLR among girls. Results also demonstrated that NLR had significant impact on stunting (Wald = 6.874, p < 0.01) rather than NS.

Use of mid-upper arm circumference in determining undernutrition and illness in rural adult Oraon men of Gumla District, Jharkhand, India

INTRODUCTION

Body mass index (BMI) is widely accepted as one of the best indicators of nutritional status in adults. Mid-upper arm circumference (MUAC) is another anthropometric measure that has also been used to evaluate adult nutritional status. The objective of this study was to evaluate the use of MUAC as a simpler and reliable alternative to BMI. A suitable cut-off value was also proposed for identification of chronic energy deficiency (CED) in relation to self-reported illness among the adult Oraon males of Jharkhand state in India.

METHODS

The study was based on a cross-sectional survey involving 205 rural adult men belonging to the Oraon tribal group of Jharkand State in India. Height and weight were measured for each participant. The BMI was calculated as kg/m2. The internationally accepted cut-off points of BMI and MUAC were utilised to determine nutritional status. An episode of illness was recorded for each subject if any working day was lost. Receiver operating characteristic curve analyses were undertaken to discover the most suitable values of MUAC both for CED and illness.

RESULTS

The MUAC values of 243 and 239 mm were identified as the best cut offs to identify CED (BMI<18.5) and illness, respectively. There were marked increases in both CED and illness prevalence rates at a MUAC level lower than 240 mm. Therefore, a MUAC value of close to 240 mm seemed appropriate as a simple and efficient cut-off point for the determination of undernutrition and higher rates of illness and loss of working days in adult Oraon males.

CONCLUSION

Because MUAC is a much simpler measure than BMI, the use of MUAC 240 mm as a cut-off point is predicted to have considerable public health implications, especially with respect to primary health care related to CED and morbidity.

Growth Pattern and Prevalence of Underweight and Stunting Among Rural Adolescents

Introduction: A cross-sectional study of 1094 (boys = 665; girls = 429) rural school children aged 11- 18 years of Midnapore Sadar North subdivision, Paschim Medinipur District, West Bengal, India, was undertaken to evaluate their growth pattern and nutritional status. Methodology: Anthropometric measurements including weight and height were measured following standard techniques. Underweight and stunting were used as indicators of nutritional status. Underweight and stunting were defined as weight-for-age (WAZ) and height-for-age (HAZ) <-2 z-scores, respectively, of the National Centre for Health Statistics (NCHS) guidelines. Results: Results revealed that boys were significantly heavier than girls from age 16 onwards; they were also significantly taller from age 14 years. The mean WAZ for boys and girls were -1.488 and -1.417, respectively. The corresponding mean values for HAZ were -1.317 and -1.486. The overall rates of underweight and stunting were 28.3% and 27.8%, respectively. The prevalence of underweight was significantly higher among boys (31.0%) than girls (24.2%). These rates for stunting were 27.4% and 28.4%, for the boys and girls. The rate of underweight and stunting was more in late adolescents (15-18 years) than early adolescents (11-14 years). In boys, the prevalence of stunting was significantly (1.5 times) more in late adolescents than early adolescents. According to the WHO classification for assessing severity of malnutrition, the rates of stunting were medium in both sexes. The rates of underweight were high and very high for girls and boys, respectively. Conclusion: In conclusion, present study provided evidence that the nutritional status of these adolescents were not satisfactory especially among late adolescents. Key Words: Adolescent; Rural; Nutritional Status; Underweight; Stunting DOI: 10.3126/jnps.v31i1.3640J Nep Paedtr Soc 2010;31(1):17-24

The Utility of a New Index for Adiposity among Pre-school Children

Obesity in children is a cause for concern because it may predict adult obesity and increased risk of coronary heart disease in adult life. Adiposity in preschool children is measured by different conventional indices. The aim of the present study was to measure the indicators of abdominal adiposity - waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHTR), conicity index (CI) and a newly proposed body mass abdominal index (BMAI), and to assess the relationship of these with overall adiposity as measured by body mass index (BMI). The study was conducted on 2,016 rural pre-school children (930 boys and 1,086 girls), aged 3-5 years from randomly selected 66 Integrated Child Development Services (ICDS) centres in the Nadia District of West Bengal, India. Results showed significant correlations for all adiposity measures with BMI in both sexes. A noteworthy point was that the correlations were strongest (p< 0.01) with BMAI (boys: r = 0.856, girls: r = 0.868, sex-combined: r = 0.863). Results of linear regression of adiposity measures with BMI revealed that BMAI had the strongest significant impact (t = 76.729) on BMI. Moreover, this new index accounted for 74.5% of variations in BMI. In conclusion, our results provide evidence for the use of body mass abdominal index (BMAI) as a good indicator of overall adiposity (BMI). More studies should be undertaken including its validation with other direct measures of adiposity.

Sex differences in the effect of birth order and parents' educational status on stunting: a study on Bengalee preschool children from eastern India

One of the greatest problems facing developing countries, including rural India, is undernutrition in terms of stunting among under 5-year-old children. However, there exists scanty information on the prevalence of stunting among preschool children in India and in particular in West Bengal. This study investigated prevalence of stunting and identified the predictor(s) of stunting among 1-5-year-old Bengalee rural preschool children of Integrated Child Development Services (ICDS) centres. This cross-sectional study was undertaken at different ICDS centres of Chapra Block, Nadia District, West Bengal, India. A total of 673 preschool children (323 boys and 350 girls), aged 1-5 years were selected from 30 randomly selected ICDS centres to study the impact of parents' educational status and child birth order on stunting. The overall (age and sex combined) rate of stunting was 39.2%. Child birth order (BO) (chi(2)=14.10, df=1, p<0.001), father educational status (FES) (chi(2)=21.11, p<0.001) and mother educational status (MES) (chi(2)=14.34, df=1, p>0.001) were significantly associated with the prevalence of stunting among girls. Logistic regression analyses revealed that both FES (Wald=19.97, p<0.001) as well as MES (Wald=13.95, p<0.001) were strong predictors of stunting among girls. Similarly BO (Wald=13.71, p<0.001) was a strong predictor of stunting among girls. Girls with >or=3rd BO had significantly higher risk (OR=2.49, CI=1.54-4.03) of stunting than those with <or=2nd BO. Moreover, girls with FES lower than secondary level had significantly (OR=3.30, CI=1.96-5.58) higher rate of stunting than those with FES>or=secondary level. Similarly, girls with MES<secondary level had significantly (OR=2.50, CI=1.54-4.03) higher rate of stunting than those with FES>or=secondary level. In conclusion our study revealed that BO as well as parents' educational status were strong predictors of stunting among girls but not boys. Sex discrimination could be a likely cause for this sex difference in the impact of BO and parents' educational status.

Prediction equations for body-fat percentage in Indian infants and young children using skinfold thickness and mid-arm circumference

The objective of the study was to develop prediction equations for fat-mass percentage in infants in India based on skinfold thickness, mid-arm circumference, and age. Skinfold thicknesses and mid-arm circumference of 46 apparently-healthy infants (27 girls and 19 boys), aged 6-24 months, from among the urban poor attending a well baby clinic of a hospital in Kolkata were measured. Their body-fat percentage was measured using the D2O dilution technique as the reference method. Equations for body-fat percentage were developed using a stepwise forward regression model using skinfold thicknesses, mid-arm circumference, and age as independent variables, and the body-fat percentage was derived by D2O dilution as the dependent variable. The new prediction equations are: body-fat percentage = -69.26+5.76xB-0.33xT2+5.40xM+0.01xA2 for girls and body-fat percentage = -8.75+3.73xB+2.57xS for boys, where B=biceps skinfold thickness, T=triceps skinfold thickness, and S=suprailiac skinfold thickness all in mm, M=mid-arm circumference in cm, and A=age in month. Using the D2O dilution technique, the means (SD) of the calculated body-fat percentage were 17.11 (7.25) for girls and 16.93 (6.62) for boys and, using the new prediction equations, these were 17.11 (6.25) for girls and 16.93 (6.02) for boys. The mean of the differences of paired values in body-fat percentage was zero. The mean (SD) of the differences of paired values for body-fat percentage derived by the D2O technique and the new equations, applied on an independent sample of 23 infants (11 girls and 12 boys) were -0.93 (6.56) for girls and 1.14 (2.43) for boys; the 95% confidence limits of the differences of paired values for body-fat percentage were -2.03 to +3.89 for girls and -0.26 to +2.54 for boys. Given that the trajectories of growth during infancy and childhood are a major risk factor for a group of diseases in adulthood, including coronary heart disease and diabetes, these predictive equations should be useful in field studies.

Proposed new anthropometric indices of childhood undernutrition

The three conventional anthropometric indicators of childhood undernutrition are stunting (low height-for-age), underweight (low weight-for-age) and wasting (low weight-for-height). Recently a new composite index, namely the Composite Index of Anthropometric Failure (CIAF) has been proposed and utilised to study childhood undernutrition. In this paper, we have attempted to construct three new indices of undernutrition, relative to the CIAF. These three indices are: Stunting Index (SI) = Stunting / CIAF, Underweight Index (UI) = Underweight / CIAF and Wasting Index (WI) = Wasting / CIAF. Furthermore, we have calculated and compared these indices using our dataset as well as other existing datasets. Using our dataset, the sex-combined values of SI, UI and WI were 0.364, 0.866 and 0.684, respectively. The corresponding values among boys were 0.364, 0.866 and 0.729. Among girls, they were 0.380, 0.866 and 0.641, respectively. When applied to the all India dataset, the values of SI, UI and WI were 0.756, 0.788 and 0.266, respectively. Similar values (SI = 0.723, UI = 0.681, WI = 0.294) were observed when they were computed on data available from Coimbatore, South India. In conclusion, we suggest that these three new indices provide additional information on the prevalence of different forms of undernutrition relative to the total level of undernutrition in a particular population.

Mid-upper Arm Circumference Based Undernutrition among Bengalee Children of Chapra, West Bengal, India

OBJECTIVE

To investigate age and sex variations in undernutrition using mid-upper arm circumference (MUAC) cut-off values among 2016 (930 boys and 1086 girls). 3-5 years old rural children of Bengalee ethnicity at 66 Integrated Child Development Services (ICDS) Centers of Nadia District, West Bengal, India.

METHODS

In a cross sectional study in west Bengal of India, MUAC was measured using standard technique. A total of 2028 children (935 boys and 1093 girls) from 66 ICDS centers were enrolled in this study. The response rate was approximately 95%.

FINDINGS

Mean MUAC among boys was higher than girls at all ages except 5 years. Significant sex differences were not observed over ages. The age-combined rates of overall (moderate and severe) undernutrition among boys (38.49%) was higher than among girls (32.22%).The age-combined rates of moderate undernutrition were 36.34% and 31.03% among boys and girls, respectively. The rates of severe undernutrition were 2.15% and 1.20% among boys and girls, respectively. There were sex differences in both moderate and severe undernutrition. In general, there was an increasing trend in the rates of overall undernutrition from 3 to 5 years in both sexes.

CONCLUSION

These children were experiencing severe nutritional stress.

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.

Leanness among early adolescents in two rural schools of two districts in West Bengal

This cross-sectional study was conducted in two districts of West Bengal, to report the prevalence of leanness among rural adolescent school children. Leanness was evaluated using age and sex specific cut-off points of triceps skinfold thickness of < 5th percentile of NCHS reference population as recommended by World Health Organization. A total of 2016 students, of these, 51.39% boys and 48.61% girls aged 10-15 years were studied. Overall (age and sex combined) 18.35% children were lean. Moreover, prevalence of leanness was significantly higher in girls (22.04%) as compared to boys (14.86%).

Prevalence of Thinness among Rural Bengalee Pre-school Children in Chapra, Nadia District, West Bengal, India

This-cross sectional study investigated the age and sex variations in thinness among 2016 (930 boys and 1086 girls) 3-5 years old rural children of Bengalee ethnicity. The children were randomly recruited from 66 Integrated Child Development Service (ICDS) centres of Chapra Block, Nadia District, West Bengal, India. The area is remote and mostly inhabited by Bengalee Muslims. All preschool children (3-5 years old) living in Chapra Block are enrolled at these centres. Anthropometric measures taken included height and weight using standard techniques and then body mass index (BMI) was computed. Age and sex specific cut-off values of body mass index (BMI) were utilised to identify thinness. Overall prevalence of thinness was 49.68% and 51.57% among boys and girls, respectively. There were significant (p< 0.05) sex differences in height, weight and BMI. In general, the frequency of thinness increased with increasing age in both sexes. The rates of Grade-III and Grade-II thinness were higher among girls (Grade-III = 7.46%, Grade-II = 13.44%) compared with boys (Grade-III = 5.48%, Grade-II = 11.72%). In contrast, Grade-I thinness was higher among boys. The results from this study indicate that the nutritional status of rural Bengalee pre-school children is unsatisfactory. These children are experiencing marked nutritional stress. There is scope for much improvement in the form of enhanced supplementary nutrition.

Receiver operating characteristics (ROC) curve estimation of low birth weight based on maternal early third trimester weight among Bengalee women of Kolkata, India

The cross-sectional hospital based study was undertaken to provide an efficient and useful cut off point of maternal early third trimester weight, for low birth weight (LBW), based on receiver operating characteristics (ROC) curve among Bengalee mothers of Kolkata, India. A total of 233 mother-baby pairs were included in the present analysis. The means for maternal age and weight were 23.44 (SD = 3.88) years and 49.45 (7.19) kg, respectively. Means for gestational age and birth weight were 38.97 (1.12) week and 2664 (324) gm, respectively. The ROC curve analysis showed maternal weight < 48.0 kg as the best cutoff point of LBW. Data showed maternal weight < or = 48.0 kg had significantly higher OR (OR = 2.92, 95% CI: 1.56-5.51) for delivering LBW baby. In conclusion, the cut-off point of maternal early third trimester weight < or = 48.0 kg could be used for nutritional intervention programs in order to combat LBW among this population.

Thinness among rural children in Bengal

OBJECTIVE

To assess the prevalence of thinness among 2-6 year old children of Integrated Child Development Services (ICDS) Scheme Bali-Gram Panchayat, Hooghly, West Bengal, India.

METHODS

Height and weight measurements were taken. The body mass index (BMI) was computed. The new international cut-off points classification proposed by Cole et al were utilized to identify thinness.

RESULTS

The overall (age-combined) mean BMI among boys and girls were 13.2 kg/m(2) (sd = 1.7) and 13.0 kg/m(2) (1.6), respectively. Mean BMI decreased from 2 to 5 years in both sexes. There were a significant (p < 0.05) sex difference in mean BMI (t = 2.57) at age 3 years. The overall (age-combined) prevalence of thinness among boys and girls were 84.8 % and 85.6 %, respectively.

CONCLUSION

The results of the present study clearly indicates that the nutritional status of these children is of concern.

Body mass index and body fat among adult Bengalee male slum dwellers in West Bengal, India

SUMMARY

OBJECTIVE

The objective of the study is to explore the relationship between body mass index (BMI) and percent body fat (PBF) in relation to hypertension among adult Bengalee males of low socio-economic status living in a slum area of West Bengal, India.

METHODS

A cross-sectional survey was carried on 436 males aged 18-60 years in a slum area called Bidhan Colony, which is approximately 15 km from Kolkata city. Data on anthropometric measurements and blood pressure were collected, following standard techniques. Logistic regression and receiver operating characteristic (ROC) curve analysis were used for testing the relationship between BMI and PBF relative to hypertension.

RESULTS

About 4.25% and 50% of the normal (BMI 18.5-22.9 kg/m(2)) and overweight (BMI 23.0-24.9 kg/m(2)) subjects, respectively, were obese according to the PBF cut-off point of >25%. The ROC curve analysis indicated that the BMI cut-off ≥23 kg/m(2) was appropriate for detecting obesity relative to hypertension. It was observed that the prevalence of hypertension increased significantly with age (r = 0.226, p < 0.001). Adjusting for age, the subjects with BMI 23-24.99 kg/m(2) had about 3.2 times (95% CI: 1.61-6.27) greater risk of hypertension than those with BMI < 23 kg/m(2), and the risk for those with BMI ≥ 25 kg/m(2) was about 4.5 times (95% CI: 2.06-9.57). As for PBF, the risk of hypertension was about 2.6 times (95% CI: 1.38-4.80) for the subjects with PBF > 25% compared to those with PBF ≤ 25%.

CONCLUSIONS

Our study validated the BMI cut-off point proposed by the WHO for Asia-Pacific populations for screening the individuals who are likely at risk of overweight. However, such data should be substantiated by independent risks of adverse health outcomes that need for public health intervention.

Maternal early second trimester pregnancy weight in relation to birth outcome among Bengalee Hindus of Kolkata, India

OBJECTIVE

The study examined to what degree maternal early second trimester pregnancy weight is useful and efficient in predicting birth outcome of Bengalee women.

SUBJECTS AND METHODS

The cross-sectional retrospective study was conducted in a government general hospital in South Kolkata, India. This hospital serves the needs of people belonging to lower and lower middle class socio-economic groups. Data were collected by one-to-one interview for confirmation of age, history of last menstrual period (LMP) including medical disorders. Mother's weight was recorded at 14-18 weeks of pregnancy from the history of LMP. Birth weight was measured within 24h of delivery and gestational age was assessed by Ballard's method using newborn physical and neurological maturity scoring. Of the 331 Bengalees, 295 mother-baby pairs met the recruitment criteria and were included in this study.

RESULT

Mean +/- SD maternal early second trimester pregnancy weight and birth weight were 45.9+/-7.0kg and 2612+/-371g, respectively. The difference in mean weight (3.74kg) between mothers who delivered low birth weight (LBW) and normal birth weight (NBW) babies was statistically significant (t = 4.497, p < 0.001). Overall, the prevalence of LBW was nearly 34%. A higher incidence of LBW and lower mean birth weight was observed in first quartile or low weight (< or =40 kg) mothers. The rate of LBW decreased (chi2 =14.47, p<0.01) and mean birth weight increased significantly with increasing maternal weight (F=9.218, p<0.001). Risk ratio (RR) for LBW, intrauterine growth retardation (IUGR) and preterm birth in low weight (first quartile or <40.0 kg) mothers were 2.72 (95% confidence interval (CI): 1.45-5.10), 3.54 (95% CI: 1.17-10.74) and 1.97 (95% CI: 0.56-6.90), respectively, compared with heavier (>50.0kg) mothers. Finally, the present data showed that the maternal weight of <46.0 kg is the best cut-off for detecting LBW with 66% sensitivity and 75% negative predictive power.

CONCLUSION

The findings suggest a positive association between maternal early second trimester pregnancy weight and birth outcome. The present study provided an efficient cut-off point for detecting LBW. Antenatal caregivers in health institutions and community health workers in the field can use this cut-off value for screening pregnant women at early second trimester.

Undernutrition in the Kora Mudi tribal population, West Bengal, India: a comparison of body mass index and mid-upper-arm circumference

BACKGROUND

Undernutrition among adult tribal women is a major health problem in India.

OBJECTIVES

To compare the utility of two different anthropometric indicators of chronic energy deficiency (CED) among tribal Kora Mudi women and to determine which of these two is a better indicator of undernutrition.

METHODS

A cross-sectional study of 123 individuals was conducted. The body mass index (BMI) and mid-upper-arm circumference (MUAC) were used to evaluate CED.

RESULTS

The prevalence of CED based on BMI less than 18.5 was 55.3%, and the prevalence of CED based on MUAC less than 22.0 cm was 51.2%. Both of these prevalence rates are classified in the very high-prevalence category (> or = 40%) and indicate a critical situation according to World Health Organization recommendations. Mean BMI increased significantly with higher quartile of MUAC. There was a significant difference in the prevalence of CED between the MUAC quartiles. The risk ratio for CED for women in the lowest quartile of MUAC was 9.33 compared with those in the highest quartile. There was a significant positive association between MUAC and BMI. Regression analysis demonstrated that MUAC had a significant positive impact on BMI; the percentage of the variation in BMI explained by MUAC was 52%. Logistic regression analysis demonstrated that overall, 82.11% of cases of CED were correctly classified with the use of MUAC. The use of MUAC correctly diagnosed 82.35% of cases of CED and 81.82% of women with normal nutritional status.

CONCLUSIONS

This population was facing severe nutritional stress. With limited resources and in the absence of skilled manpower, it may be more appropriate to use MUAC for human population surveys, particularly among tribal populations of developing countries.