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ABSTRACT
The objective of the investigation was to analyse energy protein adequacy of the
diets of Indian children residing in an urban slum. The subjects numbering 271
between the ages of 4-14 years resided in a slum in Mysore city in South India.
Nutritional status of children and mothers were determined by standard
procedures. Background information was obtained using questionnaire method.
Dietary intake data was collected using the 24-hour recall method and analysed
for adequacy of food intake, energy protein ratio of diet, sources of protein in
diet and associated factors. Results indicate that intake of cereals and pulses is
inadequate in younger children but improves with age. Intake of other vegetables
is higher than the recommended levels, but that of green leafy vegetables is
extremely low. Consumption of fats, oils and milk is very low while protein is
derived from plant sources for the majority of the children. Only 22% of children
enjoyed a diet adequate in protein and calories. Protein calorie adequacy is
influenced by age and gender of children and significantly by literacy or economic
status of mothers. Mothers nutritional status influenced protein energy adequacy
of diets significantly. Thus, intervention efforts should not only aim at improving
the socio-economic conditions of slum dwellers in general, but should also
address nutritional needs of mothers and children.
INTRODUCTION
Despite considerable improvements in the
quality of life and health status, the levels of
child malnutrition in India is very high more than half the young children show
moderate to a severe degree of malnutrition.
Chronic energy deficiency (CED) in a similar
proportion of adults suggest perpetuation
of childhood malnutrition into adulthood.
The consequence and effect of chronic
malnutrition is such that it is intergenerational beginning with mothers and
their young children, and account for a large
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165
Diet survey
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Table 1. Percent adequacy of food intake of children in relation to age and in comparison with
rural children
Foods
7-9
F
10-12
F
Rural children*
Age in years
13-14
M
4-6
7-9
10-12
M&F M&F M
13-14
M
Cereals
80
85
88
87
91 109
90 101 96
(210) (210) (270) (270) (330) (270) (420) (300)
98
98
122 97 134
Pulses
64
(45)
68
77
71
88
84
(45) (60) (60) (60) (60)
99
98
(60) (60)
47
47
50
47
57
58
Green
leafy vegetables
35
(50)
46
31
24
32
19
29
30
(50) (100) (100) (100) (100) (100) (100)
11
10
12
Other
vegetables
161
(50)
16
22
14
23
20
78
58
91 104 116 98
80
86
23
(100) (100) (100) (100) (100) (100) (200) (100)
27
28
30
42
33
58
(25)
24
28
40
32
44
40
Milk &
milk products
8
7
5
6
5
4
5
6
13
(100) (100) (100) (100) (100) (100) (100) (100)
12
13
13
17
14
16
(30)
67
63
77
60
77
56
85
97 102 98
(25) (25) (25) (25) (25)
18
22
11
13
9
(30) (30) (30) (35) (30)
86
91
(25) (25)
11
10
(35) (30)
67
M: Male, F: Female.
* Data computed from NNMB National survey report of rural children (2000).
Figures in parenthesis indicate the desirable daily intake of foods in grams as per ICMR guidelines (1999).
Plant proteins
(as % of total protein)
Animal proteins
(as % of total protein)
100
80-90
60-80
40-60
< 40
10-20
20-40
40-60
> 60
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168
Table 3. Sources of protein and energy protein ratio (EPR) of diets of children of
different age groups
Age group
(Age in years)
4-6
7-9
10-12
13-14
Mean energy
intake(Kcal.)
Mean protein
intake (Kcal.)
Protein
calories
Calculated
EPR
Ideal EPR
1524
1651
1961
1932
47.3
52.0
62.2
63.7
189
208
249
255
12.4
12.6
12.7
13.2
6.9
8.2
9.1
10.9
169
No.
Adequacy pattern
P+ C+
22%
P C P+ C
34% 41%
C+ P
3%
Age groups
4-6 y
7-9 y
10-12 y
13-14 y
15
102
130
24
-15
28
17
27
26
38
58
73
59
29
25
5
-
31.127***P = 0.000
Gender
Male
Female
122
149
11
27
30
37
56
34
3
2
17.595***P = 0.001
Nutritional grade
Normal
Grade I
Grade II
Grade III
10
82
143
36
10
25
20
19
50
38
38
56
30
37
38
25
10
0
4
0
P+ C+ :
P C :
P+ C :
C+ P :
170
Table 5. Energy protein adequacy of diets in relation to various maternal factors (in %)
Factors
No.
Adequacy pattern
P+ C+
22%
P C P+ C
34% 41%
C+ P
3%
Literacy status
Level 0
Level 1
Level 2
135
99
37
19
25
8
36
30
43
44
42
43
1
3
6
Economic status
Level 1
Level 2
Level 3
103
157
11
17
22
18
26
40
46
56
35
27
1
3
9
BMI
Normal
CED
Overweight
Obesity
168
43
40
20
22
14
18
35
36
42
38
40
40
44
38
25
2
0
6
0
CONCLUSION
The results of the study showed that the diets
of children were inadequate in terms of types
of food items, though some improvements
with increasing age were observed. The
percent adequacies of diets of girls were
better than the boys intake. The intake of
green leafy vegetables, milk and sugar was
found to be very low, while intake of other
vegetables was very good. Only 22% of
children consumed diets adequate in protein
and energy. However, it should be
emphasised that the main sources of their
protein were plant sources, which are
generally not of the same quality found in
animal sources. A majority had protein
adequate diets but had insufficient calories
indicating that diets were lacking in rich
sources of energy as well as protective foods.
The energy protein adequacy of diets was
significantly associated with age and gender
of children and nutritional status of mother.
However, these were not influenced by either
the literacy or economic level of the families.
Thus, intervention efforts should not only
aim at improving the socio-economic
conditions of slum dwellers in general, but
should also address the nutritional needs of
mothers and their children.
REFERENCES
Gopalan C, Ramasastri BV, Balasubramanian SC, Narasinga Rao BS,
Deosthale YG & Pant KC (1996).
Nutritive Value of Indian Foods.
National Institute of Nutrition,
Hyderabad, India.
Gross R, Schoeneberger H, Pfeifer H &
Preuss HJ (2000). Four dimensions of
food and nutrition security: definitions
and concepts. Nutrition and
Agriculture. SCN News No. 20 ACC/
SCN, United Nations system forum on
nutrition, WHO, Geneva, pp 20-25.
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