Nutritional Status of Pre-School Children from Urban Low Income Families

Abstract

India is currently the home of the largest number of under-nourished and over-nourished children in the world. Data from longitudinal studies in India indicate that both under nutrition and over-nutrition in childhood is associated with higher risk of over-nutrition and noncommunicable diseases in adult life. A community based mixed longitudinal study of underfive children from urban low income families was taken up to assess their nutritional status. Weight was taken every month in all; length was measured every month in infants and height was measured once in three months in 1-5 year children. BMI was computed in all. Nutritional status was assessed using the WHO anthro software package. Between 2012 and 2015, 3888 pre-school children were enrolled (49.4% boys and 50.6% girls); mean age of these children at enrolment was 22.5±16.17 months. The mean Z scores for height for age was - 1.79; weight for age was - 1.41 and -0.47 for BMI for age. Prevalence of stunting was 43.4%; underweight was 31.9%, wasting was 12% and over-nutrition was between 3-5%. The reduction in wasting rate between 0-3 years was mainly due to the increase in prevalence of stunting. With universal screening for early detection of wasting and over-nutrition and effective management of these, it will be possible to achieve the WHA targets of reducing and maintaining wasting below 5% and preventing increase in over-nutrition in this population. This may reduce the risk of over-nutrition and non-communicable diseases in these children during their adult life.

Nutritional status of Indian pre-school children and WHO nutrition targets for 2025

“…28,29 The further rise in underweight and stunting rates between 6-11 months might be due to late introduction, inadequate quantity, frequency and low-calorie density of complementary feeds as well as increase in morbidity due to infections. [28][29][30][31][32][33] Increase in the underweight and stunting rates between 12-23 months could be the result of inadequate energy intake when children shift to household diet. In India, the habitual family diets have relatively low-calorie density; infants have small stomach capacity and need to be fed 5-6 times a day to meet their food requirements.…”

“…In India, the habitual family diets have relatively low-calorie density; infants have small stomach capacity and need to be fed 5-6 times a day to meet their food requirements. [28][29][30][31][32][33] Nutrition education has a major role to play in improving infant and young child feeding practices thereby preventing rise in stunting and under-weight rates. Low birthweight children grow along a lower growth trajectory as compared to normal birthweight children; when their weight or length are compared to WHO standards they are misclassified as stunted and under-weight.…”