The existence of ethnic differences between different
tribes of India in regards to their nutritional health is well reported
[1]. Hence, in the present study, nutritional status and its correlates
among both ethnic (Tripuri) and non-ethnic (Bengali) adolescent of
Tripura was assessed.
Subjects (14-18 y) were selected using random
numbers, from 31 different government schools of Tripura (3-4 school per
district selected randomly). Only the students whose parents agreed to
sign the informed consent were included in the study. Ethical clearance
was obtained from Institutional Human Ethical Committee of Tripura
University. A prevalence of 30% for malnutrition was taken to calculate
the sample size with 95% confidence interval and absolute precision of
5% [2]. The sample size was 893. History of nutritional and
socioeconomic status was obtained by questioning the parents using a
pre-validated questionnaire. Weight and height were recorded. Frequent
calibration of the scale was done. Subjects were grouped into thinness,
overweight and normal weight categories based on CDC criteria
[3]. Student t test, chi-square test, and logistic regression were
applied for statistical analyses.
A total of 893 students (54.8% males) were evaluated.
Prevalence of thinness, overweight and normal weight was found to be
8.1%, 12.9%, and 78.9%, respectively. Highest (14.61%) and lowest
(2.07%) prevalence of thinness was seen in 14 years age group of Bengali
and Tripuri male subjects, respectively. On the other hand 18 years and
14 years age group of Bengali female was found to have highest and
lowest prevalence for overweight (20% and 11.2%, respectively) compared
to other groups (Table I). Compared to ICMR reference, 95
th
percentile value of weight and height were found to be lower and BMI was
higher in both sexes of our subjects.
TABLE I Association Between Nutritional Status and Socio-Demographic Status (N=893)
|
Demographic
|
% |
Nutritional status(%) |
|
factors |
No.(%) |
Thinness
|
Overweight
|
|
Female gender |
404 (45.24) |
8.66 |
12.87 |
|
Community
|
|
|
|
|
Tripuri |
530 (59.35) |
6.72 |
12.86 |
|
Bengali |
363 (40.65) |
9.95 |
13.17 |
|
Study area
|
|
|
|
|
Rural |
419 (46.92) |
9.07 |
12.17 |
|
Urban |
474 (53.08) |
7.17 |
13.71 |
|
Age group |
|
|
|
|
14 y
|
398 (44.57) |
6.78 |
12.06 |
|
15 y
|
223 (24.97) |
7.62 |
13.01 |
|
16 y
|
118 (13.21) |
9.32 |
13.56 |
|
17 y
|
90 (10.08) |
11.11 |
14.44 |
|
18 y
|
64 (7.17) |
10.94 |
15.62 |
On multiple logistic regression analysis, only
literacy status of parents, socioeconomic class, and physical activity
level were found to be significantly related to being overweight or
being thin (Table II).
TABLE II Logistic Regression Analysis of Factors Used With Nutritional Status
|
Factor |
Thinness
|
Overweight
|
|
OR (95% CI) |
OR (95% CI) |
|
Literacy status* |
|
|
|
Elementary |
3.10 (1.59-6.42) |
1.84 (0.60-5.11) |
|
High School |
4.98 (2.66-9.33) |
3.06 (1.09-8.65) |
|
College |
7.77 (2.78-21.61)
|
6.11 (2.06-18.07) |
|
Socioeconomic class# |
|
|
|
Middle |
1.15 (0.66-2.01) |
2.52 (1.53-4.17) |
|
Upper Middle |
1.77 (0.77-4.04) |
3.09 (1.74-5.49) |
|
Upper |
2.77 (0.97-7.91) |
3.64 (2.03-6.52) |
|
Physical activity‡ |
|
|
|
Low
|
2.58 (1.23-5.42) |
2.43 (1.49-3.96) |
|
Moderate |
1.66 (0.84-3.26) |
3.04 (1.78-5.19) |
|
High |
0.79 (0.43-1.46) |
5.45 (2.69-11.09) |
|
#P<0.001 for all classes as compared to lower socioeconomic
class; ‡P<0.001 for high and moderate physical activity and
P=0.01 for low physical activity, as compared to none; *P<0.001
for college educated and P=0.02 for high school educated, as
compared to illiterate group. |
Ethnic Tripuri subjects showed equal and in many
cases better physical characteristics compared to non-ethnic Bengali
subjects, which contradicts the findings from other studies [4,5].
Another significant observation of the study was a non-significant urban
and rural difference in nutritional status of adolescents from both the
communities of Tripura [6]. Overall prevalence of thinness found
in study was much lesser than the prevalence reported from other Indian
studies [7]. Similar to our findings, previous studies reported that
early adolescence was more vulnerable period for malnutrition [8].
Nutritional status of subjects was significantly
influenced by educational status and literacy status of their parents.
Similar influence of parental education in raising the nutritional
status of children is well reported [9]. Similar to our study, Kotian,
et al. [10] also showed that the risk of overweight was two-times
higher among the adolescents of high socio-economic status [10]. It has
been shown previously an established fact that no or low level of
physical activity is associated with overweight and obesity, which was
also evident in our study.
The present study suggests that literacy, economic
and physical activity status plays determinant role in nutritional
status of adults. Overall, there is little difference in nutritional
status between Tripuri and Bengali adolescents; as well as among urban
and rural subjects from both the groups.
Contributors: Both the authors made substantive
intellectual contribution to the study. BS: contributed to data
accusation, study design, data analysis and manuscript preparation; DC:
contributed to initial study design and analysis, drafted the initial
version of the manuscript and contributed to its critical revision. Each
author has participated sufficiently in the work to take public
responsibility for manuscript content, and has read and approved the
final manuscript.
Funding: None; Competing interest: None
stated.
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