The Micronutrient Consumption in Indian Elementary School Children across Socioeconomic Strata

Authors

  • Kshitija Patki Faculty of Applied Science, Manav Rachna International Institute of Research & Studies, Faridabad, India
  • Divya Sanghi Faculty of Applied Science, Manav Rachna International Institute of Research & Studies, Faridabad, India
  • Raju K. Parasher Amar Jyoti Institute of Physiotherapy, University of Delhi, Delhi, India
  • Barkha Bhatnagar Central University of Rajasthan, Ajmer, India

DOI:

https://doi.org/10.6000/1929-4247.2021.10.01.4

Keywords:

Micro-nutrients, School children, Socioeconomic status

Abstract

Background: The adequate intake of micronutrients in school children has a significant long term beneficial effect on a child’s overall development and performance. Thus, identifying sub-clinical deficiencies, monitoring micronutrient intake in a child’s diet, and subsequently treating each is of paramount importance. The present study aimed to determine the daily micronutrient consumption in elementary school children across socioeconomic strata (SCE) compared to age-specific, recommended daily allowance (RDA).

Subjects/Methods: Three hundred and sixty-six (366) healthy, school-going girls and boys between the ages of 6 -14 years volunteered for the study. Socioeconomic status was assessed using the urban socioeconomic status grid questionnaire, and micronutrient consumption was determined by the 24-hour recall questionnaire and the Dietcal software.

Results: Seventy per cent of the children tested had a BMI in the normal range, and approximately 15.84% of the children were underweight, of which 82% were in the Mid-low SCE strata. Paradoxically, an equal number of children (15%) were overweight, of which 89% belonged to the high SCE strata. Overall, a large number (70-90%) of children were found deficient (compared to RDA) in the intake of micronutrients, and there were significant differences between children belonging to the high and mid-low SCE strata in the intake of Calcium (10 -14 year), Iron (6 - 12 year) and Vitamin B6 (for 10 -14 year). Additionally, the deficiency in the consumption of Calcium, Iron, Vitamin B6, Vitamin 12, and Vitamin A was the most in the older children, while the consumption of Magnesium and Vitamin C across all age groups was within the recommended daily allowance (RDA).

Conclusions: Elementary schools across socioeconomic status and age groups reported severe deficiencies in the consumption of micronutrients. Interestingly, in-spite of the accessibility to nutritious food, children belonging to the high SCE strata were also deficient in micronutrient intake. Hence, it is important to re-focus our attention from gross caloric intake to the consumption of micronutrient-rich foods.

References

[1] Srivastava A, Mahmood SE, Srivastava PM, et al. Nutritional status of school-age children - A scenario of urban slums in India. Arch Public Health 2012; 70: 8-12.
https://doi.org/10.1186/0778-7367-70-8
[2] St. Leger L, Young IM. Creating the document: Promoting health in schools: from evidence to action. Global Health Promot 2009; 16(4): 69-71. 4.
https://doi.org/10.1177/1757975909348138
[3] Rezaeian S, Ahmadzadeh J, Esmailnasab N, Veisani Y, Shayan M, et al. Assessment of Health and Nutritional status in children based on School screening programs health scope. Health Scope 2014; 3(1): 1-5.
https://doi.org/10.17795/jhealthscope-14462
[4] Karak P, Maiti R, Das P, Karmakar A. Assessment of the nutritional status of school children in rural and urban areas of Bankura, West Bengal. IJPSR 2018; 9(1): 338-345
[5] Food and Agriculture Organization. The State of Food Insecurity in the World: Addressing food insecurity in protracted crises, Report, Rome 2010. Available from: http://www.fao.org/docrep/013/i1683e/i1683e.pdf [Last accessed on 2011 June 11]
[6] Kamath R, Kumar M, Pattanshetty S, Kamath A. Nutritional status assessment of school children in Mangalore city using the multicenter growth reference study WHO 2007 Z-scores. International Journal of Nutrition, Pharmacology, Neurological Diseases 2012; 2(3): 233- 236.
https://doi.org/10.4103/2231-0738.99476
[7] Sarma K, Rameshwar. Micronutrients - An Essential Aid to Daily Growth in Children. Indian Pediatrics 2009; 46: S12-19
[8] Benton D. The in?uence of dietary status on the cognitive performance of children. Mol Nutr Food Res 2010; 54: 457-470.
https://doi.org/10.1002/mnfr.200900158
[9] McCann JC, Ames BN. An overview of evidence for a causal relation between iron de?ciency during development and de?cits in cognitive or behavioral function. Am J Clin Nutr 2007; 85: 931-945.
https://doi.org/10.1093/ajcn/85.4.931
[10] Vaz M, Pauline M, Unni US, Parikh P, et al. Micronutrient Supplementation Improves Physical Performance Measures in Asian Indian School-Age Children. J Nutr 2011; 141: 2017-2023.
https://doi.org/10.3945/jn.110.135012
[11] Weight LM, Noakes TD, Labadarios D, Graves J, Jacobs P, Berman PA. Vitamin and mineral status of trained athletes, including the effects of supplementation. Am J Clin Nutr 1988; 47: 186-91.
https://doi.org/10.1093/ajcn/47.2.186
[12] Kapil U, Bhavna A. Adverse effects of poor micronutrient status during childhood and adolescence. Nutr Rev 2002; 60: S84-S90.
https://doi.org/10.1301/00296640260130803
[13] Matton L, Thomas M, Wijndaele K, Duvigneaud N, Beunen G, Claessens AL, et al. Tracking of physical ?tness and physical activity from youth to adulthood in females. Med Sci Sports Exerc 2006; 38: 1114-1120.
https://doi.org/10.1249/01.mss.0000222840.58767.40
[14] Desai IK, Kurpad AV, Virginia R. Chomitz, Thomas T. Aerobic Fitness, Micronutrient Status, and Academic Achievement in Indian School-Aged Children. PLoS ONE 2015; 10(3): 1-13.
https://doi.org/10.1371/journal.pone.0122487
[15] Subramani Y. Effect of multiple micronutrient supplementation on growth, whole-body endurance, forearm muscle strength, forearm endurance and visual reaction time; [dissertation]. Rajiv Gandhi University of Health Sciences: Bangalore 2010.
[16] Hughes D, Bryan J. The assessment of cognitive performance in children: considerations for detecting nutritional influences. Nutr Rev 2003; 61: 413-422.
https://doi.org/10.1301/nr.2003.dec.413-422
[17] Khor GL, Misra S. Micronutrient interventions on cognitive performance of children aged 5-15 years in developing countries. Asia Pac J Clin Nutr 2012; 21: 476-486.
[18] Indian National Science Academy. Micro-nutrient security for India-priorities for research and action. Report 2011.
[19] Swaminathan, Edward BS, Krupa AV. Micronutrient de?ciency and cognitive and physical performance in Indian children. European Journal of Clinical Nutrition 2013; 67: 467-474.
https://doi.org/10.1038/ejcn.2013.14
[20] Thankachan P, Rah JH, Thomas T, Selvam S, Amalrajan V, Srinivasan K, et al. Multiple micronutrient-forti?ed Rice affects physical performance and plasma vitamin B-12 and homocysteine concentrations of Indian school children. J Nutr 2012; 142: 846-852.
https://doi.org/10.3945/jn.111.149021
[21] Umamaheswari K, Bhaskaran M, Krishnamurthy G. Hemamalini, Vasudevan K. Effect of iron and zinc de?ciency on short term memory in children. Ind Pediatr 2011; 48: 289-293.
https://doi.org/10.1007/s13312-011-0060-7
[22] Karak P, Maiti R, Das P, Karmakar A: Assessment of the nutritional status of school children in rural and urban areas of Bankura, West Bengal. Int J Pharm Sci & Res 2018; 9(1): 338-45.
[23] National Institute of Nutrition. Nutrient requirements and Recommended Dietary Allowances for Indians. Indian Council of Medical Research, Hyderabad 2010.
[24] Gibbson & Ferguson. An interactive 24-hour recall for assessing the adequacy of iron and zinc intakes in developing countries, International Food Policy Research Institute (IFPRI), International Center for Tropical Agriculture (CIAT) 2008.
[25] Kaur G. Profound solutions. DIETCAL software 2015.
[26] Market Research Society of India 2011, mruc.net › sites › default › files › NEW SEC System
[27] National Nutrition Monitoring Bureau (NNMB). Diet and nutrition status of populations and Prevalence of hypertension among adults in rural areas. Technical Report No 24. National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India 2006.
[28] Rao ND, Min J, DeFries R, Ghosh-Jerath S, Valin H, Fanzo J. Healthy, affordable and climate-friendly diets in India. Global Environmental Change 2018; 49: 154-165.
https://doi.org/10.1016/j.gloenvcha.2018.02.013
[29] Mondal T, Mondal S, Biswas M.An assessment of Nutritional status of children of the government-aided primary school of west Bengal. International Journal of Elementary Education 2015; 4(3): 41-45.
https://doi.org/10.11648/j.ijeedu.20150403.11
[30] Shivaprakash & Joseph. Nutritional Status of Rural School-Going Children (6-12 Years) of Mandya District, Karnataka. International Journal of Scientific Study 2014; 2(2): 39-43.
[31] Ranjani H, Mehreen T, Pradeepa R, Anjana RM, Garg R, Anand K, Viswanathan M Epidemiology of childhood overweight & obesity in India: A systematic review. Indian J Med Res 2016; 143(2): 160-174.
https://doi.org/10.4103/0971-5916.180203
[32] Sivakumar B, Vijayaraghavan K, Vazir S, Balakrishna N, Shatrugna V, Sarma KVR, et al. Effect of micronutrient supplementation on the health and nutritional status of school children: study design. Nutrition 2006; 22: S1-7.
https://doi.org/10.1016/j.nut.2005.07.009

[33] Kwabla M, Gyan C, Zotor F Nutritional status of in-school children and its associated factors in Denkyembour District, eastern region, Ghana: comparing schools with feeding and non-school feeding policies. Nutr J 2018; 17: 8.
https://doi.org/10.1186/s12937-018-0321-6
[34] Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. Comprehensive National Nutrition Survey (CNNS) National Report, Delhi, India 2019.
[35] Nutrition Foundation of India. Nutrition and physical performance in school-age children. Delhi, India 2009.
[36] Srivastava A, Mahmood SE, Srivastava PM, Shrotriya VP, Kumar B. Nutritional status of school-age children - A scenario of urban slums in India. Arch Public Health 2012; 70(1): 8.
https://doi.org/10.1186/0778-7367-70-8
[37] Agte V, Jahagirdar M, Chiplonkar S. Apparent absorption of eight micronutrients and phytic acid from vegetarian meals in ileostomized human volunteers. Nutrition 2005; 21(6): 678-685.
https://doi.org/10.1016/j.nut.2004.11.007
[38] Yajnik CS, Deshpande SS, Lubree HG, Naik SS, Bhat DS, Uradey BS, Deshpande JA, Rege SS, Refsum H, Yudkin JS. Vitamin B12 deficiency and hyperhomocysteinemia in rural and urban Indians. J Assoc Physicians India 2006; 54: 775-782.
[39] Shridhar K, Dhillon PK, Bowen L, Kinra S, Bharathi AV, Prabhakaran D, Reddy KS, Ebrahim S. Nutritional profile of Indian vegetarian diets--the Indian Migration Study (IMS). Nutrition Journal 2014; 13(55): 1-9.
https://doi.org/10.1186/1475-2891-13-55
[40] Luo R, Yue AI, Zhou H, Shi Y, Zhang L, Martorell R, Sylvia S. The effect of a micronutrient powder home fortification program on anemia and cognitive outcomes among young children in rural China: A cluster randomized trial. BMC Public Health 2017: 17: 38.
https://doi.org/10.1186/s12889-017-4755-0
[41] McArdle W, Katch F, Katch V. Exercise Physiology: Nutrition, Energy and Human Performance 7th edition. Lippincott Williams & Wilkins publications 2008; 42-78.
[42] Maughan R. Role of micronutrients in sport and physical activity. British Medical Bulletin 1999; 55(No. 3): 683-690.
https://doi.org/10.1258/0007142991902556
[43] Beto JA. The role of Calcium in human aging. Clin Nutr Res 2015; 4(1): 1-8.
https://doi.org/10.7762/cnr.2015.4.1.1
[44] Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL, et al. editors. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US) 2011; 2. Overview of Calcium. https: //www.ncbi.nlm.nih.gov/books/NBK56060/
[45] Ekbote VH, Khadilkar AV, Khadilkar VV, Chiplonkar SA, Mughal Z. Dietary patterns with special reference to calcium intake in 2-16-year-old Urban Western Indian children. Indian J Public Health 2017; 61: 188-93.
https://doi.org/10.4103/ijph.IJPH_85_16
[46] Harinarayan CV, Ramalakshmi T, Venkataprasad U. High prevalence of low dietary Calcium and low vitamin D status in healthy south Indians. Asia Pac J Clin Nutr 2004; 13(4): 359-364.

Published

2021-02-26

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Section

General Articles