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Subject: Food and Nutrition × Author: Belwal, Ekta × Start date: 2021 × Type: Thesis ×
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    ThesisItemOpen Access
    Study on nutrition and health related practices of schools in association with nutritional status and knowledge of early adolescents in Dehradun district
    (G.B. Pant University of Agriculture and Technology, Pantnagar, District Udham Singh Nagar, Uttarakhand. PIN - 263145, 2022-04) Belwal, Ekta; Kushwaha, Archana
    Adolescence is the period of transition between childhood and adulthood. healthy lifestyle habits acquired at this age prevent childhood alnutrition and also reduce risk of developing ncds in adult life. in this regard, school can act as a place which not only serve as an easy access point to target actions oriented towards improving child malnutrition but can also bring together all the stakeholders of the society associated with children health. therefore, a cross sectional study was conducted to assess the nutrition and health related practices followed in schools (n=60, 30 government and 30 private) of dehradun district and to identify which nutrition and health related practices followed in schools are predictors of malnutrition and good nutrition knowledge among school going early adolescents. schools were scored based on the nutrition and health related practices followed therein to categorise them as ‘average’, ‘above average’ and ‘below average’ schools. a validated tool with optimal reliability (cronbach's α =0.729 and test-retest reliability coefficient =0.79) was developed to assess the nutritional knowledge (n=397) of early adolescents (10-14 years) selected from ‘above average’ and ‘below average’ schools. also, their nutritional status was assessed through anthropometry, dietary assessment and presence of signs and symptoms of nutritional deficiency. apart from school category (‘above average’ and ‘below average’) results were also analysed based on gender (boys and girls) and school type (government and private). Univariate logistic regression analysis were performed to find association between nutrition and health related practices of schools (independent variables) with nutritional status (wasting, stunting and overweight) and nutritional knowledge of early adolescents. independent variables which were found to be significantly associated were further analysed through multivariate regression analysis to find predictors of wasting, stunting and obesity and good nutrition knowledge among early adolescents. based on performance of schools for nutrition and health related practices followed in them and their practices score, 70 per cent were in ‘average’ category whereas rest of the schools were equally distributed in ‘above average’ and ‘below average’ categories (15% each). both in ‘above average’ and ‘average’ categories percentage of government schools was higher (76.67% and 20% respectively), but in ‘below average’ category of schools percentage was higher for private schools (26.67%). average nutritional knowledge score of school going early adolescents was 34.02 ±4.67 (total score=48) and majority of early adolescents (88.7%) had fair to good nutrition knowledge level (>60% score). girls (or=2.35) and early adolescents from private schools (or=2.82) had better nutrition knowledge but school category wasn’t found to be associated. overall prevalence of stunting, wasting, obesity (overweight and obese) and abdominal obesity among early adolescents was found to 7.05, 23.43, 9.32 and 8.31 per cent respectively. under-nutrition (stunting & wasting) was predominant in government schools. while provision of an adequate eating environment (or=0.45) and presence of physical education teacher (or=0.54) in schools were found to be as predictors having protective effect on underweight prevalence, likelihood of stunting was less if early adolescents were studying in a private school (or=0.20). on the other hand over-nutrition (obesity & abdominal obesity) was high in private schools, and per week allocation of physical activity period (of 30-45 min) was found to as best predictor of overweight prevalence among early adolescents (lowest odds in schools providing daily physical activity period). abdominal obesity was prominent in boys (11.11%) compared to girls (5.26%). none of the anthropometric indices (bmi-for-age, height-for-age and waist-height-ratio) were found to be associated with the category of schools. clinical examination revealed the presence of anaemia, pem and b-complex deficiencies being more prevalent in early adolescent girls than boys. school practices such as involvement of school in any nutrition/health promotion program, presence of health committee in school, provision of school meals in an adequate eating environment, regular growth and health monitoring of children and conducting of health monitoring by medical practitioners, presence of physical education teacher (pet) in staff, and ifa supplementation at schools were also found to be associated with the nutritional status and nutritional knowledge of early adolescents on univariate analysis. in schools, existence of a health and nutrition policy, delivering appropriate physical and nutrition education, regular health monitoring, and provision of a safe and hygienic environment at school can be promising for improvement of nutritional status of early adolescents.