Assessment of the nutritional status of adolescent girls aged between 15 to 18 years studying in government high school in Raipur, Chhattisgarh, India

Introduction: The prevalence of malnutrition among adolescent girls is high in India. Malnutritionhas long term effects on the physical and mental health of adolescents. Objectives: To find out theprevalence of underweight, overweight and stunting and correlate with a dietary pattern, socio-demographic profile and prevalence of clinical anemia and signs of vitamin and mineral deficiency.Method: This is a community-based cross-sectional observational study conducted for 1 year (Jan2019 – Dec 2019), including a total of 480 adolescent girls who were attending government highschool. Observations and Result: 480 girls were interviewed. As per WHO nutritional measurementcriteria, adolescent girls were classified as per their anthropometric criteria, 50.63% of girls weremoderately stunted and 7.29% had severe stunting. 7.29% of girls were in the category of severethinness, 36.04% had thinness and 9.37% were overweight. 28.12% had conjunctival pallor(anaemia), 4.80% had dental caries, 1.46% had vitamin B complex deficiency and 1.04% had signsof vitamin A deficiency. Conclusion: More than half of the (57.92%) late adolescent school girlswere stunted, 43.33% were having some form of thinness and 28.12% had clinical anaemia.Effective implementation of government programs such as the RKSK and Sabla Yojana program willbe a paradigm shift from the existing clinic-based services to promotion and prevention and reachingadolescents in their environment, such as in schools, families and communities. Skills-basednutrition education for the family and effective infection control and routine health assessment ofschool-going girls should be done.


Introduction
Adolescents are people aged between 10 to 19 years. More than 1.2 billion are adolescents worldwide [1]. About 21% of the Indian population is comprised of adolescents [2]. They require balanced nutrition comprising of macronutrients and micronutrients which helps in a rapid growth spurt and increased physical activity. The National Family Health Survey revealed that in the age group of 15-19 years, about 41.9% of girls were thin while 4.2% of girls were overweight [3]. Thinness (low BMI-forage) is a common problem among adolescents in India. Many girls are also overweight and obese [4].
This ensues as a double burden of malnutrition which is due to nutritional transition [5].
Undernutrition leads to decreased immunity whereas overweight adolescents are predisposed to non-communicable diseases [6]. Assessment of nutritional status is valuable to predict efficient physical activity and healthy reproductive outcome.
Nutritional status is the physiological state of an individual, which results from the relationship between multiple factors such as nutrient intake, requirement and body's ability to digest, absorb and use these nutrients and factors that affect the abovementioned factors. It is a total of an individual's anthropometric indices and factors that influence the dietary pattern of that individual.
These include external factors such as food safety, cultural, social, economical factors and internal factors which include age, sex, nutrition, behaviour, physical activity and diseases of the person.
Chronic undernutrition leads to short stature in adolescents. It also causes reduced lean body mass and decreased muscular strength and physical capacity. Low  7.30% of girls were severely stunted.      had 50% girls whose BMI was <18.5 and who were educated had 19% girls whose BMI was <18.5 whereas illiterate fathers had girls whose BMI was <18.5 and who were educated had 28.72% girls whose BMI was <18.5 [12].
In the present study, girls having fathers on daily wages had a high prevalence of thinness (55.97%) as compared to girls having fathers who had jobs (34.93%) and self business (43.80%). Similarly girls having mothers who were on daily wages had more prevalence of thinness (69.23%) as compared to girls having mothers who were housewives (41.04%). The Association between parental occupation and the nutritional status of their children was statistically significant. Girls having fathers who had a job had less chance of thinness (OR-0.623, P=0.316) as compared to girls having fathers who were on daily wages. Girls having mothers who are housewives has significantly less chance (OR-0.554, p=0.230) of thinness as compared to girls having mothers who were on daily wages. Raikwar R and Sharma K.K.N.
(2018) in Sagar, Madhya Pradesh reported that it is apparent that a high prevalence of severe malnutrition is found in girls whose fathers were unemployed (16.7%) as compared to other professions as daily wages and farmers. They revealed that a high prevalence of malnutrition is found in those adolescent girls whose mothers are labourer (5.0%), housewives (3%) and bidi worker (25%).
There is a positive significant correlation found between father's occupation, mother's occupation, and Body Mass Index (p<0.05) [13].

Conclusion
The present study was conducted among high school girls from government schools in Raipur city of Chhattisgarh state to evaluate their nutritional status and morbidity pattern. More than half of them (57.92%) late adolescent school girls were stunted, 43.33% were having some form of thinness and 28.12% had clinical anemia. As a preventive strategy, there is a need to apply health What does this study add to existing knowledge?
Effective implementation of these programs will be a paradigm shift from the existing clinic-based services to promotion and prevention and reaching adolescents in their environment, such as in schools, families and communities. Skills-based nutrition education for the family and effective infection control and routine health assessment of school-going girls should be done.