Prevalence and determinants of nutritional status among women and children in Pakistan

Spatial clustering of overweight/obesity among women in India: Insights from the latest National Family Health Survey

BACKGROUND

Overweight/obesity has become global health concern with increasing prevalence. This study examined district-level disparities and spatial clustering of overweight/obesity among women of reproductive age (WRA) in India using the latest National Family Health Survey-5 (2019-2021) data.

METHOD

Information of 623,656 women aged 15 to 49 from the NFHS-5 (2019-2021) were analysed in this study. The outcome variable was BMI as classified by the world health organisation (WHO). Utilising Global Moran's I, Anselin's Local Moran's I, and spatial regression models spatial clustering and associated factors were analysed.

RESULT

The study found that 24% (95% CI: 23.8-24.3) of WRA in India were overweight/obese in 2019-21. The prevalence was greatest in Punjab (41%) and lowest in Meghalaya (11%). Additionally, the Global Moran's I value for the outcome variable was 0.73, indicating a positive spatial autocorrelation in the overweight/obesity. Districts of Tamil Nadu, Andhra Pradesh, Karnataka, Kerala, Telangana, Punjab, Himachal Pradesh, Jammu & Kashmir, Haryana, and Delhi were hotspots of overweight/obesity. Several factors of overweight/obesity among WRA were identified, including place of residence (β: 0.034, p: 0.011), parity (β: 0.322, p: 0.002), social group (β: -0.031, p: 0.016), religion (β: -0.044, p: <0.001), household wealth status (β: 0.184, p: <0.001), mass-media exposure (β: 0.056, p: 0.031), and diabetes (β: 0.680, p: <0.001).

CONCLUSION

The study emphasizes the importance of targeted interventions and region-specific strategies, while also stressing the need to address associated factors to develop effective public health initiatives aimed at reducing overweight/obesity prevalence among WRA in India.

Estimation of calories intake, iron, zinc, and selenium among children of the underprivileged area in Sindh, Pakistan

INTRODUCTION

Malnutrition is one of the most serious community health issues in developing countries. This study estimated total energy intake, Iron (Fe), Zinc (Zn), Selenium (Se), Calcium (Ca), and Phosphate (PO4) levels among school-going children (aged 13-17 years) of the underprivileged area in Sindh, Pakistan.

METHODS

Children from Mithi City, District Tharparkar, were selected for this cross-sectional investigation. Students from various schools from both genders who fulfilled the selection criteria were selected. A questionnaire was filled, and five ml blood samples were taken to analyze blood parameters. Each participant's estimated nutrient intake (ENI) per day was assessed and matched to the recommended daily allowance (RDA) to determine their micro and macronutrient intake.

RESULTS

A total of 300 school-going children [150(50%) boys (mean age 15± 0.8 years) and 150(50%) girls (mean age 14±1.3years)] were included in this study. Total calories (1449±949 Kcal vs. 1245±215 Kcal; p < .001), carbohydrates (138±27 gm vs. 126 ±25 gm; p < .001) protein (47±9.1 gm vs. 44±6 gm; p < .001) was significantly higher among boys compared to girls. In contrast, calcium (1094±105 mg vs. 1144±100; 0.004), phosphate 1050±125 vs. 1148±147; p<0.001), iron (9.2±1.7 mg vs. 10±1.3 mg; p<0.001), and Zinc (7.4±1.8 mg vs. 9.9±1.7 mg; p<0.001) intake was significantly higher among girls than boys. Gender-wise comparison of serum metals in school-going children showed that serum iron was significantly lower among girls than boys (100.86±25.65 μg/dl vs. 78.48±28.66 μg/dl; p<0.001), and no difference was found in serum Zn, Se, and Ca levels. Total proteins were also significantly lower among girls than boys (6.48±1.01g/dl vs. 4.87±1.4301g/dl; p<0.001). Serum iron, Ca, and total proteins were significantly lower among girls with normal ranges compared to boys with normal ranges. Total protein was significantly lower among girls below normal ranges than boys with normal ranges (p < .001). The correlation of carbohydrates, protein, and fat with some serum biochemical parameters in school-going children showed that serum Fe was significantly linked with proteins (r = 0.255; p < .0.05).

CONCLUSION

Our findings showed a concurrent shortage of macro and micronutrients. The current study also revealed that total energy intake was lower than the RDA and significant Fe, Zn, and Se deficiencies. The findings highlight the importance of measures aimed at improving children's nutritional status.

Relationship of self-reported pica and avoidant restrictive food intake disorder symptomology with dimensions of impulsivity, perceived stress among Pakistani University students

INTRODUCTION

Pica and avoidant/restrictive food intake disorder are two of the three new eating and feeding disorders introduced in the DSM-5, this inclusion has drawn attention to the immediate need for research into their prevalence, diagnostic assessment, underlying risk factors and optimal treatment. There are very few studies available that explored the predictors or causes of these eating disorders specifically in Pakistani context.

OBJECTIVES

The objectives of the current study include (a) to estimate the presence of pica and avoidant/restrictive food intake disorder symptomology among young adults in Pakistan, (b) to examine the relationship between dimensions of impulsivity, stress and presence of pica and avoidant/restrictive food intake disorder, (c) to explore the mediation role of stress.

METHODS

The sample consisted of 660 young adults with age range 18-25 years, recruited through convenient sampling. The respondents were provided with a questionnaire comprising of an informed consent, a demographic information sheet and self-report measures including PARDI-AR-Q to assess symptomology of pica and avoidant/restrictive food intake disorder, UPPS-P Impulsive Behaviour Scale to assess dimensions of impulsivity and Perceived Stress Scale to measure perceived stress.

RESULTS

The findings show that 28 participants (4.2%) reported Pica symptomology, of which eleven participants indicated that they currently consume more than one non-food item. 19 respondents (2.8%) reported avoidant/restrictive food intake disorder symptomology. 13 respondents reported varying degrees of all three symptom clusters namely sensory based food avoidance, lack of interest in food, and fear of negative consequences of eating. Additionally, each of the dimensions of impulsivity was found to be positively correlated to the presence of pica and avoidant/restrictive food intake disorder. Perceived stress was identified as a mediating factor between each of the dimensions of impulsivity and presence of pica and avoidant/restrictive food intake disorder.

CONCLUSION

Although current study focused on a particular age range, it has drawn attention to the necessity of screening and investigating other strata of Pakistani population for pica and avoidant/restrictive food intake disorder. The clinical utility of the present research resided in the identification of factors associated with pica and avoidant/restrictive food intake disorder, an information which can be used to tailor psychological interventions, modify existing ones, and inform the future research on evidence-based treatment.