Anthropometric indicators of nutritional status among underprivileged children below 6 years: relation with feeding practices and morbidity

Abstract

Appropriateness of various anthropometric indicators for assessment of nutritional status of children below 6 years for early identification of growth faltering and its relation with morbidity and feeding practices was investigated. A mixed longitudinal study was undertaken on 2305 children (0-71 months old) residing in the areas catered to 6 AWCs in Haiderpur slums, Northwest Delhi. A total of 6334 observations from twelve rounds at three monthly intervals (August 2006-April 2010) on these children were obtained for anthropometry (weight, height, MUAC, WC and HC), morbidity (on a 15 days recall) and IYCF practices. These data were analysed cross-sectionally. Data obtained from the children (n=372) for 5 or more rounds were analyzed longitudinally. Dietary intake data were collected to compare diets of undernourished (n=111) and normal children (n=102) using interactive 24-hour recall. The mean weight, height, BMI and MUAC of the children were lower as compared to WHO 2006 standards. The mean WC and HC was 6-8 cms lower than NHANES (2003 06) at all ages. Prevalence of stunting (55%, height-for-age), wasting (53%, MUAC-for-age) and underweight (44%, weight-for-age) was higher among the group as compared to wasting (18%, weight-for-height) and low newlineBMI-for-age (13%) based on lt-2SD for all indices. BMI-for-age identified 1.5% overweight (gt2SD) children. Agewise distribution showed a steeper increase in stunting (12% to 60.5%) than underweight (30% to 44.1%) during 6-23 months of age, therefore wasting (28.8% to 19.8%) and low BMI (32.3% to 14.1%) decreased. Among the children with normal BMI, 60 % were stunted indicating that they had normal weight for their current height and age. As stunting is irreversible, BMI-for-age could help in addressing double burden of malnutrition as one-third of the children with low BMI-forage were stunted and three-fourth of overweight children were also stunted.