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FOOD CONSUMPTION PATTERN AND NUTRITIONAL
STATUS OF URBAN AND RURAL ADOLESCENT BOYS
Thesis
Submitted to the Punjab Agricultural University
in partial fulfillment of the requirements
for the degree of
MASTER OF SCIENCE
in
FOOD AND NUTRITION
(Minor Subject: Food Science and Technology)
By
Neha Mahajan
(L-2008-HSc.-214-M)
Department of Food and Nutrition
College of Home Science
©PUNJAB AGRICULTURAL UNIVERSITY
LUDHIANA-141 004
2011
1
Dedicated to
My
Loving Mother
2
CERTIFICATE-I
This is to certify that the thesis entitled, “Food Consumption Pattern and
Nutritional Status of Urban and Rural Adolescent Boys” submitted for the degree of Master
of Science, in the subject of Food and Nutrition (Minor subject: Food Science and Technology)
of Punjab Agricultural University, Ludhiana, is a bonafide research work carried out by Neha
Mahajan (L-2008-H.Sc.-214-M) under my supervision and that no part of this thesis has
been submitted for any other degree.
The assistance and help received during the course of investigation have been fully
acknowledged.
______________________________
Major Advisor
[Dr. (Mrs.) Kiran Grover]
Sr. Extension Specialist
Department of Food and Nutrition
Punjab Agricultural University
Ludhiana-141004, India
3
CERTIFICATE-II
This is to certify that the thesis entitled, “Food Consumption Pattern and
Nutritional Status of Urban and Rural Adolescent Boys” submitted by Neha Mahajan (L2008-H.Sc.-214-M) to the Punjab Agricultural University, Ludhiana, in partial fulfillment of
the requirements for the degree of Master of Science in the subject of Food and Nutrition
(Minor subject: Food Science and Technology) has been approved by the Student’s Advisory
Committee along with the head of the Department after an oral examination on the same.
____________________
Dr. R. Sachdeva
Head of the Department
______________________
Dr. (Mrs.) Kiran Grover
Major Advisor
______________________
Dr. Gursharn Singh
Dean, Postgraduate Studies
4
ACKNOWLEDGEMENTS
First and foremost, I am thankful to God, by whose kindness I’ve been able to
clear a very important phase of my life.
I feel privileged to express my deep sense of gratitude and indebtedness to my
revered Major Advisor, Dr. (Mrs.) Kiran Grover, Sr. Extension Specialist, Department of
Food and Nutrition, Punjab Agriculture University for her supervision, precious and time
devoting guidance, persistent encouragement, invaluable suggestions and constructive
criticism throughout the research work. Her association, untiring efforts and appreciable
patience during the preparation of manuscript is highly acknowledged. She has supported
me as a guardian in my endeavors every time I needed.
My sincere thanks are due to other respectable members of my advisory committee
Dr. (Mrs.) Kiran Bains, Associate professor, and Dr. (Mrs.) P Chawla, Professor,
Department of Food and Nutrition, Dr. (Mrs.) Amarjeet Kaur, Sr. Milling Technologist,
Department of Food Science and Technology.
Its beyond my grasp of words to thank the teachers of Government Model Senior
Secondry School PAU and Shaheed Colonel Harcharan Singh Sekho yadgiri Government
Senior Secondry School and all my respondents of my study for co-operating with me in my
research work.
I am heartly thankful to my respected parents and my loving sister for their
consistent support, inspiring attitude, endless affection and selfless love without which I
have never been here upto.
The words are not sufficient to express my thanks and gratitude to my maternal
uncle and aunty and my grandmother for their love, support and selfless efforts to complete
my research.
I am ever thankful to my husband Mr. Gaurav Ahuja and my in-laws for their
support and patience for my ambition to be fulfilled.
I acknowledge thanks to my friends Manisha Kumari and Neha Kumar whose
bounty love, help, care and cheerful company finds none equal, making my hard time quite
jovial and easy.
Lastly I am grateful to Mr. Rakesh for taking extra care in typing and manuscript.
Date:
Place: Ludhiana
(Neha Mahajan)
5
Title of Thesis
:
Food Consumption Pattern and Nutritional Status of Urban
and Rural Adolescent Boys
Name of the student and
:
Neha Mahajan
Admission No.
:
L-2008-HSc.-214-M
Major Subject
:
Food and Nutrition
Minor Subject
:
Food Science and Technology
Name and Designation of
Major Advisor
:
Dr. (Mrs.) Kiran Grover
Sr.Extension Specialist
Degree to be Awarded
:
Master of Science
Year of award of Degree
:
2011
Total Pages in Thesis
:
98 + Appendices + Vita
Name of University
:
Punjab Agricultural University
Ludhiana- 141004, Punjab, India
ABSTRACT
A sample of 200 adolescent boys (100 urban and 100 rural) in the age group of 16-18 years
was selected from two schools of Ludhiana namely Government Model Senior Secondry
School PAU Ludhiana in urban area and Shaheed colonel Harcharan Singh Sekho Yadgiri
Government Senior Secondry School Dakha, Ludhiana in rural area. The data on general
profile, socio-economic status, physical activity pattern and food consumption pattern
(general and fast food) were collected. Dietary intake and anthropometric measurements were
also assessed using standard methods. An educational package was developed both in English
and Punjabi consisting of thirteen chapters on nutritional and health guidelines for
adolescents. Nutrition education was imparted for three months. Impact of nutrition
intervention was assessed by comparing the knowledge scores and the mean frequency of
general and fast food consumption by the subjects before and after the intervention. The
results revealed that rural adolescent boys were physically more active with longer duration of
play, walk and exercise than urban subjects. The frequency of general food consumption was
higher among rural subjects while frequency of fast food consumption was higher among
urban boys. The per cent adequacy of food intake presented a low intake of cereals, pulses,
roots and tubers, green leafy vegetables, other vegetables, milk and milk products, meat and
chicken and fruits whereas a high intake of fats among both the groups. The data on per cent
adequacy of nutrient intake revealed that intake of protein, vitamins and minerals was low.
The energy intake was adequate while intake of fat was higher among both the groups. The
classification of Body Mass Index showed that a higher percentage of rural adolescent boys
were underweight (27 vs 14%) while more of urban adolescents as obese (38 vs 32%). A
significant impact of nutrition intervention both on knowledge scores and mean frequency of
general as well as fast food consumption was observed among urban and rural adolescent
boys, but the impact was higher among urban subjects.
Key words: Body Mass Index, dietary intake, educational package, food frequency,
nutrition intervention.
________________________
Signature of the major advisor
___________________
Signature of the student
6
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CONTENTS
Chapter
Topic
Page no.
I
INTRODUCTION
1-3
II
REVIEW OF LITERATURE
4-18
III
MATERIAL AND METHODS
19-22
IV
RESULTS AND DISCUSSION
23-85
V
SUMMARY
86-92
REFERENCES
93-99
APPENDICES
i-l
VITA
8
LIST OF TABLES
Table
No.
Title
Page
No.
3.1
List of identified fast food items
20
3.2
Food frequency scores
20
3.3
Classification based on Body Mass Index
21
4.1
General profile of urban and rural adolescent boys
24
4.2
Socio- economic background of urban and rural adolescent boys
26
4.3
Distribution of subjects according to physical activity pattern
28-29
4.4
Distribution of subjects according to life style pattern
33-34
4.5
Distribution of subjects according to activities in leisure time
36
4.6
Meal pattern of urban and rural adolescent boys
37
4.7
General food consumption pattern of urban and rural adolescent boys
39
4.8
Mean frequency of consumption of general food items by urban and
rural adolescent boys
40
4.9
Categories of frequency of general food consumption by urban and
rural adolescent boys
46
4.10
Fast food consumption pattern of urban and rural adolescent boys
49
4.11
Mean frequency of consumption of fast food items by urban and rural
adolescent boys
50
9
4.12
Categories of frequency of fast food consumption
55
4.13
Daily average food intake of urban and rural adolescent boys
57
4.14
Per cent adequacy of food intake by urban and rural adolescent boys
57
4.15
Average daily nutrient intake by urban and rural adolescent boys
61
4.16
Per cent adequacy of nutrient intake by urban and rural adolescent boys
62
4.17
Per cent contribution of carbohydrates, protein and fat to the total
energy intake of selected urban and rural adolescent boys
66
4.18
Anthropometric profile of urban and rural adolescent boys
67
4.19
Percentage of height and weight of urban and rural adolescent boys in
comparison to standards
68
4.20
Classification of subjects according to Body Mass Index, BMI
71
4.21
Impact of nutrition intervention on general food consumption pattern
of urban adolescent boys
73
4.22
Impact of nutrition intervention on fast food consumption pattern of
urban adolescent boys
75
4.23
Impact of nutrition intervention on general food consumption pattern
of rural adolescent boys
78
4.24
Impact of nutrition intervention on fast food consumption pattern of
rural adolescent boys
80
4.25
Mean knowledge scores of urban and rural adolescent boys
82
4.26
Distribution of urban adolescent boys according to level of knowledge
83
4.27
Distribution of rural adolescent boys according to level of knowledge
84
10
LIST OF FIGURES
Fig No.
Title
Page
No.
4.1
Per cent adequacy of food intake by urban and rural adolescent boys
58
4.2
Per cent adequacy of nutrient intake by urban and rural adolescent boys
62
4.3
Per cent contribution of carbohydrates, protein and fat to the total energy
intake of selected urban adolescent boys
66
4.4
Per cent contribution of carbohydrates, protein and fat to the total energy
intake of selected rural adolescent boys
67
4.5
Percentage of height of urban and rural adolescent boys in comparison to
NCHS standards
68
4.6
Percentage of height of urban and rural adolescent boys in comparison to
ICMR standards
69
4.7
Percentage of weight of urban and rural adolescent boys in comparison to
NCHS standards
69
4.8
Percentage of weight of urban and rural adolescent boys in comparison to
ICMR standards
70
11
4.9
Classification of subjects according to Body Mass Index, BMI
71
4.10
Distribution of urban adolescent boys according to level of knowledge
83
4.11
Distribution of rural adolescent boys according to level of knowledge
84
12
ABBREVIATIONS
FFQ
-
Food Frequency Questionnaire
BMI
-
Body Mass Index
NCHS
-
National Centre for Health Statistics
ICMR
-
Indian Council of Medical Research
WHO
-
World Health Organization
R
-
Rural
U
-
Urban
g
-
Grams
mg
-
Milligrams
μg
-
Micrograms
cm
-
Centimeters
MSU
-
Michigan State University
RDA
-
Recommended Dietary Allowances
SDI
-
Suggested Dietary Intakes
SE
-
Standard Error
13
CHAPTER I
INTRODUCTION
Adolescence is a decisive period of development because it represents the transition
between life as a child and life as an adult. The growth and development of adolescents
depend to a large extent on their nutrition. The complex myriad of physiological as well as
psychological changes accompanied by rapid growth and increase in physical activity, create
special nutritional needs that are higher during adolescence than at any other time in life.
Adolescence is a period of growth spurt therefore, both male and female require high energy
intake and large amounts of nutrients particularly iron, calcium and zinc (Giskes et al, 2005).
During this crucial period food intake patterns are set in place and these patterns can have
vital impact on lifetime nutritional status and health of the individuals. Adolescents represent
a window of opportunity to prepare nutritionally for a healthy adult life.
The eating pattern of adolescents first increasingly gained attention in Western
countries claiming that they have a poor diet. Owning to globalization and urbanization in
developing countries, adolescent eating behaviours is also coming under the spotlight in India
too (Puri et al, 2008).
Teenagers make many choices for themselves. This is a period when the independent
character of an individual is established. Often adolescents’ dietary habits differ from those
of children and adults. With after school activities and social lives, teens are not always able
to sit down for three meals a day. Busy schedules may lead to meal skipping, snacking
throughout the day and more eating away from home.
Many teens skip breakfast, for
example, but this meal is particularly important for getting enough energy to make it through
the day, and it may lead to better academic performance. Breakfast is often referred to as the
most important meal of the day. Evidence suggests that breakfast contributes to well being in
a number of areas. It is the central component of nutritional well being, contributing to total
daily energy and nutrient intake (Nicklas et al, 1993). When teens skip meals, they are more
likely to grab fast food from a restaurant, school canteens, fast food vendors or convenience
stores. These foods are high in fat and sugar and tend to provide little nutritional value.
Fast foods appeal to the adolescents because they are an important feature of their life
style and they fit their limiting spending money. The most well recognized aspect of the diets
of adolescents is that they tend to opt for fast foods and convenience snacks, as seen on
television and advertised in most streets in towns or cities. In fact such a style of eating has
become part of their way of life. Some adolescents as a part of their quest for independence
find difficulty in accepting existing values and life styles in the home.
They tend to
experiment against traditional practices and diet is one aspect of this. They may as a result,
place themselves at a particular nutritional risk by choosing extreme eating pattern.
1
Snack, convenience, fast foods and sweets continue to dominate food advertisements
viewed by children and adolescents. It is found that 98 per cent of television food-product
advertisements viewed by adolescents are high in fat, sugar or sodium. Frequent consumption
of fast food has adverse effects on nutrition because of excessive content of energy and fat
and low nutritional value (Sebastian et al, 2009).
Adolescents tend to consume a lot of soft drinks which have a negative effect on
intakes of magnesium, riboflavin, vitamin A and vitamin C.
It is also observed that
adolescent tend to increase the intake of saturated fat and cholesterol rich foods in comparison
to fruits and vegetables. This along with sedentary lifestyle makes them susceptible to
obesity and paves way to diseases like hypertension, cardiovascular disease and certain types
of cancers at a relatively early period in their life. Among boys, the common problem seen is
getting hooked to the drugs, smoking and alcohol. Diet surveys of adolescents between the
ages of 13 and 18 years have revealed two disturbing trends – underconsumption of vitamins,
minerals and dietary fiber and higher than recommended intakes of fat and saturated fat. The
dietary imbalance may increase risk of chronic health problems later in life and may
contribute to the growing problem of adolescent obesity (Levine et al, 1997).
By understanding adolescent eating habits one can well evaluate the nutritional
adequacy of adolescent's diet and can ensure they are meeting the minimum requirements to
maintain their health and well being. Knowledge of the nutritional consequences of
consumption patterns is important in the development of strategies to promote adolescent
nutrition because any nutritional disorder during this period can interfere with scholastic
performance, working ability, strength, physical growth, social development and intellectual
validity (Finestone et al, 2005).
Social, economic and demographic factors play a vital role on the variations in
consumption of food and nutrients. Food choices and intake were found to be related to their
socio-economic status and activity of daily living status in the homogenous population
(Rothenberg et al, 1994). Food consumption pattern vary considerably between urban and
rural areas. Generally the diet in rural areas depends upon staple foods while that of urban
areas is progressing towards modern foods. In case of rural areas though some kinds of snack
food items are available still they have lesser access to fast foods. A variety of fast food
outlets have been established in an attractive setting in urban areas which lead to a greater
availability of fast food items among urban adolescents.
Adolescence is an opportune time to train students to assess their own eating
behaviours and set goals for dietary changes. One of the keys to effective nutrition education
and counselling of teenagers is a good understanding of normal adolescent psychosocial
development. Nutrition education involves teaching the client about the importance of
nutrition, providing educational materials that reinforce messages about healthy eating,
2
teaching adolescent skills essential for making dietary change and providing information on
how to sustain behaviour change. Adolescents often are not aware of the potential health risks
associated with poor eating habits and have not thought about making dietary changes.
Therefore, the goal of nutrition education is to increase client's awareness of risks associated
with current eating habits, to teach client to eat well balanced diet that contain a variety of
foods and to learn to make wise food choices independently (Contento et al, 1995).
Most adolescents are present-oriented, which means they are generally not concerned
about how their current eating habits will affect their future health status but are concerned
about their physical appearance, maintaining a healthy weight and having plenty of energy.
While teenagers should give consideration to the potential long-term risks of an unhealthy
diet and likely benefits of healthy eating habits, focusing on short-term benefits is more likely
to make a lasting impression on adolescents and facilitate dietary change. A well planned
nutrition education sessions can built up a healthy future of an adolescent. Designing a
successful nutrition education programme for adolescents requires a systematic approach that
combines knowledge of determinants of behavior and nutrition with efficacious strategies and
an evaluation plan (Hoelscher et al, 2002)
This study focuses adolescent boys since they have greater access to fast food outlets,
are more free and lesser concerned for their health. Large studies have been conducted on
adolescent girls but in the present scenario boys are heading more towards unhealthy
behaviours. Therefore, the present study after careful consideration of all these points has
been planned with the following objectives:
1.
To study the food consumption pattern of adolescent boys from urban and rural areas.
2.
To assess the nutritional status of urban and rural adolescent boys.
3.
To develop an educational package of nutritionally adequate diet for adolescents.
4.
To study the impact of nutritional intervention on their food consumption pattern.
3
CHAPTER II
REVIEW OF LITERATURE
The relevant literature has been reviewed and presented under the following
headings:
2.1 Food consumption pattern
2.2 Physical activity pattern
2.3 Nutritional status
2.3.1 Food and nutrient intake
2.3.2 Anthropometric status
2.4 Nutrition Intervention
2.1 Food consumption pattern
With the inculcation of westernization and globalization, the food consumption
pattern of adolescents has changed drastically. Various fast food outlets have come up in a
variety of settings with attractive advertisements and flavours. This has made a shift of food
patterns from home-made healthy foods towards junk food, especially among adolescents.
Though availability of such foods is more in urban areas, adolescents in rural areas also
considerably consume fast food, but to a lesser extent than urban adolescents.
Baudier et al (1991) conducted a diet study of 1268 adolescents in three types of
colleges and high schools in East of France. They reported that breakfast was usually of
traditional type with coffee and milk, butter and jam. Some urban adolescents of high socioeconomic groups used to have fruit or fruit juices and cereals. More than half used to visit fast
food restaurants. Generally, less well-off groups used to consume a more traditional diets.
Dennison and shepherd (1995) reported that the adolescents tend to miss their meals
at home as they get older, often skip their breakfast and the meal pattern of adolescents
become more disorganized. Some dietary patterns like snacking, usually on energy dense
foods, wide use of fast foods that were low in iron, calcium, riboflavin, vitamin A, folic acid
and fibres, low consumption of fruits and vegetables and faulty dietary were more common
among the adolescents of industrialized countries
Srivastava et al (1997) conducted a study on 1000 adolescents (10-18 years) and
observed that a vast majority of respondents of high socio-economic and middle socioeconomic were eating three major meals a day, whereas respondents of lower socio-economic
group were eating only two or lesser meals per day. The practice of snacks interspersed
between the major meals was almost universal but it was less frequent in the low socioeconomic group.
Sharma (1998) conducted a study in Nepalese school children and reported that fast
foods (ready to eat snacks, chips etc.) were preferred by more than two-third of adolescents.
4
Advertising, probably TV and magazines influenced preferences in 80 per cent of these
Nepalese adolescents
Sadana and Khanna (1999) surveyed the fast food intake of 250 adolescents of both
sexes in Ludhiana and Jalandhar city of Punjab. The results revealed that among deep fried
foods, samosa, vada, bread pakora, paneer pakora, cutlets and chips were consumed while
noodles, burger, hotdog and masala dosa were shallow fried fast foods consumed by teenagers.
Adolescents were also frequently consuming pizza, patty and pastry as the baked fast food.
French and Story (2001) found that eating away from home is becoming more
common and fast food restaurant use in particular is growing even more rapidly in adolescent.
On an average frequency of fast food restaurant use was three times per week.
Anonymous (2002) A food study carried out in the schools of Myanmar showed that
approximately half of the students buy snacks as they consider them good for health and 3050 per cent of students consume snacks that are advertised. They were curious to try the new
products or liked the taste. It can also be inferred that preferences can be guided by peer
influence, which is very strong in this age group.
Videon et al (2003) determined adolescent's food consumption pattern and concluded
that almost one in five adolescents reported to have skipped breakfast the previous day. A
large percentage of adolescents reported eating less than the recommended amount of
vegetables (17%), fruits (55%), and dairy foods (47%). Adolescents with better educated
parent had better consumption pattern than those with less educated parents.
Singh et al (2003) indicated 'fast food' consumption as one of the major contributing
factors for obesity among Delhi adolescents. Similarly Bowman et al (2004) conducted a
study on more than 6000 children in USA and tested the hypothesis that fast food
consumption adversely affects dietary factors linked to obesity risk and found that children
who ate fast food with more total energy, more energy per gram of food, more total fat, more
added sugars, less fiber, less milk and fewer fruits and non-starchy vegetables had an
increased risk of obesity.
Murugkar et al (2004) observed that urbanization, higher education and income
significantly influenced the consumption of non traditional foods. The results of study
therefore indicated that an increase in income and level of education did not mean a
proportionate improvement in the quality of food consumed. Diet is influenced by interrelated
sociocultural, demographic and other lifestyle factors and may be useful in investigations of
diet–disease relations (Park et al, 2004).
Briefel and Johnson (2004) observed a change across the age groups that they
consume a large proportion of their daily food intake via snacks rather than sit-down meals,
favouring quick, easy-often non-nutritious-foods and high caloric treats be it in the form of
processed foods, street foods, fast foods or junk foods.
5
Dapi et al (2005) stated that there was higher frequency of junk food consumption
among urban than rural adolescents. In urban areas, food is readily available in a variety of
settings and sold by a multitude of vendors. In contrast there are occasional vendors within
school yards in rural areas which contributed to lower frequency of junk food consumption
among rural adolescents.
Templeton (2005) examined the effects of schools : physical environments on student
nutrition and have shown that the availability of snack foods and soft drinks i.e., carbonated
drinks such as cola at school have a significant impact of overall child nutrition. The
frequencies of consumption of meat (11.8 vs 4.5), vegetables (9.5 vs 3.9), cereals (16.5 vs
11.9), milk products (5.74 vs 0.8) and junk food (24.2 vs 8.7) was significantly higher in
urban than in rural adolescents. The frequency of in between meals was higher in urban than
in rural adolescents (4.9 vs 0.9, respectively). Arm muscle area and waist/hip ratio were
found to be significantly higher in rural than in urban adolescents although not significant.
Body mass index was higher in rural than in urban adolescents. Jain (2005) also affirmed that
faulty dietary habits like snacking in between meals, eating out, irregular meals and low
intake of fiber rich foods was a major cause of weight gain among adolescents.
Rampersaud et al (2005) stated that between 1965 and 1991 breakfast consumption in
adolescents declined by 20 per cent. Children and adolescents skipped breakfast more than
any other meal. They also evaluated energy and nutrient intakes in breakfast eaters vs.
skippers. Breakfast eaters tend to have a higher total daily intake of energy compared with
breakfast skippers. Breakfast eaters tended to have higher daily intake of total carbohydrates,
total protein, total fat and saturated fat.
Jean et al (2006) examined association between the number of items youths
purchased at the school vending machines with intake of sugar sweetened beverage in thirteen
schools of Massachusetts. Among 646 students who reported using school vending machines,
456 i.e., 71 percent were purchasing sugar sweetened beverages. Overall, 977 students (66%)
reported eating at the fast-food restaurant. Sugar sweetened beverage intakes averaged 1.2
servings per day. These findings suggested that school vending machines and fast-food
restaurants make independent contributions to overall sugar sweetened beverage intake that
increase with repeated use.
Befort et al (2006) explored home food availability and common settings of food
consumption as correlation of fruit, vegetable and fat intake among a sample of Hispanic
black and non-Hispanic white adolescents. It was found that home availability was not
significantly associated with fruit, vegetable or fat intake.
Black adolescents ate more
frequently while watching television and at buffet restaurants. On an average, both groups
reported eating with their family about 5 times per week and at other restaurants one time per
week.
6
Kumar et al (2006) concluded that samosa a deep fried Indian snack, was the most
preferred (99.2%) fast food item and pizza (22.8%) came out to the least preferred item,
despite heavy doses of advertisement in favour of pizza. Chaat also came out to be the most
common fast food item preferred by 99.2 per cent respondents. Change of routine was the
most common reason for consuming fast food given by 68.3 per cent respondents. Majority of
the respondents (73.2%) were occasional consumers of fast food.
Baric et al (2007) compared the current nutrient intakes and dietary behavior between
urban and rural school children in Croatia. The consumption of fast food, soft drinks and
alcohol was found to be more prevalent and more linked with dietary behaviour in the urban
than in rural area. In both the areas protein intake was excessive (in the urban area 38.1 per
cent of subjects and in the rural 36.2 per cent of subjects had higher than 200% RDA).
Vitamin P, folate, calcium and selenium intake was found to be 75 per cent of Recommended
Dietary Allowances (RDA). Micronutrient intakes were negatively correlated with age in both
living areas, but were more pronounced in the urban area.
Gayle et al (2007) concluded that a significant proportion of adolescents have eating
habits that deviate from Australian guide to healthy eating and as a consequence diets that are
not only inadequate in terms of their nutritional needs but also are incompatible with their
long term health. The daily inclusion of fast foods and the omission of a variety of healthy
foods by a large proportion of adolescents may contribute to the growing problem of obesity
among adolescents and the psychological and other health related consequences. They
reported that the most common contexts for snacking among adolescents were after school (46 times per week), while watching TV (3.5 times per week), and while hanging out with
friends (2.4 times per week).
Rao et al (2007) conducted a study among urban adolescents in Hyderabad and
reported that about 51 per cent of the adolescents consumed instant foods 3-4 times a week,
nearly 68 per cent reported daily consumption of bakery items and 48 per cent of them
consumed aerated drinks 1-2 times a week.
Chacko and Begum (2007) assessed the eating behavior and nutrient intake among
adolescents in developing countries and concluded that skipping meals, preference for fast
foods and consumption of foods high in both fat and sugar are very common among them. It
was also found that frequent use of bakery items bread, biscuits, cake and fast food items such
as samosa, pani-puri, Manchurian and burger were commonly consumed snacks.
Hernandez and Gomez (2008) examined the relationship between demographic and
socioeconomic factors and food consumption in Mexican adolescents and reported that
consumption of fruits, vegetables, cereals, dairy products, starchy vegetables, bread, red meat,
white meat, and fast food diminished with decreasing socioeconomic position; conversely,
individuals in a low social position consumed legumes and soft drinks more frequently.
7
Compared with Mexican adolescents residing in urban localities, those living in rural areas
consumed red meat, white meat, soft drinks, sweets, and salty snacks less frequently;
adolescents from semi urban localities consumed starchy vegetables more frequently but
fewer soft drinks. These differences can be attributed to the fact that urbanization leads to a
greater availability of food, especially industrially processed food products.
Puri et al (2008) reported that a large number of government (63.3%) and private
(53.2%) school students were not bringing tiffins in the schools. Most common food item
consumed by adolescents in canteens were hotdog (42.9%), cold drink (11.6%), samosas
(37.3%) and patties (16.3%). Nearly one fifth of adolescent students liked to eat from the
vendors outside the school and 11.6 per cent of adolescents did not take lunch at home. Half
of the adolescents usually visit restaurants/eating joints after school hours. Among the junk
food items samosa (42.4%), tikki/chat (39.7%), noodles (25.4%), burger (24.5%) and pizza
(23.3%) were preferred most by the adolescents.
Abudayya et al (2009) studied the association between sociodemographic factors and
food intake, and meal patterns among Palestinian school adolescents in North Gaza Strip and
concluded that high Socioeconomic Status was associated with the increased number of meals
and the increased intakes of many nutritious foods such as; animal food items, fruits and
vegetables and dairy foods. The percentage of adolescents having breakfast daily of high and
low Socio Economic Status was 74.5 per cent vs 55 per cent in boys. Risk of skipping lunch
was three times higher among adolescents living in the village compared to Gaza well-off
area. Adolescents who were having lunch daily were less likely to skip breakfast or dinner.
Only 11.6 per cent of boys consumed fruits daily.
Ahmad et al (2009) assessed the nutritional status of adolescents in Islamabad city
and revealed that three main meals were taken by adolescents per day. The 79.51 per cent
took breakfast regularly all days of the week and had excellent bearing on their nutritional
status. The 82.8 per cent took lunch regularly in the days of week and enjoyed better
nutritional status. Dinner was the main meal of day and 83.8 per cent dined regularly. Junk
food consumption was quite high, as 95.4 per cent consumed these regularly.
Leal et al (2010) observed that most adolescents have all three main meals: breakfast
(79%), lunch (93%) and supper (94%). As for snacks, 42 per cent had a morning snack, 78
per cent had an afternoon snack, and 16 per cent had an evening snack. 21 per cent of the
adolescents did not have breakfast. Regarding the other two main meals, the study verified
that 7 per cent of the adolescents did not have lunch, and 6 per cent did not have supper.
There was an association between being male and not having an afternoon snack (p=0.03),
which occurred in 28 per cent of the boys and 16 per cent of the girls. Another common habit
among adolescents was discovered in the analysis: 70 subjects (30.8%) replaced lunch or
supper, which normally consists of rice, beans, meat and salad, with a snack. Only 6.2 per
8
cent of the students did this at lunch, but 24.6 per cent did for supper (20.9% of the boys and
28.3% of the girls). The most common replacements for a meal were milk, chocolate milk,
french bread, margarine, and soft drinks.
Olumakaiye et al (2010) studied association between nutritional status of adolescents
and food consumption pattern and elucidated that 66.1 per cent of adolescents ate three meals
daily; this percentage was higher among rural (75.4%) than urban (61.4%) children (P <
.001). About 33.0 per cent consumed snacks daily but to a varying degree, which was higher
among urban than rural adolescents (P = .002). Prevalence of underweight was more common
in rural (22.1%) than urban adolescents (18.7%). Underweight prevalence was highest among
those who ate three meals and no snacks daily (28.6%) and least among those who ate three
meals and snacks twice daily (15.9%).
2.2 Physical activity pattern
The impact of physical activity on health is well accepted throughout the medical and
health service community. Substantial attention has been paid to the activity patterns of
adolescents largely because of changing lifestyles that have threatened the opportunity to be
active and also introduced attractive sedentary alternatives such as watching television or
playing computer games.
Wang et al (2000) stated that children and adolescents of urban families are more
overweight than in the past, possibly because of decreased physical activity. Sedentary
activities such as TV viewing and computer games is suspected to be responsible for the
decline in physical activity levels.
Jarrett et al (2003) assessed the impact of television viewing patterns on fruit and
vegetable consumption among adolescents. Students reported an average of 4.23 servings/day
of fruits and vegetable which is below the recommendation of 5 serving/day. Follow-up
measurements indicated mean total fruit and vegetable servings decreased from baseline by
0.33 servings/day or by 8 per cent. They reported 1.3 hours/day of moderate to vigorous
physical activity.
Kahn et al (2008) studied the physical activity pattern of adolescents and stated that
mean hours of physical activity ranged from 7.3-11.6 hours per week in boys. Variables
associated with physical activity were age, Body Mass Index psychosocial variables, personal
attitudes about physical activity, parental physical activity and environmental barriers to
physical activity. The study concluded that intervention to increase physical activity should
begin before adolescence.
Laxmaiah et al (2008) studied 1208 urban adolescents of Hyderabad for prevalence of
overweight and found that approximately 45 per cent of adolescents did not participate in
outdoor games, whereas only one-third were participating in any outdoor games for 6 h/week.
About two-thirds of adolescents were participating in household (HH) activities, while 91 per
9
cent reported watching television (TV) on school days. About 22 per cent of adolescents
preferred to consume 'unhealthy' foods because these were their favourite dishes while
watching television.
2.3 Nutritional status
Adolescence is a decisive period of development and during this crucial period, food
intake patterns, meal intake patterns and dietary patterns are set in place and these patterns
have vital impact on lifetime nutritional status and health of the individuals. Therefore, to
assess the nutritional status it is essential to consider food intake, nutrient intake as well as
anthropometric status of the individual.
2.3.1 Food and nutrient intake
Sarupriya and Mathew (1988) conducted a study on nutritional status of adolescents
and found that the amount of cereals consumed was much higher above the recommended
allowances. The consumption of pulses, roots and tubers, other vegetables was inadequate,
while intake of green leafy vegetables fruits, nuts and oil seeds was completely lacking during
the period of investigation.
Jelia et al (1990) analyzed the diets of adolescents and concluded that energy intake
averaged 3,006 Kcal/day for boys. Approximately 34 per cent of total energy was supplied
by fat in the diets, saturated fat accounted for more than 12 per cent of energy whereas less
than 5 per cent was found polyunsaturated fat. P/S (Polyunsaturated -to-saturated) ratio was
0.35 for boys. Cholesterol intake averaged 468 mg/day. In the diets of boys, about one half
or more of the intake of all target nutrients could be attributed to three food groups : dairy
foods, meat, fish, poultry, eggs; and bakery products. Foods from three groups contributed
57.6 per cent of total fat, 67.3 per cent of saturated fat, 58.87 per cent of Mono Unsaturated
Fatty Acid (MUFA), 41.0 per cent of Poly Unsaturated Fatty Acid (PUFA), 76.3 per cent of
cholesterol and 48.0 per cent of energy.
Michand et al (1990) assessed the food intake of 481 adolescents (both sexes) attending
high school in the Nancy area of France and recorded dietary intake using a one-day record with
normal household measurements. Quantitative information regarding the contribution of food
groups to the intake of energy, protein, simple and complex carbohydrates and total fat was thus
obtained. Bread and biscuits were eaten by 96 per cent, sugar products by 90.4 per cent, pulses
and legumes by 86.3 per cent, fresh fruits by 74.2 per cent and cheese by 69.6 per cent of
adolescents. Bread, biscuits, sugar confectionary, sugar products, red meat and potatoes
supplied 51.5 and 48.8 per cent of energy for boys and girls respectively.
Goyal et al (1991) carried out investigations on dietary intake of 14-16 years old
children of Punjab and concluded that wheat chapaties, black gram dhal, potato, and
cauliflower vegetable, banana, milk and milk products, egg omelet, pickles and samosa were
the “most liked” and preferred food items. Raungi with curry, ash guord, petha sabzi, phalsa
10
and papaya were the items “not liked” by the children. According to their preferences, milk
and milk products, preserved foods (pickles, chutneys, jam, murabba), cereals and fruits were
ranked first, second, third and fourth, respectively.
Denis et al (1992) observed that milk and milk products played an important role in
10-16 years old children in France. Chocolate milk being the beverage most frequently
consumed (44%) compared with coffee and milk (24%). Yoghurt was consumed by 12 per
cent and cheese by 7 per cent.
Sargent et al (1994) conducted a study on South Carolina adolescents and revealed
that calorie, calcium, iron and fibre intake were less than recommended intakes whereas
protein and cholesterol intakes appeared to be higher than recommended. When distribution
of energy was assessed it was found that excessive amounts of fat were consumed while
carbohydrate intake was less. General dietary practices indicated inadequate intakes of fruits,
cooked vegetables and salads but excessive intakes of hamburgers, fried foods and pastries.
Oguntona and Kanye (1996) studied the food and nutrient intake and proportion of
those supplied by street foods of 142 Nigerian adolescents. The mean energy intake was 10.85
MJ and street foods contributed almost 25 per cent of this energy. For male subjects 21 per cent
of the energy came from street foods while for females the proportion was 29 per cent. Also of
the mean intake of 62 g total protein, street foods supplied more than 50 per cent for both males
and females. The proportion was even higher for calcium (64%) and vitamin A (60%). For all
other minerals and vitamins examined, street foods supplied over 50 per cent of the intake.
Saxena (1996) conducted a survey on rural Rajput children from 346 families (4-18
years) from Rajasthan. The dietary analysis of the children revealed that the consumption of
total fat, energy, protein, calcium and iron was not adequate for their respective ages. Cereals
were main source of dietary energy, fat and protein. Since milk and milk products formed an
essential part at diet in early childhood
Perez and Zomora (1996) examined dietary habits and food intake of six food groups
(milk products, meats, cereals, fruits, vegetables and fats) in a random sample of 206
adolescents from South East Spain and reported that the adolescents had a very low intake of
vegetables (64%), some deficiencies in the intake of milk products (75%) and fruits(62%) and
excessive intake of fats (112%) as compared to recommended dietary allowances. Intake of
meat and cereal foods was adequate and agreed with the recommendation for adolescent
population.
Shatenstein and Ghadirian (1996) conducted a study on 182 French Canadian
children (5-18 years) and elucidated that nutrient intakes surpassed most of the age-specific
and sex specific 1990 Canadian RNI's (Recommended Nutrient Intakes). Energy intake was
83.-98 per cent of RNI's. Calcium was most frequently found below the 66 per cent age-sex
specific RNI cut off. On average protein comprised 16 per cent of energy, fat 36-37 per cent
11
and carbohydrates 48-49 per cent for males and females. Simple sugar comprised 16-19 per
cent of energy among boys and 16-20 per cent among girls fluctuating with age. Only a small
proportion of respondents (15.4%) had a lower relative total fat intake. Among those within
adequate intake, 26 per cent lived in lower middle income sector of Montreal, however no
clear pattern emerged linking dietary adequacy and socio-economic factors.
Cole et al (1997) studied the energy intake of 22 healthy Nigerian adolescents aged
11-17 years residing in a hostel.
The results showed that daily intake of energy by
adolescents was 6510 KJ/day which is lower than the FAO/WHO requirement. Contribution
of total energy from carbohydrate, protein and fat were 52.2, 12.5 and 28.3 per cent
respectively.
Munoz et al (1997) compared food intakes of US children and adolescents with
Recommended Dietary Allowances (RDA) and found that 30 per cent of youths met
recommendations for fruit, grain, meat, and dairy intake while 36 per cent of them met
recommendations for vegetables. Sixteen per cent of youth did not meet any
recommendations, and 1 per cent met all recommendations. The pattern of meeting all
recommendations resulted in nutrient intakes above the recommended dietary allowances and
was high in fat. Conversely, meeting none of the recommendations resulted in intakes well
below the recommended dietary allowances for some nutrients. Total fat and added sugars
averaged 35 per cent and 15 per cent of energy, respectively, and levels were similar among
most demographic groups.
Rahman and Rao (2001) reported that the intake of quantitative foods decreased
significantly with the increase of income and educational status. The intake of qualitative
foods increased with the increase of income and level of education. It was found that
irrespective of per capita income, intake of cereals and millets was lower and intake of
qualitative foods of animal and vegetable origin increased significantly.
French and Story (2001) found significant association between Frequent Fast Food
Restaurant Use (FFFRU) and nutrient intake among male adolescents. The findings inferred
that males who visited restaurants three or more times a week reported significantly higher
total fat, saturated fat and caffeine intake, and significantly lower calcium, vitamin A, vitamin
C and carotene intake, compared with adolescents who visited restaurants two or fewer times
a week. Compared with males who never ate at a fast food restaurant during the week, males
who ate at a fast food restaurant three or more times during the week reported 42 per cent
greater soft drink consumption, 73 per cent greater cheeseburger consumption, and 53 per
cent greater french fries consumption; 27 per cent less fruit consumption, 32 per cent less
vegetable consumption (excluding french fries), and 22 per cent less milk consumption than
the recommendations.
12
Paeratakul et al (2003) assessed the food consumption pattern and dietary intake
profiles of adolescents (14-18 years) and observed that fast food is especially popular among
adolescents, who on an average visit a fast-food outlet twice per week. The results showed
that adolescents who reported eating fast food had a significantly lower intake of bread and
cereals. They also consumed fewer dark green vegetables and other vegetables but
significantly more fried potatoes. The intake of other fruits (non-citrus), milk and legumes
was lower compared with the intake of those did not report eating fast food. The adolescents
who reported eating fast food had a significantly higher intake of total energy and fat, and a
lower intake of protein, vitamin A, and β-carotene compared with children who did not report
eating fast food.
Shanthy et al (2004) studied 6212 children and adolescents (4-19 yrs.).
They
examined the associations between fast food consumption and measures of dietary quality and
concluded that on a typical day, 30.3 per cent of the total subjects reported consuming fast
food. Those who ate fast food compared with those who did not consume more total energy
(187 Kcal), more total fat (9g), more total carbohydrates (24 g), more added sugars (26 g),
more sugar sweetened beverages (228 g), less fibre (-1.1 g), less milk (-65 g) and fewer fruits
and non-starchy vegetables (-45 g).
Rao et al (2006) concluded that the average intake of cereals and millets among tribal
adolescents was lower than in rural adolescents, except for 16-18 years age group. The intake of
qualitative foods such as pulses, milk and milk products, oils and fats and sugar and jaggery was
lower among tribal adolescents of all age groups. However, the average intake of green leafy
vegetables was relatively higher among the tribal adolescents compared to their rural
counterparts, while that of other vegetables were similar. The consumption of milk and milk
products among tribes was grossly inadequate. The average intake of all the nutrients by
adolescent boys and girls of the tribes was below the RDA in all the age groups. The extent of
deficit in the intake of micronutrients such as vitamin A (80-85%), iron (70-80%), free folic acid
(50-55%) and riboflavin (40-50%) was relatively more, compared to that of energy (10-40%)
and protein (20-30%). Compared to their rural counterparts, the intake of all nutrients except for
vitamin A and vitamin C were lower.
Anding et al (2007) examined 48 adolescent diets using 24-hour recall and a 2-day
food record during summer months. Total intake and snacks identified by the subjects were
analyzed for energy and nutrient content. Male and female subjects reported similar intake of
fat, cholesterol and sugar. Ninety eight per cent of subjects reported at least one snack daily.
Snacks contributed 25 per cent to the total energy, vitamin C, calcium and magnesium
intakes.
Hurson and Corish (2008) evaluated lifestyle, food consumption and nutrient intake
patterns from a group of 390 pupils aged between 12-18 years. Mean energy intake for boys
13
(15-18 years) was 8.9 MJ. For boys micronutrient intake for iron and folate achieved 98 and
90 per cent of the recommended nutrient intake (RNI). Mean dietary fibre intakes were
approximately 19.6-25 g/day. The main sources of energy were bread, meat and meat
products, potatoes/chips, confectionery and preserves. Fruit and vegetable consumption was
low. Five per cent boys (15-18 yrs) consumed snack foods rich in fat and sugar.
Hejazi and Mazloom (2009) studied the youth’s eating patterns and meals consumed
away from home and found that soft drink consumption was high among the subjects with an
average of 360 ml/day. Consumption of fat (37 per cent energy, 566 Kcal with 12 per cent
saturated fat ; 183 Kcal) were high as compared to recommended 20-35 per cent of calories
(306-535 Kcal) from fat and less than 10 per cent of calories (153 Kcal) from saturated fat.
Fruit and vegetable intakes were low (1.82 serving per day, 109.2 Kcal and 1.45 servings per
day, 36.25 Kcal respectively); 5-9 servings of fruit is recommended according to the United
States Department of Agriculture Food Guide Pyramid. Furthermore the youth’s consumed 1
serving of whole grains (30 g), 11.6 g fibre and 180 ml of milk per day.
Ramírez et al (2009) assessed energy and nutrient intake in Mexican adolescents.
Median energy intake in boys was higher in urban than in rural areas (1 943 kcal vs. 1 776
kcal (p< 0.05)). Fiber intake varied from 20 g in the urban to 22.8 g in the rural areas, with
statistically significant difference between areas (p< 0.05). Protein and fat intakes were higher
in the urban than in the rural areas; the same pattern was observed for the micronutrients
analyzed (vitamins A and C, folates, iron, zinc, and calcium). Haem iron intake was higher in
the urban (0.33 mg) than in the rural areas (0.18 mg) (p< 0.05), corresponding to 2.8 per cent
and 1.5 per cent of total iron, respectively.
Dapi (2010) assessed the dietary intake of adolescents in Cameroon, Africa and
reported a significantly lower consumption frequency of seven out of ten food groups in rural
adolescents. Eggs and milk products were five times more consumed by the urban
adolescents. Urban adolescents significantly more often reported eating lunch and had five
times higher frequency of in- between meals than the rural adolescents. In contrast rural
adolescents more often ate breakfast compared with urban adolescents.
Leal et al (2010) studied food intake and meal patterns of adolescents and concluded
that the total energy intake was lower than recommended among 66 per cent of the
adolescents. The consumption of lipids was above the upper recommended limit for 47 per
cent of the adolescents. The intake of proteins was also above the recommendation for 40 per
cent of the subjects. On the other hand, the intake of carbohydrates was below the lower
recommended limit for 46 per cent of the adolescents The intake of vitamin A was below
recommended for 86 per cent of the boys. A positive association was observed between being
male and low intake of vitamin A. According to the recommendations 90 per cent of the boys
14
ingested an insufficient quantity of calcium. There was a statistically significant association
(p<0.001) between the overconsumption of iron and being male (88 per cent).
2.3.2 Anthropometric Status
Pai and Naik (1989) assessed the nutritional status of 254 rural school children by
anthropometry. The results revealed that all children were significantly below the ICMR
standard both in height and weight .Of the total children, 48.85 per cent were classified as
normal, while 11.81 per cent were categorized as currently underfed, 23.62 per cent were
normally fed and only two children (0.79 per cent) were classified as currently over fed with
past history of malnutrition
Himes and Bouchard (1989) reported that Body Mass Index (BMI) for age was
recommended as the best indicator for use in adolescence. It has been validated as an
indicator of total body fat at the upper percentiles. However, BMI has not been fully
validated as an indicator of thinness or under nutrition in adolescents.
Nonetheless, it
provides a single index of body mass, applicable at both extremes
Satyanarayana et al (1990) elucidated that the school boys in Andhra Pradesh, India
had 26 per cent deficit in weight for age, 7 per cent deficit in height for age and 14 per cent
deficit in weight for height as compared to North American standards. In absolute terms rural
boys around Hyderabad were shorter by 8 to 12 cm and lighter by 10 to 15 kg at
corresponding ages as compared to NCHS boys.
Amigo et al (1995) measured the weight, height and mid upper arm circumference
(MUAC) of children of low and high socio economic status. It was found that the mean
weight, height and Mid Upper Arm Circumference (MUAC) were higher in children of high
socio-economic status. Among children of low socio-economic status, height/age ratios were
lower in males and height/weight ratios were higher in females. These differences were not
observed in children of high socio-economic level. In a similar study conducted on 637 school
boys (16.7 ± 1.3 yrs.) in Sri Lanka, it was reported that 7 per cent of subjects had BMI above
the reference range (Atukerala et al 1997).
Joshi and Rao (1996) collected longitudinal data for 3 years of 972 rural children (587
boys and 385 girls) aged 8-18 years. The adult height estimated was smaller for anaemic
boys (161.7 cm) compared to normal (164.7 cm).
Anand et al (1999) conducted a study on rural school children (12-18 years) of
Haryana and reported that the increase in mean height was about 8 cm per year among boys.
The prevalence of stunting in boys showed a declining trend from 56 per cent at 12 years of
age to 25 per cent at 17 years of age. The mean heights reported at 13, 14 and 15 years of age
were 143.86 ± 8.890, 152.61 ± 7.68 and 160.37 ± 8.28 respectively and the mean BMI's were
15.99 ± 1.67, 16.49 ± 1.18 and 16.83 ± 1.60 respectively.
15
Zia-ud-Din and
Paracha (2003)
found a
significant
correlation between
anthropometric, dietary and socio-economic characteristics of the families.
The study
concluded that nutritional status of boys studying in private schools was better than those
studying in the public schools and that family size and income were partly responsible for
their better nutritional status.
Gharib and Rasheed (2009) conducted a study on the anthropometric status of school
children (6-18 years) enrolled in the primary, intermediate and secondary government schools in
all populated regions of Bahrain. The sample size included 2594 students (1326 girls and 1268
boys). Compared to WHO reference standards, the median height of Bahraini children and
adolescents in the age range of 6 to 18 years was close to the 25th percentile or lower, while the
median BMI during adolescent years was comparable in boys, but higher than WHO standards
in girls, reaching the 75th percentile. The cut-off values of BMI for overweight/obesity status
(85th and 95th percentile) were higher by 3-6 kg/m 2 compared to WHO standards. While skin
fold thicknesses were also higher in Bahraini adolescents compared to their American
counterparts (NHANES II), arm muscularity was substantially lower.
2.4 Nutrition intervention
As a result of rapid socioeconomic advancements in the recent decades, the
population has undergone significant lifestyle changes which are adversely affecting the
health of youths. With the persistence of such problems, it was noted that nutrition education
is a long – term solution to inculcate the culture of healthy eating in a community.
Anlinker et al (1990) concluded that nutrition counseling has a definite impact on
children's nutrition knowledge. The results were based on several nutritional intervention
studies conducted on pre-school and school aged children. A knowledge of the nutritional
needs of the adolescents and the amount of local foods that can fulfill this need is essential in
good nutrition education (Hgdedioh 1990).
Misra and Aguillon (2001) stated that the assessment and the enhancement of health
education for adolescents in rural areas can lead to improved health behaviours and help reach
the goals set for health.
Joshi and Singh (2002) elucidated that structural dissemination of knowledge in form of
educational booklet did have a positive impact in raising the levels of knowledge in area of health.
Even a short-term nutrition education program can significantly improve nutrition and sport
supplement knowledge in high school students of low socio-economic status (Little et al, 2002).
Hoelscher et al (2002) stated that by altering dietary behaviour, nutrition
interventions during adolescence have the potential of affecting children at that time and later
in life. The majority of interventions implemented in the teen years have occurred in schools,
but other intervention sites have included after-school programs, summer camps, community
centres, libraries and grocery stores.
16
Anderson et al (2003) assessed the impact of school-based education intervention
aimed at increasing the consumption of fruits and vegetables. It was found that children in the
intervention schools had an average increase in fruit intake (133 ± 1.9 to 183 ± 17.0 g/day)
that was significantly (P<0.05) greater than the increase (100 ±11.7 to 107 ± 14.2 g/day )
estimated in subjects in control groups. Increase in scores for variables relating to knowledge
about fruits and vegetables and subjective norms were also greater in the intervention than in
control groups.
Kapur et al (2003) assessed the effectiveness of nutrition education intervention by
using a Flip Chart , Information Leaflet, A Calendar and a Video Program focused on foodbased strategies promoting consumption of iron-rich foods and foods that increase absorption
of iron (vitamin C rich foods). The intervention brought about significant changes in intake of
nutrients (energy, protein, iron and vitamin C). The adequacy of cereals, pulses, other
vegetables, fruits, oil/fats intake was high in groups where nutrition education was a
component as compared to control and supplementation group. Although the intake of green
leafy vegetables was low among children. Further, the high vitamin C intake attributed to the
high intakes of fruits and other vegetables recorded in the food intake data specific to
nutrition education group may have also contributed in terms of better absorption of iron from
the diet.
Koon et al (2006) aimed to report the outcome evaluation of the nutrition education
programme in terms of nutritional status, nutrition knowledge, attitudes and practices.
Nutrition education components included nutrition modules. Interactive CDs, a comic book as
well as worksheets and other nutrition and health related activities. Nutrition knowledge
increased significantly from 64.6 ± 19.8 marks during baseline to 69.6 ± 20.8 marks at follow
up in school students. More students were aware of the importance of breakfast, whereby 53.9
per cent agreed that breakfast was important for health and not just to curb hunger in the
morning and encouraging change in the dietary habits was demonstrated by reduction in
snacking practice as well as fast food consumption
Payne et al (2007) implemented a planned nutrition education program aiming to
promote healthy eating and consumption of a variety of foods in a residential camp setting for
Australian adolescents. Nutrition education package for use at the camp restaurants included
nutrition information together with individual ‘passport’ booklets involving puzzles and
questions with incentives for completion. Of those surveyed, 77 per cent felt they had learned
something from the health promotion material; 94 per cent said they had changed their eating
habits to include more core food groups during the camp, with more than 40 per cent stating
they had increased vegetable consumption compared with their usual intake. However,
approximately 60 per cent of campers were apparently unaware of the incentives offered and
less than 30 per cent demonstrated completion of their passports.
17
Subha Rao et al (2007) conducted the study in schools of old city of Hyderabad. A
significant improvement was found in the knowledge levels of both the experimental and
control groups after the intervention. The extent of improvement in the mean scores of the
experimental group (3.09 ± 0.19) was significantly higher than the control group (1.65 ± 0.21)
indicating positive impact of intervention.
Kaur et al (2007) assessed the nutritional awareness of 60 school going adolescents of
13-19 years age in rural area of district Kurukshetra before and after imparting nutrition
education regarding healthy nutrition and dietary habits. The nutrition education was imparted
through lectures, audiovisual aids and demonstrations for three months. After providing
nutrition education, a significant improvement in their nutritional knowledge was viewed and
quantum of improvement was 1.67 times. The analysis of data also inferred that the students
scoring more marks in science subject were found more attentive during the counseling
sessions and had showed a rapid improvement in their score.
John and Narasimhan (2008) conducted nutrition education programme on the 50
breakfast consumers and 50 breakfast skipper school children.
A pre and post test on
knowledge and awareness was done on subject using a checklist. Children had a good
knowledge and awareness in terms of nutrition, but after teaching basic nutritional needs, it
helped to reinforce the ideas already known. The nutrition education programme thus served
to be a vital tool in driving the children to put into practice their knowledge and awareness.
Jeong et al (2009) found that class-based nutrition intervention combining traditional
lecture and interactive activities was successful in decreasing soft drink consumption. Total
milk consumption, specifically fat free milk, increased in females and male students changed
milk choice favouring skim milk over low fat milk (1% and 2%).
Mihas et al (2010) assessed the short-term (15 days) and long-term (12-month)
effects of a school-based health and nutrition education intervention on diet, nutrition intake
and BMI. It was found that twelve months after the intervention, the programme was effective
in reducing various indices in the Intervention Group (IG) compared with baseline findings
(BMI: 23.3 ± 2.8 vs 24.0 ± 3.1 kg/m2, P < 0.001; daily energy intake: 8112.4 ± 1412.4 vs
8503.3 ± 1419.3 kJ/d, P < 0.001; total fat intake: 31.3 ± 4.4 vs 35.4 ± 4.77 % of daily energy,
P < 0.001). Except for BMI, decreases in the before mentioned indices were also observed
fifteen days after the intervention. In addition, students of the Intervention Group reduced
their weekly consumption of red meat and non-home-made meals and increased their
frequency of fruit and breakfast cereal consumption.
18
CHAPTER III
MATERIAL AND METHODS
The present study was undertaken to study the Food consumption pattern and
nutritional status of urban and rural adolescent boys. The material and methods used in the
investigation are discussed under the following headings:
3.1
Locale of study
3.2
Selection of subjects
3.3
Development of interview schedule
3.4
Collection of data
3.4.1 Background information
3.4.2 Physical activity pattern
3.4.3 Dietary survey
3.4.4 Anthropometric measurements
3.5
Nutrition intervention
3.5.1 Development of educational package
3.5.2 Implementation of nutrition intervention
3.5.3 Effectiveness of nutrition intervention
3.6
Statistical analysis
3.1 Locale of study
The study was conducted in Government Model Senior Secondry School PAU
Ludhiana in urban area and Shaheed Colonel Harcharan Singh Sekho yadgiri Government
Senior Secondry School, Dakha, in rural area of Ludhiana district of Punjab for the
convenience of the researcher.
3.2 Selection of subjects
A total sample of two hundred subjects (100 urban and 100 rural) in the age group of
16 to 18 years were selected randomly from the two schools.
3.3 Development of interview schedule
An interview schedule was developed to obtain the desired information on various
aspects of data collection. The reliability and feasibility of the schedule was worked out by
pre-testing on 10 respondents selected randomly on non-sampled subjects in both urban and
rural areas. Based on the response received during pre-testing, certain necessary changes were
incorporated in the schedule. Hence, the pre-tested and reconstructed schedules were used to
collect the ultimate data for the present study.
3.4 Collection of data
The required data were collected through personal interview technique using the
especially structured schedule (Appendix-II). The reference year of the study was 2009-10.
19
3.4.1 Background information
The data pertaining to age, birth order, family size and type, educational level of
parents, family occupation and income were collected.
3.4.2 Physical activity pattern
Time spend on various activities such as sleep, school, study after school, outdoor
games, indoor games, TV viewing, household work, walk and exercise in 24 hours was
recorded from each subject.
3.4.3 Dietary survey
Food consumption pattern
A list of most frequently consumed food items by adolescent boys was prepared
by interviewing with adolescents (not the subjects), parents, teachers, dietitians and
vendors. A total of 44 fast/junk food items were identified as listed below (Table 3.1).
Further the food frequency questionnaire (FFQ) was used to assess the food pattern
(general as well as fast food) over recent months. The frequencies in the questionnaire
were scored from 0-6 as given in the Table 3.2. Thereafter, mean frequency was
calculated for each food item consumed by each subject.
Table 3.1 List of identified fast food items
Food items
1.Aloo Tikki
2.Bhelpuri
3.Bread Pakora
4.Buiscuits (sweet)
5. Biscuits (salty)
6. Biscuits (cream)
7.Burger
8.Cheese chilly
9.Chips
10.Cream Roll
11.Chhole Bhature
16.Egg roll
12.Craxs
17.Finger Fries
13.Chocolates
18.Fryams
14.Cakes
19.Golgappe
15.Candies
20.Grilled Sandwich
21.Hog dog
22.Ice cream
23.Kurkure
24.Kulche chhole
25.Macroni
26.Manchurian
27.Momos
28.Magi
29.Muffins
30.Mc Puff
31.Namkeens
32.Noodles
33.Pizza
34.Patties
35.Pav Bhaji
36.Paneer wrap
37.Pastry
38.Paneer Pakore
39.Sandwich
40.Samosa
41.Soft drink
42.Spring Rolls
43.Veg Pakore
44.Veg rolls
Table: 3.2 Food frequency scores
Frequency
Scores
Daily
6
Thrice a week
5
Twice a week
4
Weekly
3
Fortnightly
2
Rarely
1
Never
0
Mean Frequency
20
Dietary intake
Information regarding the food intake was collected by using 24 hours recall method,
for three consecutive days. The food consumed was converted into their raw equivalents and
the average daily intake of food and nutrients was calculated by using 'MSU-Nutriguide'
(Song et al, 1992). The food and nutrient intake were compared with suggested Dietary
Intakes (ICMR 1999) and Recommended Dietary Allowances (ICMR 2000). The per cent
adequacy of food and nutrient intakes was also calculated.
3.4.4
Anthropometric measurements
Anthropometric measurements viz. height and weight were measured by using
standard methods (Jelliffe 1966). The Body Mass Index (BMI) of the subjects was calculated
and categorized according to International Obesity Task Force (IOTF) method proposed by
Cole et al (2000).
3.4.4.1 Height
Measurement was taken with the help of an anthropometric rod to the nearest 0.5 cm.
The subjects were asked to stand erect against the rod without shoes, with feet parallel and
heels together, back of the head touching the measuring rod. The head was held comfortably
erect and the arms were hanging at the sides.
3.4.4.2 Weight
The body weight was taken using portable weighing balance machine. The subjects
were asked to remove their shoes before weighing and to stand in the centre of the platform
without touching anything, with minimum of clothing. The weighing scale was recalibrated
frequently by taking weight of the researcher and also zero error of the scale recalibrated after
every use. The reading was taken to the nearest 0.5 kg.
Height and weight of the respondents were compared with NCHS and ICMR standards
(ICMR 2000).
3.4.4.3 Body Mass Index
Body Mass Index was calculated by using the following formula
Weight (kg)
Body Mass Index (kg/m ) = 
Height (m2)
2
Table 3.3 Classification based on Body Mass Index (Cole et al, 2000)
BMI
Interpretation of BMI Category
<18.5
Underweight
18.5-22.9
Normal
23-24.9
At risk for obesity
25-29.9
>30
Obese I
Obese II
21
3.5 Nutrition intervention
3.5.1 Development of educational package
The information obtained from the subjects was utilized for preparing an educational
package. The booklet entitled “Educational package on Nutritional and Health Guidelines for
adolescents” in English (Appendix I) and “Sikhlayi package-Kishor Ladkyan layi sehat atte
poshan sambandhi hadaytan” in Punjabi was prepared. This booklet contained thirteen
chapters on Health, Balanced diet, Food nutrients, Healthy habits, Importance and health
benefits of water drinking, Benefits of fibre consumption, Effects of alcohol on adolescent’s
body, Junk food and related health risks, Obesity and its complications and food and nutrient
requirements for adolescents. Meal plans for both vegetarian and non- vegetarian adolescents
was also included. The method to assess the nutritional status was also explained in the
booklet.
3.5.2 Implementation of nutrition intervention
Subjects were imparted nutrition education through lecture-cum-discussion using
electronic media (power-point presentation). The lectures on mentioned topics were delivered
for a period of three months at the interval of 15 days. The booklets were distributed to the
subjects and to the staff. The extra copies were also provided for their library.
3.5.3 Effectiveness of nutrition intervention
To study the impact of nutrition intervention, the schools were revisited during the
fourth month. A knowledge test (Appendix III) consisting of 50 questions both closed and
open ended was conducted before and after the intervention. The frequency of consumption of
general as well as fast food was also recorded after the intervention. Thus, the impact of
nutrition intervention was studied after comparing the pre and post intervention scores and
food frequency.
3.6 Statistical analysis

Computation of some descriptive statistical measures such as percentage
distribution, mean and standard deviation for variables.

Student paired t-test was applied to test the significance of mean differences for
various parameters related to nutritional status and food consumption pattern of
urban and rural adolescent boys.

Student unpaired t-test was applied to test the significance of mean differences
for parameters related to food consumption pattern before and after the
intervention among both urban and rural adolescent boys.

Chi-square was also applied for some parameters related to physical activity
pattern of urban and rural adolescent boys.
22
Educational Package
Distributing educational package to adolescent boys
1
CHAPTER IV
RESULTS AND DISCUSSION
The present study entitled “Food Consumption Pattern and Nutritional Status of
Urban and Rural Adolescent Boys” was undertaken on a sample of 200 (100 urban and 100
rural) adolescent boys in two schools namely Government Model Senior Secondary School
PAU, Ludhiana in the urban area and Shaheed Colonel Harcharan Singh Sekho Yadgiri
Government Senior Secondary School Dakha, Ludhiana in the rural area. The results of the
investigation have been presented and discussed under the following headings:
4.1
Background information
4.1.1 General profile
4.1.2 Socio-economic status
4.2
Physical activity pattern
4.3
Food consumption pattern
4.4
Nutritional status
4.4.1 Food and nutrient intake
4.4.2 Anthropometric profile
4.5
Impact of Nutrition Intervention
4.5.1 Food consumption pattern
4.5.2 Knowledge level
4.1 Background information of subjects
It consisted of general profile and socio-economic status of the urban and rural
adolescent boys.
4.1.1 General profile
The general profile of the selected subjects is presented in the Table 4.1. The
distribution of subjects on the basis of age revealed that majority of the subjects i.e., 93 per
cent of the urban and 88 per cent of the rural boys were between the age group of 17 to 18
years. Seven per cent urban and 12 per cent of rural boys fall between 16 to 17 years. The
mean age of urban adolescent boys was 17.45 ± 0.63 while that of rural adolescent boys was
17.35 ± 0.89 years.
With respect to the birth order, the data revealed that majority of the urban (41%)
subjects were at the second place followed by 35 per cent of adolescent boys acquiring first
place. Nineteen per cent of the urban subjects were found to be at third place while only 5 per
cent of them acquired more than third place. However, it was observed that majority of the
rural (47%) adolescent boys were at third place followed by 25 per cent of them acquiring
first place. Sixteen per cent of rural subjects acquired more than third place while 12 per cent
of them were at second place.
23
Table 4.1: General profile of urban and rural adolescent boys (n=200)
(Percentage)
Profile
Urban (n=100)
Rural (n=100)
16-17
7
12
17-18
93
88
Mean ± SE
17.45 ± 0.63
17.35 ± 0.89
1
35
25
2
41
12
3
19
47
>3
5
16
Nuclear
89
83
Joint
11
17
Upto 4
43
21
5-8
50
79
>8
7
0
Mean ± SE
5.16 ± 1.98
5.04 ± 1.00
0
9
11
1
36
16
2
31
57
3
19
15
>3
5
1
Mean ± SE
1.80 ± 1.17
1.79 ± 0.87
Vegetarian
42
38
Non – vegetarian
45
54
Ova vegetarian
13
8
Age (years)
Birth Order
Family type
Family Size
No of siblings
Food Habits
24
The distribution of subjects according to type of family revealed that majority of the
subjects that is 89 per cent of the urban and 83 per cent of rural subjects belonged to nuclear
families while 11 per cent of urban and 17 per cent of rural adolescent boys were living in a
joint family.
It was further recorded that 50 per cent of urban adolescent boys had a family size
comprising of 5-8 members followed by 43 per cent of them having a family size comprising
upto 4 members. Only 7 per cent of urban subjects had a family size comprising more than 8
members. However, 79 per cent of rural adolescent boys had an average family size
comprising of 5-8 members followed by 21 per cent of them having family size comprising
upto 4 members.
The data (Table 4.1) further revealed that majority of the urban adolescent boys
(36%) had one sibling as compared to 16 per cent of rural adolescent boys. Majority of the
rural subjects (57%) while 31 per cent of the urban subjects had two siblings. Nineteen per
cent of urban and 15 per cent of rural subjects had three siblings while 5 per cent of urban
adolescent boys had more than three siblings as compared to only 1 per cent of rural
adolescent boys. Nine per cent of urban whereas 11 per cent of rural subjects did not have any
sibling. The observation of Koon et al (2006) also recorded majority of the adolescents
(51.3%) were from families with 3-4 children, while most (63.3%) were either firstborn or
second child.
The data highlighted that majority of urban and rural adolescent boys were nonvegetarian. However the percentage of non-vegetarian boys was higher in rural area (54%) as
compared to urban (45%) area. On the contrary the percentage of vegetarian (42 vs 38%) and
ova-vegetarian (13 vs 8%) adolescent boys was higher in urban area. Kumar et al (2006)
reported about half of the adolescents (48%) as non-vegetarians in the study.
4.1.2 Socio-economic status
The socio-economic status of both urban and rural adolescent boys is given in the
Table 4.2. It was revealed that majority of the urban mothers (48%) were educated upto
matric followed by 21 per cent graduate and 13 per cent middle level. It was further observed
that 16 per cent of them were illiterate while only 2 per cent of urban mothers were postgraduate. Similarly, majority of the rural mothers (58%) were recorded to be educated upto
matric followed by 34 per cent upto middle level. Only 8 per cent of rural mothers were found
to be illiterate while none of them were post-graduate.
The data pertaining to education level of fathers revealed that majority of the urban
(61%) and rural (70%) fathers were matriculated. A higher percentage of urban fathers (22%)
were graduate as compared to rural fathers (9%). Further, 7 per cent of urban and 11 per cent
25
of rural fathers were educated upto middle standard. It was also observed that only 2 per cent
of urban fathers were illiterate as compared to 8 per cent of rural counterparts. Only 8 per cent
of urban and 2 per cent of rural fathers were reported to be post-graduate.
Table 4.2: Socio- economic status of urban and rural adolescent boys (n=200)
Mother's Education
Urban (n=100)
(Percentage)
Rural (n=100)
Illiterate
16
8
Upto Middle
13
34
Matric
48
58
Graduate
21
0
Postgraduate
2
0
Illiterate
2
8
Upto Middle
7
11
Matric
61
70
Graduate
22
9
Postgraduate
8
2
Housewife
78
92
Working
22
8
Retired
3
2
Farming
1
20
Business
27
17
Service
59
26
Self-Employed
5
19
Labour
5
16
Upto 10000
39
78
10001-20000
45
12
20001-30000
7
5
30001-40000
5
4
40001-50000
2
0
>50000
2
1
Mean ± SE
16115.0 ± 12308.30
10540.0 ± 9554.38
Father's Education
Mother's Occupation
Father's Occupation
Family Income (Rs./Month)
Giving the significance of education of both mother and father, Fernández (2006)
revealed that family educational level and socioeconomic status have a marked effect on
children’s lifestyles and dietary habits. The mother’s educational level is the one of the best
26
predictors of the type and quality of child’s diet, although the father’s educational level may
also have an effect.
The distribution of subjects according to the occupation of mothers revealed that majority of
the rural mothers (92%) were housewives as compared to urban mothers (78%). More of the urban
mothers were working (22 vs 8%). The working mothers in urban areas were pursuing business,
government service, private services as well as some of them were self employed. However,
working mothers in rural areas were engaged in farming and government job as teachers. The
present results were in line with the study by Kumar et al (2006) stating that mothers of 80.5 per cent
of adolescents were housewives and of only 19.5 per cent respondents, mothers were engaged in
some other occupations mainly teachers.
Table 4.2 further elucidated the occupation of the fathers and it was observed that 2
per cent of rural and 3 per cent of urban fathers were retired from their work and were getting
a regular government pension. A higher percentage of rural families were engaged in farming
as compared to urban families (20 vs 1%). However business was pursued by a higher
percentage of urban families than rural families (27 vs 17%). Majority of the urban families
(59%) were in service as compared to 26 per cent of rural families. Self-employment was
observed in19 per cent of rural families while it pursued in only 5 per cent of urban families.
Remaining 16 per cent of rural and 5 per cent of urban fathers were labourers.
With respect to family income the data reported that majority of rural (78%)subject
belonged to families earning upto Rs 10,000 per month as compared to 39 per cent of urban
subjects. However, a relatively higher percentage of urban (45%) subjects belonged to
families earning between Rs 10,000 and Rs 20,000 per month whereas 12 per cent of rural
subjects belonged to this category. Monthly income of 5 per cent of rural and 7 per cent of
urban families was between Rs 20,000 to 30,000. Four per cent of rural and 5 per cent of
urban subjects belonged to families earning between Rs 30,000 and 40,000 per month. Only 2
per cent of urban families earned between Rs 40,000 to 50,000 per month while rest of both
rural (1%) and urban (2%) subjects belonged to families earning above Rs 50,000 per month.
The mean family income of urban subjects was Rs 16,115.0 ± 12308.30 per month
which was higher than the mean family income of rural subjects recorded as Rs 10,540 ±
9554.38 per month.
4.2 Physical activity pattern
Table 4.3 revealed the physical activity pattern of urban and rural adolescent boys.
It was observed that majority of the urban adolescent boys (60%) used to get up
between 6:00-7:00 am in the morning, followed by 33 per cent getting up between 5:00-6:00
am. Seven per cent of urban subjects used to get up after 7:00 am in the morning. However
majority of rural subjects (65%) were early risers and started their routine between 5:00-6:00
am in the morning, followed by 34 per cent getting up between 4:00-5:00 am.
27
Table 4.3: Distribution of subjects according to physical activity pattern (n=200)
(Percentage)
Physical Activities
Urban (n=100)
Rural (n=100)
4:00-5:00 am
0
34
5:00-6:00 am
33
65
6:00-7:00 am
60
0
After 7:00 am
7
1
7:00-7:30 am
0
19
7:30-8.00 am
31
17
8:00-8:30 am
69
64
Bike/Scooter
32
2
Bus
0
24
Walking
8
12
Cycle
53
52
Auto
7
10
Cricket
73
53
Badminton
0
13
Football
25
10
Kabaddi
17
24
Basketball
10
0
Computer Games
3
0
Hockey
6
0
30 min -1:00
53
38
1:00-2.00
34
44
2.00-3:00
13
18
Mean ± SE
1.56 ± 0.76
1.75 ± 0.66
Time of Getting up
Time of Leaving for School
Mode of Vehicle
Games Played
Daily Play Time (hours)
1.89NS
t-value
28
Play During Recess
Yes
19
43
No
81
57
13.46*
Chi-square
Time of Reaching Home
2:30-3:00 pm
72
0
3:00-3:30 pm
19
78
3:30-4:00 pm
9
22
Yes
46
83
No
54
17
Rest after School
29.89*
Chi-square
N=46
N=83
Upto 0:30
23
26
0:30-1:00
50
0
1.00-2:00
27
74
Mean ± SE
1.14 ± 0.56
0.95 ± 0.39
Duration of Rest (hours)
2.26**
t-value
Exercise
Yes
18
45
No
82
55
16.89*
Chi-square
*Significant at 1% level
** Significant at 5% level
The data highlighted that majority of the urban subjects left for school between 8:008:30 am as compared to 64 per cent of rural subjects. Thirty one per cent of urban whereas 17
per cent of rural subjects left for school between 7:30-8:00 am. However 19 per cent of rural
left for school between 7:00-7:30 am.
29
Table 4.3 further revealed the mode of vehicle used by urban and rural adolescent
boys. It was noted that majority of urban and rural adolescent boys used cycle as a mode of
vehicle. A higher percentage of urban (32%) than rural (2%) used bike/scooter as a mode
vehicle. Further the data showed that 24 per cent of rural subjects were commuting by bus.
Eight per cent of urban and 12 per cent of rural boys preferred walking to school. However, 7
per cent of urban while 10 per cent of rural subjects used auto as the mode of vehicle. It was,
therefore, observed that less number of urban boys preferred walking and were having some
kind of vehicle as a mode of conveyance to school, whereas rural subjects had fewer
conveniences, so they also used public vehicles like bus. The results were in line with the
study by Dapi et al (2005) who also revealed that urban adolescents went to school by
motorcycle, taxi, auto. In contrast, rural adolescents walked a long distance to school or used
a cycle.
The results further depicted that the cricket was most preferred game among 73 per
cent of urban and 53 per cent of rural adolescent boys. Twenty five per cent of urban,
whereas 10 per cent of rural subjects liked to play football. It was noted that kabaddi was
more popular among rural (24%) as compared to urban (17%) adolescent boys. Badminton
was found to be the game played by 13 per cent of rural subjects, whereas none of the urban
subjects reported to play badminton. Further, it was elucidated that urban adolescent boys also
played games like basket ball (10%), computer games (3%) and hockey (6%), while none of
the rural subjects reported to play the above mentioned games. With the observation of urban
and rural sports facility trends, it was observed that adolescent boys used to play those games
more frequently for which facilities were provided in the schools.
On perusal of data it was observed that majority of the urban subjects (53%)
played for 30 min-1 hour daily, followed by 34 per cent playing for 1-2 hours daily.
Thirteen per cent of urban subjects reported the daily playing time to be 2-3 hours.
However, majority of rural adolescent boys (44%) played for 1-2 hours daily followed by 38
per cent for 30 min - 1 hour daily. Eighteen per cent of rural subjects reported that they
played for 2-3 hours daily. The mean playing hours were revealed as 1.56 ± 0.76 hours for
urban and 1.75 ± 0.66 hours for rural adolescent boys, showing a non-significant difference
between the two groups. Further, the data revealed that majority of urban (81%) adolescent
boys did not play during recess as compared to 57 per cent of urban adolescent boys.
However 19 per cent of urban, whereas 43 per cent of rural boys reported to play during
recess. The results depicted that playing during recess was significantly (P ≤ 0.01) related to
both the urban and rural areas.
Table 4.3 showed that 72 per cent of urban adolescent boys reached home between
2:30-3:00 pm, followed by 19 per cent reaching home between 3:00-3:30 pm. Nine per cent
of urban subjects reached home between 3:30-4:00 pm. Further it was observed that 78 per
30
cent of rural subjects reached home between 3:00-3:30 pm, followed by 22 per cent reaching
home between 3:30-4:00 pm. Both were government schools and the timings were also same,
yet the rural adolescent boys reached home late as they had to walk a long distance to home
whereas urban boys had some kind of mode of conveyance with them.
The results highlighted that major percentage of urban adolescent boys (54%) did not
take rest after school as compared to only 17 per cent of rural adolescent boys. However
majority of rural (83%) subjects took rest as compared to 46 per cent of urban subjects since
rural adolescent boys were early risers and more active than their urban counterparts so they
wanted to take some rest after school. Further it was revealed that rest duration after school
was significantly (P ≤ 0.01) related to both the urban and rural boys.
Table 4.3 depicted the duration of rest period of urban and rural subjects who took
rest after school. It was observed that majority of the urban adolescent boys (50%) took
rest for 30 minutes - 1 hour daily, followed by 27 per cent who took rest for 1-2 hours daily.
Twenty three per cent of urban subjects took rest up to 30 minutes. However, it was
observed that majority of rural subjects (74%) took rest for 1-2 hours daily, followed by 26
per cent taking rest upto 30 minutes. Mean duration of rest was reported to be significantly
(P ≤ 0.05) longer among urban (1.14 ± 0.56 hours) than rural (0.95 ± 0.39 hours) adolescent
boys.
Table 4.3 further depicted that majority of urban (82%) adolescent boys as compared
to 55 per cent of rural subjects did not engage in exercise daily. Further it was observed that
only 18 per cent of urban, whereas 45 per cent of rural subjects had a regular exercise
schedule. It was observed that a significant (P ≤ 0.01) relation existed between the daily
exercise schedule and both the urban and rural subjects.
On the whole it was observed that rural subjects were early risers as compared to
urban subjects. It was also observed that rural boys were more physically active, generally
preferred walking and used cycles as a mode of conveyance whereas a large percentage of
urban subjects used bike/ scooter. Urban adolescent boys were reported to play a variety of
games due to greater facilities but the playing hours were less as compared to their rural
counterparts. Though, majority of rural boys used to take rest after school but for a lesser
time. The data also highlighted that majority of the rural adolescent boys had a regular
exercise schedule. The physical activity level was significantly higher among boys in rural
than in urban areas.
Mean duration of time spent on television viewing and/or at the
computer (playing games or on the Internet) among urban and rural boys were 4.6 and 4.1
hours per day, respectively; and both had a significant difference. Kelishadi et al (2007)
suggested that adolescents are more likely to be physically active if they have a circle of
friends who are active.
31
Life style pattern
Table 4.4 revealed the life style pattern of urban and rural adolescent boys. It was
observed that 45 per cent of urban subjects slept for 8 hours daily, followed by 38 per cent, who
slept for 7 hours daily. Seventeen per cent of urban adolescent boys had sleep duration of 6
hours daily. However, the data showed that majority of the rural (47%) slept for 7 hours daily,
followed by 33 per cent, having sleep duration of 8 hours. Ten per cent of rural adolescent boys
had sleep duration of 6 hours, and the remaining 10 per cent of them slept for 5 hours daily. The
mean sleep duration was reported as 7.28 ± 0.78 hours for urban and 7.17 ± 0.98 hours for rural
adolescent boys, with a non-significant difference between the two groups.
It was further revealed that majority of urban adolescent boys (42%) did not walk
daily as compared to 26 per cent of rural subjects. However majority of rural (42%) whereas
37 per cent of urban adolescent boys walked upto 30 minutes daily. Twenty one per cent of
urban while 32 per cent of rural subjects walked for 30 minutes - 1 hour daily. The variation
in mean walk duration between urban (0.39 ± 0.39 hours) and rural (0.53 ± 0.38 hours)
subjects, revealed a significantly (P ≤ 0.05) longer walk duration among rural than urban
adolescent boys. It was observed that lesser facilities were available to rural boys; therefore
they had to walk to reach their destinations.
The data highlighted that 57 per cent of urban adolescent boys, as compared to 59
per cent of rural subjects watched television for 2 hours daily. Further, it was observed that
28 per cent of urban, while 41 per cent of rural subjects watched television for 1 hour daily.
However, 15 per cent of urban, whereas none of the rural adolescent boys watched
television for 3 hours daily. Mean hours of television watching was observed as 1.86 ± 0.71
and 1.59 ± 0.49 hours for urban and rural adolescent boys, with a difference that was
significant (P ≤ 0.01), in support of urban subjects. Urban boys being less active as reported
early, preferred watching television so as to entertain themselves rather than engaging in
other activities. Wang et al (2000) also stated that children and adolescents of urban families
are more overweight than in the past, possibly because of decreased physical activity.
Sedentary activities such as TV viewing and computer games is suspected to be responsible
for the decline in physical activity levels.
Table 4.4 depicted the daily reading duration of urban and rural adolescent boys. It
was revealed that majority of urban adolescent boys (52%) read for 2 hours daily, as
compared to 49 per cent of rural subjects. Forty per cent of urban whereas 32 per cent of rural
subjects read upto 1 hour daily. However, 8 per cent of urban, while 19 per cent of rural
adolescent boys read for 2 hours daily. A significantly (P ≤ 0.01) longer duration of reading
was observed among rural than urban adolescent boys.
The mean reading hours were
reported as 1.65 ± 0.66 hours for urban and 2.06 ± 1.04 hours for rural subjects.
32
Table 4.4: Distribution of subjects according to life style pattern (n=200)
(Percentage)
Life Style Pattern
Urban (n=100)
Rural (n=100)
5 hours
0
10
6 hours
17
10
7 hours
38
47
8 hours
45
33
7.28 ± 0.78
7.17 ± 0.98
Sleep
Mean ± SE
0.88NS
t-value
Walk
Nil
42
26
Upto 0:30 hours
37
42
0:30-1:00 hours
21
32
0.39 ± 0.39
0.53 ± 0.38
Mean ± SE
2.57**
t-value
TV Watching
1:00 hours
28
41
2:00 hours
57
59
3:00 hours
15
0
Mean ± SE
1.86 ± 0.71
1.59 ± 0.49
3.13*
t-value
Reading
Upto 1:00 hours
40
32
2:00 hours
52
49
3:00 hours
8
19
Mean ± SE
1.65 ± 0.66
2.06 ± 1.04
3.33*
t-value
Household Work
Nil
52
30
Upto 1:00 hour
48
70
0.40 ± 0.45
0.64 ± 0.50
Mean ± SE
3.57*
t-value
33
Exercise
Nil
76
39
Upto 0:30 hours
6
17
0:30-1:00 hours
17
12
1:00-1:30 hours
2
32
0.22 ± 0.42
0.85 ± 0.86
Mean ± SE
6.58*
t-value
Computer Games
Nil
45
64
Upto 0:30 hours
4
1
0:30- 1:00 hours
40
35
1:00- 2:00 hours
10
0
0.65 ± 0.69
0.36 ± 0.48
Mean ± SE
3.45*
t-value
School duration
6:00 hours
100
100
*Significant at 1% level
** Significant at 5% level
The data showed that majority of urban subjects (52%) did not engage themselves in
household work, whereas majority of rural boys (70%) reported to be engaged in the
household chores daily upto 1 hour. However, 48 per cent of urban subjects engaged
themselves in household work upto 1 hour daily. It was further noted that only 30 per cent of
rural adolescent boys were not doing any type of household work.
Mean duration of household work was reported as 0.40 ± 0.45 hours for urban and 0.64 ±
0.50 hour for rural adolescent boys, with a significant (P ≤ 0.01) difference showing that rural
boys were engaged in household activities for a longer duration than urban boys. Rural adolescent
boys were supposed to do various household work as most of the parents were engaged in faming
whereas urban adolescents were not involved in household activities by their parents.
On perusal of data it was further revealed that 76 per cent of urban adolescent boys
did not do exercise, as compared to only 39 per cent of rural adolescent boys. Seventeen per
cent of urban subjects did exercise for 30 minutes - 1 hour daily followed by 6 per cent, doing
exercise upto 30 minutes daily. However 17 per cent of rural subjects did exercise upto 30
minutes daily followed by 12 per cent, who did exercise for 30 minutes - 1 hour daily.
Further it was observed that 32 per cent of rural, whereas only 2 per cent of urban subjects did
exercise for 1 -1:30 hours daily.
34
The data revealed a significantly (P ≤ 0.01) longer duration of exercise among rural
than urban adolescent boys with mean frequencies as 0.22 ± 0.42 hours for urban and 0.85 ±
0.86 hours for rural subjects. It was observed that rural boys had a regular exercise schedule
for longer duration than their urban counterparts. Even the rural subjects had greater stamina
to follow a vigorous exercise schedule.
Table 4.4 showed that 45 per cent of urban adolescent boys did not play computer
games, followed by 40 per cent of them, who played computer games daily for 30 minutes
- 1 hour. Ten per cent of urban subjects reported to play computer games for 1-2 hours
daily. Remaining 4 per cent of urban subjects played upto 30 minutes. However, majority
of rural adolescent boys (64%) did not play computer games, followed by 35 per cent of
them, playing for 30 minutes - 1 hour daily. The computer facilities as well as knowledge
of computer games were observed to be less in rural areas. Mean hours of playing
computer games was reported as 0.65 ± 0.69 hours for urban and 0.36 ± 0.48 hours for
rural adolescent boys, with a significant (P ≤ 0.01) difference, favouring urban adolescent
boys. School duration was reported to be 6 hours daily for both urban and rural adolescent
boys.
On perusal of data it was revealed that life style pattern was more active and
healthier among rural boys. Maximum of them had 7 hour sleep duration whereas it was 8
hours among urban subjects. Mean walking hours were found to be longer among rural than
urban adolescents. However, television watching was more prevalent among urban boys
with a longer duration. It was further observed that more of the rural adolescent boys were
engaged in household activities as well as regular exercise. Due to lesser availability and
awareness of computer, rural boys were less likely to play computer games as compared to
urban subjects.
Dapi et al (2005) also stated that urban adolescents described their activities as
watching television, listening to music, sleeping resting, playing computer games, playing
outdoor games cleaning and washing. . In contrast, rural adolescents described their activities
as farming, carrying water, dishing, sweeping, washing, cooking and playing games like
kabaddi, football and cricket.
Leisure time activities
Table 4.5 revealed the activities in leisure time for urban and rural adolescent boys.
It was found that majority of the urban adolescents (68%) used to do extra work in
their leisure time followed by 32 per cent who do their home work. However, majority of the
rural adolescent boys complete home work in their leisure time, followed by only 19 per cent
who involved themselves in extra work. Home work /extra work was found to have a
significant relation with both urban and rural adolescent boys.
35
Table 4.5: Distribution of subjects according to activities in leisure time (n=200)
(Percentage)
Activities
Urban (n=100)
Rural (n=100)
Home Work
32
81
Extra Work
68
19
Home Work/Extra Work
48.85*
Chi-square
Literature Reading
Yes
54
45
No
46
55
1.62NS
Chi-square
Indoor/Outdoor Games
Indoor
22
19
Outdoor
77
72
Nil
1
9
Yes
100
100
No
0
0
Watching TV
*Significant at 1% level
** Significant at 5% level
The data further highlighted that 54 per cent of urban adolescent boys read literature
like story books, comics, novels etc. in their leisure time as compared to 45 per cent of rural
adolescent boys. However, 46 per cent of urban while 55 per cent of rural subjects did not
engage in any type of literature reading in their leisure time. It was further revealed that
literature reading was significantly related to the urban and rural subjects.
Table 4.5 revealed that 77 per cent of urban adolescent boys played outdoor games, as
compared to 72 per cent of rural subjects. It was further observed that 22 per cent of urban
whereas 19 per cent of rural adolescent boys played indoor games in their free time. However,
only 1 per cent of urban and 9 per cent of rural subjects did not play any type of game, in their
leisure time. It was found that rural subjects were more physically active and this might be
due to lesser availability of indoor games, hence they preferred to play outdoor games. The
data further showed that almost all the urban and rural adolescent boys preferred watching
television daily in their free time.
36
The data on the whole revealed that majority of the rural adolescent boys used to do
their home work, play outdoor games and watch television in their leisure time whereas doing
extra work, reading literature like comics, story books, novels etc., playing outdoor games and
watching television were preferred by urban subjects. The present results were in
confirmation with the study by Laxmaiah et al (2008) stating that approximately 45 per cent
of adolescents did not participate in outdoor games, whereas only one-third were participating
in any outdoor games for 6 h/week. About two-thirds of adolescents were participating in
household (HH) activities, while 91 per cent reported watching television (TV) on school
days.
4.3 Food consumption pattern
In the recent years, the use of dietary pattern analysis has become popular for
characterizing the whole diet in combination because this approach captures complex
behaviour and potentially interactive and antagonistic effects among nutrients that
might impact health outcomes. Firstly the meal pattern of subjects is presented in
Table 4.6.
Table: 4.6 Meal pattern of urban and rural adolescent boys (n=200)
(Percentage)
Meal
Urban (n=100)
Rural (n=100)
Early morning
17
65
Breakfast
82
87
Canteen
78
55
Packed Lunch
22
45
Lunch at home
87
94
Evening tea
92
89
Dinner
86
91
Bed time
21
65
In - between meals
96
61
During Recess
Table 4.6 presents the meal pattern of urban and rural adolescent boys. It was
observed that 65 per cent of the rural and only 17 per cent of the urban subjects had early
morning meal as most of the rural subjects were early risers (Table 4.3) and they generally
preferred to have tea in the morning. Majority of the subjects i.e., 82 per cent of urban and 87
37
per cent of rural subjects used to have their breakfast daily. Videon et al (2003) while
determining adolescent's food consumption pattern also concluded that only one in five
adolescents skip their breakfast. The data further showed that 78 per cent of urban as
compared to 55 per cent of rural adolescents had snacks during recess from canteen while 45
per cent of rural and only 22 per cent of urban adolescent boys bought packed lunches to
school. A variety of fast food items were available in the urban school canteens therefore
urban boys had easy access to them. Puri et al (2008) also reported that a large number of
government (63.3%) and private (53.2%) school students were not bringing tiffins in the
schools. Majority of both urban (87%) and rural (94%) subjects used to have lunch at home
after the school. Adolescents who were having lunch daily were reported less likely to skip
breakfast or dinner (Abudayya et al, 2009). Similarly Ahmad et al (2009) revealed that 82.8
per cent of adolescent boys took lunch regularly in the days of week and enjoyed better
nutritional status.
A large percentage of adolescent boys i.e., 92 per cent of urban and 89 per cent of
rural were found to have evening tea. Further it was noted that 86 per cent of urban
subjects as compared to 91 per cent of rural had dinner daily. The present results were in
confirmation with the study stating that dinner was the main meal of day and 83.8 per
cent dined regularly (Abudayya et al, 2009). It was observed that only 21 per cent of
urban whereas 65 per cent of rural, adolescent boys had their bed time meals. Most of the
rural subjects used to drink milk while some of the urban subjects reported to have tea or
coffee at bed time.
Major percentage of urban adolescent boys (96%) had in between meals, whereas this
pattern was observed in 61 per cent of rural adolescent boys. Due to greater availability of
variety of snacks in a more attractive setting in urban area and greater awareness among urban
adolescent boys, led to higher consumption of in-between meals. Templeton (2005) also
observed the high frequency of in-between meals in urban than in rural adolescents (4.9 vs
0.9). Olumakaiye et al (2010) stated that about 33.0 per cent consumed snacks daily but to a
varying degree, which was higher among urban than rural adolescents. It was further observed
by Leal et al (2010) that 42 per cent of adolescent boys had a morning snack, 78 per cent had
an afternoon snack, and 16 per cent had an evening snack.
General food consumption pattern
Cereals
Tables 4.7 and 4.8 present the daily food consumption pattern of the rural and urban
adolescent boys. Both the rural and urban subjects consumed chapattis daily with a mean
frequency of 6.00 ± 0.00 for both the groups.
38
Table: 4.7 General food consumption pattern of urban and rural adolescent boys (n=200)
(Percentage)
Food items
Daily
Thrice a week
U
R
Cereals
Chapatti
100
100
0
Parantha
49
45
28
Poories
0
0
0
Bread
0
2
Dalia
0
Rice
4
Maize chapatti
R
Weekly
U
R
U
0
0
0
24
16
1
3
2
31
9
0
5
0
4
0
12
Whole Pulses
Bengal gram
0
Black gram
0
Kabuli chana
Fortnightly
Rarely
Never
R
U
R
R
U
R
U
0
0
0
0
0
0
0
0
4
12
2
0
1
18
0
0
4
25
39
43
10
30
35
0
9
47
31
18
37
2
10
2
6
0
5
7
26
24
34
37
25
20
10
9
0
3
2
20
27
55
32
14
22
3
17
0
0
0
23
22
29
39
26
30
7
9
3
0
0
0
3
32
25
39
53
22
17
7
2
0
0
0
0
1
4
27
33
54
35
17
19
1
9
0
0
0
0
2
3
18
24
46
38
29
31
5
4
0
0
Cow pea
0
0
0
0
2
11
27
38
44
35
27
14
0
2
Green gram
0
0
14
22
31
29
38
37
14
11
3
1
0
0
Rajmah
0
0
0
7
25
31
55
47
20
15
0
0
0
0
Dehusked Pulses
Bengal gram
0
1
0
9
5
15
47
39
25
29
23
7
0
0
Green gram
0
8
8
12
23
51
34
25
22
4
13
0
0
0
Lentil
0
0
2
7
15
22
50
25
31
39
2
7
0
0
Red gram
0
0
0
0
0
4
19
30
19
39
62
27
0
0
Milk and Milk Products
Milk
70
U
Twice a week
77
12
8
13
7
2
4
3
2
0
2
0
0
Buttermilk
10
56
27
34
36
7
18
2
6
0
3
1
0
0
Curd
13
11
32
24
41
36
12
23
1
4
1
0
0
2
Paneer
0
1
4
14
39
22
37
45
17
14
3
3
0
1
Green Leafy Vegetables
Bathua leaves
0
0
0
1
6
22
32
46
50
23
12
8
0
0
Fenugreek leaves
0
0
1
12
36
28
47
49
8
10
8
1
0
0
Mustard leaves
0
0
11
10
44
35
35
49
6
5
4
1
0
0
Spinach
0
0
1
10
29
18
47
48
23
22
0
1
0
1
Roots & Tubers
Carrot
12
7
40
32
34
41
13
19
0
1
1
0
0
0
Onion
86
46
7
35
7
15
0
3
0
1
0
0
0
0
Potato
52
12
35
58
13
19
0
0
0
11
0
0
0
0
Radish
2
16
32
16
49
50
16
16
1
2
0
0
0
0
Sweet Potato
0
0
0
0
3
5
5
28
34
48
58
15
0
4
Other Vegetables
3
5
66
28
26
43
5
22
0
2
0
0
0
0
Fruits
1
23
28
19
40
23
23
23
8
12
0
0
0
0
Sweets
0
19
16
30
39
8
30
12
15
16
0
15
0
0
U-Urban
R-Rural
39
Table 4.8: Mean frequency of consumption of general food items by urban and rural
adolescent boys (n=200)
Food items
Cereals
Chapati
Parantha
Poories
Bread
Dalia
Rice
Maize chapatti
Whole pulses
Bengal gram
Black gram
Kabuli chana
Cow pea
Green gram
Rajmah
Dehusked pulses
Bengal gram
Green gram
Lentil
Red gram
Milk and milk products
Milk
Buttermilk
Curd
Paneer
Green leafy vegetables
Bathua leaves
Fenugreek leaves
Mustard leaves
Spinach
Roots and tubers
Carrot
Onion
Potato
Radish
Sweet Potato
Other Vegetables
Fruits
Sweets
*Significant at 1% level
**Significant at 5% level
Urban (n=100)
Mean ± SE
Rural (n=100)
Mean ± SE
t-value
6.00 ± 0.00
5.15 ± 1.07
1.99 ± 0.8
4.06 ± 0.87
3.03 ± 1.07
3.20 ± 0.97
2.74 ± 0.91
6.00 ± 0.00
4.48 ± 1.89
2.03 ± 1.24
3.18 ± 1.27
2.91 ± 1.16
2.75 ± 1.1
3.98 ± 1.24
NA
3.08*
0.27NS
5.51NS
1.22NS
3.07*
8.08*
3.1 ± 0.79
3.1 ± 0.72
2.83 ± 0.85
2.04 ± 0.79
3.39 ± 0.99
3.06 ± 0.67
3.96 ± 0.91
3.04 ± 1.04
2.91 ± 0.91
2.42 ± 0.93
3.60 ± 0.98
3.30 ± 0.81
7.16*
0.48NS
0.64NS
3.11*
1.50NS
2.37**
2.34 ± 0.89
2.91 ± 1.14
2.84 ± 0.77
1.57 ± 0.69
2.93 ± 1.08
3.95 ± 0.93
2.83 ± 1.04
2.11 ± 0.85
4.20*
7.09*
0.08NS
4.64*
5.50 ± 0.92
4.08 ± 1.17
4.41 ± 0.97
3.24 ± 0.89
5.48 ± 1.13
5.41 ± 0.84
4.07 ± 1.18
3.30 ± 1.07
0.27NS
9.23*
2.23**
0.43NS
2.32 ± 0.76
3.14 ± 0.89
3.52 ± 0.92
3.08 ± 0.75
2.85 ± 0.89
3.40 ± 0.86
3.48 ± 0.79
3.11 ± 0.96
4.51*
2.10**
0.33NS
0.25NS
4.48 ± 0.94
5.79 ± 0.56
5.39 ± 0.71
4.18 ± 0.76
1.53 ± 0.73
4.67 ± 0.62
3.91 ± 0.93
3.56 ± 0.94
4.25 ± 0.88
5.22 ± 0.88
4.60 ± 1.07
4.28 ± 0.99
2.15 ± 0.88
4.12 ± 0.88
4.18 ± 1.34
3.79 ± 1.78
1.79NS
5.46*
6.14*
0.81NS
5.42*
5.11*
1.65NS
1.15NS
40
Table 4.7 revealed that 39 per cent of rural adolescent boys consumed poorie weekly
while 43 per cent of urban adolescent boys consumed it once in a fortnight. The difference in
the mean frequency of poorie consumption was non-significant between urban and rural
adolescent boys (1.99 ± 0.80 and 2.03 ± 1.24). The data showed that 49 per cent of urban and
45 per cent of rural adolescent boys consumed parantha daily. The mean frequency of
parantha consumption was 4.48 ± 1.89 for rural and 5.15 ± 1.07 for urban adolescent boys
with a significant (P ≤ 0.01) difference favouring the urban subjects.
Further the data (Table 4.7) showed that 47 per cent of urban adolescent boys
consumed bread twice a week while 37 per cent of rural adolescent boys consumed it weekly.
The mean frequency of bread consumption was 4.06 ± 0.87 in urban and 3.18 ± 1.27 in rural
adolescent boys with a non-significant difference (Table 4.8). The results showed that 34 per
cent of urban and 37 per cent of rural adolescent boys consumed dalia once in a week. The
mean frequency of dalia consumption was 3.03 ± 1.07 for urban and 2.91 ± 1.16 for rural
adolescent boys with non- significant difference between the two groups. The rice
consumption was recorded to be once in a week by 55 per cent of urban and 32 per cent of
rural adolescent boys. The variation in the intake of rice was found to be significantly (P ≤
0.01) higher among urban (3.20 ± 0.97) than rural (2.75 ± 1.10) adolescent boys. The data
further revealed that 39 per cent of urban adolescent boys consumed maize chapatti once a
week while 29 per cent of rural consumed maize twice a week. A significant (P ≤ 0.01)
difference in maize consumption was observed between urban and rural adolescent boys with
higher mean frequency of consumption among rural (3.98 ± 1.24) than in urban (2.74 ± 0.91)
adolescent boys.
On the whole it was observed that though cereals were frequently consumed by both
urban and rural adolescent boys yet it was higher in rural subjects since cereals like wheat and
maize are the major crops grown by farmers in rural areas of Punjab. Another reason observed
was that rural boys were more physically active than urban boys. Therefore they consider the
cereals specially wheat and maize chapattis as the best source of energy. The above results
were in confirmation with the study by Chacko and Begum (2007) which revealed that cereal
and cereal products were consumed frequently by a considerably large segment of selected
adolescent subjects from middle income families.
Whole pulses and legumes
Table 4.7 and 4.8 further provided the data regarding frequency of whole pulses by
urban and rural adolescent boys. Fifty three per cent of urban adolescent boys consumed
bengal gram once a week whereas 39 per cent of rural subjects consumed bengal gram thrice
a week The mean frequency of consumption of bengal gram was 3.10 ± 0.79 for urban and
3.96  0.91 for rural adolescent boys. The difference in frequency was reported to be
significantly (P ≤ 0.01) higher in rural than in urban subjects. Table 4.7 reported that 54 per
41
cent of urban and 35 per cent of rural adolescent boys consumed black gram once a week.
The mean frequency of black gram consumption was 3.10  0.72 for urban and 3.04 ± 1.04
for rural adolescent boys with a non-significant difference. The data further highlighted that
46 per cent of urban while 38 per cent of rural subjects consumed kabuli chana once a week.
The difference in mean frequency of kabuli chana consumption was found to be nonsignificant. Forty four per cent of urban adolescent boys consumed cow pea once in a
fortnight while 38 per cent of rural adolescent boys consumed it weekly The mean frequency
of cow pea consumption was noted as 2.04  0.79 for urban and 2.42  0.93 for rural
adolescent boys, with a difference that was significant (P ≤ 0.01) favouring rural adolescent
boys. On perusal of data it was found that 38 per cent of urban and 37 per cent of rural boys
consumed green gram weekly. The difference in frequency of consumption of green gram was
found to be non significant between urban and rural adolescent boys. The mean frequency of
green gram consumption was reported as 3.39 ± 0.99 for urban and 3.60  0.98 for rural
subjects. The results (Table 4.7) indicated that 55 per cent of urban and 47 per cent of rural
adolescent boys consumed rajmah once a week. The mean frequency of rajmah consumption
was 3.06  0.67 for urban and 3.30  0.81 for rural adolescent boys, displaying a significant
(P ≤ 0.05) difference in support of rural adolescent boys.
The above results in general revealed that frequency of consumption of whole pulses
like rajmah, bengal gram, kabuli chana, green gram and black gram was once a week on an
average for both urban and rural adolescent boys though consumption of cow pea, rajmah and
bengal gram was observed to be higher among rural adolescent boys. Perez and Zomora
(1996) also reported that the whole legumes and pulses were consumed less frequently by
majority of the adolescents.
Dehusked pulses
The results depicted that 47 per cent of urban and 39 per cent of rural adolescent boys
consumed bengal gram dhal once a week. Table 4.8 reported the mean frequency of bengal
gram dhal consumption as 2.34  0.89 for urban and 2.93  1.08 for rural adolescent boys,
with rural subjects consuming significantly (P ≤ 0.01) higher bengal gram dhal than urban
subjects. The data further highlighted that 34 per cent of urban and 51 per cent of rural
adolescents consumed green gram dhal once a week and twice a week respectively. The mean
frequency of green gram dhal consumption was 2.91  1.14 for urban and 3.95  0.93 for rural
adolescent boys displaying a significantly (P ≤ 0.01) higher consumption among rural subjects.
The data revealed that majority of urban subjects (50%) consumed lentil dhal weekly while
39 per cent of rural subjects consumed it once in a fortnight. The difference in the mean
frequency of consumption of lentil dhal in two areas was found to be non-significant with
mean frequencies as 2.84 ± 0.77 for urban and 2.83 ± 1.04 for rural adolescent boys. Sixty
42
two per cent of urban subjects consumed red gram dhal rarely whereas 39 per cent of rural
subjects consumed red gram dhal once in a fortnight. The variation in mean frequencies of red
gram dhal consumption between rural (2.11  0.85) and urban (1.57  0.69) adolescent boys
indicated a significantly (P ≤ 0.01) higher consumption among rural adolescent boys.
The above results indicated that the frequency of consumption of dehusked pulses
(dhals) were higher among rural than urban adolescent boys. Most commonly consumed
dhals as per their preference were green gram, Bengal gram, lentil and red gram. Olivares et
al (2004) confirmed the above results by reporting that the frequency of consumption of dhal
and legumes varied from once a week to twice a week in adolescent subjects.
Milk and milk products
Table 4.7 revealed that the majority of both of urban (70%) and rural (77%) subjects
consumed milk daily. The mean frequency for milk consumption was 5.50  0.92 for urban
and 5.48  1.13 for rural adolescents displaying a non- significant difference between the two
groups (Table 4.8). The data showed that 36 per cent of urban adolescent boys used to drink
buttermilk twice a week whereas 56 per cent of rural adolescent boys consumed it daily. The
mean frequency of buttermilk consumption was observed as 4.08 ± 1.17 for urban and 5.41 ±
0.84 for rural adolescent boys with a significantly (P ≤ 0.01) higher consumption frequency
among rural adolescent boys. The results depicted that 41 per cent of urban and 36 per cent of
rural subjects consumed curd twice a week. A significantly (P ≤ 0.05) higher consumption of
curd was found among urban adolescent boys with mean frequencies of 4.41  0.97 for urban
and 4.07 ± 1.18 for rural adolescent boys. Further, it was revealed that 39 per cent of urban
subjects consumed paneer twice a week while 45 per cent of rural subjects consumed it
weekly. Table 4.8 depicted a non-significant difference for the consumption of paneer
between urban and rural adolescent boys. The mean frequency of paneer consumption was
3.24  0.89 for urban and 3.30  1.07 for rural adolescent boys.
Milk is the product that is considered as a complete food and is produced in large
amounts in rural areas as well as it is also supplied to urban areas especially to processing plants
like verka. Therefore, due to easy availability in Punjab, milk and milk products are consumed
satisfactorily in both areas. The present results are in line with the results reporting that dairy
products including milk and yoghurt were most frequently consumed among adolescents
(Olivares et al, 2004). Further, Leal et al (2010) also observed the satisfactory intake of milk
and milk products among the adolescent boys as it was close to the expected frequency of 0.85.
Green leafy vegetables
The results revealed that 50 per cent of urban subjects consumed bathua leaves once
in a fortnight while 46 per cent of rural subjects consumed it once a week. The mean
frequency of bathua leaves consumption was 2.32  0.76 for urban and 2.85  0.89 for rural
43
subjects. The difference in the means indicated a significantly (P ≤ 0.01) higher consumption
of bathua leaves among rural than urban adolescent boys (Table 4.8). The data further
revealed that 47 per cent of urban and 49 per cent of rural subjects consumed fenugreek
leaves once a week. A significant (P ≤ 0.05) difference in consumption of fenugreek leaves
was observed, indicating a higher consumption among rural subjects (3.40  0.86 vs 3.14 
0.89). Table 4.7 depicted that 44 per cent of urban adolescent boys consumed mustard leaves
twice a week while 49 per cent of rural adolescent boys consumed it weekly. A nonsignificant difference in consumption of mustard leaves between rural & urban adolescent
boys was observed with mean frequency as 3.52  0.92 for urban and 3.48  0.79 for rural
subjects. The data further showed that 47 per cent of urban and 48 per cent of rural subjects
consumed spinach once a week. The mean frequency of spinach consumption among urban
adolescent boys was 3.08 ± 0.75 and 3.11 ± 0.96 for rural adolescent boys, indicating a nonsignificant difference between the two groups.
On perusal of the data it was observed that on the whole the consumption of green
leafy vegetables like mustard leaves, fenugreek leaves, bathua and spinach varied from once a
week to fortnightly though it was higher among rural adolescent boys. Abudayya et al (2009)
while assessing the food consumption pattern of adolescents also observed that the mean
frequency of consumption of green vegetables was 8.5 per week i.e., adolescents consumed
two or three servings per day. Majority of adolescents did not meet the dietary
recommendations of WHO on five portions of green vegetables per day.
Roots and Tubers
On perusal of data it was revealed that 40 per cent of urban and 41 per cent of rural
subjects consumed carrot thrice a week and twice a week respectively. However, the mean
frequencies of carrot consumption were 4.48  0.94 for urban and 4.25  0.88 for rural
adolescent boys showing a non-significant difference. The results depicted that 86 per cent of
urban and 46 per cent of rural subjects consumed onion daily. The mean frequency of onion
was significantly higher among urban (5.79 ± 0.56) than rural (5.22 ± 0.88) adolescent boys.
Potato consumption was reported to be daily by 52 per cent of urban subjects while 58 per
cent of rural subjects consumed it thrice a week. The mean frequency of potato consumption
was found to be significantly (P ≤ 0.01) higher among urban (5.39 ± 0.71) than rural (4.60 
1.07) adolescent boys (Table 4.8). Table 4.7 displayed that 49 per cent of urban and 50 per
cent of rural consumed radish twice a week. The mean frequency of radish consumption was
4.18  0.76 and 4.28  0.99 for urban and rural subjects with a non- significant difference
between the two groups. The data further revealed that 58 per cent of urban adolescents
consumed sweet potato rarely whereas 48 per cent of rural adolescents consumed it once in a
44
fortnight. A significantly (P ≤ 0.01) higher mean frequency of consumption of sweet potato
among rural (2.15  0.88) than urban (1.53  0.73) adolescent boys was observed.
The above results showed that consumption of roots and tubers varied from daily to
fortnightly but was higher among urban boys. Dapi (2010) also reported that roots and tubers
were significantly more often consumed by urban than by rural adolescents.
Other vegetables
Table 4.7 depicted that majority of urban (66%) subjects consumed other vegetables
like cauliflower, ladyfinger, capsicum, green peas, brinjal, French beans etc. thrice a week
while 43 per cent of rural subjects consumed them twice a week. The mean frequency of
consumption of other vegetables was noted as 4.67  0.62 and 4.12  0.88 among urban and
rural adolescent boys with a significant (P ≤ 0.01) difference, favouring urban subjects.
Fruits
The results highlighted that 40 per cent of urban adolescent boys consumed them twice
week whereas 23 per cent of rural adolescent boys consumed fruits weekly, twice a week and
daily. It was further observed that mean frequencies of fruit consumption for urban and rural
adolescent boys were 3.91  0.93 and 4.18 1.34, with a non-significant difference of means.
Chacko and Begum (2007) confirmed the results by stating that consumption of other vegetables
including roots and tubers (5-51%) as well as fruits (4-61%) exhibited large variations, certain
important items like onion, tomatoes and banana were consumed daily by the adolescents.
Sweets
The results further indicated that 39 per cent of urban subjects consumed sweets twice a
week while 30 per cent of rural subjects consumed them thrice a week. The mean frequency of
sweets consumption was found to be 3.56  0.94 for urban and 3.79  1.78 for rural adolescent
boys, displaying a non-significant difference between the two groups. The present results were
in confirmation with the study by Leal et al (2010) showing that the consumption of the group
sugars and sweets was 3.11 times the expected frequency among adolescents.
Categories of frequency of general food consumption by urban and rural
adolescent boys.
Table 4.9 presents the categories of frequency of general food consumption by urban
and rural adolescent boys. It was revealed that intake of most of the cereal products, pulses
and legumes, green leafy vegetables and sweets were moderate by both urban and rural
adolescent boys. However, Templeton (2005) revealed that the frequencies of consumption of
meat (11.8 vs 4.5), vegetables (9.5 vs 3.9), cereals (16.5 vs 11.9), milk products (5.74 vs 0.8)
and junk food (24.2 vs 8.7) was significantly higher in urban than in rural adolescents.
45
Table 4.9: Categories of frequency of general food consumption by urban and rural
adolescent boys (n=200)
Categories of
frequency*
Urban
(n=100)
Rural
(n=100)
Low (0-2)
Poories, red gram, sweet potato
-
Moderate (2-4)
Rice, dalia, maize chapatti, cow
pea, rajmah, bengal gram, Kabuli
chana, green gram, black gram,
bengal gram dhal, green gram
dhal, lentil, paneer, mustard
leaves, fenugreek leaves, spinach,
bathua leaves, fruits, sweets
Poories, bread, Rice, dalia, maize
chapatti, cow pea, rajmah, bengal gram,
Kabuli chana, green gram, black gram,
bengal gram dhal, red gram, green gram
dhal, lentil, paneer, mustard leaves,
fenugreek leaves, spinach, bathua
leaves, sweets, sweet potato.
High (4-6)
Chapatti, parantha, bread, milk, Chapatti, parantha, bread, milk,
buttermilk, curd, potato, onion, buttermilk, curd, potato, onion, radish,
radish, carrot, other vegetables. carrot, other vegetables, fruits.
*Mean frequency
Further it was observed that chapattis and parantha were highly consumed by them.
The frequency of bread intake was high (4-6) i.e., daily to twice a week among urban boys
whereas it was moderate (2-4) i.e., twice a week to fortnightly among rural boys. The data
highlighted that intake of milk and milk products, other vegetables and roots and tubers were
high by both urban and rural subjects. However, the intake of fruits was high among rural
while moderate among urban adolescent boys. Further, the results depicted that the
consumption of poories, red gram dhal and sweet potato was low (0-2) i.e., fortnightly to
never among urban boys.
Fast food consumption pattern
Tables 4.10 and 4.11 represent the fast food consumption pattern of urban and rural
adolescent boys
Table 4.10 revealed that 48 per cent of urban adolescent boys consumed aloo tikki
weekly whereas 55 per cent of rural subjects consumed it twice a week. The mean frequency
of aloo tikki consumption was 3.21  0.87 for urban and 3.36  0.80 for rural adolescent boys.
The difference in mean frequencies was reported to be non-significant between the two
groups since potatoes were the most liked tuber by both urban and rural adolescent boys.
The results depicted that majority of urban (61%) subjects consumed bhelpuri rarely
whereas 32 per cent of rural subjects consumed bhelpuri once in a fortnight. It was further
observed that the mean frequency of bhelpuri consumption was 1.71 0.97 and 2.441.17
for urban and rural adolescent boys. A significant (P ≤ 0.01) difference prevailed between
the mean frequencies of bhelpuri consumption of the two groups, with the rural subjects
reporting a higher frequency of consumption. This snack was observed to be sold by small
shops and street vendors at a reasonable cost during recess period in the schools of urban
46
areas. Table 4.10 further highlighted that 57 per cent of urban whereas 49 per cent of rural
subjects consumed bread pakora weekly. The mean frequencies of bread pakora
consumption were 2.130.66 and 2.700.83 for urban and rural adolescent boys with a
significantly (P  0.01) lower frequency of consumption among urban adolescents. It was
observed that less number of urban adolescents liked bread pakora as a snack than rural
adolescent boys.
The frequency of sweet biscuits was observed as thrice a week by 54 per cent
of urban adolescent boys while 33 per cent of rural subjects consumed them once in fortnight.
The results indicated that the frequency of sweet biscuits consumption was 4.52  0.64 for
urban and 4.10  1.62 for rural adolescent boys, displaying a significant (P ≤ 0.05) difference
in support of urban subjects because the availability of variety of sweet biscuits and its
awareness was found to be higher among urban areas. The data showed that 46 per cent of
urban subjects consumed salty biscuits rarely while 47 per cent of rural subjects consumed
salty biscuits weekly. The mean frequency of salty biscuit consumption was 1.92  0.99 for
urban and 2.57  0.84 for rural adolescent boys. The difference in frequency was found to be
significantly (P ≤ 0.01), higher among rural subjects (Table 4.11). It was further found that
40 per cent of urban subjects consumed cream biscuits rarely while 43 per cent of rural
adolescent boys consumed them once a week. Table 4.9 revealed that the mean frequency
of cream biscuit consumption was reported to be 2.15  1.16 for urban and 2.81  0.88 for
rural adolescent boys, depicting significant (P ≤ 0.01) difference, in support of rural
subjects since rural boys liked cream biscuits more than the urban boys. Table 4.10 showed
that 49 per cent of urban as compared to 34 per cent of rural adolescents consumed burger
twice a week. The mean frequency of burger consumption was revealed as 3.82 ± 0.86 and
3.35 ± 1.02 for urban and rural adolescent boys with significant (P ≤ 0.01) difference
favouring urban subjects (Table 4.11). Chacko and Begum (2007) also found that bakery
items such as bread, biscuits, cake and fast food items such as samosa, pani-puri, Manchurian
and burger were commonly consumed snacks by the adolescents.
On perusal of data it was elucidated that 43 percent of urban subjects consumed
cheese chilly weekly while majority of the rural (50%) subjects consumed it once in a
fortnight as the availability of cheese chilly was more in urban fast food outlets than in rural
areas. The variation in mean frequencies of cheese chilly consumption between urban (2.68 
0.98) and rural (1.940.86) adolescent boys indicated a significantly (P ≤ 0.01) higher
consumption among urban adolescent boys. Forty five percent of adolescent boys consumed
chips twice a week while 57 percent of rural adolescent boys consumed them once in a
fortnight. The data revealed the mean frequency of chips consumption as 3.84 ± 0.79 for
urban and 2.22  0.69 for rural adolescent boys. The variation in frequency was found to be
47
statistically significant (p ≤ 0.01) reporting a higher frequency of consumption among urban
than rural adolescent boys since a variety of chips were available in urban school canteen and
chips being a relishing and handy snack was more popular among urban adolescent boys.
Forty four percent of urban and rural subjects consumed cream roll twice a week and once a
week respectively. Table 4.11 depicted that cream roll consumption was significantly (P ≤
0.01) higher among urban than rural subjects with mean frequencies as 3.69  0.92 for urban
and 3.31  0.96 for rural adolescent boys. The results highlighted that majority of urban
(43%) and rural (68%) subjects consumed chhole bhature once in a fortnight. A nonsignificant difference was observed in chhole bhature consumption among urban and rural
adolescent boys with mean frequencies as 2.60  0.98 for urban and 2.60  1.08 for rural
subjects. A multitude of street vendors use to set stalls outside the schools during recess
where chhole bhature was a common snack in both urban and rural areas.
Forty three percent of urban subjects consumed crax rarely while majority of rural (35%)
subjects never consumed crax as it was stated to be more popular among young children. A
significant (P ≤ 0.01) difference was observed in frequency of crax consumption, which
favoured urban adolescent boys. Mean frequency of crax consumption was thereby 1.74 ±
0.81 for urban and 0.99  0.87 for rural adolescent boys. Table 4.10 elucidated that 45 percent
of urban adolescent boys consumed chocolates weekly while 49 percent of rural subjects
consumed them once in a fortnight. The mean frequency of chocolate consumption was
reported to be 3.12  0.98 for urban and 2.55  0.72 for rural adolescent boys with a
significant (P ≤ 0.01) difference, urban subjects having a higher frequency of chocolate
consumption in comparison to their rural counter-parts due to popularity and availability in
large variety in urban areas (Table 4.11). It was further observed that 44 percent of urban and
45 percent of rural adolescent boys consumed cakes once in a fortnight. The mean frequency
of cake consumption was noted to be 2.0  0.77 for urban for 2.09  1.02 for rural subjects,
indicating a non-significant difference between the two groups. The data highlighted that 32
percent of urban subjects consumed candies once in a fortnight and similar percentage of
them consumed them weekly too while 42 percent of rural subjects consumed them once in a
fortnight (Table 4.10). The results further indicated that the mean frequency of candies
consumption was 2.37  1.00 for urban and 2.15  0.95 for rural adolescent boys with a nonsignificant difference (Table 4.11). Thirty five percent of urban adolescent boys consumed
egg roll rarely whereas 39 percent of rural adolescent boys consumed it once in a fortnight.
The reported mean frequency of egg roll consumption was 1.72  1.06 for urban and 1.41 
0.93 for rural adolescent boys indicating a significant (P ≤ 0.05) difference favouring urban
adolescent boys since it is easily available by the street vendors in the urban areas and
percentage of ova-vegetarians was higher among urban adolescent boys.
48
Table: 4.10: Fast food consumption pattern of urban and rural adolescent boys (n=200)
(Percentage)
Food items
Aloo Tikki
Bhelpuri
Bread Pakora
Buiscuits (sweet)
Biscuits (salty)
Biscuits (cream)
Burger
Cheese chilly
Chips
Cream Roll
Chhole bhature
Craxs
Chocolates
Cakes
Candies
Egg roll
Finger Fries
Fryams
Golgappe
Grilled Sandwich
Hog dog
Ice cream
Kurkure
Kulche chhole
Macroni
Manchurian
Momos
Magi
Muffins
Mc Puff
Namkeens
Noodles
Pizza
Patties
Pav Bhaji
Paneer wrap
Pastry
Paneer Pakore
Sandwich
Samosa
Soft drink
Spring Rolls
Veg Pakore
Veg rolls
Daily
U
0
0
0
2
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
16
0
0
0
R
0
0
0
26
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
9
0
0
0
0
0
0
0
9
0
3
0
0
0
Thrice a
week
U
R
8
0
0
1
0
0
54
24
1
5
0
1
20
13
5
0
21
0
18
7
3
15
0
0
9
0
0
0
0
0
0
0
0
0
0
0
27
1
0
0
0
0
12
0
1
0
16
0
0
0
2
0
0
0
20
0
2
0
0
0
50
20
6
2
0
0
10
0
0
0
0
0
0
0
1
0
34
0
19
9
42
3
1
0
4
0
1
0
Twice a
week
U
R
25
55
5
19
22
15
38
17
4
1
14
21
49
34
9
4
45
3
44
36
16
0
2
0
19
10
1
6
14
5
5
1
11
0
0
0
40
15
0
0
1
0
40
3
20
1
31
42
20
14
12
1
0
0
37
14
0
0
0
0
45
36
34
8
7
0
41
6
1
1
0
0
6
1
15
1
44
35
59
41
23
41
1
1
11
16
8
0
U-Urban
R-Rural
49
Weekly
U
48
22
57
6
27
23
26
43
31
29
29
9
45
27
32
19
16
7
30
16
13
28
31
38
39
21
28
37
24
6
2
46
21
22
28
17
24
23
17
22
18
7
40
12
R
27
29
49
0
47
43
30
18
28
44
16
3
38
28
32
9
13
17
56
0
24
28
26
14
6
14
0
34
16
0
28
26
10
37
13
0
16
35
24
14
26
10
36
6
Fortnightly
U
18
12
21
0
22
22
3
35
3
7
43
40
24
44
32
30
47
42
3
42
38
19
35
14
22
48
32
6
23
41
2
10
52
26
49
39
40
40
5
0
1
37
44
47
R
17
32
27
33
40
28
21
50
57
10
68
28
49
45
42
39
33
50
28
4
45
41
50
2
39
41
17
40
44
30
7
46
37
40
36
15
56
62
17
36
8
39
33
43
Rarely
U
1
61
0
0
46
40
2
8
0
2
8
43
2
28
21
35
26
51
0
42
45
1
12
1
19
15
40
0
51
48
0
4
20
1
16
38
30
21
0
0
0
52
1
31
R
1
12
9
0
7
7
2
24
12
0
1
34
3
11
15
32
28
26
0
48
9
28
17
33
41
33
42
12
25
32
0
18
38
7
50
40
21
2
15
0
19
27
15
30
Never
U
0
0
0
0
0
0
0
0
0
0
1
6
0
0
1
11
0
0
0
0
3
0
0
0
0
0
0
0
0
5
0
0
0
0
6
6
0
0
0
0
0
2
0
1
R
0
7
0
0
0
0
0
4
0
3
0
35
0
10
6
19
26
7
0
48
22
0
6
0
0
11
41
0
15
38
0
0
15
10
0
45
6
0
0
0
0
23
0
21
Table 4.11: Mean frequency of consumption of fast food items by urban and rural
adolescent boys (n=200)
Food items
Aloo Tikki
Bhelpuri
Bread Pakora
Buiscuits (sweet)
Biscuits (salty)
Biscuits (cream)
Burger
Cheese chilly
Chips
Cream Roll
Chhole Bhature
Craxs
Chocolates
Cakes
Candies
Egg roll
Finger Fries
Fryams
Golgappe
Grilled Sandwich
Hog dog
Ice cream
Kurkure
Kulche chhole
Macroni
Manchurian
Momos
Magi
Muffins
Mc Puff
Namkeens
Noodles
Pizza
Patties
Pav Bhaji
Paneer wrap
Pastry
Paneer Pakore
Sandwich
Samosa
Soft drink
Spring Rolls
Veg Pakore
Veg rolls
Urban (n=100)
Mean ± SE
3.21 ± 0.87
1.71 ± 0.97
2.13 ± 0.66
4.52 ± 0.64
1.92 ± 0.99
2.15 ± 1.16
3.82 ± 0.86
2.68 ± 0.92
3.84 ± 0.79
3.69 ± 0.92
2.60 ± 0.98
1.74 ± 0.81
3.12 ± 0.98
2.01 ± 0.77
2.37 ± 1.00
1.72 ± 1.06
2.12 ± 0.92
1.56 ± 0.62
3.91 ± 0.83
1.74 ± 0.72
1.64 ± 0.79
3.43 ± 0.97
1.86 ± 1.03
3.47 ± 0.96
2.60 ± 1.01
2.37 ± 0.96
1.92 ± 0.82
3.71 ± 0.86
1.79 ± 0.95
1.48 ± 0.69
4.46 ± 0.66
3.28 ± 0.88
2.15 ± 0.82
3.33 ± 1.01
2.02 ± 0.85
1.67 ± 0.83
2.06 ± 0.89
2.35 ± 1.01
4.07 ± 0.84
3.97 ± 0.64
3.54 ± 1.00
1.52 ± 0.79
2.73 ± 0.83
1.98 ± 0.94
*Significant at 1% level
**Significant 5%level
50
Rural (n=100)
Mean ± SE
3.36 ± 0.8
2.44 ± 1.17
2.70 ± 0.83
4.10 ± 1.62
2.57 ± 0.84
2.81 ± 0.88
3.35 ± 1.02
1.94 ± 0.86
2.22 ± 0.69
3.31 ± 0.96
2.60 ± 1.08
0.99 ± 0.87
2.55 ± 0.72
2.09 ± 1.02
2.15 ± 0.95
1.41 ± 0.93
1.33 ± 1.01
1.77 ± 0.81
2.89 ± 0.68
0.56 ± 0.57
1.71 ± 1.07
2.06 ± 0.83
1.99 ± 0.85
3.01 ± 1.61
1.93 ± 1.02
1.61 ± 0.9
0.76 ± 0.73
2.50 ± 0.88
1.61 ± 0.93
0.92 ± 0.82
3.96 ± 1.06
2.30 ± 0.93
1.42 ± 0.87
2.20 ± 1.02
1.65 ± 0.74
0.70 ± 0.72
1.85 ± 0.80
2.35 ± 0.54
3.15 ± 1.39
3.23 ± 1.04
3.10 ± 1.28
1.39 ± 0.98
2.53 ± 0.94
1.34 ± 0.88
t-value
1.27NS
4.80*
2.92*
2.41**
4.99*
4.53*
3.53*
5.83*
15.47*
2.86*
1.47NS
4.94*
4.71*
0.63NS
1.6NS
2.20**
5.78*
2.05**
9.51*
12.82*
0.53NS
10.77*
5.03*
2.35**
4.66*
5.89*
9.17*
9.84*
1.36NS
5.21*
4.00*
7.68*
6.12*
7.75*
3.27*
8.84*
1.67NS
0.26NS
4.78*
6.04*
2.71*
1.18NS
1.6NS
4.97*
Table 4.10 further elucidated that 47 per cent of urban while 33 per cent of rural
subjects consumed finger fries once in a fortnight. The mean frequency of finger fries
consumption was observed as 2.12 ± 0.92 for urban and 1.33 ± 1.01 for rural adolescent boys.
The variation in mean frequencies depicted a significant (P ≤ 0.01) difference between the
two groups, favouring urban subjects. Finger fries is a common fast food item which is
popular and available in all the fast food outlets in the urban area. The results indicated that
51 per cent of urban subjects consumed fryams rarely whereas 50 per cent of rural subjects
consumed them once in a fortnight. Table 4.11 showed that the mean frequency of fryams
consumption was 1.56 ± 0.62 and 1.77  0.81 for urban and rural adolescent boys with a
significant (P ≤ 0.05) difference in favour of rural adolescent boys since fryams are the snacks
often prepared in rural areas during tea time whereas urban adolescents prefer a variety of
other snacks available in the market. It was further revealed that 40 per cent of urban
adolescents consumed gol-gappe twice a week whereas 56 per cent of rural adolescents
consumed them weekly. Mean frequency of gol-gappe consumption was noted as 3.91  0.83
for urban and 2.89  0.68 for rural adolescent boys indicating a significant (P ≤ 0.01)
difference, favouring urban adolescent boys. Gol-gappe are easily available by a multitude of
street vendors in urban areas and being a relishing snack is consumed both by urban and rural
subjects though its frequency is higher among urban adolescents.
The data depicted that the frequency of consumption of grilled sandwich was once in
a fortnight and rarely by 42 per cent of urban adolescent boys. Forty eight per cent of rural
subjects did not consume grilled sandwich while same percentage of them (48%) consumed
the item rarely as it is one of the modern fast food item available in urban areas. The method
and ingredients to prepare grilled sandwich is hardly known in rural areas (Table 4.9). The
mean frequency of grilled sandwich consumption was further reported as 1.74  0.72 for
urban and 0.56  0.57 for rural subjects. The variation in frequency was found to be
significant (P  0.01), reporting a higher frequency of consumption by urban adolescents
(Table 4.11). The data showed 45 per cent of urban and rural adolescent boys consumed hot
dog rarely and once in a fortnight. A non-significant difference was depicted in the Table 4.11
for hot dog consumption between urban and rural adolescent boys with mean frequencies as
1.64  0.79 for urban and 1.71  1.07 for rural subjects.
On perusal of the data it was observed that 40 per cent of urban subjects consumed
ice-cream twice a week while 41 per cent of rural subjects consumed it once in a fortnight.
The fast food outlets sell ice-creams in a variety of flavours and attractive manner in urban
areas therefore, it is more oftenly consumed by urban adolescents. Table 4.11 elucidated the
mean frequency of ice-cream consumption as 3.43  0.97 for urban and 2.06  0.83 for rural
adolescent boys displaying a statistically significant (P ≤ 0.01) difference in support of urban
51
adolescent boys. Table 4.10 further revealed that 35 per cent of urban while 50 per cent of
rural adolescent boys consumed kurkure once in fortnight. The mean frequency of kurkure
consumption was 1.86  1.03 for urban and 1.99  0.85 for rural adolescent boys, indicating a
significant (P ≤ 0.01) difference in favour of rural subjects. It was found that majority of
urban (38%) subjects consumed kulche chhole once a week while 42 per cent of rural subjects
consumed it twice a week. The reported mean frequency of kulche Chhole consumption was
3.47  0.96 and 3.01  1.61 for urban and rural adolescent boys indicating a significant (P ≤
0.05) difference in favour of urban subjects. Kulche chhole was one of the snacks that was
available in urban school canteen and by street vendors in rural areas. Being a filling snack, it
was consumed by large number of boys as a substitute for packed lunch.
Table 4.10 indicated that 39 per cent of urban subject consumed macroni weekly
while similar percentage of rural subjects (39%) consumed it once in a fortnight. The mean
frequency of macroni consumption was 2.60  1.01 for urban and 1.93  1.02 for rural
adolescent boys, with a difference that was significant (P ≤ 0.01) favouring urban adolescent
boys. Macroni preparation was hardly known in rural areas and it was only available in fast
food outlets that were far from the living places of rural adolescents. The data showed that 48
per cent of urban and 41 per cent of rural adolescent boys consumed manchurian once in a
fortnight. It was further revealed that the mean frequency of manchurian consumption was
2.37  0.96 for urban and 1.61  0.90 for rural subjects indicating a significant (P ≤ 0.01)
difference, favouring urban subjects. It was noted that 40 per cent of urban adolescents
consumed momos rarely while 41 per cent of rural adolescents did not consume them ever.
The mean frequency of momos consumption was significantly (P ≤ 0.01) higher among urban
(1.92  0.82) than rural (0.76  0.73) adolescent boys since it was only available in modern
fast food outlets as well as by various street vendors in urban areas. A large number of rural
subjects were unaware of this fast food. Thirty seven per cent of urban subjects consumed
maggi weekly as well as twice a week while 40 per cent of rural subjects consumed it once in
a fortnight since the upcoming flavours of maggi were known by urban adolescents and they
had more curiosity to try each and every flavour more than the rural adolescents as well as it
was one of the items most liked by urban boys.
A significantly (P ≤ 0.01) higher
consumption of maggi was observed among urban than in rural adolescent boys with the
mean frequencies as 3.71  0.86 for urban and 2.50  0.88 for rural subjects.
The data elucidated that majority of urban (51%) subjects consumed muffin rarely
whereas 44 per cent of rural adolescent boys consumed them once in a fortnight. Table 4.9
further showed that the mean frequency of muffin consumption as 1.79  0.95 and 1.61  0.93
for urban and rural adolescent boys, showing a non-significant difference between the two
groups. The results further revealed that 48 per cent of urban adolescent boys consumed Mc
Puff rarely while 38 per cent of rural adolescent boys did not consume Mc Puff ever as it is
52
the fast food item available in Mc Donalds, an outlet only seen in urban areas. The mean
frequency of Mc Puff consumption was depicted as 1.48  0.69 for urban and 0.92  0.82 for
rural adolescent boys. The two groups exhibited a significant (P ≤ 0.01) difference, favouring
urban adolescent boys. It was observed that majority of urban (50%) adolescent boys
consumed namkeens thrice a week whereas 36 per cent of rural adolescent boys consumed it
twice a week. Table 4.11 depicted the mean frequency of namkeens consumption as 4.46 
0.66 for urban and 3.96  1.06 for rural adolescent boys. The difference was significant (P ≤
0.01) for urban subjects consuming namkeens more frequently than rural subjects since in
rural areas only local made namkeens are available whereas in urban areas a variety of them
are available in attractive packs and attracts more of the adolescent boys.
The data highlighted that 46 per cent of urban subjects consumed noodles weekly
while 46 per cent of rural adolescents consumed it once in a fortnight. Table 4.11 showed a
significantly (P ≤ 0.01) higher frequency of noodles consumption among urban (3.28  0.88)
than rural (2.30  0.93) adolescent boys since it was available in the urban school canteens.
The results revealed that majority of urban (52%) adolescent boys consumed pizza once in a
fortnight while 38 per cent of rural adolescent boys consumed it rarely as pizza being a highly
popular item in urban than in rural areas. The mean frequency of pizza consumption was 2.15
 0.82 for urban and 1.42  0.87 for rural and subjects displaying a significant difference in
support of urban adolescent boys. Table 4.10 further revealed that 41 per cent of urban
adolescents consumed patties twice a week whereas 37 per cent of rural subjects consumed it
once a week. The frequency of consuming patties was significantly higher among urban than
rural boys (3.33 ± 1.01 vs 2.20  1.02). The present results were in confirmation with the
study by Puri et al (2008) which stated that most common food item consumed by adolescents
in canteens were hotdog (42.9%), cold drink (11.6%), samosas (37.3%) and patties (16.3%).
Among the junk food items samosa (42.4%), tikki/chat (39.7%), noodles (25.4%), burger
(24.5%) and pizza (23.3%) were preferred most by the adolescents.
The results of the present study depicted that 49 per cent of urban subjects consumed
pav bhaji once in a fortnight whereas 50 per cent of rural subjects consumed it rarely. Mean
frequency of pav bhaji consumption was noted as 2.02  0.85 and 1.65  0.74 for urban and
rural adolescent boys, displaying a significantly (P ≤ 0.01) higher consumption of pav bhaji
among urban adolescent boys since pav bhaji is one of the traditional and more popular fast
food item among urban adolescent boys. It was also observed that pav bhaji was prepared by
urban mothers more oftenly. Thirty nine per cent of urban subjects consumed paneer wrap
once in a fortnight whereas 45 per cent of rural subjects consumed paneer wrap rarely as it
was also an item available in Mc donalds, an outlet seen in urban areas only. Table 4.11
further showed that the mean frequency of paneer wrap consumption was 1.67  0.83 and
53
0.70  0.72 for urban and rural adolescent boys. A significantly (P ≤ 0.01) lower frequency of
consumption by rural in contrast to urban subjects was observed. On perusal of the data it was
found that 40 per cent of urban while 56 per cent of rural subjects consumed pastry once in a
fortnight. The mean frequency of pastry consumption was found to be 2.06  0.89 for urban
and 1.85  0.80 for rural subjects, with a non-significant difference between the two groups
since it was easily available in both the urban and rural canteens.
Majority of rural adolescent boys (62%) while 40 per cent of urban adolescent boys
consumed paneer pakora once in a fortnight. The results showed that the mean frequency of
paneer pakora consumption was 2.35  1.01 for urban and 2.35  0.54 for rural subjects
depicting a non-significant difference between the two groups since paneer is easily available
both in urban and rural areas. It was noted that panner pakora was prepared by mothers in
both the areas. The data showed that 44 per cent of urban and 35 per cent of rural adolescent
boys consumed sandwiches twice a week. A significantly (P ≤ 0.01) higher consumption of
sandwiches was observed among urban subjects (4.07  0.84) than their rural (3.15  1.39)
counterparts. Table 4.10 showed that 59 per cent of urban whereas 41 per cent of rural
subjects consumed samosa twice a week. The mean frequency of samosa consumption was
noted as 3.97 ± 0.64 for urban and 3.23  1.04 for rural adolescent boys. The difference
between the frequencies was found to be significant (P ≤ 0.01), favouring urban subjects.
Though samosa was available in both rural and urban canteens but urban boys consume it
more oftenly as greater percentage of them were not bringing their packed lunches to school
and enjoyed this snack in the canteen. The above results were in line with the study by Sadana
and Khanna (1999) who revealed that among deep fried foods, samosa, vada, bread pakora,
paneer pakora, cutlets and chips were consumed while noodles, burger, hotdog and masala
dosa were shallow fried fast foods consumed by teenagers. Adolescents were also frequently
consuming pizza, patty and pastry as the baked fast food.
It was further revealed that majority of urban subjects (42%) consumed soft drinks
thrice a week while 41 per cent of rural subject consumed them twice a week. Table 4.9
depicted significantly higher mean frequency of soft drink consumption among urban (3.54 
1.00) than rural (3.10  1.28) adolescent boys. Rao et al (2007) also observed that 48 per cent
of them consumed aerated drinks 1-2 times a week. Table 4.10 indicated that 37 per cent of
urban and 39 per cent of rural adolescents consumed spring rolls once in a fortnight. The
mean frequency of spring roll consumption was recorded as 1.52 ± 0.79 for urban and 1.39 ±
0.98 for rural adolescent boys with a non significant difference between the two groups. Forty
four per cent of urban subjects consumed veg pakora once in a fortnight while 36 per cent of
rural subjects consumed it once a week. A non-significant difference was found for veg
pakora consumption between the urban (2.73 ± 0.83) and rural (2.53  0.94) adolescent boys
54
since it was prepared in both urban and rural homes. It was further revealed that 47 per cent of
urban whereas 43 per cent of rural subjects consumed veg roll once in a fortnight. Table 4.11
elucidated the mean frequency of veg roll consumption as 1.98 ± 0.94 and 1.34 ± 0.88 for
urban and rural adolescent boys with a difference which was statistically significant (P ≤
0.01), favouring urban adolescent boys.
Fast food consumption was found more frequently consumed by majority of the urban
than the rural adolescent boys, since availability of fast food is more in urban areas. Various fast
food outlets have been established in attractive settings in urban areas. Some traditional fast
food items like samosa, fryams, pav Bhaji, chhole kulche, Chhole bhature, cream roll etc are
considerably consumed in rural areas too. Most of the rural adolescent boys were unaware of
the modern fast food outlets and their items like Mc puff, momos, paneer wrap etc. The fast
food consumption pattern prevailed higher among urban than rural adolescent boys. The study
by Baric et al (2007) also reported that the consumption of fast food, soft drinks and alcohol
was found to be more prevalent and more linked with dietary behaviour in the urban than in
rural area. The present results about fast food consumption pattern of adolescents were in line
with the study by Hejazi and Mazloom (2009) which reported that 82.6 per cent adolescents
consumed fast food on weekly basis. Similarly it was found that adolescents visit fast food
outlets more than twice a week (French and Story 2001). Kumar et al (2006) also affirmed that
majority of the adolescent respondents (73.2%) were occasional consumers of fast food.
Categories of frequency of fast food consumption
Table 4.12: Categories of frequency of fast food consumption
Categories of
frequency*
Urban
(n=100)
Rural
(n=100)
Low (0-2)
Bhelpuri, salty biscuits, crax,
egg roll, fryams, grilled
sandwich, hot dog, kurkure,
momos, muffins, Mc puff,
paneer wrap, spring rolls, veg
roll.
Cheese chilly, crax, egg roll, finger
fries, fryams, grilled sandwich, hot
dog, kukure, macroni, manchurian,
momos, muffins, Mc puff, pizza,
paneer wrap, pastry, spring rolls, pav
bhaji, veg roll.
Moderate (2-4)
Aloo tikki, bread pakora, cream
biscuits, burger, cheese chilly,
chips, cream roll, chhole
bhature, chocolates, cakes,
candies, finger fries, golgappe,
ice cream, kulche chhole,
macroni, manchurian, maggi,
noodles, patties, pav bhaji,
pizza, pastry, paneer pakora,
samosa, soft drink, veg pakora.
Aloo tikki, bhelpuri, cream biscuits,
salty biscuits, bread pakora, burger,
chips, cream roll, chhole bhature,
chocolates, cakes, candies, golgappe,
ice cream, kulche chhole, maggi,
namkeens, noodles, patties, paneer
pakora, sandwich, samosa, soft drink,
veg pakora.
High (4-6)
Sweet
biscuits,
sandwiches
namkeens, Sweet biscuits
*Mean frequency
55
Table 4.12 highlights the categories of frequency of fast food intake among urban and
rural adolescent boys. The data highlighted that out of 44 fast foods identified, the intake of
27 food items was moderate i.e., twice a week to fortnightly, among urban adolescent boys
followed by 14 items whose consumption was low i.e., fortnightly to never. The intake of 3
fast food items was high i.e., daily to twice a week among them. However, intake of 24 fast
food items was high among rural adolescent boys followed by 19 items whose frequency of
consumption was low. It was further observed that intake of only one fast food item was high
among rural subjects.
4.4 Nutritional Status
4.4.1 Food Intake
The average daily intake of food and its per cent adequacy has been presented in
tables 4.13 and 4.14 and fig 4.1.
Cereal
The data revealed that the consumption of cereals among the urban and rural
adolescent boys as 368.89  79.21g and 400.24  69.84 g. The variation in the intake was
found to be significantly (p  0.01) higher among rural than urban subjects. It was further
revealed that the intake of cereal was 92 and 100 per cent for urban and rural adolescent boys.
The intake of cereals was found to be adequate (≥ 90% of SDI) for both urban and rural
adolescent boys. The cereal intake in the form of chapattis was observed to be higher in rural
areas. The present results are in confirmation with the results of the study by Sarupriya and
Mathew (1988) which reported higher consumption of cereals among adolescents.
Pulses and legumes
The mean daily consumption of pulses was 33.86  6.59g for urban and 37.44 
7.25g for rural adolescent boys. A significantly (P  0.01) higher consumption of pulses was
observed among rural than urban adolescent boys. However, per cent adequacy was found to
be low in both urban (56%) and rural (62%) adolescent boys though it was higher among rural
boys. It was observed that the recommended portion size of pulses was not consumed by the
boys in both the areas though some of the legumes like rajmah, bengal gram, black gram were
consumed in greater quantity by the rural subjects. Sarupriya and Mathew (1988) also
reported inadequate consumption of pulses and legumes among the adolescents.
Roots and Tubers
The daily consumption of roots and tubers was found to be 54.80  16.78g and 57.25
 12.83g for urban and rural adolescent boys with a non-significant difference between the
two groups. The adequacy of roots and tubers was found to be very low among adolescents
both in urban (27) as well as among rural (29) area (Table 4.14). Among roots and tubers only
potato was consumed in greater quantity than any other vegetable since it was available in
56
Table 4.13: Daily average food intake of urban and rural adolescent boys (n=200)
Food Item
Urban
Rural
(n=100)
(n=100)
Mean ± SE
Mean ± SE
t-value
Cereals (g)
368.89 ± 79.21
400.24 ± 69.84
2.97*
Pulses And Legumes (g)
33.86 ± 6.59
37.44 ± 7.25
3.65*
Roots And Tubers (g)
54.80 ± 16.78
57.25 ± 12.83
1.16NS
Green Leafy Vegetables (g)
62.89 ± 13.09
75.71 ± 17.25
5.92*
Other Vegetables (g)
50.77 ± 11.97
51.17 ± 11.73
0.24NS
Milk and Milk Products (g)
332.25 ± 55.79
383.05 ± 57.67
6.33*
Sugar and Jaggery (g)
36.28 ± 9.56
40.84 ± 8.47
3.57*
Fruits (g)
65.03 ± 20.66
69.29 ± 19.91
1.49NS
Meat And Chicken (g)
20.85 ± 2.76
28.75 ± 58.43
1.35NS
Fats and Oils (g)Δ
39.12 ± 2.83
36.99 ± 1.97
6.18*
*Significant at 1% level
**Significant at 5% level
Δ
Visible fats
Table 4.14: Per cent adequacy of food intake by urban and rural adolescent boys (n=200)
Food Items
Urban
Rural
(n=100)
(n=100)
Cereals
92
100
420 g
Pulses and legumes
56
62
60 g
Roots and Tubers
27
29
100 g
Green Leafy vegetables
63
76
100 g
Other Vegetables
51
51
100 g
Milk and Milk Products
66
77
500 g
Sugar and Jaggery
104
117
35 g
Fruits
65
69
100 g
Meat and Chicken
42
57
50 g
Fats and Oils
156
148
25 g
*Suggested Dietary Intake, ICMR (1999)
57
SDI (g)*
Percent SDI
180
160
140
120
100
80
60
40
20
0
156
148
117
104
100
92
62
63
56
27
29
76
51
51 66
77
65 69
57
42
Urban
Rural
Food groups
Fig.4.1: Per cent adequacy of food intake by urban and rural adolescent boys.
variety of processed forms like chips, finger fries, aloo chaat, burgers etc. Other roots and
tubers like radish, carrot, sweet potato were not included in such forms therefore were not
preferred by the boys. Salad consumption was also found to be very low among boys in both
the areas.
Green Leafy Vegetables
The results (Table 4.13) indicated that the intake of green leafy vegetable was
significantly (P ≤ 0.01) higher among rural 75.71  17.25g than urban 62.89  13.09g
adolescent boys. Further, the adequacy of intake of green leafy vegetables was observed
to be low among both urban (63) and rural (76) adolescent boys though it was
comparatively higher among rural subjects (Fig. 4.1). Most of the adolescent boys
disliked green leafy vegetables like bathua, fenugreek leaves and spinach, and stated that
their parents made a compulsion for them to eat. Only mustard leaves were preferred by
them. It was also observed that consumption of greens like fenugreek and bathua leaves
was found more frequently consumed by rural adolescent boys. It was reported that the
average intake of green leafy vegetables was relatively higher among the tribal
adolescents compared to their rural counterparts, while that of other vegetables were
similar (Rao et al, 2006).
58
Other vegetables
The intake of other vegetables was 50.77  11.97g for urban and 51.17  1173g for
rural adolescent boys, displaying a non-significant difference in the intake between the
subjects (Table 4.13). The adequacy of other vegetables among urban and rural adolescent
boys was found to be nearly half of the suggested dietary intake i.e., 51 per cent each because
most of the boys from both the areas disliked many of the vegetables like brinjal, capsicum,
French beans, bottlegourd, bittergourd, pumpkin, turnip etc. However, French and Story
(2001) reported 29 per cent less vegetable consumption among adolescents.
Milk and Milk Products
The average intake of milk and milk products was reported to be 332.25  55.79 and
383.05  57.67 g for urban and rural adolescent boys. The variation in intake was significant
(P ≤ 0.01), favouring rural subjects, since the production and availability of milk and milk
products is greater in rural areas of Punjab, the intake was found higher in rural than in urban
area. The adequacy of Milk and its products was reported to be 66 and 77 per cent for urban
and rural subjects (Fig. 4.1). Perez and Zomora (1996) also found that the adolescents had
some deficiencies in intake of milk and milk products (75%) when compared to
recommended dietary allowances.
Sugar and Jaggery
The results revealed that the intake of sugar and jaggery was 36.28  9.56g for urban
and 40.84  8.47g for rural adolescent boys with rural boys consuming significantly (P ≤
0.01) higher than the urban subjects (Table 4.13). However, the intake of sugar and jaggery
was found to be higher than that of suggested dietary intake of 25 g among both urban (104)
and rural (117) subjects, but was higher among urban boys (Fig. 4.1). Adolescent boys
consumed more table sugar, sweets, bakery and fast food items which might have contributed
to higher intakes than recommended.
Fruits
The mean daily consumption of fruits was 65.03  20.66g for urban and 69.29 
19.91g for rural adolescent boys. The two groups exhibited a non-significant difference
between the intakes. Fruits intake was found to be deficit by 35 and 31 per cent among urban
and rural adolescent boys (Table 4.14). Fruit consumption was inadequate in both the groups
since most of the boys had specific choices for fruits and were also unaware of the health
benefits that fruits provide. Adolescent boys preferred fast food items that are available by a
multitude of street vendors instead of fruit juices or fruit chaat. The results were in
confirmation with the study by Perez and Zomora (1996) that the adolescents consumed
inadequate amount of fruits (62%) compared to RDA. Paeratakul et al (2003) also observed
that the intake of other (non citrus) fruits and juices, milk, and legumes among those who
59
consumed fast food was lower compared with the intake of those who did not report eating
fast food.
Meat and Chicken
The data elucidated the mean daily intakes of meat and chicken as 20.85 ± 2.76 for
urban and 28.75  58.43g for rural adolescent boys, depicting a non-significant difference
between the intakes. The per cent adequacy was revealed as 42 and 57 per cent of SDI of 50 g
for urban and rural subjects. It was observed that meat and chicken was prepared in both
urban and rural homes rarely i.e., once a month or once in a fortnight and was preferred
mostly during some festive occasions. Adolescent boys reported to consume non-vegetarian
food items mostly in the fast food outlets and its frequency was low.
Fats and Oils
The results revealed that the intake of visible fats and oils was and 39.12  2.83
and 36.99  1.97g for urban and rural adolescent boys. The two groups exhibited a
statistically significant (P ≤ 0.01) difference between the intakes favouring urban
adolescent boys. The adequacy was 156 and 148 per cent for urban and rural subjects (Fig.
4.1). The high intake of fats and oil was contributed by daily consumption of parathas,
butter, ghee in diets of majority of subjects as well as it was recorded higher in urban
subjects due to more frequent consumption of fast foods than the rural subjects. The
results were in confirmation with the study by Hejazi and Mazloom (2009) reporting that
consumption of fat (37% energy, 566 Kcal with 12 per cent saturated fat; 183 Kcal) was
high as compared to recommended 20-35 per cent of calories (306-535 Kcal) from fat and
less than 10 per cent of calories (153 Kcal) from saturated fat among adolescents.
Thus it may be concluded that intake of cereals was adequate among rural while it
was nearly adequate among urban boys. The intake of pulses and legumes (56 and 62%),
green leafy vegetables (63 and 76), milk and milk products (66 and 77%) and fruits (65 and
69%) was found to be inadequate as compared to the SDI values among both urban and
rural boys but was lower among urban adolescents. The intake of roots and tubers was
below 50 per cent of SDI among both urban (27%) and rural (29%) boys. The intake of
meat and chicken was below 50 per cent for urban (42%) while it was 57 per cent of SDI
among rural subjects. The adequacy of intake of other vegetables was found to be nearly
half of the SDI values for both urban and rural (51%) subjects. It was further observed that
intake of fats was higher than the SDI values in both the groups, but was higher among
urban (156%) than rural (148%) subjects. On the whole it can be stated that consumption of
fast food among adolescent boys, contributed to high intake of fats and oils and inadequate
intake of all the food groups. Perez and Zomora (1996) also observed that the adolescents
had a very low intake of vegetables (64%), some deficiencies in the intake of milk products
60
(75%) and fruits (62%) and excessive intake of fats (112%) as compared to recommended
dietary allowances. Intake of meat and cereal foods was adequate and agreed with the
recommendation for adolescent population.
4.4.2 Nutrient Intake
In nutritional research, it is more common to consider food consumption in terms of
nutrient intakes than in terms of food consumed. The average daily nutrient intake and its per
cent adequacy have been presented in table 4.15 and 4.16 and Fig 4.2.
Energy
The average daily intake of energy by the selected boys was 2382.8  276.87 Kcal for
urban and 2446.94  195.78 Kcal for rural adolescent boys. A non-significant difference was
observed between the intakes of rural and urban adolescent boys. The energy intake was
found to be nearly adequate among both urban (90%) and rural (93%) adolescent boys since
higher percentage of energy was supplied from fat among both urban (34%) and rural (31%)
subjects. However, Leal et al (2010) reported only 70 per cent of energy intake by the
adolescent boys.
Table 4.15: Average daily nutrient intake by urban and rural adolescent boys (n=200)
Urban
(n=100)
Rural
(n=100)
Mean ± SE
Mean ± SE
2382.8 ± 276.87
2446.94 ± 195.78
1.89NS
56.36 ± 9.09
60.11 ± 8.76
2.97*
336.21 ± 59.72
364.02 ± 41.48
3.83*
90.28 ± 9.50
83.38 ± 8.56
5.39*
β-carotene (μg)
992.38 ± 390.95
1043.22 ± 296.42
1.04NS
Thiamine (mg)
0.85 ± 0.17
0.98 ± 0.20
4.95*
Riboflavin (mg)
0.98 ± 0.25
1.14 ± 0.24
4.62*
Niacin (mg)
10.45 ± 2.09
12.20 ± 2.34
5.57*
Vitamin B12 (μg)
0.08 ± 0.02
0.12 ± 0.09
4.34*
Folacin (μg)
72.92 ± 7.28
83.45 ± 10.29
8.35*
Ascorbic acid (mg)
27.35 ± 4.14
29.58 ± 4.84
3.50*
Iron (mg)
31.02 ± 12.74
30.31 ± 9.90
0.44NS
Calcium (mg)
363.84 ± 68.28
386.74 ± 77.87
2.21**
Nutrients
Energy (Kcal)
Protein (g)
Carbohydrates Δ (g)
Fat* (g)
*Significant at 1% level
**Significant at 5% level
*30% of the Non-Protein Calories
Δ
70% of the Non-Protein Calories
61
t-value
Table 4.16: Per cent adequacy of nutrient intake by urban and rural adolescent boys (n=200)
Nutrients
Urban
(n=100)
Rural
(n=100)
RDA
Energy
90
93
2640 Kcal
Protein
72
77
78 g
Carbohydrates
83
89
407 g
Fat
116
107
78 g
β-carotene
41
43
2400 μg
Thiamine
83
95
1.3 mg
Riboflavin
61
71
1.6 mg
Niacin
61
72
17 mg
Vitamin B12
40
60
0.2 μg
Folacin
73
83
100 μg
Ascorbic acid
68
74
40 mg
Iron
62
61
50 mg
77
500 mg
73
Calcium
RDA= Recommended Dietary Allowance, ICMR (2000)
140
116
120
107
90
100
93
77
80
95
89
83
83
83
61
60
41
40
72
71
72
61
43
73
60
40
74
68
73
62
77
61
Urban
Rural
20
0
Fig.4.2: Per cent adequacy of nutrient intake by urban and rural adolescent boys.
Protein
The results showed that the mean intake of protein in urban and rural adolescent boys
was 56.36 ± 9.09 and 60.11  8.76g. The protein intake was found to be significantly (P ≤
0.01) higher among rural than urban adolescent boys. The per cent adequacy of protein intake
was reported to be low among both 72 and 77 per cent for urban and rural adolescent boys
62
though it was observed higher among rural boys. The diets of adolescent boys were deficit in
protein rich foods like pulses, legumes, milk and milk products, meat and chicken, though a
better consumption of such products were found among rural subjects. The present results
were in line with the study by Rao et al (2006) who stated that the average intake of protein
among adolescents was below the recommended dietary intakes. The deficit in intake of
protein was reported to be 20-30 per cent.
Carbohydrates
Table 4.15 depicted that the mean intake of carbohydrates was significantly (P ≤
0.01) higher among rural (364.02 ± 41.48 g) than urban (336.21 ± 59.72 g) adolescent boys.
Further the per cent adequacy was revealed as 82.61 and 89.44 per cent for urban and rural
adolescent boys. Sargent et al (1994) also found inadequate intake of carbohydrates by the
adolescents.
Fat
Table 4.15 presents the average daily intake of total fat by urban and rural adolescent
boys as 90.28  9.50g and 83.38  8.56 g. A significantly (P ≤ 0.01) lower intake by rural in
contrast to urban subjects was observed. The adequacy of fat intake was noted as 116 and 107
per cent in urban and rural adolescent boys. In a study by Munoz et al (1997) fat intake was
found to be above the recommended dietary allowances owing to greater consumption of fast
food items among the adolescents.
-carotene
The ingested values for - carotene were 992.38  390.95g and 1043.22  296.42g
for urban and rural adolescent boys displaying a non-significant difference. The per cent
adequacy for urban and rural adolescent boys was observed as 41 and 43 per cent. The
findings were confirmed by Leal et al (2010) who reported the intake of β-carotene below the
recommended for 86 per cent of the boys and there was a positive association between being
male and low intake of β-carotene. (Leal et al, 2010).
Thiamine
Thiamine intake was reported to be 0.83  0.17 and 0.98  0.20mg for urban and rural
adolescent boys, with a significant (P  0.01) difference, rural adolescent boys having a
higher intake of the vitamin in comparison to their urban counter parts (Table 4.15). The
adequacy was found to be 83 and 95 per cent for urban and rural adolescent boys (Table
4.16). Dapi (2010) also reported a higher intake of thiamine in rural than in urban adolescents.
Riboflavin
The intake of vitamin B2 was noted to be 0.98  0.25 and 1.14  0.24 mg for urban
and rural adolescent boys. The difference of the mean intake was significant (P  0.01) for
63
rural subjects ingesting a greater amount of the vitamin than the urban subjects. The
adequacy was 61 and 71 per cent for urban and rural adolescent boys. The results were in
confirmation with the study by Rao et al (2006) stating that the average intake of
riboflavin by adolescent boys was below the Recommended Dietary Allowances (RDA).
The extent of deficit in the intake of micronutrient was 40-50 per cent.
Niacin
The data (Table 4.15) showed that intake was 10.45  2.0 and 12.20  2.34 mg for
urban and rural adolescent boys. A significantly (P  0.01) higher intake of vitamin was
observed among rural than urban adolescent boys. The per cent adequacy was reported to be
61 and 72 per cent for urban and rural subjects. Olivares et al (2004) also reported a lower
intake of niacin as compared to recommended dietary intakes among adolescents.
Vitamin B12
The intake of Vitamin B12 was 0.08 ± 0.02 μg for urban and 0.12  0.09 g for rural
adolescent boys. A significant (P ≤ 0.01) difference persisted between the intakes of the
nutrient between the two groups, with rural adolescent boys reporting a higher intake.
Vitamin B12 is found only in animal sources. Meat and chicken intake was found to be
inadequate among both rural and urban boys, though a higher percentage of non-vegetarians
was recorded in rural areas. Dapi (2010) also observed that the proportion of the adolescents
below the recommendations for vitamin B12 was significantly lower among the urban than
rural areas. The per cent adequacy was revealed as 40 and 60 per cent for urban and rural
adolescent boys (Fig. 4.2).
Folacin
The average intake of folacin was observed as 72.92  7.28g and 83.45  10.29g
for urban and rural adolescent boys, with rural subject reporting a significantly (P  0.01)
higher intake of folacin than their urban counter-parts. The adequacy of the vitamin was 73
and 83 per cent for urban and rural subjects. Hurson and Corish (2008) also found that
micronutrient intake for iron and folate achieved only 83 and 78 per cent of the recommended
nutrient intake for boys of 15–18 years.
Ascorbic Acid
The mean daily intake of ascorbic acid was found to be 27.35  4.14 mg and 29.58 
4.84 mg for urban and rural adolescent boys, with rural boys reporting a significantly (P ≤
0.01) higher intake of vitamin than the urban boys. Adequacy of the vitamin was observed as
68 and 74 per cent of RDA of 40 mg for urban and rural subjects. The inadequate intake of
ascorbic acid was primarily due to lesser consumption of green leafy vegetables and fruits by
both urban and rural adolescent boys. The results are in confirmation with the reported
64
literature. Dapi (2010) stated that the adolescents with high, middle and high Socio Economic
Status were all below the RDA for median intakes of vitamin C.
Iron
The data on nutrient intake revealed that the average daily intake of iron by urban
adolescent boys was 31.02  12.74 mg and by rural subjects was 30.31  9.90 mg depicting a
non-significant difference between the two groups. However, the adequacy was reported to be
low among both urban (62%) and rural (61%) subjects. The inadequate intake of iron might
be attributed to the poor intake of green leafy vegetables and other iron rich foods.
Calcium
The data showed that the average daily calcium intake was significantly (P  0.05)
higher among rural (386.74  77.87 mg) than urban (363.84  68.28 mg) adolescent boys.
The adequacy of calcium intake was reported to be 73 and 77 per cent for urban and rural
adolescent boys (Fig. 4.2). The probable reason might be low intake of milk and milk
products among both the urban and rural adolescent boys, though it was found higher among
rural boys. The results were in accordance with Leal et al (2010) who have reported that 90
per cent of the boys ingested insufficient quantity of calcium.
Thus it is evident from these results that the energy intake was nearly adequate in
urban and rural adolescent boys. The intake of fat was much higher than that of RDA among
both the groups. Further, the intake of protein, β-carotene, thiamine, riboflavin, iron, niacin,
folacin, vitamin B12, ascorbic acid, and calcium was inadequate among both urban and rural
adolescent boys. The deficiency in the intake of protein and micronutrient intake might be
attributed to the fact that there was more consumption of fast food among both urban and
rural areas, which only contributed to empty calories. Though rural adolescent boys had lower
frequency of fast food consumption, yet they had enough of it to lower the micronutrient
adequacy. Another reason was that the adolescent boys were unaware of the balanced diet, its
impact on health and the role of nutrients in the body as was evident by pre-testing their
knowledge level. The present results are in line with the observations by Paeratakul et al
(2003) who assessed the food consumption pattern and dietary intake profiles of adolescents
(14-18 years) and reported that fast food is especially popular among adolescents, who on
average visit a fast-food outlet twice per week. The adolescents who reported eating fast food
had a significantly lower intake of bread and cereals. They also consumed fewer dark green
vegetables and other vegetables but significantly more fried potatoes. The intake of other
fruits (non-citrus), milk and legumes was lower compared with the intake of those did not
report eating fast food. The adolescents who reported eating fast food had a significantly
higher intake of total energy and fat, and a lower intake of protein, vitamin A, and β-carotene
compared with adolescents who did not report eating fast food.
65
Per cent contribution of carbohydrates, protein and fat to the total energy intake of
selected urban and rural adolescent boys
Analyzing the contribution of proximate principles to the total energy intake
(Table 4.17 and fig 4.3 and 4.4 ), it was found that on an average carbohydrates, protein
and fat contributed 57, 9 and 34 per cent respectively to the total energy intake of urban
adolescent boys. However the contribution by carbohydrates, protein and fat to total
energy intake of rural boys was 59, 10 and 31 per cent respectively. In comparison with
the ICMR (2000) recommendations, the contribution of carbohydrates to total energy
intake was observed to be nearly adequate among both urban and rural adolescent boys.
Protein was below the recommendations among urban subjects but was on the borderline
among rural subjects. However, fat was higher than the recommendations for urban and
rural subjects, but was observed to be higher among urban adolescent boys. Jelia et al
(1990) analyzed the diets of adolescents and concluded that energy intake averaged 3,006
Kcal/day for boys. Approximately 34 per cent of total energy was supplied by fat in the
Table 4.17: Per cent contribution of carbohydrates, protein and fat to the total energy
intake of selected urban and rural adolescent boys (n=200)
Recommended*
Urban
(n=100)
Rural
(n=100)
Carbohydrates
55-70
57
59
Protein
10-15
9
10
Total fat
20-30
34
31
Proximate principles
* ICMR (2000)
34
Carbohydrates
Protein
57
Total fat
9
Fig.4.3: Per cent contribution of carbohydrates, protein and fat to the total energy
intake of selected urban adolescent boys.
66
31
Carbohydrates
Protein
59
Total fat
10
Fig.4.4: Per cent contribution of carbohydrates, protein and fat to the total energy
intake of selected rural adolescent boys.
diets, saturated fat accounted for more than 12 per cent of energy whereas less than 5 per
cent was found polyunsaturated fat. Further, Cole et al (1997) reported the contribution of
total energy from carbohydrate, protein and fat were 52.2, 12.5 and 28.3 per cent
respectively.
4.4.2 Anthropometric Status
Measurement of growth has been a widely used tool for assessment of health or
nutritional status of adolescents. For the evaluation of growth performance, the observed
level of growth has to be compared with a standard, which is considered to best represent the
‘normal’ growth (Gopaladas and Seshadri 1987). The World Health Organisation (WHO) in
1996 made provisional recommendations for the interpretation of anthropometric data during
adolescence and recommend the use of the National Centre for Health Statistics (NCHS)
reference values for comparison.
Table 4.18: Anthropometric profile of urban and rural adolescent boys (n=200)
Parameters
Urban
Rural
t- value
(n=100)
(n=100)
16-17 years
165.50 ± 6.00
170.13 ± 2.32
2.42**
17-18 years
169.57 ± 4.79
172.85 ± 8.25
3.29**
16 -17 years
52.57 ± 10.01
58.60 ± 8.60
1.39NS
17-18 years
**Significant at 5% level
61.97 ± 6.18
61.42 ± 7.76
0.53NS
Height (cm)
Weight (kg)
67
Table 4.19: Percentage of height and weight of urban and rural adolescent boys in
comparison to standards (n=200)
Parameters
NCHS
Urban
Rural
ICMR
Urban
Rural
(cm)
(%)
(%)
(cm)
(%)
(%)
16-17 years
171
97
99
168
98
101
17-18 years
175
97
98
173
98
100
16-17 years
58
91
101
55
95
105
17-18 years
63
99
98
58
107
106
Height (cm)
Weight (kg)
NCHS, ICMR (ICMR 2000)
Height
The mean height of the selected adolescent boys and its comparison with ICMR and
NCHS standards has been presented in Table 4.18 and 4.19 and Fig 4.5 and 4.6.
Table 4.18 shows the mean height of urban and rural adolescent boys aged 16-17
years to be 165.50 ± 6.00 cm and 170.13 ± 2.32 cm, while of those aged 17-18 years was
169.57 ± 4.79 cm and 172.85 ± 8.25 cm. The analysis brought out that urban boys were
significantly (P ≤ 0.05) shorter than their rural counterparts in both the age groups.
99.5
99
Percenntage
99
98.5
98
98
97.5
Urban
97
97
97
Rural
96.5
96
16-17
17-18
Age groups
Fig.4.5: Percentage of height of urban and rural adolescent boys in comparison to
NCHS standards.
68
Percentage
101.5
101
100.5
100
99.5
99
98.5
98
97.5
97
96.5
101
100
Urban
98
98
16-17
Rural
17-18
Age group
Fig.4.6: Percentage of height of urban and rural adolescent boys in comparison to
ICMR standards.
The comparison of the present values with NCHS standards revealed that the mean
height was 97 and 99 per cent for 16-17 years adolescents and 97 and 98 per cent for 17-18
years urban and rural adolescent boys (Fig. 4.5). Similarly, when these values were compared
with ICMR standards, it was revealed that mean height was 98 and 101 per cent (16-17 years)
and 98 and 100 per cent (17-18 years) for urban and rural adolescent boys (Fig. 4). On the
whole it was found that rural adolescent boys were taller than their urban counterparts, but
heights of both urban and rural adolescent boys were comparable to the international as well
as national standards.
Weight
The mean weight of the urban and rural subjects and its comparison with NCHS and
Percentage
ICMR standards has been presented in Table 4.18 and 4.19 and Fig 4.7 and 4.8.
102
100
98
96
94
92
90
88
86
101
99
98
Urban
91
Rural
16-17
17-18
Age group
Fig.4.7: Percentage of weight of urban and rural adolescent boys in comparison to
NCHS standards.
69
Percentage
108
106
104
102
100
98
96
94
92
90
88
107
105
106
Urban
95
Rural
16-17
17-18
Age group
Fig.4.8: Percentage of weight of urban and rural adolescent boys in comparison to
ICMR standards.
The data indicated that the mean weight of the urban and rural adolescent boys
aged 16-17 years was 52.57 ± 10.01 and 58.6 ± 8.60 kg, and for those aged 17-18 years, it
was 61.97 ± 6.18 and 61.42 ± 7.76 kg. The difference of means was found to be nonsignificant in both the age groups in urban and rural subjects. Ahmad et al (2009) also
reported the mean weight of adolescent boys as 52.3 ± 10.8 kg. The collation of present
values with NCHS standards (Table 4.19) revealed that mean weight was 91 and 101 per
cent for urban and rural adolescent boys aged 16-17 years. For rural and urban subjects
aged 17-18 years the mean weight was 99 and 98 per cent of the standard values.
Similarly when these values were compared with ICMR standards, it was revealed that
the mean weight of urban and rural adolescent boys aged 16-17 years was 95 and 105 per
cent (Fig. 4.8). The mean weight for urban and rural subjects in the age group of 17-18
years was found to be 107 and 106 per cent. It was noted that the weight of rural
adolescent boys in both the age groups was comparable with the NCHS standards,
however, higher than the ICMR standards. It was further recorded that the weight of
urban adolescent boys was comparable to NCHS and ICMR standards but only in the age
group of 17-18 years, was higher than ICMR standards. However, Pai and Naik (1989)
revealed that all adolescents were significantly below the ICMR standard both in height
and weight.
Classification of the subjects based on BMI
The classification of the subjects based on BMI is presented in table 4.20 and Fig.
4.9. BMI for age was recommended as the best indicator for use in adolescence (Himes and
Bouchard 1989).
70
Table 4.20 Classification of subjects according to Body Mass Index, BMI (n=200).
(Percentage)
Rural
BMI
Urban
Categories #
(n=100)
(n=100)
14
27
48
41
13
12
24
20
1
-
< 18.5
Underweight
18.5 - 22.9
Normal
23 - 24.9
At risk of obesity
25 - 29.9
Obese I
>30
Obese II
# Cole et al (2000)
60
48
Percentage
50
41
40
27
30
20
24
14
13
Urban (n=100)
20
Rural (n=100)
12
10
1
0
Underweight
Normal
At risk of
Obese I
obesity
BMI categories
Obese II
Fig. 4.9: Classification of subjects according to Body Mass Index.
The findings (Table 4.20) revealed that more of the rural (27%) subjects were
underweight as compared to their urban (14%) counterparts. While 41 per cent of rural and 48
per cent of urban boys were found to be under normal category. The results further indicated
that nearly same percentage of urban (13%) and rural (12%) boys were at risk of obesity
while more of the urban (24%) than rural (20%) adolescent boys were identified as ‘Grade I’
obese. One per cent of the urban adolescent boys were also identified as ‘Grade II’ obese. A
higher percentage of adolescent boys was found to be obese in urban (38%) than in rural
(32%) areas due to greater consumption of fast food and lesser physical activity than their
71
rural counterparts. The results are in confirmation with Olumakaiye et al (2010) who stated
that prevalence of underweight was more common in rural (22.1%) than urban adolescents
(18.7%). Underweight prevalence was highest among those who ate three meals and no
snacks daily (28.6%) and least among those who ate three meals and snacks twice daily
(15.9%). However, Ahmad et al (2009) reported that 14.1 per cent of adolescents were obese
or overweight and 12.2 per cent of them were underweight. It was further reported by
Olivares et al (2004) that 13.1 per cent of adolescent boys were obese.
4.5 Impact of nutrition intervention
4.5.1 Food consumption pattern
General food consumption pattern of urban adolescent boys
Table 4.21 depicted the impact of nutrition intervention on the mean frequencies of
general food consumption among urban adolescent boys. On perusal of data it was revealed
that among cereals, the mean frequency of parantha consumption was 5.15 ± 1.07 before
intervention and 5.01 ± 1.03 after intervention with a significant (P ≤ 0.01) difference
showing a decreased consumption of parantha.
Among whole pulses and legumes the mean frequencies of rajmah (3.06  0.067
to 3.20 ± 0.60) and Bengal gram (3.10 ± 0.79 to 3.35 ± 0.82) consumption increased
significantly (P ≤ 0.01), (P ≤ 0.05 after the intervention, thus displaying a positive impact.
The data highlighted that in the food group of milk and milk products the mean
frequency of curd consumption was 4.41 ± 0.97 before intervention and 4.62 ± 0.90 after
intervention, depicting a significant (P ≤ 0.01) improvement in consumption among urban
subjects. Among green leafy vegetables the mean frequency of fenugreek leaves and
spinach consumption was revealed as 3.14 ± 0.89 and 3.28 ± 0.91 before the intervention
which significantly (P ≤ 0.01) increased to 3.08 ± 0.75 and 3.26 ± 0.78 respectively, after
the intervention. A positive impact was thus observed. Table 4.21 elucidated that in the
food group of roots and tubers the mean frequency of radish consumption significantly (P
≤ 0.01) increased to 4.32 ± 0.77 from 4.18 ± 0.76 after the intervention thus depicting a
positive impact of intervention. Fruits consumption by urban subjects increased after the
intervention. A significant (P ≤ 0.01) impact was thus observed with mean frequencies as
3.91 ± 0.93 before intervention and 4.21 ± 0.89 after intervention. The mean frequency of
sweets consumption was revealed as 3.56 ± 0.94 before intervention which decreased to
3.52 ± 0.93 after intervention showing a significant (P ≤ 0.05) impact of the intervention.
Further, the data highlighted a positive impact of nutrition intervention on
general food consumption pattern, though not to large extent. The frequency of
consumption of general food items like parantha and sweets decreased while that of
rajmah, whole bengal gram, curd, fenugreek leaves, spinach, radish and fruits increased
significantly.
72
Table 4.21: Impact of nutrition intervention on general food consumption pattern of
urban adolescent boys (n=100)
Food items
Pre-Intervention
Mean ± SE
Post-Intervention
Mean ± SE
t-value
6.00 ± 0.00
5.15 ± 1.07
1.99 ± 0.80
4.06 ± 0.87
3.03 ± 1.07
3.20 ± 0.97
2.74 ± 0.91
6.00 ± 0.00
5.01 ± 1.03
1.93 ± 0.74
4.00 ± 0.88
2.97 ± 1.06
3.18± 0.99
2.74 ± 0.91
0.00NS
3.11*
1.92NS
1.75NS
1.92NS
1.42NS
0.00NS
3.10 ± 0.79
3.10 ± 0.72
2.83 ± 0.85
2.04 ± 0.79
3.39 ± 0.99
3.06 ± 0.67
3.35 ± 0.82
3.10 ± 0.72
2.83 ± 0.85
2.04 ± 0.79
3.39 ± 0.99
3.20 ± 0.60
2.15**
0.00NS
0.00NS
0.00NS
0.00NS
3.65*
2.34 ± 0.89
2.91 ± 1.14
2.84 ± 0.77
1.57 ± 0.69
2.34 ± 0.89
2.91 ± 1.14
2.84 ± 0.79
1.57 ± 0.69
0.00NS
0.00NS
0.00NS
0.00NS
5.51 ± 0.92
4.08 ± 1.17
4.41 ± 0.97
3.24 ± 0.89
5.51 ± 0.92
4.11 ± 1.14
4.62 ± 0.90
3.24 ± 0.89
0.00NS
1.35NS
4.05*
0.00NS
2.32 ± 0.76
3.14 ± 0.89
3.52 ± 0.92
3.08 ± 0.75
2.32 ± 0.76
3.28 ± 0.91
3.52 ± 0.92
3.26 ± 0.78
0.00NS
3.72*
0.00NS
4.13*
4.48 ± 0.94
5.79 ± 0.56
5.39 ± 0.71
4.18 ± 0.76
1.53 ± 0.73
4.67 ± 0.62
3.91 ± 0.93
3.56 ± 0.94
4.48 ± 0.94
5.79 ± 0.56
5.39 ± 0.71
4.32 ± 0.77
1.53 ± 0.72
4.67 ± 0.62
4.21 ± 0.89
3.52 ± 0.93
0.00NS
0.00NS
0.00NS
3.72*
0.00NS
0.00NS
4.18*
2.03**
Cereals
Chapati
Parantha
Poories
Bread
Dalia
Rice
Maize chapatti
Whole pulses and legumes
Bengal gram
Back gram
Kabuli chana
Cow pea
Green gram
Rajmah
Dehusked pulses
Bengal gram
Green gram
Lentil
Red gram
Milk and milk products
Milk
Buttermilk
Curd
Paneer
Green leafy vegetables
Bathua leaves
Fenugreek leaves
Mustard leaves
Spinach
Roots and tubers
Carrot
Onion
Potato
Radish
Sweet Potato
Other Vegetables
Fruits
Sweets
*Significant at 1% level
**Significant at 5% level
73
Fast food consumption pattern of urban adolescent boys
Table 4.22 depicted the impact of nutrition intervention on mean frequencies of
consumption of fast food items among urban adolescent boys.
The mean frequencies of bread pakora consumption were 2.13  0.66 and 2.01 0.69
before and after the intervention. A significantly (P  0.01) lower frequency of consumption
was thus observed, with a positive impact. The results indicated that the frequency of sweet
biscuits consumption was 4.52  0.64 before intervention and 4.330.68 after intervention,
displaying a significant (P ≤ 0.01) positive impact of intervention. Table 4.22 revealed that
the mean frequency of cream biscuit consumption was 2.15  1.16 before intervention and
2.07  1.09 after intervention, depicting significant (P ≤ 0.01) impact of the intervention,
showing a decreased consumption. A significant (P ≤ 0.01) difference in consumption of
burger was observed after the intervention showing a positive impact with the mean
frequencies as 3.82 ± 0.86 and 3.46 ± 0.86 before and after intervention.
The variation in mean frequencies of cheese chilly consumption before and after
intervention (2.68  0.98 to 2.47  0.88) indicated a significant (P ≤ 0.01) impact of the
intervention among urban adolescent boys.The data revealed the mean frequency of chips
consumption as 3.84 ± 0.79 before intervention and 3.35  0.78 after intervention among
urban adolescent boys. The variation in frequency was found to be significant (p ≤ 0.01)
reporting a positive impact of the intervention.Table 4.22 depicted that cream roll
consumption was significantly (P ≤ 0.01) lower after the intervention, showing a positive
impact. The mean frequencies were observed as 3.69  0.92 before intervention and 3.36 
0.84 after intervention.The mean frequency of chhole bhature consumption was 2.60  0.98
before intervention and 2.39  0.87 after intervention, depicting a significant (P ≤ 0.01)
decrease in the frequency of consumption.
The data (Table 4.22) further highlighted the mean frequency of consumption of
chocolates as 3.12  0.98 before intervention and 2.83  0.73 after intervention with a
significant (P ≤ 0.01) difference, depicting a positive impact of the intervention. A
significantly (P ≤ 0.01) lower consumption of candies was observed after the intervention,
showing a positive impact. The mean frequency was 2.37 ± 1.00 before intervention and
2.22 ± 0.89 after intervention. The mean frequency of finger fries consumption was
observed as 2.12 ± 0.92 before intervention and 1.95 ± 0.81 after intervention. The variation
in mean frequencies depicted a significant (P ≤ 0.01) impact of the nutrition intervention
(Table 4.22)
The data depicted the mean frequency of grilled sandwich consumption as 1.74 
0.72 before intervention and 1.69 ± 0.66 after intervention showing a significant (P ≤ 0.05)
difference and a positive impact of intervention. The mean frequency of hot dog consumption
74
Table 4.22: Impact of nutrition intervention on fast food consumption pattern of urban
adolescent boys (n=100)
Food items
Aloo Tikki
Bhelpuri
Bread Pakora
Buiscuits (sweet)
Biscuits (salty)
Biscuits (cream)
Burger
Cheese chilly
Chips
Cream Roll
Chhole Bhature
Craxs
Chocolates
Cakes
Candies
Egg roll
Finger Fries
Fryams
Golgappe
Grilled Sandwich
Hog dog
Ice cream
Kurkure
Kulche Chhole
Macroni
Manchurian
Momos
Maggi
Muffins
Mc Puff
Namkeens
Noodles
Pizza
Patties
Pav Bhaji
Paneer wrap
Pastry
Paneer Pakore
Sandwich
Samosa
Soft drink
Spring Rolls
Veg Pakore
Veg rolls
Pre-Intervention
Mean ± SE
3.21 ± 0.87
1.71 ± 0.97
2.13 ± 0.66
4.52 ± 0.64
1.92 ± 0.99
2.15 ± 1.16
3.82 ± 0.86
2.68 ± 0.92
3.84 ± 0.79
3.69 ± 0.92
2.60 ± 0.98
1.74 ± 0.81
3.12 ± 0.98
2.01 ± 0.77
2.37 ± 1.00
1.72 ± 1.06
2.12 ± 0.92
1.56 ± 0.62
3.91 ± 0.83
1.74 ± 0.72
1.64 ± 0.79
3.43± 0.97
1.86 ± 1.03
3.47 ± 0.96
2.60 ± 1.01
2.37 ± 0.96
1.92 ± 0.82
3.71 ± 0.86
1.79 ± 0.95
1.48 ± 0.69
4.46 ± 0.66
3.28 ± 0.88
2.15 ± 0.82
3.33 ± 1.01
2.02 ± 0.85
1.67 ± 0.83
2.06 ± 0.89
2.35 ± 1.01
4.07 ± 0.84
3.97 ± 0.64
3.54 ± 1.00
1.52 ± 0.79
2.73 ± 0.83
1.98 ± 0.94
*Significant at 1% level
**Significant at 5% level
75
Post-Intervention
Mean ± SE
3.21 ± 0.87
1.71 ± 0.97
2.01 ± 0.69
4.33 ± 0.68
1.92 ± 0.99
2.07 ± 1.09
3.46 ± 0.86
2.47 ± 0.88
3.35 ± 0.78
3.36 ± 0.84
2.39 ± 0.87
1.74 ± 0.81
2.83 ± 0.73
2.01 ± 0.77
2.22 ± 0.89
1.72 ± 1.05
1.95 ± 0.81
1.56 ± 0.62
3.91 ± 0.83
1.69 ± 0.66
1.60 ± 0.74
3.07 ± 0.86
1.86 ± 1.03
3.21 ± 0.83
2.36 ± 0.93
2.15 ± 0.85
1.92 ± 0.82
3.36 ± 0.69
1.79 ± 0.95
1.48 ± 0.69
3.94 ± 0.74
2.85 ± 0.74
1.99 ± 0.70
3.01 ± 0.82
2.02 ± 0.85
1.55 ± 0.73
1.98 ± 0.78
2.26 ± 0.91
3.72 ± 0.84
3.50 ± 0.67
3.32 ± 0.95
1.52 ± 0.79
2.60 ± 0.72
1.98 ± 0.94
t-value
0.00NS
0.00NS
5.20*
4.53*
0.00NS
2.93*
5.34*
4.21*
7.11*
5.79*
4.40*
0.00NS
4.64*
0.00NS
3.89*
0.00NS
3.97*
0.00NS
0.00NS
2.28**
2.03**
5.59*
0.00NS
5.61*
4.21*
3.94*
0.00NS
5.74*
0.00NS
0.00NS
7.89*
5.79*
3.29*
5.48*
0.00NS
3.13*
2.93*
2.56**
6.09*
6.20*
4.76*
0.00NS
3.11*
0.00NS
was 1.640.79 before intervention and 1.60  0.74 after intervention depicting a significant (P
≤ 0.05) impact with a lower frequency of consumption after the intervention.
Table 4.22 elucidated the mean frequency of ice-cream consumption as 3.43  0.97
before intervention and 3.07  0.86 after intervention displaying a significant (P ≤ 0.05)
difference. A positive impact of the intervention was thus observed. The data further revealed
the mean frequency of kulche Chhole consumption as 3.47  0.96 and 3.21  0.83 before and
after intervention indicating a significant (P ≤ 0.01) impact of the intervention among urban
adolescent boys.
Table 4.22 indicated that the mean frequency of macroni consumption was 2.60 
1.01 before intervention and 2.36  0.93 after intervention with a difference that was
significant (P ≤ 0.01) showing a decreased consumption of macroni. It was further revealed
that the mean frequency of manchurian consumption was 2.37  0.96 before intervention and
2.15  0.85 after intervention indicating a significant (P ≤ 0.01) impact of intervention
showing a decreased frequency of consumption. A significantly (P ≤ 0.01) lower consumption
of maggi was observed after the intervention among urban boys depicting a positive impact.
The mean frequencies were 3.71  0.86 before intervention and 3.36  0.69 after intervention
among urban adolescent boys. Table 4.22 depicted the mean frequency of namkeens
consumption as 4.46  0.66 before intervention and 3.94  0.74 after intervention among
urban adolescent boys. The difference was significant (P ≤ 0.01) showing a decreased
consumption of namkeens after the intervention.The data highlighted a significant (P ≤ 0.01)
difference in frequency of noodles consumption with mean frequencies as 3.28  0.88 and
2.85  0.74 before and after intervention, thus revealing a positive impact of the intervention
among urban subjects.The results revealed that the mean frequency of pizza consumption was
2.15  0.82 before intervention and 1.99  0.70 after intervention displaying a significant (P ≤
0.01) difference and a positive impact.
Table 4.22 further revealed that the frequency of consuming patties was 3.33 ± 1.01
before intervention 3.01 ± 0.82 after intervention, with a significant (P ≤ 0.01) impact of
intervention.
The data further showed that the mean frequency of paneer wrap consumption was 1.67 
0.83 and 1.55  0.73 before and after intervention. A significantly (P ≤ 0.01) lower frequency
of consumption was observed post-intervention in contrast to pre-intervention. On perusal of
the data it was found that the mean frequency of pastry consumption was 2.06  0.89 before
intervention and 1.98  0.78 after intervention. A significantly (P ≤ 0.01) lower frequency of
consumption was observed after the intervention with a positive impact. A significantly (P ≤
0.05) lower mean frequency of consumption of paneer pakora was observed after the
76
intervention (2.26 ± 0.91 vs 2.35 ± 1.01 ) with a positive impact among urban subjects. The
data revealed a significant (P ≤ 0.01) difference in the consumption of sandwiches with mean
frequencies as 4.07  0.84 and 3.72  0.84 before and after intervention. A positive impact of
nutrition intervention was depicted among urban adolescent boys.
Table 4.22 showed the mean frequency of samosa consumption as 3.97 ± 0.64 before
intervention and 3.50  0.67 after intervention among urban adolescent boys. The difference
between the frequencies was found to be significant (P ≤ 0.01) showing a positive impact of
intervention. It was further revealed that the mean frequency of soft drink consumption was
3.54  1.00 before intervention and 3.32 ± 0.95 after intervention. A significantly (P ≤ 0.01)
lower frequency of consumption of soft drink was observed after the intervention among
urban boys. The mean frequency of veg pakora consumption was revealed as 2.73 ± 0.83
before intervention and 2.60 ± 0.72 after intervention showing a significant (P ≤ 0.01)
difference. A lower frequency of consumption was observed after the intervention revealing a
positive impact among urban subjects.
On the whole it was found that frequency of fast food items like bread pakora, sweet
biscuits, cream biscuits, burger, cheese chilly, chips, cream roll, chhole bhature, chocolates,
candies, finger fries, grilled sandwich, hot dog, ice-cream, kulche chhole, macroni,
Manchurian, maggi, namkeens, noodles, pizza, patties, paneer wrap, pastry, paneer pakora,
sandwich, samosa, soft drink and veg pakora, decreased significantly after the intervention
thus depicting a positive impact of nutrition intervention. Koon et al (2006) also found that
there was marked improvement in snacking habit, with a decrease of 23.6 per cent, from 95.1
per cent at baseline to 71.5 per cent at follow-up. The frequency of fast food consumption had
also reduced to some extent. The proportion that cited daily fast food consumption was
reduced by almost half. There was also an improvement in the choices of food items
purchased by the children at the school canteen during school break. Overall, the proportion
that chose less healthy foods decreased while selection of healthier food items increased. The
percentage of children who chose fried foods or other high-fat foods decreased by 6.1 per
cent, sugary foods declined by 5.6 per cent, and healthier foods increased by 11.7 per cent. On
the whole, choice of beverages had also improved. The percentage of children who selected
carbonated drinks decreased by 12.3 per cent.
General food consumption pattern of rural adolescent boys
Table 4.23 depicted the impact of nutrition intervention on the mean frequencies of
general food consumption among rural adolescent boys.
On perusal of data it was revealed that among cereals the mean frequency of parantha
consumption was 4.48 ± 1.89 before intervention and 3.98 ± 1.75 after intervention with a
77
Table 4.23: Impact of nutrition intervention on general food consumption pattern of
rural adolescent boys (n=100)
Food items
Cereals
Chapati
Parantha
Poories
Bread
Dalia
Rice
Maize chapatti
Whole pulses and legumes
Bengal gram
Black gram
Kabuli chana
Cow pea
Green gram
Rajmah
Dehusked pulses
Bengal gram
Green gram
Lentil
Red gram
Milk and milk products
Milk
Buttermilk
Curd
Paneer
Green leafy vegetables
Bathua leaves
Fenugreek leaves
Mustard leaves
Spinach
Roots and tubers
Carot
Onion
Potato
Radish
Sweet Potato
Other Vegetables
Fruits
Sweets
*Significant at 1% level
**Significant at 5% level
Pre-Intervention
Mean ± SE
Post-Intervention
Mean ± SE
t-value
6.00 ± 0.00
4.48 ± 1.89
2.03 ± 1.24
3.18 ± 1.27
2.91 ± 1.16
2.75 ± 1.10
3.98 ± 1.24
6.00 ± 0.00
3.98 ± 1.75
1.79 ± 1.05
3.04 ± 1.20
2.91 ± 1.16
2.75 ± 1.10
3.98 ± 1.24
0.00NS
3.11*
1.92NS
1.75NS
0.00NS
0.00NS
0.00NS
3.96 ± 0.91
3.04 ± 1.04
2.91 ± 0.91
2.42 ± 0.93
3.60 ± 0.98
3.30 ± 0.81
4.05 ± 0.83
3.05 ± 1.02
2.91 ± 0.91
2.42 ± 0.93
3.60 ± 0.98
3.44 ± 0.76
2.15**
0.02NS
0.00NS
0.00NS
0.00NS
1.54NS
2.93 ± 1.08
3.95 ± 0.93
2.83 ± 1.04
2.11 ± 0.85
2.93 ± 1.08
3.95 ± 0.93
2.83 ± 1.07
2.11 ± 0.85
0.00NS
0.00NS
0.00NS
0.00NS
5.48 ± 1.13
5.41 ± 0.84
4.07 ± 1.18
3.30 ± 1.07
5.48 ± 1.13
5.41 ± 0.84
4.07 ± 1.18
3.30 ± 1.07
0.00NS
0.00NS
0.00NS
0.00NS
2.85 ± 0.89
3.40 ± 0.86
3.48 ± 0.79
3.11 ± 0.96
2.85 ± 0.89
3.40 ± 0.86
3.66 ± 0.82
3.31 ± 0.94
0.00NS
0.00NS
2.15**
1.37NS
4.25 ± 0.88
5.22 ± 0.88
4.60 ± 1.07
4.28 ± 0.99
2.15 ± 0.88
4.12 ± 0.88
4.18 ± 1.34
3.79 ± 1.78
4.25 ± 0.88
5.22 ± 0.88
4.60 ± 1.07
4.28 ± 0.99
2.15 ± 0.88
4.12 ± 0.88
4.70 ± 1.11
3.20 ± 1.43
0.00NS
0.00NS
0.00NS
0.00NS
0.00NS
0.00NS
4.96*
5.70*
78
significant (P ≤ 0.01) difference showing a decreased consumption of parantha. In the food
group of whole pulses and legumes the mean frequency of consumption of bengal gram was
3.96 ± 0.91 before intervention and 4.05 ± 0.83 after intervention. The difference in frequency
was reported a significant (P ≤ 0.05) impact of intervention on bengal gram consumption. The
data highlighted that among green leafy vegetables the mean frequency of mustard leaves
consumption was 3.48 ± 0.79 and 3.66 ± 0.82 before and after intervention, depicting a
significant (P ≤ 0.05) improvement in consumption among rural subjects. Fruits consumption
by rural subjects increased after the intervention. A significant (P ≤ 0.01) impact was
observed with mean frequencies as 4.18 ± 1.34 before intervention and 4.70 ± 1.11 after
intervention. The mean frequency of sweets consumption was revealed as 3.79 ± 1.78 before
intervention which decreased to 3.20 ± 1.43 after intervention showing a significant (P ≤
0.01) impact of intervention.
On perusal of the data it was revealed that the frequency of general food items like
parantha and sweets was decreased, while that of whole bengal gram, mustard leaves, and
fruits was significantly increased after the intervention, showing a positive impact of nutrition
intervention.
Fast food consumption pattern among rural adolescent boys
Table 4.24 revealed the impact of nutrition intervention on the mean frequencies of
consumption of fast food items among rural adolescent boys.
The results indicated that the frequency of aloo tikki consumption was 3.36  0.80
before intervention and 3.14  0.86 after intervention, displaying a significant (P ≤ 0.05)
positive impact of intervention. The mean frequencies of bread pakora consumption were 2.70
 0.83 and 2.58  0.81 before and after intervention. A significantly (P  0.01) lower frequency
of consumption was observed after the intervention, with a positive impact. A significantly (P ≤
0.01) lower consumption of burger was observed after the intervention showing a positive
impact. The mean frequency of burger consumption was revealed as 3.35 ± 1.02 and 3.10 ±
1.02 before and after intervention. The mean frequencies of cheese chilly consumption was
depicted as 1.94  0.86 and 1.83  0.82 before and after intervention indicating a significant (P
≤ 0.01) impact of intervention among urban adolescent boys. The data revealed the mean
frequency of chips consumption as 2.22 ± 0.69 before intervention and 2.13  0.65 after
intervention. The variation in frequency was found to be significant (p ≤ 0.05) reporting a
positive impact of intervention. The mean frequency of golgappe consumption was 2.89  0.68
before intervention and 2.74  0.66 after intervention, depicting a significant (P ≤ 0.05) impact
of intervention. The data (Table 4.24) further highlighted the mean frequency of macroni
consumption as 1.93  1.02 before intervention and 1.78  0.88 after intervention with a
significant (P ≤ 0.01) difference, depicting a positive impact of intervention. A significantly (P ≤
0.05) lower consumption of manchurian (1.61 ± 0.90 vs 1.54 ± 0.85) was observed after the
79
Table 4.24: Impact of nutrition intervention on fast food consumption pattern of rural
adolescent boys (n=100)
Food items
Aloo Tikki
Bhelpuri
Bread Pakora
Buiscuits (sweet)
Biscuits (salty)
Biscuits (cream)
Burger
Cheese chilly
Chips
Cream Roll
Chhole Bhature
Craxs
Chocolates
Cakes
Candies
Egg roll
Finger Fries
Fryams
Golgappe
Grilled Sandwich
Hog dog
Ice cream
Kurkure
Kulche Chhole
Macroni
Manchurian
Momos
Maggi
Muffins
Mc Puff
Namkeens
Noodles
Pizza
Patties
Pav Bhaji
Paneer wrap
Pastry
Paneer Pakore
Sandwich
Samosa
Soft drink
Spring Rolls
Veg Pakore
Veg rolls
Pre-Intervention
Mean ± SE
3.36 ± 0.80
2.44 ± 1.17
2.70 ± 0.83
4.10 ± 1.62
2.57 ± 0.84
2.81± 0.88
3.35 ± 1.02
1.94 ± 0.86
2.22 ± 0.69
3.31 ± 0.96
2.60 ± 1.08
0.99 ± 0.87
2.55 ± 0.72
2.09 ± 1.02
2.15 ± 0.95
1.41 ± 0.93
1.33 ± 1.01
1.77 ± 0.81
2.89 ± 0.68
0.56 ± 0.57
1.71 ± 1.07
2.06 ± 0.83
1.99 ± 0.85
3.01 ± 1.61
1.93 ± 1.02
1.61 ± 0.90
0.76 ± 0.73
2.50 ± 0.88
1.61 ± 0.93
0.92 ± 0.82
3.96 ± 1.06
2.30 ± 0.93
1.42 ± 0.87
2.20 ± 1.02
1.65 ± 0.74
0.70 ± 0.72
1.85 ± 0.80
2.35 ± 0.54
3.15 ± 1.39
3.23 ± 1.04
3.10 ± 1.28
1.39 ± 0.98
2.53 ± 0.94
1.34 ± 0.88
*Significant at 1% level
**Significant at 5% level
80
Post-Intervention
Mean ± SE
3.14 ± 0.86
2.44 ± 1.17
2.58 ± 0.81
4.10 ± 1.62
2.57 ± 0.84
2.81 ± 0.88
3.10 ± 1.02
1.83 ± 0.82
2.13 ± 0.65
3.31 ± 0.96
2.60 ± 1.08
0.99 ± 0.87
2.55 ± 0.72
2.09 ± 1.02
2.15 ± 0.95
1.41 ± 0.93
1.33 ± 1.01
1.77 ± 0.81
2.74 ± 0.66
0.56 ± 0.57
1.71 ± 1.07
2.01 ± 0.77
1.99 ± 0.85
3.03 ± 1.62
1.78 ± 0.88
1.54 ± 0.85
0.76 ± 0.73
2.35 ± 0.85
1.61 ± 0.93
0.92 ± 0.82
3.69 ± 0.96
2.10 ± 0.81
1.38 ± 0.84
2.22 ± 1.02
1.65 ± 0.74
0.70 ± 0.72
1.86 ± 0.80
2.38 ± 0.54
2.84 ± 1.46
2.91 ± 0.93
2.77 ± 1.17
1.40 ± 0.99
2.38 ± 0.89
1.34 ± 0.88
t-value
2.37**
0.00NS
3.37*
0.00NS
0.00NS
0.00NS
3.49*
2.59*
2.07**
0.00NS
0.00NS
0.00NS
0.00NS
0.00NS
0.00NS
0.00NS
0.00NS
0.00NS
1.98**
0.00NS
0.00NS
0.87NS
0.00NS
0.01NS
2.89*
1.97**
0.00NS
2.23**
0.00NS
0.00NS
3.81*
3.90*
1.27NS
0.01NS
0.08NS
0.00NS
0.01NS
0.03NS
1.97**
4.61*
4.84*
0.01NS
3.28*
0.00NS
intervention, showing a positive impact among rural subjects. The mean frequency of maggi
consumption was observed as 2.50 ± 0.88 before intervention and 2.35 ± 0.85 after
intervention. The variation in mean frequencies depicted a significant (P ≤ 0.05) impact of
nutrition intervention (Table 4.24). The data depicted the mean frequency of namkeens
consumption as 3.96  1.06 before intervention and 3.69 ± 0.96 after intervention showing a
significant (P ≤ 0.05) difference and a positive impact of intervention.
The mean frequency of noodles consumption was 2.30  0.93 before intervention and
2.10  0.81 after intervention depicting a significant (P ≤ 0.01) impact with a lower frequency
of consumption after the intervention. Table 4.24 elucidated the mean frequency of sandwich
consumption as 3.15  0.97 before intervention and 2.84  1.46 after intervention displaying a
significant (P ≤ 0.05) difference. A positive impact of intervention was thus observed.
The data further revealed the mean frequency of samosa consumption as 3.23  1.04
and 2.91  0.93 before and after the intervention indicating a significant (P ≤ 0.01) impact of
intervention with a decreased frequency among rural boys. Table 4.24 indicated that the mean
frequency of soft drink consumption was 3.10  1.28 before intervention and 2.77  1.17 after
intervention with a difference that was significant (P ≤ 0.01) showing a decreased
consumption of soft drink after the intervention. It was further revealed that the mean
frequency of veg pakora consumption was 2.53  0.96 before intervention and 2.38  0.89
after intervention indicating a significant (P ≤ 0.01) impact of intervention showing a
decreased frequency of consumption.
On the whole it was observed that frequency of consumption of fast food items like
alloo tikki, bread pakora, burger, cheese chilly, chips, golgappe, macroni, manchurian,
maggi, namkeens, noodles, sandwich, samosa, soft drink and veg pakora significantly
decreased after the nutrition intervention, thus depicting a positive impact. It was revealed
that a greater positive impact of intervention on general and fast food consumption was
observed among urban than rural adolescent boys since it was very difficult to pursue rural
adolescent boys. The food consumption trends in rural areas are rigid and flexibility is less
expected. On asking from rural subjects about the change in food pattern they explained that
though they wanted to change, but their parents didn’t allow. They were of the view that
ongoing food pattern from past decades is beneficial for today’s youngsters and the diet must
include good amount of fat and cereals for energy and good health. Parents were also unaware
of the harmful effects of fast food and excessive amount of unhealthy fat on body, therefore
impact of intervention on rural subjects was limited. Whereas urban adolescent boys and their
families were flexible and understood the impact of fast food and unhealthy eating habits on
body which led to a greater change in their food consumption pattern after the intervention.
Anderson et al (2003) assessed the impact of school-based education intervention aimed at
81
increasing the consumption of fruits and vegetables. It was found that children in the
intervention schools had an average increase in fruit intake (133 ± 1.9 to 183 ± 17.0 g/day)
that was significantly (P ≤ 0.05) greater than the increase (100 ± 11.7 to 107 ± 14.2 g/day )
estimated in subjects in control groups. Increase in scores for variables relating to knowledge
about fruits and vegetables and subjective norms were also greater in the intervention than in
control groups. Further, Kapur et al (2003) reported that the intervention brought about
significant changes in intake of nutrients (energy, protein, iron and vitamin C). The adequacy
of cereals, pulses, other vegetables, fruits, oil/fats intake was high in groups where nutrition
education was a component as compared to control and supplementation group. Although the
intake of green leafy vegetables was low among children. Further, the high vitamin C intake
attributed to the high intakes of fruits and other vegetables recorded in the food intake data
specific to nutrition education group may have also contributed in terms of better absorption
of iron from the diet. Jeong et al (2009) also found that class-based nutrition intervention
combining traditional lecture and interactive activities was successful in decreasing fast food
consumption.
4.5.2 Knowledge level
Knowledge Scores
Table 4.25 presents the knowledge scores of urban and rural adolescent boys before
and after the intervention.
Table 4.25: Mean knowledge scores of urban and rural adolescent boys (n=200)
Category
Pre-Intervention
ScoresΔ
Post-Intervention
Scores
Paired
(Mean ± SE)
(Mean ± SE)
t-value
Urban (n=100)
36.91 ± 3.90
43.96 ± 3.11
20.61*
Rural (n=100)
35.92 ± 3.84
42.78 ± 3.88
19.38*
1.81NS
2.37**
t-value
*Significant at 1% level
**Significant at 5% level
Δ
Scores out of 50
Nutrition intervention was given to urban and rural adolescent boys through lecture-
cum-discussion using electronic media (power-point presentation). The lectures were
delivered for a period of three months at the interval of 15 days. A knowledge test was
conducted using a questionnaire consisting of 50 questions related to balanced diet, essential
nutrients and their role in the body, healthy habits, life style pattern and food groups. Impact
of intervention was evaluated by comparing the scores obtained out of 50 by both urban and
rural adolescent boys before and after the intervention. It was observed that the mean scores
82
before intervention were 36.91 ± 3.90 and 35.92 ± 3.84 for urban and rural adolescent boys,
with a non-significant difference indicating almost similar knowledge level among both the
groups. Further, the data revealed that the mean scores increased to 43.96 ± 3.11 among urban
and 42.78 ± 3.88 among rural adolescent boys. A significant (P ≤ 0.01) improvement in
scores was observed in both the groups, though it was significantly (P ≤ 0.05) higher among
urban adolescent boys. The results were in confirmation with the study by Koon et al (2006)
also revealed that nutrition knowledge increased significantly from 64.6 ± 19.8 marks during
baseline to 69.6 ± 20.8 marks at follow up in school students. More students were aware of
the importance of breakfast, whereby 53.9 per cent agreed that breakfast was important for
health and not just to curb hunger in the morning and encouraging change in the dietary habits
was demonstrated by reduction in snacking practice as well as fast food consumption.
Knowledge level
Table 4.26 and 4.27 and Fig. 4.10 and 4.11 presents the knowledge level of urban and
rural adolescent boys before and after the intervention.
Table 4.26: Distribution of urban adolescent boys according to level of knowledge (n=100)
(Percentage)
Level of Knowledge
Pre-Intervention
Post-Intervention
Low (≤ 17)#
0
0
Average (18-33)
28
15
High (>33)
72
85
30.27*
Chi-square
*Significant at 1% level
#
Scores out of 50
100
85
72
Percentage
80
60
40
Pre-Intervention
28
Post-Intervention
15
20
0
0
0
Low (≤ 17)
Average (18-33)
Knowledge level
High (>33)
Fig.4.10: Distribution of urban adolescent boys according to level of knowledge.
83
Table 4.26 and Fig 4.10 depicted the level of knowledge before and after the
intervention among urban adolescent boys. It was revealed that before intervention 28
per cent of urban subjects had an average level of knowledge, attaining scores between
18-33, while 72 per cent of urban subjects had a high level of knowledge. It was further
observed that 85 per cent of urban boys attained a high level of knowledge after the
intervention, while only 15 per cent had an average level of knowledge. The increase in
the percentage of urban boys with high level of knowledge indicated a significant impact
of nutrition intervention.
Table 4.27: Distribution of rural adolescent boys according to level of knowledge (n=100)
(Percentage)
Level of Knowledge
Pre-Intervention
Post-Intervention
Low (≤ 17)#
0
0
Average (18-33)
25
20
High (>33)
75
80
23.39 *
Chi-square
*Significant at 1% level
#
Scores out of 50
100
75
Percentage
80
80
60
40
25
Pre-Intervention
20
Post-Intervention
20
0
0
0
Low (≤ 17)
Average (18-33)
Knowledge level
High (>33)
Fig.4.11: Distribution of rural adolescent boys according to level of knowledge.
On perusal of data (Table 4.27 and Fig 4.11) it was revealed that before intervention
25 per cent of rural subjects had an average knowledge level, obtaining scores between 18-33
out of 50 while 75 per cent of them had high level of knowledge with scores above 33. Post
intervention scores revealed that the percentage of rural subjects attaining a high level of
knowledge increased to 80 per cent, whereas the percentage of subjects having average level
of knowledge decreased to 20 per cent. A positive impact of nutrition intervention was thus
observed among rural subjects.
84
On the whole it was observed that a positive impact of intervention prevailed among
both urban and rural adolescent boys, but it was more significant among urban boys. Joshi
and Singh (2002) also elucidated that structural dissemination of knowledge in form of
educational booklet did have a positive impact in raising the levels of knowledge in area of
health. It was further observed by John and Narasimhan (2008) that adolescents had a good
knowledge and awareness in terms of nutrition, but after teaching basic nutritional needs, it
helped to reinforce the ideas already known. The nutrition education programme thus served
to be a vital tool in driving the children to put into practice their knowledge and awareness.
85
CHAPTER V
SUMMARY
The present study was undertaken to study the food consumption pattern and
nutritional status of urban and rural adolescent boys. A total sample of two hundred subjects
in the age group of 16 to 18 years were selected randomly from two schools. Hundred
adolescent boys in the urban area were selected from Government Model Senior Secondry
School, PAU, Ludhiana and similarly 100 adolescent boys in the rural area were selected
from Shaheed Colonel Harcharan Singh Sekho Yadgiri Government Senior Secondry School
Dakha, Ludhiana.
General information regarding age, birth order, family size and type, educational level
of parents, family occupation and income, physical activity pattern and lifestyle-related
information of the subjects were collected through personal interview technique using the
especially structured schedule. A list of most frequently consumed food items by adolescent
boys was prepared by interviewing with adolescents (not the subjects), parents, teachers,
dietitians and vendors and a food frequency questionnaire (FFQ) was used to assess the food
pattern (general as well as fast food) over recent months. Information regarding the food
intake was collected for three consecutive days by using 24 hours recall method. The average
daily intake of food and nutrients was calculated by using 'MSU-Nutriguide'. The food and
nutrient intake were compared with suggested Dietary Intakes (ICMR 1999) and
Recommended Dietary Allowances (ICMR 2000) and the per cent adequacy of food and
nutrient intakes was also calculated.
Anthropometric measurements viz. height and weight were measured by using
standard methods (Jelliffe 1966). The height and weight of adolescent boys were compared
with International (NCHS) and National (ICMR) standards (ICMR 2000). Body Mass Index
(BMI) was calculated using the standard formula and the classification of the subjects based
on BMI was done in accordance to the categorization proposed by Cole et al (2000).
The information obtained from the subjects was utilized for preparing an educational
package. The booklet entitled “Educational package on Nutritional and Health Guidelines for
adolescents” in English and “Sikhlayi package-Kishor Ladkyan layi sehat atte poshan
sambandhi hadaytan” in Punjabi was prepared. This booklet contained thirteen chapters Health, Balanced diet, Food nutrients, Healthy habits, Importance and health benefits of water
drinking, Benefits of fibre consumption, Effects of alcohol on adolescent’s body, Junk food
and related health risks, Obesity and its complications and Food and Nutrient requirements
for adolescents. Meal plans for both vegetarian and non- vegetarian adolescents was also
included. At the end the method to assess their nutritional status was also explained in the
booklet.
86
Subjects were imparted nutrition education through lecture-cum-discussion using
electronic media (power-point presentation). The lectures on mentioned topics were delivered
for a period of three months at the interval of 15 days. The booklets were distributed to the
subjects and to the staff. The extra copies were also provided for their library.
To study the impact of nutritional intervention, the schools were revisited during the
fourth month. A knowledge test consisting of 50 questions both closed and open ended was
conducted before and after the intervention. The frequency of consumption of general as well
as fast food was also recorded after the intervention. Thus a pre and post intervention
comparison of knowledge scores and mean frequency of consumption determined the impact
of nutritional intervention imparted for three months.
The results of the present study revealed that majority of the subjects i.e., 93 per cent
of the urban and 88 per cent of the rural boys were between the age group of 17 to 18 years.
Forty one per cent of urban subjects were at second place and 47 per cent of rural subjects
were at third place, in terms of birth order. A higher percentage of urban (35%) were found to
be at first place as compared to rural subjects (25%). Eighty per cent of the urban and 83 per
cent of rural subjects belonged to nuclear families while rest of them belonged to joint
families. More of the rural subjects (79%) had an average family size comprising of 5-8
members. Majority of the urban adolescent boys (36%) had one sibling whereas 57 per cent of
rural subjects had two siblings. Forty two per cent of urban and 38 per cent of rural adolescent
boys were non-vegetarian. However, the percentage of vegetarian and ova-vegetarian
adolescent boys was higher in urban area (42 and 13% vs 38 and 8%).
The socio-economic status revealed that the majority of the parents of both rural and
urban adolescent were educated upto matric level. The distribution of subjects according to
the occupation of mothers revealed that majority of the rural mothers (92%) were housewives
as compared to urban mothers (78%) while rest of them were working. Further, it was
observed that major occupation of majority of the urban families (59%) was service as
compared to 26 per cent of rural families, while a higher percentage of rural families were
engaged in farming as compared to urban families (20 vs 1%). The mean family income of
urban subjects was Rs 16,115.0 per month which was higher than the mean family income of
rural subjects recorded as Rs 10,540 per month.
The observation on the physical activity and lifestyle pattern revealed that rural
subjects were early risers as compared to urban subjects. They used to get up between 4.006.00 am. It was also observed that rural boys were more physically active, generally preferred
to walk and used cycles (52%) whereas a large percentage of urban subjects (32%) used to
enjoy bike/ scooter as a mode of conveyance. Urban adolescent boys were reported to play a
variety of games but the mean playing hours were less as compared to their rural counterparts
(1.56 vs 1.75 hours). Though majority of rural boys took rest after school but mean duration
87
was again less than the urban boys (0.95 vs 1.14 hours). Forty five per cent of rural whereas
only 18 per cent of urban adolescent boys had a regular exercise schedule. Maximum of rural
subjects had 7 hour sleep duration whereas it was 8 hours among urban subjects. Mean
walking hours were found to be longer among rural (0.53 hours) than urban (0.39 hours)
adolescents. However, television watching was more prevalent among urban boys with a
longer duration than rural subjects (1.86 vs 1.59 hours). It was further observed that more of
the rural adolescent boys (70 vs 48%) were engaged in household activities with longer mean
duration of work than their urban counterparts (0.64 vs 0.40 hours). Computer games were
not as popular among rural as among urban adolescent boy. Majority of the rural adolescent
boys used to complete their home work (81%), play outdoor games (72%) and watch
television (100%) in their leisure time whereas doing extra work (68%), reading literature
(54%) like comics, story books, novels etc., playing outdoor games (77%) and watching
television (100%) were preferred by urban subjects.
The meal pattern of the subjects revealed that 65 per cent of the rural and only 17 per
cent of the urban subjects had early morning meal. Eighty two per cent of urban and 87 per
cent of rural subjects used to have their breakfast daily. Further it was observed that 78 per
cent of urban as compared to 55 per cent of rural adolescents had snacks during recess from
canteen while rest of them used to bring packed lunches. Majority of urban (87%) and rural
(94%) subjects were in the habit of having lunch at home after the school. A large percentage
of adolescent boys i.e., 92 per cent of urban and 89 per cent of rural were found to have
evening tea. It was also observed that higher percentage of rural (65%) adolescent boys used
to have milk at bed time as compared to 21 per cent of urban adolescent boys having milk, tea
or coffee. Major percentage of urban adolescent boys (96%) had in between meals, whereas
this pattern was observed in 61 per cent of rural adolescent boys.
Similarly, the data on food consumption pattern indicated that cereal products like
maize chapattis (3.98 vs 2.74) were more frequently consumed by rural than urban adolescent
boys while the mean frequency of bread (4.06 vs 3.18), parantha (5.15 vs 4.48), and rice (3.2
vs 2.75) consumption was higher among urban subjects. Frequency of consumption of whole
pulses like rajmah, bengal gram, kabuli chana, green gram and black gram was once a week
on an average for both urban and rural adolescent boys though mean frequency of
consumption of cow pea (2.42 vs 2.02), rajmah (3.3 vs 3.06) and bengal gram (3.96 vs 3.1)
was observed to be higher among rural adolescent boys. However, frequency of dehusked
pulses (dhals) consumption was higher among rural than urban adolescent boys. Most
commonly consumed dhals as per their preference were green gram, bengal gram, lentil and
red gram with mean frequencies as 2.91, 2.34, 2.84 and 1.57 for urban and 3.95, 2.93, 2.83
and 2.11 for rural subjects. Milk and milk products were consumed satisfactorily in both areas
varying from weekly to daily. The mean frequencies of milk, buttermilk, curd and paneer
88
were 5.5, 4.08, 4.41 and 3.24 for urban and 5.48, 5.41, 4.07 and 3.3 for rural adolescent boys.
It was further observed that on the whole the consumption of green leafy vegetables like
bathua, fenugreek leaves, mustard leaves and spinach varied from once a week to fortnightly
with mean frequencies as 2.32, 3.14, 3.52 and 3.08 for urban and 2.84, 3.4, 3.48 and 3.11 for
rural subjects, though it was higher among rural adolescent boys. The consumption of roots
and tubers varied from daily to fortnightly but was higher among urban boys. Majority of
urban subjects (66%) consumed other vegetables like cauliflower, ladyfinger, capsicum, green
peas, brinjal, french beans etc. thrice a week while 43 per cent of rural subjects consumed
them twice a week which was significantly higher among urban subjects. The consumption of
fruits varied from weekly to twice a week among both urban (3.19) and rural (4.18)
adolescent boys while frequency of sweets consumption was twice to thrice a week among
both the urban and rural subjects (3.56 and 3.79).
Fast foods were found to be more frequently consumed by majority of the urban than
the rural adolescent boys, since availability of fast food is more in urban areas. Various fast
food outlets have been established in attractive settings in urban areas. Some traditional fast
food items like bhelpuri, bread pakora, biscuits, samosa, fryams, pav Bhaji, chhole kulche,
Chhole bhature, cream roll, paneer and veg pakore etc were considerably consumed in rural
areas too. Most of the rural adolescent boys were unaware of the modern fast food outlets and
their items like Mc puff, momos, paneer wrap etc. The fast food consumption pattern
prevailed higher among urban than rural adolescent boys. It was observed that out of 44 fast
foods identified, the intake of 27 food items was moderate i.e., twice a week to fortnightly,
among urban adolescent boys followed by 14 items whose consumption was low i.e.,
fortnightly to never. The intake of 3 fast food items was high i.e., daily to twice a week
among them. However, intake of 24 fast food items was high among rural adolescent boys
followed by 19 items whose frequency of consumption was low. It was further observed that
intake of only one fast food item was high among rural subjects.
The daily intake of food groups by urban and rural adolescent boys showed that the
intake of cereals (400.24 vs 368.89 g), pulses and legumes (37.44 vs 33.86 g), roots and
tubers (57.25 vs 54.80 g), green leafy vegetable (75.71 vs 62.89 g), milk and milk products
(383.05 vs 332.25 g), sugar and jaggery (40.84 vs 36.28 g) was higher among rural adolescent
boys but non-significantly higher intake of other vegetables (51.17 vs 50.77 g), fruits (69.29
vs 65.03 g) and meat and chicken (28.75 vs 20.85 g) among rural than urban adolescent boys.
Whereas, intake of fats and oils (39.12 vs 36.99 g) was reported to be significantly higher
among urban than rural subjects.
Further, the per cent adequacy of food intake depicted that the intake of pulses and
legumes (56 and 62%), green leafy vegetables (63 and 76%), milk and milk products (66 and
77%) and fruits (65and 69%) was found to be inadequate as compared to the SDI values
89
among both urban and rural boys but was lower among urban adolescents. The intake of roots
and tubers was below 50 per cent of SDI among both urban (27%) and rural (29%) boys. The
intake of meat and chicken was below 50 per cent for urban (42%) while it was 57 per cent of
SDI among rural subjects. The adequacy of intake of other vegetables was found to be nearly
half of the SDI values for both urban and rural (51%) subjects. It was further observed that
intake of fat was higher than the SDI values in both the groups, but was higher among urban
(156%) than rural (148%) subjects. On the whole it can be stated that due to consumption of
fast food among adolescent boys, the consumption of all the food groups except fats and oils
was lower and inadequate in both the areas.
The intake of nutrients by the urban and rural adolescent boys showed that rural
adolescent boys had significantly higher intake of protein (60.11vs 56.36g), carbohydrates
(364.02 vs 336.21g), thiamine (0.98 vs 0.83mg), riboflavin (1.14 vs 0.98mg), niacin (12.20 vs
10.45mg), Vitamin B12 (0.12 vs 0.08μg), folacin (83.45 vs 72.92g), ascorbic acid (29.58 vs
27.35mg) and calcium (386.74 vs 363.84mg) than urban adolescent boys, while a nonsignificant difference was observed in the intake of energy (2382.8 vs 2446.94 Kcal), βcarotene (992.38vs 1043.22g) and iron (31.02 vs 30.31mg) between urban and rural
adolescent boys. The intake of fat (90.28 vs 83.38g) was higher among urban than rural
subjects.
Comparing the adequacy of nutrient intake, the energy intake (90 vs 93%) was found
to be nearly adequate in urban and rural adolescent boys. The intake of fat (116vs 107%) was
much higher than that of RDA among both the groups. Further, the intake of protein (72 vs
77), β-carotene (41 vs 43%), thiamine (83 vs 95%), riboflavin (61 vs 71%), iron (62 vs 61%),
niacin (61 vs 72%), folacin (73 vs 83%), vitamin B12 (40 vs 60%), ascorbic acid (68 vs 74%),
and calcium (73 vs 77%) was inadequate among both urban and rural adolescent boys.
Analyzing the contribution of proximate principles to the total energy intake, it was
found that on an average carbohydrates, protein and fat contributed 57, 9 and 34 per cent
respectively to the total energy intake of urban adolescent boys. However, the contribution by
carbohydrates, protein and fat to total energy intake of rural boys was 59, 10 and 31 per cent
respectively. In comparison with the ICMR (2000) recommendations, the contribution of
carbohydrates (57 vs 59 per cent) to total energy intake was observed to be nearly adequate
among both urban and rural adolescent boys. Protein was below (9%) the recommendations
for urban subjects while it was at borderline (10%) for rural subjects. However, fat (34 vs 31
per cent) was higher than the recommendations for urban and rural subjects, but was observed
to be higher among urban adolescent boys.
Anthropometric status of urban and rural adolescent boys revealed that rural
adolescent boys were taller than their urban counterparts (170.13 vs 165.5 cm in the age
90
group 16-17 and 172.85 vs 169.57 cm in the age group of 17-18), but heights of both urban
and rural adolescent boys were comparable to the international as well as national standards.
The mean weights of urban and rural adolescent boys were 52.57 and 58.6 kg in the age group
of 16-17 years and 61.97 and 61.42 kg in the age group of 17-18 years. Further, it was
observed that the weight of rural adolescent boys in both the age groups was comparable with
the NCHS standards, however, higher than the ICMR standards. The weight of urban
adolescent boys was comparable to standards but only in the age group of 17-18 years, was
higher than ICMR standards.
Further, the classification of the subjects according to BMI indicated that that more of
the rural (27%) subjects were underweight as compared to their urban (14%) counterparts.
While 41 per cent of rural and 48 per cent of urban boys were found to be normal with BMI
18.5-22.9. The results further revealed that nearly same percentage of urban (13%) and rural
(12%) boys were at risk of obesity while more of the urban (24%) than rural (20%) adolescent
boys were identified as ‘Grade I’ obese. One per cent of the urban adolescent boys were also
identified as ‘Grade II’ obese. A higher percentage of adolescent boys was found to be obese
in urban (38%) than in rural (32%) areas.
Impact of nutrition intervention on knowledge level revealed that mean scores before
intervention were 36.91 and 35.92 for urban and rural adolescent boys. Further, it was
revealed that the mean scores after the intervention increased to 43.96 among urban and 42.78
among rural adolescent boys, showing a significant improvement in scores but was higher
among urban subjects. It was further observed that before intervention 28 per cent of urban
and 25 per cent of rural subjects had an average level of knowledge, attaining scores between
18-33, while 72 per cent of urban and 75 per cent of rural subjects had a high level of
knowledge. After the nutrition intervention the per cent age of adolescents attaining high level
of knowledge improved to 85 per cent in urban and 80 per cent in rural area.
Similarly, impact of nutrition intervention on food consumption pattern depicted that
the mean frequency of consumption of general food items like parantha (5.15 to 5.01) and
sweets (3.56 to 3.52) decreased while that of rajmah (3.06 to 3.20), whole bengal gram (3.10 to
3.35), curd (4.41 to 4.62), fenugreek leaves (3.14 to 3.28), spinach (3.08 to 3.26), radish (4.18 to
4.32) and fruits (3.91 to 4.21) increased significantly. Among rural subjects the frequency of
consumption of parantha (4.48 to 3.98) and sweets (3.79 to 3.20) was decreased, while that of
whole bengal gram (3.96 to 4.05), mustard leaves (3.48 to 3.66), and fruits (4.18 to 4.70) was
significantly increased after the intervention, showing a positive impact of nutrition
intervention. Further it was revealed that among urban adolescent boys the mean frequency of
fast food items like bread pakora (2.13 to 2.01), sweet biscuits (4.52 to 4.33), cream biscuits
(2.15 to 2.07), burger (3.82 to 3.46), cheese chilly (2.68 to 2.47), chips (3.84 to 3.35), cream
roll (3.69 to 3.36), chhole bhature (2.60 to 2.39), chocolates (3.12 to 2.83), candies (2.37 to
91
2.22), finger fries (2.12 to 1.95), grilled sandwich (1.74 to 1.69), hot dog (1.64 to 1.60), icecream (3.43 to 3.07), kulche chhole (3.47 to 3.21), macroni (2.60 to 2.36), manchurian (2.37 to
2.15), maggi (3.71 to 3.36), namkeens (4.46 to 3.94), noodles (3.28 to 2.85), pizza (2.15 to
1.99), patties (3.33 to 3.01), paneer wrap (1.67 to 1.55), pastry (2.06 to 1.98), paneer pakora
(2.26 to 2.35), sandwich (4.07 to 3.72), samosa (3.97 to 3.50), soft drink (3.54 to 3.32) and veg
pakora (2.73 to 2.60), decreased significantly after the intervention. On the contrary, among
rural subjects the mean frequency of consumption of alloo tikki (3.36 to 3.14), bread pakora
(2.70 to 2.58), burger (3.35 to 3.10), cheese chilly (1.94 to 1.83), chips (2.22 to 2.13), golgappe
(2.89 to 2.74), macroni (1.93 to 1.78), manchurian (1.61 to 1.54), maggi (2.50 to 2.35),
namkeens (3.96 to 3.69), noodles (2.30 to 2.10), sandwich (3.15 to 2.84), samosa (3.23 to 2.91),
soft drink (3.10 to 2.77 ) and veg pakora (2.53 to 2.38) significantly decreased after the nutrition
intervention. A greater positive impact of intervention was thus observed among urban than
rural adolescent boys.
CONCLUSIONS
●
Rural adolescent boys were physically more active than urban adolescent boys. Urban
subjects had a sedentary life style with lesser duration of play, walk and exercise as
compared to their rural counterparts.
●
A variety of fast foods were available in the urban areas, therefore urban adolescent
boys had a higher frequency of fast food consumption than their rural counterparts.
●
The intake of cereals, pulses, green leafy vegetables, milk and milk products was
higher among rural than urban adolescent boys, while intake of fats and oils was
higher among urban subjects.
●
The diets of rural adolescent boys contained higher amounts of protein, carbohydrates,
thiamine, riboflavin, niacin, folic acid, calcium, Vitamin B12 and ascorbic acid.
●
A higher percentage of urban adolescent boys were obese than rural subjects.
●
A significant impact of nutrition intervention both on knowledge level and food
consumption pattern was observed among urban and rural adolescent boys but was
greater among urban subjects.
RECOMMENDATIONS
●
It is pertinent to focus on improvement of eating practices of both urban and rural
adolescents in order to prepare a healthy future.
●
More attention needs to be given to the regular consumption of meals, healthy snacks,
while fast food should be discouraged for achieving desired nutritional status of the
adolescents.
●
School and community based intervention measures are necessary to develop a
healthy lifestyle during adolescence in both urban and rural areas.
92
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99
Appendix I
(Educational Package)
100
Educational Package
On
Nutritional and Health
Guidelines
For Adolescents
Neha Mahajan
Dr. Kiran Grover
101
CONTENTS
S. No.
Title
Page
No.
I
Health
i
II
Balance diet
ii
III
Food nutrients
ix
IV
Healthy habits
xv
V
Importance of water drinking
xvi
VI
Benefits of fibre consumption
xix
VII
Effect of alcohol on an adolescent’s body
xx
VIII
Junk food
xxii
IX
How to remain fit and healthy
xxv
X
Obesity
xxvi
XI
Nutritional and food requirements for
xxx
adolescents
XII
Guidelines
xxxvi
XIII
Know your status
xxxvii
102
(I)
Health is the word used to describe how your body feels.
Being healthy is important because it makes you feel
good and live longer.
Getting healthy depends on:

Eating the right food.

Doing the right exercise.

Taking medicine if you are sick.

Knowing what to do if you have an illness or
disability.

Feeling good about yourself.
A balanced diet comprising of healthy and diverse foods is key to
promoting good health.
We are what we eat - eating healthy food promotes good health and
unhealthy food habits lead to a diseased body.
Foods contain vital nutrients that aid our body to remain healthy.
A lack of consumption of these nutrients or feeding upon the wrong
kinds of food leads to an accumulation of toxins within the body, resulting in
chronic diseases in the long run.
A nutritious diet while ensuring overall well being, helps to maintain a
healthy Body, reduces the risk of several diseases like cancer, heart diseases,
diabetes, bone disorders and brain related diseases.
A healthy person is always cheerful. He finds interest in doing a thing.
He has got strength of mind. He always sees the bright side of a thing. He is
always hopeful. He does not lose heart easily. A healthy man is then the
happiest of all men.
Health is wealth !
i
(II)
The human body requires food
 to provide energy for all life process and
 for growth, repair and maintenance of cells and
tissues.
A balanced diet contains different types of foods in
such quantities and proportions that the need for
calories, minerals, vitamins and other nutrients is
adequately met and small provision is made for extra
nutrients to with stand short duration of leanness.
 If there is not enough protein, you will not be able to grow properly
and you will not be able to repair yourself i.e. wounds will not heal
properly.
 If you do not have enough energy containing foods you will feel very
tired, you will not have enough energy.
 If you have too much energy containing foods you will become
overweight.
 If you do not have enough of vitamins and minerals in your diet you
may suffer from many deficiency diseases.
 You must have carbohydrate, protein, fat, vitamins, minerals and fibre
in the correct proportions.
 Lack of fibre in diet may lead to digestion problems, heart diseases by
increased cholesterol and can also lead to obesity.
 Water is essential for various activities in the body. You must have 8-10
glasses of water daily to remain healthy.
ii
Five Basic Food Groups
The food pyramid arranges the foods from
high calorie foods at the top to low calorie foods
at bottom. It is an excellent tool to help you
make healthy food choices. The food pyramid
can help you choose from a variety of foods so
you get the nutrients you need, and the
suggested amounts can help you control the
amount of calories, fat, saturated fat, cholesterol,
sugar or sodium in your diet.
 Cereals include wheat, rice, bread, semolina, bajra, jowar etc
 Pulses include moong, arhar, urd, chana, masar, rajmah, rongi etc.
 Cereals are rich sorces of carbohydrates, fibre and protein. They form
the major component of our diet and gives maximum amount of energy.
 Pulses and legumes are rich sources of protein. Protein helps body to
grow and repair damaged cells.
iii
Soyabean
contains carbohydrates, fat, protein,
vitamins and minerals like calcium, folic acid and iron,
the protein content of soyabean is very high and is
excellent for growth and development.
Sprouts are rich in nutrients like vitamin C, B
vitamins and protein. Sprouted pulses improve
digestibility and nutritional qualities when compared to
non sprouted food. They also contain a lot of fibre and
water content which makes it helpful in overcoming
constipation.
Method of sprouting
 Thoroughly wash the whole legumes ( green
gram, Bengal gram, Chick pea, soyabean,
moth beans etc.) with clean water.
 Soak them in water overnight.
 Drain off the extra water, tie them in a
damp muslin cloth and keep it in a warm
place for 12-24 hours.
 The sprouted legumes must then be cooked
in a pressure cooker for 2-3 minutes. They
can be used in the form of salad, chaat etc.
iv
 Mother Nature has offered a large variety of vegetables such as spinach,
methi, pudina, sarson, dhania, cabbage, potato, cauliflower, carrot, radish,
turnip, onion, ladyfinger, lauki, karela, brinjal, capsicum, french beans,
kaddu etc. and fruits such as amla, apple, banana, grapes, guava, lemon,
orange, mango, peach, pear, melon, water melon etc.
 Fresh vegetables are an important part of a healthy diet. They provide
several vitamins, minerals, fibers and enzymes and offer a number of
health benefits.
 Green, leafy vegetables are rich in iron, vitamin C, vitamin A/carotene,
vitamin K and lots of fibre.
 Consumption of vegetables in their raw form or in the form of juice is
more preferable, so that you can get all their health benefits.
 Fruits are a rich source of vitamins, minerals, fibres and carbohydrates.
They contain a high quantity of antioxidants, which protect the body from
potentially harmful substances.
 Fruits such as lemons, grapes and oranges (citrus fruits), amla, guava are
high in vitamin C.
 The fruits like apricot, papaya, mango and peach are a rich source of
vitamin A.
 They should be eaten in good amounts.
 Good quantity of seasonal fruits and vegetables should be eaten.
v
 Milk products include milk, cheese, cream, butter and yogurt.
 They are an excellent source of calcium and proteins.
 Dairy foods are also rich in vitamin A, B and D.
 Calcium is important for the health of bones.
 Vitamin D is required for building and maintaining bone health.
 Most milk products are high in fats, which help to build up the body
and provide energy.
 Curd is fermented food product, easy to digest and low in calories. It
should be eaten in good amounts.
 Consumption should be in moderate amounts
vi
 They are the most important source of protein, zinc, iron and B
vitamins.
 These nutrients are necessary for growth and repair of the body.
 Eggs are a rich source of protein.
 Meat is a major source of vitamin B12.
 Fish is also a significant source of protein.
 Some oily fish contain high levels of omega-essential fatty acids which
is good for heart.
 They should be eaten in less amounts
vii
 They are the powerful sources of energy required for our body.
 Fats such as butter, cheese, salad dressings and oils are high in calories.
 Sweets such as desserts, syrups, jellies, jams, candies and soft drinks
contain high amounts of sugar.
 Most foods in this category don’t consist of vitamins and minerals.
That’s why they are known as ‘empty calorie’ foods.
 They can be consumed in an adequate quantity as a part of healthy diet.
 If we consume them in excess quantity, it causes obesity.
 Unsaturated fats present in vegetable oils, seeds, nuts, olive oils and
oily fish are beneficial for health, as they lower the cholesterol levels.
 By balancing these five food groups in your daily diet, you can
maintain the normal functioning of the body and lead a healthy life.
viii
(III)
Food nutrients consist of carbohydrates, protein, fat, vitamins and
minerals.
Nutrients
Functions
Rich sources
Carbohydrates To supply energy to the
body
Deficiency
Cereals, millets, Weakness,
roots and tubers lethargy, low
such as potatoes, concentration.
sweet potato,
yam, tapioca etc.
And sugar and
jaggery.
Proteins
To build and repair body
tissues, muscles and vital
fluids like blood and help
form enzymes and
antibodies to fight
infections.
Fresh milk,
cheese, curd,
oilseeds and
nuts, soyabean,
yeast, pulses,
meat, liver, fish,
egg and cereals
Growth
retardation, weight
loss, anaemia,
reduced resistance
to infection,
healing of wounds
will be delayed,
fatigue, muscular
weakness.
Fat
To serve as a concentrated
source of energy and
supply fat soluble
vitamins.
Butter,ghee,
vegetable oils
and fat, oilseeds
and nuts, fish
liver oils and
egg yolk.
Very low amounts
effect body
growth. although
excess of fat is
more harmful
leading to obesity,
digestion
problems.
ix
Fat soluble vitamins
To keep the skin and
mucous membrane healthy
and to protect against night
blindness and other eye
damaging diseases.
Fish liver oils,
liver, milk and
milk
products(curd,
butter,
ghee),carrots,
green leafy
vegetables and
yellow fruits and
vegetables
Vitamin D
To keep bones healthy.
Milk, butter, egg
yolk, fish, fish
oils, and sunlight.
Soft, weak and
brittle bones,
poorly
developed
muscles and
restlessness.
Vitamin E
To keep blood cells healthy,
and maintain fertility.
Vegetable oil,
dairy products,
meat, eggs,
cereals, nuts, leafy
vegetables and
yellow vegetables.
Muscular
weakness and
reduced blood
level.
Vitamin K
Required for blood clotting.
Green leafy
vegetables,
tomatoes,
cauliflower, egg
yolk, soyabean oil
and liver.
Decreased
efficiency of
blood clotting.
Vitamin A
x
Eye disorders,
loss of appetite
and weight,
skin disorders.
Water soluble vitamins
Vitamin B1
( Thiamine )
For normal appetite
and digestion, healthy
nervous system, and
to change good
carbohydrates into
energy for work.
Liver, eggs,
milk, pork,
legumes,
pulses, nuts,
oilseeds,
fruits,, yeast,
wholegrain
cereals and
parboiled
rice.
Loss of appetite,
indigestion,
depression,
weakness, heart
problems and
nervous system
also affected.
Vitamin B2
(Riboflavin)
To help the cells use
oxygen, to keep
vision clear and
smooth
Milk,
skimmed
milk, curd,
cheese, eggs,
liver, and
leafy
vegetables.
Delayed wound
healing, swelling
of lips, cracks at
the corner of lips,
eyes become
sensitive to light
and are easily
tired with itching
and burning.
Vitamin B3
(Niacin)
to preserve health of
skin, functioning of
the stomach and
intestines and
nervous system.
Cereals,
whole
grains, meat,
liver, yeast
oilseeds,
nuts,
legumes,
and pulses.
Rough skin,
weakness,
headaches, loss of
weight and
appetite and
nervous disorders
like confusion,
poor memory,
irritation. Loose
motions also
occur.
xi
Vitamin B5
(Pantothenic acid)
For formation of
blood and
conversion of
carbohydrates and
fat into energy in our
body.
Yeast, liver,
rice, whole
cereals,
legumes,
nuts, egg,
fish and
meat.
Loss of appetite,
weakness,
headache, lack of
sleep, dizziness,
muscle weakness
and changes in
blood pressure.
Vitamin B6
(Pyridoxine)
Helps in growth,
energy generation
and formation of
blood.
Yeast, wheat,
corn, liver,
kidney, meat,
egg and fish,
milk,
potatoes,
sweet
potatoes and
vegetables.
Anaemia,
weakness,
vomiting and
abdominal pain.
Nervous system is
also affected.
Folic acid
Formation of blood.
Fresh green
leafy
vegetables
like spinach
and lettuce,
liver, kidney,
dry beans
and pulses.
Anaemia, red
tongue, weight
loss and loose
motions.
Vitamin B12
For normal
(Cyanocobalamine) functioning of all cells
but particularly of
bone, nervous system
and digestive system.
Liver,
kidney and
meat, milk,
cheese, and
eggs.
Anaemia.
Vitamin C
(Ascorbic acid)
Amla, guava,
citrus fruits,
fresh
vegetables,
salad, and
sprouted
pulses,
Joint pains, growth
failure, anaemia,
shortness of
breath, poor
healing of wounds
and infections
occur more easily.
To help cement body
cells together,
strengthen the walls
of blood vessels,
provide resistance to
infections and help
in healing.
xii
Minerals
Calcium
Normal development and
maintenance of bones and
teeth, clotting of blood,
normal muscle activity and
nervous function.
Milk, cheese,
dark green leafy
vegetable, chana
dal, rajma,
soyabean.
Poor growth,
tooth and
bone
formation,
slow clotting
of blood and
muscle
weakness.
Phosphorous
Normal development and
maintenance of strong
bones and teeth, normal
muscle and cell activity.
Milk, cheese,
egg-yolk, meat,
fish, whole
grains, legumes
and nuts.
Poor growth,
poor bone
and teeth
formation,
loss of sleep
and pain in
bones.
Potassium
Electrolyte balance in
Meat, whole
body, for normal heart beat grains, leafy
and nerve impulses.
vegetables,
whole dals,
oranges, and
bananas.
Muscle
weakness,
abnormal
heartbeat.
Sodium
Electrolyte balance in the
body, normal functioning
of muscles and nerves.
Feeling of
vomiting,
loose
motions,
muscle
cramps,
abdominal
pain.
xiii
Salt, meat, fish,
eggs, milk,
pickles,
chutneys,
processed foods.
Iron
Essential for formation of
blood.
Liver and meat,
dried fruits,
whole dals,
whole grains,
dark green leafy
vegetables,
potatoes, jaggery.
Anaemia,
weakness,
dizziness,
and loss of
weight.
Iodine
Formation of hormone
(thyroxine)
Salt water fish,
foods grown in
soil near salt
water, iodized
salt.
Goitre, dry
skin, hair
loss,
weakness,
growth
failure
mental
retardation.
Fluorine
Protects tooth against
decay.
Fluorinated
water.
Tooth decay
xiv
(IV)
 Maintain regularity in your routine
 Eat balanced food
 Eat as much as natural foods
 Consume seasonal foods as far as possible
 Eat well but do not overeat
 Avoid excessive salt and spices
 Avoid too much sweets especially sugar
 Eat lots of salad
 Eat more whole foods and avoid refined foods
 Avoid fried foods
 Watch your weight and maintain ideal weight
 Eat a variety of foods; avoid eating the same kind of foods all the time.
 Drink plenty of water.
 Eat healthy snacks and avoid junk food.
 Exercise daily.
xv
(V)
Drinking a healthy amount of water is
vital to your health. The human body consist of
55% to 78% water depending on body size i.e.,
2/3rd of body is water, and it is the main
component of human body.
● Muscle consists of 75% water
● Brain consists of 90% of water
● Bone consists of 22% of water
● Blood consists of 83% water
The functions of water in human body are vital.
The water:
● Transport nutrients and oxygen into cells
● Moisturizes the air in lungs
● Helps with metabolism
● Protect our vital organ
● Helps our organs to absorb nutrients better
● Regulates body temperature
● Detoxifies
● Protect and moisturizes our joints
Every cell in your body needs water from head to toe. That is why it is
so important to drink enough fluid.
Take for example, brain consists of 90% of water, if you do not supply
enough water to your body, your brain cannot function well, and you will get
headache or migraine.
xvi
You will be amazed of the benefits of drinking water as follow:
Lose weight: Drinking water helps you lose weight
because it removes fat from the body . Drinking water
reduces hunger; it’s an effective appetite suppressant so
you’ll eat less. Plus, water has zero calories.

Natural Remedy for Headache: Helps to relieve headache
and back pains due to dehydration.

Look Younger with Healthier Skin: You’ll look younger
when your skin is properly hydrated. Water helps to
replenish skin tissues, moisturizes skin and increase skin
elasticity.

Better Productivity at Work: Your brain is mostly made up
of water, thus drinking water helps you think better, be
more alert and more concentrate.

Better Exercise: Drinking water regulates your body
temperature. You’ll feel more energetic when doing
exercises and water helps to fuel your muscle.

Helps in Digestion and Constipation: Drinking water
raises your metabolism because it helps in digestion.
Fibre and water goes hand in hand so that you can have
your daily bowel movement.

Less Cramps and Sprains: Proper hydration helps keep
your joints and muscles lubricated, so you’ll less likely get
cramps and sprains.
xvii

Less Likely to Get Sick and Feel Healthy: Drinking plenty
of water helps fight against flu and other ailments like
kidney stones and heart attack. Water adds with lemon is
used for ailments like respiratory disease, intestinal
problems, rheumatism and arthritis etc. Water can
improve our immune system.

Relieves Fatigue: Water is used by the body to help flush
out toxins and waste products from the body. If your body
lacks of water, your heart, for instance, need to work
harder to pump out the oxygenated blood to all cells, so
are the rest of the vital organs, your organs will be
exhausted and so are you.

Good Mood: Your body feels very good that’s why your
soul feels happy.

Reduce the Risk of Cancer: Related to the digestive
system, some studies show that drinking a healthy
amount of water may reduce the risks of bladder cancer
and colon cancer. Water dilutes the concentration of
cancer-causing agents in the urine and shortens the time
in which they are in contact with bladder lining.
xviii
(VI)
Avoiding and Relieving Constipation
Fibre can absorb large amounts of water in the bowels, and this makes
stools softer and easier to pass. Increasing fibre in the diet will relieve
constipation within hours or days.
Preventing Certain Diseases
 Heart disease
 Cancer
 Diabetes
 Gallstones and kidney stones
 Obesity
Keeping Weight Under Control
Foods containing plenty of fibre have more bulk than low-fibre foods.
If taken in the right form at the right time and at sufficient quantities, fibre
can sometimes slow the onset of hunger.
xix
(VII)
During the period of adolescent’s body is still maturing and a substance
such as alcohol can have its own effects on child’s physical well-being.
Note:- Alcohol is not legal until the age of 21.
Initial effects of alcohol
At the start of taking in alcohol, he may actually
begin to feel even better, he may be filled with a
confidence that he would not normally feel. But these
feelings will die down, and sedation or drowsiness
will replace them. These are just initial effects of
alcohol.
xx
Hazards of overdose
When a teenager takes in a large amount of alcohol in a short amount of
time, it may lead to a hazardous overdose. If the adolescent skips a meal and
then goes out drinking, this too can be particularly hazardous.
Moderate alcohol intake may lead to nausea and headaches from hangovers,
Excessive alcohol intake leads to : Poor—memory,
judgment,
problem
slowed
solving
reflexes,
abilities,
concentration,
attention
distorted
vision, and even blackouts
 Vitamin deficiencies,
 Appetite loss,
 Skin rashes/irritations, and
 Damage to the liver, heart, or central
nervous system,
 Stomach illnesses.
 Increase risks for a variety of lifethreatening diseases, including cancer.
 Alcohol affects self-control.
 Drinking large amounts of alcohol can lead to coma or even death. Also, in
1998, 35.8 percent of traffic deaths of 15- to 20-year-olds were alcoholrelated.
xxi
(VIII)
A food that is poor in nutrients is considered
unhealthy and may be called junk food.
 A food that is high in fat, sodium, and/or sugar is known
as a junk food.
 Junk food is easy to carry, purchase and consume.
 Generally, a junk food is given a very attractive
appearance by adding food ad
 Additives and
colors to enhance
flavor,
texture,
appearance, and increasing long self life.
 Junk food isn't just greasy burgers from fast food restaurants.
 Junk food includes overly salty foods such as potato chips, kurkure, crax
etc.
 Foods loaded with sugar such as packaged cupcakes and candies are also
junk food.
 Foods that are high in saturated fats, sodium and refined sugar usually
provide little or no nutritional value.
 Your body can't convert junk food into bone, muscle or healthy organ
cells.
Remember, junk foods are empty calories. An empty calorie lacks in
micro-nutrients such as vitamins, minerals, or amino acids, and fiber
but has high energy (calories).
xxii
Junk
food contains
a lot of
saturated
fats.
Vitamins and
minerals are
not found in
junk food.
Sometime
it is made
using unclean ingredients.
-
Packed
junk food has
preservatives and
colouring which
are both
unhealthy
-.
Eating
junk food
will result in
gaining
weight.
Eating junk food
can increase the
risk of diabetes.
Junk food can
actually speed up
the effects of
aging.
xxiii

Sugars, Refined foods, like sugar and refined flour (maida) based items
like white bread and cakes, pastries etc. Our body turns sugars into fat.
If you consume just 3 tsp of sugar daily, imagine how
much sugar you would have consumed by the time you
are 50 years of age; it will be about 275 kg !, about 5 time
your weight !! Sugar is stored in the liver as glucose, but
the liver can only store a finite amount. Excess sugar is
stored in the body as fat. Eating too much sugar makes you fat. This fat
is difficult to burn off and can ultimately result in obesity, heart disease
and other health issues. Refined sugar is linked to tooth
decay because sugar breaks down calcium.
 Fats & Hydrogenated oils They are found in cookies,
chips, candy bars, fried foods, muffins, etc. etc. Many
snacks, such as potato chips, cheeseburgers and fries,
have high levels of fat, sugar or salt-ingredients. The
saturated fat mainly comes from animal products. The
excessive fats stick to our arteries and cause the
blockages leading to heart disease and strokes. They
can also lead to cancer, arthritis and other diseases.

Salt: Excessive salt is not good for our body. However, sodium in
moderate amount, along with potassium, maintains the water balance in
our body. But too much sodium can cause high blood
pressure. kurkure,
chips and many canned food items
contain excessive salt.
xxiv
(IX)
 Avoid junk food as much as possible.
 Eat home prepared foods
 Instead
of
coldrinks
enjoy
shikanjvi,
buttermilk, lassi, milk shakes, mango pana to
beat the heat in summers.
 Eat lots of fruits whenever you feel hungry.
 Include snacks such as home made vegetable
sandwiches, poha, roasted chane, cornflakes,
idli, fruit chaat, sprouted chaat, popcorns,
besan ke chille, home made bhelpuri etc.
 Avoid snacks such as magi, chips, samosa,
patties, burgers and other unhealthy foods.
(X)
xxv
An obese person has accumulated so much body fat that it might have a
negative effect on their health. If a person's bodyweight is at least 20% higher
than it should be, he or she is considered obese.
xxvi
 Consuming too many calories:- People are
eating much more than they used to. Most
of the increased food consumption has
consisted
of
carbohydrates
(sugars),
sweetened drinks, fried foods and fast food.
 Lack of activity:- With the arrival of
televisions,
computers,
video
games,
remote controls, using bikes and scooters
instead of walking or cycling, playing
indoor games etc. The majority of people
are
leading
a
much
more
sedentary
lifestyle compared to their parents and
grandparents. The less you move around
the fewer calories you burn.
 Not sleeping enough:- If you do not sleep
enough your risk of becoming obese
doubles. Lack of sleep leads to increased
hunger and finally to obesity.
xxvii
 Hereditary factor:- Obesity in parents may lead to
obesity in children.
 Social and cultural factors:- People in upper
socioeconomic status tend to be more obese mainly
due to their rich food intake and luxurious lifestyle with
minimum physical activity.
 Emotional factors:- Overeating may result from boredom
and loneliness. Today while watching television many
teenagers and adults eating crisp, oily snacks with
soft drinks as a means of passing time.
xxviii
Bone deformities and joint pains
Heart diseases
Gallbladder stones
Breathing problems
Several cancers
Diabetes
Lack of sleep
Lack of concentration
xxix
(XI)
Healthy eating during adolescence is important as important body
changes during this time affect an individual's nutritional and dietary needs.
Adolescents are becoming more independent and making many food
decisions on their own. Many adolescents experience a growth spurt and an
increase in appetite and need healthy foods to meet their growth needs.
Adolescents tend to eat more meals away from home than younger children.
They are also heavily influenced by their peers. Meal convenience is
important to many adolescents and they may be eating too much of the wrong
types of food (i.e., soft drinks, fast-food, processed foods). Therefore its
necessary to make healthy food choices to remain healthy lifelong
Importance of meals:Breakfast–
 It is the most important meal of the day.
 Better concentration
 You feel active whole day
 Good school performance
 Regular attendance as you don’t get sick easily.
 Resistance to infections increases
 It should include milk, fruits and cereals.
A saying well defines the importance of breakfast:-
Lunch
Eat breakfast as the prince, lunch as the king and dinner as the beggar.
xxx
 Taking lunch at right time better digestion and reduced gastric
problems
 Concentration is better at work.
 If you take any fruit or sweet just before lunch makes you lose
your taste and hunger.
 If you take excess of lunch it may lead to health problems like
obesity and indigestion.
Dinner
 Skipping dinner leads to acidity and other digestion problems.
 As there is long time gap till the next morning its essential to provide
energy through dinner.
 Eating a healthy dinner will maintain your ideal weight.
 Skipping dinner will lead to stress.
 Dinner should be taken 2-3 hours before going to bed.
xxxi
Food
Vegetarian (g)
Non-vegetarian(g)
Cereals
420
420
Pulses
60
30
Milk
500
500
Roots and tubers
200
200
Green leafy vegetables
100
100
Other vegetables
100
100
Fruits
100
100
Fats and oils
25
25
-
50
35
35
Meat/chicken/ fish/egg
Sugar and jiggery
Reference
Dietary guidelines for Indians – A manual
NIN – 1999(Hyderabad)
xxxii
Nutrients
RDA
Energy
2640 kcal
Protein
78 g
Visible fat
22 g
Calcium
500 mg
Iron
50 mg
Vitamin A
2400 μg(β- carotene)
600 μg(retinol)
Vitamin B1
1.3 mg
Vitamin B2
1.6 mg
Niacin
17 mg
Vitamin B6
2 mg
Vitamin C
40mg
Folic acid
100 μg
Vitamin B12
0.2 μg
xxxiii
For vegetarians
Breakfast –
milk / milk shakes / lassi – 1glass
Stuffed paratha(2) / vegetable sandwiches(4) / egg (2)and
bread (4 slices) / missi roti(3) and curd(1 bowl)
Mid morning –
Lunch -
seasonal fruits (2)
chapatti (4)
Vegetable ( 1 bowl)
Curd ( 1 bowl)
Salad ( half plate)
Evening
snacks –
poha( 1 plate) / besan or atta laddoo(2) / bread jam(2) /
roasted chana( half bowl) / sprouted chat ( 1 bowl) /
popcorns / besan ki chile(2) / sandwiches(2)
Tea – 1 cup
Dinner -
chapattis (2)
Dal palak( 1 bowl) / any dal(1bowl)
Vegetable ( 1 bowl)
rice(1 bowl)
salad (half plate)
Any sweet
Bed time –
milk( 1 cup)
The above menu provides approximately:Calories = 2437 kcal, Protein= 72g, Fat = 43g
Meal plan for non-vegetarians
xxxiv
Breakfast – milk/ milk shakes/lassi – 1 glass
Stuffed paratha(2) / egg rolls (2) / boiled eggs(or in any form) and
bread (4 pc) / missi roti(3) and curd(1 bowl)
Lunch - chapatti – 4
Vegetable (1 bowl)
Curd (1 bowl)
Salad(half plate)
Evening
snacks -
poha( 1 plate) / besan or atta laddoo(2) / bread jam(2) / roasted
chana( half bowl) / sprouted chat ( 1 bowl) / popcorns / besan ki
chile(2) / sandwiches(2)
Dinner –
chapatti(2)
chicken/ meat / fish curry ( 2 bowls)
rice( 1bowl)
salad (half plate)
Any sweet
Bed time – milk ( 1 cup)
The above menu provides approximately:Calories – 2540 kcal, Protein – 75 g, Fat – 46 g
xxxv
(XII)
Guidelines

All seasonal vegetables and fruits should be eaten.

Try to include green leafy vegetables in your diet as much as possible.

Milk and milk products must be taken daily in good quantity.

It is important to have all the meals specially breakfast.

Try to avoid junk foods and eat home prepared foods as much as possible.

Do not overeat.
How to calculate your ideal weight?
1. Convert your height in cm for eg. 5 feet 3 inches = 157.5 cm
2. Subtract 100 from it. (157.5 – 100 = 57.5)
3. The value obtained is the approximate ideal weight according to
your height.
Standard Height and Weight for Age for Adolescents (NCHS)
Age
Height (cm)
Weight (kg)
16 +
171
58
17 +
175
62.7
Reference
Nutritional Requirement and Recommended Dietary Allowances for Indians
ICMR (1990)
xxxvi
(XIII)
Know your status
By calculating BMI (Body Mass Index) you can judge your body status.
BMI can be defined as ratio of weight in kg to height in meter square. An
individual can be categorised as follows according to his BMI: Underweight – if BMI falls under 18.5
 Normal – if his BMI falls between 18.5 – 22.9
 At risk of obesity – if his BMI falls between 23 – 24.9
 1st grade obese – if his BMI falls between 25 – 29.9
 2nd grade obese- if his BMI falls above 30
BMI can be calculated using following formula:Weight (kg)
Height ( m2)
For example:Gurjeet singh has 65 kg weight and his height is 5feet 8inches
5feet 8 inches = 170 cm = 1.70 m
1.702= 2.89
= 65
2.89
= 22.49 (BMI)
22.49 falls in the second category that is he is normal.
xxxvii
Appendix II
(Interview Schedule)
xxxviii
FOOD CONSUMPTION PATTERN AND NUTRITIONAL STATUS OF
URBAN AND RURAL ADOLESCENT BOYS
Code No :
School :
(i)
Date :
General Information :-
1.
Name of the respondent :
.
.
2.
Date of Birth
.
.
3.
Sex
4.
Father’s Name
:
.
.
5.
Mother’s Name
:
.
.
6.
Contact no.
7.
Permanent Address
:
:
.
:
:
.
.
.
.
.
.
.
8.
Monthly income
:
9.
Type of family
:
10.
Birth Order
11.
No. of siblings
.
.
joint :
nuclear :
:
:
Male :
Female :
(ii) No. of Family Members :S.No.
Name
Relationship
Qualification
Occupation
Approximate
Monthly income
1
2
3
4
5
6
7
xxxviii
(iii) Dietary Pattern :a) Food Choice :
Vegetarian/Non-vegetarian/Ova vegetarian
b) Food Likes :
c)
Food dislikes
:
d) Do you take breakfast
:
Yes/No
If yes, List the menu :
e) Meal Pattern :
Sno.
1
2
3
4
5
6
7
√/×
Meal
Early Morning
Break fast
Recess
Lunch at Home
Evening Tea
Dinner
Bed time
Packed Lunch/Canteen
f) Do you take Lunch : Yes/No
Packed Lunch/At home /Any other source : ______________
g) Do you skip any meal :
Yes/No
If yes, which : Breakfast/Lunch/Dinner
h) Do you take any food item between meals : Yes/No
xxxix
If yes list the items –
i)
How often do you consume the following :-
S.no.
Food items
(a)
Cereals
(b)
(c)
(d)
(e)
Daily
Thrice a
week
Twice a Weekly
week
Chapati
Parantha
Poories
Bread
Rice
Dalia
Maize chapatti
Whole Pulses
Raungi
Rajma
Kale Chane
Chhole
Moong
Urd
Dehusked pulses
Chane ki daal
Arhar
Moong dal
Masar
Milk & Milk
Products
Milk
Lassi
Curd
Paneer
Green Leafy
vegetables
Sarso ka saag
Methi
Palak
Bathua
xl
Fortnightly
Rarely
Never
(f)
(g)
(h)
(i)
Roots & Tubers
Potato
Onion
Sweet Potato
Radish
Carrot
Other Vegetables
Fruits
Sweets
j)
How often do you consume fast food?
S.no.
Food items
1
Aloo Tikki
2
Bhelpuri
3
Bread Pakora
4
Buiscuits (sweet)
5
Biscuits (salty)
6
Biscuits (cream)
7
Burger
8
Cheese chilly
9
Chips
10
Cream Roll
11
Chhole Bhature
12
Craxs
13
Chocolates
14
Cakes
15
Candies
16
Egg roll
17
Finger Fries
18
Fryams
19
Golgappe
20
Grilled Sandwich
Daily
Thrice
a week
Twice a Weekly
week
xli
Fortnightly Rarely
Never
21
Hog dog
22
Ice cream
23
Kurkure
24
Kulche Chhole
25
Macroni
26
Manchurian
27
Momos
28
Maggi
29
Muffins
30
Mc Puff
31
Namkeens
32
Noodles
33
Pizza
34
Patties
35
Pav Bhaji
36
Paneer wrap
37
Pastry
38
Paneer Pakore
39
Sandwich
40
Samosa
41
Soft drink
42
Spring Rolls
43
Veg Pakore
44
Veg rolls
xlii
(iv) Dietary Information for Three Days:
S.no. Description
(i)
1ST DAY
1
Early morning
2
Breakfast
3
Mid morning
4
Lunch
5
Evening Tea
6
Dinner
7
Bed Time
(ii)
2ND DAY
1
Early morning
2
Breakfast
3
Mid morning
4
Lunch
5
Evening Tea
6
Dinner
7
Bed Time
(iii)
3RD DAY
1
Early morning
2
Breakfast
3
Mid morning
4
Lunch
5
Evening Tea
6
Dinner
7
Bed Time
Menu
Ingredients
xliii
Household
Raw(g)
Cooked(g)
(v) Physical Activity Pattern :
a) At what time do you get up?
b) At what time do you leave for school?
c) What is the mode of vehicle?
d) Which game do you play?
e) How many hours do you play daily?
f) Do you play during recess?
g) At what time do you reach home after school?
h) Do you take rest after school hours?
If yes, for how long?
i)
Do you perform any other exercise?
(vi) Life Style Pattern:Time Spent for
(a) Sleep
(b)
Walk
(c)
TV Viewing
(d)
Reading
(e)
Household work
(f)
Exercises
(g)
Computer games
(h)
School
What do you do in your free time?
a) Study (home work & extra work)
b) Read novels/comics/story books
c) Play games : Indoor/Outdoor
d) Watch TV
e) Any other (Specify)
(vii)
Anthropometric Parameter
Weight (kg):
Height (cm):
xliv
Appendix III
(Knowledge Test)
xlv
FOOD CONSUMPTION PATTERN AND NUTRITIONAL
STATUS OF URBAN AND RURAL ADOLESCENT BOYS
KNOWLEDGE TEST
Name
:
…………………………………………………………………
School
:
…………………………………………………………………
1H
2H
;zs[fbs nkjko ftZu eh^eh nkT[Adk j?<
^
gq'NhB
^
ekop';
^
ftNkfwB ns/ yfDi
^
gkDh
^
T[go'es ;ko/
i/ s[;hA tZX wksok ftZu ekop'jkJhvo/N; iK t;k b?Ad/
j' sK s[;hA^
3H
4H
5H
6H
^
w'N/ j' ikT[r/
^
gsb/ j' ikT[r/
^
e'Jh coe BjhA nkt/rk
fejVk G'iB tZX wksok ftZu ykDk ukjhdk j?<
^
nBki ns/ dkbK
^
|b ns/ ;pIhnK
^
d[ZX s'A pD/ gdkoE
^
t;k ns/ Peo
dkbK fe; dk Go{o ;o's j?<
^
ekop';
^
gq'NhB
^
t;k
^
ftNkfwB
ftNkfwB dh dk ;G s'A ;;sk ns/ Gog{o ;o's fejVk j?<
^
nwo{d
^
nktbk
^
nzr{o
^
;zsok
fejVk g"PfNe sZs jZvhnK ns/ dzdK d/ ;jh sohe/ ftu
tZXD bJh Io{oh j?<
xlv
7H
^
ftNkfwB Jh (E)
^
e?bPhnw
^
;'vhnw
^
ftNkfwB J/ (A)
ykDk
gekT[D
t/b/
fejV/
s/b
dh
tos'A
BjhA
eoBhA
ukjhdh<
8H
^
fockfJzv s/b
^
;o'A dk s/b
^
vkbvk
(b'j/) nkfJoB dh nkjko ftZu ;jh wksok fe; fpwkoh s'A
pukT[Adh j?<
9H
^
fdb dh fpwkoh
^
Peo o'r
^
y{B dh ewh
^
bhto dh fpwkoh
nZyK B{z szdo[;s oZyD bJh fe; feNkfwB dh b'V j[zdh
j?<
10H
11H
12H
^
ftNkfwB Jh (E)
^
ftNkfwB vh (D)
^
ftNkfwB J/ (A)
^
ftNkfwB Jh (C)
fdB ftu fe; ;w/A dk ykDk Io{oh j[zdk j?<
^
;t/o dk
^
d[gfjo dk
^
oks dk
nkfJoB (b'j/) dh tZX wksok tkbk ;o's fejVk j?<
^
joh gZs/dko ;pIhnK
^
Peo
^
|b
^
d[ZX s'A pD/ gdkoE
oks d/ ykD/ s/ ;"D ftu fezB/ ;w/A dk |oe j'Dk ukjhdk
j?.
xlvi
13H
^
15 fwzN
^
2^3 xzN/
^
½ xzN/
d' tes d/ ykD/ ftueko G[Zy bZrD s/ eh ykDk ukjhdk
j?<
14H
15H
16H
17H
18H
^
fwmkJhnK ns/ u"eb/N
^
pIkoh ykDk
^
|b s/ ;B?e;
^
e'bv fvqze;
pIkoh ykD/ ftu eh j[zdk j?<
^
tZX Peo ns/ Bwe (b{D)
^
tZX t;k
^
fockfJzv nkNk
^
T[go'es ;ko/
nkjko ftu eh ykD Bkb tZX Pesh nkT[Adh j?<
^
ekop';
^
t;k
^
gq'NhB
^
ftNkfwB ns/ fwBob
rowh s'A puD bJh ;G s'A tXhnk eh ghD :'r j?<
^
gkDh
^
e'bv fvqze;
^
i{;
^
d[ZX
;kv/ Poho ftZu gkDh dk ;G s'A Io{oh eh ezw j?<
^
Io{oh nzrK dk pukT[
^
Pohoe skgwkB B{z ;zs[fbs eoBk
^
jkBhekoe
^
T[go'es ;ko/
ykbh ;w/A dh ;jh tos'A eh eoe/ eoBh ukjhdh j?<
^
NhHthH d/ye/
^
pkjo y/vK y/v e/
^
;"Dk
xlvii
^
19H
20H
21H
22H
23H
24H
25H
;zrhs ;[BDk
y{B pBkT[D bJh fejVk Io{oh j?<
^
e?bPhnw
^
nkfJoB (b'jk)
^
ekop';
^
ftNkfwB J/ (A)
ftNkfwB J/ dk w[Zy ;o's fejVk j?<
^
gghsk
^
nzp
^
eZd{
^
T[go'es ;ko/
\{B izwD bJh fejVk ftNkfwB ukjhdk j[zdk j?<
^
ftNkfwB J/ (A)
^
ftNkfwB vh (D)
^
ftNkfwB e/ (K)
^
ftNkfwB Jh (E)
;zs[fbs nkjko d/ f;XKs eh jB<
^
;jh wksok
^
fGzBsk
^
r[Dsk
^
T[go'es ;ko/
;jh wksok ftu o/Pk fe; s'A fwbdk j?<
^
skik |b s/ ;pIhnK
^
nBki
^
N'NthA dkbK (fpBK fSbe/ s'A)
pIkoh$pkjoh ykDk ykD d/ eh Bshi/ jB<
^
Gko tZX iKdk j?
^
Gko xZN iKdk j?
^
Gko ;jh ofjzdk j?
^
T[go'es ;ko/
yZN/ o;hb/ |b fe; ftNkfwB dk w[Zy ;o's jB<
^
ftNkfwB J/ (A)
^
ftNkfwB ;h (C)
xlviii
^
ftNkfwB Jh (E)
^
ftNkfwB e/ (K)
xlix
1.
xo ftu pDkfJnk ykDk pkjo d/ ykD/ s'A tXhnk j?<
jK$BjhA
2.
Pokp f;js bJh uzrh j?<
jK$BjhA
3.
wZSbh dk ;/tB fdb bJh bkGekoh j[zdk j?<
jK$BjhA
4.
Eh ;bkd G'iB dk fJZe Io{oh fjZ;k j'Dk ukjhdk j?<
jK$BjhA
5.
Poho B{z szdo[;s oZyD bJh o'I e;os eoBh Io{oh j?<
jK$BjhA
6.
fe;/ th ;w/A dk ykDk SZvD Bkb f;js ns/ ekoiekoh ftu jK$BjhA
coe g?dk j?<
7.
g{oh BhAd b?Dk tXhnk ekoiekoh bJh Io{oh j?<
jK$BjhA
8.
eh d[ZX ns/ d[ZX s'A pD/ gdkoE
ekoiekoh s/ tZX ftu bkGekoh j?<
pZu/ dh tXhnk
jK$BjhA
9.
eh ;zs[fbs nkjko Bkb ;e{b ftu uzrh fefonk ns/
tXhnk fJekfrosk bJh Io{oh j?<
jK$BjhA
10.
jo fe;/ B{z w";wh |b s/ ;pIhnK ykDHnK ukjhdhnK jB<
jK$BjhA
11.
jo fJZe B{z nkT{fvB tkbk b{D ykDk ukjhdk j?<
jK$BjhA
12.
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iKdh j?<
13.
pIkoh ykD/ Bkb Peo o'r ns/ fdb dh fpwkoh tZXD dk jK$BjhA
\sok j[zdk j?<
14.
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15.
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goj/I eoBk ukjhdk j?<
16.
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jK$BjhA
17.
fSbe/ tkbhnK dkbK X'shnK$X[bhnK dkbK s'A tXhnk jB<
jK$BjhA
18.
;'nkphB s'A ;jh wksok ftu gq'NhB gqkgs jz[dk j?<
jK$BjhA
19.
eh tZX Gko T[BK dh jkBhekoe j? fizBK xZN Gko<
jK$BjhA
20.
wZyD iK xh tZX wksok ftu ykD Bkb fdb dh fpwkoh dk jK$BjhA
\sok th tZX iKdk j?<
21.
djhA f;js bJh bkGekoh j?<
22.
jo fJZe B{z xZN s'A xZN 8 s'A 10 frbk; gkDh o'I jK$BjhA
ghDk ukjhdk j?<
23.
bZ;h e'bv fvqze; Bkb'A tXhnk j?<
jK$BjhA
24.
Eh e[dosh ykDk gq';?;v ykD/ Bkb'A tXhnk j?<
jK$BjhA
25.
eh g{zrohnK dkbK g"PfNe j[zdhnK jB<
jK$BjhA
jK$BjhA
jK$BjhA
l
VITA
Name of the Student
:
Neha Mahajan
Father’s name
:
Sh. Deepak Mahajan
Mother’s name
:
Smt. Sunita Mahajan
Nationality
:
Indian
Date of Birth
:
14.02.1986
Permanent home address
:
House no. 315/21, Sector 11, Indira
Nagar, Lucknow, Uttar Pradesh.
EDUCATIONAL QUALIFICATION
Bachelor’s Degree
:
B.Sc. (Hons.) Home Science
University
:
Chandra Shekhar Azad University of
Agriculture and Technology, Kanpur.
Year of award
:
2008
OCPA
:
7.94/10.00
Master’s Degree
:
M.Sc. (Food and Nutrition)
OCPA
:
8.21/10.00
University
:
Punjab Agricultural University,
Year of award
:
2011
Title of Master’s Thesis
:
Food Consumption Pattern and
Nutritional Status of Urban and Rural
Adolescent Boys.
Awards/Fellowships/
Scholarships/Distinction
:
Merit scholarship (2004-08).
National Cultural Certificates (2006-08)
JRF fellowship (2008-2010)
Ludhiana.
li