Transcript Fig. 6 Food Intake (% RDA) among 1

NATIONAL NUTRITION MONITORING
BUREAU
Dr.G.N.V.Brahmam
Dy. Director, Field Division,
National Institute of Nutrition, (I.C.M.R.)
Jamai-Osmania (P.O.),
Hyderabad – 500 007.
“Nutrition monitoring is the measurement of the
changes over time in the nutritional status of a
population or a specific group of individuals”
-- WHO, 1984
Nutrition Monitoring is essential
- to assess the type, magnitude & distribution of
nutrition problems in the community,
- to evolve policies and to formulate & implement
programmes for the prevention and control of
malnutrition and
- to evaluate on-going nutrition programmes to
assess their impact and to initiate corrective
steps needed, if any.
NNMB was established in the year 1972, under
the aegis of ICMR in the States of :

ANDHRA PRADESH

KARNATAKA

KERALA

TAMIL NADU

MAHARASHTRA

MADHYA PRADESH

ORISSA

UTTAR PRADESH

GUJARAT AND

WEST BENGAL
OBJECTIVES OF NNMB

To collect, on a continuous basis, on
representative segments of population in each of
the States, data on dietary pattern and nutritional
status by adopting standardized and uniform
procedures and techniques, and

To evaluate periodically, the ongoing national
nutrition programmes, to identify their strengths
and weaknesses and recommend appropriate
corrective measures.
ORGANIZATION CHART OF NNMB
ICMR
STEERING COMMITTEE
NIN - CRL
10 State Units
STAFF / UNIT
Medical Officer
Nutritionist
Social Worker
Field Attendant
Driver
INVESTIGATIONS

Household
particulars,

Dietary intakes of households / individuals,

Anthropometry viz., Heights, weights, MUAC &
Skinfold at Triceps,

Clinical examination for prevalence of signs of
nutritional deficiencies and

Village level information such as population,
agricultural production, nutritional & other
developmental programmes.
demographic
&
socio-economic
SAMPLING DESIGN
VILLAGES:

Sub-sample of NSSO sample frame of Consumer
Expenditure survey carried out once in five years
– to get better spatial distribution.
HOUSEHOLDS

Cluster sampling method
INDIVIDUALS

All individuals from the selected HHs.

Sub-sample
procedure
by
systematic
random
sampling
SAMPLE SIZE
•
Computed to arrive at State level estimates
HIGHLIGHTS OF NNMB SURVEYS

Coverage of rural, tribal & urban communities,

Repeat surveys in rural communities during 197579, 88-90, and 96-97, covering same villages,

Repeat surveys among tribal communities during
1985-87 & 1998-99,

Study of physiologically vulnerable groups such
as adolescent girls, elderly etc.,

Assessment of MNDs such as IDA, VAD & IDD by
covering adequate sample sizes to arrive at State
level estimates, and

Evaluation National nutrition programmes
NUTRITIONAL STATUS OF THE RURAL
POPULATIONS (2001 - 02)
SOCIO ECONOMIC PROFILE OF HOUSEHOLDS (%)
COMMUNITY
60
TYPE OF HOUSE
60.4
60
40
31.9
36.1
40
21.5
20
0
10.5
20
0
SC
29.3
ST
BC
Others
10.3
Kutcha
OCCUPATION
Semi-Pucca
Pucca
LAND OWNERSHIP
60
60
45.0
40
33.3
40
36.0
26.4
20
0
18.3
22.0
20
9.6
9.4
0
Agri. Lab
Other Lab
Cultivators
Others
No Land Marginal
Farmers
Small
Farmers
Large
Farmers
SOCIO ECONOMIC PROFILE OF HOUSEHOLDS
(Contd..)
FEMALE LITERACY (% )
PER CAPITA INCOME / MONTH (% )
50.0
60
43.3
34.0
40.0
53.1
50
40
30.0
29.8
30
20.0
10.7
12.0
10.0
20
13.8
3.3
10
0.0
<300
300-600
600-900
>=900
0
Illiterate
80
39.5
40
College
67.4
32.4
55.7
60
30
9-12 std.
BASIC AMENITIES (% )
SOURCE OF DRINKING WATER (% )
50
1-8 std.
26.1
40
20
26.2
10
1.1
0.9
20
0
Open
Well
Tube
Well
Tap
Pond Stream
0
Sanitary Latrine
Separate
Kitchen
Electrification
Food Intake (% RDA) among 1-6 Years Children
77.7
Cereals
80.4
34.3
Pulses
Green Leafy Veg.
1-3 Yrs.
4-6 Yrs.
51.5
15.0
18.0
85.0
Other Veg.
93.3
230.0
Roots & Tubers
Milk & Milk Prod.
Fats & Oils
Sugar & Jaggery
0.0
180.0
24.0
20.4
33.3
28.0
36.7
30.0
50.0
100.0
Percent RDA
150.0
200.0
Average intake of Food stuffs (as % of RDA)
by Adult Males and Females
94.8
99.4
Cereals
Males
65
Pulses
Green Leafy Veg.
Females
85
18
45
125
Other Veg.
95
138
Roots & Tubers
150
67
Milk & Milk Prod.
56.7
60
Fats & Oils
35
45.7
Sugar & Jaggery
0.0
56.7
20.0
40.0
60.0
80.0
Percent of RDA
100.0
120.0
140.0
160.0
Median Intake of Nutrients (as % RDA) by
Children
81.4
87.3
Protein
56.9
60.8
Energy
30.2
Calcium
45.0
33.3
35.0
Iron
Vitamin A
12.4
15.5
66.7
66.7
Thiamin
28.5
30.0
Riboflavin
57.5
Niacin
70.0
33.3
37.5
Vitamin C
0.0
1-3 Yrs.
4-6 Yrs.
25.0
50.0
Percent of RDA
75.0
100.0
125.0
Median Intake of Nutrient (as % RDA) By
Adult Males and Females - Sedentary
90.8
90.2
88.4
Protein
Energy
Males
Females
97.4
105.0
Calcium
86.0
50.0
Iron
38.3
20.3
16.0
Vitamin A
108.3
Thiamin
122.2
50.0
54.5
Riboflavin
101.3
Niacin
118.3
82.5
Vitamin C
72.5
0
25
50
Percent of RDA
75
100
125
Distribution (%) of children according to
Protein - Calorie Adequacy
1-3 Yrs
21.6
P- C-
4-6 Yrs
8.9
7-9 Yrs
7.0
46.9
62.5
P+ C-
62.0
31.5
P+ C+
28.6
31.0
0
20
40
60
Distribution (%) of Adults according to
Protein - Calorie Adequacy Status
P- C+
0.6
Males
1.3
Females
6.9
P- C-
5.1
12.8
P+ C-
5.8
79.7
P+ C+
87.8
0
20
40
60
80
100
Distribution (%) of Pre-school children
according to Gomez Classification
43.4
43.3
Boys
41.5 41.1
Girls
Percent
40
20
8.7
0
9.2
Normal
6.4 6.4
Mild
Moderate
Severe
Prevalence (%) of Undernutrition Among 1-5 yr
children According to SD Classification
(<Median - 2SD) By Gender
61.5
60
Percent
Boys
Girls
62.2
48.6 50.0
40
22.9 22.0
20
0
Underweight
Stunting
Wasting
Distribution (%) of Adults by BMI Grades
Percent
40
Males
56.9
60
52.5
37.4
Females
39.3
20
5.7
0
CED
Normal
8.2
Over Weight
UNDERWEIGHT (%) BY SOCIO-ECONOMIC VARIABLES
BY COMMUNITY
80
60
40
20
0
68.6
ST
SC
BC
Others
BY TYPE OF HOUSE)
62.4
58.8
56.4
80
60
40
30.4
23.0
20.6
16.3
20
< Median - 3SD < Median - 2SD
0
BY MONTHLY PCI
60
< 300
300 - 600
600 - 900
>=900
64.9
0
64.0
59.8
47.4
24.0
20.3
14.9
< Median - 3SD < Median - 2SD
BY FEMALE LITERACY
70
59.2
51.2
43.3
40
20
Kutcha
Semi Pucca
Pucca
25.2
18.2
15.7
11.4
< Median - 3SD < Median - 2SD
50
30
Illiterate
Upto 8th
9 - 12 Std.
College
65.2 59.9
55.3
47.6
24.721.3
16.113.3
10
-10
< Median - 3SD < Median - 2SD
INTRA-FAMILY DISTRIBUTION OF DIETARY ENERGY IN
RURAL INDIA
Distribution (%) of Households According to Dietary
Energy Adequacy Status of Adults and Children (199697)
DIETARY ENERGY
AGE GROUP
+
Preschool
(n=1696)
31.1
School
age
(n=2356)
47.3
Adolescents
(n=1406)
61.6
+
-
42.9
27.4
13.2
+
-
+
1.4
1.4
2.1
+
-
-
4.2
2.2
1.4
-
+
+
2.9
4.7
7.3
-
+
-
9.3
8.8
6.2
-
-
+
1.0
1.2
2.2
-
-
-
7.2
7.0
6.0
Adult
Male
Adult
Female
Child
+
+
+
+ : Adequate - : Inadequate ;
Child Inadequacy
2 : 308.6 , p<0.001
63.6
45.4
26.8
Distribution (%) of Households According Dietary
Energy Adequacy Status of Adults & Pre-school Child
-- Time Trends
50
42.9
1975-80
1996-97
40
Per cent
31.0 31.0
30
25.4
19.0
20
7.0
10
0
All Adequate
Adult Adequate
& Preschool
Inadequate
All Inadequate
NUTRITIONAL STATUS OF THE RURAL
POPULATIONS – TIME TRENDS
Average Intake of Foodstuffs (per CU/day)
as % of RDI by Period of Survey
109.8
102
97.8
Cereals
1975-77
1988-90
1996-97
85.0
80
Pulses
67.5
20.0
22.5
GLV
37.5
90.0
81.7
O.Veg.
78.3
0
50
100
Percent
150
Average Intake of Foodstuffs (per CU/day)
as % of RDI by Period of Survey (contd.)
112.0
82.0
88.0
Roots&Tub.
1975-77
1988-90
1996-97
77.3
61.3
57.3
Milk&MP
70.0
65.0
60.0
Fats&Oils
76.7
96.7
Sug&Jag.
70.0
0
50
Percent
100
150
Average Intake of Nutrients (per CU/day) as
% of RDI by Period of Survey
102.5
97.3
89.5
Protein
1975-79
1988-90
1996-97
96.9
94.1
86.9
Energy
151.5
141.3
Calcium
107.9
97.1
Iron
130.3
88.9
0
50
100
Percent
150
Average Intake of Nutrients (per CU/day) as
% of RDI by Period of Survey (Contd.)
1975-79
1988-90
1996-97
41.0
47.0
50.0
Vitamin A
125.0
108.3
100.0
Thiamin
57.1
64.3
64.3
Riboflavin
91.9
88.8
79.4
Niacin
97.5
92.5
100.0
Vitamin C
0
50
Percent
100
150
Distribution (%) of Households with
Protein Calorie adequacy
57.8
1975-79
1988-90
1996-97
53.3
Calorie
47.6
77.9
83.5
Protein
79.5
0
50
Percent
100
Distance charts for Heights and Weights
for Males and Females - Andhra Pradesh
18 +
20-25
30-35
40-45
50-55
60 & above
18 +
20-25
30-35
40-45
50-55
60 & above
16 +
14 +
12 +
10 +
8+
6+
50-55
40-45
30-35
20-25
18 +
60 & above
Age (Yrs)
16 +
14 +
12 +
10 +
8+
0
6+
0
4+
20
2+
20
4+
40
2+
40
60
<1
60
<1
1975 - 1979
1988 - 1990
1996 - 1997
NCHS Std.
80
Weight (Kg)
80
Females
100
1975 - 1979
1988 - 1990
1996 - 1997
NCHS Std.
16 +
Age (Yrs)
Males
100
14 +
<1
60 & above
50-55
40-45
30-35
20-25
18 +
16 +
14 +
12 +
10 +
8+
6+
60
4+
60
2+
80
12 +
100
80
Age (Yrs)
Weight (Kg)
120
10 +
100
140
8+
120
160
2+
Height (Cm)
140
<1
Height (Cm)
160
1975 - 1979
1988 - 1990
1996 - 1997
NCHS Std.
180
6+
1975 - 1979
1988 - 1990
1996 - 1997
NCHS Std.
180
Females
200
4+
Males
200
Age (Yrs)
Distribution (%) of Pre-school children (1-5 Yrs)
According to Gomez Classification
47.5
43.8
44.3
50
40.6
37.6
40
Percent
1975-79
1988-90
1996-97
31.6
30
20
15.0
9.9
10
0
8.7
8.9
6.2
5.9
Normal
Mild
Moderate
Severe
Distribution (%) of Children by Undernutrition
and Period of Survey
67.3
64.1
60.1
60
1990-91
2000-01
Percent
49.3
40
20.7 22.5
20
0
Stunting
Underweight
Wasting
UNDERNUTRITION (< Median - 2SD)
Distribution (%) of Adult Males according to
BMI Grades by Period of Survey
60
55.6
Percent
49
45.5
50.4
48.4
1975-79
1988-90
1996-97
42.1
40
20
2.3 2.6
0
CED
BMI <18.5
Normal
BMI:18.5 – 25.0
4.1
Over Weight
BMI: >=25.0
Distribution (%) of Adult Females according to
BMI Grades by Period of Survey
1975-79
1988-90
1996-97
60
51.8
49.3
47.7
Percent
44.8
46.6 46.3
40
20
3.4
4.1
6.0
0
CED
Normal
Over Weight
BMI <18.5
BMI:18.5 – 25.0
BMI: >=25.0
Prevalence (%) of Nutritional deficiency signs
among Preschool Children
5.7
Ang.Stomat.
5.7
2.1
1.8
Bitot Spots
0.7
0.7
1.3
1975-79
1988-90
1996-97
0.6
Marasmus
0.1
0
1
2
3
Percent
4
5
6
7
MICRO-NUTRIENT DEFICIENCIES
(2002 – 03)
Prevalence (%) of Bitot spots among
1 - <5 year children
Madhya Pradesh
1.2
Orissa
0.3
Maharashtra
1.4
Andhra Pradesh
1.2
Karnataka
0.8
West Bengal
0.6
Pooled: 0.7
< 0.5 %
 0.5 %
Kerala
0
Tamil Nadu
0.5
Prevalence (%) of Bitot Spots among 1 - <5 yrs. Children
1.2
1
Per cent
0.8
0.8
0.7
0.7
NNMB-MND
ICMR-MND
0.6
*
0.4
0.2
0
NNMB-2001
* WHO cut-off level (0.5%) of Public Health significance
Prevalence (%) of Bitot Spots in 1 - <5 Yrs.
Children by Community
Prevalence (%) of Bitot Spots in 1 - <5 Yrs.
Children by Occupation
2
2
1.4
1.5
1.1
Per cent
Per cent
1.5
1
0.5
0.5
0.4
0.6
0.5
0
SC
OBC
A gl. La bo ut
Ag.
Labour
OC
Prevalence (%) of Bitot Spots in 1 - <5 Yrs.
Children by Family Size
2
2
1.5
1.5
0.9
1
0.7
0.6
0
0
>=8
0.3
O t he r
C ult iv a t o rs
A rt is a ns
S e rv ic e
B us ine s s
Service
Other
Artisans
Cultivators
Business
La bo ur
Labour
1
0.5
5-7
0.4
1.0
0.5
<=4
0.5
Prevalence (%) of Bitot Spots in 1 - <5 Yrs.
Children by Female Literacy Status
Per cent
Per cent
0.9
1
0
ST
1.2
0.4
Illiterate
Literate
Prevalence (%) of Anaemia Among Different
Physiological and Age Groups
10.2
0.03
2.1
11.2
0.03
1.1
11.0
0.03
9.9
0.03
10.6
0.03
1.8
4.1
3.0
20.5
20.7
Mean
±SE
31.4
41.7
45.5
47
47.2
23.7
43.3
24.7
32.5
Pre-school
children
31.4
30.3
Adol. 12-14 Yrs.
Adol.15-17 Yrs.
Normal
Mild
25.7
22.3
Preg.women
> 6 months
Lact.women
< 6 months
Moderate
Severe
Prevalence (%) of IDD
among 6 - <12 Year Children
Madhya Pradesh
4.3
Maharashtra
12.2
Orissa
0.1
West Bengal
9.0
Andhra Pradesh
3.8
Karnataka
1.9
Pooled: 3.9
<5%
Kerala
0.6
Tamil Nadu
0
>5%
Per cent of Households consuming salt having adequate
Amount (>=15 ppm) of Iodine
80
70
60
54.6
Per cent
49.9
50
40
29.7
31.3
29.4
30
25.6
24.4
23.3
20
10.1
10
0
WB
KER
AP
MR
TN
STATES
* By spot test
KAR
ORI
MP
POOLED