A Study to Estimate the Nutritional Status of Preschool Children

Lunch contributes around one third of daily energy and nutrient requirement for primary school students. If the nutrition content of the lunch boxes deviates from the dietary recommendations, it may cause adverse effect on student's health. The aim of this study is to give a concept to the public about the quantity and the quality of the foods in school lunch box currently supplied by mother. As most primary schools in Muzaffarnagar change from half day to full day, it is becoming more likely that students will have lunch at school. It is also clear that the trend of using lunch box catering service will increase as well. The most of the lunch boxes supplied by mother contained lots of high fat foods and was considered to be unhealthy. Unhealthy school lunch has a wide range of potential effects on students' lives since what students eat may affect their growth and various health outcomes, both in their childhood and in adulthood. The preschool years are characterized as a time of increasing autonomy, expanding language skills, increasing ability to control behavior, and broadening social circumstances, such as attending preschool or staying with friends or relatives (100). Preschool children continue to expand their gross and fine motor capabilities and by age 4 years, a child can hop, jump on one foot, ride a tricycle or bicycle with training wheels, and throw a ball overhand. Most children consume the foods eaten by the rest of the family by age 2 to 3 years. Feeding is not as messy because the child can use a fork, spoon, and cup well, although the ability to use a knife to cut or spread foods is not fully developed. The overall rate of growth continues to be relatively slow, with periods of growth “spurts.”Consequently, the preschool child has a relatively small appetite with periods of increasing food intake in advance of a growth spurt. Although the preschool child’s intake may fluctuate widely from meal to meal and day to day, over a week’s time the intake remains relatively stable because preschool children have the ability to self-regulate food intake and to adjust their caloric intake to meet caloric needs (133). The child’s increasing autonomy and expression of food preferences, combined with a variable appetite, cause many parents to describe their child as a “picky eater” (100). More importantly, as students consume about one third of their daily food at school, an unbalanced diet may predispose to childhood obesity, which itself is considered in comprehensive obesity prevention program.

It is commonly agreed that the criterion of defining a healthy lunch box should include the conditions that it should be prepared by healthier cooking methods, the portion size & nutrient value of vegetable, meat and cereal products should follow the recommended value. However, there is no available criterion on how to define an unhealthy lunch box though the presence of high fat food and inappropriate food portion size was commonly suggested by some studies. In this study, we arbitrarily define an unhealthy lunch box as the nutritional status of foods was very low & does not meet with the recommended value.

The years between a child’s 2nd and 5th birthdays represent a period of rapid social, intellectual and emotional growth. At the same time, overall physical growth is decelerating while motor skills are being fine-tuned. Preschoolers are busy exploring the environment. They have tested their independence and are now ready to learn. Preschoolers have two common preferences. Firstly, they have a preference for routine in daily life. Most children need some structure and routine to their day. Generally, they prefer meals and snacks at regular times, as governed by the family’s lifestyle. Secondly, they have a preference for simplicity. Many children may like simply prepared, mild tasting foods that they can easily identify. They prefer foods they can manage, for example, cut-up vegetables they can eat with their fingers and soups they can drink from a cup. In the preschool years, food takes on more complex meanings. Preschoolers have an association with food of more than eating. Foods have specific meanings determined by a child’s associations With them. For example, sweets may mean a reward for good behavior in the supermarket. Additionally, caregivers should be aware that early impressions associated with various uses of food, affect food-related attitudes and practices that can last throughout life. Food preferences can now be influenced; parents and friends as well as television advertising will affect food consumed.

How much food is eaten at this age varies from child to child and from day to day and is influenced by growth and activity levels. The following serving sizes and amounts can be used as a guide to feeding 4 – 7 year These suggestions are a guide only. Every child is different, and their activity and growth rate changes from day to day. The main focus should be on the introduction of a healthy eating pattern and family meal acceptance rather than on serves.

The study was undertaken with the objective “A study to estimate the nutritional adequacy of lunch boxes of preschool children’s& their nutritional status” Assessment of nutritional status is the first step in the formulation of any public health strategy to combat malnutrition. The children within 4-6 years of age were selected randomly from the identified schools. 150 children from rural and urban areas each constituted the otal sample of 300. Three tools were used in the study to assess the nutritional health status-Nutrition Survey, 24-hr recall method, questionnaire cum interview schedule. Clinical examination is commonly used in survey, since it is relatively simple and do not call for sophisticated equipment. It reveals the anatomical changes due to malnutrition that can be diagnosed by the naked eyes.24-hr recall method is generally used to obtain a general picture of person’s food intake. It is used to elicit an accurate picture of the diet history. In 24-hr recall method, the actual food and drink consumed in the immediate past 24 hours is recorded. Sometimes,

it and then compared with the Recommended Dietary Allowances. Questionnaire is either interviewer administered or self-completed. A detailed questionnaire includes the list of foods and the subject answers as to how often and in what quantity each food is eaten per day, per week and per month. The collected information of the food consumed is then checked with the Recommended Dietary Allowances (RDA by ICMR, 1990). It gives an estimate of the amount and frequency of the various nutrients consumed by the individual. The data will be obtained from dietary survey, anthropometric measurement; nutrient intake will be analyzed by using mean standard deviation & percentage.

RESULT AND DISCUSSION

There are different full day primary schools in Muzaffarnagar District. All primary school were agreed to take part in the study, among the participating schools, all were subsidized schools.

Table shows that 73% of respondents give fried food in their child’s lunchbox whereas 27% respondents don’t give fried food in their child’s lunchbox.

items to their child.

The study revealed that the foods in most of the lunch boxes currently supplied by the mothers did not meet with the dietary recommended serving value for primary school students. There is considerable variation in children’s appetite, fluctuating from day to day, depending on their rate of growth and level of physical activity. Children are able to decide how much food they need if allowed to eat to appetite, encourage parents to allow this. Children commonly eat small amounts of foods, frequently, due to their small stomach capacity. Many parents find their children eat better at certain times of the day. Forcing children to ‘clean the plate’ or giving sweets as rewards may lead to problems of Overeating later on. That’s why it is very necessary to provide nutritious food in their lunch box by their mother to improve their growth and development according to age with respect to anthropometric measurement.

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