Effect of mid-day meal on nutritional status of adolescents: A cross-sectional study from Gujarat

Abstract

Objective: To evaluate the effect of mid-day meal (MDM) on the nutritional status of adolescents and compare it with healthy comparison group. Settings and Design: A cross-sectional study on apparently healthy adolescents (10-14 years) receiving MDM and not receiving MDM (comparison group) was conducted in two cities (Ahmedabad and Patan) of Gujarat, Western India, from January 2012 to March 2014. Materials and Methods: A total of 401 adolescents (200 boys) were selected randomly, using computerized random number generation, from two private and two municipal/government schools. Anthropometric measurements were performed. Height, weight, and body mass index Z scores were computed using ethnic data. Diet was recorded by 24 h recall and nutrient intakes were computed (C-diet V-2.1) as a percentage of the recommended dietary allowance (RDA). Student’s t-test and Chi-square tests were used to compare differences in nutritional status. Results: Percentage of stunting (24% boys and 19% girls) and wasting (17% boys and 18% girls) was significantly higher in adolescents receiving MDM (p<0.001), while the percentage of risk of being overweight, i.e., BMI for age Z (BAZ) >1 or above 85th percentile (18% boys and 12% girls) was predominant in non-MDM receiving adolescents (p<0.001). Compared to non-MDM, MDM receiving adolescents consumed significantly reduced quantity of nutrients (p<0.05). On comparing RDA based on the 24 h dietary recall, it was seen that MDM receiving boys met 60% energy, 78% protein, 50% calcium, and 53% of micronutrient requirements while MDM receiving girls met 59% energy, 67% protein, 44% calcium, and 48% of micronutrient requirements. Non-MDM receiving adolescents had close to RDA or above intake for the most nutrients (p<0.05 for all). Conclusion: Although MDM scheme restricted the percentage of stunting to some extent, the percentage of wasting was critical in terms of public health significance. MDM receiving adolescents were vulnerable to energy, protein, and micronutrient deficiencies.
Key words: Adolescents, Nutritional status, Micronutrients, Mid-day