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\parsep 2\p@ plus\p@ minus\p@ \itemsep 1pt} } \makeatother \fvset{frame=single,numberblanklines=false,xleftmargin=5mm,xrightmargin=5mm} \fancyhf{} \setlength{\headheight}{14pt} \fancyhead[LE]{\bfseries\leftmark} \fancyhead[RO]{\bfseries\rightmark} \fancyfoot[RO]{} \fancyfoot[CO]{\thepage} \fancyfoot[LO]{\TheID} \fancyfoot[LE]{} \fancyfoot[CE]{\thepage} \fancyfoot[RE]{\TheID} \hypersetup{citebordercolor=0.75 0.75 0.75,linkbordercolor=0.75 0.75 0.75,urlbordercolor=0.75 0.75 0.75,bookmarksnumbered=true} \fancypagestyle{plain}{\fancyhead{}\renewcommand{\headrulewidth}{0pt}} \date{} \usepackage{authblk} \providecommand{\keywords}[1] { \footnotesize \textbf{\textit{Index terms---}} #1 } \usepackage{graphicx,xcolor} \definecolor{GJBlue}{HTML}{273B81} \definecolor{GJLightBlue}{HTML}{0A9DD9} \definecolor{GJMediumGrey}{HTML}{6D6E70} \definecolor{GJLightGrey}{HTML}{929497} \renewenvironment{abstract}{% \setlength{\parindent}{0pt}\raggedright \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt \textcolor{GJBlue}{\large\bfseries\abstractname\space} }{% \vskip8pt \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt } \usepackage[absolute,overlay]{textpos} \makeatother \usepackage{lineno} \linenumbers \begin{document} \author[1]{Ajeet Jaiswal} \affil[1]{ Pondicherry University, Puducherry, India} \renewcommand\Authands{ and } \date{\small \em Received: 8 December 2012 Accepted: 31 December 2012 Published: 15 January 2013} \maketitle \begin{abstract} Health and nutritional status of an individual depends on the food he eats. Man needs a wide range of nutrients to lead a healthy and active life and these are derived through the diet they consume daily. Good nutrition is a basic component of health. This paper deals with the utility of various anthropometric cut-off points in the evaluation of nutritional & Health status.Total 616 subjects studied from 201 household of the five villages of Baigachak area. Anthropometric measurements taken were height and weight. Dietary data was collected using 24hr recall method. The extent of malnutrition for preschool children was assessed by SD classification and the nutritional status of adults was assessed by BMI classification. \end{abstract} \keywords{bhumia tribe, nutritional status, nutrient intake.} \begin{textblock*}{18cm}(1cm,1cm) % {block width} (coords) \textcolor{GJBlue}{\LARGE Global Journals \LaTeX\ JournalKaleidoscope\texttrademark} \end{textblock*} \begin{textblock*}{18cm}(1.4cm,1.5cm) % {block width} (coords) \textcolor{GJBlue}{\footnotesize \\ Artificial Intelligence formulated this projection for compatibility purposes from the original article published at Global Journals. However, this technology is currently in beta. \emph{Therefore, kindly ignore odd layouts, missed formulae, text, tables, or figures.}} \end{textblock*} \let\tabcellsep& \section[{Introduction}]{Introduction}\par Madhya Pradesh is the largest tribal state, with 23\% of the total tribal population in the country \& of 46 tribal groups in Madhya Pradesh six are considered to be primitive, based on neglect in the past, backwardness and low economic level. The Baiga, Bhumia tribe one of these six primitive tribes are mainly in five districts (Madla, Shahdol, Bilaspur, Bhalaghat and Rajnandgaon). Bhumia tribes are also located in the states of Bihar, Madhya Pradesh, Maharashtra, Orissa, and West Bengal. According to 1961 Census Data, Bhumia was Author : Pondicherry University, Puducherry, India. e-mail: rpgajeet@gmail.com reported from 9 districts of Madhya Pradesh totaling to 54520 (M.L. {\ref Patel 2007)}. Baigas or Bhumia are one of the oldest aboriginal tribes and classified as one of the primitive tribe of Madhya Pradesh on the basis of preagricultural technology, low literacy and stagnant and diminishing population \hyperref[b22]{(Tewari 1984}). Shifting cultivation depicted as an important means of livelihood.\par Tribal peoples are acknowledged to have very close association with the ecosystem and the environment because of their fulfillment of daily nutritional requirements with food foraged from nature. Inadequacies in nutritional intake or under-nutrition can be considered a major source of many adverse effects on the growth and health of individuals (Gordon et al., 1968). Knowledge of the nutritional status of a community or a region is necessary to have a comprehensive idea about it development process, as under nutrition is one of the major health problems in developing countries. It is reported that the basic cause of under nutrition and infection of people are poverty, poor hygienic condition and little access to preventive health care \hyperref[b16]{(Mitra 1985} {\ref , WHO 1990)}. Nutritional status can be assessed by dietary, anthropometric, biochemical and clinical methods. Ideally, a combination of methods should be used when assessing nutritional status using standardised techniques.\par The Bhumia's economy is still highly depended on agricultural pursuits and collection of minor forest produces. Maize, Vargu and Rice is the staple grain and forms an important item of daily diet. The baiga people also kodo, kutki, drink pej, eat little flour and are normally content with what little that they get. One of the prime foods is pej that can be made from grounding macca or from the water left from boiling rice. Also, they eat several items from the forest that includes primarily Chirota Bhaji, Gular leaves such as Chirota, chinch, chakora, sarroota, peepal etc. They also eat BirarKand, Kadukand and other rhizomes. Mushroom is also a delicacy. Numerous fruits such as mango, char, jamun, tendu are also eaten. They hunt as well, primarily fish and small mammals (K. \hyperref[b20]{Sharma 2007)} Out of 35 States (28 states and 7 union territories) in India, some are identified as demograpically lagging behind and Bhumia Tribes of Madhya Pradesh also falls in this category and needs a situational analysis related to nutritional and Health condition. The present paper deals with the health Abstract-Health and nutritional status of an individual depends on the food he eats. Man needs a wide range of nutrients to lead a healthy and active life and these are derived through the diet they consume daily. Good nutrition is a basic component of health. This paper deals with the utility of various anthropometric cut-off points in the evaluation of nutritional \& Health status. he tribal population of the country, as per the 2001 census, is 8.43 crore, constituting 8.2\% of the total population with 91.7\% of them living in rural areas and 8.3\% in urban areas. The population of tribes had grown at the growth rate of 24.45\% during 1991-2001. More than half of the Scheduled Tribe population is concen-trated in the States of Madhya Pradesh (14.51\%).\par T II. \section[{Material and Methods}]{Material and Methods}\par This study is a review work, done to understand the prevalence of under nutrition \& health status among Bhumia tribe of Baigachak area of Dindori district in Madhya Pradesh. The implications of the discussed research will help in formulating better recommenddations for further research so as to reduce this nutritional burden. The Baigachak area is spread out in 39 villages in three blocks. Total five villages were selected purposely from all three blocks for this study considering its accessibility during survey.\par A total of 201 households comprising of 616 which 317 male, 299 female including 125 preschool children were randomly selected during the study. Thus the present investigation has been conducted by random sampling using pre tested, structured interview schedule. Simultaneously, group discussion and informal interview methods have been used. Observation has been conducted through semi-participant method. Anthropometric measurements were taken using standard procedure \hyperref[b25]{(Weiner and Lourie (1981;} {\ref Jeliffee, 1966)}. BMI was computed using the following standard equation: BMI = weight (kg)/ height² (m²). Nutritional status was evaluated using internationally accepted BMI guidelines using James' classification \hyperref[b14]{(James 1988}). Body weight was measured using lever actuated balance in Kg with accuracy of 100gm with minimum clothing. Height was measured by anthropometry rod (SECA, Yogul and Halke, Gmbh and Co. Humburg, Germany). Diet survey was carried out in every fifth household using 24 hours Dietary recall method \hyperref[b23]{(Thimmayama 1987}). The nutrient intake was calculated using food tables for Indian foods \hyperref[b7]{(Gopalan et al. 1990}) and food intakes were compared with the balanced diets recommended for Indians {\ref (ICMR 1981)}. The intake of nutrients was compared with the recommended Dietary allowances for Indians {\ref (ICMR 1990}). The results were compared with the tribal data of National Nutrition Monitoring Bureau {\ref (NNMB, 2009)}.\par The data analysis was carried out using statistical software package SPSS 13.0 version. Univariate analysis using t-test was applied to evaluate the statistical significance. Mean and Standard Deviation of the anthropometric data was calculated for each age group and compared with NCHS (National Center of Health statistics) standards {\ref (NCHS 1976)}. (NCHS data are of whole year). \section[{III.}]{III.} \section[{Results}]{Results}\par A total of six hundred and sixteen individuals' height and weight were recorded (Table \hyperref[tab_0]{1}). Preschool girls were slightly taller than the boys of same age group. However mean weight was comparable in both genders in the same age group. In the 7-10 years age group there was no difference in the mean height of boys and girls. However adolescent girls up to 15 years were taller by about 2-3 cm and heavier by 1-2 kg as compared to boys of the same age group.\par In contrast boys of 16 years old were taller by about 6-10 cm and heavier by 3-5 kg as compared to the girls of the same age group. Similar observation was made with respect to adults also. The tribals were shorter and lighter when compared with the NCHS standards (Table \hyperref[tab_1]{2}). The overall stunting was 42.2\% and wasting was 36.2\% and severely stunting and wasting was 20.1\% and 9\% respectively. Prevalence of chronic energy deficiency (BMI<18.5) through body mass index was about 77 per cent among adult population and adults females are slightly better nourished (26.0\%) as compared to males (21.4\%) (Table \hyperref[tab_3]{4}). Two hundred and thirty six individuals were assessed for Dietary intake information. Maize and Rice formed the bulk of Bhumias diet. The mean intake of cereals (475g/day) was higher than the recommended level (P<0.05).\par However the intake of foodstuffs, such as pulses, green leafy vegetables, root and tubers, oil and fat, sugar and jaggery was significantly lower than recommended level (Table \hyperref[tab_4]{5}) (P<0.05). The milk intake (5.5 g/day) was almost negligible in Bhumias. The intake of all nutrients except calcium was significantly lower than recommended level (Table \hyperref[tab_5]{6}) (P<0.05).\par IV. \section[{Discussion}]{Discussion}\par Health is a universally cherished goal. Health cannot be forced upon the people. It is a positive attribute of life and the organization of health services to all people is considered to be the key step towards development \hyperref[b21]{(Srinivasan 1987)}. Health care is one of the most important of all human endeavours to improve the quality of life especially of the tribal people \hyperref[b0]{(Balgir, 1995}\hyperref[b2]{(Balgir, , 2000}\hyperref[b3]{(Balgir, , 2005}\hyperref[b4]{(Balgir, \& 2007 ) )}.\par It implies the provision of conditions for normal, physical and mental development and functioning of human being individually as well as in a group. Health problems and health practices of tribal communities have been profoundly influenced by the inter-play of complex social, cultural, educational, economic and political practices \hyperref[b3]{(Balgir 2005}). The common beliefs, customs, traditions, values and practices connected with health and disease have been closely associated with the treatment of diseases. In most tribal communities, there is a wealth of folklore associated with health belief.\par Tribal populations are particularly vulnerable to malnutrition due to their traditional socio-cultural practices and low literacy level. Several studies on growth and nutritional status were done in rural or urban India \hyperref[b19]{(Reddy 2000)}. Studies on primitive tribes are very few and there is no report on the growth or nutritional status of Bhumia. .\par The finding in the present study opens a debatable point about the role of different indices of health and nutritional status assessment. The mean anthropometric measurements indicated that the growth spurt of boys is around 16 years at that age they overcome the girls of same age in both height and weight. Similar trend was reported by various other studies (Hanumanth Rao 1994). The magnitude of wasting in pre-school children was more (36.2\%) as compared to NFHS (29.6\%) and NNMB (23.7\%) report for tribals of Madhya Pradesh and this proportion was observed significantly higher (P<0.05) {\ref (NFHS, 1998 and} {\ref NNMB, 2000)}. The wide variation could be due to different sampling techniques used in different studies, similarly the prevalence of chronic energy deficiency was 78\% among adults, which was considerably high (P<0.05) than the reported figures of 48\% among tribals of Madhya Pradesh {\ref (NNMB 2000)}. The high prevalence of malnutrition observed in the present study could be mainly due to inadequate Dietary intake.\par Other reasons could be poor socio-economic status, low purchasing power and faulty feeding habits etc. \hyperref[b24]{(Verma 1999}). In the present study the intake of cereals was higher than the recommended level. Similar observations were also reported by other authors among tribes of Maharashtra and Bihar (Hanumantha {\ref Rao et al. 1992 and}\hyperref[b5]{Chandrasekhar 1997)}. This is because most of the tribals diet is a cereal-based diet. Most of the nutrients (calories, protein, Iron etc.) except calcium mean intake were inadequate as compared to RDA. Hanumantha \hyperref[b10]{Rao et al. (1993)} also reported lower intake of such nutrients in Jenu Kurubas, a primitive tribe of Karnataka. The low value of Carotene and Riboflavin could be due to low intake of green vegetable and negligible amount of milk in their diet. The high calcium value was mainly due to frequent consumption of fetid cassia leaves (Cassia-Tora) by this tribe.\par From the above discussion, it can be attributed that the poor growth pattern of the Bumia may be due to the poor socio-economic condition. Most of the Bhumia populations of Madhya Pradesh live without modern health care and transport facilities. Hence, the Bhumia the study area face many health and nutritional hazards due to poverty, illiteracy and ignorance. The health and nutrition status of the Bhumia tribes requires an immediate attention in the implementation of short-term supplementary feeding programmes, general medical, and awareness and health care facilities, improvement of food security are needed to overcome the nutrient deficits. \begin{figure}[htbp] \noindent\textbf{1} \par \begin{longtable}{P{0.3782967032967033\textwidth}P{0.1728021978021978\textwidth}P{0.14945054945054945\textwidth}P{0.14945054945054945\textwidth}} \tabcellsep and Sex\tabcellsep \tabcellsep \\ Age group\tabcellsep \tabcellsep \tabcellsep \\ (in Yrs.)\tabcellsep Male\tabcellsep Female\tabcellsep Total\\ < 1\tabcellsep 1\tabcellsep 2\tabcellsep 3\\ 1-5\tabcellsep 61\tabcellsep 49\tabcellsep 110\\ 6-10\tabcellsep 27\tabcellsep 27\tabcellsep 54\\ 11-14\tabcellsep 29\tabcellsep 25\tabcellsep 54\\ 15-19\tabcellsep 38\tabcellsep 31\tabcellsep 69\\ 20-24\tabcellsep 26\tabcellsep 35\tabcellsep 61\\ 25-29\tabcellsep 45\tabcellsep 42\tabcellsep 87\\ 30-34\tabcellsep 33\tabcellsep 37\tabcellsep 70\\ 35-39\tabcellsep 20\tabcellsep 20\tabcellsep 40\\ 40-44\tabcellsep 16\tabcellsep 14\tabcellsep 30\\ 45-50\tabcellsep 13\tabcellsep 12\tabcellsep 25\\ 51-60\tabcellsep 5\tabcellsep 4\tabcellsep 9\\ 60+\tabcellsep 3\tabcellsep 1\tabcellsep 4\\ Total\tabcellsep 317\tabcellsep 299\tabcellsep 616\end{longtable} \par \caption{\label{tab_0}Table 1 :}\end{figure} \begin{figure}[htbp] \noindent\textbf{2} \par \begin{longtable}{P{0.14381778741865509\textwidth}P{0.11984815618221258\textwidth}P{0.15856832971800433\textwidth}P{0.10325379609544467\textwidth}P{0.047939262472885026\textwidth}P{0.09219088937093275\textwidth}P{0.04978308026030369\textwidth}P{0.09587852494577005\textwidth}P{0.03872017353579176\textwidth}} 2013\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ D D D D ) D\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ (\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\ \tabcellsep \tabcellsep \multicolumn{2}{l}{Height}\tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{Weight}\tabcellsep \\ Age group\tabcellsep Male\tabcellsep \tabcellsep Female\tabcellsep \tabcellsep Male\tabcellsep \tabcellsep Female\tabcellsep \\ (in Yrs.)\tabcellsep Mean ±S.D.\tabcellsep \multicolumn{7}{l}{Median Mean±S.D Median Mean±S.D. Median Mean±S.D Median}\\ 1+\tabcellsep 74.1±0.2\tabcellsep 76.0\tabcellsep 76.1±0.5\tabcellsep 76.0\tabcellsep 6.2±1.1\tabcellsep 5.8\tabcellsep 6.7±1.3\tabcellsep 6.5\\ 2+\tabcellsep 80.4 ±4.1\tabcellsep 81.5\tabcellsep 81.7±3.4\tabcellsep 82.0\tabcellsep 9.1±1.8\tabcellsep 8.5\tabcellsep 8.8±1.6\tabcellsep 8.8\\ 3+\tabcellsep 85.7±5.1\tabcellsep 85.3\tabcellsep 86.5±7.1\tabcellsep 86.0\tabcellsep 10.6±1.5\tabcellsep 9.8\tabcellsep 10.4±1.5\tabcellsep 9.8\\ 4+\tabcellsep 92.3±6.6\tabcellsep 91.0\tabcellsep 93.2±5.1\tabcellsep 93.0\tabcellsep 12.0±2.4\tabcellsep 10.5\tabcellsep 11.2±1.8\tabcellsep 11.0\\ 5+\tabcellsep 100.5±7.1\tabcellsep 99.0\tabcellsep 101.4±7.0\tabcellsep 101.0\tabcellsep 14.3±2.6\tabcellsep 11.7\tabcellsep 13.1±2.6\tabcellsep 13.0\\ 6+\tabcellsep 102.2±7.2\tabcellsep 101.0\tabcellsep 103.2±6.7\tabcellsep 104.0\tabcellsep 14.4±2.1\tabcellsep 13.7\tabcellsep 13.5±2.1\tabcellsep 14.0\\ \multicolumn{2}{l}{© 2013 Global Journals Inc. (US)}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \end{longtable} \par \caption{\label{tab_1}Table 2 :}\end{figure} \begin{figure}[htbp] \noindent\textbf{3} \par \begin{longtable}{P{0.34386363636363637\textwidth}P{0.1893181818181818\textwidth}P{0.07727272727272727\textwidth}P{0.04636363636363636\textwidth}P{0.11977272727272727\textwidth}P{0.07340909090909091\textwidth}} Indicators\tabcellsep \multicolumn{3}{l}{< -3SD -3SD to<-2SD -2SD to<-1SD}\tabcellsep -1SD to Median\\ \tabcellsep Severe\tabcellsep Moderate\tabcellsep \tabcellsep Normal\tabcellsep \\ Weight for Age (Underweight)\tabcellsep 23.2\tabcellsep 35.6\tabcellsep 28.1\tabcellsep 7.6\tabcellsep 1.2\\ Height for Age(Stunting)\tabcellsep 20.1\tabcellsep 22.1\tabcellsep 22.6\tabcellsep 16.8\tabcellsep 13.1\\ Weight for Height (Wasting)\tabcellsep 9.0\tabcellsep 27.2\tabcellsep 27.2\tabcellsep 21.3\tabcellsep 11.1\end{longtable} \par \caption{\label{tab_2}Table 3 :}\end{figure} \begin{figure}[htbp] \noindent\textbf{4} \par \begin{longtable}{P{0.3618243243243243\textwidth}P{0.15793918918918917\textwidth}P{0.16368243243243244\textwidth}P{0.16655405405405405\textwidth}} BMI Grades\tabcellsep Male\tabcellsep Female\tabcellsep Total\\ CED III (<16.0)\tabcellsep 39.6 (100)\tabcellsep 35.3 (83)\tabcellsep 37.6 (183)\\ CED II (16.0-17.0)\tabcellsep 15.2 (38)\tabcellsep 14.7 (35)\tabcellsep 15.0 (73)\\ CED I (17.0-18.5)\tabcellsep 23.0(58)\tabcellsep 23.6 (55)\tabcellsep 23.4 (113)\\ Low Weight Normal (18.5-20.0)\tabcellsep 14.9 (36)\tabcellsep 16.4 (38)\tabcellsep 15.6 (74)\\ Normal (20.0-25.0)\tabcellsep 6.5 (17)\tabcellsep 9.6 (22)\tabcellsep 8.0 (39)\\ Over Weight (>25.0)\tabcellsep 0.2 (1)\tabcellsep 0.4 (2)\tabcellsep 0.3 (3)\end{longtable} \par \caption{\label{tab_3}Table 4 :}\end{figure} \begin{figure}[htbp] \noindent\textbf{5} \par \begin{longtable}{P{0.4748275862068965\textwidth}P{0.29017241379310343\textwidth}P{0.085\textwidth}} \multicolumn{2}{l}{Bhumias (gm/cu/day)}\tabcellsep \\ Food Items\tabcellsep Mean ± SD\tabcellsep RDA\\ \tabcellsep (n=475)\tabcellsep (ICMR)\\ Cereals\tabcellsep 475.4*±185.5\tabcellsep 460\\ Pulses\tabcellsep 28.8*±13.6\tabcellsep 40\\ Green leafy\tabcellsep 29.7*±12.7\tabcellsep 40\\ vegetables\tabcellsep \tabcellsep \\ Roots and Tubers\tabcellsep 13.2*±4.6\tabcellsep 50\\ Other vegetables\tabcellsep 46.5*±24.4\tabcellsep 60\\ Flesh food\tabcellsep 1.7*±1.6\tabcellsep 40\\ Milk and milk\tabcellsep 5.5*±3.2\tabcellsep 150\\ products\tabcellsep \tabcellsep \\ Oil and fats\tabcellsep 2.2*±3.6\tabcellsep 40\\ Sugar and\tabcellsep 0.4*±0.1\tabcellsep 30\\ jaggery\tabcellsep \tabcellsep \\ * P<0.05\tabcellsep \tabcellsep \end{longtable} \par \caption{\label{tab_4}Table 5 :}\end{figure} \begin{figure}[htbp] \noindent\textbf{6} \par \begin{longtable}{P{0.3974820143884892\textwidth}P{0.3485611510791367\textwidth}P{0.1039568345323741\textwidth}} \tabcellsep (cu/day)\tabcellsep \\ Nutrient intake\tabcellsep Mean ± SD\tabcellsep RDA\\ \tabcellsep (n=475)\tabcellsep (ICMR)\\ Energy (Kcal)\tabcellsep 1810.5*±739.6\tabcellsep 2425\\ Protein (g)\tabcellsep 50.4*±21.1\tabcellsep 60\\ Fat (g)\tabcellsep 11.1*±6.4\tabcellsep 20\\ Calcium (mg)\tabcellsep 435.5±232.2\tabcellsep 400\\ Iron (mg)\tabcellsep 15.7*±13.3\tabcellsep 28\\ Carotene (?g)\tabcellsep 368.1*±256.2\tabcellsep 2400\\ Thiamine (mg)\tabcellsep 1.3±0.4\tabcellsep 1.2\\ Riboflavin (mg)\tabcellsep 0.4*±0.3\tabcellsep 1.4\\ Vitamin C (mg)\tabcellsep 17.8*±13.7\tabcellsep 40\\ * P<0.05\tabcellsep \tabcellsep \end{longtable} \par \caption{\label{tab_5}Table 6 :}\end{figure} \footnote{© 2013 Global Journals Inc. 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