Background:

Our college, Padma Kanya Multiple Campus had organized one day field trip for us (Masters 3 rd
semester, food and nutrition) to a nearby Chandragiri Municipality with the total area of
16km2. This municipality is at about 12km from our college which consisted of total 15000
population where most of them (99.9%) were literate. There were 1 campus, 1 higher secondary
school and 3 private schools. The main source of income were agriculture, small and large scale
industries, tourism etc. The people over there followed normal food habit. We are thankful to the
whole department of Home Science for providing us an opportunity to learn about the lifestyle
and their food habit.

Introduction:
Adolescence is the period in human growth and development that occurs after childhood
and before adulthood, from ages 10 to 19 years. It represents one of the critical transitions
in the life span and is characterized by a tremendous pace in growth and change that is
second only to that of infancy (WHO, 2015).
Adolescence is the time of life when growth is completed and individuals become sexually
mature. Biological processes drive many aspects of theadolescent growth and development, with
the onset of puberty marking the passage fromchildhood to adolescence. The process of
adolescence is a period of preparation foradulthood during which time several key
developmental experiences occur. Whileadolescence is a time of tremendous growth and
potential, it is also a time of considerablerisk during which social contexts exert powerful
influences.

1. Early adolescence (10–14 years):

The age of 10 to 14 years can be considered as early adolescence. It is at this stage that
physical changes generally commence, usually beginning with a growth spurt and soon
followed by the development of the sex organs and secondary sexual characteristics.
Theseexternal changes are often very obvious and can be a source of anxiety as well as
excitement or pride for the individual whose body is undergoing the transformation. The
internal changes in the individual, although less evident, are equally profound. The brain
also undergoes a spectacular burst of electrical and physiological development.
Thenumber of brain cells can almost double in the course of a year, while neural
networks are radically reorganized, with a consequent impact on emotional, physical and
mental ability.
2. Late adolescence (15–19 years)
Late adolescence encompasses the ages of 15 and 19 years. The major physical changes
have usually occurred by now, although the body is still developing. The brain continues
todevelop and reorganize itself, and the capacity for analytical and reflective thought
isgreatly enhanced. Peer-group opinions still tend to be important at the outset, but their
holddiminishes as adolescents gain more clarity and confidence in their own identity and
opinions.
Changes during adolescence
1. Physical changes: Growth in physical size during adolescence is second to the growth
that occurs in infancy. Some physical changes during teenage are as below:
a. Body composition: During adolescence, boy’s muscle mass increases and
shoulders broaden, whereas girlsincrease their body fat and develop rounder hips
and smaller waists. The pattern and rate ofdevelopment in body composition
differ in boys and girls. Girls attain peak height growthvelocity at a younger age
than boys, i.e. at 11.5 years of age but boys attain a maximalheight growth
velocity 13.5 years of age, which is higher than that for girls and heightincreases
for a longer period of time.
b. Sexual maturity: The growth spurt is accompanied by sexual maturity.Sexual
maturation can be determined byevaluating pubertal development based on
secondary sex characteristics: testicular andpenile development and
appearance of pubic hair in boys; breast development andappearance of pubic
hair in girls which is known as tanner stage rating.
2. Psycho-social changes: Besides physical and sexual maturation, changes include
movement toward social andeconomic independence, and development of identity,
the acquisition of skills needed tocarry out adult relationships and roles, and the
capacity for abstract reasoning. As adolescence is a transition to adulthood, they try
to develop self-identity. Thedesire to be accepted in their peer group changes their
food habits, dressing and groupconduct. This in turn brings psychological, emotional
and social stress. There is occurrence of transition towards greater autonomy from
parents and their values,and a progressively more central role of peers as role models,
advisors, friends anddeterminants of interests and values.

Factors affecting adolescent nutritional status

Some factors that could affect the nutritional status of adolescents are as below:

1. Dietary adequacy:
Adolescent growth and development is closely linked to the diet they receive during
childhood and adolescence. Adequate nutrition of any individual is determined by
twofactors. The first is the adequate availability of food in terms of quantity as well as
quality,which depends on socioeconomic status, food practices, cultural traditions,
and allocationof the food. The second factor is the ability to digest, absorb, and utilize
the food. Thisability can be hampered by infection and by metabolic disorders.
Dietary inadequacies might be caused by an inadequate supply of food or by
mothershaving too little time to prepare food.
 2. Physiological condition and lifestyle:
Growth imposes additional nutritional requirements inadolescence. Athletes who
need to maintain a certain weight for competition may resort to extreme weight-loss
measures (diet pills, laxatives, starvation, etc.) that can impair bothperformance and
health. Weight and dieting concerns of adolescent athletes place them atgreater risk of
eating disorders and low-energy diets are more likely to be inadequate
inmicronutrients such as calcium, iron, magnesium, zinc and vitamin B6.
3. Psycho-social factors:
Although parents can still be effective role models, adolescents are generally strongly
influenced by their peers, their personal food preferences, and their own developing
senseof which foods constitute a healthful and adequate diet. Changes in eating
patterns during adolescence are influenced by cognitive, physical, social,and lifestyle
factors. Weight management and body image are topics of great importance,and
interest in adolescence. Serious concerns about body image can cause some health
consequences such as dietary disorders, and psychological discontent.The search for
identity, the struggle for independence and acceptance, and concern aboutappearance,
are changes that may have a great impact on lifestyle, eating patterns and
intakes of adolescents.

Nutritional requirements of adolescents

A requirement is an intake level, which will meet specified criteria of adequacy, preventing
risk of deficit or excess (FAO and WHO, 2001).After puberty, there is difference in nutritional
requirement of girls and boys. Thereason for it includes earlier maturation of females and
variations in physiological needsfor some nutrients by sex e.g., difference in the requirement of
iron. Besides differences inheight and weight, boys gain proportionately more muscle mass than
fat as compared togirls. They experience increased linear growth to produce a heavier skeleton
and developgreater red blood cell mass than girls. Girls on the other hand have more fat than
muscletissues. These differences in body composition have important implications for
nutritionalneeds of male and female adolescents.
Recommended Dietary Allowance (RDA) is the average daily dietary nutrient intake
level sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy
individuals in a particular life stage and gender group (ICMR, 2010). ICMR has calculated
the nutrient requirements considering all adolescents as moderately active. Therecommended
Daily allowance as provided by ICMR in 2010 is given as below:
Energy and nutrient requirements of boys:
Age in years
Nutrients 10 11 12 13 14 15 16 17 18
Energy (kcal) 2030 2180 2370 2580 2760 2890 2980 3060 2730
Protein (g) 36.3 39.60 43.7 49.8 54.7 58.2 60.8 62.2 60
Visible fat (g) 35 35 35 45 45 45 50 50 30
Calcium (mg) 800 800 800 800 800 800 800 800 600
Iron (mg) 21 21 21 32 32 32 28 28 17
Vitamin A (μg)Retinol 600 600 600 600 600 600 600 600 600
β-carotene 4800 4800 4800 4800 4800 4800 4800 4800 4800
Thiamine (mg) 1.1 1.1 1.1 1.4 1.4 1.4 1.5 1.5 1.4
Riboflavin (mg) 1.3 1.3 1.3 1.6 1.6 1.6 1.8 1.8 1.6
Niacin equivalent (mg) 15 15 15 16 16 16 17 17 18
Pyridoxine (mg) 1.6 1.6 1.6 2 2 2 2 2 2
Ascorbic Acid (mg) 40 40 40 40 40 40 40 40 40
Dietary folate (μg) 140 140 140 150 150 150 200 200 200
Vitamin B12 (μg) 0.2-1 0.2-1 0.2-1 0.2-1 0.2-1 0.2-1 0.2-1 0.2-1 1
Magnesium (μg) 120 120 120 165 165 165 195 195 340
Zinc (mg) 9 9 9 11 11 11 12 12 12

Objectives of field visit:

 To assess nutritional status and dietary intake of adolescents’ boys of Chandragiri

municipality, ward number 4.
 To collect information about dietary intake and dietary habits of adolescents boy.
 To identify the factors affecting nutritional status.

Study Area:

Study was done in Private School of Chandragiri Municipality

Ward number: 4
Ward president: Krishna Prasad Khadki

Methods and Methodology:

 Food intake, knowledge about nutrients, their current health status were obtained by
questionnaires.
 Physical parameters were used to obtain anthropometric information.
Result and Discussion:

Anthropometric information
180

160

140

120

100

80

60

40

20

0
Adolescent boys

Sn Age Height (cm) Weight (kg) stunted BMI underweight wasting

Food Behavior:
Feeding habit per day: 65% of the adolescent participant feeds themselves 2 to 3 times per day
and rest of the 35% feeds 3 to 5 times per day.

Almost all adolescent boys were non vegetarian and preferred chicken meat whereas, only 5%
were vegetarian.

Dairy product and meat consumption intake was found commonly once a week (30%),
moderately twice a week (25%) and rest by once or twice a month.
All 95% preferred junk food example noodles and only one participant r fresh and cooked green
leafy vegetables and fruits

Al most all the participants’ consumed tea and biscuits along with it for Breakfast and few also
consumed breads.

Almost all the adolescent boys consumed Rice or chapatti, lentils and mixed vegetables and meat
products occasionally as the Nepali pattern of lunch and dinner.
On other hand, snacks included variations such as,
1. Noodles. chowmin
2. beaten rice
3. Momo
4. Roti
 5. Egg
6. Donuts
7. Potato fries
8. Horse Grams (Chana)

All the adolescent boy participants had regularly protein such as pulses and beans.

All the adolescent boy participants included Green leafy vegetables in their diet regularly.

Mostly the adolescent boy participants included fruits in their diet whenever available.

Most of the adolescent boy participants drank water 2 to 4 glass of water (300ml) in a day and 3
of them use to drink 8 or more glass of water (300ml) in a day.

Many of the participants use to buy their food for in between snack time during school from shop
due to unavailability of canteen in the school and only brought home made tiffin. Therefore
almost all the boys had to carry their pocket money in order to buy foods in between school for
tiffin. They usually buy packaged food and ready to eat foods with high sugar and refined flour
for snacking such as:
1. Noodles
2. Samosa
3. Donuts
4. Chips
5. Biscuits
6. Sweets , Candies
7. Egg
8. Dalmot

Almost all the participants said they were satisfied with their body weight, except one who
wanted to lose his weight since, he was overweight according to his age. Similarly, No one
wanted to lose their current body weight except the one participant who was overweight.

Most of the participants use to skip their night meal because they use to have heavy snack right
after returning back from school. However, only few had dinner and quite rarely.

None (100%) of the participants were found to smoke. However, the alcohol consumption was
seen among the adolescent participants. In details, 25% boys consumed alcohol and rest 75% did
not. Among the 25% showed the reason for drinking alcohol as a part of their culture since they
were Newar which were ethnic community and uses alcohol for every auspicious occasions.

Clinical Assessment:
For the clinical assessment, factors like Hair color and luster, Nails, Eyes, Skin and Edema were
detected, where all the factors were assessed normal. None of the participants had unusual hair
color, spooned nails, pale eyes, edema and rough and dry skin however some had dry skin which
were considered to be due to cold and winter.
Conclusion and suggestions:
Most of the Adolescent boys participated in our questionnaires were found to have homemade
foods where different items of food, vegetables and fruits were included. However, they did not
have the proper idea on nutrition neither any nutrition related programs were conducted there.
So, conduction of nutritional programs for all age groups in that area would be highly fruitful.
 NUTRITIONAL ASSESSMENT OF
ADOLESCENT BOYS
CENTRAL DEPARTMENT OF HOME SCIENCE, TRIBHUVAN UNIVERSITY

SUBMITTED TO: PREPARED BY:

DR. JAYA PRADHAN ANUSHKA THAPA
MS. MANODHARA SHAKYA SNIKA RAI
MRS. SWETA BADE HITAMAYA TAMANG
RANJILA DAHAL
BIMLA THAPA
CHANDRA GIRI
PUJA KHADKA
BHISMA RAI
Sample questions
Survey Questionnaire
A. General information

1. Name of child: _________________________________

2. Age (in years):_________ Date of birth (B.S.):

3. Address: ___

B. Anthropometric information

Height (cm):

Weight (kg):

C. Basic Questions

1. how many times a day do you eat?

 2-3 times/day
 3-5 times/day
 5-8 times/day

2. What are you?

 Vegan
 Lacto-vegetarian
 Lacto-ovo vegetarian
 Non-vegetarian

3. If non vegetarian, what do you prefer to eat?

 chicken/duck
 pork
 mutton
 buff

4. How often do you intake meat and milk product?

 Daily
 Twice a week
 Once a week
 Once or twice a month

5. What do you prefer eating more?

 Fast foods
 junk foods
 Sweets
 Fresh and cooked green leafy vegetables and fruits
6. What do you eat in breakfast?

 Tea/coffee
 Bread
 Biscuits
 Oat meals

If others, mention______________

7. What do you eat in lunch?

8.What do you include in snacks?

9.What do you have in dinner?

10. How often do you have pulses, beans?

11.Do you include green leafy vegetables in your diet?

 Yes
 No

If yes, how often? _______

12. how often do you eat fruits?

 Everyday
 In an irregular day
 Whenever available

13. How many glasses (300 ml) of water do you drink/day?

 1
 2-4
 5-7
 8 or more

14. Do you have daily pocket money?

 Yes
 No
 Sometimes

15. Where do you buy food from?

 school canteen
 shops
 restaurants

16. what do you buy most?

(----------------------)
17. How do you feel about your figure?

 Overweight
 Right weight
 Thin

18. Have you ever tried losing weight?

 Yes
 No

19. Have you ever tried gaining weight?

 Yes
 No

20. Do you escape meal?

 Yes
 No

If yes, how often do you escape?

(________________)

21. Do you smoke?

 Yes
 No

If yes,

a. when did you start?

(_________________)
b. who did you get influenced by?
 Family
 Friends
 Neighbors
 Movies

If other, mention_____________

21. Do you drink alcoholic beverages

 Yes
 No
Thank you!