Bio-Social correlates of nutritional status among the Bengali Muslim and the Meitei Women of Cachar district of Assam, India

Introduction

The body mass index (BMI) is a simple numeric measure to assess fatness or thinness of an individual by comparing an individual's weight and height. It is the most established anthropometric indicator used not only for assessment of adult nutritional status but also the socio-economic situation of a population, especially adult populations in developing country like India.1, 2 Nutritional status based on BMI is also related to demographic, economic, social and environmental conditions of the population.3, 4

India is one of the few countries in the world where males and females have nearly the same life expectancy at birth.5 The distinctive female advantage in life expectancy is not observed in India which advocates that there are organized problems with women’s health. The health of Indian female is basically linked to their status in society as most of the Indian communities follow patrilineal social structure which bears strong influence on gender differences. Studies revealed that CED malnutrition based on BMI reduces physical capacity, increases mortality and morbidity.1, 6, 7 But the prevalence of different grades of nutritional status varies from one population to other.

Geographically Cachar district is located in the southernmost part of Assam. It lies between 90˚4’E and 93˚15’E latitude and 24˚22’N and 25˚8’N longitude and covers an area of 3786 sq.km. Cachar district is considered as a plain district but a number of hills spread across and surrounding the district. It is one of the most economically backward districts of India which is largely due to geographical barrier with the rest of the country. The district has a population of 1,736,319 with a sex ratio of 958 females per 1000 males and a literacy rate of 80.36%.8

The people inhabiting in the district are primarily known as Sylheti Bengali (Bengali people who speak in sylheti, a Bengali dialect). Besides, there are different endogamous ethnic communities also inhabiting in the district such as Bengali, Meitei, Brishnupriya, Dimasa Kachari, Hmar, Khasi, etc. Linguistically the Bengali Muslims belong to the Indo-Aryan ethnic group of Caucasoid racial stock but Meiteis belong to the Tibeto-Burman ethnic group of Mongoloid racial stock. 9 Bengali Muslims follow Islam but Meiteis follow Hinduism. Rice is their staple food and agriculture is their mainstay of livelihood. Their family structure is patrilineal in nature and marriage by negotiation is the prevailing practice among them. Present study attempts to know the influence of age and family income on the nutritional status of Bengali Muslim and Meitei women of Cachar District of Assam.

The main objectives of the present research are

Materials and Methods

The data have been collected by household census method and nutritional anthropometry among 172 Bengali Muslim and 181 Meitei women of 20 to 64 years age of Bhaurikandi Part-II, Ganganagar Part-IV, Dakshin Mohanpur Part-V, Sundari Part-IV and Saint Katherine village of Cachar District, Assam. Out of these villages first two are inhabited by Muslim population while the last three are inhabited by Meitei Population. Socio-economic data have been collected by household census method from 176 Bengali Muslim households and 159 Meitei households. Socio-economic data include the relevant information such as sex, age, education, occupation, income, expenditure, household assets, cultivable land, crops and vegetable cultivations, etc.

Anthropometric measurements such as weight and height have been taken by using standard techniques.10 Height and weight have been recorded to the nearest 0.1 cm and 0.5 kg using standard anthropometer and weighing scale respectively. The sample is free from any selection bias. All the available willing individuals who fall within the age group 20-64 years were included in the study. Pregnant women were excluded from the study. Assessment of nutritional status has been done by following James et al. classification.11 Nutritional status has also been assessed by following WHO classification to compare the present data with earlier findings of NFHS-3 data.12 All Statistical Analysis have been carried out by using the Statistical Package for Social Science (SPSS) 16.0 version. Chi-square test has been applied and a p value of <0.05 was considered as significant. Pearson’s correlation coefficient was performed to see the association of weight, height and BMI with age (year) and family income (INR).

Results and Discussion

The study reveals that more than 40 percent of Bengali Muslim women (Table 2, Table 3) are having chronic energy deficiency (CED) malnutrition while 30.4% of Meitei women are suffering from CED malnutrition. On the other hand low normal, normal and overweight women are more among the Meiteis compared to Bengali Muslims. While only two Meitei women are found to be obese (1.1%).

In a developing country like India generally a male enjoys better socio-economic status compared to a female. In an earlier research it was expressed that females were more likely to have musculoskeletal problems than males, which perhaps reflect harder life faced by females who never retire from household work unless totally disabled.13 According to the local people Meiteis are supposed to have better nutritional status compared to Bengali Muslims as they are living in a relatively better socio-economic condition (Table 1). The findings of the present study indicate community differences on nutritional status. Statistically no significant difference (p-0.195) is observed between Bengali Muslim and Meitei women in regard to their nutritional status.

The course of human life is influenced by several factors like biological, cultural and psychological factors. Health is one of the principal assets of every human being and it has a very close association with chronological age.14 An individual become more vulnerable to multiple diseases with the advancement of age and the affect of which reflects in health status. Age is categorized into three groups such as 20-34, 35-49 and 50-64 years age group. Thereafter, these three groups will be referred to as young aged, middle-aged and old aged respectively to observe the nutritional status with reference to age (Table 4).

It is observed from the study that CED malnutrition is very high (51.9%) among the Bengali Muslim women of old aged group in comparison to young and middle-aged women. It is observed that Bengali Muslim women of middle-aged group enjoy better nutritional status (low normal-26.4% and normal-39.6%). But a small proportion of middle aged Bengali Muslim women are found to be overweight (3.8%). Earlier findings also mentioned about high prevalence (40.86%) of CED malnutrition among the Dimasa women living in the same environment.15

On the other hand, young aged Meitei women show healthier nutritional status (low normal-33.3% as well as normal-40.6%) compared to middle and old aged group. Although overweight status is prevalent among the middle and old aged Meitei women but two women are found to be obese in young aged group. Middle aged Meiteis are more prone to CED malnutrition (37.7%) in comparison to other two age groups. Chi square test doesn’t show any statistical significant difference (chi square) on the prevalence of CED malnutrition among the three age groups of both Bengali Muslim and Meitei women. But the occurrence of CED malnutrition shows significant difference (p-0.012) between the two communities in young aged group.

Occupation of an individual is greatly influenced by his or her educational status which in turn made an impact on his or her income in specific and overall family income in general. Nutritional status of the individuals has been studied against family income by dividing the yearly family income into three categories such as upto 1 lac, 1 lac to 2 lacs and more than 2 lacs (Table 5). Thereafter, these three categories will be referred to as low, medium and high income group.

CED malnutrition is found to be very less among the Bengali Muslim (26.7%) and Meitei (23.0%) women whose family income is more than 2 lacs (annual) in contrast to other two income groups. Frequency of normal nutritional status is found to be very high among the women of both the communities (Muslim-40.0% and Meitei-44.6%) who belong to high income group. So, the result indicates that individuals whose family income is high enjoy better nutritional status. Chi-square tests do not provide any statistical significant difference among the three income groups of both the communities. Earlier study indicated that some important aspects of living circumstances such as food, shelter, health, etc. matters much more than the conventional income.16

A negligible positive association (Pearson’s correlation coefficient) is observed between BMI and age of the Bengali Muslim women (r_xy=-0.042) but it has significant positive correlation with annual family income (r_xy=0.209, p<0.01). Earlier findings pointed out a negative association between age and BMI of adults.17 Same correlation coefficient (Table 6) among the Meitei women indicates that BMI has very low positive association with age (r_xy=0.080) and but significant positive correlation exist between BMI and yearly family income (r_xy=0.165, p<0.05). A sizeable number of middle aged Meiteis (especially 50-59 age groups) live in relatively better socio-economic condition due to which a positive relation may be observed between age and BMI of the present study. Some of the earlier researchers mentioned that women malnutrition is associated with different bio-social factors like age, occupation, education, standard of living, etc.18, 19, 20

National Family Health Survey-3 data (NFHS-3 during the year 2005-06) of state of Assam showed that the frequency of underweight, normal, overweight and obese women are 34.4%, 56.0%, 8.3% and 1.3% respectively.21 Normal nutritional status is found to be very high (69.6%) in the North-East zone (Table 7) against country’s (55.8%) scenario. Underweight (19.7%), overweight (9.2%) and obese individuals (1.5%) are found to be very less in the north east zone in comparison to overall picture of the country (29.0%, 11.7%, and 3.5% respectively).

North-east zone consists of 8 (eight) different states such as Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura. But apart from Assam and Tripura numerically dominant inhabitants of other six states are tribal population. Comparison of nutritional status of the Meitei women of the present study indicates that it is worse than North East zone scenario but better than state and country picture (Table 7). Although same trend is also visible among the Bengali Muslim women but the prevalence of underweight is found to be very high among them. So, the result may be an indication of the role genetics as well as other socio-environmental factors on the nutritional status which were not considered in the present study.

Conclusion

The present study reveals that Meitei women are enjoying better nutritional status in contrast to Bengali Muslim women. Frequency of CED malnutrition is found to be high among the old aged Bengali Muslim women. But the frequency of normal nutritional status is high among the middle aged Bengali Muslim women due to which a negligible negative correlation between BMI and age. Although young aged Meitei women enjoy healthier nutritional status but the prevalence of CED malnutrition is comparatively high among the middle aged Meiteis resulting very low positive association between age and BMI. Prevalence of CED malnutrition is found to be very less among the Bengali Muslim and Meitei women of high family income group. Family income shows a significant positive correlation with BMI in both the communities and so better (normal) nutritional status is observed among the women of high family income group. Further studies are required to get deep insight knowledge as present study is an attempt to get base line information on adult nutritional status of the Bengali Muslim and Meitei community living in five villages of that particular area.

Source of Funding

None.

Conflict of Interest

Authors declare no conflict of interest.