NUTRITIONAL PROFILE OF ADULT BIRHORS OF PURULIA: A PARTICULARLY VULNERABLE TRIBAL GROUP OF WEST...

AARJMD VOLUME 1 ISSUE 5 (JANUARY 2013)

Asian Academic Research Journal of Multidisciplinary

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A Peer Reviewed International Journal of Asian

Academic Research Associates

AARJMD

ASIAN ACADEMIC RESEARCH

JOURNAL OF MULTIDISCIPLINARY

NUTRITIONAL PROFILE OF ADULT BIRHORS OF PURULIA: A

PARTICULARLY VULNERABLE TRIBAL GROUP OF WEST BENGAL, INDIA.

SUBAL DAS*; MILEVA MAHATA**; KAUSHIK BOSE ***

*Assistant Professor (ad-hoc),

Department of Anthropology & Tribal development, GGV, Bilaspur,

**Student, Department of Anthropology,

Vidyasagar University, Midnapore, West Bengal.

***Associate Professor and Head,

Department of Anthropology, Vidyasagar University,

Midnapore, West Bengal.

ABSTRACT

Birhors are one of the Particularly Vulnerable Tribal Groups (PTGs) of West Bengal

with their old traditional techniques of hunting. The present study is the first, to investigate

the nutritional status of adult tribals of this ethnic group. This cross-sectional study was

undertaken to determine the prevalence of undernutrition using body mass index (BMI)

among 18 years and above Birhor adults of Purulia District, West Bengal, India. A total of

147 (72 males and 75 females) adult from Bhupatipalli and Bareriya villages were measured.

The BMI was used to evaluate nutritional status. Result revealed that prevalence of

undernutrition (age and sex combined) among Birhors was 26.5 %. The sex specific rates

were 33.3 % and 19.4 % among females and males, respectively. There was a highly

significant sex difference in CED prevalence based on BMI (Chi-square (x2) = 10.334, df = 4,

P= 0.05). Birhor adults of Purulia, West Bengal, India were experiencing high (serious)

situation for all age groups and the women and oldest among them were experiencing the

most serious situation with respect to their health and nutritional status.

Key words: Age-trend; India; Body mass index; chronic energy deficiency.

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Introduction

Nutrition is the basics for the survival of an individual. It is not just confined with the

intake of nutrients but also the utilization for proper growth and development of the body.

Nutritional status grossly depends upon the feeding habits, ecology, vegetation of the area and

the socioeconomic condition of the community. India, in recent years has become self-

sufficient from the agricultural point of view, but the problem of malnutrition still continues

undoubtedly and it is still considered to be one of the crucial issues. According to Calder and

Jackson (2000) undernutrition is one of the major causes of morbidity and mortality in the

developing world. Inadequate dietary intake and disease are immediate causes of malnutrition

and they reinforce one another synergistically (Scrimshaw et al., 1968). Malnourishment may

increase income inequality, lower social returns to educational expenditure, impede economic

growth and increase unemployment. Epidemiological data show that the world‟s populations

living under low socio-economic conditions and high rates of parasitic diseases are also those

that have most of the world‟s malnutrition (Crompton and Nesheim, 1982). Nutrition plays a

major role in human adaptation because it acts both as an independent stress (e.g. food

scarcity) that may necessitate adjustment and as an important modifier of other stresses (e.g.

disease severity). Good nutrition promotes the production and activities of growth hormones,

which influences the metabolism of proteins, carbohydrates, fats and mineral and promotes

nitrogen retention. Tribals who constitute 8.2 % of India‟s population are drawing the

attention of planners and administrators and are given priority in developmental measures

(Census, 2011). The objective of the present study was to evaluate the nutritional status of the

adult Birhor tribe of Purulia, West Bengal, India.

Materials and Methods

The present study is cross-sectional and was conducted among 147 adult Birhor tribals

of Purulia, West Bengal. A total of 72 males and 75 females were measured. Adults were

grouped into three to observe the age-trend in their anthropometric measures as well the age

group wise nutritional status. There were 86 young adults group (G-I), 43 middle aged adults

(G-II) and 18 elderly (G-III) Birhors (both sex). In the present study Birhors of age from 18 to

80 years (both males and females) were included. Data were collected during June and July,

2011. The villages are situated in rural areas within the Baghmundi block. The study was

carried out by one of the authors (MM) to fulfill her M.Sc. (Masters of Science) dissertation.




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The study area comprised of two villages namely Bhupatipalli and Bareriya; it belongs to

Baghmundi block, Purulia, West Bengal. It is approximately 400 kms from Kolkata, the

provincial capital of West Bengal. These villages are situated approximately 22 km from

Borabhum railway station. The houses are situated in scattered fashion with few (those were

made by the block authority) for the betterment of the community. Birhor population

comprises of 278 people in the state and is confined to Purulia village only

(www.indianexpress.com/news/first-to-join...birhor-boy.../815394/). Birhors belong to the

„Proto-Australoid‟ stock; linguistically, they originated from the „Austro-Asiatic‟ group.

Birhors live in 6 villages spread across three Blocks, namely Baghmundi (Bhupatipalli,

Bareriya), Balarampur (Bersa), Jhalda-I (Chhotobakad) of Puruliya district of West Bengal.

In West Bengal, three tribes were declared as Particularly Vulnerable Tribal Groups (PTGs)

i.e. Lodha, Birhor and Toto. Their traditional and primary occupation was rope making.

However, this occupation has been abandoned by them due to deforestation and shifting.

Thus raw materials are not available. So they have to change their occupation. Now they are

working as daily labour, some of them are still using their traditional occupation but with a

new method i.e., they now use plastic shake for rope making. Weight (Wt), height (Ht),

circumferences and skinfolds were measured using the standard methodology of Lohman et

al., (1988). Technical errors of measurements (TEM) were within acceptable limits. Ethical

approval was obtained from Vidyasagar University Ethics Committee before commencement

of the study. The BMI was computed using the following standard equation:

BMI = Weight (kg) / height (m2).

Nutritional status was evaluated using internationally accepted BMI guidelines (WHO, 1995).

The following cut-off points were used:

CED BMI <18.5

Normal: BMI = 18.5-24.9

Overweight: BMI ≥ 25.0

CED was further divided into CED III, CED II and CED I as BMI < 16.0, 16.0-16.9 and 17.0-

18.4 kg/m2, respectively. We followed the World Health Organization's classification (1995)

of the public health problem of low BMI, based on adult populations worldwide. This

classification categorizes prevalence according to percentage of a population with BMI< 18.5.

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265

Low (5-9%): warning sign, monitoring required.

Medium (10-19%): poor situation.

High (20-39%): serious situation.

Very high (≥ 40%): critical situation.

Student's t-tests were performed to test for sex differences in mean values. Age-group

difference was performed by ANOVA (F test). Sex differences in CED were determined by

chi-square (x2) test. All statistical analyses were undertaken using the Statistical Package

(SPSS- 16). Statistical significance was set at p < 0.05.

Results

Mean, standard deviation, t-test and significance (p) of age and some anthropometric

variables viz., weight (kg), height (cm), mid-upper arm circumference (MUAC; cm), waist

circumference (WC; cm), hip circumference (HC, cm), biceps skinfold (BSF; mm), triceps

skinfold (TSF; mm), sub-scapular skinfold (SSSF; mm) and BMI (kg/m2) of ≥ 18 years old

Birhor tribals are presented in Table 1. Significant (p < 0.001) sex differences in mean Wt (t

= 3.637, p < 0.001) and Ht (t = 6.035, p < 0.001) were observed.

Marked trend (Table 2) in Ht, WC, HC & BSF with increasing age-group among

females; marked decline in HT, MUAC, WC & HC among males and TSF & SSSF among

females with increasing age-group; marked increase then decrease in mean values of WT,

BSF, TSF, SSSF & BMI among males and WT MUAC & BMI among females with

increasing age-group were observed. Significant sex difference in mean weight (t = 3.474,

p<0.001) in 18-39 & (t = 2.245, p<0.05) in (40-59) years age group, in mean height (t =

5.355, p<0.001) in 18-39 & (t = 2.610, p<0.01) in 40-59 years age group, in mean MUAC (t =

2.537, p<0.01) in 18-39 years age group were observed. Results of ANOVA revealed

significant (p<0.05) differences in TSF, SSSF & BMI.

Table 3 shows the prevalence of chronic energy deficiency (CED Grade I, II and III)

among the adult Birhors of Purulia age-group wise. Result revealed that prevalence of

undernutrition (CED grades age and sex combined) among Birhors was 26.5 %. The sex

specific rates were 33.3 % and 19.4 %, among females and males, respectively. It was also

observed that young adult females (18-39 years) had the highest prevalence of CED (36.4 %)




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followed by elderly males and females (33.3 %), group-II females (27.3 %), group-I males

(21.4 %) and group-II males (9.5 %), respectively. There was a highly significant sex

difference in CED prevalence based on BMI (X2= 10.334, df = 4, p= 0.05).

Discussion

India has a large and diverse tribal population. There are wide variations among the

groups in nutritional status and access to utilization of nutrition and health services.

Comparisons of mean BMI (among males and females) of the present study with various

tribal populations of West Bengal are shown in Table 4. From this table it is clear that Santal

(Birbhum) (Mukhopadhyay, 2009) and Birhors (present study) have the highest mean BMI

(20.5 kg/m2) followed by Santal (20.0 kg/m

2) (Bose et al., 2006c); Dhimal (Banik et al.,

2007), Lodha (Mondal, 2007), Lodha (Bose et al., 2008) & Santal (Das & Bose, 2010) (19.5

kg/m2); Oraon (18.8 kg/m

2) (Mittal and Srivastava, 2006); Bhumij (Ghosh, 2007), Kora Mudi

(Bose et al ., 2006b), Munda (Ghosh and Bharati, 2006) & Bhumij (18.7 kg/m2) (Bose et al.,

2008); Kora Mudi (18.6 kg/m2) (Bisai et al., 2008) and least mean BMI was observed among

the Santal (18.5 kg/m2) (Ghosh and Malik, 2007) males of West Bengal.

Similarly, Birhors (present study) females have the highest mean BMI (20.2 kg/m2)

followed by Oraon (19.7 kg/m2) (Mittal and Srivastava, 2006); Santal (19.5 kg/m

2)

(Mukhopadhyay, 2009); Lodha (Mondal, 2007) & Santal (19.3 kg/m2) (Bose et al., 2006c);

Dhimal (19.1 kg/m2) (Banik et al., 2007); Santal (18.7 kg/m

2) (Ghosh and Malik, 2007);

Bhumij (18.4 kg/m2) (Ghosh, 2007); Kora Mudi (18.3 kg/m

2) (Bose et al ., 2006b; Bisai et

al., 2008); Santal (18.1 kg/m2) (Das & Bose 2010) and the least among them was observed

among Munda (17.7 kg/m2) (Ghosh and Bharati, 2006) females of West Bengal.

In general, prevalence of CED among the tribals of West Bengal is presented in

Figure 1. Overall CED was highest among the Mundas (58.5 %) of Kolkata (Ghosh and

Bharati, 2006) followed by Bhumij & Santal (53.7 %) (Ghosh, 2007; Ghosh and Malik,

2007); Kora Mudi (53.5 %) (Bisai et al., 2008); Kora Mudi (52.2 %) (Bose et al., 2006b);

Bhumij (48.4 %) (Bose et al., 2008); Santal (46.7 %) (Das & Bose, 2010); Lodha (45.2 %)

(Bose et al., 2008); Lodha (43.0 %) (Mondal, 2007); Oraon (39.4 %) (Mittal and Srivastava,

2006); Dhimal (36.7 %) (Banik et al., 2007); Santal (34.5 %) (Mukhopadhyay, 2009); Santal

(31.6 %) (Bose et al., 2006c) and the present study Birhor (26.5 %) hade the least prevalence

of CED among the other studied tribal community of West Bengal.




267

According to National Family Health Statistics- 3 report (NFHS-3, 2005-2006), the

prevalence of undernutrition in India is 33.0% among males and 28.1% among females. In

urban areas, these figures were 19.8% and 17.5%, respectively. In rural areas these were

38.8% and 33.1%, respectively. However, the situation is much worse in West Bengal with

corresponding prevalence of 37.7% and 31.6%, respectively. Among urban males and

females they were 19.9% and 15.5%, respectively. The corresponding rural figures were

44.9% (males) and 38.0% (females). Therefore, the use of BMI and WHO (1995) BMI based

cut-off points for the evaluation of CED are valid for use among tribal populations of India.

The primary importance, from the public health perspective is the need for immediate

nutritional intervention programs to be implemented among Birhors of Purulia and all other

tribal groups experiencing nutritional stress.

The Government should play an active role in reducing the rates of undernutrition

among tribal people. It is imperative that the recommendations should include not only

adequate dietary intake but also various ways in which they can enhance their socio-economic

status through improved education and employment opportunities. It has already been

emphasized (Topal and Samal, 2001) that there exists variation in social and economic

conditions among tribes of India. Similar studies should also be undertaken among all other

tribal populations in India since they constitute a sizeable portion of India‟s population.

Conclusion

From our study it can be concluded that the nutritional status of Birhor was serious;

females and oldest peoples experiencing the most severe situation then the others. There is

strong evidence that, in general, Birhor and other tribal populations of India were

experiencing serious to critical nutritional stress.

Acknowledgements

Authors were gratefully acknowledged villagers and block authorities for their

cooperation.




268

References

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www.indianexpress.com/news/first-to-join...birhor-boy.../815394/. Retrieved August 17,

2011.

Table 1: Mean (SD) and t-test with significance (p) of anthropometric measurements (including

circumferences & skinfolds)

of adult Birhor tribals of Purulia.

Variables

Sex

T p Male Female

µ sd µ sd

AGE 37.8056 15.70560 36.8000 15.57632 0.390 0.697

WT 48.1806 6.53555 44.0000 7.35766 3.637 0.000

HT 153.4139 5.51427 147.6293 6.07853 6.035 0.000

MUAC 24.7500 2.53583 23.7267 3.77954 1.920 0.057

WC 71.0056 5.46035 70.7920 6.10079 0.223 0.824

HC 80.5806 4.61936 80.6347 5.31249 -0.066 0.948

BSF 3.3028 .79629 3.1373 .75584 1.292 0.198

TSF 4.2325 1.01745 4.2333 1.23642 -0.004 0.996

SSSKF 5.3597 1.21478 5.3200 1.54754 0.173 0.863

BMI 20.5010 2.81591 20.1977 3.30034 0.598 0.551

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272

Table 2: Age-trend in mean (SD), t-test and ANOVA (F) with significance (p) of anthropometric

measurements (including circumferences & skinfolds)

of adult Birhor tribals of Purulia.

Variables

Sex

&

T

Age-group (Years)

F P (18-39)

(40-59)

(≥ 60)

WT

Male 48.17

(5.24)

50.14

(7.62)

43.67

(7.78) 3.293 0.043

Female 43.61 (6.78) 44.59

(8.54)

44.44

(1.82) 0.145 0.866

T 3.474*** 2.245* -0.213

HT

Male 154.24 (5.09) 152.40

(6.25)

151.92

(5.52) 1.161 0.319

Female 147.42 (6.20) 147.65

(5.69)

148.59

(6.99) 0.134 0.874

T 5.355*** 2.610** 1.123

MUAC

Male 24.99 (2.11) 24.54

(3.11)

24.11

(3.05) 0.544 0.583

Female 23.28 (3.86) 24.43

(4.06)

24.20

(2.45) 0.751 0.475

T 2.537** 0.100 -0.068

WC

Male 71.69 (5.00) 71.27

(5.67)

67.18

(6.07) 2.691 0.075

Female 70.13 (6.08) 71.13

(6.41)

73.20

(5.34) 0.992 0.376

T 1.297 0.078 0.938




273

HC

Male 81.28 (4.22) 80.13

(5.16)

78.37

(4.80) 1.641 0.201

Female 79.76 (4.85) 81.38

(5.84)

83.38

(5.73) 1.796 0.173

T 1.543 -0.739 -1.890

BSF

Male 3.24 (0.86) 3.60 (0.70) 2.90 (0.42) 2.889 0.062

Female 3.12 (0.70) 3.15 (0.84) 3.27 (0.87) 0.165 0.848

T 0.793 1.929 -1.108

TSF

Male 4.14 (1.13) 4.69 (0.76) 3.60 (0.42) 4.461 0.015

Female 4.26 (1.13) 4.25 (1.59) 4.04 (0.76) 0.117 0.889

T -0.515 1.154 -1.539

SSSKF

Male 5.32 (1.23) 5.81 (1.14) 4.47 (0.77) 4.285 0.018

Female 5.35 (1.31) 5.33 (1.90) 5.16 (1.85) 0.057 0.945

T -0.087 1.003 -1.029

BMI

Male 20.27 (2.22) 21.65

(3.44)

18.90

(2.96) 3.579 0.033

Female 20.13 (3.34) 20.36

(3.31)

20.14

(3.46) 0.038 0.963

T 0.232 1.249 -0.814




274

Table 3: Prevalence of CED (%) based on BMI (kg/m2)

among the studied community.

Nutritional

Status

MALE

(n=72)

FEMALE

(n=75)

18-39

(n= 42)

40- 59 (n=

21)

≥ 60

(n= 09)

18-39

(n= 44)

40- 59

(n= 22)

≥ 60

(n= 09)

CED III - 4.8 11.1 4.5 9.1 11.1

CED II - - - 13.6 4.5 -

CED I 21.4 4.8 22.2 18.2 13.6 22.2

Overall CED 21.4 9.5 33.3 36.4 27.3 33.3

Normal 76.2 76.2 66.7 54.5 63.6 55.6

Overweight 2.4 14.3 - 9.1 9.1 11.1

All figures presented are percentages.

Sex difference: chi-square =10.334, df = 4, p < 0.05.




275

Table 4: Comparison of mean BMI (kg/m2) and CED prevalence among tribal population of West

Bengal.

Community

Male

Female

Overall

Mean

Reference

Bhumij 18.7 18.4 18.6 Ghosh, 2007

Dhimal 19.5 19.1 19.3 Banik et al, 2007

Kora Mudi 18.7 18.3 18.5 Bose et al, 2006b

Kora Mudi 18.6 18.3 18.5 Bisai et al, 2008

Lodha 19.5 19.3 19.4 Mondal, 2007

Munda 18.7 17.7 18.2 Ghosh & Bharati, 2006

Oraon 18.8 19.7 19.3 Mittal & Sivastava, 2006

Santal 20.0 19.3 19.7 Bose et al, 2006c

Santal 18.5 18.7 18.6 Ghosh & Mallik, 2007

Santal 20.5 19.5 20.0 Mukhopadhyay, 2009

Lodha 19.5 -- -- Bose et al, 2008

Bhumij 18.7 -- -- Bose et al, 2008

Santal 19.5 18.1 18.8 Das & Bose, 2010

Birhor 20.5 20.2 20.3 Present study

Figure 1: Comparison of CED prevalence among tribal population of West Bengal.




276

53.7

36.7

52.2

53.5

43

58.5

39.4

31.6

53.7

34.5

45.2

48.4

46.7

26.5

Bhumij

Dhimal

Kora Mudi

Kora Mudi

Lodha

Munda

Oraon

Santal

Santal

Santal

Lodha

Bhumij

Santal

Birhor

Co

mm

un

ity

CED (%)

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