1. Nutritional assessment

2. Gujarat Ahmedabad (selected by GoI) Ahmedabad Municipal Corporartion (10 schools) Dascroi (6 schools) Sanand (6 schools) Sabarkantha (selected by GoG) Himmatnagar (6 schools) Bhiloda (6 schools) Sample size (385 children) Sample size (173)

3.  Anthropometic Assessment  Diet Pattern Survey  Clinical Survey

4.  Body weight  Height  Mid upper arm circumference (MUAC)

5. Body weightHeightMUAC Anthropometric Measurement

6. Age(n)%HeightWeightBMIMUAC 5(10)1.79110.55±3.7215.24±2.2212.48±1.7115.50±1 6(37)6.63110.86±4.6916.53±3.1213.37±1.5115.67±1.56 7(46)8.24115.11±4.6918.30±3.1213.71±1.5116.19±1.56 8(58)10.39122.01±6.1120.67±3.6113.81±1.5716.81±1.55 9(60)10.75127.31±7.0822.81±3.7914.00±1.4517.36±1.67 10(75)13.44131.11±7.2224.64±4.7914.23±1.6717.63±1.92 11(60)10.75137.29±6.4128.13±4.4214.88±1.8118.64±2.41 12(76)13.62140.25±7.3630.52±6.0015.45±2.3919.34±2.61 13 (78)13.97 145.47±7.9733.22±5.8015.62±1.9819.77±2.19 14(49)8.78149.70±6.5337.30±7.2016.60±2.7920.93±2.71 15(6)1.07154.63±4.2941.27±1.1317.30±1.1820.64±2.41 16(2)0.35150.00±2.8343.40±14.7019.42±7.2718.95±1.48 18(1)0.17163.00±0.0044.70±0.0016.82±0.0023.00±0.00 Table-1 Anthropometric parameters and BMI of school children as per age

7. AgenHeight (cm)Weight (kg)BMI (kg/m 2 )MUAC (cm) MaleFemaleMaleFemaleMaleFemaleMaleFemaleMaleFemale 546 110.88±2.4 6 110.33±4.5 9 16.48±0.6 1 14.42±2.5 8 13.40±0.1 0 11.86±2.0 4 15.38±0.6 3 15.58±1.2 4 61819 113.06±5.5 4 109.00±3.0 3 17.49±4.3 2 15.70±1.3 4 13.53±2.0 0 13.22±1.0 2 15.78±2.1 0 15.55±1.0 3 72224 115.43±6.0 7 114.22±4.9 1 18.41±3.5 7 17.82±3.0 2 13.72±1.6 9 13.60±1.6 7 15.95±1.6 0 16.20±1.5 0 82434 122.42±7.0 7 121.59±5.4 7 20.92±4.3 5 20.42±3.0 6 13.82±1.5 4 13.79±1.6 3 16.67±1.6 5 16.91±1.5 1 93327 128.30±7.6 2 126.48±6.0 8 23.22±3.9 1 22.45±3.6 3 14.04±1.4 2 13.97±1.5 5 17.28±1.8 3 17.52±1.4 5 103639 131.14±7.5 7 131.22±7.0 4 24.73±4.7 6 24.61±4.9 3 14.29±1.7 9 14.17±1.6 1 17.49±1.9 0 17.78±1.9 7 112436 136.17±5.1 0 137.90±7.1 7 28.47±3.8 9 27.64±4.5 0 15.37±2.1 2 14.45±1.3 5 18.46±2.8 4 18.58±1.8 8 124135 140.95±7.9 3 139.59±6.8 2 31.66±6.4 9 29.31±5.3 4 15.86±2.5 0 14.99±2.2 5 19.69±2.8 5 18.92±2.3 2 133543 139.59±6.8 2 146.04±8.1 4 29.31±5.3 4 33.83±5.4 3 14.99±2.2 5 15.83±2.1 6 18.92±2.3 2 20.04±2.5 0 142524 149.62±6.1 7 149.48±7.0 1 35.53±5.1 4 38.87±8.6 7 15.87±2.1 3 17.30±3.2 8 20.36±1.9 2 21.50±3.3 5 1524 157.45±7.1 4 153.38±3.5 0 41.50±0.7 1 41.50±1.2 9 16.80±1.8 1 17.67±1.1 2 20.75±0.3 5 20.25±3.2 8 1602-150±2.83- 43.4±14.7 1 - 19.42±7.2 7 - 18.95±1.4 8 1810163-44.7-16.82-23- Table-2 Nutritional status of school children as per age and gender

8. BMI (Z scores) Primary school Gender Normal n (%) Moderate undernutrition n (%) Severe undernutrition n (%) Overweight n (%) Total Male89 (54.26)43(26.22)26(15.85)6 (3.65)164 Female100(57.47)56(32.18)15(8.62)3(1.72)174 BMI Upper Primary school Male49(49.49)27 (27.27)21(21.21)2 (2.02)99 Female64(52.89)37 (30.57)14 (11.57)6 (4.95)121 Table-3 Nutritional status of primary and upper primary school children as per gender Ref: WHO (2007)

9. Nutritional Status

19.  The quantity served per child was generally as per the requirement of primary school or upper primary school children.  In some schools more number of children were present in comparison to the number of children who consumed MDM.

23. Age (yrs)WeightEnergy (Kcal)Protein (gm) 7-925.1169029.5 Boys10-1234.3219039.9 Girls10-1235201040.4 Boys13-1547.6275054.3 Girls13-1546.6233051.9 Boys16-1755.4302061.5 Girls16-1752.1244055.5

24. Meal Ener gy Prote in Fa t Carot ene Thiam ine Ribofla vin Niaci n Vit B1 2 Folaci n Vit C Iro n Calciu m Vit A Dal rice+ Brinjal potato 5661016640.2 403817134192 Chana sabzi + Roti 20868370.1010380246119 Khichdi36168500201301123 Pulao4337.386.60.1 2.3010.33.3116163. 7

25.  It was observed that the recipes could not meet the expected amounts of energy and proteins, compared to RDAs  Only Dal rice and brinjal potato(566 kcal) could provide energy close to expected amounts(646 Kcal).  Flourosis was observed in majority of the children.

26.  It is desirable to have cereals and pulses along with vegetables and fruits.  Drumstick leaves should be included in recipes.  One piece of sapota or mango approximately 100-150 g may be distributed along with rice.  20 g of whole Bengal gram for primary and 30 g upper primary be soaked and cooked with pulao to give balance of protein and energy.  Recipes like LAPSI are not liked by children therefore a substitute for this should be thought of.

27.  The last 10 per cent of the children having lowest academic performance should be medically examined regularly for anaemia, IDD, hearing and eyes.