Objectives No data exists for nutritional status of female adolescent school dropouts despite one in seven adolescent girls in Sri Lanka being an early school leaver. The aim of this study was to assess the nutritional status of working and non-working female adolescent school dropouts. Methods A cross-sectional design was used to recruit 613 female adolescent school dropouts, aged 15-19 years, in two districts of the Western Province of Sri Lanka. BMI was calculated by assessment of weight and height. Haemoglobin, serum ferritin, serum folic acid, vitamin B12, and serum zinc were measured. Results When girls were grouped into age specific BMI categories, 32.8% of girls were underweight, while 6.1% were overweight. Prevalence of anaemia (haemoglobin <120 g/l) in the study population was 17 %. Low iron status (serum ferritin <20 μg/l) was noted in 29.4 % of girls, low serum folate in 28% (folic acid <3 μg/l) and zinc deficiency in 28.8% (zinc <66 μg/dl). Regression modeling indicated that dropping out of school early (at <14 years of age) was a significant risk factor for low serum ferritin (p=0.001, odds ratio=2.1). Working adolescents were at greater risk of low micronutrient status: low serum ferritin (p=0.009; odds ratio=1.8) serum folic acid (p=0.006; odds ratio=1.9) and zinc deficiency (p=0.001; odds ratio=2.1) than non-working adolescents.

Existing SFT prediction-equations are unsuitable for predicting %FM in this population. The new equation utilizing one peripheral and one truncal skin-fold, is appropriate for prediction of %FM in this population and may be applicable to other South Asian/Asian-Indian adolescents following validation.

BackgroundValid skinfold thickness (SFT) equations for the prediction of body fat are currently unavailable for South Asian women and would be a potentially robust field tool. Our aim was to assess the validity of existing SFT equations against deuterium (2H2O) dilution and, if invalid, to develop and validate an SFT equation for % fat mass (%FM) in Sri Lankan women.MethodsH2O dilution was used with Fourier transform infrared (FTIR) spectroscopy as the criterion method for the assessment of %FM in urban Sri Lankan women (30–45 years). This data was used to assess the validity of available SFT equations and to generate and validate a new SFT equation for the prediction of %FM against the criterion method. Women (n = 164) were divided into validation and cross-validation groups for the development and validation of the new equation. The level of agreement between the %FM calculated by the final derived prediction equation and the %FM obtained by 2H2O dilution was assessed using Pearson’s correlation coefficient (R) and Bland Altman plots. Student’s t test was used to assess over- or underestimation, and significance was set at p < 0.05.ResultsExisting equations significantly (p < 0.001) underestimated %FM compared with the 2H2O dilution method. The final equation obtained was %FM = 19.621 + (0.237*weight) + (0.259*triceps). When compared with 2H2O dilution, %FM by the equation was not significantly different. There was a significant (p < 0.001) correlation between %FM by the reference method and %FM by the equation. The limit of agreement by Bland Altman plot was narrow with a small mean positive bias.ConclusionsExisting SFT equations were not applicable to this population. The new equation derived was valid. We report a new SFT equation to predict %FM in women of South Asian ancestry suitable for field use.

Specific dietary patterns are associated with the risk of chronic disease. An in-depth understanding more reflective of lifestyle would be possible when assessing the synergistic effects of both diet and physical activity in pattern analysis. In the present study, we examined the biochemical markers of dysglycaemia and cardiometabolic risk in relation to lifestyle patterns using principal component analysis (PCA). Urban women (n 2800) aged 30 -45 years were screened for dysglycaemia using cluster sampling from the Colombo Municipal Council area. All the 272 dysglycaemic women detected through screening and 345 randomly selected normoglycaemic women were enrolled. The International Physical Activity Questionnaire and a quantitative FFQ were used to assess physical activity and diet, respectively. Anthropometric measurements, bioelectrical impedance analysis and biochemical estimations were carried out. Lifestyle patterns were identified based on dietary and physical activity data using exploratory factor analysis. PCA was used for the extraction of factors. A total of three lifestyle patterns were identified. Women who were predominantly physically inactive and consumed snacks and dairy products had the greatest cardiometabolic risk, with a higher likelihood of having unfavourable obesity indices (increased waist circumference, fat mass percentage and BMI and decreased fat-free mass percentage), glycaemic indices (increased glycosylated Hb (HbA1c) and fasting blood sugar concentrations) and lipid profile (increased total cholesterol/TAG and decreased HDL-cholesterol concentrations) and increased high-sensitivity C-reactive protein concentrations. For the first time, we report lifestyle patterns and demonstrate the synergistic effects of physical activity/inactivity and diet and their relative association with cardiometabolic risk in urban women. Lifestyle pattern analysis greatly increases our understanding of high-risk behaviours occurring within real-life complexities.

Background: Urbanisation has been reported to have negative effects on lifestyle and possibly on body composition. The aim of this study was to assess the effect of urbanization on dietary patterns and measures of body composition in Sri Lankan adolescent girls. Methods: Body Mass Index was calculated in 552 adolescent school dropouts. Percentage body fat was calculated using a population specific skin fold thickness equation. Dietary patterns were identified based on information obtained from a food frequency questionnaire. Extraction of factors of the dietary patterns was by principal component analysis. The sum of hours / week spent on physical activity was calculated. Focus group discussions were held to gather supportive qualitative data on food related behaviors. Multivariate linear regression models were used to assess the association between independent variables and dietary patterns. Results: Two dietary patterns were identified; a convenience-based dietary pattern with higher factor loadings for starchy foods other than rice, animal foods, dairy products, fruits, sweetened food and fried food, and a traditional pattern with higher factor loadings for rice, tubers and potatoes, vegetables and dark green leafy vegetables. An urban girl had greater than three times the risk of having a higher percentage body-fat than a rural girl (P = 0.01, OR = 3.2). Time spent on physical activity was significantly (P = 0.003) higher among the rural girls. Focus group discussions indicate that urban girls preferred food from vendors due to convenience while rural girls preferred home cooked meals. Conclusions: Urban adolescents in this study followed a convenience based dietary pattern and this dietary pattern and lower physical activity was associated with overweight and higher body fat.