Nutritional study among Great Andamanese

The great Andamanese is a negrito tribe living in the Andaman group of islands. Before the British colonization, they were a predominant population in the Andaman islands. Although referred commonly as the Great Andamanese, there were at least ten sub-groups among them and each had their own language and culture. During the beginning of 20th century their population was in excess of 5,000. Most of these sub-groups have extinct. At present the Great Andamanese population consists of less then 40 individuals. A noticeable change has already happened in their culture and food habits. The impact of this transition on their health status is not fully understood. As a first step in understanding the impact of acculturation, a nutritional survey was conducted among the Great Andamanese tribe settled at Strait Island. The survey included a diet survey and nutritional anthropometry. Diet survey was done by weighment method for three consecutive days.

Fig 1. Decline in the Great Andamanese population

during 20th century

Lengths of children aged two years or less were measured using infantometer and the heights of others were measured using Anthropometer rod. Weights were measured using lever type weighing machines. Mid-upper arm circumference was measured using non-stretchable fibre glass measuring tapes and fat fold thickness using calipers. Mean values of anthropometric measurements for each age were calculated separately for males and females. Children under 6 years of age were classified into different nutritional grades following Gomez Classification and children below 19 years as per Waterlow classification. Body Mass Indices (BMI) were calculated for adults and they were classified into different grades of Chronic Energy Deficiency (CED) as per the cut off values suggested by WHO.

Table 1. Consumption pattern of various food

groups by Andamanese

Table 1 shows the food group consumption profile per consumption unit (CU). Their intake of Green Leafy Vegetables (GLV), other vegetables and milk and milk products were much less than the respective recommended dietary allowances. Consumption of other forms of food was more than the recommended  allowance.  Meat consumption is more than eight times the recommended daily allowance and intake of oils and fats almost double the recommended allowance. Though the average consumption of most of the food groups per CU  was above the recommended level, the consumption pattern differed from family to family with 33 to 67% of the families having deficient intakes of various food groups except fats, oils and meat. All the families were deficient in their intake per CU of GLVs and milk and milk products and 83% of them had deficient intake of other vegetables also.

Average intakes of various nutrients per CU are given in table 3.2. Average consumption per CU for the whole community were above the recommended levels for all the nutrients except iron, Vit. A and riboflavin

Table 2. Nutrient intake pattern of Great Andamanese

(* Recommended Dietary Allowance  # Consumption Unit)

Average intakes of various nutrients per CU are given in table 2. Average consumption per CU for the whole community were above the recommended levels for all the nutrients except iron, Vit. A and riboflavin

Fig 2. Proportion of families with deficient

intake of nutrients

Fig.2 shows the proportion of families having deficient intake of different nutrients. All the families had deficient intake of iron, Vit. A and riboflavin and none had deficiency in proteins and fat intake.

In spite of rich availability of food, the dietary pattern showed gross imbalance with high deficiency in intake of green leafy vegetables, other vegetables and milk and excess intakes of meat, oils and fats. Consequently their diet is poor in iron, Vit. A, and riboflavin but excessive in energy, protein and fat. Unavailability of locally grown vegetables and operational difficulties in transporting from other islands might account for the low intake of vegetables.

 

Fig 3. Nutritional status of children aged 6 years and less	3.4. Nutritional status of children aged below 19 years
Four out of the seven (57.1%) children, aged 6 years or less, were having moderate to severe degree of malnutrition and  another 2  (28.6%) had mild degree of malnutrition making the prevalence of under-nourishment among preschool children 85.7% (fig. 3). All the children aged 19 years and less had weights and heights lower than the NCHS reference values for their respective ages and sex.. There were 18 children in this age group and 14 (77.8%) among them were malnourished with 7 (38.9%) showing both stunting and wasting and the another 6 (33.3%) showing only wasting (fig. 4). The remaining one had only stunting. This high prevalence of both stunting and wasting among children indicate that the problem of malnutrition in the community has been existing for quite a long time. Malnutrition was found to be equally prevalent in both boys and girls. The adult Andamanese of both  sexes were shorter by 2 to 11 cms as compared to rural Indians, but men were heavier by 1 to 5 kg and the women, except those in the age group of 40-49 years, lighter by 1.5 to 8 kg compared to rural Indians.  The mean values of mid upper arm circumference and fat fold thickness at triceps were also higher compared to their rural counterparts except among women in the age group of 30-39 years. The mean BMI of Andamanese adults, above the age of 19 years, was 21.07 (S.D. 3.73) which is within the accepted range of BMI for  population groups. Clinical signs of anaemia were present in 14 out of 18 (77.8%) children aged less than 19 years. Other nutritional deficiency signs observed were conjunctival xerosis  in 4 children, carries tooth in 3 children, angular stomatitis and phrynoderma in 2 children each. Thirty-three out of 35 persons (94.3%) were found have anaemia. 29 out of 30 persons (96.7%) examined were found to harbour one or more types of intestinal parasites.  The commonest parasite encountered was Trichuris trichura (93.3% prevalence) followed by Ascaris lumbricoides (43.3%).  Malnutrition was found to be widely prevalent among the children and adolescents of the community. Micro-nutrient deficiency disorders like anaemia, Vit. A deficiency and iodine deficiency were also prevalent among them. In contrast to this poor nutritional status of the children, the adults were having better general nourishment. These findings of the nutritional study were communicated to the Dept. of Tribal Welfare, Andaman and Nicobar Administration, who institutes welfare measures including nutritional supplementation among the Great Andamanese tribe. Based on the recommendations of the Centre, appropriate modifications have been made to the nutritional programme.