THE NUTRITIONAL STATUS OF PRE-SCHOOL CHILDREN IN PRIMARY SCHOOL ATTRACTED TO TERTIARY AND NON TERTIARY INSTITUTION IN OWERRI MUNICIPAL COUNCIL
CHAPTER ONE
1.0    INTRODUCTION
Nutritional status is the balance between the intake of nutrients by an organism and the expenditure of these in the process of growth, reproduction, and health maintenance (Kruuse, 2007). Nutritional status can be measured for individual as well as for population. Accurate measurement of individual nutritional status is required in clinical practice. The choice of nutritional status assessment method must be made mindful of the level at which one wants information as well as of the validity and reliability of the method. All method have error (Kruuse, 2007). All method produces imperfect measures that are indirect approximations, of the process. Whatever method is chosen for assessment of nutritional status the data obtained must be compared with reference data to produce an indicator of nutritional status. The quality of the available reference data is therefore another factor that affects the assessment data. Ideal method are sensitive and specific. It is difficult to achieve both in the ability of a technique to correctly identify those affected by condition. Specificity refers to the ability of a technique to correctly classify normal individual as having normal nutritional status. Body mass index  is a global measure of nutritional status. Most persons who consume insufficient energy have low body mass index, so the measure is sensitive. However, there are other causes of low body mass index, including genetics and disease, so body mass index is not specific to nutritional status. The assessment of nutritional status is commonly summarized by the mnemonics “ABCD” which stands for anthropometric measurement, biochemical or Laboratory test. Clinical indicators and dietary assessment (Wilson, 2005).
 1.2   ANTHROPOMETRIC APPROACHES TO
        NUTRITIONAL STATUS.
Anthropometric approaches are for the most part relatively noninvasive methods that assess the size or body composition of an individual. For child body weight and height are used to evaluate overall nutritional status and to classify individual or non healthy weight. In the United States of America and other industrialized countries the emphasis for unhealthy weight is over-weight and obesity. The standards for these have changed over time. The most recent classification is to use body mass index BMI, Henrietta (2006). BMI, regardless of age or population, is normal at 18.5 to 25. O  over weight at 25.0 to 29.9 and obese at over 30.0 (Gythrie, 2006 ). In general BMI greater than 30 is assumed to be due to excessive in children. Growth charts have been developed to allow researchers and clinicians to assess weight and height for-age as well as weight –for-height for children, in addition to weight and height, measure of mid-arm circumference and skin fold measured over the triceps muscle at the mid-arm are used to estimate fat and muscle mass.  (Wilson, 2008) Anthropometric measurement of nutritional status can be compromised by other health condition, for example edema characteristics of some forms of malnutrition and other disease status can conceal wasting by increasing body weight. Head circumference can be used in children 36 months and presence of malnutrition. To interpret anthropometries data they must be compared with reference data.  (Wilson 2008)
1.2 STATEMENT OF PROBLEM OF NUTRTION         
STATUS
      Child that grows within normal range for his height and weight chart is said to be growing adequately. There are several growth charts available for reference such as NCHS growth chart. Growth not only depends on genetic potential but also no other factors such as poverty (poverty can lead to poor food intake and improper growth) ethnic background (Asians are genetically shorter as compared to the whites) and emotional well being improper growth can be in form of over-nutrition Obesity) or undernutrition.
1.3    OBJECTIVE OF THE STUDY
          To assess the nutritional status of pre-school children in primary school attracted to tertiary and non tertiary institution in Owerri Municipal Council.