Dietary practices of school children in Sindh, Pakistan.

BACKGROUND: Malnutrition in Pakistan has remained an unresolved issue for decades. Data on nutrient intake and variety in children's diet is lacking.

AIM: This paper describes the dietary practices of school children across eight districts of Sindh.

METHODS: A school-based survey of dietary practices among 1109 students from classes 2-5 in 36 schools was conducted using a pre-tested interviewer-completed questionnaire.

RESULTS: Descriptive and comparative analysis of data showed that more than 75% school children ate breakfast, lunch and dinner regularly. However, 10% children skipped breakfast and nearly one-third of them skipped mid-morning and evening snacks. Skipping breakfast and snacks was related to low socio-economic status and rural residence. Children's intake of protein-rich food items and fruits also illustrated that urban residence and better socio-economic status have a positive effect on the frequency and variety of daily protein and fruit intake. Though affordability and geographic location were key determinants of children's dietary practices, significantly higher percentages of children studying in class 2, 3 and 4 consumed different kinds of protein-rich food items, fruits and vegetables more frequently as opposed to children studying in class 5. Junk food consumption was more common in urban areas and better socio-economic strata.

CONCLUSION: Development of school-based nutrition education programmes and behavior change strategies emphasizing the regular intake of meals and nutrient-rich snacks, and encouraging consumption of easily available and affordable food items such as dried seeds, fruits, vegetables, milk and its derivatives is essential for addressing nutrient deficiencies.