Introduction

Rational and healthy nutrition defines the quality of life; growth, development, mental and physical health, increases immune response of organism to the unfavorable effect of environment, which has importance in children especially (1). During last years, diet ingredients people consume have changed, towards deficiency of vitamins and essential microelements (2-4). Unbalanced nutrition is also associated with loss of ability to work and have unfavorable dynamics leading to loss of health and significantly contributing to demographic problems, affecting mostly people of work age.

In children and adolescents, malnutrition is one of the causes of high cardiovascular and noninfectious diseases mortality (5-9). According to recent data, malnutrition affected about 165 million children of age < 5 years old, was responsible for 45% of total mortality in this population (10, 11). Pediatric malnutrition (under nutrition) is defined as an imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein or micronutrients that may negatively affect growth development and other relevant outcomes (12, 13).

Balanced nutrition depending on age, sex, climate zone of living and health state, prevents development of several nutrition dependent diseases (14, 15). Despite this, socio-economic changes in our country do not allow providing population with balanced rational nutrition and especially children and adolescents in many families. The improvement of health population can only be achieved by applying complex interventions, including the healthy nutrition, defined as defined as presence of physical, social and economic availability of safe food in sufficient amount that meets physiological demand of organism to sustain active and healthy lifestyle (16).             The population of Kyrgyz Republic was 6,000,000 by the end of 2015 and 17.9% (1,043,629) of them were children of school age. The contemporary average population density in republic is 28 persons per km². Currently, because of economic crisis and fall in living standards of the most part of Kyrgyzstan population, there are changes in demographic processes as birth rate, mortality, natural increase and dynamics of population, and migration.

The aim of the current study was to analyze the nutrition status and morbidity of adolescents in Kyrgyz Republic.

Methods

The data for the current study were obtained from the database of National statistical

Committee of Kyrgyz Republic for the period of 2009-2014 on nutritional and energy value of nutrition of urban and rural population of Kyrgyz Republic living in conditions of high-, middle- and low-altitudes (17, 18). We compared obtained data with current recommended norms of consumption for food ingredients, energy and food products for different population groups of Kyrgyz Republic (19). The malnutrition levels for children and adolescents were defined according to the generally accepted standards (13). The data were analyzed using software package Analysis ToolPack – VBA, EXCEL – 6.0

Results

According to national statistical committee of Kyrgyz Republic (2015 data) (17), 30.6% of population live below poverty line, among them 1.2% live in poverty, and most of this population (32.6%) live in rural area.   Poverty level is higher in high altitude area as compared to valley (39.3% vs. 37.3%). Among population of children of 0-17 year’s age-range, 44.6% live below the poverty line and 5.6% in poverty. Number of children in families living above poverty line is 1.9, and in families living below poverty line – 2.7.   Malnutrition rate among girls is 6.5%, among boys – 3.3%.  

Level of healthy nutrition availability n Kyrgyzstan is low, especially in remote areas and villages. For the past 5 years, there have been several raises in world prices for food affecting prices for food in our country.  Prices for food products have risen by 41.7% for past 5 years as compared to prices in 2010. The increase in price for bread and flour products for a period 2010-2015 was equal to 44.8%, including increase in price for flour by 1.6 times and bread (by 54.3%). The prices for raw meat for past five years showed stable increase. In 2015 as compared to 2010 the prices for meat increased by 68.2%, milk – 10.5%, fruits – 20.3% and sugar – 7.6%. Imbalance in rise of food products prices and income/salaries reduced consumption of main food products:  meat, eggs, fish, mild products, vegetables and fruits. According to statistical data, in 2014 minimum living standard expenses in KR was 4957,71 som or 72.9 US dollars per month per person. At the same time, the expenses for food products in 2013 reached 2937.6 som and in 2014 – 3223.15 som.  Real expenses for food products were 65% in 2015 that is higher by 1.2% as compared to 2009. As can be seen from current analysis, expenses for balanced nutrition increased and quality of food ingredients consumed by the majority of population worsened.

Comparison of mean consumption of food products for a period of 2010-2014 with recommended norms of consumption of food ingredients, energy and food products (2011) showed that consumption of milk and its products was only 44.4% of recommended consumption quantity, meat products – 42.6%, fish products – 12.1%, vegetables – 58.8%, fruits – 23,9.%. However, consumption of several products was higher than recommended, i.e. fat, butter and bread products (Table 2.)

The daily protein level was only 10.9% with normal range of 10 to 15%, being on the lower level of normal values for population living in poverty.

The protein content (Table 2) in diet is compensated by consumption of wheat products, while it is known that amino acid value of plant proteins is lower in comparison to meat proteins. The deficiency of proteins in nutrition negatively affects the growth and development of children and adolescents; digestion problems of food ingredients lead to damage of heart muscle, worsening of memory and work capacity. These can be explained by that proteins practically take part in all functions of organism. It should be also noted that protein deficiency reduces immune response to infections, and frequently is accompanied by vitamin and microelements deficiency.

The value of fat is also lower than recommended norms for different climate zones of Kyrgyzstan. Carbohydrates are mainly represented by group of bread, sweet, wheat products, vegetables and potatoes. The carbohydrates value is equal to 110% of recommended physiological norms. The ratio of proteins: fat: carbohydrates for total population was equal 1:1:5.9 (recommended norm 1:1:4), for poor – 1:1:6.2 and for population living below poverty line – 1:1:6.7. Thus, the main contributor to energy value of ration was carbohydrates. Excessive carbohydrate intake stimulates fat development and obesity. Hyperglycemia also facilitates development of diabetes, atherosclerosis and cardiovascular diseases. Also, it is associated with increased incidence/ prevalence of caries and allergy.

Our analysis demonstrated a high prevalence of cardiovascular, respiratory, gastrointestinal and endocrine system diseases and neoplasms, due to disorders of nutrition (Table 3).