title: Nutritional status and food security: winter nutrition monitoring in Sarajevo 1993-1994.
abstract: OBJECTIVE
  To monitor nutritional status and food security throughout the winter of 1993-1994 in order to provide early warning of any deterioration, identify the nutritionally vulnerable and so enable humanitarian agencies to respond appropriately.
  
  
  METHODS
  Four different household groups were prospectively followed: residents, refugees in collective centres, refugees in private accommodation and elderly living alone (either residents or refugees). Four local communities were purposively selected and two collective centres were randomly selected. Households were randomly selected within each community and collective centre. An additional sample of all elderly inhabitants of the old people's home were nutritionally assessed only.
  
  
  METHODS
  Monitoring was implemented in the besieged city of Sarajevo.
  
  
  METHODS
  143 households with 90 children (< 18 years), 230 adults (18-59 years), and 94 elderly (60 + years) members, and 40 elderly inhabitants of the old people's home were monitored.
  
  
  METHODS
  Every month from December 1993 to March 1994, information on household food security was collected through structured questionnaires. All subjects were weighed and their heights measured. Weight for age Z scores in children (six months to 12 years) and body mass index (BMI) in adults and the elderly were calculated.
  
  
  RESULTS
  While the nutritional status of adults and children consistently remained normal, high levels of undernutrition were detected among the elderly ranging from 16% to 21% (BMI < 18.5). Between December 1993 and February 1994, adults lost an average of 260 grams in weight (paired t test p = 0.005). Indicators of household food security (food stocks per person, market food prices and access to food aid) showed negative trends during the same time period.
  
  
  CONCLUSIONS
  Whilst there was no nutritional disaster in Sarajevo over the winter 1993-1994, there were signs that capacity to cope was weakening in some groups. The elderly were identified as the most nutritionally vulnerable due to sickness, cold, stress and problems related to food preparation. The most food insecure group were refugees in collective centres who were highly dependent on food aid, were less likely to have relatives outside Sarajevo to support them, had fewer possessions to sell and were least likely to have gardens.
authors.affiliation: WHO Area Office, Zagreb, Croatia.
authors.forename: F
authors.initials: F
authors.lastname: Watson
authors.forename: I
authors.initials: I
authors.lastname: Kulenovic
authors.forename: J
authors.initials: J
authors.lastname: Vespa
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D017522:Bosnia and Herzegovina; D002648:Child; D004435:Eating; D005260:Female; D005523:Food Supply; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D012494:Sampling Studies; D012621:Seasons; D013997:Time Factors; D014857:Warfare