ABSTRACT
Changes in the nutrient intake combined with increasing
sedentary life style and urbanization contribute to the emergence of chronic
disease as a major health risk. This study assessed nutritional status,
physical activity, dietary pattern and micronutrient status of adolescents
attending Secondary School in Jos South Local Government Area (LGA) of Plateau
State. A cross-sectional study was conducted using 588 adolescents attending
Private and Public Secondary Schools of Jos South LGA between September and
December 2014. Data on demographic characteristics were collected using
semi-structured, pretested questionnaires. Measurements of weight and height
were made using standardized weighing scales and standiometer respectively.
Adolescent Body Mass Index-for-Age was compared with WHO (2007) growth reference.
Dietary pattern and micronutrient status were accessed using standard methods.
Results obtained showed mean Age, BMI and Waist/ Hip ratio were 16.09 years,
21.05±2.65 and 0.81±0.06 respectively. General prevalence of Overweight was
high (11.22 %), particularly among the Private Secondary School girls (19.01%).
Majority of the adolescents (57.99 %) had a fairly low Physical Activity Level
and Private Secondary School boys showed the highest frequency (64.23%).
Dietary pattern of the adolescents showed weekly intake of all types of food
from “4 to 6 times” to “7
or more times” below 50 percent, except for bread, cereals, tubers and
other carbohydrate based foods. Mean PCV, serum iron, zinc and copper for the
Private Secondary School Adolescents were 38.71 percent, 96.15µg /dl, 86.31µg
/dl and 84.44 µg /dl respectively. A percentage of 9.68 %, 16.13 % and 19.35 %
adolescents recorded low values for serum iron, zinc and copper respectively
when compared to reference ranges for iron, zinc and copper. The results
obtained showed a prevalence of overweight and a fairly low physical activity
particularly among the Girls. Consumption of cereals, tubers, pasta and other
carbohydrate based foods was high while mean serum values for Iron, Zinc and
Copper for the Private Secondary School adolescents were within the normal
ranges. Results of this study emphasize the need for educational interventions
which should include increased exercise and Physical Activity at early ages
involving the whole family that will promote optimal nutritional status and
wellbeing.
CHAPTER
1
1.0
INTRODUCTION
1.1 Malnutrition
Generally, malnutrition refers to both undernutrition and
overnutrition (Blossner and De Onis, 2005). It is a state in which a
deficiency or excess of energy, proteins, and other nutrients causes measurable
adverse effects on body form and function, and clinical outcome. Although malnutrition
refers to both under and over nutrition, it is often associated more to
under-nutrition (Todorovic et al., 2003). Malnutrition has become an
urgent global health issue, with under-nutrition killing or disabling millions
of children each year. Malnutrition also prevents millions more from reaching
their full potentials. In children, severe malnutrition accounts for
approximately 1 million deaths annually, with 20 million children under the age
of five suffering from severe malnutrition (Ismail and Suffia, 2013).
Malnutrition is therefore a health outcome as well as a risk factor for disease
and malnutrition.
Many factors can cause malnutrition, most of which relate to
poor diet or severe and repeated infections (Blossner and De Onis, 2005).
Causes of malnutrition include general low intake of food due to short supply,
various diseases such as diabetes, cancer and infections, physical and
psychological trauma, which increases cellular requirements for some nutrients,
the use of pharmaceutical drugs, foreign bodies such as implants and various
environmental factors (Niedzwiecki and Rath,2005)
Malnutrition can disrupt the functions of various immune
system components. This weakens the immune defence, decreasing its
effectiveness in the elimination of pathogens and making individuals vulnerable
to disease which in turn causes the loss of many nutrients, which further
aggravates already existing nutrient deficiency (Niedzwiecki and Rath, 2005).
Under-nutrition does the greatest damage early in life,
marked by underweight, wasting and stunting, while over-nutrition degrades the
body gradually with heart disease, cancer, and other chronic diseases striking
typically in middle and old age. The effects of under-nutrition such as
stunting and blindness are often irreversible, while the effects of
over-nutrition can be tamed through changes in diet and lifestyle (Gardner et
al., 2000).
Adolescence is difficult to define in precise terms, for
several reasons which include difference in the onset of puberty but generally
it can be estimated from 10 years to 19 years, beginning with the onset of
physiologically normal puberty, and ends when an adult identity and behaviour
are accepted (Centre for Disease Control., 2014). Adolescent malnutrition not
only impacts future adult physique and sense of self esteem, it also affects
future metabolic and cardiovascular outcomes (Yusuf et al., 2013).
Adolescence is a period of intense physiological, psychological and social
change. The main problems in adolescence are micronutrient deficiencies, and
dietary inadequacies are likely more of a threat among adolescents because of
unstable eating patterns (Delisle et al., 2000). Changes in lifestyle
are often more obvious among urban adolescents, as they are typically ‗early
adopters‘ (Delisle et al., 2005).
1.2 Statement of
Problem
Approximately 20% of the world‘s population are adolescents,
84% of whom live in developing countries (Montazerifar et al., 2009). In
adolescence, requirement for all nutrients increase as it is one of the most
challenging periods of human development (Dapi et al.,
2009).Aproximately 20% of final adult height and 50% of adult weight is
attained and bones mass increases by 45% during adolescence and even red blood
cell mass increases (Ronsen, 2004).
Adolescence is a very decisive period of development because
it represents the transition between life as a child, and life as an adult
(Ahmad et al., 2009). Over the life course, there may be an accumulation
of biological and social risks (Delisle, 2005). Adolescents make many more choices for themselves than they do as children. At some
time, social pressure makes them to make choices that can have lasting effects
on their nutritional health. During this period, dietary intake patterns are
set in place and these patterns can have vital impact on lifetime nutritional
status and health of the individuals (Ahmad et al., 2009).
Type 2 diabetes mellitus, hypertension, obesity,
deficiencies and anaemia are partly related to Dietary habits (Dapi et al.,
2005). Obesity in combination with certain developed lifestyles such as smoking
and physical inactivity may increase the risk of chronic diseases (Yahia et
al., 2008).
1.3 Justification
Nearly 900 million people worldwide suffer from
under-nutrition, 95% of whom live in the developing world. In Sub-Saharan
Africa, about 27% of the population (250 million) is chronically
under-nourished (World Health Organisation, 2007).
Adolescence is an important phase as shown in ―malnutrition
through life circle‖. Evidence shows that better nourishment encourages better
growth. Furthermore, adolescence is an appropriate time for health promotion
programmes based on documented relationship between behaviour in this age
group, obesity, cardiovascular and other chronic disease risk factors (Delisle et
al., 2005).
Information from this study may help implement nutrition
education programs for adolescents which could lead to better food consumption
patterns, dietary habits, and routine exercise which also reduces the risk of
nutritionally related diseases.
1.4 Aim
The aim of this
study is to assess dietary intake pattern and nutritional status of adolescents
attending secondary schools in Jos South Local Government Area, Plateau State.
1.5 Specific
Objectives
(1)
To document demographic
characteristics of adolescents attending secondary schools in Jos South Local
Government Area, Plateau State
(2)
To determine nutritional status and
Physical activity Levels of adolescents attending secondary schools in Jos
South Local Government, Plateau State.
(3)
To assess dietary pattern of the
adolescents using Food Frequency Questionnaires.
(4)
To determine serum iron, zinc and
copper of adolescents attending Private secondary schools in Jos South Local
Government, Plateau State.
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