ABSTRACT
Nutritional status, dietary habit and physical activity are
recognized as a major determinants of health. The study was conducted to assess
the nutritional status, dietary pattern and prevalence of risk factors and
chronic diseases among adults in Bida Local Government Area, Niger State. A
cross sectional study was conducted among 210 adults between the ages of 18-65
years. The study population comprised of 111 (52.91%) female and 99 (47.1%)
male. Food frequency questionnaire (FFQ) was used to collect data on dietary
habits of the respondents. Data was analyzed using IBM SPPS version 20. BMI
showed that 38 (18.1%) of the respondents within the age 30-39 years were
overweight while 72% of the respondents are having a waste circumference that
is above the normal range. High prevalence of unhealthy eating habits was
recorded among the respondents. About 52%, 44% and 40% consumed milk and dairy
products, egg and confectionary (snacks) respectively thrice weekly while
fruits (25.7%) and vegetables (14.3%) consumption at least 7 times in a week
was low. Tobacco use among the respondents between the ages to 30-39 years was
47.5% which indicates a high level of its use. Physical activities of the
respondents was very low because about 97% reported having a normal sedentary
leisure time. Blood glucose level (36.7%) was high among the respondents about
48% of the respondents are having an elevated blood pressure while total
cholesterol, HDL and LDL, of the respondents was normal. The study demonstrated
a high prevalence of unhealthy eating habit and life style changes. Several
risk factors may be contributing to it such as, nutritional transition, low
intake of fruits and vegetables, urbanization, physical nutrition and health
awareness. Intervention programme by health professionals are needed to reverse
the trend particularly with special focus on promotion of healthy eating and
physical activity.
CHAPTER ONE
1.0 INTRODUCTION
1.1 Background Introduction
The major cause of mortality in developed and developing
countries of the world are diseases in which nutritional lifestyle plays an
important role. The choices of what people eat are determined by various
factors such as religions, customs and socio-economic differences (Shehu et
al., 2011). The environments affect individual‘s lifestyle. Changing these
factors in the direction of nutritional lifestyle patterns could postpone the
age of onset of permanent mobidity, disability, disease occurrences and death
and could have a major effect on quality of life (Waijers et al., 2006).
Nutrition as the science of food and its relationship to health has been
recognized in recent years as the cornerstone of socioeconomic development
(Parks, 2009). Adequate nutrition is important for a variety of reasons,
including optimal cardiovascular function, muscle strength, respiratory
ventilation, protection from infection, wound healing and psychological
well-being (Martin, 2006). Adequate nutrition entails a diet that contains the
constituents (carbohydrate, fats, proteins, vitamins and minerals) that are
required for body building, energy supply, body defense and regulatory
functions in quantities commensurate with the body need. Malnutrition refers to
either inadequate intake of nutrients due to lack of food, ignorance, socio
cultural factors, and diseases among other causes, resulting in underweight and
other nutrient deficiency diseases; or intake of nutrients in excess of body
requirements due to poor dietary habit (erroneously perceived as a sign of affluence),
resulting in overweight and obesity.
Poor diet (high consumption of
sugar, salt, saturated fat, etc) and unhealthy lifestyle (smoking, alcohol
consumption and physical inactivity) have been identified as major risk factors
of cardiovascular disease and other non-communicable diseases (NCDs)
According to the World Health Organization (WHO) estimates,
36 million, out of the 57 million deaths (almost two thirds) that occurred
globally in 2008 were due to non-communicable diseases (NCDs), comprising
mainly cardiovascular diseases, cancers, diabetes mellitus and chronic lung
diseases (WHO, 2009).
Rural population depends on available natural foods like
green vegetables, fresh fruits and dairy products in their immediate
environment. Although, significant amount of refined foods could also be
noticeable in the rural areas such as bread, soft drinks and other refined or
processed food products. Rural people have a high physical activity related energy
expenditure compared to urban subjects (Lestra et al., 2005).
Food choice is an important determinant of people quality of
life. Poor or unbalanced diets as in the case of excessive eating and
undernutrition, are risk factors for several chronic diseases (Haveman et
al., 2003). Poor food intake reduces the level of nutrients in the body
thereby exposing the individual to nutritional health related problems (Haveman
et al., 2003). The choice of good nutrition is not only important in
preventing health problems and promoting active living, but it is a critical
part of managing diseases among those who are infected or sick (Haveman et
al., 2003) .
As has been reported for
several developing countries (Delisle, 2010), West Africa has also
undergone periods of changes in dietary habits and shifts in eating patterns in
response to socio-economic and socio-political factors. Increasing urbanization
and large movements of populations to urban centres with reduced access to
traditional and indigenous food resources also exacerbated the nutrition
transition phenomenon (Albala et al., 2002). This reduced access to
indigenous food resources has resulted in the replacement in diets of the
hitherto diversified food resources by energy dense and nutrient poor convenience
foods.
Nupe people are Nupoid-speaking
people living near the confluence of the Niger and Kaduna rivers in
west-central Nigeria. The Nupe people live in the heart of Nigeria,
spread over the low basin formed by the two rivers, Niger and Kaduna (Usman,
2002). Nupe land is made up of an agrarian population, where the economy
and social life revolve round agriculture and the people are active farmers.
Major crops grown are rice, sorghum, sugar cane, millet, melon, vegetables,
yam, homestead livestock management and fishing. Cassava, maize, and sweet
potatoes (grown inland) are of secondary importance (Yahaya, 2003).
The Nupe are found in Gbako, Lavun, Bida, Bia and
Agai local government area of Niger State (Yahaya, 2003). A major staple food
that is common to many households in Nupe land is rice. Other common
foods are porridge from millet, sorghum or maize called ―Kunu‖ (Yahaya,
2003). This is consumed along with certain snacks like akara (bean
cake), ―masa‖ sorghum cake, ―mashe‖ (early millet cake) or ―Dakuwa‖
special confectionery from a combination of fried ground nut and maize and
lastly Kuli-Kuli made from groundnut after extraction of the oil
(Yahaya, 2003).
Chronic diseases, often referred to as non-communicable
diseases (NCDs), usually emerge in middle age after long exposure to an
unhealthy lifestyle involving tobacco use, a lack of regular physical activity,
and consumption of diets rich in highly saturated fats, sugars, and salt,
typified by "refined foods. Nutrition and nutritional qualities of food
are widely considered to be crucial for health and well-being of the humans
(Levy-Costa et al., 2005). The well documented evidences from
epidemiological studies indicate several diseases (Nikoo et al., 2010),
such as cardiovascular diseases and some types of cancers are linked with diet
and nutrition uptake and its regulations. All these diet-related diseases are
likely to change in eating habits, processing technologies, and products (Shils,
2005).
Obesity has occurred in
parallel with the globalization of food systems and the expansion of trade and
foreign direct investment. Intake of excessive refined foods has been connected
to most major health issues including: osteoporosis, cancer, hypoglycemia,
cardiovascular disease, adrenal
exhaustion, metabolic, endocrine, and
reproductive disorders, parasitic and yeast infections. Increased consumption
of refined food with less activity leads to an increased incidence of obesity
and diet-related diseases like diabetes, coronary heart disease (CHD) and
certain types of cancer (Shetty, 2002).
The change in lifestyle has
brought about a dramatic nutrition transition characterized by a decrease in
the consumption of traditional foods and an increasing reliance on refined
foods (Mead et al., 2010; Sharma et al., 2010). There is
significant and valid concern for the health implications of consuming
increased amounts of these fat- and sugar-rich foods (Kuhnlein et al.,
2004)
Traditional foods are those
eaten by people over the longer course of civilization and which have supported
health – cultivated, produced, and harvested from the earth and out of nature
– foods which are wholly
unaltered and organic, and contain the highest levels of nutrition or are nutrient-dense
(Umeh, 2007). Traditional foods by their very nature contain
the highest levels of nutrition available because they are grown with
sustainable methods which increase nutrient content and without chemicals and
other harmful substances which have been found to diminish nutritional value
(Umeh, 2007).
Lifestyle diseases are diseases that appear to increase in
frequency as countries become more industrialized (Mercola, 2014). Lifestyle
diseases share risk factors similar to prolonged exposure to three main
modifiable lifestyle behaviors--smoking, unhealthy diet (including alcohol abuse), and physical
inactivity can result in the development of non-communicable and chronic
diseases, substantially degenerative diseases (heart disease, stroke, diabetes,
obesity, metabolic syndrome, chronic obstructive pulmonary disease, and some
types of cancer), that can actually be considered consequence of "contagious"
behaviors. These conditions imply loss of independence, years of disability, or
death, and impose a considerable economic burden on health services (Mercola,
2014).
1.1 Statement
of Research Problem
The current burden of chronic disease reflects the cumulative
effects of unhealthy lifestyles and the resulting risk factors over the life
span of people. Three decades ago, the food available was mostly fresh and
grown locally (Marcola, 2014). The majority of foods served, whether at home,
in school or in restaurants, are highly refined foods, filled with sugars,
harmful processed fats, and chemical additives (Marcola, 2014). Trends in food
availability in households in the last three decades reveal that diverse
traditional foods have been replaced by industrialized convenience foods
(Levy-Costa et al., 2005).
Obesity is a worldwide phenomenon that has reached both
developed and developing countries. The increasing prevalence of obesity and
other cardiovascular risk factors (Batsis et al.,2007) have been partially
attributed to changing nutritional habits and reduced level of regular
physical activity. The obesity epidemic is also influenced by social network
phenomena characterized by behavioural person-to-person interaction (Christakis
and Fowler, 2007). Refined food consumption, defined as inexpensive food, sold
by means of self-service systems or carry-out eating locales without waiter
services has been implicated as a potential reason for the epidemic
(Rosenheck,2008). The rapidly increasing burden of chronic diseases is a key
determinant of global public health. Already 79% of deaths attributable to chronic
diseases are occurring in developing countries, predominantly in middle-aged
men (Barker, 2000). There is increasing evidence that chronic disease risks
begin in fetal life and continue into old age (WHO, 2002). Adult chronic
disease, therefore, reflects cumulative differential lifetime exposures to
damaging physical and social environments.
Closely linked to refined food is another version of
out-of-home food consumption termed Street Food (SF). This entity has
old, historical roots with complex social-economic and cultural
implications (Parente, 2010). Street food is present even in less developed
countries, and has occasionally been considered to be the hallmark of the early
development of fast food (Winarno and Allain, 2014). It is quickly available
and consumed, and generally affordable to large parts of the population.
1.2 Justification
The primary role of diet is to
provide sufficient nutrients to meet the nutritional requirements of an
individual. There is now increasing scientific evidence to support the
hypothesis that some foods and food components have beneficial physiological
and psychological effects over and above the provision of the basic nutrients
(WHO, 2013). Many traditional food products including fruits, vegetables, soya,
whole grains and milk have been found to contain components with potential
health benefits (Ene-Obong, 2001).
Traditional foods consumed by
people over a long period of time, play an important role in establishing local
identity, culture, and custom, and they transfer cultural heritage from
generation to generation (Albayrak and Gunes, 2010; Inamdar, et al.,
2005). During the past two decades, several researchers have claimed that
traditional foods are healthier products and good sources of micronutrients. Therefore, there is an
ardent need to study the dietary patterns of local people and also assess their
health status as this will be useful in policy planning and understanding
trends to reduce most diseases of affluences.
1.3 Aim
and Objectives
The general aim of
this study is to assess the nutritional status, dietary pattern, prevalence of chronic diseases
(obesity and blood pressure) and risks factors among adults in Bida Local Government Area,
Niger State.
The specific
objectives are to:
i.
Assess the anthropometric parameters
(BMI, waist circumference) of adult in Bida Local Government Area of Niger
State.
ii.
Assess the dietary pattern among
adult in Bida Local Government Area, Niger State.
iii.
Determine the prevalence of chronic
diseases (Medical History and On-Point measurement of Blood pressure and
obesity) and risks factors (blood sugar level and lipid profile) among adults
in Bida Local Government Area, Niger State.
iv.
Assess the level of physical
activities among adult in Bida Local Government Area, Niger State.
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