ABSTRACT
Adolescent overweight and obesity have been observed as one of serious public health challenges of the 21st century by the World Health Organization (WHO). Over the past few decades adolescent food consumption has undergone a great deal of transition from the starchy carbohydrates from roots and tubers to the highly refined cereals and sugary beverages. The highly refined cereals consumption contributes in no small measure to body adiposity. Physical inactivity further aggravates the calorie-imbalances that will later develop into overweight and obesity. This study determined the food diet quality and physical activity and overweight and obesity among the private secondary school students in Lagos state, Nigeria. Cross-sectional analytical design was used in this study. A total of 515 adolescent students were randomly selected using multistage and stratified sampling techniques from 8 private secondary schools in two zonal inspectorate divisions. The instruments of data collection used were a modified food frequency questionnaire and Physical Activity Questionnaire for Adolescents (PAQ-A). Digital bathroom scale and stadiometer were used to measure the weight and height of the students respectively and observation checklist was used to assess the functionality of school facilities. Data was analyzed using statistical package for social sciences (SPSS, Version 20) and WHO anthroplus package. Food diet quality of participants indicated that 77% consumed breakfast and 4.5% added more than 5 teaspoonful of sugar to their beverages daily. The participants mostly consumed refined carbohydrates was doughnut and biscuits (2.36±0.99) times per week, while mostly consumed fat and oil was vegetable oil in soup (2.54±0.96) times per week. Furthermore, the fatty protein mostly consumed was fish pies and fish rolls (2.71±0.87) times per week and mostly consumed fruit was pawpaw (2.56±0.89) times per week. Participants’ hours of sleep indicated that 50.3% had 7-8 hours of sleep daily. Physical activity level indicated that 48.7% were moderately active and 39.4% were highly active per week. Observation checklist results indicated that all the schools had functional sporting facilities (100%). Body mass index (BMI) for age of participants showed that 29.1% were underweight, 4.7% were overweight while less than 1% were obese. The Pearson correlation between BMI for age and food diet quality (FCP) was (r=0.012, p =0.785), BMI for age and physical activity level (r=-0.105, p= 0.017). ANOVA of BMI for age and food diet quality showed significance (p= 0.001). There was no significant difference between BMI for age and the metabolic equivalent scores (METs) of the participants (p=0.725). Despite the relatively low prevalence of overweight and obesity observed, of concern was high underweight and low BMI for age in this study. Result findings indicated low frequency of food consumption and moderate physical activity levels. The parents and guardians should improve on the frequency of consumption of nutritious food for the adolescent students in private secondary schools and their physical activity level should be sustained.
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study
Adolescents as a vulnerable group require special attention and nutritional care because of the negative nutritional consequences that may occur among them as a result of inadequate consumption of healthy foods and physical inactivity. Overweight and obesity in childhood and in adolescents are emerging as one of the major public health of concern in the last few decades. Overweight and obesity conditions develop when there is an imbalance between calories consumed and calories expended mostly due to inadequate consumption of healthy foods and physical inactivity that cut-across all age groupings. It is known to be associated with substantial loss of quality of life and social stigmatisation that may trigger depression, anxiety, low self-esteem, feelings of guilt and chronic diseases development in the crop of individuals that may constitute a higher percentage of the world labour force in few years to come (Onyiriuka, Umoru, & Ibeawuchi, 2013). Globally, the increasing prevalence of overweight and obesity among adolescent began to draw the world attention as early as 1991 in the United States of America (USA) when there was a decline in the proportion of students in grade 9 to 12 years participation in daily physical education from 42% in 1991 to 29% in 1999 (Boyle & Holben, 2006). In 1997, a World Health Organization (WHO) Consultative group formally recognized that the obesity epidemic occurs worldwide and that the prevalence is increasing faster in developing countries than in developed countries (Hafiz, Ibrahim, & Atiku, 2012; WHO, 2008). The healthy people 2010 initiative of the US department of health and human services (DHHS) progress review indicated that the proportion of children and adolescent age six to nine years who were overweight had increased from 11% in late 1980s to 16% in 2002. The initiative’s objectives on the consumption of fruits, vegetable and grain had not been met as at that time, therefore another goal was set for 2020 (Boyle & Holben, 2006).
According to Ferrara (2009), more than 17% of children in the United State of America (USA) were overweight or obese and about 35% of college students in USA were overweight or obese. The prevalence of overweight and obesity among school children in Eastern Mediterranean Region (EMR) was between 7% and 45% (Abdurrahman, 2011).
Okoth (2013) reported overweight prevalence of 18.7% for female adolescent and 10.3% for male adolescent while the obesity prevalence for both male and female adolescents were 0% and 2.1% respectively among adolescents in Kenya. Adamu,
Adjei and Kubuga (2012) put adolescents’ overweight and obesity prevalence in Ghana between 4% and 7%. In Nigeria the prevalence of overweight and obesity among adolescent varies according to the regions and between urban and rural, as well as between private and public school students. For instance in the Southern Nigeria, the prevalence of overweight was between 13.2% and 24.2% and the prevalence of obesity was between 1% and 2.5% (Onyiriuka et al, 2013). In the Western Nigeria, recent study indicated a high prevalence of underweight (29.6%) in the adolescent (Hafiz, et al., 2012).
However, these interventions are limited in some countries especially in the Western Nigeria where there is a great diversity in the cultural practices that influence adolescent dietary behaviour. According to OlubanjiOjofeitimi, Ojofeitimi, Olugbenga-Bello, Adekanle, & Adeomi, 2011) the dietary practices of adolescent girls in private private secondary schools studied indicated that majority (60.2%) were unhealthy. Similarly, overweight and obesity were significantly higher in adolescent girls who lived sedentary lifestyles in Nigeria as was reported in (OlubanjiOjofeitimi et al, 2011). Furthermore, the study indicated the difference in the prevalence of overweight and obesity among adolescents from private schools and public schools. The difference was concluded to be due to poor healthy dietary practices and sedentary lifestyles of the adolescents in private schools. Therefore this study on the food diet quality and physical activity and overweight and obesity will be very useful among adolescent students in private secondary schools in the West Central Nigeria where Lagos state is situated. This is important so that appropriate school based intervention can be put in place for the students.
1.2 Problem Statement
Nutrition-related health problems such as overweight and obesity in adolescents are increasingly significant causes of disability and premature death both in developed and developing countries including Nigeria (Boyle & Holben, 2006). The epidemic of obesity alongside continuing problems of under- nutrition has plagued African countries. According to Karl and Pengpid (2011) whose study was on the assessment of overweight and obesity and associated factors in school-going adolescents in low-income African countries (Ghana and Uganda), adolescents consumed fruits or vegetables in less than one times in a day, while more than three quarters of them were physically inactive
Studies on adolescents overweight and obesity among private secondary schools students in Nigeria had shown progressive increase in the prevalence of overweight and obesity especially in the private private secondary schools (Eberechukwu, Eyam, &Nsan, 2013; Ene-Obong, Ibeanu, Onuoha & Ejekwu, 2012 ; OlubanjiOjofeitimi et al, 2011). Little information on overweight and obesity is available on the private secondary schools students particularly in Lagos state. Childhood and adolescents obesity are strong predictors of adult obesity which has now become the public health challenges of the 21st century according to World Health Organization (Fadupin & Olayiwola, 2011; Monyeki, vanLenthe, & Steyn, 1999; Popkin, Adair, & Ng, 2012). Many co-morbid conditions like metabolic, cardiovascular, psychological, orthopaedic, neurological, hepatic, pulmonary and renal disorders are seen in association with childhood obesity (Raj & Kumar, 2010). Therefore, there was need to determine overweight and obesity prevalence among the private secondary schools in Lagos state, Nigeria. This study on the food diet quality and physical activity and overweight and obesity among adolescent in private secondary schools in Lagos state determined the weight status of the public schools students in the West Central geo-political region which Lagos state is situated.
1.3 Purpose of the Study
The purpose of the study was to determine the food diet quality, physical activity levels and their association with overweight and obesity among adolescent students in private secondary schools in Lagos State, Nigeria.
1.4 Objectives of the Study
The specific objectives of the study were to;
1. Determine the demographic characteristics of adolescent students in private secondary schools in Lagos State.
2. Determine the food diet quality of adolescent students in private secondary school in Lagos state.
3. Establish prevalence of overweight and obesity among adolescent students in private secondary schools in Lagos State.
4. Establish the relationship between food diet quality, physical activity and overweight and obesity of adolescent students in private secondary schools in Lagos State.
1.5 Hypotheses of the Study
H01: There is no relationship between the food diet quality and overweight and obesity among adolescent students in private secondary schools in Lagos State.
1.6 Significance of the Study
The study findings would enable the ministry of education and schools’ administrators to develop policy framework on student’s food diet quality and physical activity practices at the private secondary school level especially in Lagos state in Nigeria.
1.7 Delimitations of the Study
The study was conducted in private secondary schools located in the southern senatorial districts of Lagos State among day students.
1.8 Limitation of the Study This study was carried out in the school setting which may have influenced the food diet quality and physical activity level of the participants. Also data on food consumption was collected on recall basis from students and actual weighing of foods consumed was not made.
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