ABSTRACT
The aim of this study was to compare anthropometry and food intake patterns in bus drivers working during the day and night. One hundred and fifty males (81 night workers and 69 day workers) participated in the study. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. Measurements of height, weight, waist circumference (WC), systolic and diastolic blood pressure, blood glucose, and lipid profile were obtained. A significant difference between groups was observed for mean WC (98.5 ± 10.7 cm in day workers versus 103.2 ± 9.7 cm in night workers; p 0.005). Night workers had higher prevalence of being overweight and obese (BMI 25 kg/m2) than day workers (78.2% day workers versus 90.2% night workers; p 0.004) and increased WC (494 cm) (72.4% day workers versus 86.4% night workers; p 0.03). Significant differences were found for meat consumption (2.3 servings ±0.9 for night workers versus 2.0 servings ±0.7 day workers, p 0.04) and fruit intake (0.9 servings ±0.4 for night workers versus 0.7 servings for day workers ±0.5; p 0.006). Night workers had a lower intake of vegetables than recommended compared to day workers (100 versus 92.7%, respectively, p 0.01) and higher intake of oil (40.7 versus 24.6%, p 0.03). Multivariate logistic regression analysis indicated that night work was associated with being overweight (OR 2.94, 95% IC: 1.14–7.66, p 0.03) and abnormal values of WC (OR 2.82, 95% IC: 1.20–6.69, p 0.009) after adjusting for potential confounders. It is concluded that night workers had a higher prevalence and risk of being overweight/obese and increased WC compared with day workers.
Night workers also presented a higher proportion of inappropriate intakes of food groups when compared to day workers, even though both groups were eating poor diets. These results demonstrate the need of lifestyle-intervention programs in these workers.
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
19:00 and 6:00 h (Monk & Folkard, 1992) and often refers to an arrangement of alternating day shifts, evening shifts and/or night shifts. Regarding the night shifts, most of working hours take place between 22:00 and 6:00 h (Akerstedt, 1998). Recent evidence has shown that shift work affects 420% of the working population in the world (De Bacquer et al., 2009). No comparative data are available for the total population of Brazil, but research performed in the area around the city of Sao Paulo has suggested that 11% of the working population does shift work (Fischer et al., 1995).
Evidence from the literature indicates that night work is associated with several health problems, including metabolic and nutritional disorders such as diabetes (Dochi et al. 2009; Guo et al., 2013; Karlsson et al., 2003; Pietroiusti et al., 2010), dyslipidemias (Karlsson et al., 2001; Monk & Buysse, 2013; Romon et al., 1992), metabolic syndrome (Esquirol et al., 2009; Li et al., 2011; Lin et al., 2009; Pietroiusti et al., 2010; Szosland, 2010) and, particularly, obesity (Amani & Gill, 2013; Di Lorenzo et al., 2003; Karlsson et al., 2001; van Amelsvoort et al., 1999).
Weight gain in these workers has been associated with several mechanisms, including poor diet (Geliebter et al., 2000; Mota et al., 2013), sedentary lifestyle (French et al., 1994; Mota et al., 2013), short sleep duration (Macagnan et al., 2012; Mota et al., 2013) and desyn- chronization of circadian rhythms (McDonald et al., 2013). From the nutritional point of the view, it has been reported that shift workers exhibit an altered nutritional intake (De Assis et al., 2003a; Mota et al., 2013; Pasqua & Moreno, 2004; Waterhouse et al., 2003), including an excessive number of eating events per day (De Assis et al., 2003b), high calorie intake (French et al., 1994), and increased consumption of saturated fat and foods with a high glycemic index (Di Lorenzo et al., 2003).
Studies have demonstrated that workers from the transportation industry also present high proportions of being overweight and obese (Hirata et al., 2012; Winkleby et al., 1988), but these findings have been associated weight gain with shift work. Nevertheless, overweight and obese individuals have presented higher rates of mortality, morbidity and absenteeism rates due to their adiposity (Hirata et al., 2012; Winkleby et al., 1988). A study carried out in USA and involving4600 000 workers found the highest prevalence of obesity among male employees who worked in highway transportation services (31.7%) (Caban et al., 2005). In Brazil, Hirata et al. (2012) found that over half the population of drivers (57.5%) was characterized as overweight and ~20% was considered obese, 77.5% of the total sample having excess weight.
Although a few studies suggest that professional drivers have dietary habits that predispose towards obesity (Cavagioni, 2006; Marqueze et al., 2012), the qualitative food intake patterns of drivers on different work schedules is poorly described in the literature. Based on this, the hypothesis of this study is that bus drivers who work at night exhibit a poor diet and higher proportions of obesity when compared with those who work in the daytime. Thus, the aim of this study was to compare anthropometry and food intake patterns of bus drivers working during the day or night.
Nutrition forms the foundation for human health and development across all stages of the life course. Almost one in three people on the planet grapple with a lack of adequate nutrition, making this one of the most devastating problems to face the global community. (WHO, 2015). Adequate nutrition in an individual is important for both current and future health, as this period is perhaps the only window of opportunity for the catch-up nutrition needed to prevent a vicious inter-generational effect of malnutrition World Health Organization, (WHO, 2015). According to WHO in 2014, every country in the world is affected by one or more forms of malnutrition. Combating malnutrition in all it forms is one of the greatest global health challenges. Around 45% of death among individuals are linked to undernutrition. These mostly occur in low and middle-income countries. At the same time, in these countries, rates of overweight and obesity are rising (United Nation, 2012). Also, malnutrition increases health care costs, reduces productivity and lows economic growth, which can perpetuate a cycle of poverty and ill-health (WHO, 2014).
Globally, people are consuming foods and drinks that are more energy dense (high in sugar and fats), and engaging in less physical activity. Unhealthy diet and poor nutrition are among the top risk factors for diet -related non-communicable diseases (NCDs) such as cardiovascular disease, certain cancers, and diabetes globally (United Nation, 2016). Unhealthy eating habits have contributed to the obesity epidemic in the United States: about one-third of U.S. adults (33.8%) are obese and approximately 17% (or 12.5 million) of college Bus drivers are obese (Centre for Diseases Control, 2011).
Dietary pattern (DP) is the general profile of food and nutrients consumption which is characterized on the basis of the usual eating habits (World Health Organization WHO, 2015). The assessment of dietary patterns gives a more comprehensive impression of the food consumption habits within a population. It may be better at predicting the risk of disease than the analysis of isolated nutrients or food because the joint effect of various nutrients involved would be better identified (Hu, 2002).
Patterns of nutritional behavior adopted in Bus drivers are mostly continued in adults life and increased the risk of development of many chronic disease (Kpakaskrzypczak et al. 2012). Diet in childhood and Bus driver have Agric Department health implication due to evidence relating poor nutrition in childhood to subsequent obesity and elevated risk for type 2 diabetes, metabolic syndrome and cardiovascular disease (Canete, Gil-Campos, Aguilera, and Gil, 2007) which are increasing in prevalence (WHO, 2004).
Nutritional status is the sum total at an individual anthropemetric indices as influenced by intake and utilization of nutrients, which is determined from information obtained by physical, biochemical and dietary studies (UN, 2015). It is a result of interrelated factors influenced by quality and quantity of food consumed and the physical health of the individual. The transition from adolescence to adulthood is an important, period for establishing behavioural patterns that effect long term health and chronic disease risk (Meg small, Bailey-Davis and Maggs, 2012). University Bus drivers seem to be the most affected by this nutritional transition (Baldini, Pasqui, Bordoni and Maranesi 2009).
1.2 Statement of the Problem
Adequate nutrition promotes good nutritional status and thus satisfies the requirement to good physical health hence the risk of malnutrition is increased with unhealthy dietary habit and practice (Adamu et al, 2012). Nutritional status has a great impact on the learning capacity of children on their productivity as adults as well as and on their quality of life in general (Flynn et al, 2006). According to the United Nation nearly 870 million people of the 1.7 billion in the world or one in eight suffered from chronic undernourishment in 2010 to 2012. Almost all the hungry people, 852 million, live in developing countries. In Africa nearly one in four people are hungry; the number of hungry people grew over this period from 175 to 220 million, with nearly, 20million added in the last few years only 16 million undernourished people resides in the developed countries (FAO, 2012). It is believed that almost one third of children and Bus driver in developing countries are malnourished (FAO, 2015). Contrary to widely held notion that malnutrition is due to poverty, anecdotal evidence suggest that this may be caused by people choosing to eat that the wrong types of food, rather than lack of what to eat which reflect the lifestyle of most undergraduate (Tropy, 2004) many bus drivers encounter numerous health risk and bear the brunt of undernutrition and suffer the highest risk of disability and death associated with it. Even feeding them later in life in too letter, too expensive and too late to improve nutrition or future productivity (World Bank, 2008). About 60% of young people who die from common disease like malaria and diarrheas would not have died if they are not under nourished in the first place as a result of their dietary habit (WHO, 2016). In 2001 54% of all mortality was attributed directly or indirectly only a small part of the total disease burden due to malnutrition from the choice of eating habit (Salem and Hamza, 2005). These unhealthy habit can lead to undernourishment or overnourishment with the resistant increase in the susceptibility of avoidable disease. University Bus drivers seem to be the most affected by this nutrition transition. Studies from developed countries have shown that young adult leaving their parent and living away from home to attend college experience numerous health related behavioral changes, including the adoption of unhealthy dietary habit (Ajala, 2006). These behaviour are attributed to drastic, changes in the environment and resources available, frequent exposure to unhealthy, food and habits leading to higher consumption of high calories snacks, fast foods and lower consumption of fruit and vegetable, added to this skipping meals may also become frequent. (Achinihu, 2009).
Evidence shows that providing information on eating habit and on nutritional status result in improved health. Despite this recognition poverty and lack of clear policy on eating habit and nutritional status assessment make it difficult for Bus drivers to monitor and moderate their eating habit result in malnutrition. Therefore, this study seeks to assess dietary pattern and nutritional status among bus drivers in Imo state.
1.3 General Objectives of the Study
The general objective of this study is to assess dietary pattern and nutritional status among bus drivers in Imo state University.
1.4 Specific Objective of the Study
1.4 Aim
The aim of this study is to assess dietary intake pattern and nutritional status of Bus drivers in Imo State.
1.5 Specific Objectives
(1) To document demographic characteristics of Bus drivers, Imo State
(2) To determine nutritional status and Physical activity Levels of Bus drivers in Imo State.
(3) To assess dietary pattern of the Bus drivers using Food Frequency Questionnaires.
(4) To determine serum iron, zinc and copper of Bus drivers attending Food and nutrition in Imo State.
1.4 Significance of the Study
The result of the study will provide information that may be used to design and improve on nutritional service provision in school based on health care, especially in Imo state. Non- governmental organization (NGOs) may use the finding to improve on nutrition services to people in the society. Result on dietary pattern and nutritional status together with recommendation that will be given will provide solution on how to encourage bus drivers to exhibit healthy eating habit behavior researcher and academicians may further develop area for research based on the findings from this study.
1.5 Limitation of the Study
Many of the bus drivers may not like to give information on their dietary pattern and nutritional, status and therefore so much time will be spent in the field to explain the benefit of this study to the undergraduate Bus driver to encourage participation.
1.6 Operational Definition of Terms
Assessment: Refers to the act of evaluating.
Dietary pattern: Simply refers to food consumption habits within a population.
Nutrition: Is the science of food and it relationship to health.
Nutrition status: Is the sum total of an individual food intake both in terms of quantity and quality and also by the physical health of the individual.
Body mass index: Refers to weight in (kg) over height in metre square (m²).
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