Dietary Pattern And Nutritional Status Of In-school Adolescents In Abeokuta South And Abeokuta North Local Government Areas Of Ogun State Nigeria

Adolescents are considered as a nutritionally vulnerable subgroup. A rapid growth rate combined with marginal nutrient intakes increases the risk of nutritional deficiencies in this population. Poor nutritional status in adolescence compounds the risk of adolescent pregnancy and it is an important determinant of health outcomes at a later stage of life. A knowledge of an healthy dietary pattern in adolescence is an Investment in Present and Future Health. The objective of this study was to Characterize the dietary pattern and Assess the Nutritional status of in-School Adolescents in Abeokuta South and Abeokuta North local Government Areas of Ogun State.

The study was descriptive cross-sectional in design. A multi-stage sampling technique was used to select 775 in-school adolescent boys and girls aged 10 -19 years in 10 public secondary schools each in Abeokuta South and North local Government Areas. Anthropometric measurements were taken using Standard Procedures, Socio demographic Data were obtained through a self- administered questionnaire while usual nutrient intakes were determined through a 24 hour dietary recall. Dietary pattern was determined by factor analysis of data obtained from the self administered food frequency questionnaire. Additional structured questions on eating habits were answered on a different questionnaire to serve as correlates of dietary pattern. Statistical analysis included descriptive, inferential and dimension reduction statistics.

More than one-third (35.4%) of the subjects were boys while 64.6% were girls. About half (50.3%) were in junior secondary school, while 49.7% were in senior secondary school. The boys and girls had a mean weight of 45.68 and 45.05 kg respectively, a mean height of 155.84 and 155.08 cm respectively and a mean BMI of 18.84 and 18.68 kg/m2 respectively. The Mean NAR for Energy, Carbohydrate and Protein were 0.83, 2.47 and 1.61 respectively while Mean NAR for Calcium, Folate, Zinc and Iron were 0.23, 1.14, 0.44 and 0.73 respectively. Factor analysis revealed 2 distinct dietary patterns labelled a “western” pattern highly loaded in Pastries, beverages, Dairy, Canned foods, Sugared drinks and Poultry and a “mixed” pattern which loaded highly in Cereals, Legumes, Roots and tubers, Fruits, Vegetables and Processed Cereals. Both patterns explained 38.18 and 31.46% of the variation of food intakes respectively. More than one-third (39.9%) of the subjects had irregular breakfast, 52.6% had irregular lunch and 19.7% had irregular dinner. Majority (90.3%) of the subjects snacks on a daily basis, 67.2% eats out or order food at varying degrees.

The prevalence of stunting for boys and girls were 10.7% and 9.5% respectively. The prevalence of underweight was 13.7% for boys and 16% for girls. The prevalence of overweight was 2.7% for boys and 3.8% for girls, while 2.7% of boys and 1.1% of girls were obese. 

The “western” dietary pattern was significantly associated with snacking (p<0.05), and higher sodium intake (P<0.005). The “mixed” pattern was significantly associated with breakfast consumption (P<0.05). Stunting was significantly associated with school level (P<0.05), snacking (P<0.05) and eating out/food order (P<0.05). Underweight was significantly associated with the method of refuse disposal (p<0.005) and lunch consumption (p<0.05).

Key words: Adolescents, Dietary pattern, Factor analysis, Nutritional Status.

Contents  Page

Title page i

Attestation ii

Dedication  iii

Abstract  v-v

List of Tables x

List of Figures xi

List of Acronyms  xii

Chapter One: Introduction

1.1 Statement of the problem  3

1.2 Justification for the study 4

1.3 Objectives of the study 5

1.3.1 General objective 5

1.3.2 Specific objectives 5

1.4 Research questions 5

Chapter Two: Literature Review

2.1 Adolescents  6

2.1.1 Nutritional Needs of Adolescents 8

2.1.2 Energy and Nutrients Needs 9

2.2 Adoption and Consolidation of Sound Dietary habits in Adolescence 12 

2.3 Improving Adolescents’ Nutrition Behaviours is an Investment in Adult Health. 12

2.4 Is there a Potential for Correcting Nutritional Inadequacies and Perhaps even for Catch up Growth in Adolescence? 13

2.5 Adolescence is a Period of Nutritional Vulnerability 16

2.6 Over view of Nutritional Status in Adolescence 17

2.6.1 Poor Nutritional Status Compounds the Risk of Adolescent Pregnancy 19  

2.6.2 Malnutrition Reduces Adolescents’ Work Capacity 19

2.6.3 Major threats to Adolescents’ Nutritional Status 20

2.7 Typical Eating Patterns and Intakes of Adolescents 21

2.7.1 Commercial, Cultural and Psychosocial Influences on eating Patterns 24 

2.8 Dietary Pattern Analysis 26

2.8.1 Methods for Defining Dietary Pattern  27

2.8.2 Factor Analysis 28

2.8.3 Cluster Analysis  28 

2.8.4 Dietary Indices 28

2.9 The Reproducibility and Validity of Dietary Pattern 29

2.9.1 Limitations of Dietary Pattern Analysis 30

2.9.2 New Approaches to the Study of Dietary Pattern 32

2.9.3 Empirical Findings  34

Chapter Three: Methodology

3.1 Study design 42

3.2 Study area  42

3.3 Study subjects 42

3.4 Sample size calculation  42

3.5 Sampling 43

3.6 Data collection 43

3.7 Data Analysis  41

3.8 Ethical considerations 42

 

Chapter Four: Results

4.1 Socio demographic characteristics of the subjects  43

4.2 Dietary Pattern of the Respondents 47

4.3 Anthropometric Characteristics of the Respondents 56

4.4 Mean Nutrient Intakes of the Respondents 56 

4.5 Nutritional Status of the Respondents  62

4.6 Association of Dietary Pattern with Socio-demographic Variables 68

4.7 Association of Dietary Pattern with Nutritional Status 69

4.8 Association of Dietary Pattern with Nutrient Adequacy 69

4.9 Association of Dietary Pattern with Eating habits 69

4.9.1 Association of Nutritional Status with Socio-demographic Variables 69

4.9.2 Association of Nutritional Status with Eating Habits 90

Chapter Five: Discussion and Conclusion 71

References  80 

Appendixes 90 

 LIST OF TABLES 

Table 4.10 Socio-demographic Characteristics of the Respondents  44 

Table 4.11 Socio-demographic Characteristics of the Respondents (Cont’d) 45 

Table 4.12 Socio-demographic Characteristics of the Respondents (Cont’d) 46 

Table 4.20 Varimax Rotation 48 

Table 4.21 Food groups used in the factor analysis 49 

Table 4.22 Mean Factor Scores of the Varimax Rotation 50 

Table 4.23 Meal Consumption Pattern of the Respondents 50 

Table 4.24 Snacking Pattern of the Respondents  51 

Table 4.25 Eating Out Frequency of the Respondents 52 

Table 4.26 Usual Breakfasts of the Respondents  52 

Table 4.27 Usual Lunch Consumption of the Respondents 53 

Table 4.28 Usual Dinner Consumption of the Respondents  53 

Table 4.30 Anthropometric Measurement of the Respondents 58 

Table 4.41 Mean Energy and Macro Nutrient Intakes of the Respondents 58

Table 4.42 Mean Micro Nutrient Intakes of the Respondents 59 

Table 4.50 Nutritional Status of the Respondents 59

Figure 4.1 Bar chart Showing the Breakfast Consumption Frequency of the boys 54 Figure 4.2 Bar chart Showing the Breakfast Consumption Frequency of the girls 55 

Figure 4.3 Bar chart Showing the Lunch Consumption Frequency of the boys 56 

Figure 4.4 Bar chart Showing the Lunch Consumption Frequency of the girls 57 

Figure 4.5 Bar chart Showing the Dinner Consumption Frequency of the boys 58

Figure 4.6 Bar chart Showing the Dinner Consumption Frequency of the girls 59

Figure 4.7 Bar chart Showing the Snacking times of the boys 60

Figure 4.8 Bar chart Showing the Snacking times of the girls 61

Figure 4.9 Prevalence of Stunting among the boys  65

Figure 4.9.1 Prevalence of Stunting among the girls 66

Figure 4.9.2 Weight Status of the Boys 67

Figure 4.9.3 Weight Status of the Girls 68