EVALUATION OF DIETARY PATTERN, ANTHROPOMETRIC CHARACTERISTICS AND MICRONUTRIENT STATUS OF ADOLESCENTS ATTENDING SECONDARY SCHOOLS IN JOS SOUTH LOCAL GOVERNMENT AREA, PLATEAU STATE

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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Item Type: Project Material  |  Size: 109 pages  |  Chapters: 1-5
Format: MS Word  |  Delivery: Within 30Mins.
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