ABSTRACT
Milk and milk product is a total foodstuff which has a unique contribution to the nutritional status as well as the health status of the smallholder household members. Milk consumption among children and adolescents has decreased over time in both developed and developing countries, in spite of its undeniable nutritive value. This study was conducted to access the milk and milk product consumption behavior, anthropometric and calcium status of the school aged (6-12 years) children in Umuneke, Udi L.G.A of Enugu State. This Cross-sectional study was employed to obtain data from the school aged children using multistage sampling (which included purposive and simple random sampling methods), to select 215 students. A self administrative questionnaire was designed based on the objectives of the study. Using IBM-SPSS version 20.0 software, the collected data was analyzed via descriptive statistics. The results revealed that 51.6% of females participated in the study; 30.2% were in primary six (6); 39.5% attended public schools and 57.2% lived with their father and mother. The socio-demographic characteristics of the parents revealed that 39.5% of fathers had no formal education and 36.7% were unemployed. The table also showed that 35.3% of the parents/guardian had an average income between ₦18,500 - ₦49,000. Majority of the children (97.7%) consumed milk, and just a few (2.3%) did not. Furthermore, 37.7% consumed milk during breakfast and while 29.3% had no particular meal they consume milk with. Most of the children (85.1%) who consumed milk had no particular milk they preferred. The respondents were accessed on their knowledge of milk and milk products and the result showed that they had an average knowledge (59.1%) of milk and its products. The result on attitude showed the respondents had a positive attitude at 54.0%. The result on anthropometric status showed that 57.0% had a normal weight for age, 43.0% were underweight and 50.0% were stunted, this result also showed that the children were at risk of stunting and underweight, they were also at risk of hypocalcaemia with 45.4% of the calcium level being low.
TABLE OF CONTENTS
TITLE PAGE i
CERTIFICATION ii
DEDICATION iii
ACKNOWLEDGEMENT iv
TABLE OF CONTENTS v
LIST OF TABLE vi
LIST OF FIGURES vii
ABSTRACT viii
CHAPTER 1
INTRODUCTION
1.1 Statement of the problem 3
1.2 Objective of the study 4
1.3 Significance of the study 4
CHAPTER 2
LITERATURE REVIEW
2.1 Milk and dairy products 5
2.2 Dairy products 6
2.3 Functions of milk and dairy products 7
2.3.1 Cognitive function 7
2.3.2 Cardiovascular diseases 8
2.3.3 Milk, dairy products and hypertension 10
2.3.4 Milk, dairy products and colon cancer 11
2.4 Calcium 13
2.5 Calcium bioavailability 13
2.6 Calcium homeostasis 14
2.7 Factors affecting calcium absorption 15
2.8 Functions of calcium 16
2.8.1 Cancer 17
2.8.2 Cardiovascular diseases 17
2.8.3 High blood pressure 17
2.8.4 Preclampsia 18
2.8.5 Kidney stone 18
2.8.6 Weight loss 18
2.8.7 Calcium and bones 18
2.9 Calcium daily requirement 19
2.9.1 Life stage recommended daily amount of calcium 20
2.10 Food sources of calcium 20
2.11 Calcium deficiency 21
2.12 Milk and milk product intake in children and adolescents 21
2.13 Factors which affect the consumption of milk in childhood 23
2.13.1 Sex 23
2.13.2 Age 23
2.13.3 Dietary pattern 24
2.13.4 Parental influence 24
CHAPTER 3
MATERIALS AND METHODS
3.1 Study design 25
3.2 Area of study 25
3.3 Population of the study 26
3.4 Sampling and sampling techniques 26
3.4.1 Sample size determination 26
3.4.2 Sampling procedure 27
3.5 Preliminary activities 28
3.6 Data collection 29
3.7 Data analysis 31
3.8 Statistical analysis 33
CHAPTER 4
RESULTS AND DISCUSSION
4.1 Socio-demographic characteristics of the respondents 34
4.2 Socio-demographic characteristics of the parents/guardian 35
4.3 Milk consumption behavior of the respondents 37
4.4 Knowledge of the respondents on milk and milk produce 46
4.5 Attitude of the respondents towards milk and milk products 47
4.6 Anthropometric measurements of the respondents 49
4.7 Urinary calcium measurement of the respondents 50
4.8 24-Hours recall of the intake of milk and milk products of the respondents 50
CHAPTER 5
CONCLUSION
5.1 Conclusion 53
5.2 Recommendation 53
REFERENCES 54
Appendix I 59
Appendix II 69
LIST OF TABLES
Table 4.1: Socio-demographic characteristics of the respondents 34
Table 4.2: Socio-demographic characteristics of the parents/guardian 36
Table 4.3: Milk consumption behavior 38
Table 4.3: Milk consumption behavior 39
Table 4.3: Milk consumption behavior 42
Table 4.3: Milk consumption behavior 43
Table 4.4: Knowledge of the respondents on milk and milk products 47
Table 4.5: Attitude of the respondents towards milk and milk products 48
Table 4.6: Anthropometric measurements of the respondents 49
Table 4.7: Urinary calcium measurement 50
Table 4.8: 24-Hour recall of intake of milk and milk products 51
Table 4.8: 24-Hour recall of intake of milk and milk products 52
CHAPTER 1
INTRODUCTION
Milk is the secreted fluid of the mammary gland of female mammals (Belitz et al., 2008). It is the primary source of nutrition for infant mammals. Early lactation of milk contains “Colostrums”, which carries the mother’s antibodies to its young (Guetouache, 2014). Mankind has used the milk of Goats, Sheep and Cow as food since the earliest times (Werner et al., 2008). However, the term “Milk” today has become synonymous with Cow’s milk, therefore leaving the milk of other animals to be spelled out, example; Sheep milk, Goat milk, etc. (Werner et al., 2008). Milk products also known as “Diary products” are a type of food produced from or containing the milk of mammals such as; “yogurt, cheese and butter. Milk products in Nigeria are sourced both locally and internationally, with the major local milk products in Nigeria being; Nono (sour milk), Kindrimo (sour yogurt), Cuku (Fulani cheese), and Wara (Yoruba cheese) (Akinyosoye, 2007). Milk and milk products are total foodstuff which have a unique contribution to nutritional status as well as health status of the smallholder household members (Melesse and Beyene et al., 2009). More so, apart from milk and milk products being of considerable biological value in terms of protein, they consist of other indispensible nutrients, such as protein, calcium, magnesium, folate, B1, B2, B6, B12 and vitamins A, D and K (Murphy et al.,1994; Black et al., 2002; Oni et al., 2002; Lonnerdal, 2003).
Calcium is a chemical element that is essential for living organisms, including humans. It is very essential in bone mineralization, muscle contraction, building strong bones and teeth, blood clotting, nerve impulse transmission, regulating heart beat and fluid balance within cells (Pravina et al., 2012). In children, low intake or low absorption of calcium and vitamin D may reduce statural growth (Aline et al., 2008). The normal range for blood total calcium is (8.5 to 10.5mg/dL) (Goldstein, 1990).
Anthropometric measurements are systematic measurements of the size, shape and composition of the body. These measurements can be gotten in children using the World Health Organisation (WHO) indicators which include; “weight-for-age (<-2 standard deviation for underweight), height-for-age (<-2 standard deviation for stunting) and weight-for-height (<-2 standard deviation for wasting and >+2 standard deviation for overweight). According to the National Nutrition and Health Survey (NNHS) (2018), the prevalence of underweight, stunting and wasting among children 0-59 months in Nigeria was recorded to be 19.9%, 32.0% and 7.0% respectively.
Milk consumption among children and adolescents has decreased over time in both developed and developing countries (Daphna et al., 2013). According to a study carried out among school aged children in Iran, the low consumption of milk and milk products among the school aged showed that 41% 0f children consumed milk daily, while 59% did not consume milk (Zahra et al.,2017). However, milk consumption presents geographical variation due to the difference in the socio-economic aspects, tastes and food habits of people across different agro-climatic regions (Krishnadas, 2016). Other factors which may determine the consumption behavior of milk and milk products of people are likely to include household size and composition, level of income, prices, and social customs (Krishnadas, 2016).
1.1. Statement of problem
Malnutrition which includes micronutrient deficiency is one problem of public health importance in Nigeria, leading to morbidity and mortality of many (Ozoka, 2018).In Nigeria the prevalence of stunting, underweight and wasting was recorded to be 32.0%, 19.9% and 7.0% respectively (National Nutrition and Health Survey NNHS 2018). One micronutrient deficiency which remains common among Nigerian children is calcium deficiency and its related health risks such as “Nutritional rickets” (which causes bone deformities through impaired mineralization of actively growing bone), with up to 9% of children in central Nigeria having physical findings consistent with rickets (Mariaelisa et al., 2014).
One good source of meeting the nutritional needs of the school aged children can be from milk and milk products which remains a first class source of calcium and other nutrients, which must be a priority in child feeding (Liliya et al., 2014). Unfortunately, the consumption of milk and milk product among the school aged children remains low in most countries, with some children taking milk occasionally and some not taking at all and this is insufficient for the mineralization of their teeth, and other health functions (Daphna et al.,2013; Liliya et al., 2014; Zahra et al., 2017).
This study tends to evaluate out the milk and milk product consumption behavior of the school aged and its relationship on their anthropometric and calcium status.
1.2. Objectives of the study
1.2.1. General objective
To evaluate milk and milk product consumption behavior, anthropometric and calcium status of school aged children (6-12 years) in Umuneke Udi L.G.A of Enugu state.
1.2.2. Specific objectives
The specific objectives of the study include:
i. assess the socio-demographic characteristic of the children and their parents.
ii. determine the consumption behavior of the children towards milk and milk products.
iii. evaluate the knowledge and attitude of the children towards milk and milk products.
iv. assess the anthropometric status of the children in Umuneke, Udi L.G.A of Enugu state.
v. assess the calcium status of the children in Umuneke, Udi L.G.A of Enugu state.
1.3. Significance of the study
Primarily, this study will provide information on the different consumption behavior, level of knowledge and attitude that affects milk and milk product consumption among school aged children in the study area. Also, the findings from this study will contribute to academic literature on the consumption behavior of milk and milk product among school aged and also help to give an insight to researchers who may wish to carry out further studies on this topic or a related course.
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