NUTRITIONAL STATUS AND DIET QUALITY OF ADULTS IN OBINGWA L.G.A ABIA STATE

 ABSTRACT

The study assessed the nutritional status and diet quality of adult in Obingwa L.G.A Abia state. A multi-stage sampling technique was used to select the study sample.   10% of the total  number of villages in Obingwa  (137 villages) was used for the study.  The sample size of the study consisted of 238 respondents.  Data collected were survey data and anthropometric measurements. Anthropometric measurements obtained during the  study include weight, height, arm circumference, hip circumference, waste circumference an data on dietary measurement. Statstucal analysis of the data obtained was done using IBM SPSS version 23. Relationship between nutritional status, diet quality,  demographic and socioeconomic data was determined using correlation coefficient. Significance was accepted at p<0.05. A greater percentage (93.3%) of the respondents belonged to the Igbo ethnic group, 51.7% were married. 43.7% of the respondents had tertiary education qualification. Regarding the occupation of the respondents, 20.6% 23.5%, 11.3%, 19.3%, 16.4%, 2.1%, 4.2% and 2.5% of the respondents were traders, farmers, teachers, civil servants, businessmen/women, retired and students respectively.  Results on the dietary quality of the respondents and 24 h hour dietary recall of the respondents showed that many of  many of the respondents consumed more of cereals/grains  and  roots/tubers. Also 90.6% of the respondents did not smoke and 79.6% of them  do not consume alcohol. Regarding the BMI, the mean BMI  results showed that  8.8%, 69.0%, 15.1% and 7.1% of the males were underweight, normal, over weight and obese respectively.  The results on the BMI of  females in the study area showed that 8.1%, 63.7%, 15.8% and 12.4% were under weight, normal, over weight and obese respectively. Results on Waist hip ratio showed that 70.5%, 26.7% and 2.9% of the males were at low risk, moderate risk and high risk respectively while 71.6%,24.1% and 4.3%of the females were at low risk, moderate risk and high risk respectively.  Regarding waist circumference status, 61.1%, 34.5% and 4.4% of the males were at low risk, moderate risk and high risk respectively while 61.55%, 34.6% and 3.85% of the females were at low risk, moderate risk and high risk respectively.  There was also a Positive and weak but yet significant (p>0.01) relationship between Income and Educational Status. And also a negative and weak but yet significant relationship (p>0.05) between BMI and Educational Status.

LIST OF TABLES

Table 2.1         Functions and sources of vitamins                                                                  38

Table 2.2         Functions and sources of common minerals.                                                  40

Table 4.1a:       Socio-demographic Characteristics of the Respondents                                60

Table 4.1b:      Socio-economic Characteristics of the Respondents                                      63

Table 4.2a:       Diet Quality of the Respondents                                                                    65

Table 4.2b:      Diet Quality of the Respondents                                                                    67

Table 4.2c:       Diet Quality of the Respondents                                                                    69

Table 4.3a:       Food choices of the Respondents                                                                   71

Table 4.3b:      Food choices of the Respondents                                                                   73

Table 4.3c:       Food choices of the Respondents                                                                   75

Table 4.4:        Attitude towards consumption of Fruit and Vegetable                                 76

Table 4.5a:       24-Hour Dietary Recall of the Respondents                                                  78

Table 4.5b:      24-Hour Dietary Recall of the Respondents                                                  79

Table 4.5c:       24-Hour Dietary Recall of the Respondents                                                  81

Table 4.5d:      24-Hour Dietary Recall of the Respondents                                                  83

Table 4.5e:       24-Hour Dietary Recall of the Respondents                                                  85

Table 4.6a:       Dietary Lifestyle of the Respondents                                                             87

Table 4.6b:      Dietary Lifestyle of the Respondents                                                             89

Table 4.6c:       Dietary Lifestyle of the Respondents                                                             91

Table 4.7a:       Mean Anthropometric Characteristics of the Respondents                               93

Table 4.7b:      Anthropometric Characteristics of the Respondents                                        96

Table 4.8:        Relationship between nutritional status, diet quality, demographic and socio-economic characteristics of the Respondents                                                         93

CHAPTER 1

INTRODUCTION

1.0  Background to the Study

Nutritional status is defined as a measurement of the extent to which an individual’s physiologic need for nutrients is being met (Mahan and Stump, 2000). Assessment of nutritional status of an individual involves biochemical tests, clinical observations, diet history and anthropometric data (Akhtar, Bhatty, Sattar and Javed, 2001). The three most often used anthropometric indices are weight-for- height, height-for-age, and weight-for-age. Values which fall below the 5th percentile range give indication of wasting, stunting and underweight, respectively (Gorstein et al., 2004). Individual nutritional status has been reported to vary on the basis of a person's living conditions, availability of the food supply, health and socioeconomic status (Akhtar et al., 2001). Understanding the relationship between adults socioeconomic background and nutritional status is needed to develop effective intervention programmes (Madhavan and Townsend, 2007). Improvements in health and nutrition among disadvantaged adults help in their cognitive development, and at a later stage would help in increasing work productivity, thus contributing to wealth creation. It has been shown that early nutritional improvements can have a powerful positive impact on the population’s health, which is a prerequisite to economic development (Iram and Butt, 2006).

In general, both the adolescent and young adults have similar problematic eating patterns.  This pattern include skipping of meals especially breakfast, which leads to a higher probability of snacking (Shaw, 2012), frequent skipping of meals has been reported to be associated with poorer nutritional statues and the risk of cardiovascular diseases, diabetics and some cancers.  (Anderson and Smith, 2003).

According to the World Health Organization (WHO), 2006 dietary recommendations for individuals and populations should provide adequate energy balance for a healthy weight and such diet should include a limited intake of fats, while shifting fat consumption away from saturated fats to unsaturated fats and elimination of trans-fatty acids. It should also include increased consumption of fruits and vegetables, legumes, whole-grains and nuts, while limiting the intake of free sugars and salt (sodium) consumption (WHO 2012).

Diet quality refers to a diversified, balanced and healthy diet, which provides energy and all essential nutrients for growth and a healthy and active life, (International atomic energy agency IAEA, 2013).  A variety of foods is needed to cover a person’s nutrient needs. Stable isotopes can be used to assess diet quality and the effects on vitamin A and nutritional status. Diet quality refers to both the amount of nutrients and the uptake of specific nutrients from foods to support body maintenance, growth, physiological status (for instance pregnancy and lactation), physical activity and protection against infection, ((IAEA, 2013). Diet quality is also reflected in the variety (diversity) of food groups consumed. In resource-constrained settings, diets are majorly composed of plant-based foodstuffs which may be deficient in key nutrients such as proteins, vitamin A, iron and zinc.

Inadequate intake of high quality protein and micronutrients (especially zinc and iron) is associated with growth retardation, mortality and infections in young children and adults, reduced capacity for learning in young adults, and hence productivity in adults. Under improved economic conditions, diets change to include more animal food products, fats and oils, sugars and ultra-processed foods. This is called nutrition transition and can have longer-term health consequences, such as increasing the risk of becoming overweight or obese and developing non-communicable diseases later in life. Keeping this in view this study was planned to assess the nutritional status and diet quality of adult in Obingwa L.G.A Abia state.

1.1  Statement of the Problem

According to the World Health Organisation, the burden of chronic diseases is rapidly increasing worldwide. In 2001, chronic diseases accounted for around 60% of the total reported deaths in the world and 46% of the global burden of disease. Almost half of total chronic disease deaths are attributable to cardiovascular diseases. Obesity and diabetes are also showing worrying trends, not only because they already affect a large proportion of the population, but also because they have started to appear earlier in life (WHO, 2014). The relevance of diet quality in the prevention and management of disease and premature death caused by noncommunicable diseases (NCDs) is scientifically supported by epidemiological data. Eating patterns may have a positive impact on healthy growth and development throughout childhood and adolescence (Assman et al, 2013), and on the mitigation of health problems in adults (Alkerwi et al, 2014).

However, “diet quality” and nutritional status remains a somewhat imprecise term, due to the heterogeneous and multidimensional nature of the concept itself, whose definition should ideally reflect aspects relevant to a number of fields, including nutrition, toxicology, economics and the food industry (Elmadfa and  Meyer, 2015). Although consensus has yet to be reached on the concept, a high-quality diet may be defined as one which is hygienically safe; nutritious and balanced and adapted to individual requirements in order to prevent disease and ensure a good state of health as well as optimal development and growth (Pelletier, et al, 2017).

Methods for assessing diet and nutritional quality have attracted growing interest since Patterson published the first dietary quality index in 1994 (Patterson, et al, 1994). While the concept itself is undoubtedly heterogeneous and multidisciplinary, dietary quality indices (DQIs) are no more than mathematical algorithms aimed at quantifying the extent to which real food and nutrient intake complies with the reference intake values recommended in national dietary guidelines, or at analysing dietary patterns in the population and weighting those components whose consumption has been linked, in scientific studies, either to the appearance of the disease or to the preservation of an optimal state of health (Gil et al, 2015).

An adult is referred to a person who is fully grown or developed and is capable of performing necessary tasks. This development is followed by a responsibility of decision making, making it a critical period for habit and lifestyle development, also the influence of peer pressure is high on this group, making it a period when new habits (healthy or unhealthy) and lifestyle (healthy or unhealthy) are formed. These lifestyles have been shown to have either a positive or detrimental effect on the nutritional status which in turn affects the health and general wellbeing of the individual both in the short and long run (Vieira et al., 2002; Monteiro et al., 2009).  Despite the strong emphasis on meeting nutritional requirements every day to achieve optimal health, many adults tend to care less about or neglect their nutritional requirements and diet quality. Yet, meeting nutritional requirements remains important in achieving one’s health (Noriega and Shin, 2018). However, this is not only prevalent to the developing third world populace alone but also to the developed countries of the world. According to Nzeagwu and Akagu (2011). 

Malnutrition remains one of the major obstacles to human well-being and economic prosperity in developing total rise (Ecker and Nene 2012, Stevens et al., 2012).  Poor nutrition among adults which started during childhood causes them to be reserved in class, dull in life, lethargic and withdrawal with low self-concepts and esteem, suffer illness, brain damage, delayed development in terms of intellectual development. Adults needs to develop good Food Habits because the lack of adequate nutrients leads to several nutritional problems which may persist till death (Kramer 2002).  Poor nutritional quality of adults can be links to the worsening socioeconomic condition of the country, which has affected the feeding habit of many families, (Ighodalo, 2004).

However, a healthy diet can have a significant effect on many adults’ main concerns by contributing to maintaining a healthy weight, improving physical and intellectual performance, optimizing growth and improving skin health. Moreover, if an adult do not attain adequate nutrition daily, a decrease in social or physical performance can result (Abraham et al., 2018).

Malnutrition, the insufficient and imbalance in the intake of nutrients is said to be a leading cause of death among Nigerians. Adults need to develop good food habit because the lack of adequate nutrients in diet can lead to several nutritional problems which when not properly handled can lead to sickness and death. It is to this effect that the researcher seeks to assess the nutritional status and diet quality of adults in Obingwa L.G.A, Abia State.

1.2  Objectives of the Study

1.2.1 General objective

The general objective of this study is to assess the nutritional status and diet quality of adult in Obingwa L.G.A Abia state.

The specific objectives of the study are to:

        i.            To determine socio-economic and demographic characteristics of the selected adults in Obingwa L.G.A of Abia state.

      ii.            To evaluate the diet quality (Food groups: nutrient contents, food choice, toxicology, economic and the food industry) of the study groups.

    iii.            To ascertain the nutritional status of the study population.

    iv.            To determine relationship between nutritional status, diet quality, demographic and socio-economic data of the study population.

1.3 Significance of the Study

This study will be of great important to health and social care professional, and those working in residential care homes to be aware of relationship between diet quality and nutritional status of adults for future nutrition and health talks. The study will also be of great benefit to doctors ,nurses, dieticians, nutritionists, health professional, health workers, government policy and decision  makers to know the health effects  of malnutrition on the life of adults as well as their infants. (if an adult has poor nutritional status and knowledge, it will be transferred to their young ones in the sense that you can’t teach your child what you don’t no). Nutritionist and Dieticians will provide information that will aid them in managing and counselling adults towards the feeding habits and its effects on their health status.

The study will disclose information on the adult’s nutrients intake and its impact on their nutritional status which may create health problems that can indirectly or directly affect the society.