ASSESSMENT OF NUTRITIONAL KNOWLEDGE, DIETARY HABIT AND ANTHROPOMETRY STATUS OF MOTHERS (19-60 YEARS) IN IKWUANO LOCAL GOVERNMENT AREA OF ABIA STATE

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ABSTRACT

This study was designed to assess the nutritional knowledge, dietary habit and anthropometric status of mothers in Ikwuano Local Government Area of Abia State, Nigeria. A total of 149 mothers were selected using systematic sampling technique. Data on background information, socio-economic characteristics, feeding practices, assessment of nutrition knowledge and practices were collected using a structured questionnaire. Anthropometric measurements of weight, height, hip and waist circumferences were taken using standard procedures. Data were analyzed using frequencies, percentages, means and standard deviation with IBM SPSS Version 20. Some (28.2%) of the mothers were aged between 26-33 years, while 28.2% were aged between 34-41 years. Most (71.1%) of the mothers were married. Less than half (45.6%) of them earned between N0 to N10,0000 monthly while about 21.6% earned between N10,001 to N20,000 monthly. Some (27.5%) of the mothers obtained information on nutrition through talk show while about 37.6% of the mothers obtain information on breastfeeding through mass media. Most (95.3%) of the mothers did not consume any food before breakfast while tea and bread was the most commonly consumed food during breakfast. Less than half (45.6%) of the mothers had normal BMI. 48.9% of them were overweight while 5.4% were underweight. A larger percentage (83.9%) of the mothers were at high risk of obesity while 16.1% were normal according to their waist-hip ratio (WHR) status. There was no significant relationship (p>0.05) between the socio-economic characteristics (educational status, occupational status and income status) of the mothers and their BMI status while their educational status and income status have significant relationship (p<0.05) with their waist-hip ratio. Cultivation of vegetables and fruits and consuming them can prove to be an important factor in maintaining better nutritional status.







TABLE OF CONTENTS

Title page i
Certification ii
Dedication iii
Acknowledgement iv
Table of content v
Lists of tables ix
Abstract x

CHAPTER 1
INTRODUCTION
1.1 Statement of Problem 5
1.2  Objectives 6
1.2.1 General objective 6
1.2.2 Specific objectives 6
1.3 Significances of the Study 7

CHAPTER 2
LITERATURE REVIEW
2.1 Maternal Nutritional Knowledge 9
2.1.1 Methods of Evaluation of Mothers Knowledge 10
2.2 Methods of Evaluating Nutrition Programs  10
2.3 Nutritional Requirements of Mothers 11
2.3.1 Energy 11
2.3.2 Protein 14
2.3.3 Carbohydrates 14
2.3.4 Fat 14
2.3.5 Vitamins 16
2.3.5.1 Water-soluble vitamins 16
2.3.5.2 Fat-soluble vitamins 16
2.3.6 Minerals 17
2.4 Energy and Nutrient needs of the Mothers  18
2.5 Anthropometric Assessment 20
2.5.1 Height measurements 20
2.5.2 Weight measurement 21
2.5.3 Body mass index 21
2.5.4 Waist circumference (WC) 22
2.5.5 Hip circumference  23
2.5.6 Skin fold thickness  23
2.6 Nutritional Status 23

CHAPTER 3
MATERIALS AND METHODS
3.1 Study Design 26
3.2 Area of Study 26
3.3 Population of the Study 26
3.4 Sampling and Sampling Techniques 27
3.4.1 Sample size 27
3.4.2 Sampling procedure 28
3.5 Preliminary Activities 28
3.5.1 Preliminary visit 28
3.5.2 Informed consent 29
3.6 Data Collection  29
3.6.1 Questionnaire  29
3.6.2 Anthropometric measurements 29
3.7 Data Analysis 31
3.8 Statistical Analysis 31

CHAPTER 4
RESULT AND DISCUSSION
4.1 Background information and socio-economic characteristics of the mothers 33
4.2. Mothers awareness on nutrition and breastfeeding information 35
4.2.2 Mothers knowledge on nutrition 32
4.3 Information on the dietary intake of mothers using food frequency 39
4.4 Information on the 24 hours dietary recall of respondents 51
4.5 Anthropometric status of the Mothers 55
4.6 Relationship between socio-economic characteristics and anthropometric indices (BMI status) 57
4.7 Relationship between socio-economic characteristics and anthropometric indices (WHR status) 58
4.8 Relationship between nutritional knowledge and anthropometric indices of the mothers 59

CHAPTER 5
CONCLUSION AND RECOMMENDATIONS
5.1 Conclusion 62
5.2 Recommendations 62
References
Appendix





LIST OF TABLES

Table 2.1 Recommended dietary allowances for selected nutrients for pregnant, non-pregnant and lactating women    13

Table 4.1: Background information and socio-economic characteristics of the mothers 34

Table 4.2a Mothers awareness on nutrition and breastfeeding information 37

Table 4.2b Mothers knowledge of nutrition 38

Table 4.3a: Frequency of consumption of cereals based food among the mothers 40

Table 4.3b: Frequency of consumption of legume based food among the mothers 42

Table 4.3c: Frequency of consumption of meat and meat product based food among the mothers 43

Table 4.3d: Frequency of consumption of milk and milk product based food among the mothers 45

Table 4.3e: Frequency of consumption of fats and oil based food among the mothers 46

Table 4.3f: Frequency of consumption of root and tuber based food among the mothers 48

Table 4.3g: Frequency of consumption of fruits and vegetable based food among the mothers 49

Table 4.4: 24 Hours dietary recall of respondents 52

Table 4.5a: Anthropometric status of mothers 56

Table 4.5b: Anthropometric indices of the respondents  56

Table 4.6 Relationship between socio-economic characteristics and anthropometric indices (BMI status) 58

Table 4.7: Relationship between socio-economic characteristics and anthropometric indices (WHR status) 51

Table 4.8a: Relationship between nutritional knowledge and anthropometric indices of the mothers  60

Table 4.8b: Relationship between nutritional knowledge and anthropometric indices (WHR status) 61





CHAPTER  1
INTRODUCTION

Inadequate nutrition is often related to health problems that lower the quality of life and significantly influence morbidity and total mortality. Food is an everyday necessity. Adequate nutrition has become one of the most important issues of modern society. Economic development, industrialization and urbanization, together with a sedentary lifestyle, have led to changes in dietary habits in most of the world population. These changes have contributed to an increase in body mass in all age groups, leading to a global crisis with significant consequences for world health (WHO, 2004). Nutrition is related to health, creativity, efficiency, cognitive functioning, and well-being. Obesity rates are increasing regardless of socioeconomic status but are more pronounced in populations with lower income and lower education (Malarias etal., 2000; Troung and Sturn, 2004). This observation is expected because  the cheapest foods are rich in fat and sugar but poor in nutritive value (Drenowski and Specter, 2004). According to the World Health Organization, non-communicable chronic diseases are the leading cause of death (60-68%) and disability (70%) in the world, while the leading risk factors are inadequate nutrition and sedentary lifestyle (Mokdadet al., 2001).

Current approaches to increase nutrition knowledge tend to focus on familiarizing people with important nutritional terms, emphasizing on reduced intake of certain nutrients and focusing on certain foods, which should be substituted. Therefore, to put a good understanding of practices, the consumer must be able to cope with issues such as quantities of food needed for maintenance of health. Oguntonaet al. (2002) stressed the importance of nutritional knowledge and emphasized that an abundance of food does not in itself guarantee that it would be well nourished but how food is been selected from food group.

Knowledge of food nutrition facilitate a selection of  an adequate diet. Unfortunately there is a wide spread ignorance of the nutritional and health benefit of our locally available foods leading to faulty food selection and habits (Ene-obong, 2001). Most people eat what they like because it is a norm or out of habit. Their selection of food is influenced by the awareness of the nutritive values. Few people know the way the body utilizes food (Ene-obong, 2001).

Poor nutritional knowledge, dietary habit on food selection due to misuse of the function of food while some may be from dietary practices that were developed from culture, many people are allergies to certain food despite their nutritional value and so people avoid food which they react to in one way or the other. It is however, important to know that some factors may contribute to dietary  inadequacy such as skipping of meal; inadequate lunches, eaten away from home and failure to eat enough meals, eggs, fruits, meats and vegetables. It is therefore, necessary that mothers should ensure that their nutritional needs are met in order to enhance their nutritional status (Inardlawet al., 2004).
 
Many people are paying considerable attention to what they eat and with the idea that food is closely related with the sense of well-being, more and more people seek for nutritional information and this advance in knowledge towards nutrition have had a great effect in our diet over last 300 years (Laiden, 2000). Information about the food practice of various groups may show where the weakness in their knowledge of nutrition uses and thus point to area in which nutrition education is needed. Ignorance of nutrition knowledge affects the dietary habit of mothers (Laiden, 2000).

The food is a raw material that the body makes use of and its intake at the right amount will be evident in one’s appearance, efficiency, and emotional well-being (Peckman and Freeland-graves, 2007). Knowledge is the capacity to acquire, retain and use information in mixture of comprehension, experience, discernment and skill (Libraham, 1995). 

Knowledge of food and nutrition facilitate the selection of adequate diet. Unfortunately there is a wide ignorance of the nutritional and benefits of our locally available food, leading to faulty food choices and habits (Ene-obong, 2001). Most people eat what they like or all because it is a norm or out of habits. Their choice is influenced by the awareness of its nutritive value, few people know the way the body utilize food. It is also necessary to understand that a delicious dish is not necessary a nutritious one (Shub, 2002).

Factors that influences or prevent mothers from eating right. among them are lack of nutrition knowledge, availability of food, poor or low purchasing power, culture and religious values and advertising individual’s food habit, time constraints, location (urban and rural) family size processing and preparation procedure, individual test, hunger and the cost of food (Inardlawet al., 2004).

Anthropometry comes from the Greek words anthropos  meaning “man” and methron meaning “measure” . Anthropology is dealing specifically with measuring the human body. It is still the most widely used method of measuring body composition and has recently been used to estimate that distribution (Goranet al., 1998). It involves the measurement of weight, height, chest, head and arm circumferences as well as skinfold thickness. Skinfold thickness and arm circumference are accepted as body fatness predictors (Wang et al., 2000).

Simon (1999) reported that anthropometric on measurement (body dimensions and composition) are often used as proxies for assessing the eventual extent and severing of malnutrition. The distinct advantage of anthropometry are that is portable non-invasive and inexpensive and useful in field studies (Shub, 2002).
Anthropometric assessment is defined as measurement of the variation of the physical dimensions and gross composition of the human body at different age levels and degrees of nutrition (Wang et al., 2000). Anthropometry is the science which deals with human measurement in particularly the bones and skulls of human skeleton and its segments (Wang et al., 2000).

Nutritional anthropometry involves the measurement of variation in the physical dimension, and the gross composition of the human body at different ages and levels of activity. Anthropometry is defined as the use of body measurements to obtain information about nutritional status. Anthropometry involves the use of weight and height scales, skin fold caliper, arm, head and chest circumference tapes, sliding calipers of various population groups (Onimawo and Cole, 2002). The instruments are weighing balance scale, metre rule, height rule, tape rule and skinfold calipers.  The measure value reflects the current nutritional status and does not differentiate between acute and chronic changes. Other anthropometric measurements are mid-arm circumference, skin fold thickness, head circumference, hip, waist ration and it is used to know the nutritional status indicators for example body mass index is a measure that describes relative weight for height and is significantly correlated with total body fat content (Gordon, 1999). It is useful in assessing the risk of overweight and is used as a measure of fatness in group or obese people.

1.1 STATEMENT OF THE PROBLEM
Lack of dietary knowledge are often major environmental determinant of malnutrition in developing countries (Jelliffe and Jelliffe, 2001). When there is lack of knowledge on nutrients and nutrition, there will be serious problem. Most of the rural mothers in Ikwuano L.G.A lack nutritional knowledge, inadequate dietary habit and as such could lead to malnutrition both overnutrition and undernutrition, and could be due to the type of occupation (mainly farming and trading) they are involved. According to the World Health Organization, non-communicable chronic diseases are the leading cause of death (60-80%) and disability (70%) in the world, while the leading risk factors are inadequate nutrition and sedentary lifestyle (Mokdadet al., 2001). Nutritional knowledge, dietary habits, nutritional status, and physical activity of women population are the subjects of numerous studies.

The critical problem of mothers is the lack of nutritional knowledge, dietary and practice of food value, selection and preparation, which is the inability to combine calories and to select adequate diet (Angers, 2004). Rural mothers need to have a good nutritional knowledge and dietary habits because lack of appropriate nutritional practice will affect them and the whole family. Those that are pregnant will give birth to low birth babies which may have stunted growth that will follow them to adult stage. Therefore, the present study is aimed at assessing the nutritional knowledge, dietary habits and anthropometry status ok mother in Ikwuano local government Area of Abia state.

1.2  OBJECTIVES
1.2.1 General objective
The general objective of the study was to assess the nutritional knowledge, dietary habits and anthropometry status of mothers in Ikwuano Local Government Area of Abia state.

1.2.2 Specific objectives
The specific objectives of the study are to:

1. assess the socio-economic characteristic of mothers in Ikwuano Local Government.

2. ascertain the nutritional knowledge and dietary habits of the mothers.

3. evaluate the anthropometric status of mothers.

4. determine the effect of socio-economic characteristics, nutritional knowledge and dietary habits on the anthropometric status of the mothers.

1.3 SIGNIFICANCE OF THE STUDY
This study will disclose information on the nutritional knowledge, dietary habits and anthropometric status of mothers in Ikwuano Local Government Area. It is also hoped that the information obtained from this study will assist the Government, policy and decision makers, non-governmental organization and or rural populations to have access to nutritious food/diet for healthy living.

Additionally, the research findings will form absolute data which the nutritionist will use to educate the rural mothers on healthy feeding habit and for suggestion plans for improving nutritional knowledge, dietary habits and anthropometric status of mother could be adjusted.
The result of this study will be used to add to knowledge base and also to validate other researches done on the same topic.


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