Ultra-processed foods are formulations made by the food industry mostly from substances extracted from foods or obtained from the further processing of constituents of foods or through chemical synthesis, with little if any whole foods. Consumption of ultra-processed foods has been pointed out as a risk factor for increasing obesity, as measured by BMI, among both adolescents and adults. This study assessed the consumption of ultra-processed food, drinks, and anthropometric status of adolescents in Aba North Local Government Area, Abia State, Nigeria. It was a cross-sectional study. Multi-stage random sampling was used to select 439 adolescents from ten years to nineteen years for the study. Every adolescent was subjected to anthropometric measurements using standard technique. Data were collected with a well-structured and validated questionnaire to obtain information on socio-economic status, food frequency of ultra-processed foods and drinks, and anthropometric measurement. Data were analyzed using SPSS version 23. The respondents comprised mostly of Female adolescents (56.0%), while 44.0% were male adolescents. Majority of the adolescents (65.4%) were within the ages of 16-19 years and 36.4% of the adolescents were within the ages of 12-15 years. Cakes were consumed daily by 65.6% of the respondents. Most of the respondents consumed soft drinks (74.7%), packaged bread (68.8%), cookies (71.8%) and instant noodles (59.9%) sometimes. A huge number of respondents never consumed canned fruits, (66.1%), chocolate bars, (76.1%) and candy/sweets, (75.9%) respectively. Most of the respondents were obese (77.6%), obesity was more prevalent in females (48.7%) than males (28.9%) while 5.3% were overweight and 2.5% of the respondents were underweight. The chi-square result indicated that there was a significant (p<0.000) relationship between obesity and some of the ultra-processed food consumed. There was a significant relationship between the consumption of margarine (p<0.000), sausage (p<0.000), chips (p<0.000), canned vegetables (p<0.000), pasta (p<0.000) and obesity. This study showed that there was a High rate of obesity amongst the respondents, it also showed a higher prevalence in female respondents than male respondents. This study showed a significant relationship between obesity and some of the consumed ultra-processed foods and drinks. Thus, it can be deduced that consumption of some ultra-processed food can be related to an adolescent’s increase in weight, but there are other factors that could also cause weight gain in an adolescent to a relative extent. Suggestion for creating of awareness of the effect of ultra-processed foods and drinks to human body and encouraging the consumption of natural and cultural food and drinks. Nutrition education is also needed to improve the nutrition knowledge of the parents to guide, encourage healthy, and appropriate adolescents feeding habits as these adolescents learn most food consumption and dietary pattern at home.
TABLE OF CONTENTS
TITLE PAGE i
TABLE OF CONTENTS v
LIST OF TABLES vii
1.1 Statement of problem 3
1.2 Objectives 6
1.3 Significance of study 7
2.1 Ultra-Processed Foods 8
2.2 Identifying Ultra -Processed Foods 9
2.3 Nova Food Classification System 11
2.4 Ultra-Processed and Non-Communicable Diseases 15
2.4.1ultra-Processed Food, Obesity, Diabetes 16
2.4.2 Ultra-Processed Food and Cardiometabolic Outcomes 17
2.5 Ultra-Processed Food Consumption Levels 18
2.6 Consumption of Ultra-Processed Foods and Social Economic Position 20
2.6.1 Social-Economic Position Indicators 21
2.6.2 Dietary Patterns Of Adolescents 22
MATERIALS AND METHODS
3.1 Study Design 24
3.2 Area of study 24
3.3 Population of the study 25
3.4 Sampling and sampling techniques 25
3.4.1 sample size 25
3.4.2 sampling procedures 26
3.5 Preliminary activities 26
3.5.1 preliminary visit 26
3.5.2 training of research assistants 26
3.5.3 ethical approval 27
3.6 Data collection 27
3.6.1 questionnaire administration 27
3.6.2 anthropometry 27
3.6.3 dietary measurement 29
3.7 Data analysis 29
3.8 Statistical analysis 29
RESULT AND DISCUSSION
4.1 socioeconomic characteristics of respondents 30
4.2 Consumption pattern of ultra-processed food and drink products of the respondents studied 33
4.3 Anthropometric status of the adolescents studied 36
4.4 Relationship between ultra-processed food consumption and the body mass index of the Respondents 37
CONCLUSION AND RECOMMENDATION
5.1 Conclusion 40
5.2 Recommendation 41
LIST OF TABLES
Table 4.1: Background information and socioeconomic characteristics of adolescents studied 32
Table 4.2: Consumption patterns of ultra-processed foods and drinks products of the respondents studied 35
Table 4.3: Anthropometric status of adolescents studied 36
Table 4.4: relationship between ultra-processed food consumption and the body mass index of the population studied 39
The dietary patterns of the World population are changing, mainly due to the higher consumption of ready-to-eat foods, which have high levels of fat and sugar, and lower intake of unprocessed foods, such as fruits, vegetables, tubers, and cereals (Popkin, 2001). Ultra-processed foods are formulations made by the food industry mostly from substances extracted from foods or obtained from the further processing of constituents of foods or through chemical synthesis, with little if any whole foods (Monteiro et al., 2012; Moodie et al., 2013). Compared to the rest of the diet, these formulations have less fibre and protein, more added sugar, and, when solid, higher energy density (Monteiro et al., 2011; Moubarac et al., 2013). They are also extremely palatable and habit-forming, convenient, sold in large portion sizes, and aggressively advertised and marketed (Monteiro et al., 2012; Moodie et al., 2013; Ludwig, 2011). Sales of ultra-processed foods have increased in parallel with the rates of obesity worldwide, particularly in middle income countries (Monteiro et al., 2013).
In recent decades, there has been a reversal of population dietary patterns, with reductions in the consumption of traditional foods and increases in foods that are ready for consumption (Martins et al., 2013; Popkin, 2011). This change has been associated to the occurrence of high prevalence of obesity worldwide (Popkin and Slining, 2013). In this context, a new classification of foods called “NOVA”, which is based on the extent, order and type of processing used in their production, has been proposed. NOVA is a valid tool for nutrition research and classifies all foods and food products into four groups: unprocessed or minimally processed foods, processed culinary ingredients, and processed and ultra-processed food products (Monteiro et al., 2012).
Childhood and adolescent obesity have presented a growing prevalence over the last three decades (Fleming and Robinson, 2014). Over the same period, modiﬁcations to how foods are produced and increasing availability of transportation facilities have been observed, characterizing an ‘obesogenic’ environment (Popkin, 2006) with increasing prevalence of non-healthy eating habits (Popkin, 2006) and decreasing prevalence of physical activity (Owen et al., 2010). Consumption of ultra-processed foods has been pointed out as a risk factor for increasing obesity, as measured by BMI, among both adolescents and adults (Louzada et al., 2015; Mendonça et al., 2016). Moreover, it has been shown in the literature that individuals who are obese at an early age tend to remain obese throughout life (Singh et al., 2015). The development and progression of cardiovascular disease is related to several risk factors that begin in childhood, such as diet and Physical activity (Morrison et al., 2012; Costa et al., 2018). Dietary habits that are formed early are likely to track later in childhood and form the basis for adult eating patterns (Nicklaus and Remy, 2013). Among adolescents, the time spent at sedentary behaviours like watching TV and using videogames and computers has increased over time (Moreno et al., 2014). The habit of spending more time sitting is associated with several unfavourable health outcomes (Moreno et al., 2014; Costigan et al., 2013; Nelson and Gordon-Larsen et al., 2006) including obesity, and can lead to greater consumption of Ultra-Processed Foods (Vereecken et al.,2006; Santaliestra-Pasías et al., 2012) due to the ease in ingesting these products, since they are purchased in packaged form, ready to eat or heat (Monteiro et al., 2018). Adolescence is an important phase for health promotion and the prevention of risk factors, since eating habits are acquired during this phase, as well as in childhood, and tend to persist throughout life (World Health Organization, 2003). However, only a limited number of studies have investigated the association between ultra-processed food consumption and health’s damage during childhood.
Considering the growing prevalence of obesity, the consumption of ultra-processed foods by adolescents worldwide, and the limited number of research relating the consumption of ultra-processed with the increasing number of the prevalence of adolescent obesity and health damage during childhood in Nigeria, the objective of this study is to identify consumption of ultra-processed food and drinks, dietary patterns and anthropometric status of adolescents in Aba North Local Government Area, Abia State Nigeria.
1.1 STATEMENT OF PROBLEM
The eating pattern of adolescents is characterized by the low consumption of fruits, vegetables and greens, and by the high intake of foods with high levels of sugars, fats and sodium. Adolescents usually choose food with flavourful attributes, such as those that are ultra-processed, high in salt, sugar and fat, which are also easy to carry and ready to eat; therefore, it is believed that their consumption is high (Denise and Adriana, 2018). Increasingly sophisticated processing methods have altered food structure, nutritional content, and taste reducing the value of foods and its Nutritional content (Zoebel et al, 2016). Traditional diets that feature whole or minimally processed foods and emphasize home-cooking and food preparation are being replaced by diets comprised of industrially processed and prepared food products which is accessible to most school children and adolescents increasing their health risk at the high consumption of these ultra-processed foods. Worldwide, approximately 20-25% of adolescents (individuals aged 10-19 years) are overweight. According to Abia State Ministry of Health Survey, the prevalence of abdominal obesity in the population was 21.75%. In men and women, it was 3.2% and 39.2%, respectively; for School aged children, the prevalence of overweight was 7.7% while that of obesity was 3.1%; then for adolescents the prevalence of underweight, overweight was 46.2% and 6.6% respectively (Chukwuonye and John, 2013). Adolescents are tomorrow’s adult population, and their health and well-being are crucial.
Although, adolescents are tomorrow’s adult population, and their health and well-being are crucial. Ultra-processed foods and drinks are now foods that everybody enjoys to eat rather than eating natural and nutrient dense foods which provides adequate nutrients and maintains a proper health status, there is a need to look at this pattern of eating in our regional communities and surroundings, to avoid poor nutrition knowledge that leads to superstition and misconceptions about food requirements and nutritive value of food, a very common condition in developing countries of the world.
1.2 OBJECTIVES OF THE STUDY
The general objective of this study is to assess the consumption of ultra-processed foods, dietary patterns and anthropometry status of adolescents in Aba North local Government Area, Abia State.
1. to determine the socio-economic characteristics of adolescent in Aba North Local Government Area.
2. to determine the anthropometry status of adolescent in Aba North Local Government Area and its association with ultra-processed foods and drinks consumption.
3. to determine the dietary pattern of ultra-processed food and drinks of adolescent in Aba North Local Government Area.
4. to determine the relationship between ultra-processed foods and drinks on the body mass index of adolescent in Aba North Local Government Area.
1.3 SIGNIFICANCE OF THE STUDY
The findings of the study will be significant in the area of assessing the general knowledge of adolescent in Aba south local government of Abia State on the consumption of ultra-processed foods and drinks, to evaluate the dietary pattern and nutritional status of adolescent in Aba south local government area. It will help the students to develop interest in the subject matter. Students of Human Nutrition and other related fields of study will be motivated by the result of this study to engage more on studies pertaining to Dietary habit and nutritional status. The findings of the study will enable adolescent to be more conscious of their food intakes in order to eat balance diet regularly. The study will be of benefit to the family budget planners to make adequate provision for feeding the adolescent be it boy or girl in the family. This study will be of immense benefits to organizations like World Health Organization (WHO), Food and agricultural organization (FAO) Nutritionists and health practitioners will use the result of this study to design nutrition in creating awareness about the relationship between the consumption of ultra¬-processed foods and drinks and the health challenges that are associated with them. The nutritional status and dietary pattern of people will change when they are properly informed about the risk and severity of consuming such foods in abnormal ways. The results of this study could help policy makers review existing and future policies and programmes regarding the consumption of ultra -processed food and drink. It will be an “eye opener” to health workers nutritionist, dietitians and food policy makers to advocate effect of consuming such foods in moderations.
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