ABSTRACT
Nutritional status is the combination of health as influenced by intake and utilization of nutrients and determined from information obtained by physical, biochemical and dietary studies. The study assessed the correlation between perceived and actual nutritional status of undergraduates in Michael Okpara University of Agriculture, Umudike (MOUAU) and Abia State University, Umuahia Campus (ABSU). The study employed a descriptive and cross sectional in design. The target population of the study included all the 4,080 undergraduate University students of Abia State University, Uturu, and 14, 999 students of Michael Okpara University of Agriculture Umudike, Abia State. The study employed a multi-staged sampling technique to select 300 students from Michael Okpara University of Agriculture, Umudike (MOUAU) and 131 from Abia State University, Umuahia Campus (ABSU). The data for the study were collected with the aid of a structured questionnaire while the anthropometric data were collected using height and weight measurements. Descriptive statistics of frequency, percentage and mean was used to analyse the socio- demographic characteristics and anthropometric status (BMI, Waist hip rate and Blood pressure level while Pearson correlation was used to determine the relationship between perceived and actual nutritional status. The study found that more than half (59.4%) were males while about 40.0% were females. About 48.0% of the participants were aged between 23-28 years. On perceived nutritional status, Majority (60.8%) believe they have a normal weight status while 41.1% believe they should maintain their current weight based on their perceived body mass. Majority (94.9%) don't know what their blood pressure numbers should be while 29.6% thought their blood pressure was normal. About half (52%) were a little concerned about their blood pressure. On perceived dietary assessment, majority (71.2%) believed their diet was sometimes adequate. More than half (68.2%) always had a diverse variety of food while a majority (59.2%) always had a healthy diet. Actual dietary assessment revealed that majority (96.3%) had a high dietary diversity score. On actual anthropometry, majority (65%) of the participants had a normal weight while less than a quarter of the participants (16.2%) were overweight. Almost half (47.3%) of the participants had a high waist-hip ratio while majority (74.7%) had a normal waist circumference and about 58.9% had normal blood pressure. On the relationship between actual and perceived nutritional status, there was a significant (<0.05) positive correlation between BMI and what describes weight status (r= 0.207, p= 0.000), diagrams that describes BMI (r = 0.241, p =0.000) and what should be done based on perceived body mass (r = 0.208, p= 0.000). The study also showed a significant (<0.05) positive correlation between blood pressure classification and what describes weight status (r =0.153, p=0.001), what should be done based on perceived body mass (r =0.149, p= 0.002) and perceived healthy diet (r =0.152, p= 0.002). The study therefore concludes that there is significant positive correlation between perceived and actual nutritional status of undergraduates. Non-governmental organization and health professionals promote healthy living amongst young adults and adolescents by creating workshops and seminars to create health care awareness amongst young adults and adolescents especially undergraduate.
TABLE
OF CONTENTS
Cover
Page
Title
Page i
Certification ii
Declaration iii
Dedication iv
Acknowledgment v
Table
of Contents vi
List
of Tables ix
Abstract x
CHAPTER 1 INTRODUCTION
1.1 Statement of the Problem 2
1.2 Objectives of the Study 8
1.3 Significance of the Study 8
CHAPTER 2 LITERATURE REVIEW
2.1 Concept of Nutrition 9
2.2 Nutritional Status 11
2.3
Percieved Nutrition Knowledge of Undergraduate 11
2.4 Perceived
Attitudes of Undergraduate Students towards Nutrition 13
2.5
Nutritional Behavior of Undergraduate Students 14
2.6 Nutritional Status among Undergraduate 14
2.7 Evaluating
Diet Quality 19
2.8
Component of Assessing Nutritional Status 22
CHAPTER 3 RESEARCH METHODOLOGY
3.1 Study Design 27
3.2 Area of Study 27
3.3 Population Study 29
3.4 Sampling and Sampling Techniques 29
3.4.1 Sample Size 29
3.4.2
Sampling Techniques 30
3.5 Preliminary Activities 30
3.5.1 Preliminary Visits 30
3.5.2 Informed Consent/Ethical Approval 30
3.5.3 Training of Research Assistants 31
3.6 Data Collection Procedures 31
3.6.1 Questionnaire Administration 31
3.6.2 Anthropometry 31
3.7 Data
Analysis 33
3.7.1
Body Mass Index (BMI) 33
3.7.2 Waist hip ratio (WHR) 33
3.7.3
Classification of Blood Pressure by the Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure (2003) 34
3.7.4 Dietary Diversity
Score 34
3.8
Statistical Analysis 35
CHAPTER
4 RESULTS AND DISCUSSION
4.1.
Socio-Economic Characteristics 36
4.2 Awareness of
Anthropometric Status 39
4.3 Awareness of
Biochemical/Clinical Appraisal 39
4.4 Perceived
Dietary Assessment 41
4.5 Dietary
Assessment 42
4.6
Anthropometric Characteristics of the Participants 43
4.7 Relationship between Actual and Perceived Nutritional Status of Respondents 45
CHAPTER
FIVE CONCLUSION AND
RECOMMENDATIONS
5.1 Conclusion 47
5.2 Recommendations 48
REFERENCES
LIST
OF TABLES
3.1: The International classification of BMI
in adults 33
3.2: Waist-Hip Ratio classification 33
3.3: Blood
pressure classification 34
3.4: Waist circumference classification
34
3.5 Classification for dietary diversity score
(DDS) 34
4.1: Socio-economic characteristics of the
participants 36
4.2. Awareness
of Anthropometric status 39
4.3. Awareness
of biochemical/clinical appraisal 40
4.4 Perceived dietary assessment 41
4.5 Dietary Diversity Score (DDS) of
participants 42
4.6 Anthropometric indices of the participants 44
4.7. Relationship between actual and perceived nutritional status of respondents 46
CHAPTER
1
INTRODUCTION
1.1
Background to the Study
Undergraduates are described as university
students under training with a view to be awarded a bachelor’s degree upon
completion (World English Dictionary, 2011) and these group are mostly young
adults and adolescents. Generally young adults and adolescents form the bulk of
the undergraduate population. Adolescence is the period between childhood and adulthood,
the age group within the range is 10 – 19 years of age (WHO, 2013). Adolescence
is a unique period of development of physiological, psychosocial and cognitive
levels all of which affect the nutritional needs of the adolescence (Qlan,
2017). A young adult is a person who just passed the stage of adolescence. Thus,
among the undergraduate, a population of late adolescents and young adults and adolescents
and early adulthood category was found.
Undergraduate level is a developmental stage
for the young adults and adolescents and young adult to be prepared to face the
real world by exposing them to advanced knowledge and meeting people from
different tribes and ethnic groups. It is an important period as well for
establishment of healthy behaviour for adequate nutrient intakes. An adequate
nutrient intake promotes appropriate physical growth, development, and plays an
important role in maintaining mental and emotional stability (Patal et al., 2007).
Nutritional status is the combination of
health as influenced by intake and utilization of nutrients and determined from
information obtained by physical, biochemical and dietary studies (Gibson, 2005).
According to Gibson (2005), nutritional status involves different aspect which
includes the anthropometric measurement, biochemical investigation, dietary
intake and clinical appraisal. Nutritional status involves detecting the change
of body composition and also assessing the nutritional status in specific
population groups like newborn, children, adolescents and adults. A
comprehensive nutritional assessment includes (1) anthropometric measurements
of body composition; (2) biochemical measurements of serum protein, micronutrients,
and metabolic parameters; (3) clinical assessment of altered nutritional
requirements and social or psychological issues that may preclude adequate
intake; and (4) measurement of dietary intake. Techniques for measuring body
composition of fat and lean body mass include anthropometry and bioelectric
impedance analysis (Delisle et al., 2019). Biochemical assessment uses
laboratory measurements of serum protein, serum micronutrient levels, serum
lipids, and immunological parameters to assess general nutritional status and to
identify specific nutritional deficiencies (American Dietetic Association, 2018). Dietary intake assessment is a scientific
assessment of eating pattern that could detect nutrient deficiency. The
clinical assessment refers to collecting information and drawing conclusions through the use of
observation, psychological tests, neurological tests, and interviews to
determine what the person's problem is and what symptoms he/she is presenting
with (Delisle, et al., 2019).
The undergraduate period is a period of
risk, associated with the gradual emergence of health problems which will have
potentially severe consequences later in life (Chandra-Mouli et al., 2016). This is a time when many
are on their own for the first time and will develop many important habit that
will follow them in adulthood.
During undergraduate period, a number of
social changes influence eating habits. This perceived social changes
influences student eating habit greatly. The overweight or big framed individual
in Nigeria could be perceived as being well fed, very healthy or look rich,
while skinny or underweight are sometimes perceived as a model or the right
figure or body size. This perceptions are also held by young adult in the
university which is why some especially girls tend to skip meals and eat light
food so as to have the perceived right figure and some tend to perceive that
taking junk food is enjoyment and evidence of good living. This lifestyle tend
to be detrimental which is why there is increase in the intake of soft drinks,
snacks and fast foods are the rule, as long as the products are fashionable and
fit for young adults and adolescents image (Barbara and Robert, 2011).
A
more direct problem for adolescence involves poor level of health awareness or
low health care utilization e.g medical checkup amongst young adult which is
why some young adult lack necessary information on how to improve their health
status (Hedley et al., 2014). A study
carried out by Adeyemo et al., (2014) in Egbedore Local Government Area of Osun
State in Nigeria among the young adult residents of the town showed that while
85.2% of the respondents paid no visits to at least one health facility within
their vicinity when sick, 14.8% considered services given in these facilities
inadequate and unsatisfying to them especially those respondents with no formal
education. Sule et al., (2010) in their survey of a rural community in South
West Nigeria found that about 44% of young adult respondents utilized
self-medication in Ogun State when ill. The associated influences on this poor
utilization of health care facilities observed were; past experiences with
health services, perception about the quality and efficiency of health care
services. Once an individual is ill, he assumes a sick role and is expected to
seek the services of health providers and at the same time cooperate with
medical advice and expertise for complete exploitation of good health.
Surprisingly, this is not so as most individuals either delay in seeking prompt
orthodox medical care or prefer the use of self-medication approach which
negatively affects the overall outcome of their illness (Ahmed, et al., 2011).
A study carried out by Adeyemo et al.,
(2014) in Osun state University in Nigeria among the students of the university
showed that while 85.2% of the respondents do pay visits to at least one health
facility within their vicinity when sick, 14.8% considered services given in
these facilities inadequate and unsatisfying to them, 87.5% preferred self-medication.
The associated influences on this poor utilization of health care facilities
observed were to have limited students’ knowledge on health awareness.
In order to seek help in increasing its
health awareness knowledge, students must begin by thinking there is a problem
requiring professional attention. Once a student reaches out to seek help,
he/she must decide where to seek help and also from whom. For example, students
may turn to informal help sources such as roommates and friends. They may also
seek assistance from formal help sources such as counsellor or general health centre
staff. When students do seek help, they will continue to make decisions about
the extent to which this help is still needed. Students‟ ability to carry out
these help-seeking behaviours rests on a multitude of factors. Their
help-seeking behaviours also depend on a host of environmental and campus-
related factors, including the nature and extent of health supports or series
available on campus and within the community (Campus Health and Safety, 2014).
The shift from late young adults and adolescents
years to adulthood has been shown to be a period of acceptance for many
negative health behaviour including increase in smoking, reduced physical
activity and low fruit and vegetable consumption (Hedley et al., 2014). Hoffman et al.,
(2016) also found that the first year of university and college student
life may often lead to adoption of unhealthy dietary pattern, and they are more
susceptible to gain more weight (Hoffman et
al., 2016). The undergraduates tend to consume much of the carbohydrate,
fat and oil contents of food than other nutrients that can also work hand in hand
to promote their health and growth during this period.
Broadly speaking, undergraduates (young
adults and adolescents and young adults) problems are malnutrition,
micro-nutrient deficiencies and nutrition related chronic diseases. This is
because undergraduate students tend to practice poor eating habit (Abolfotouh et al., 2017). The nutritional status of
most Nigerian undergraduates is not the best; indeed, it needs urgent attention
(Oguntona, 2018). Undergraduates (young adults and adolescents and young adult)
being the largest proportion of Nigeria population are likely to be greatly
affected (Olumakaiye, et al., 2010).
1.2 Statement of the Problem
In the world, the
number of young adult between the ages of 15 and 24 is 1.1 billion; young adult
constitute 18 % of the global population (WHO, 2018). Young adult and adolescents
combined account for nearly 40 % of the world’s population (Hedley et al., 2014). Approximately 60 % of
youth live in Asia; 15 %, in Africa; 10 %, in Latin America and the Caribbean; and
the remaining 15 %, in developed countries and regions. Nigeria is the seventh
most populous country in the world, with 190 million citizens in 2017—Nigeria’s
youth population is proportionally even larger (WHO, 2018).
This
teeming population of young people experience variety of transformations that
lead them to preoccupation with body image, assertions of independence and also
uncertainties about sexuality, future relationships and career options (Trexier
and Sargent, 2013). This leads to display of irregular lifestyle and influences
by many outside factors which in turn predispose them to food habits that
ultimately affect their nutritional status. West and Cumines (2016) had noted
that adolescence and young adulthood is a period when peer pressure can affect
eating behaviors and they may be skipping meals or possibly under-eat or over
eat. Olumakaiye et al., (2010)
revealed that problematic eating habit like skipping of meals (especially
breakfast) leads to higher level of snacking among this population group.
Delisle et al., (2019) also observed
that eating habits or pattern are frequently erratic in young adults and adolescents
and this may be a common factor of nutritional risk, irrespective of area.
In
African, latest
estimates show that the regional poverty rate decreased by 1.6
% between 2015 and 2018. This translates to 40% of the population living
below the US$1.90 a day poverty line in 2018 and Sub-Saharan Africa accounting
for two-thirds
of the global extreme poor population
(Chandra-Mouli,
et al., 2016). Although, the poverty
rate decreased from 56% in 1990 to 40% in 2018, a large number of them are
still affected. According to Oguntona, (2018), the poverty level has made it
difficult for most people to keep up with nutritious food due to extreme
poverty rate which is a major problem for young adult in higher institutions.
According
to Abolfotouh et al., (2017), people
with low socioeconomic status have dietary profiles less consistent with
nutritional recommendations or dietary guidelines, hence contributing to their
poorer health status. Daly et al., (2015),
suggest that education, occupation and income are standard economic component
for monitoring links between socioeconomic status and health. Undergraduate
students from poor family background are not consistent with nutritional
recommendation because of insufficient income to obtain nutritious food, as
limited resources are channeled to other aspect of livelihood such as tuition and
books while feeding is less prioritized.
Qlan
(2011) noted that due to time constraints, some students may frequently neglect
entire meals during the day; and as a result resort to late-night binge eating.
Some dietary patterns which include snacking (usually on energy dense foods),
meal skipping (particularly breakfast), irregular and wide use of fast foods
appear quite common among young adults and adolescents. Some of these factors
have been associated with overweight and obesity (Thompson-Mccomick et al., 2010). As young adults move into
an independent living situation, there is a high risk for unhealthy eating
habits (Gower et al., 2009). Far from
the care of parents, most undergraduates may begin to develop unhealthy eating
habits over a short span of time (Freedman and Conners, 2010).
According
to Rivweral et al., (2014) an estimated
20 million young adult were overweight or obese in 2018 (Mistry and Puthussery,
2015). It has been projected that approximately 30% of all young adult was
affected by these conditions by 2030 (Mistry and Puthussery, 2015).
A
study conducted among Nigerian adolescent/young adults reported the prevalence
of over nutrition affected 4% for ages 18-20 year and 3 % for ages 21-25 with
higher values among females (Ansa et al.
2001).
Malnutrition constitutes the most serious
risk factor in causing ill health and death (Muller and Krawinkel, 2005). WHO
(2013), recognize malnutrition as a serious public health problem that has been
linked to a substantial increase in the risk of mortality and morbidity.
Malnutrition has damaging implications for people and communities, thus
hindering the socio economic and human development of a nation. It remains one
of the most critical health issues because of its long-lasting negative
effects. WHO (2002) and FAO (2004) estimated that 852 million people are
undernourished worldwide with most (815 million) living in developing
countries. This confirms the ever increasing figure of people that are
undernourished globally.
Similar studies have been conducted on the
nutritional status of undergraduates as shown in Abolfotouh et al., (2017) and Daly et al., (2015)
studies. But, no recent research has been done on perceived and actual
nutritional status of undergraduate, which this study will address and add to
existing literature.
Based
on this problems, this study will correlates between perceived and actual
nutritional status of undergraduates in Michael Okpara University of
Agriculture, Umudike and Abia State University, Umuahia Campus.
1.3
Objectives of the Study
The general objective of the study is to assess
the correlation between perceived and actual nutritional status of
undergraduates in Michael Okpara University of Agriculture, Umudike and Abia
State University, Umuahia Campus.
The specific objectives are to:
1. Assess
the socioeconomics characteristics of the respondents.
2. To
determine their perceived nutritional status (Body Mass Index, waist/hip ratio,
blood pressure level).
3. To
assess their actual nutritional status using standard procedures.
4.
Evaluate the correlation between actual and
perceived nutritional status
1.4
Significance of the Study
Information from this study will help the
government make policies, recommendations and provide incentives to improve the
socioeconomic status and nutritional of household.
The study will also help non-governmental
organization and health professionals promote healthy living amongst young
adults and young adults and adolescents by creating workshops and seminars to
create health care awareness amongst young adults and young adults and adolescents
especially undergraduate.
This
study was relevant to mothers and caregivers as to know the nutritional status
of their undergraduate children and its health implication, then make
appropriate adjustment where needed.
The study was useful to Nutritionist and scientist
to create nutritional programmes and recommendations in improving household
food and nutrition security through effective decision making. It could also be
used in planning and implementing food, nutrition programmes and interventions on
the quality and adequacy of food consumed by young adults.
The study was of great benefit to
researchers because it will serve as a guide or research material to subsequent
research on this study.
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