ABSTRACT
University students tend to have poor eating practices and this is related to nutrition status and academic performance. This cross sectional study was done to assess nutritional status and academic performances of undergraduates in Imo State University. A total of 397 students were randomly selected for the study. The students completed a set of questionnaire comprising their personal data, socio-economic status of their parents, their food consumption patterns, 24 hours dietary recall and food frequency. Weights, heights, waist circumferences and hip circumferences of the students were measured. Nutrient intake was calculated using Nigerian food composition table. More than half (52.6%) of the students were within 21-25 years old and (33.2%) were 16-20 years old. The students levels ranged from 100 (22.2%) to 500 (7.6%) and (29.7%) of them were in 200 level. The mean nutrient intakes of the male and female students for protein (77.82g and 69.55g) and vitamin B1 (thiamin) (1.08mg and 1.36mg) were higher than (55g and 49g) and (1.2mg and 1.1mg), folate (221.70µg and 147.82µg) were lower than 400µg while fat (77.46g and 52.88g) were within the range of (48-11g and 37.86g) when compared with FAO/WHO reference nutrient intakes (RNI) for adolescents (10-18years) and adults (19 years and above). Carbohydrate, vitamin A, vitamin C and folate rich foods were mostly consumed by the students. Some (33.2% and 32.7%) of the students had CGPA between 2.49-1.50 and 3.49-2.50. More females tend to skip breakfast compared to male students with the percentage of 55.8% and 37.8%, due to time constraints (47.5%), all the students ate in-between meals. More males (40.3%) consumed their breakfast in the canteen compared to females (37.1%). Some (23.7%) females and (15.1%) males were overweight while 1.8% females and 1.7% males were obese. Type of food and beverages consumed especially during breakfast significantly (p<0.05) affected their CGPA. Similarly, age significantly (p<0.05) affected the CGPA of the students. Present finding suggests the need for nutrition education campaigns regarding healthier food choices as well as the impacts of breakfast consumption on brain function and general health, so that they can maintain good health and have quality life expectancy which includes better performances in academics.
TABLE OF CONTENTS
Title page i
Certification ii
Dedication iii
Acknowledgements iv
Table of contents v
Lists of tables x
Abstract xi
CHAPTER 1
INTRODUCTION 1
1.1 Statement of the Problem 5
1.2 Objectives of the Study 7
1.3 Significance of Study 8
CHAPTER 2
LITERATURE REVIEW 9
2.1 Nutritional Status 9
2.2 Nutritional Assessment 9
2.3 Ways of Assessing Nutritional Status 10
2.3.1 Dietary Assessment Methods 10
2.3.1.1 Diet History 11
2.3.1.2 24-Hour Recall Method 12
2.3.1.3 Food Frequency Questionnaire (FFQ) 13
2.3.1.4 Weighed Food Intake 13
2.3.2 Anthropometric Measurements 15
2.3.2.1 Weight Measurement 16
2.3.2.2 Height Measurement 16
2.3.2.3 Body Mass Index 17
2.3.2.4 Waist Circumference 17
2.3.2.5 Hip Circumference 18
2.3.2.6 Waist Hip Ratio 18
2.5 Clinical Observation 19
2.6 Biochemical/Laboratory Assessment 20
2.7 Food and Academic Performance 20
2.7.1 Nutritional Neuroscience 20
2.7.2 Malnutrition 24
2.7.2.1 Pre-natal and Early Childhood Undernutrition 26
2.7.2.2 Later Childhood Undernutrition 26
2.7.2.3 Childhood Overnutrition 27
2.7.3 Diet Quality (Adequancy) 28
2.8 Health Challenges Caused By Poor Nutrition 29
2.8.1 Direct Impact of Nutrition on School Performance 29
2.8.2 Indirect Impact of Nutrition to School Performance 30
2.9 Breakfast and Academic Performance 30
2.10 Relationships between Nutrition and Brain Function 32
2.11 Impact of Food Insecurity and Insufficiency on Academic Performance 36
CHAPTER 3
MATERIALS AND METHOD 37
3.1 Study Design 37
3.2 Area of Study 37
3.3 Population of the Study 38
3.4 Sampling and Sampling Techniques 38
3.4.1 Sample Size 38
3.4.2 Sampling Technique 39
3.5 Preliminary Activities 39
3.5.1 Preliminary Visits 39
3.5.2 Training of Research Assistants 40
3.5.3 Informed Consent 40
3.6 Data Collection 40
3.6.1 Questionnaire Administration 40
3.6.2 Anthropometric Measurements 41
3.6.3 Assessment of Academic Performance 43
3.7 Dietary Patterns and Intakes 43
3.7a. 24-hour Dietary Recall 44
3.7b Food Frequency Questionnaire (FFQ) 44
3.7c Weighed Food Intake 44
3.8 Data Analysis 45
3.9 Statistical Analysis 46
CHAPTER 4
RESULTS AND DISCUSSION 48
4.1 Personal Information of the Students 48
4.2 Socio-Economic Status of the Parents of the Students 51
4.3 Food Consumption Patterns of the Students 54
4.4 24-Hour Dietary Recall of the Students 61
4.5 Frequency of Food Consumption by the Students 65
4.6 Dietary Intakes of the Students 75
4.7 Anthropometric Indicators of the Students and their Means 78
4.8 Academic Performance of the Students 84
4.9 Relationship between Anthropometric Status and Breakfast
Consumption among the Students 86
4.10 Relationship between Personal Information of the Students and their academic Performances 89
4.11 Relationship between Food Consumption Patterns and Academic Performance of the Students 92
4.12 Relationship between the Academic Performance and Anthropometric Status of the Students 95
CHAPTER 5
CONCLUSION AND RECOMMENDATIONS 98
5.1: Conclusion 98
5.2: Recommendation 99
REFERENCES 100
APPENDIX: 123
LIST OF TABLES
4.1: Personal information of the students 50
4.2: Socio-economic status of the parents 53
4.3a: Food consumption patterns of the students 57
4.3b: Continuation of Food consumption patterns of the students 60
4.4a: 24-hour dietary recall of the students 62
4.4b: Continuation of 24-hour dietary recall of the students 64
4.5a: Weekly consumption of bread and legume by the students 67
4.5b: Weekly consumption of meat and meat products, milk and milk products, fats and oil and roots and tubers by the students 69
4.5c: Weekly consumption of roots and tubers by the students 71
4.5d: Weekly consumption of fruits and vegetables by the students 74
4.6: Dietary intakes of the students 77
4.7a: Anthropometric indicators of the students 81
4.7b: Anthropometric indicators of the students 83
4.8: Classification of the students according to their academic performance 85
4.9: Relationship between anthropometric status and breakfast consumption among the Students 88
4.10: Relationship between personal information of the students and their academic performances 91
4.11: Relationship between Food Consumption Patterns and Academic Performance of the Students 94
4.12: Relationship between the Academic Performance and Anthropometric Status of the Students 97
CHAPTER 1
INTRODUCTION
Ecker and Nene (2012) quoting UNESCO 2011 states that more than a quarter of children below fifteen years of age in Sub-Saharan Africa are underweight due to poor diet and malnutrition, making them more vulnerable to disease and less able to concentrate at school. Nutrition is a fundamental pillar to human life, health and development through the entire life span (Nicole, 2006). Good nutrition refers to the intake of adequate diet which supplies the essential nutrients to meet the entire body's nutrient requirements (Joshi, 2012). Malnutrition is generally defined as a chronic condition which results as a consequence of over or under-consumption of any of the several essential macro or micronutrients relative to the individual’s physiological and pathological requirements (Ecker and Nene, 2012). Malnutrition is also a dangerous condition that develops when the body does not get enough nutrients to function properly. Poor nutrition can be caused by lack of food or an unbalanced diet that is missing or insufficient in one or more nutrients (Chinyoka and Naidu, 2013).
An undergraduate is a student in a university or college who has not received a first, especially a bachelor's degree. An undergraduate is a college or university student who is not a graduate yet but after high school, he/she will become an undergraduate.
Undergraduates are students of universities and colleges who have graduated from high schools and have been accepted to colleges, but they haven't graduated yet.
University students in every country constitute a large proportion of the total population. The students are usually within the age range of 17-25 years (Fuamatu and Epstein, 2000). Average age is expected to be skewed - while the vast majority of students will be in their late teens and early 20s, older adults also represent a significant portion of the student population. Measures based on median age – that is, the age at which half the students are older and half are younger – therefore provide more reliable indicators of trends in the age composition of students and recent graduates of colleges and universities.
Those who do not consume adequate amounts of key nutrients, including calcium, potassium and vitamin C etc., may be unable to work to their full potential at school (Nabarro et al., 2012). A study by Connell (2010) revealed that 34% of low birth weight children were either repeating grades or placed in special education classrooms while only 14% of normal birth-weight children experienced the same outcomes. Another research also reports elevated levels of grade repetition as a result of low birth weight due to poor nutrition (Bray et al., 2010, Duncan et al., 2008). Knowing more about what nutritional deficiencies can lead to, in terms of learning, will help families to feed their children adequately to succeed in class. This shows that nutrition is of paramount importance in the academic performance of students.
Shrestha and Pathak (2012) as well as Brauw et al, (2012) concur that underfeeding in childhood was thought to hinder mental development solely by producing permanent structural damage to the brain. A child’s brain during the first three years of life is rapidly developing through generation of neurons, synaptogenesis, axonal and dendric growth, and synaptic pruning each of which build upon each other (Orazem et al., 2007). Any interruption in this process, such as trauma, stress, under nutrition, or lack of nutrients can have long-term effects on the brain’s structure and on the child’s socio-emotional development and academic performance. Thus, research has established that poor nutrition in early life can limit long term intellectual development (Lacour and Tissington, 2011). Implicit to the above, people should not be exposed to malnutrition even at an early age for it has detrimental effects to their academic performance and their holistic development (Lacour and Tissington, 2011).
A number of studies in Latin America, Africa and the United States reported that on intelligence tests, people with a history of malnutrition attained lower scores than those of similar social and economic status who were properly nourished (Fanzo, 2012). Thus protein energy malnutrition, iron deficiency, anaemia, Vitamin A deficiency and poverty related conditions decrease resistance to diseases in general. Malnutrition therefore causes illness, brain damage, delayed physical growth, delayed development of motor skills and delayed intellectual development. It is against this background that this study explores the nutrition status and academic performance of undergraduates in Imo State University (IMSU).
Nutritional status is the balance between the intake of nutrients and the expenditure of these in the processes of growth, reproduction, and health maintenance. Because this process is highly complex and quite individualized, nutritional status assessment can be directed at a wide variety of aspects of nutrition (WHO, 2010). The assessment of nutritional status is commonly summarized by the mnemonic "ABCD," which stands for anthropometric measurement, biochemical or laboratory tests, clinical indicators, and dietary assessment (WHO, 2010). Anthropometric measurement involves the use of weight, height; arm circumference and skin fold measurements as indicators for assessment of nutritional status. Biochemical analysis involves quantitative chemical analysis of the blood, urine or other bodily fluids. The analyses are either made for a given nutrient or for some of the metabolites of that nutrient (WHO, 2010). Clinical assessment of an individuals’ nutritional status indicates the level of health in relation to food consumption. Clinical examination is usually made by a doctor or nutritionist (WHO, 2010). The first stage of any nutritional deficiency is identified by dietary assessment methods. Several dietary methods are available including the 24-hour recalls, food records, dietary history and food frequency questionnaire (Kristjansdottir et al., 2006).
1.1 STATEMENT OF PROBLEM
Malnutrition remains one of the major obstacles to human well-being and economic prosperity in developing totalries (Ecker and Nene 2012, Stevens et al., 2012). The most recent report from Save the Children, stated that adults who were malnourished as children earn 20% less in academic performance on average, than those who were not (Save the Children, 2012). Poor nutrition among undergraduates which started during childhood causes them to be reserved in class, lethargic and withdrawal with low self-concept and esteem, suffer illness, brain damage, delayed development of motor skills and intellectual development. They lag behind in academic performance as a result. In agreement, the Integrated Regional Information Networks (IRIN) (2011) report in Chinyoka and Naidu (2013) states that malnutrition and poor health is a large contributor to low retention and poor performance in school. Research participants posit that food insecurity and significant malnutrition levels can have direct effects on a person’s performance and achievement in school and hence on his or her future prospects (Chinyoka and Naidu, 2013).
In a study carried out among under 5 years old in Makurdi state Nigeria, the prevalence of undernutrition was 12.1%, 33.5%, and 54.4% for underweight, wasting, and stunting, respectively. This was similar to a study by Idowu (2013) among mothers and child in rural and urban communities of Lagos state where the prevalence of under-nutrition among mothers was significantly higher in rural than urban communities (10.7% vs. 2.7%). The prevalence of underweight and stunted children were also significantly higher in rural than urban communities (19.4% vs. 9.3%) and (43.3% vs. 12.6%) respectively. According to WHO (2013), about 35% of adults aged 20 and over in Nigeria were overweight in 2008, and 11% were obese. An earlier cross-sectional study in the southwestern part of Nigeria also found obesity to be present in 21.2 % of the subjects (Ojofeitimi et al., 2007) and that of (Kolawole et al., 2011) where the prevalence rate was 21.0 %.
A study conducted in Northern Nigeria reported the prevalence of overweight among females and males to be 29.8% and 9.3%, respectively (Kolawole et al., 2011). Ukegbu et al., (2016) reported that the prevalence of obesity was 33.7% among fresh university students.It was significantly higher than that of students in other levels. Studies among university students in developing countries show high prevalence of overweight and obesity: Africa (Nigeria: 10% (Nwachukwu et al., 2010); Egypt: 25.3%–59.4% (Abolfotouh et al., 2007; Bakre et al., 2002); South Africa: 10.8%–24% (Cilliers et al., 2006; Bodibar et al., 2008); Asia (Bangladesh: 20.8% (Sultana et al., 2011); China: 2.9%–14.3% (Sakamaki et al., 2005; Jingya et al., 2013); Malaysia: 20%–30.1% (; Boo et al., 2010), Thailand: 31% (Banwell et al., 2009), Pakistan: 13%–52.6% (Chaudhry et al., 2012), and India: 11%–37.5% (Seo et al., 2009; Balhara et al.,2012; Bhongir et al., 2011; Pengpid and Peltzer, 2014); Latin America (Colombia: 12.4%–16.7% (Vargas et al., 2008). Due to these problems identified, it is worth carrying out this research with the view to finding solutions to them.
1.2 OBJECTIVES OF THE STUDY
The general objective of this study is to determine the nutritional status and academic performance of undergraduates in Imo State University.
The specific objectives are to:
(i) Determine personal information of the undergraduate and socio-economic status of their parents.
(ii) Determine the nutritional status of the undergraduates using anthropometric measurements and dietary assessment (weighed food intake).
(iii) Determine academic performances of the undergraduates using information obtained from the questionnaire.
(iv) Determine the relationship between age, gender and academic performances of the undergraduates, as well as their food consumption patterns.
(v) Determine the relationship between anthropometric measurement and breakfast consumption among the undergraduates.
1.3 SIGNIFICANCE OF THE STUDY
Information gotten from this study will help to improve the existing knowledge in the field of Human Nutrition and Dietetics and will be a base for further research on the above topic or fill the gap in knowledge in other universities within Nigeria and the entire world.
The study may be handy to food outlets and restaurants on the university campus in order to plan and organize a variety of meal for the students bearing in mind their nutritional needs. Results obtained would be vital to university administration, student union government, student affairs and other organizations involved in student welfare to study the schedules of students in relation to their nutritional and health needs. Information gathered would be used as the foundation for the compilation of recommendations for a nutrition education programme in order to improve students’ food choices. Also, this study will improve students’ eating habits, and reduce the risks caused by poor food choices.
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