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ASSOCIATION BETWEEN EATING HABITS AND BODY MASS INDEX AMONG ADOLESCENTS IN SELECTED SECONDARY SCHOOLS,EBONYI STATE.
Background to the study
Obesity is the condition in which excess fat accumulates in the body, mostly in the subcutaneous tissues; clinically, obesity is considered when the body mass index is 30kg/m2and above for adults above 20 years (Matin, 2007) and 95 percentile and above for adolescents 11 – 19 years (WHO 2009). Obesity is from the Latin word “obsesitas” meaning “stout or plump”. The Oxford English Dictionary documented its first usage in 1611 by Randle Cotgrave and during the middle-ages and renaissance; obesity was often seen as a sign of affluence and was relatively common among the elites ((Woodhouse 2008)). From most of human history, mankind struggled with food scarcity and for that reason; obesity has been historically viewed as a sign of wealth and prosperity.
The Greeks were the first to recognize obesity as a medical disorder; Hippocrates wrote that “corpulence” is not only a disease itself but harbinger of others (Woodhouse, 2008). In United States of America, 300,000 deaths are caused by obesity annually, 6 million adults are morbidly obese (BM1 above 40) while 9.6 million have a body mass index of 35-40 (WHO 2009).
In 1996, the World Health Organization states that more than one third of African women and a quarter of African men are estimated to be overweight and predicted that it will rise to 41% and 30% respectively in 2016 (Sharma 2007). Although data from Nigeria is scarce, conservative estimates suggest that as many as 250,000 people are obese (Sharma, 2007). Once considered a problem only in high income countries, overweight and obesity are now dramatically on the increase in low income and middle income countries particularly in urban settings.
Body mass index is a measure of a person’s weight based on the individual’s body weight divided by the square of his or her height; it is the most widely used tool to identify weight problem within a population (WHO 2009). Although a number of factors are implicated in the cause of obesity, the root cause is eating habit – over consumption of calories more than the body’s energy needs (Ajala, 2006). Age is a very important factor in diet and nutrition. Energy and nutrient needs are determined by basal metabolic rate, activity, body size and growth. Adolescents are noted for their voracious appetites (especially boys). Many adolescents eat food that are calorie– rich but have little nutrient value especially when they are away from home (Ajala, 2009). Students who share an off campus apartment do not plan their meals (Ajala, 2009). They may not have enough time or money to shop and prepare nourishing meals, instead they make up with junk foods and snacks. These habits have a deleterious effect on their health, physical condition and even their grades in school, if not addressed (Sharma, 2007).
Teens often get one third of their energy and nutrients from snacks. Their reasons for snacking include opportunities to get out and socialize with friends, accessibility, hunger and celebration of special events (Ajala, 2009). The snacks frequently taken include potatoes and corn chips, cookies, candies, meat pies, biscuits and ice creams. The snacks are always taken with soft drinks all of which have high calorie value, which when taken in excess can have harmful effect on the body (Ajala, 2006). Overcrowding the diet with sweat treats can leave little room for important nutrient – dense foods, such as proteins, fruits and vegetables (Ajala, 2006).
According to Sharma (2007) snacks, soft drinks and beverages supply mostly simple sugars which are easily absorbed in the digestive tract; for instance, glucose and galactose undergo active absorption process. He further states that the simple sugar in the absorptive cells is then transported to the liver through the portal vein. After necessary transformation, they are released into the blood stream for transportation to organs like the brain, muscles, kidney and adipose tissue. Some of the glucose that cannot be used immediately is stored as glycogen in the liver and muscles and fat in the adipose tissue. Excessive accumulation of this fat resulting from over consumption of snacks, soft drinks and beverages is termed obesity (Sharma, 2007).
Complications of obesity can affect the cardiovascular system, endocrine system, reproductive system, integumentary system, nervous system respiratory system, urinary system, musculo-skeletal system among others (WHO, 2009). Apart from affecting all the systems, the social, economic, psychological and other pathological or public health impacts cannot be over emphasized. Teens can obtain many nutrients from snacking, beverages and even quick-service restaurants if good choices are made and eating habit is moderated(Sharma, 2007). Poor dietary habits formed during teenage years often continue into adulthood giving rise to the problems mentioned earlier. Getting this message across to the teenagers early enough is an important task for both parents and health professionals, considering the numerous health implications involved (Sharma, 2007).
This research work is therefore aimed at investigating the association between eating habits and body mass index among adolescents in Secondary Schools in Abakaliki, Ebonyi State in order to advise the adolescents appropriately based on the findings.
Statement of Problem
Adolescence is the only period following infancy when the rate of physical growth spurt is high and sudden (Ajala, 2006). This sudden growth spurt is associated with hormonal, cognitive, and emotional changes that make adolescence an especially vulnerable period of life. Sharma (2007) explains that there is a greater demand for calories and nutrients due to the dramatic increase in physical growth and development over a relatively short period of time. Secondly, adolescence is a time of changing lifestyles and food habit-changes that affect both nutrient needs and intake. Thirdly, the adolescents’ drive for individuation means more opportunity to assert food choices and expand or narrow healthy options (Ajala, 2006).
Adolescents of both sexes and in all income and racial/ethnic groups are at risk for dietary excesses and deficiencies (Califonia Nutrition Association, 2012). Some nutrition-related concerns for adolescents include overconsumption of sugar-sweetened beverages (SSBs), iron-deficiency anaemia, inadequate calcium intake, unsafe weight-loss methods and eating disorders. Overweight and obesity in children and adolescents are generally caused by poor eating habits and physical inactivity or a combination of the two.
As teens become more independent in their food choices, they tend to make the wrong choices – even teens that were brought up eating healthy. According to the American Dietetic Association (2012), the worst food habits teens have are as discussed below:
Skipping breakfast: Thisis a major bad food habit that teenagers have; according to the American Dietetic Association (2012), more than half of male teens and more than two-thirds of female teens do not eat breakfast on a regular basis. Breakfast is the most important meal of the day. Eating breakfast can upstart the teen’s metabolism, which helps with weight control, mood and school performance.
Increased eating outside of the home: Teens hit the fast food restaurants much more often than they did when they were younger. This tends to be as a result of schools’ sports and work schedules overlapping regular meal times. There is an increase in soft drink consumption among the adolescents. This is also in accordance with the researcher’s observation.
From the researcher’s casual observations, there is an increase in the number of provision stores around the schools in Abakaliki metropolis with high patronage by parents and students in the morning and afternoon buying sweetened snacks. There is also an increase in the number of yoghurt and ice cream vendors around the schools with high patronage by the same customers. The schools in addition, frequently invite representatives of Mr. Biggs, Crunches and City chef fast food restaurants to supply fast food to the students on the financial account of their parents. Many parents do not prepare breakfasts or lunches for their children since they can always get something for them around the school. Most of the students stay late in school to participate in the school extra lessons and this increases the patronage of snacks, yoghurts and ice cream vendors by the students. Some of the students, especially those that patronize the vendors of the food items mentioned before, look obese and bulky while others are slim. The researcher from this casual observation wonders if there is a relationship between eating habits and body mass index in adolescents and this is what motivated the researcher to go into the study. The researcher feels that planned observation, anthropometric measurements of the research participants and the use of appropriate analytical tools as shall be discussed later, will help in addressing this research problem.
Purpose of the study
The purpose of the study is to determine the association between eating habits and body mass index among adolescents in Secondary Schools in Abakaliki.
Specifically, the objectives of this study include to:
- Identify the adolescents’ eating habits in the schools under study.
- Identify the factors influencing their eating habits
- Determine the anthropometric measurements of the respondents.
- Establish the relationship between their eating habits and their body mass index.
The hypothesis is as stated below:
H0: There is a significant relationship between eating habits and body mass index of the adolescents.
Ha: There is no significant relationship between eating habits and body mass index of adolescents.
Significance of the study
The findings will be used to educate the adolescents and parents on the association between eating habits and the risk for obesity which will invariably minimize the chances of obesity related diseases. It will act as a guide to health professionals on the areas of emphasis in health educating parents and adolescents concerning healthy eating habits.
The result will motivate more research work in the field. Moreover, it will bring about behaviour change as it concerns adolescents’ eating habits because the findings will be a good behaviour change resource for both nutritionists and school health programmes. The findings will also help the government and school authority in policy formulation regarding school meals. Academically, this research work findings will add to the existing body of knowledge generated by other researchers in related fields.
Scope of the study
The area of focus is the association between eating habit and body mass index among the adolescents in the schools under study. The adolescents’, anthropometric measurements, eating habits and factors influencing their nutrition habits are all within the scope of the study. The scope of the study is all the adolescents in the selected Secondary Schools in Abakaliki, Ebonyi State which include Holy Ghost Foundation Secondary School Abakaliki, Adventure International Secondary School, Abakaliki, Urban Model Comprehensive Secondary School Abakaliki and Government Technical School, Abakaliki.
Operational Definition of Terms
The following terms were operationalized in this research work.
- Association between eating habits and body mass index among adolescents: This refers to whether eating habits increases or decreases body mass index among adolescents under study.
- Body mass index (BMI): This is a measure of body weight based on a person’s weight in kilogram and height in metres squared which is used to determine whether one is obese or not. For the categorization, see the appendix.
- Eating habits: means the regularity or frequency of eating a particular food item. It may be once daily, twice daily, thrice daily or more. It also includes the way various food items of different classes or nutrient source are combined in a particular meal or alternated in the food menu.
- Adolescents: For the purpose of this research, an adolescent is a male or female between the age of 11 and 19. It begins with puberty and ends with adulthood.
- Factors influencing eating habit: refer to family upbringing, peer pressure, taste, time, economic status, and availability of food item, which may guide the decision on the frequency, regularity and combination of various classes of food in a particular meal by adolescents.
- Anthropometric measurement: This includes the weight in kilogrammes, height in metres and body mass index calculated using the weight in kilogrammes and square of height in metres of the adolescents. The weight and height are measured with bathroom weighing scale and metre rule respectively.