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Year : 2018 | Volume : 6 | Issue : 2 | Page : 65 - 69  


Original Articles
An interventional study about food habits of school going adolescents at Guttigar PHC of Karnataka

Shruthi Narayan Bhat (Shruthi Sagar Borker)1, Sagar Borker2*

1Senior resident in Anatomy, University College of Medical sciences, New Delhi 110001

2* Assistant Professor of PSM, RML Hospital, New Delhi 110001

*Corresponding Author

Email: sagarborker@gmail.com

Abstract:

Background: Adolescence represents an important stage for the development of healthy nutrition behaviors. Inadequate diet during adolescence period can result in decreased learning ability, delayed sexual maturity, iron deficiency anemia, lack of concentration, impaired school performance and slow growth.

Objectives: 1. To study the nutritional status of rural adolescents. 2. To educate the general public regarding commonest illness causing malnutrition and some habits like (smoking, alcohol, chewing tobacco) causing malnutrition.

Methods: The study sample of about 100 adolescents, between the ages 12-18 years of both the sexes were selected randomly for the study which was conducted in the rural primary health care centre Guttigar, Sullia Taluk of Dakshina Kannada district, Karnataka in the month of April -June 2014 when come to PHC as OPD attendant, patients attendant and some surrounding locality adolescents. The study variables include bio-data and food habit questionnaires.

Results: From the results, by using Wilcoxon test it was found that there was a significant association was found between before and after intervention scores (p<0.001).

Conclusion: The showed a good improvement in the food habit of adolescents after intervention. Therefore conducting nutrition education will help to improve the food habit as well as nutritional status of the study subjects.

Key words: Adolescents, food habits, intervention-rural area

Introduction:

The adolescence is marked by special attributes in life. These include rapid physical growth and development, physical, social and psychological maturity. Adolescents are overlooked in most health programmers as they are basically considered healthy populations but the scenario varies. The nutritional demands associated with the rapid physical and cognitive development and maturation are substantial. 1 Nutrition is usually taken as a significant indicator of health and overall status of adolescents. Additionally unsuitable food habits increase obesity/overweight and the risk of incidence of diet related chronic diseases among adolescents. 2 Adequate nutrition is practically critical for adolescents as it is a primary development of spurt of growth that characterizes adolescents. 3

Diet and health are the synonymous with wellbeing of an individual. In absence of proper nutrition, a person can develop several developmental malformations. Many studies have documented that malnutrition affects body growth and development especially during crucial period of adolescence. 4

Nutrition research in India has focused primarily on the problem of under nutrition, particularly among vulnerable women and children. There is some evidence of emerging nutrition transition in India. The rising urbanization and improvement in economic development has lead to the demographic and epidemiological transition. Large shifts have occurred in diet and in physical activity pattern, particularly in last decade. 3

Therefore to know the food habits of adolescents in the rural area this study was conducted in the primary health centre Guttigar, Karnataka State. So the current study was conducted to know the food habits of rural adolescents and to educate the general public regarding commonest illness causing malnutrition and some habits like (smoking, alcohol, chewing tobacco) causing malnutrition.

Methods:

This study was carried out in the month of April - June 2014 in the rural primary health centre Guttigar, Sullia Taluk of Dakshina Kannada district. A prior permission was obtained from the medical officer of the Primary health centre for the conduction of the study. About 100 adolescents, between the ages 12-18 years of both the sexes were selected randomly when come to PHC as OPD attendant, patients attendant and some surrounding locality adolescents were taken for the study. The study sample included Adolescents between the ages 12-18 years of both the sexes, Are available during the study, their residence in the village, those willing, to be examined

The following were excluded from the study.

  1. Subjects above 19 years and below 11,
  2. Those not willing to be examined.

The data was collected by personal interview of each adolescent. The study variables include bio-data and food habits questionnaires. The collected bio-data includes socio-demographic characters like age, sex, school (studying/completed), religion, economic status, marital status, caste.

After collecting the bio-data, anthropometric data from subjects individually and some food habit questionnaires including questions regarding breakfast, boiled drinking water, use of alcohol, tobacco smoking. Junk foods like soft drinks, chips, magi noodles, and chocolates, biscuits, and fruits uncooked vegetables etc were asked to the each subject separately and explained each question in a local language and their response were collected in the questionnaire sheet itself as YES and NO respectively.

Once the answer is collected, then after seeing their results tried to educate them and to create awareness among themselves about the importance of food and healthy eating habits which in turn help to prevent malnutrition Then again after a month later (June 2014) same food habits questionnaires were asked to the same subject individually their response were collected in the questionnaire sheet itself as YES and NO respectively. Data generated, was entered and analyzed using SPSS software. By using Wilcoxsons test, the collected results were compared with the previous results to see any improvement or changes in their food habits.

Results:

The sample size comprised of 100 adolescents, females are higher in number than males. There are more than 3/4th are Hindus i.e., 93% and only one Christian boy is found. All the subjects are unmarried. The majority of them with low income group of about 68%. The caste category of the studied samples includes- GM - Brahmin, I - Maniyani, IIA- Poojari, Malayali, Devadiga, IIB - Muslim, IIIA - Gowda, Hegdae, IIIB - Christian, Lingayath, Bants, Marathi respectively. (Table 1)

By using Wilcoxon test it was found that there was a significant association was found between before and after intervention scores. (P < 0.001) (Table 3)

Discussion:

The present study shows only 75% of them took stomach full of breakfast before intervention. Similar data have been obtained in other studies, according to which breakfast skipping is highly prevalent in the United States and Europe (10% to 30%) [Rampersaud et al 2005]. 5 The various reasons were given by the subjects who skip meals or dont eat properly says that they may not feel hungry or some get up late in the morning so it is difficult to have stomach full because they should walk many kilometers to school. Ahmed et al (2010) finds that 79.51% of them take regular breakfast. 6 It is very important since it has been proven that eating the first meal of the day may improve cognitive functions related to memory, school grades, and school attendance [Rampersaud et al 2005]. 5 But in the present study 100% improvement is found in eating stomach full of breakfast after intervention.

Eating something within the first half an hour of getting up from bed is very essential because of rapid BMR weight loss may takes place. Before intervention it shows 57% of them practiced this habit but afterwards it is increased only to 58% in the present studied sample. Boiling water is very essential in destroying several classes of waterborne pathogens like bacterial spores, fungi, and protozoan and helminthes ova. Drinking boiling water also shows increased blood circulation. 7 In the present study 80% of them drinks boiled water and after intervention it is raised to 96%. About 20% of them before use to drink cold water and they say that boiled water doesnt tastes well. Which may be due to during heating process the water tastes flat because of removal of carbon dioxide. 7 Good hand washing is the first line defense against the spread of much illness from the common cold to more serious infections such as meningitis, bronchitis, the flu, hepatitis A, most type of infectious diarrhea and other GIT infections. 8 In the present study shows better improvement in hand washing after intervention of about 94%.

Junk foods are usually low in nutrients and high in salt, sugar and fat. But in the present study about 76% of them eat chips/soft drinks and about 33% of them eat magi noodles and after intervention it is reduced to 32%. And about 98% of them eat chocolates. Even though they eat junk foods, but the quantity is very less, only a small chocolate or sharing of junk foods with their elders or youngers makes the quantity very less. 9 Ahmed et al reported that consumption of junk food is quite higher of about 95.4% consumed this regularly. 6 Recent study on junk foods mainly magi has proved and is banned due to the presence of high amount of monosodium glutamate and lead, which is very dangerous to health. Therefore further research should focus on consumption of these foods and it should be stopped.

Some fruits and vegetable photochemical have antioxidants and anti inflammatory effects. Antioxidants help to prevent damaging reactions within the human body and have a beneficial effect upon health. By reducing free radical damage and inflammation it can lower blood pressure, reduce risk of heart disease and stroke, prevent some types of cancer, lower risk of eye and digestive problems, and have a positive effect upon blood sugar which can help keep appetite in check. 10 The vegetables should be eaten at least 5-6 times/day and fruits about 4-5 times/day (WHO 1993). 6 In the present study before intervention fruits and vegetables eaten are 56% and 68%. And later after intervention it is increased to 97% and 89% respectively.

Chewing food before swallowing helps to maintain the structural integrity of the oro-facial tissues. It also stimulates salivary flow and hence allows the food to be mixed and lubricated which makes swallowing easier and help in easy digestion and absorption. In present study all the subjects were started to chew the food properly after intervention. 11 Drinking lots of liquid during meals dilute gastric juice and slow down digestion. But drinking water up to 20-30 before and after meals can avoid dehydration. In the present study 94% of them avoid drinking too much of water during after intervention. The gap of at least 3 hours between meals taken and sleep which helps in easy digestion. The present findings show that about 24% of them before intervention and 38% of them take < 2 hrs time for sleeping after food. Chewing tobacco, alcohol and smoking leads to dangerous diseases in later life and leads to malnutrition etc were found only 1 boy who chews tobacco for 2-3/week but after intervention he stopped it completely. And no one is found drinking alcohol and smoking.

It was found from the present study that before intervention 4% of them showing not adequate knowledge, 31% shows moderate knowledge, 49% of them shows good knowledge, 16% of them shows very good knowledge regarding food habits respectively. Then after intervention there is a tremendous improvement is observed in their food habits. i. e. about 56% of them shows very good knowledge, only 7% shows moderate knowledge, 37% of them show good knowledge towards food habits. Similarly Citozi (2013) finds that about half of the subjects (49.9%) have good nutritional knowledge (most females), but 42.2% of the students (most males) have insufficient nutritional knowledge. Only 7.9% of the sample has quite good nutritional knowledge (higher among females). 12

Now government has started Mid day meal programs and ksheera bhagya yojana for primary and high school children, which helps in getting full attendance in school and to improve the nutritional status as well as hunger of many poor class children.

The present study was based on self reported questionnaires. This can be seen as the limitation of the study and other limitations is the sample size, duration of the study etc.

Conclusion:

Even though the studies shows lots of improvement after intervention programme but also more attention need to be given to the eating junk foods like magi and it should be stopped completely by giving further intervention program and eating within half an hour of getting from bed and regarding eating fruits and vegetables. Even though there is an improvement but also they eat most commonly once in a week etc. So it should be raised up to 4-5 days as per WHO.

Finally from this study it can be concluded that dietary habits of adolescents can still be improved by giving subsequent health education and intervention program in PHC, Schools and Colleges as well as through mass media to convey the basic necessity of adopting healthy practices and also giving better nutritional informations in all the food products will help adolescents to choose nutritious food for healthy life.

References:

  1. McNaughton SA, Ball K, Mishra GD, Crawford DA. Dietary patterns of adolescents and risk of obesity and hypertension. J Nutr Epidemiol 2008;21:364-70.
  2. Montazerifar F, Karajibani M, Dashipour RA. Evaluation of dietary Intake and Food Patterns of Adolescent Girls in Sistan and Baluchistan Province, Iran. Functional Foods Health Dis 2012;2(3):62-71.
  3. Iyer UM, Bhoite RM, Roy S. An exploratory study on the Nutritional Status and determinants of malnutrition of urban and rural of Adolescent children (12-16) years of Vadodara city. Int J Applied Biol Pharmaceutical Technol 2011;2(1):102-7.
  4. Dhingra R. An Assessment of Health Status of Adolescent Gujjar Tribal Girls of Jammu District. Stud Tribes Tribal 2011;9(2):133-8.
  5. Przys┼éawsk J, Stelmach M, Grygiel-G rniak B, Mardas M, Walkowiak J. Dietary Habits and Nutritional Status of Female Adolescents from the Great Poland Region. Pol J Food Nutr Sci 2011;61(1):73–8.
  6. Ahmad H, Liaqat P, Paracha PI, Qayyam A. Assessment of nutritional status of adolescents versus eating practices in Islamabad City. Pak J Nutr 2009;8(8):1304-8.
  7. The advantages of boiling water before drinking it. Available from: http://ezinoarticles.com/?expert=crisologo-ramasasa
  8. http://www.betterhealth.nic.gov.au/bhcv2/bhcarticles.nsf/pages/handwashing_why_its_important
  9. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/food_to_have_sometimes?open
  10. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vegetables-and-fruits
  11. http://www.answers.com/Q/What_is_the_advantage_of_chewing_food_rather_than_swallowing_it_whole
  12. Citozi R, Bozo D, Pano G. An assessment of the perception of physical activity, eating habits, self-efficacy and the knowledge about healthy food in Albanian adolescents. J Hum Sport Exerc 2013;8 Proc 2; S192-S203.

Table 1: Demographic characteristics of study population

Age group

 

Number

Percentage

12-14Y

66

66.0%

15-16Y

19

19.0%

17-18Y

15

15.0%

Sex

Males

42

42.0%

females

58

58.0%

School(standard studying or completed)

High school

93

93.0%

College

7

7.0%

Religion

Hindu

90

90.0%

Muslim

9

9.0%

Christian

1

1.0%

Economic status

APL

32

32.0%

BPL

68

68.0%

Marital status

Unmarried

100

100.0%

Married

0

0%

Caste

GM

3

3.0%

I

1

1.0%

IIA

7

7.0%

IIB

9

9.0%

IIIA

47

47.0%

IIIB

16

16.0%

SC/ST

17

17.0%

Table 2: Response of adolescents towards food habits

Questions

Correct practice before intervention

Correct practice after intervention

eating within the first half an hour of getting up from bed

57

58

Eating stomach full of breakfast

75

100

Doesnt feel hungry before the interval time in school

82

91

Taking food from the house to eat during the interval time

1

0

If yes, subjects feel hungry till they eat lunch

1

0

Taking filtered or boiled water to school

80

96

Washing hands before meals in school

96

96

Doesnt drink soft drinks or eat chips

24

24

Doesnt eat magi noodles

67

68

Doesnt eat chocolates

2

2

Doesnt eat biscuits

11

10

Proper chewing food l before swallowing

97

100

Doesnt drink lots of water during meals

62

94

Eating fruits

68

89

Eating fresh uncooked vegetables

56

97

Average time taken to go to bed after food

  1. Immediately - 5
  2. few minutes to < 2 hours - 62
  3. few minutes to < 2 hours - 71
  4. > 2 hours - 24
  5. > 2 hours - 38
 
 
   

Average time duration between meals

> 4 hours

> 4 hours

Doesnt chew tobacco

99

100

Doesnt drink alcohol

100

100

Doesnt smoke

100

100

Figure1: showing Knowledge of Adolescents regarding food habits

Table 3: Wilcoxon Test

 

After intervention - Before intervention

Z

-7.834

Asymptomatic Sig. (2-tailed)

.000

 





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