NUTRITIONAL STATUS, DIETARY PATTERN AND PREVALENCE OF SOME CHRONIC DISEASES AMONG ADULTS IN BIDA LOCAL GOVERNMENT AREA, NIGER STATE, NIGERIA
Nutritional status, dietary habit and physical activity are recognized as a major determinants of health. The study was conducted to assess the nutritional status, dietary pattern and prevalence of risk factors and chronic diseases among adults in Bida Local Government Area, Niger State. A cross sectional study was conducted among 210 adults between the ages of 18-65 years. The study population comprised of 111 (52.91%) female and 99 (47.1%) male. Food frequency questionnaire (FFQ) was used to collect data on dietary habits of the respondents. Data was analyzed using IBM SPPS version 20. BMI showed that 38 (18.1%) of the respondents within the age 30-39 years were overweight while 72% of the respondents are having a waste circumference that is above the normal range. High prevalence of unhealthy eating habits was recorded among the respondents. About 52%, 44% and 40% consumed milk and dairy products, egg and confectionary (snacks) respectively thrice weekly while fruits (25.7%) and vegetables (14.3%) consumption at least 7 times in a week was low. Tobacco use among the respondents between the ages to 30-39 years was 47.5% which indicates a high level of its use. Physical activities of the respondents was very low because about 97% reported having a normal sedentary leisure time. Blood glucose level (36.7%) was high among the respondents about 48% of the respondents are having an elevated blood pressure while total cholesterol, HDL and LDL, of the respondents was normal. The study demonstrated a high prevalence of unhealthy eating habit and life style changes. Several risk factors may be contributing to it such as, nutritional transition, low intake of fruits and vegetables, urbanization, physical nutrition and health awareness. Intervention programme by health professionals are needed to reverse the trend particularly with special focus on promotion of healthy eating and physical activity.
1.1 Background Introduction
The major cause of mortality in developed and developing countries of the world are diseases in which nutritional lifestyle plays an important role. The choices of what people eat are determined by various factors such as religions, customs and socio-economic differences (Shehu et al., 2011). The environments affect individual‘s lifestyle. Changing these factors in the direction of nutritional lifestyle patterns could postpone the age of onset of permanent mobidity, disability, disease occurrences and death and could have a major effect on quality of life (Waijers et al., 2006). Nutrition as the science of food and its relationship to health has been recognized in recent years as the cornerstone of socioeconomic development (Parks, 2009). Adequate nutrition is important for a variety of reasons, including optimal cardiovascular function, muscle strength, respiratory ventilation, protection from infection, wound healing and psychological well-being (Martin, 2006). Adequate nutrition entails a diet that contains the constituents (carbohydrate, fats, proteins, vitamins and minerals) that are required for body building, energy supply, body defense and regulatory functions in quantities commensurate with the body need. Malnutrition refers to either inadequate intake of nutrients due to lack of food, ignorance, socio cultural factors, and diseases among other causes, resulting in underweight and other nutrient deficiency diseases; or intake of nutrients in excess of body requirements due to poor dietary habit (erroneously perceived as a sign of affluence), resulting in overweight and obesity.
Poor diet (high consumption of sugar, salt, saturated fat, etc) and unhealthy lifestyle (smoking, alcohol consumption and physical inactivity) have been identified as major risk factors of cardiovascular disease and other non-communicable diseases (NCDs)
According to the World Health Organization (WHO) estimates, 36 million, out of the 57 million deaths (almost two thirds) that occurred globally in 2008 were due to non-communicable diseases (NCDs), comprising mainly cardiovascular diseases, cancers, diabetes mellitus and chronic lung diseases (WHO, 2009).
Rural population depends on available natural foods like green vegetables, fresh fruits and dairy products in their immediate environment. Although, significant amount of refined foods could also be noticeable in the rural areas such as bread, soft drinks and other refined or processed food products. Rural people have a high physical activity related energy expenditure compared to urban subjects (Lestra et al., 2005).
Food choice is an important determinant of people quality of life. Poor or unbalanced diets as in the case of excessive eating and undernutrition, are risk factors for several chronic diseases (Haveman et al., 2003). Poor food intake reduces the level of nutrients in the body thereby exposing the individual to nutritional health related problems (Haveman et al., 2003). The choice of good nutrition is not only important in preventing health problems and promoting active living, but it is a critical part of managing diseases among those who are infected or sick (Haveman et al., 2003) .
As has been reported for several developing countries (Delisle, 2010), West Africa has also undergone periods of changes in dietary habits and shifts in eating patterns in response to socio-economic and socio-political factors. Increasing urbanization and large movements of populations to urban centres with reduced access to traditional and indigenous food resources also exacerbated the nutrition transition phenomenon (Albala et al., 2002). This reduced access to indigenous food resources has resulted in the replacement in diets of the hitherto diversified food resources by energy dense and nutrient poor convenience foods.
Nupe people are Nupoid-speaking people living near the confluence of the Niger and Kaduna rivers in west-central Nigeria. The Nupe people live in the heart of Nigeria, spread over the low basin formed by the two rivers, Niger and Kaduna (Usman, 2002). Nupe land is made up of an agrarian population, where the economy and social life revolve round agriculture and the people are active farmers. Major crops grown are rice, sorghum, sugar cane, millet, melon, vegetables, yam, homestead livestock management and fishing. Cassava, maize, and sweet potatoes (grown inland) are of secondary importance (Yahaya, 2003).
The Nupe are found in Gbako, Lavun, Bida, Bia and Agai local government area of Niger State (Yahaya, 2003). A major staple food that is common to many households in Nupe land is rice. Other common foods are porridge from millet, sorghum or maize called ―Kunu‖ (Yahaya, 2003). This is consumed along with certain snacks like akara (bean cake), ―masa‖ sorghum cake, ―mashe‖ (early millet cake) or ―Dakuwa‖ special confectionery from a combination of fried ground nut and maize and lastly Kuli-Kuli made from groundnut after extraction of the oil (Yahaya, 2003).
Chronic diseases, often referred to as non-communicable diseases (NCDs), usually emerge in middle age after long exposure to an unhealthy lifestyle involving tobacco use, a lack of regular physical activity, and consumption of diets rich in highly saturated fats, sugars, and salt, typified by “refined foods. Nutrition and nutritional qualities of food are widely considered to be crucial for health and well-being of the humans (Levy-Costa et al., 2005). The well documented evidences from epidemiological studies indicate several diseases (Nikoo et al., 2010), such as cardiovascular diseases and some types of cancers are linked with diet and nutrition uptake and its regulations. All these diet-related diseases are likely to change in eating habits, processing technologies, and products (Shils, 2005).
Obesity has occurred in parallel with the globalization of food systems and the expansion of trade and foreign direct investment. Intake of excessive refined foods has been connected to most major health issues including: osteoporosis, cancer, hypoglycemia, cardiovascular disease, adrenal exhaustion, metabolic, endocrine, and reproductive disorders, parasitic and yeast infections. Increased consumption of refined food with less activity leads to an increased incidence of obesity and diet-related diseases like diabetes, coronary heart disease (CHD) and certain types of cancer (Shetty, 2002).
The change in lifestyle has brought about a dramatic nutrition transition characterized by a decrease in the consumption of traditional foods and an increasing reliance on refined foods (Mead et al., 2010; Sharma et al., 2010). There is significant and valid concern for the health implications of consuming increased amounts of these fat- and sugar-rich foods (Kuhnlein et al., 2004)
Traditional foods are those eaten by people over the longer course of civilization and which have supported health – cultivated, produced, and harvested from the earth and out of nature
– foods which are wholly unaltered and organic, and contain the highest levels of nutrition or are nutrient-dense (Umeh, 2007). Traditional foods by their very nature contain the highest levels of nutrition available because they are grown with sustainable methods which increase nutrient content and without chemicals and other harmful substances which have been found to diminish nutritional value (Umeh, 2007).
Lifestyle diseases are diseases that appear to increase in frequency as countries become more industrialized (Mercola, 2014). Lifestyle diseases share risk factors similar to prolonged exposure to three main modifiable lifestyle behaviors–smoking, unhealthy diet (including alcohol abuse), and physical inactivity can result in the development of non-communicable and chronic diseases, substantially degenerative diseases (heart disease, stroke, diabetes, obesity, metabolic syndrome, chronic obstructive pulmonary disease, and some types of cancer), that can actually be considered consequence of “contagious” behaviors. These conditions imply loss of independence, years of disability, or death, and impose a considerable economic burden on health services (Mercola, 2014).
NUTRITIONAL STATUS, DIETARY PATTERN AND PREVALENCE OF SOME CHRONIC DISEASES AMONG ADULTS IN BIDA LOCAL GOVERNMENT AREA, NIGER STATE, NIGERIA
1.1 Statement of Research Problem
The current burden of chronic disease reflects the cumulative effects of unhealthy lifestyles and the resulting risk factors over the life span of people. Three decades ago, the food available was mostly fresh and grown locally (Marcola, 2014). The majority of foods served, whether at home, in school or in restaurants, are highly refined foods, filled with sugars, harmful processed fats, and chemical additives (Marcola, 2014). Trends in food availability in households in the last three decades reveal that diverse traditional foods have been replaced by industrialized convenience foods (Levy-Costa et al., 2005).
Obesity is a worldwide phenomenon that has reached both developed and developing countries. The increasing prevalence of obesity and other cardiovascular risk factors (Batsis et al.,2007) have been partially attributed to changing nutritional habits and reduced level of regular physical activity. The obesity epidemic is also influenced by social network phenomena characterized by behavioural person-to-person interaction (Christakis and Fowler, 2007). Refined food consumption, defined as inexpensive food, sold by means of self-service systems or carry-out eating locales without waiter services has been implicated as a potential reason for the epidemic (Rosenheck,2008). The rapidly increasing burden of chronic diseases is a key determinant of global public health. Already 79% of deaths attributable to chronic diseases are occurring in developing countries, predominantly in middle-aged men (Barker, 2000). There is increasing evidence that chronic disease risks begin in fetal life and continue into old age (WHO, 2002). Adult chronic disease, therefore, reflects cumulative differential lifetime exposures to damaging physical and social environments.
Closely linked to refined food is another version of out-of-home food consumption termed Street Food (SF). This entity has old, historical roots with complex social-economic and cultural implications (Parente, 2010). Street food is present even in less developed countries, and has occasionally been considered to be the hallmark of the early development of fast food (Winarno and Allain, 2014). It is quickly available and consumed, and generally affordable to large parts of the population.
The primary role of diet is to provide sufficient nutrients to meet the nutritional requirements of an individual. There is now increasing scientific evidence to support the hypothesis that some foods and food components have beneficial physiological and psychological effects over and above the provision of the basic nutrients (WHO, 2013). Many traditional food products including fruits, vegetables, soya, whole grains and milk have been found to contain components with potential health benefits (Ene-Obong, 2001).
Traditional foods consumed by people over a long period of time, play an important role in establishing local identity, culture, and custom, and they transfer cultural heritage from generation to generation (Albayrak and Gunes, 2010; Inamdar, et al., 2005). During the past two decades, several researchers have claimed that traditional foods are healthier products and good sources of micronutrients. Therefore, there is an ardent need to study the dietary patterns of local people and also assess their health status as this will be useful in policy planning and understanding trends to reduce most diseases of affluences.
1.3 Aim and Objectives
The general aim of this study is to assess the nutritional status, dietary pattern, prevalence of chronic diseases (obesity and blood pressure) and risks factors among adults in Bida Local Government Area, Niger State.
The specific objectives are to:
- Assess the anthropometric parameters (BMI, waist circumference) of adult in Bida Local Government Area of Niger State.
- Assess the dietary pattern among adult in Bida Local Government Area, Niger State.
- Determine the prevalence of chronic diseases (Medical History and On-Point measurement of Blood pressure and obesity) and risks factors (blood sugar level and lipid profile) among adults in Bida Local Government Area, Niger State.
- Assess the level of physical activities among adult in Bida Local Government Area, Niger State.