ABSTRACT
Changes in the nutrient intake combined with increasing sedentary life style and urbanization
contribute to the emergence of chronic disease as a major health risk. This study assessed nutritional
status, physical activity, dietary pattern and micronutrient status of adolescents attending Secondary
School in Jos South Local Government Area (LGA) of Plateau State. A cross-sectional study was
conducted using 588 adolescents attending Private and Public Secondary Schools of Jos South LGA
between September and December 2014. Data on demographic characteristics were collected using
semi-structured, pretested questionnaires. Measurements of weight and height were made using
standardized weighing scales and standiometer respectively. Adolescent Body Mass Index-for-Age
was compared with WHO (2007) growth reference. Dietary pattern and micronutrient status were
accessed using standard methods. Results obtained showed mean Age, BMI and Waist/ Hip ratio
were 16.09 years, 21.05±2.65 and 0.81±0.06 respectively. General prevalence of Overweight was
high (11.22 %), particularly among the Private Secondary School girls (19.01%). Majority of the
adolescents (57.99 %) had a fairly low Physical Activity Level and Private Secondary School boys
showed the highest frequency (64.23%). Dietary pattern of the adolescents showed weekly intake of
all types of food from “4 to 6 times” to “7 or more times” below 50 percent, except for bread,
cereals, tubers and other carbohydrate based foods. Mean PCV, serum iron, zinc and copper for the
Private Secondary School Adolescents were 38.71 percent, 96.15µg /dl, 86.31µg /dl and 84.44 µg /dl
respectively. A percentage of 9.68 %, 16.13 % and 19.35 % adolescents recorded low values for
serum iron, zinc and copper respectively when compared to reference ranges for iron, zinc and
copper. The results obtained showed a prevalence of overweight and a fairly low physical activity
particularly among the Girls. Consumption of cereals, tubers, pasta and other carbohydrate based
foods was high while mean serum values for Iron, Zinc and Copper for the Private Secondary School
adolescents were within the normal ranges. Results of this study emphasize the need for educational
interventions which should include increased exercise and Physical Activity at early ages involving
the whole family that will promote optimal nutritional status and wellbeing.
TABLE OF CONTENTS
Title page …………………………………………………………………………………i
Certification Page ……………………………………………………………………… - …ii
Declaration …………………………………………………………………………………iii
Acknowledgement ……………………………………………………………………… - …iv
Abstract ………………………………………………………………………………… - v
Table of Contents …………………………………………………………………………vi
List of Table ………………………………………………………………………… - … - xi
List of Figure …………………………………………………………………………… - …xiii
List of Appendices …………………………………………………………………………xiv
List of Abbreviation ……………………………………………………………………………xv
CHAPTER ONE
10 INTRODUCTION …………… - ……………………………………………… - ……1
11 Malnutrition ……………………………………………………………………………1
12 Statement of Problem ………… - ………………………………………………………2
13 Justification ……………………………………………………………………………3
14 Aim ………………………………………………………………………… - - - 3
15 Specific Objectives ……………………………………………………………………4
CHAPTER TWO
20 LITERATURE REVIEW - ………………………………………………………… - 5
21 Nutrition ……………………………………………………………………………………5
22 Adolescent Nutrition …… - …………………………………………………………… - 7
23 Adolescent Nutritional Challenges Developing Countries - - - …………………
9
24 Demographic Factors Associated with Nutritional Status - - - ………………11
241 Age ………………………………………………………… - - - - - - …11
242 Gender …………………………………………………………………………………12
243 Physical activity - ………………………………………………… - - - - - - 12
244 Socio-economic status ………………………………………… - - - - - - 14
25 Dietary Factors Associated with Nutritional Status ………………………………………15
251 Effect of calcium and dairy foods ………………………………………………… - 15
252 Effect of dietary fiber and whole grain …… - ……………………………………………16
253 Effect of fruits and vegetables ………………………………………………………… - 17
254 Effect of dietary pattern ……………………………………………………………………18
26 Role of Iron, Zinc and Copper in the Human Metabolic Process … - ………………18
261 Iron …………… - …………………………………………………………………19
2611 Iron transport, metabolism and storage ……………………………………………20
2612 Excretion …………………………………………………………………………20
2613 Function ……………………………………………………………………………20
2614 Dietary sources and intake of Iron ……… - …………………………………………22
262 Zinc …………………………………………………………………………………22
2621 Zinc transport, metabolism and storage ……………………………………… - 22
2622 Excretion ……………………………………………………………………… - …23
2623 Function ………………………………………………………………………… - 24
2624 Dietary sources and intake of zinc - …………………………………………………25
263 Copper …………………………………………………………………………………25
2631 Copper transport, metabolism and storage …………………………………………25
2632 Excretion ……………………………………………………………………… - …26
2633 Function …………………………………………………………………………26
2634 Dietary sources and intake of copper …………………………………………………27
CHAPTER THREE
30 MATERIALS AND METHODS ………………………………………………… - ……………28
31 Materials ……………………………………………………………………………………………28
311 Reagents and instruments …………………………………………………………………………28
312 Study Area ………………………………………………………………………… - 28
313 Study Population …………………………………………………………………29
314 Inclusion Criteria …………………………………………………………………29
315 Exclusion Criteria ……… - …………………………………………………… - …29
316 Informed Consent ………………………………………………………………… - 30
317 Ethical Approval - …………………………………………………………………30
318 Study Design ………………………………………………………………………30
319 Sampling Technique …………………………………………………………………30
3110 Sampling Size …………………………………………………………………………32
32Method …………………………………………………………………………………33
321 Determination of weight and height ……………………………………………………33
322 Determination of Body Mass Index for age (BMI for Age) … - ………………… - …33
323 Determination of waist and hip circumference - - - - - - - - - - - 33
324 Determination of demographic and physical Activity characteristics ………………… - 34
325 Dietary intake records …………………………………………………………………34
326 Blood Sample Collection ……………………………………………………… - …34
327 determination of Packed Cell Volume (PCV) …………………………………………35
328 Estimation of serum iron, zinc and copper …………………………………………35
329 Statistical Analysis ………………………………………………………………… - 36
CHAPTER FOUR
40 RESULTS ……… - …………………………………………………………… - - 37
41 Demographic Characteristics of Adolescents in Secondary Schools ……… - ……… - 37
42Anthropometric and Physical Activity Characteristics of Adolescents …………39
421 Mean anthropometric characteristics of adolelescent ……… - …………………………39
422 Nutritional status distribution of adolescents ………………………………… - ………39
423 Physical activity level distribution of adolescents …………………… - ………………42
424 Correlation between age, anthropometric and physical activity
characteristics of adolescents …………………………………………………………44
425 Distribution by age of BMI and physical activity level of adolescents … - ………46
426 Distribution by gender and type of school of BMI and physical
activity level of adolescents ………………………………………………… - ………49
427 Physical activity between overweight and normal adolescents………………… - ………49
43 Dietary Patterns of Adolescents in Secondary Schools …………………………53
431 Dietary pattern between girls in secondary schools …………………………………56
432 Dietary pattern between boys in secondary schools …………………………………59
433 Dietary Pattern between girls and boys in secondary school ……… - …………………62
434 Dietary Pattern between adolescents in secondary Schools …………………………65
435 Dietary pattern between normal and overweight adolescents in secondary schools - 68
44 Micronutrients Status of Adolescents attending Secondary Schools… - ………………72
441 Serum micronutrient distribution of adolescents in private secondary schools - …………72
442 Correlation of anthropometric characteristic, physical activity level
and micronutrient status of students in private secondary schools ………… - ………72
443 Serum iron, zinc and copper by age in adolescents of private secondary schools … - 76
444 Serum iron, zinc, and copper by gender in adolescents of private secondary schools - …76
CHAPTER FIVE
50 DISCUSSION ……………………………………………………………… - ………79
51 Anthropometry and Physical Activity Characteristics of Adolescents …………79
52 Dietary Patterns of Adolescents…… - ………………………………………………… - 82
54 Micronutrient Status of Adolescents attending Private Secondary Schools - …………84
CHAPTER SIX
60 SUMMARY, CONCLUSIONS AND RECOMMENDATIONS ……………………86
61 Summary ……………………………………………………………………………… - …86
62 Conclusion ……………………………………………………………………………87
63 Recommendations ………………… - …………………………………………… - 87
64 Limitations ……………………………………………………………………………87
REFERENCES …………………………………………………………………………88
APPENDICES …………………………………………………………………………97
