Predictors of Nutrition Status among Adolescent Students in Public Day Secondary Schools in Machakos County, Kenya

Abstract

Over nutrition among the adolescents have been largely increasing worldwide. The growing trends in obesity and overweight reliable and up to date data among adolescents would be useful and especially in Machakos Sub-County where urbanization and changing lifestyles has increased risk factors like motorized transport and increased fast food intake. Even though researchers have done studies on obesity in the Machakos County, most of these studies have focused on adults and children making the existing data on adolescents rare. There is a gap on data on causes of over nutrition in Machakos County. Other studies done on adolescents’ nutrition status in other parts of Kenya like Kisumu indicate high rates of overweight, a justification to find out the nutrition status of adolescents in other counties in Kenya like Machakos County. The study aimed to establish the nutrition status and its predictors among adolescent students in public day secondary schools in Machakos Sub-County. The study adopted cross-sectional analytical study design. Sample of 401 adolescents was distributed to five randomly selected secondary day schools. Food Frequency Questionnaire (FFQ) and 24-hour recall was used to gather facts on eating habits and forms of food intake. A stadiometer and digital bathroom scale was used to measure height and weight for the adolescent students respectively. Fat percentage and body composition was measured by Bioelectrical Impedance Analysis (BIA) Beurer model BF 750. Physical Activity Questionnaire for Adolescents (PAQ-A) was used to measure physical activity level among the adolescents. Body Mass Index (BMI) and (BIA) were used to determine the prevalence of obesity/overweight among adolescents. Dietary intake data was analyzed using Nutri-survey software 2007. WHO anthroplus software was used to analyze anthropometric data. SPSS software version 20 and descriptive analysis was used to analyze dietary practices data, demographic and socio-economic characteristics. Pearson and Chi-square tests was done to establish the associations among the study variables. About a third (36.3%) of the adolescents were between ages 17-18 years with more girls (55.9%) than boys. The prevalence of overweight and obesity among boys was 5.2% and 1.8%, respectively while for girls was 7.3% and 3.6%, respectively as assessed by BMI. By use BIA, males was 8.8% and 4.1% respectively while for females was 10.1% and 5.1% respectively. The study noted no significant difference in results by use of either BMI or BIA (P value=0.091). Over half (55.9%) of the adolescent students consumed three meals per day. The mean IDDS score was 4.21± 1.61. From food frequency 88.1% of the adolescent students consumed diets made from cereals and grain product up to six days. However, consumption of fruits and vegetables, nuts, tubers and meats were low. The study results indicated that >85% of the adolescent students met the recommended daily allowance for energy. Majority (51.5%) of the adolescents were engaged in low physical activity. Regression analysis showed the most significant predictors were energy intake and physical activity based on BMI and BIA. Odds ratio showed that adolescents who had a higher energy intake were 1.4 times and 1.5 times likely to have high BMI and BIA respectively. The study concludes that the possibility of females being overweight and obese is higher compared to the males. The study recommends nutrition education and public health interventions to improve nutrition status among students in relation to dietary practices and physical activity.