Nutritional status and dietary habits of urban and peri-urban primary school children (10-13 years) in Tanzania: A comparative study between public and private schools

Paper Details

Research Paper 01/09/2021
Views (520) Download (54)
current_issue_feature_image
publication_file

Nutritional status and dietary habits of urban and peri-urban primary school children (10-13 years) in Tanzania: A comparative study between public and private schools

Renatha Pacific, Haikael D. Martin, Kissa Kulwa, Pammla Petrucka
Int. J. Biosci.19( 3), 12-30, September 2021.
Certificate: IJB 2021 [Generate Certificate]

Abstract

This study determined overweight and obesity prevalence and its association with dietary habits in primary school children in Ilala and Mkuranga Districts, Tanzania. A comparative cross-sectional survey was carried out among 406 school children (10-13 years). Indices such as weight, height, mid-upper arm circumference, and body composition were measured. Body Mass Index-for-age-related Z-scores were computed using the World Health Organization’s AnthroPlus™ software to classify children’s nutrition status according to the defined cut-off values. A structured questionnaire collected dietary habits data. Descriptive, non-parametric methods and regression were used for analysis. A combined prevalence of overweight and obesity was 22.6%, significantly higher in private than in public schools (32.4% vs. 14.8%, p<0.001). Prevalence of thinness was 3.9% and stunting was 10.1%. It is clear that medians for body mass index for age (p=0.002), percentage body fat (p<0.001), and mid-upper arm circumference (p<0.001) were significantly higher in private schools than in public schools. Girls also had higher median BMI-for-age (p=0.021), percentage body fat (p<0.001), and mid-upper arm circumference (0.006) than boys. Consumption of fruits, vegetables, and milk was relatively low in all participants. Intake of cereal foods and sugary snacks among boys and low preference for fruit among girls was associated with high median BMI-for-age (p<0.05). The prevalence of overweight and obesity among school children is high. Median BMI-for-age was associated with selected dietary habits. Context-specific school-based interventions are fundamental in reducing the prevalence of overweight/obesity and modifying the dietary habits of school children after formulating policy options.

VIEWS 65

Adesina AF, Peterside O, Anochie I, Akan NA. 2012. Weight status of adolescents in secondary schools in Port Harcourt using body mass index (BMI). Italian Journal of Pediatrics 38, 31. https://doi.org/10.1186/1824-7288-38-31.

Adom T, Kengne AP, De Villiers A, Puoane T. 2019. Association between school-level attributes and weight status of Ghanaian primary school children. BMC Public Health 19, 577 https://doi.org/10.1186/s12889-019-6937-4

Alangea DO, Aryeetey RN, Gray HL, Laar AK, Adanu RMK. 2018. Dietary patterns and associated risk factors among school age children in urban Ghana. BMC Nutrition 4, 22. https://doi.org/10.1186/s40795-018-0230-2.

Annan-Asare J, Asante M, Amoah AGB. 2017. Obesity and its correlates among junior high school children in the Accra Metropolis. Journal of Nutrition and Health Sciences 4(2), 206. https://doi.org/10.15744/2393-9060.4.206.

Baard ML, McKersie J. 2014. Obesity in 7 – 10-year-old children in urban primary schools in Port Elizabeth. South African Journal of Sports Medicine 26(2), 55-58. http://dx.doi.org/10.7196/SAJSM.526.

Chebet M, Nsibambi C, Otala J, Goon DT. 2014. Prevalence of overweight and obesity among primary school children in Kampala central, Uganda. African Journal for Physical Health Education, Recreation and Dance 20(4), 1365-1378.

Collison KS, Zaidi MZ, Subhani SN, Al-Rubeaan K, Shoukri M, Al-Mohanna FA. 2010. Sugar-sweetened carbonated beverage consumption correlates with BMI, waist circumference, and poor dietary choices in school children. BMC Public Health 10, 234. https://doi.org/10.1186/1471-2458-10-234.

Corvalán C, Garmendia ML, Jones-Smith J, Lutter CK, Miranda JJ, Pedraza LS, Popkin BM, Ramirez-Zea M, Salvo D, Stein AD. 2017. Nutrition status of children in Latin America. Obesity Reviews 18(S2), 7–18. https://doi.org/10.1111/obr.12571.

Craig E, Bland R, Ndirangu J, Reilly JJ. 2014. Use of mid-upper arm circumference for determining overweight and overfatness in children and adolescents. Archives of Disease in Childhood 99, 763–766. https://doi.org/10.1136/archdischild-2013-305137

De Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. 2007. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization 85, 660-667. https://doi.org/10.2471/blt.07.043497.

De Pádua Cintra I, Ferrari, GL, Soares ACSV, Passos MAZ, Fisberg M, Vitalle MS, De S. 2013. Body fat percentiles of Brazilian adolescents according to age and sexual maturation: a cross-sectional study. BMC Pediatrics 13, 96. https://doi.org/10.1186/1471-2431-13-96.

El-Mouzan MI, Foster PJ, Al Herbish AS, Al Salloum AA, Al Omer AA, Qurachi MM, Kecojevic T. 2010. Prevalence of overweight and obesity in Saudi children and adolescents. Annuals of Saudi Medicine 30(3), 203-208. https://doi.org/10.4103/0256-4947.62833.

Ene-Obong H, Ibeanu V, Onuoha N, Ejekwu A. 2012. Prevalence of overweight, obesity, and thinness among urban school-aged children and adolescents in southern Nigeria. Food and Nutrition Bulletin 33(4), 242-250. https://doi.org/10.1177/156482651203300404.

Food and Agriculture Organization. 2006. The double burden of malnutrition: Case studies from six developing countries, FAO-Food and Nutrition.  Paper, 84.

Frignani RR, Passos MA, Ferrari GL, Niskier SR, Fisberg M, de Pádua Cintra I. 2015. Reference curves of the body fat index in adolescents and their association with anthropometric variables. Journal of Pediatric (Rio J) 91, 248-55. https://doi.org/10.1016/j.jped.2014.07.009.

Govender K, Naicker A, Napier CE, Singh D. 2018. School snacking preferences of children from a low socioeconomic status community in South Africa. Journal of Consumer Sciences, Special Edition Food and nutrition challenges in Southern Africa 3, 1-10.

Hanandita W, Tampubolon G. 2015. The double burden of malnutrition in Indonesia: Social determinants and geographical variations. SSM-Population Health 1, 16–25. https://doi.org/10.1016/j.ssmph.2015.10.002.

Hebestreit A, Börnhorst C, Pala V, Barba G, Eiben G, Veidebaum T, Hadjigergiou C, Molnár D, Claessens M, Fernández-Alvira JM, Pigeot I. 2014. Dietary energy density in young children across Europe. International Journal of Obesity 38, S124–S134. https://doi.org/10.1038/ijo.2014.143.

International Atomic Energy Agency. 2010. Introduction to Body Composition Assessment Using The Deuterium Dilution Technique With Analysis of Saliva Samples By Fourier Transform Infrared Spectrometry, IAEA Human Health Series NO. 12 website accessed on 7th June 2021. http://www.iaea.org/Publications/index.html

Jeyakumar A, Ghugre P, Gadhave S. 2013. Mid-Upper-Arm Circumference (MUAC) as a Simple Measure to Assess the Nutritional Status of Adolescent Girls as Compared With BMI ICAN. Infant, Child, and Adolescent Nutrition 5(1), 22-25. https://doi.org/10.1177/1941406412471848.

Jezewska-Zychowicz M, Gawecki J, Wadolowska L. Czarnocinska J, Galinski G, Kollajtis-Dolowy A, Roszkowski W, Wawrzyniak A, Przybylowicz K, Krusinska B, Hawrysz I, Slowinska MA, Niedzwiedzka E. 2017. Dietary Habits and Nutrition Beliefs Questionnaire for people 15-65 years old, version 1.1. – Interviewer administered questionnaire. Chapter 1. (in:) Dietary Habits and Nutrition Beliefs Questionnaire and the manual for developing of nutritional data. Ed. Gawecki J. The Committee of Human Nutrition, Polish Academy of Sciences, Olsztyn, 3-20. Available at: http://www.knozc.pan.pl/

Joy EJM, Green R, Agrawal S, Aleksandrowicz L, Bowen L, Kinra S, Macdiarmid JI, Haines A, Dangour AD. 2017. Dietary patterns and non-communicable disease risk in Indian adults: secondary analysis of Indian Migration Study data. Public Health Nutrition 20(11), 1963–1972. https://doi.org/10.1017/S1368980017000416.

Kyallo F, Makokha A, Mwangi AM. 2013. Overweight and obesity among public and private primary school children in Nairobi, Kenya. Health 5(83A), 85-90. https://doi.org/10.4236/health.2013.58A3012.

Lassibille ÂG, Tan J. 2001. Are Private Schools More Efficient Than Public Schools? Evidence from Tanzania, Education Economics 9(2), 145-172. https://doi.org/10.1080/09645290110056985.

Larson NI, Story M, Wall M, Neumark-Sztainer D. 2006. Calcium and Dairy Intakes of Adolescents Are Associated with Their Home Environment, Taste Preferences, Personal Health Beliefs, and Meal Patterns. Journal of the American Dietetic Association 106(11), 1816-1824. https://doi.org/10.1016/j.jada.2006.08.018.

Laurson KR, Eisenmann JC, Welk GJ. 2011. Body fat percentile curves for U.S. children and adolescents. American Journal of Preventive Medicine 41(4S2), S87–S92. https://doi.org/10.1016/j.amepre.2011.06.044.

Marques-Vidal P, Marcelino G, Ravasco P, Ermelinda MC, Oliveira JM. 2008. Body fat levels in children and adolescents: Effects on the prevalence of obesity. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism 3, e321-e327. https://doi.org/10.1016/j.eclnm.2008.07.007e322.

Marras S. 2018. Street Food in Tanzania. A Literature Review. Food and Agriculture Organization of the United Nations. Dar-es-Salaam, Tanzania.

Maddah M, Nikooyeh B. 2009. Factors associated with overweight in children in Rasht, Iran: gender, maternal education, skipping breakfast and parental obesity. Public Health Nutrition 13(2), 196-200 https://doi.org/10.1017/S1368980009990589.

Mekonnen T, Tariku A, Abebe SM. 2018.  Overweight/obesity among school aged children in Bahir Dar City: cross sectional study. Italian Journal of Pediatrics 44, 17 https://doi.org/10.1186/s13052-018-0452-6.

Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), [Tanzania Mainland, Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS) and ICF. 2016. 2015-2016 TDHS-MIS Key Findings. Rockville, Maryland, USA: MoHCDGEC, MoH, NBS, OCGS and ICF.

Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], Tanzania Food and Nutrition Centre (TFNC), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS) [Zanzibar] and UNICEF. 2018. Tanzania National Nutrition Survey using SMART Methodology (TNNS) 2018. Dar es Salaam, Tanzania: MoHCDGEC, MoH, TFNC, NBS, OCGS, and UNICEF.

Modjadji P, Madiba S. 2019. The double burden of malnutrition in a rural health and demographic surveillance system site in South Africa: a study of primary schoolchildren and their mothers. BMC Public Health 19, 1087 https://doi.org/10.1186/s12889-019-7412-y

Mogendi JB, De Steur H, Gellynck X, Saeed HA, Makokha A. 2015. Efficacy of mid-upper arm circumference in identification, follow-up and discharge of malnourished children during nutrition rehabilitation. Nutrition Research and Practice 9(3), 268-277. https://doi.org/10.4162/nrp.2015.9.3.268.

Mohammed H, Vuvor F. 2012. Prevalence of childhood overweight /obesity in basic school in Accra. Ghana Medical Journal 46(3), 124-127.

Mosha TCE, Fungo S. 2010. Prevalence of overweight and obesity among children aged 6-12 years in Dodoma and Kinondoni Municipalities, Tanzania. Tanzania Journal of Health Research 12(1), 6-16. PMID: 20737824. https://doi.org/10.4314/thrb.v12i1.56202.

Muhihi AJ, Mpembeni RNM, Njelekela MA, Anaeli A, Chillo O, Kubhoja S, Lujani B, Maghembe M, Ngarashi D. 2013. Prevalence and determinants of obesity among school children in Dar es Salaam,Tanzania. Archives of Public Health 71, 26. https://doi.org/10.1186/0778-7367-71-26.

Musa DI, Toriola AL, Monyeki MA, Lawal B. 2012. Prevalence of childhood and adolescent overweight and obesity in Benue State, Nigeria. Tropical Medicine and International Health 17(11), 1369–1375.

Mwaikambo SA, Leyna GH, Killewo J, Simba A, Puoane T. 2015. Why are primary school children overweight and obese? A cross sectional study undertaken in Kinondoni district, Dar-es-Salaam. BMC Public Health 15, 1269. https://doi.org/10.1186/s12889-015-2598-0.

Naeeni MM, Jafari S, Fouladgar M, Heidari K, Farajzadegan Z, Fakhri M, Karami P, Omidi R. 2014. Nutrition knowledge, practices, and dietary habits among school children and adolescents. International Journal of Preventive Medicine 5(2), S171-S178.

Naserirad M, Akbari H. 2018. Food Group Consumption Pattern of School-aged Children and Adolescents Inside and Outside the School Setting: a Cross-sectional Study of a Community in North-eastern Iran. Journal of Nutritional Sciences and Dietetics 4(4), 139-146.

Neeley SM. 2011. The Influence of School Eating Environment on Children’s Eating Behaviors: An Examination of the SNDA-III. Masters dissertation, Wright State University, Dayton, Ohio.

Okop KJ, Ndayi K, Tsolekile L, Sanders D, Puoane T. 2019. Low intake of commonly available fruits and vegetables in socio-economically disadvantaged communities of South Africa: influence of affordability and sugary drinks intake. BMC Public Health 19, 940. https://doi.org/10.1186/s12889-019-7254-7.

Pangani IN, Kiplamai FK, Onwera VO. 2016. Prevalence of overweight and obesity among primary school children aged 8-13 in Dar-es-salaam City, Tanzania. Advances in Preventive Medicine 2016, 1-6. http://dx.doi.org/10.1155/2016/1345017

Papandreou D, Malindretos P, Rousso I. 2010. First body fat percentiles for 607 children from Thessaloniki-Northern Greece. Hippokratia 14(3), 208-211.

Peltzer K, Pengpid S. 2010. Fruits and vegetables consumption and associated factors among in-school adolescents in seven African countries. International Journal of Public Health 55, 669–678. https://doi.org/10.1007/s00038-010-0194-8.

Peltzer K, Pengpid S. 2011. Overweight and obesity and associated factors among school-aged adolescents in Ghana and Uganda. International Journal of Environmental Research and Public Health 8, 3859-3870. https://doi.org/10.3390/ijerph8103859.

Peltzer K, Pengpid S. 2012. Fruits and vegetables consumption and associated factors among in-school adolescents in five Southeast Asian countries. International Journal of Environmental Research and Public Health 9, 3575-3587. https://doi.org/10.3390/ijerph9103575.

Puckree T, Naidoo P, Pillay P, Naidoo T. 2011. Underweight and overweight in primary school children in eThekwini district in KwaZulu-Natal, South Africa. African Journal of Primary Health Care and Family Medicine 3(1), 1-6. https://doi.org/10.4102/phcfm.v3i1.203.

Rankin J, Matthews L, Cobley S, Han A, Sanders R, Wiltshire HD, Baker JS. 2016. Psychological consequences of childhood obesity: Psychiatric comorbidity and prevention. Adolescent, Health and Therapeutics 7, 125-146. https://doi.org/10.2147/AHMT.S101631.

Rao DP, Kropac E, Do MT, Roberts KC, Jayaraman GC. 2016. Childhood overweight and obesity trends in Canada: Health promotion and chronic disease prevention in Canada. Research, Policy and Practice 36(9), 194-198.

Taha AA, Marawan HM. 2015. Socio-behavioral determinants of overweight and obesity in Egyptian primary school children. Journal of Child and Adolescent Behavior 3, 236. https://doi.org/10.4172/2375-4494.1000236.

Ulbricht L, de Campos MF, Esmanhoto E, Ripka WL. 2018. Prevalence of excessive body fat among adolescents of a south Brazilian metropolitan region and State capital, associated risk factors, and consequences. BMC Public Health 18, 312. https://doi.org/10.1186/s12889-018-5216-0.

Umar IU, Kakale IM, Gwarzo GD, Muutassim I. 2018. Prevalence of childhood and adolescent overweight and obesity in Kano State, Nigeria. EC Paediatrics 7(4), 231-238.

Vargas L, Jime´nez-Cruz A, Montserrat Bacardı´-Gascon M. 2013. Unhealthy and healthy food consumption inside and outside of the school by pre-school and elementary school Mexican children in Tijuana, Mexico. Journal of Community Health 38(6), 1166–1174. https://doi.org/10.1007/s10900-013-9729-2.

Wall CR, Stewart AW, Hancox RJ, Murphy R, Braithwaite I, Beasley R, Mitchell EA. 2018. Association between Frequency of Consumption of Fruits, Vegetables, Nuts and Pulses and BMI: Analyses of the International study of Asthma and Allergies in Childhood (ISAAC). Nutrients 10, 316. https://doi.org/10.3390/nu10030316.

Wamba PCF, Oben JE, Cianflone K. 2013. Prevalence of Overweight, Obesity, and Thinness in Cameroon Urban Children and Adolescents. Journal of Obesity. 2013, 737592. https://doi.org/10.1155/2013/737592.

World Health Organization. 2005. Non-communicable Diseases and Mental Health Cluster. WHO STEPS surveillance manual: the WHO STEPwise approach to chronic disease risk factor surveillance / Non-communicable Diseases and Mental Health, World Health Organization. https://apps.who.int/iris/handle/10665/43376

WHO AnthroPlus for personal computers Manual. 2009. Software for assessing growth of the world’s children and adolescents. Geneva. http://www.who.int/growthref/tools/en/

Ziaei R, Shahi H, Dastgiri S. Mohammadi R, Viitasara E. 2020. Fruit and vegetable intake and its correlates among high-school adolescents in Iran: a cross-sectional study. Journal of Public Health 28, 711-718. https://doi.org/10.1007/s10389-019-01084-2.