Nutrition Knowledge, Dietary Practices And Nutrition Status Of Secondary School Adolescents (13-18 Years) In Ruiru Sub County, Kenya

Abstract

Adolescence is a vulnerable stage of life characterized by rapid growth and development and increased nutrients requirement. Good nutrition is important in promoting health and is dependent on appropriate dietary practices. Nutrition knowledge is critical for forming good eating habits and dietary practices. The dietary practices of adolescents have been described poor because of their busy schedules, peer pressure, imbalance in hormone production and independent nature of their behavior. The objective of this study was to determine socio demographic characteristics and nutrition knowledge, their association with dietary practices and nutrition status of secondary school adolescents. A total of 216 adolescents were enrolled in this cross-sectional study. Semi structured questionnaires were used to collect the data. The data was analyzed using SPSS software package with p-value for statistical significance being set at p< 0.05. Over half (55.1%) of the adolescents had good nutrition knowledge. Nutrition knowledge increased as adolescents advanced in age and girls had slightly higher nutrition knowledge scores than boys. Majority (76.2%) of adolescents got their nutrition knowledge from school. Generally adolescents exhibited optimal dietary practices, majority (74.1%) had more than three meals in a day in reference to recommended 5-6 meals including snacks. Compared with others lunch was the most skipped meal, being missed by three out of ten adolescents. Association between socio-demographic and dietary practice based on gender was significant at p-value 0.005 with female students preferring breakfast as the heaviest meal p=0.000, χ2 =15.63, skipped meals p=0.001, χ2 =5.12, took less than two litres of water p=0.008, χ2 =9.66 and preferred fried foods p=0.003, χ2 =213.95 comparing with male. Increasing nutrition knowledge had a positive relationship but not significant (r=0.20, p= 0.294) with xvi dietary diversity. Nutrition knowledge with number of meals taken had positive relationship but not significant (r=0.36, p=0.495) and nutrition knowledge with skipping of meals had a positive relationship but not significant (r=0.39, p=0.465). Most (77.3%) of adolescent had normal BMI for age with the rest either being overweight (12.5%) and moderately thin (10.3%). The nutrition status did not significantly differ between the gender. Age was significantly associated with nutrition status where more of the older adolescents had normal BMI for age as compared to the younger adolescents at (p= 0.043, χ2 = 9.84,). Students who skipped meals were thin compared to those who consumed all meals p=0.041, χ2 =9.95. Students who consumed milk 3-6 times a week were 11 times more likely (OR=11.25) to be on normal nutrition status rather than overweight. Students who used fat and oils every day were six times more likely to have normal nutrition status rather than overweight (OR=5. 80). Conclusion: The study has shown that secondary school adolescents within Ruiru Sub County had good nutrition knowledge. The nutrition knowledge increased as adolescents advanced in age with girls having slightly higher nutritional knowledge scores compared with boys. Diet for adolescents constitute high consumption of cereal based diet and low intake of high biological value protein foods. There was a gap between knowledge and practice. Despite good nutrition knowledge, adolescents, girls especially practice non optimal dietary practices that included skipping of meals particularly lunch and taking less than two litres of water daily. Most of the adolescent student had optimal dietary practices as they eat three meals in a day. Skipping of xvii meals, especially lunch and snacking constituted the most suboptimal dietary practice by the students. Recommendations: Interventions and education strategies to promote the intake of high biological value proteins should target school students. Inclusion of lessons on healthy eating and optimal dietary practices (with practical aspects) in the curriculum of High Schools would alleviate the situation. There is also a need for further studies to obtain the views of school children on factors (barriers and promoters) in school which affect their desire to eat healthy foods.