A Study to Evaluate the food habits and perceived constraints in practicing good nutrition among adolescent girls studying in Kanya Vidya Mandir, Loni (BK)

 

Mrs. Sheena John

Lecturer, Gokhale Education Society, Sir. Dr. M. S. Gosavi Institute of Nursing Education Training and Research, M S G Center for Excellence, Krushi Nagar, Near Jogging Track, College Road, Nashik-422005

 

ABSTRACT:

Background: Adolescence is the transition period between childhood and adulthood. It is one of the fastest growing periods of a person’s life. During this stage, physical changes affect the body’s nutritional needs while changes in lifestyle may affect eating habits and food choices. Adequate nutrition plays a very important role in maintaining good health. Adolescent’s growth and development is closely linked to the diet they receive during childhood and adolescence. Objectives: A study was 1)To assess the food habits among adolescent girls ii) To evaluate the perceived constraints in practicing good nutrition among adolescent girls iii)To compare the food habits and perceived constraints of adolescent girls with selected demographic variables iv) To find association between food habits and selected socio demographic variables v) To find association between food constraints and selected socio demographic variables.vi) To determine the relationship between food habits and perceived constraints of adolescent girls.Material and Methods: Descriptive survey approach to assess the food habits and constraints of adolescent girls,Kanya Vidya Mandir, Loni. Data were collected from 150 adolescent girls; the modified structure interview schedule was used to collect data .The data was analyzed with descriptive and inferential statistics. Results: It was noted that the adolescents studying in Kanya Vidya Mandir, Loni had a satisfactory food habits and have a moderate constraints like father’s education, occupation and income. There is a significant association was found between food habits and socio demographic data like total no of family members. A positive relationship existed between food habits and constraints.Conclusion: The study outcome revealed that adolescents had a satisfactory food habits and they have moderate constraints in all aspects.

 

 

 

INTRODUCTION:

UNICEF (2012) reported that more than half of adolescent girls in India are anemic. Malnourishment among India’s adolescent population is found to be higher than even some of the least developed countries¹. According to WHO, Anemia is currently one of the most common and intractable nutritional problems globally. It is a global public health problem that affects both developing and developed countries with major consequences for human health as well as social and economic development. WHO estimates the number of anemic people worldwide to be a staggering two billion with approximately 50% of all anemia’s attributable to iron deficiency. Adolescents, particularly girls, are vulnerable to iron deficiency. The World Health Report (2002) identified iron deficiency among the 10 most serious risks in countries with high infant mortality coupled with high adult mortality and reported that measures to address iron deficiency anemia are among the most cost effective public health interventions.²

 

Swetha Singh (2011) mentioned  that 26.6% of adolescent girls were undernourished and 16.3% adolescent girls were at high risk of developing obesity in near future due to increased BMI (>25.9) .Caste, religion and marital status were significantly (p < 0.05) associated with nutritional status of adolescents³. Therefore the study recommends the strong need of nutritional education for adolescents in the rural area. Oellingrath and Naerum (2006) Socioeconomic position may however be measured in different ways. For instance, found fathers’ occupation to be a determinant of healthy eating. If the fathers had high occupation status, the adolescents were eating healthier. This tendency was not significant for students in secondary school, indicating that the association between socioeconomic position and dietary habits decreases with age⁴. Among Rural adolescents in India, some of these patterns are also likely to be common but very little information is available. Therefore, this study was carried out among school going rural adolescents, with the objective to assess their food habits and perceived constraints in practicing good nutrition among adolescent girls.

 

MATERIALS AND METHODS:

Research Design and approach:

Non-experimental research, a descriptive study design, with cross sectional survey approach was used to assess the food habits of adolescence and perceived constraints in practicing good nutrition among adolescent girls studying in Kanya Vidya Mandir,Loni.

 

Setting of the study: 

The present study was conducted in Kanya Vidya Mandir School in Loni village, district Ahmednagar, 150 km away from Pune city and 20 km near to Shirdi. The school runs from lower KG to 12^th classess. Approximately 5000 students studying in this school. The school had 180 teaching faculties and 15 non teaching faculties with one principal and one supervisor.

 

Population:

The population for the present study was the adolescent girls who were studying in Kanya Vidya  Mandir, Loni. The total number of adolescent girls were in Kanya Vidya Mandir school is 450.

 

Sample size and technique:

The sample for the present study was the adolescence girls from 13 years to 17 years who were studying in the Kanya Vidya Mandir , Loni. Probability method, stratified random sampling technique (proportionate) was used for selecting the adolescent’s girls studying in Kanya Vidya Mandir, Loni, based on the sample selection criteria. The percentage proportion of samples were 30 % in 8^th standard, 30% in 9^th standard, 30% in 10^th standard, 30% in 11^th standard, and 30% in 12^th standard.

 

Criteria for selection of sample:

Inclusion Criteria:

·      Age group of 13-17years Who is studying in Kanya Vidya Mandir, Loni

·      Able to read and write Marathi.

·      Willing to participate and co-operate in the study.

·      Present during the period of data collection.

 

Exclusion criteria:

·      Below 13 years and above 17 years.

·      Not willing to participate and co-operate in the study.

·      Who were not understand and know Marathi.

 

Method of data collection:

The Structured interview schedule was used to collect data from the adolescent girls studying in Kanya Vidya Mandir, Loni.

Following standard techniques were used for measurements-

 

Height:

Height in centimeters was marked on a wall with the help of a measuring tape. All girls were measured against the wall without foot wear and with heels together and their heads positioned so that the line of vision was perpendicular to the body. A glass scale was brought down to the topmost point on the head. The height was recorded to the nearest 1 cm.

 

Weight:

The weight was measured using a weighing machine with an accuracy of + 100gm. The subjects were asked to remove their footwear before measuring their weight. The scales were recalibrated after each measurement. Accuracy of the weighing scale was verified from time to time against known weights.

 

BMI:

BMI of the study subject was calculated by using the formula weight (kg)/ height2 (m2). For grading proposed criteria of BMI and Center for Disease control and Prevention (CDC) was adopted.

Table No.1-Classification of Body Mass Index

 

Development of tool:

The structured interview schedule was prepared in the form of rating scale to evaluate the food habits and perceived constraints of the adolescent girls at Kanya Vidya Mandir, Loni,while considering the steps like

 

A) Review of Literature:

Related books, journals, e-sources, articles, periodicals, and news papers, published and unpublished studies and used to develop the tool.

 

B) Preparation of blue print:

The blue print of items pertaining to the assessment and constraints of food habits was prepared while considering the objectives and theoretical frame work.

 

C) Consultation of the experts:

The tool was given to the experts in various fields like Dieticians, Department of Community Health Nursing, Department of preventive and social medicine, Department of Home science, statistics and language. Their opinion and suggestion were taken in to consideration with consultation of the guide to finalize the tool.

 

D) Preparation of final draft:

Final draft of rating scale of food habits and constraints of adolescent girls was prepared after testing the validity, reliability and pilot study.

 

Description of tool:

The structured interview schedule was prepared in three sections to collect the data.

 

Section I: It consists of two parts,

Part A: Socio-demographic data of adolescent girls like age in years, educational standard ,Religion, Type of family, Total no. of family members, Living situation, Dietary habits, Frequency of meals, Height, Weight, Suffering any illness, undergone any surgery.

Part B: Socio-demographic data of parents like Father’s education, Mother’s education, Occupation of father, Occupation of the mother, Monthly income.

 

Section II: Rating scale to assess the food habits of adolescent girls, consists of 25 items which divided in to 4 aspects, out of which 6 items to assess the meal time habits, 8 items to assess the eating habits, 5 items to assess the satisfaction with diet, and 6 items to assess the social support and availability. Each item has five alternatives like never, rarely, sometimes, frequently and always with the score of 0, 1, 2, 3 and 4 respectively. The maximum obtainable score was 100.

Section III: Rating scale to assess the food constraints of adolescent girls, consist of 24 items. Each item has five alternatives like never, rarely, sometimes, frequently and always with the score of 0, 1, 2, 3 and 4 respectively. The maximum obtainable score was 96.

 

Standardization of tool:

Validity and Reliability:

Content validity of the structured interview schedule was established by consulting with the experts the validity was established by consulting the expert like Department of Nutrition, Community Health Nursing, Preventive and Social Medicine, Department of Home science, Statistics and language. The tool was modified according to the suggestion and recommendation of experts in consultation with guide.

 

The reliability of the tool was tested by implementing the structured interview schedule on 10  adolescent girls studying in Kanya Vidya Mandir, Loni (BK) other than the sample; the split half reliability method was used to test the homogeneity of the tool. The tool found to be reliable with the ‘r’ value was respectively 0.93 and 0.85.

 

Data collection procedure:

i)  Ethical consideration:

The present study was approved by the Institutional Ethics Committee (IEC) and Institutional Research Committee (IRC) of PIMS (DU).Prior to data collection, written permission was obtained from Principal, Kanya Vidya Mandir, Loni (BK) for main study. Informed consent was obtained from all the adolescent girls who were participated in the scientific work.

 

ii)   The process of data collection:

Before data collection, the purpose of the study explained to the adolescent girls with self-introduction and informed consent was taken to participate in the study. The participants were approached and were made comfortable. Instructions regarding tools were given to facilitate co-operation. First the information was collected related to socio demographic data of the adolescent girls and parents. The assessment and constraints tools were filled up by adolescent girls. The average time taken by the client to fill the form was 30 minutes.

 

Plan for data analysis:

Descriptive and inferential statistics was planned for data analysis. The collected data was organized, tabulated and analyzed by using descriptive statistics, i.e. mean percentage, mean and standard deviation used to assess the food habits and constraints of adolescent girls. The inferential statistics like Chi-square test and Co-efficient of co relation test was planned to use.1) to find association between food habits and selected socio demographic variables.2) to find association between food constraints and selected socio demographic variable.3) to test the relationship between food habits and perceived constraints of adolescent girls respectively. The data was planned to present in the form of tables, graphs and figures.

 

RESULTS:

Finding related to socio-demographic data of adolescent girls and parents:

Fig 1 showing the highest percentage (92%) of the adolescent girls were Hindus similarly Swetha Singh (2002) noted that 91.7% of adolescent girls were Hindus⁵.

 

 

Fig 1

 

Pie diagram showing the per cent wise distribution of adolescent girls according to their religion:

Fig 2 showing the (44%) of the adolescent girls was underweight similarly shahid (2009) revealed that 20% of adolescent girls were having underweight, 77% were normal weight and 3% were obese⁶.

 

 

Fig 2

 

Bar diagram showing the per cent wise distribution of adolescent girls according to their Body Mass Index.

Fig 3: (83%) of the adolescent girls frequency of meals was 3 to 4 times per day Similarly Lien N (2005) found that 76% of adolescent had 3 meals per day in his study⁷.

 

Fig 3

 

Bar diagram showing the per cent wise distribution of adolescence according to their frequency of meals

Fig 4: (77%) of the adolescents mothers were house wives Similarly Kurubaran Gunasegaram (2012) found his study (57.6 %) of mothers were housewives⁸.

 

 

Fig 4

 

Bar diagram showing the per cent wise distribution of adolescent girls according to their mother’s education.

Fig 5: (36%) of the adolescent fathers education were higher secondary Similarly Kylie Lange and Rebecca Golley (2013) found that (56%) of the adolescent girl’s father’s education were higher secondary⁹.

 

 

Fig 5

 

Pie diagram showing the per cent wise distribution of adolescent girls according to their father’s occupation.

Fig 6: (41%) of adolescent girls family income ranged between Rs.3000 to 5000. Similarly Kotecha P V (2013)  found that 44 % of the adolescent family income was less than 5000 Rs¹⁰.

 

Fig 6

Pie diagram showing the per cent wise distribution of adolescent girls according to their monthly income.

 

 

 

Table 2: Item wise comparison of assessment of food habits of adolescence girls Meal time habits

 

 

 

 

Table3: Eating Habits

S.N	Questions	Never (0)	Rarely (1)	Sometime (2)	Frequently (3)	Always (4)	Total
7	I like eating fast foods (Pasteries, Chinese, Burger, Soft drinks, pizzas, Chips and sandwiches etc)	19	22	35	7	17	100
8	I eat snacks.	9	16	42	11	22	100
9	I try to eat lot of fruits and green leafy vegetables	3	14	20	16	47	100
10	I try to have a nutritious food	2	12	27	15	44	100
11	I go to school without eating.	49	13	25	6	7	100
12	I  drink soft drinks	19	19	41	12	9	100
13	I  do fasting	47	28	20	2	3	100
14	I carry chocolates and biscuits in  my Tiffin box	55	19	18	2	6	100

 

 

 

 

Table 4: Satisfaction with Diet

SN	Questions	Never (0)	Rarely(1)	Sometime (2)	Frequently(3)	Always (4)	Total
15	I always feel my diet is healthy	6	13	21	15	45	100
16	I am always aware about my weight, while having food	28	7	17	11	37	100
17	I feel satisfied after meals	8	13	26	13	40	100
18	I enjoy my meals	2	7	13	10	68	100
19	I feel full after meals	9	4	6	9	72	100

 

 

Table 5: Social Support and availability of food

S.N	Questions	Never (0)	Rarely (1)	Sometime (2)	Frequently (3)	Always (4)	Total
20	Does your parent encourage you to have a healthy diet	9	4	6	9	72	100
21	Does your friend encourage you to eat a healthy diet	15	6	26	21	32	100
22	Is it possible to buy snacks at school during recess or lunch break?	23	13	19	11	34	100
23	Is it possible to get fast foods near to your school?	41	12	9	3	35	100
24	Fruits are always available at home	3	3	15	8	71	100
25	I am aware of the ill effects/diseases of unhealthy foods	13	11	8	16	52	100

 

 

Table 6: Item wise comparison of assessment of perceived constraints of food habits of adolescent girls.

SN	Questions	Never (0)	Rarely(1)	Sometime (2)	Frequently(3)	Always (4)	Total
1	How often do you minimize your food intake due to lack of money?	68	15	14	0	3	100
2	How often do you reduce your food intake due to lack of knowledge of the nutritional content of food?	37	21	32	9	1	100
3	How often does you avoid food intake when it is unhygienic?	10	25	25	24	16	100
4	How often do you believe that religious rituals like fasting hinder food intake?	34	17	26	9	14	100
5	How often do you tend to eat more at social gatherings like marriage, festivals?	55	18	15	7	5	100
6	How often do you reduce food intake due to the size of family?	93	1	3	1	2	100
7	How often does your food intake make you worry about putting on weight?	36	18	17	10	19	100
8	How often do the media like TV influence your eating habits?	34	34	20	8	4	100
9	How often do you minimize your food intake due to lack of time?	19	36	26	15	4	100
10	How often does engaging in physical activity like sports, exercises etc affect your food intake?	27	35	20	12	6	100
11	How often does your concern about your body image influence your food intake?	31	28	21	10	10	100
12	How often you tend to eat more upon your mother’s encouragement?	10	24	28	18	20	100
13	How often you tend to eat more when with friends?	14	22	37	11	16	100
14	How often does your poor perception about food limit the food intake?	28	31	21	15	5	100
15	How often does the pleasant environment influence your food intake?	15	10	25	20	30	100
16	How often do you limit the food due to the burden of study?	24	29	28	12	7	100
17	How often does the snacking in between influence your food intake?	31	26	26	7	10	100
18	How often does gender differences in your family influences the food intake.	78	12	8	1	1	100
19	How often your mood does affect your food intake?	25	26	23	12	14	100
20	How often does the appearance of food influence the food intake?	37	27	25	4	7	100
21	How often the unavailability of specific food does influence the food intake?	38	26	23	6	7	100
22	How often does any conflict in your family affect the food intake?	57	19	15	6	3	100
23	How often does the cost of food influence the food intake?	65	21	10	1	3	100
24	How often does the feeling of weakness affect your food intake?	15	22	34	16	13	100

 

Table 7 Findings revealed that there is a significant association between food habits of adolescent girls with their selected socio demographic variables

SN	Variables	Chi Square value	Level of significance.
1	Age	0.21	Not significant
2	Educational standard	0.28	Not significant
3	Religion	0.03	Not significant
4	Type of family	1.73	Not significant
5	Total No. of family members	3.84	significant
6	Living situation	1.13	Not significant
7	Body Mass Index	1.98	Not significant

Df=1

Table value=3.84

(p>0.05 not significant)

 

Table 8 Findings revealed that there is a significant association between adolescent food constraints with their selected socio demographic variables

SN	Variables	Chi Square value	Level of significance.
1	Age	2.3	Not significant
2	Educational standard	0.28	Not significant
3	Religion	0.43	Not significant
4	Type of family	0.24	Not significant
5	Total No. of family members	5.97	significant
6	Living situation	3.82	Not significant
7	Body Mass Index	3.81	Not significant

Df=1

Table value=5.97

(p>0.05 not significant)

 

There is a significant association between adolescent food habits and total no. of family members (ϗ²=3.84). There is a significant association between adolescent food constraints and total no. of family members (ϗ²=5.97). Similarly study done by Togo P (2001) observed in his research work that  there is a significant association between total number of family members¹¹.

 

Finding related to relationship between food habits and perceived constraints of adolescent girls:

The calculated co-efficient of co-relation test value revealed that among the selected study like food habits and food constraints of an adolescent girls adopted indicates positive correlation between them with the ‘r value’ of 0.14. Kollątaj W (2011) There are correlations between dietary habits and, educational status of parents, economic situation of households, and housing conditions¹².

RECOMMENDATION:

·      There is a need for nutrition counseling to bridge the gap between knowledge and practice. Adolescents knew what is regular and good food but their practice showed that they did not quiet follow the dietary pattern that they considered good because of the social factors on one side and less-perceived importance of the regular and quality food on the other.

·      This study can be conducted in large samples.

·      Experimental studies can be done by using nutrition education.

·      There is a need for nutrition intervention programmes for teenagers. It is necessary to educate this group about the relationship between food intakes and body’s need according to age and activity.

·      Nutrition education targeting adolescents should be strengthened and intensified, and geared towards more specific sub-groups (e.g. adolescents from low income group).

·      Investigate the factors responsible for not translating nutritional knowledge into behavioral change towards healthy eating to improve the eating patterns of adolescence.

 

CONCLUSION:

The conclusion drawn from the study was that the adolescent girls who were  in 13 years of age having a satisfactory food habits and Who were in 10^th standard, Muslims, extended family, staying in hostel, more than 5 members and overweight having moderate constraints. There is an association between food habits and socio demographic variables like total number of family members (3.84) and also association between food constraints and socio demographic variables like total number of family members (5.97) and there is a positive co-relation between food habits and food constraints (0.14).

ACKNOWLEDGEMENT:

The author expresses sincere thanks to Principal, Kanya Vidya Mandir Loni. Dr.Prathibha Chandekar Principal cum guide Pravara Institute of Medical Science, College of Nursing Loni (BK). Dr.T Sivabalan class co-ordinaor and the girls at Kanya Vidya Mandir,Loni for their kind co-operation and support.

 

REFERENCE:

1.     UNICEF,”2012 More than half of girls are anemic, [access on 14/7/14] Available from  http://www.who.int/topics/anaemia/en/http://archive.indianexpress.com/news/more-than-half-of-adolescent-girls-in-india-anaemic-unicef/755548

2.     WHO report 2002.Available from URL, http://www.who.int/topics/anaemia/en/

3.     Swetha singh, Sangeetha kansale, Alok kumar. Assessment of nutritional status of adolescent girls in rural areas of district Varanasi. Indian journal of Research Anvikshiki 2002: Page No-1119-1125. Available from URL [http//nkrc.niscair.res.in/browse]

4.     Oellingrath, I. M. and Nærum, K. R. Dietary habits in adolescence related to sociodemographic factors, physical activity and self-esteem, 2006 Available from [http://www.ntnu.no/documents/6409319/17892466/FULLTEXT01.pdf]

5.     Swetha Singh, sangeetha Kansale, Alok kumar. Assessment of nutritional status of adolescent girls in rural area of  district Varanasi. Indian journal of Research Anvikshiki 2002; Page no: 1119-1125. Available from URL [http//nkrc.niscair.res.in/browse]

6.     Shahid A, Siddiqui F.R, Bhatti M.A, Ahmed M, Khan M.W. Assessment of   Nutritional Status of Adolescent College Girls at Rawalpindi. ANNALS VOL 15. NO.1JAN.MAR.2009.Pageno.11-15.AvailablefromURLhttp://www.annalskemu.org/journal/index.php/annals/article/viewFile/24/26

7.     Shi Z Lien N,kumar B N, Holmboe-ottesen G .Socio-demographic differences in food habits and preferences of school adolescents in china. Nutrition Journal 2005.Page no.1439-48Available from http://www.ncbi.nlm.nih.gov/pubmed/16118652

8.     Kurubaran Ganasegeram, Sami AR. Social and psychological factors affecting eating habits among university students in Malayasia school. Europes Journal of nutrition 2012 Page no.1186-1475. Available from  http://www.nutritionj.com/content/11/1/48

9.     Kylie Lange and Rebecca Golley. Change in the family food environment is associated with positive dietary change in children. International Journal of Behavioral Nutrition and Physical Activity 2013; 1186/1479-5868-10-4.Available from URL  http://www.ijbnpa.org/.

10.   Kotecha P V,sangita V Patel,R K Baxi,Mazymdar,Misra Shobha ,Dietary pattern of a school going adolescents in Baroda,Journal of health population,2013,Page no,490-496.Available from URL : http//www.ncbi.nlm.nih.gov.

11.   Togo P, Osler M, Sorensen TI, Heitman Bl. Food intake pattern of body mass index in observational studies. International journal of obesity and related metabolic disorder 2001: Page :1741-1751.Available from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697260/

12.   Kollątaj W, Sygit K, Sygit M, Karwat. Eating habits of children and adolescents from rural regions depending on gender, education, and economic status of parents. Journal of agriculture and general medicine 2011 Dec;18(2):393-95. Available from  URL aaem.pl/fulltxt.php? ICID=1067432.

 

 

 

 

 

 

 

 

Received on 03.10.2017                Modified on 29.10.2017

Accepted on 20.11.2017       ©AandV Publications All right reserved