DIETARY PATTERN, NUTRITIONAL STATUS AND BLOOD PRESSURE LEVEL OF IN-SCHOOL ADOLESCENTS IN EDO STATE, NIGERIA

Abstract

Poor eating habit and dietary pattern predispose adolescents to Diet-related Non-Communicable Diseases (DrNCDs) including hypertension. The dietary pattern, nutritional status and blood pressure of adolescents needed to be adequately understood to inform appropriate intervention strategy against DrNCDs. This study was designed to assess the dietary pattern, nutritional status and blood pressure of in-school adolescents in Edo State, Nigeria. The cross-sectional study included a total of 1440 respondents selected using a three-stage simple random sampling technique. Two hundred and forty respondents were selected from two schools per Local Government Areas (LGAs) in each of the three Senatorial District in the State. A validated, standard interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics, dietary pattern, diversity and anthropometric characteristics of respondents. Dietary pattern was assessed using one-week food frequency questionnaire, while 24-hour recall was used to determine Dietary Diversity (DD) and nutrient intake. The DD was assessed with a 9-point scale categorised as low (1-3), medium (4-5) and high (6-9). Adapted Total Diet Assessment software was used to determine nutrient adequacy, classified as inadequate (<80.0%), adequate (80.0-120.0%) and excess (>120.0%). Weight (kg) and height (m) were assessed and analysed using WHO Anthro-Plus to generate Body Mass Index for Age [BMI/A (kg/m2)] z-score, classified as underweight (<-2SD); normal (-2SD to 1SD); overweight (>1SD to 2SD) and obese (>2SD). Waist Circumference [WC (cm)] was classified as normal (<75th percentile), moderate (≥75th-≤90th percentile) and high (>90th percentile). Validated sphygmomanometer was used to assess Blood Pressure [BP (mmHg)], classified as normal (<90th percentile), pre-hypertension (≥90th-≤95th percentile) and hypertension (>95th percentile). Data were analysed using descriptive statistics and linear regression at α0.05. Age of respondents was 14.5±1.9 years, 50.0% were female and 77.2% were ethnic minority in Edo State. Consumption pattern included: Staples- rice (52.3%), eba (40.7%) and yam (40.1%); Proteins- fish (64.1%), crayfish (53.3%), egg (42.8%) and beans (37.9%); Fruits (30.1%) and vegetables (31.0%). Meal skipping was high particularly lunch (48.7%) and breakfast (42.1%), while 30.9% added extra salt to food. Majority (56.6%) of the respondents had medium DD while 40.7% and 2.7% had low and high dietary diversity, respectively. Respondents adequately consumed total fat (97.9%), energy (89.6%), protein (87.9%), sodium (87.7%), vitamin A (74.2%) and carbohydrate (77.1%). However, respondents adequately consumed Potassium (1.9%), Calcium (4.1%), vitamin C (4.4%), dietary fibre (13.5%), folate (21.3%) and iron (31.7%). Prevalence of abnormal BMI/A (underweight, overweight and obesity) was 29.6% (9.0%, 18.1% and 2.5%, respectively). More males (45.8%, 6.7%) than females (32.4%, 4.6%) had moderate and high WC, indicative of cardio-metabolic risk. Prevalence of pre-hypertension and hypertension was 34.1% and 11.9%, respectively. Gender, ethnicity, WC and DD significantly predict BMI/A (β= 0.123, β = -0.068, β=0.310 and β= -0.041, respectively). However, the WC, BMI/A and DD were not significant predictors of BP (β=-0.029; β=-0.019 and β=0.030, respectively). The pattern of regular intake of macronutrient than micronutrient by the adolescents was established while observed Low DD and high WC were associated with malnutrition than hypertension hence corrective nutrition education should be promoted among adolescents.