ABSTRACT
The eating habits of adolescents are of concern for public health, as
there is a direct association between inadequate diet during this phase and the
occurrence of obesity. Adolescents are
considered to be a nutritionally vulnerable segment of the population.
Adolescents’ initial experiences with eating and food are strongly shaped by
the parents. The link between parental involvement and influence on
adolescents’ dietary practices have been the least explored area. The general objective of
this study was to assess
parental involvement, and factors associated with the dietary patterns of
adolescents in the study area.
This research was a cross-sectional survey
which was carried out among 411 respondents (parent-adolescent dyads) who
resided in Alimosho Local Government of Lagos state. A semi-structured
instrument (questionnaire) was used for data collection. They were selected
through the use of the multistage random sampling technique which involved the
selection of wards and houses which made it possible to get to the participants
for the study. Associations
between selected factors of adolescents’ dietary patterns (daily intake of
candy and sweets, soft drinks, fruit and vegetables) and parental
socio-economic position (occupation and income) was examined. Data
collected were analyzed using Statistical Package for Social Science (SPSS)
version 21 with levels of significance set at 0.05.
Findings revealed that there were
235 (57.3%) male adolescents and 176 (42.8%) female adolescents in this study
with mean age of 16.09 ± 2.17 with however most adolescents (23.8%) of age 17
years old. Findings showed that these individual factors affecting dietary
pattern varied across the demographic characteristics of both adolescents and
parents; gender of respondents was found to have varied individual factors (df
= 11; F = 11.72; P < 0,05), also
was age of adolescents (df = 11; F = 10.26; P
< 0,05), religion (df = 11; F = 11.20; P < 0,05). Dietary pattern of adolescents however was described
as follows: consumption of red meat (beef), chicken and fish was low as just
only 32 adolescents consumed these always as compared to 238 and 126
adolescents who never and rarely consumed these respectively. Result showed
that adolescents’ parents involvement has a significant influence of their
dietary pattern (F = 13.76; R Square = 0.033; P < 0.05) which can be deduced to be a 3.3% influence. However,
this influence was determined to be negative (t = -3.71; β = -0.18) indicating
the involvement of parent led to a low dietary pattern of adolescents in this
study area.
In conclusion, parental involvement
was poor, from playing role model and making healthy food available to eat at
home, this in turn led to a poor dietary pattern by respondents. In light of
this, health promotion intervention tailored towards improving dietary pattern
of adolescents should not only be directed towards the adolescent but rather
towards their parents and also, design of public health education program
should be carried out which will aim at increasing the knowledge of parents on
the needed classes of food that makes up a balanced diet.
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Lifestyle
of adolescents, especially their
food pattern encounters dramatic changes,
mainly due to
their higher freedom
in decision making, including selection and purchasing of foods
(Daniel, 2002). The assessment of food consumption
pattern of this highly vulnerable age group is important in enhancing health
status of next generations. So, recognizing
food consumption pattern and method of adolescents is one of
the most important
research priorities in designing
appropriate programs and
applying effective approaches toward improving the health status of
future adults.There is a greater need to look into the dietary patterns of adolescents
but unfortunately, precise estimates of their dietary intake, dietary practices
have been the least explored area. The current direction in nutrition
education reinforces the notion that parental involvement might be necessary
for substantial dietary change in children and adolescents. However, research
on family determinants of food patterns is limited.
Involvement of
the parents is a mixture of obligation and active contribution to the
adolescent child. Adolescents’ initial experiences with eating and food are
strongly shaped by the parents. Parental involvement talks about forces and
conditions in the home which lure the child physically, intellectually and
emotionally.
According to the World Health
Organization (WHO) adolescence is a period between the ages of 10-19 years
(WHO, 2016). Adolescents represent approximately 20 % of the world’s population
and most (84 %) are living in developing or emerging countries (Ghai, Gupta & Paul,
2006).The prevalence of adolescents’ obesity is rapidly growing
worldwide (WHO, 2013). This trend is of concern due to the negative health
effects associated with increased body mass. Many studies reported that parents, particularly mothers, have a
considerable influence on their children’s eating and dieting patterns, because
of their presumed central role in acting out the nature and importance of
thinness and the gender-stereotyped nature of dieting itself (Rafiroiu, Sargent,
&Thompson, 2003).Community beliefs
and family dietary practices have
also been identified
as important predisposing factor
to malnutrition (Abubakar, Holding, Mwangome, & Maitland, 2011; Wong, 2014).
The eating habits of adolescents are of concern
for public health, as there is a direct association between inadequate diet
during this phase and the occurrence of obesity and other chronic diseases in
adulthood (McNaughton, Ball, Mishra, & Crawford, 2008). Worsening this
scenario, the prevalence of obesity and related diseases has significantly
increased worldwide. (Gupta, Goel, Shah, &Misra, 2012; Robinson, Geier,
Rizzolo, & Sedrak, 2011).
Adequate intake of foods and nutrients contribute significantly to the
growth and development during the adolescence period particularly among the
girls, who are the future mothers. A
balanced diet during childhood and adolescence is crucial not only for the
well-being and growth of the child, but also for the establishment of sound
dietary habits that will persist in later life (Westenhoefer,
2002). An
optimal diet during adolescence is important to support normal growth and
development. (Vereecken, Inchley, & Subramanian, 2005). Dietary habits developed in adolescence may
contribute to form adult dietary habits. Adolescent eating behaviour is a function of
individual and environmental influences. Individual influences are
psychological as well as biological, whereas, environmental influences include
immediate social environments such as family, friend, and peer networks and
other factors such as school meals and fast food outlets. In addition, another
important factor is social system or macro system which includes mass media, marketing
and advertising, social and cultural norms of the society (Story,
Neumark-Sztainer, & French, 2002). Mishra, Ball, Arbuckle and Crawford,
2002 carried out a study in which education,
occupation, income and employment were considered simultaneously, it was
indicated that education
and occupation are usually the strongest determinants of socio-economic status, however, education and the
parent’s occupation have
had more effects on
food intake.
Mikkila,
Rasanen, Raitakari, Pietinen and Viikari (2005) advanced that just limited
researches have studied adolescents’ dietary patterns alongside environmental
and social factors which could have effect on them through their life period.
These studies on dietary patterns of young adults were grounded on small
populations such as school classes.
Maria,
June, Lily, Rachel, Judith, and Margaret (2011) established that the availability of foods in the
home is likely to be related to consumption. We know of no studies that have
reported this association in African-American participants, and few studies
have examined home food availability using objective methods.
Arabshahi, Pourmoghim,
Pouraram, Aminpour, Kalantari, Golestan, & Abtahi, 2003 addressed the
relations of socioeconomic factors and the anthropometric indicators of
adolescents. It was shown that it had
more effects on factors
like education and
occupation of parents
and the family size
on food intake
and anthropometric
indicators of this
age group. In spite
of these findings, it
is difficult to
say how much
of the seen differences
is the result
of each indicator.
Accordingly, knowledge about actual nutritional intake and diet
behaviour among children and adolescents is essential. Information on dietary
patterns reflect the overall nutritional behaviour better than information on
single foods or nutrients (Hu, 2002). Therefore, the analysis of dietary
patterns gives a more comprehensive impression of the food consumption habits
within a population.It is common for adolescents to
substitute main meals with high-calorie snacks or to skip important meals such
as breakfast. In addition, they consume many foods with a high content of
sugar, refined carbohydrates and saturated fats, and do not consume enough
fruit and vegetables; they are also prone to adopting monotonous diets or food
fads (Slattery, 2008).
1.2 Statement of the Problem
Adolescents eating patterns
should be encouraged in adolescents and especially in females. This could
assist in preventing the development of diseases associated with an inadequate
intake of nutritious food (Ogunkunle & Oludele, 2013). It was established that
understanding
the overall dietary patterns of a population is an important and key step in
initiating appropriate nutritional interventions and policies. Studies characterising the dietarypatterns of Nigerian mothers and children are
lacking (Nwaru, Onyeka, Ndiokwelu, Esangbedo,
Nguw & Okolo, 2015). Few studies have compared parent–child dietary intake
among adolescents who are overweight or obese which is a nutritional problem.
Helping parents improve their diet may promote improvements in their adolescent's
diet and is a potential target for interventions designed to increase healthy
eating among adolescents (Allison, Louise, Susan, Chris & Rhona,
2014).
The diets of children and
adolescents are of public health concern due to evidence relating poor nutrition
in childhood to subsequent obesity and elevated risks for type 2 diabetes, the
metabolic syndrome and CVD
(Canete, Gil-Campos, Aguilera & Gil, 2007)
all of which are increasing in prevalence (WHO, 2004). Research indicates that parents play an important
rolein influencing the eating behaviors of adolescents (Rasmussen, Krolner & Klepp (2006), Pearson,
Biddle & Gorely, 2008). However, relatively few healthy eating programs have utilized parents as
potential avenues for intervening with adolescents. (Pearson,
Atkin & Biddle, 2010). Parents influence the availability of food within the home but can also
exert their influence through their attitudes and beliefs regarding eating, by
exposing their adolescents to certain foods or by actively encouraging or
controlling certain eating behaviors (Pearson, Biddle & Gorely,
2008; Brug, Tak & Velde,
2008). Less
research has examined report of parenting practices and their associations with
adolescent dietary intakes (Pearson, Biddle & Gorely,
2008).
However,
parental report might be a more valid measure than adolescent report; for
example, parents may be able to more accurately report their own attitudes,
beliefs and behaviors and may have a better sense than adolescents of the home
availability of specific foods, given that parents primarily control which
foods are purchased for and served in the home (Hanson, Neumark-Sztainer, & Eisenberg, 2005). It
is believed that almost one third of children in developing countries are
malnourished (FAO, 2015). Identifying
factors that influence the dietary patterns of adolescents may assist in
targeting at risk groups and developing strategies to improve dietary intakes. Many
studies have been done concerning involvement of parents in the dietary
patterns of children most especially. However, there could be a dearth in
research about the involvement of the parents in dietary patterns of
adolescents or young adults especially in the proposed study of location.
1.3 Objective of the Study
The general
objective of this study is to assess parental influence, and factors associated
with the dietary patterns of adolescents in the study area. The specific
objectives are to:
1. determine
the relationship between socio demographic characteristics of parents’ and
adolescents’ and individual beliefs to their dietary patterns;
- identify
the main dietary patterns among adolescents;
3. identify level of parental involvement influencing dietary
patterns of adolescents;
4. assess associated factors influencing adolescent’s
dietary patterns;
5. examine the relationship between accessibility
and availability of food products and dietary patterns of adolescents at the
household level;
6. assess the difference between dietary
patterns of adolescents across parents’ socioeconomic status and
7. examine the relationship between parents’
education and socioeconomic status associated with dietary patterns of the
adolescents.
1.4 Research Questions
1. Is
there a relationship between socio demographic characteristics of parents’ and
adolescents’ and individual beliefs to their dietary patterns?
2.
What are the main
dietary patterns among adolescents?
3. In what way would parental involvement influence
dietary patterns of adolescents?
4.
Which of the
associated factors influence adolescent’s dietary patterns?
5.
What is the
relationship between accessibility and availability of food products and
dietary patterns of adolescents at the household level?
6.
What is the
difference between dietary patterns of adolescents across parents’
socioeconomic status?
7.
What is the
relationship between parents’ education and socioeconomic status associated
with dietary patterns of the adolescents?
1.5 Significance of the Study
At the end of this
study, the findings would provide a better understanding of parents’
involvement in the dietary patterns of adolescents and also the associated
factors. The study would provide information on the need of parents to be more
involved in adolescents’ dietary patterns. The findings may also provide useful
information for parents to become more involved in their young adults’ food
intake in order to enhance good health by taking the necessary measures. Also,
this study would benefit the community, academic institution and the nation at
large by making them informed and providing solutions to dietary issues of
adolescents.
Dietary habits among adolescents
represent an important public health issue because of the long-term effects on
health and health behaviour. Knowledge
of this age group and their dietary habits may provide a good basis for future
health promotion initiatives and would also help public health workers to be
able to tease out other areas where they can be involved in solving dietary
issues.
1.6 Justification forthe Study
The focus of the study is on the involvement of parent
and associated factors in dietary patterns of adolescents’. Past research in
this field points out that there is a weak relationship between parents and
their adolescents’. Studies carried out in Ireland, suggest that it is
necessary to include a parent component in which it may influence dietary
patterns of adolescents’ (Amanda, Caroline,
Elizabeth & Colette, 2010).
A study
conducted by (Miller, Hering, Cothran, Croteau, and Dunlap,
2012), suggests that only a few studies
have examined the effect of parental supervision on diet quality of older
children and adolescents.Studies also revealed that parents do not usually get
involved in dietary patterns of adolescents, unlike how they do with toddlers
and children. Dietary intake during adolescence contributes to lifelong eating
habits and the development of early risk factors for disease in adulthood. Few
studies have examined the dietary patterns of adolescents and the social and
environmental factors that may affect them during this life stage. (Gina,
Wendy, Monique, Therese, Beth, Nick, Sven, Stephen, Garth, Fiona &
Lawrence, 2008).Since
there is very little information about dietary intakes and the relationship
with parental influence of adolescent population an attempt would be made to
find the relationship between dietary intakes and parental influence.
Research indicates that
parents play an important role in influencing the eating behaviors of adolescents.
(Rasmussen,Krolner& Klepp (2006),
Pearson, Biddle&Gorely, 2008). However, relatively few healthy eating programs
have utilized the home environment or parents as potential avenues for intervening
with adolescents. (Pearson, Atkin & Biddle, 2010). Parents influence the
availability of food within the home but can also exert their influence through
their attitudes and beliefs regarding eating, by exposing their adolescents to
certain foods or by actively encouraging or controlling certain eating
behaviors. (Pearson, Biddle&Gorely, 2008; Brug,Tak& Velde, 2008). Most of the research
examining parental influences on adolescent fruit consumption has examined
adolescent perceptions (Pearson, Biddle&Gorely, 2008) less research has examined
parent report of parenting practices and their associations with adolescent
dietary intakes. However, parental report might be a more valid measure than adolescent
report; for example, parents may be able to more accurately report their own
attitudes, beliefs and behaviors and may have a better sense than adolescents
of the home availability of specific foods, given that parents primarily
control which foods are purchased for and served in the home (Hanson,Neumark-Sztainer,& Eisenberg, 2005).
Many of the studies that
have been conducted are not conceptually and logically grounded in behavioral
theories to identify some salient factors associated with parental involvement
in the dietary patterns among adolescents. This study is therefore designed
appropriately in such a way that, it is guided by an ecological model that will
enable the salient factors associated with parental involvement of dietary
patterns of adolescents in the area of study. Findings showed that no study was
found conducted in Alimosho Local Government of Lagos state, Nigeria that
addresses the involvement of parents in dietary patterns of adolescents. This
study seeks to bridge this gap.
1.7 Operational Definition of Terms
Parental
involvement: This is a combination of
commitment and active participation on the part of the parent to the adolescent.
Dietary patterns:
This is referred to as quantities, proportions, variety or combination
of different foods, drinks, and. nutrients in diets, and the frequency with
which they are habitually consumed.
Adolescents: They
are young people between the ages of 10 and 19 years who are often thought of
as a healthy group. Nevertheless, many adolescents do die prematurely due to
accidents, suicide, violence, pregnancy related complications and other
illnesses that are either preventable or treatable. Many more suffer chronic
ill-health and disability. In addition,
many serious diseases in adulthood have their roots in adolescence.
Associated
Factors: They are factors that needs to be
recognised and they have a relationship with the dependent variable.
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