Dietary diversity and nutritional status of adolescents in Lagos, Nigeria.

Background/Objectives: Adolescents in low- and middle-income countries, such as Nigeria, are at increased risk of malnutrition, especially obesity, but there is limited data describing the risk. We assessed this risk by examining the nutritional status and associated factors such as dietary habits, dietary diversity, nutritional knowledge and sociodemographic characteristics among adolescents in Lagos, Nigeria. Methods: A descriptive cross-sectional study in which 682 adolescents were selected from their communities using a multistage sampling technique. Dietary habits were assessed using a food frequency questionnaire, and dietary diversity was assessed through nonquantifiable 24-h diet recall. Anthropometric measurements were taken to determine nutritional status. Data were analyzed using Epi-Info software version 7.2.3.1. Nutritional status was evaluated using WHO AnthroPlus software. Chi-square was used to test for an association between categorical variables, and P values ≤0.05 were considered statistically significant. Results: The mean age of the adolescents was 13.6 ± 2.3 years, and only 47.4% of them had good nutritional knowledge. Dietary habits were poor and dietary diversity was low. The prevalence of overweight and obesity was 13.4% and 7.0%. Eating dinner, dieting to control weight and daily consumption of foods outside the home were associated with overweight and obesity (P < 0.05). Conclusions: Dietary habits and diversity of the adolescents were poor, while overweight and obesity were high. Eating dinner and daily consumption of foods outside the home were factors associated with being overweight and obesity. Our findings emphasize the critical need for adolescent nutrition programs that address weight control, especially among those who eat outside their homes.

Childhood diarrhoea in southwestern Nigeria: Predictors of low osmolarity ORS and zinc use among mothers.

Objectives: Diarrhoea is a leading cause of mortality among children in resource-limited countries. However, very scarce literature exists regarding the factors influencing the awareness and use of low osmolarity oral rehydration salts (Lo-ORS) and zinc supplementation in the management of childhood diarrhoea among mothers of children under 5 years of age in southwestern Nigeria. This study, performed in Lagos, Nigeria, aimed to address this lack of knowledge. Methods: Through a cross-sectional survey design, 336 mothers of children under 5 years of age were selected through a multi-stage sampling procedure. Data were collected with a pretested, semi-structured interviewer administered questionnaire and analysed in SPSS version 23. Descriptive and inferential statistical techniques were used for data analysis. Results: A total of 10.4% of the mothers were aware of Lo-ORS, whereas 6.5% had ever used it; 53.3% were aware of zinc supplementation, whereas 42% had ever used it. Awareness was influenced by educational level (AOR: 2.017; 95% CI: 1.123-3.626) and the age of the child (AOR: 2.257; 95% CI: 1.237-4.117) for Lo-ORS, and by average monthly income (AOR: 1.582; 95% CI: 1.144-2.187) for zinc supplementation. The utilisation level was associated with educational level (p = 0.039) and awareness (p < 0.001) for Lo-ORS, and with marital status (p = 0.018) and awareness (p < 0.001) for zinc supplementation. Conclusion: Awareness and use of Lo-ORS was poorer than that of zinc supplementation among the mothers. Efforts to promote awareness regarding these treatments among mothers and health workers should be intensified to promote their use and help bridge the gap between policy change and effectiveness.

Association Between Breakfast Consumption and Anthropometrically Determined Nutritional Status of Secondary-School Adolescents in Lagos, Southwest Nigeria.

Background and Objectives: Breakfast skipping has been associated with obesity among adolescents in some studies but little is known about the relationship between breakfast consumption and obesity among secondary-school adolescents in Nigeria. This study contributes to the empirical literature by analyzing the relationship between breakfast consumption and anthropometrically determined nutritional status of secondary-school adolescents in Lagos, Nigeria. Methods: This was a descriptive cross-sectional study in which multi-stage sampling was used to select 397 secondary-school adolescents (10 to 19 years, mean = 13.8 ± 1.7 years). They were classified into student groups from public or private schools in Lagos. Data were collected using a semi-structured self-administered questionnaire and analyzed using Epi-info version 7. The independent variables were the proportion of adolescents who had a high level of knowledge about breakfast consumption, while the outcome variable was the proportion of adolescents who were overweight or obese. World Health Organization (WHO) AnthroPlus software was used to determine the nutritional status of adolescents. Mean and standard deviations were computed for continuous variables, and frequency tables were generated for categorical variables. Significant associations between variables were obtained using Chi-square with the level of significance set at p < 0.05. Results: Only 17% of the adolescents had good knowledge of breakfast consumption. More than half (57.4%) of the participants ate a daily breakfast. The percentage of adolescents who skipped breakfast was higher among older 16-19 years (52.2%) and middle 13-15 years (43%) than the younger adolescents (34.7%). Girls skipped breakfast more than boys. Most respondents were in the normal Body Mass Index (BMI) ranges for their genders. Prevalence of overweight and obesity were 7.1% and 3.3% among males and 7.1% and 2.8% among females respectively. The mean BMI of those who skipped breakfast (19.33 ± 3.27kg/m2) was significantly higher than the BMI of those who ate breakfast (18.56 ± 3.05 kg/m2) (p=0.019). Most of the adolescents who ate a daily breakfast had mothers who had completed only primary school education although the relationship was not statistically significant (χ2 =5, p=0.172). Conclusion and Global Health Implications: Breakfast knowledge was low, while breakfast consumption was average. Adolescents who skipped breakfast had a significantly higher BMI (19.33 ± 3.27kg/m2) than those who ate breakfast (18.56 ± 3.05 kg/m2) (p=0.019). Nutrition education that emphasizes the importance of breakfast consumption with the purpose of behavioral change should be intensified among adolescents.

Dietary habits, diversity, and predictors among pregnant women attending primary health care centers for antenatal care in Lagos, Nigeria.

BACKGROUND AND AIM: Inadequate nutrition during fetal development resulting from poor dietary habits leads to reprogramming within fetal tissues and poses as a risk factor for non-communicable diseases in later life. This study was conducted to determine the dietary habits, diversity, and predictors among pregnant women in Lagos, Nigeria. METHODS: A descriptive cross-sectional study was conducted using a structured interviewer-administered questionnaire to obtain data from pregnant women attending primary health care centers in Lagos, Nigeria. A multistage sampling method was used to select 350 pregnant women. A food frequency questionnaire was used to assess the dietary habits while dietary diversity was measured using non-quantifiable 24-hour recall. Data were analyzed using Epi-Info version 7.2 computer software. Chi-square and t-test were used to test for associations and P value < 0.05 was considered to be statistically significant. RESULTS: Only 16.7% of respondents consumed five servings of fruits and vegetables daily while the rice was the most frequent meal taken (45.4%). Meat was the commonest animal protein (20.3%) and only 30.8% had a high dietary diversity score (DDS). High DDS was significantly associated with parity of 1-3, living in a duplex or detached house, completion of at least secondary school education, and highly skilled professionals. CONCLUSION: Healthy dietary habits and high DDS were low and associated with low parity and higher socio-economic status. Nutrition intervention that encourages higher dietary diversity is needed especially among women of higher parity and lower socioeconomic status in Lagos.

Inflammatory Bowel Disease in Children: Experience and Constraints in a Resource-limited Setting.

INTRODUCTION: Inflammatory bowel disease (IBD), though well described in the Caucasian population, is rarely encountered in the black African children. The aim of this study was to increase the awareness of this emerging condition in African children and highlight the constraints of management in a resource-limited setting like Nigeria. METHODS: This study included an audit of children with IBD who were seen between January 2015 and February 2020 at the Lagos University Teaching Hospital (LUTH). The clinical records of children aged one to 16 years who presented with recurrent abdominal pain, weight loss, and gastrointestinal (GI) bleeding with clinical suspicion of IBD were reviewed. Clinical features, endoscopic findings, histopathologic findings, and treatment were documented. RESULTS: Eight children with IBD were seen during the study period. The median age was 12.0 years (range: five to 15 years). The most common reported concerns in the children were chronic abdominal pain [seen in four patients (50%)] and bloody diarrhea [seen in three patients (42.30%)]. Weight loss and arthritis were seen in three (37.5%) and one (12.5%) children, respectively. Endoscopy confirmed two cases of Crohn's disease (CD), three cases of ulcerative colitis (UC), and three cases of indeterminate colitis (IC). The children with CD were treated with steroids and exclusive enteral nutrition, with one patient receiving methotrexate, while the UC and IC patients received 5-aminosalicylate therapy. CONCLUSION: Although IBD is uncommon in Nigeria, a high index of suspicion is vital to enable early diagnosis and appropriate treatment. Management in the African setting is severely constrained by limited access to endoscopy facilities and nonavailability of other effective treatment options such as biologic agents.

Overweight and Obesity Among School-aged Children and Maternal Preventive Practices against Childhood Obesity in Select Local Government Areas of Lagos, Southwest, Nigeria.

BACKGROUND: Childhood obesity is an emerging epidemic in the developing countries, particularly in the urban settings. This study examines the prevalence of overweight and obesity among school-aged children and the maternal preventive practices against childhood obesity. METHODS: This is a cross-sectional study of school-aged children aged 6-13 years and mothers from two Local Government Areas of Lagos State, Southwest Nigeria. Multi-stage sampling technique was used to select study areas and participants, while data were collected using an interviewer administered questionnaire. The Body Mass Index (BMI) of children were determined using the World Health Organisation (WHO) 2007 reference charts. Chi-square test was used to analyze categorical variables and logistic regression analyses were conducted to determine the factors associated with the nutritional status and maternal childhood obesity preventive practices. All analyses were conducted using the Statistical Package for Social Sciences (SPSS) 21. RESULTS: In all, 440 children comprising of 232 boys (52.7%) and 208 girls (42.3%) were studied. Of these, 29 of the participants (6.6%) were overweight, while 39 of them (8.9%) were obese. Most of the children (71.2%) consumed root/tubers and processed cereals while 9 (0.02%) and (17) 0.04% consumed fruits and vegetables. BMI was only significantly related to child age and sex. In all, 243 mothers (55.2%) had good practices against childhood obesity. Levels of maternal preventive practices were not significantly associated with child BMI. CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS: Overweight/obesity among school-aged children in Lagos is high. Only half of the mothers were involved in preventive practices against childhood obesity. There is need for continuous education and advocacy concerning healthy diet and other preventive strategies against childhood obesity in Lagos, and potentially other parts of the developing world.

Nutritional Assessment and Maternal Perception of Toddler Body Size using Toddler Silhouette Scale in Nigeria a Developing Country.

BACKGROUND AND OBJECTIVES: The toddler silhouettes scales have been validated in the caucascian population in developing countries but in the African population, the use of these scales is yet to be evaluated. The aim of this study was to determine the perception of mothers on the body size of toddlers using a validated scale in an African population. METHODS: This was a cross sectional study of 241 mothers and their toddlers. Study participants were recruited from the immunization and pediatric clinics. The mothers' perceptions of the body sizes of toddlers and their own child was determined with the use of a validated 7-scale toddler silhouette. Each mother also assessed their own child with the scale. Each child's anthropometry was documented. RESULTS: Majority of the mothers were able to correctly classify the underweight (95.0%) and overweight toddler silhouettes (95.7%). However, 30% of the respondents misclassified Silhouette 6 (overweight silhouette) as normal and 48.2% of the respondents misclassified a normal silhouette as underweight. The overall maternal accuracy in assessing their toddler size was 41.1%. There was a significant relationship between maternal accuracy and the maternal educational status, tribe, and toddler size. CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS: Toddler silhouette scales is a quick way of assessing the body size of children and could be of significant use in the developing countries. There is a need for caregivers to accurately assess the body size of their children as this will significantly influence the food mothers will give their children and thus children's eventual growth and development.

Assessment of factors affecting self-rated health among elderly people in Southwest Nigeria.

CONTEXT: Self-rated health (SRH) is a subjective measure of health considered valid to predict mortality among the elderly. With the rapid increase of older people living in Nigeria and the lack of adequate social security, it is important to identify factors affecting their SRH. Social support has also taken on added importance among the elderly in view of scarce resources. OBJECTIVE: To determine the level of satisfaction with the forms of social support received by the elderly and the factors associated with their SRH. SETTINGS AND DESIGN: The study was a descriptive cross-sectional study design among the elderly in Southwest Nigeria. SUBJECTS AND METHODS: A multistage sampling technique was employed to select 360 elderly respondents for the study. A standardised questionnaire, Short Form Health Survey-36 was interviewer administered. The data were analysed using Statistical Package for the Social Sciences version 20. Significant associations between categorical variables were evaluated using Chi-square (χ2) test. Multiple regression test and adjusted odds ratios (ORs) were employed to assess the relationship of the various predictors of SRH. The level of significance was set at P < 0.05. RESULTS: The mean age of the 360 elderly respondents was 73 ± 9.3 years, 60.3% were female and 43.9% were widowed. Almost all (91.9%) the respondents received emotional while domestic support was the least in 50.3%. About 30.0% of the elderly self-rated their health as poor. The predictors of good SRH after multiple logistic regression included being married (OR = 1.84, 95% confidence interval [CI]: 1.01-3.33, P = 0.04); engagement in work (OR = 2.27, 95% CI: 1.11-4.63, P = 0.02); the absence of morbid conditions (OR = 12.6, 95% CI: 2.86-55.4, P = 0.001) and higher levels of education (OR = 0.41, 95% CI: 0.19-0.91, P = 0.03). CONCLUSIONS: About one-third of the elderly had poor SRH. Targeted interventions such as creating employment fit for the elderly and improving healthcare access is recommended.