|ORIGINAL RESEARCH REPORT
|Year : 2017 | Volume
| Issue : 2 | Page : 68-73
Knowledge and consumption of fruits and vegetables among secondary school students of Obele Community Junior High School, Surulere, Lagos State, Nigeria
Oluwakanyinsola Ojuolape Silva, Olayinka O Ayankogbe, Tinuola O Odugbemi
Department of Community Health and Primary Care, Faculty of Clinical Sciences, University of Lagos, Lagos, Nigeria
|Date of Web Publication||18-Apr-2017|
Oluwakanyinsola Ojuolape Silva
Department of Community Health and Primary Care, Faculty of Clinical Sciences, University of Lagos, Lagos
Source of Support: None, Conflict of Interest: None
Background: The incidence of noncommunicable diseases (NCDs) is increasing in developing countries, largely due to lifestyle and dietary changes. Adolescents are a nutritionally vulnerable age group; however, poor eating habits are often observed in adolescents. It has been observed that individuals who develop healthy eating habits early on in life are more likely to maintain them into adulthood and have a reduced risk of developing NCDs. This study aimed to assess the knowledge and consumption pattern of fruits and vegetables among junior secondary school students. Materials and Methods: This was a cross-sectional descriptive study of 220 respondents selected using a multistage sampling technique. An interviewer-administered questionnaire was used to collect data, which was analyzed using Epi Info Version 7 statistical software. Results obtained were presented with the use of frequency tables. Results: Results from this study revealed that 84.99% of the respondents displayed good knowledge of the nutritional and health values of fruits and vegetables; however, the consumption of fruits and vegetables was appropriate in only 5.48% of the respondents, having five portions of fruits and vegetables daily. Parental intake, encouragement, and supervision as well as availability and accessibility to fruits and vegetables at home were motivators for appropriate consumption. Conclusion: This study has revealed that the students of Obele Community Junior High School, Surulere, have good knowledge of the nutritional and health values of fruits and vegetables. However, the students have inappropriate daily consumption, as their consumption falls below the World Health Organization recommended five portions daily. Efforts should be made by the students themselves, the family, the School, all and sundry in the community to effect change soonest, so that these adolescents maintain healthy eating habits into adulthood, and hence prevent the occurrence of nutrition-related NCDs later on in life.
Keywords: Adolescents, consumption, diet, fruits and vegetables, knowledge
|How to cite this article:|
Silva OO, Ayankogbe OO, Odugbemi TO. Knowledge and consumption of fruits and vegetables among secondary school students of Obele Community Junior High School, Surulere, Lagos State, Nigeria. J Clin Sci 2017;14:68-73
|How to cite this URL:|
Silva OO, Ayankogbe OO, Odugbemi TO. Knowledge and consumption of fruits and vegetables among secondary school students of Obele Community Junior High School, Surulere, Lagos State, Nigeria. J Clin Sci [serial online] 2017 [cited 2019 Jan 23];14:68-73. Available from: http://www.jcsjournal.org/text.asp?2017/14/2/68/204704
| Introduction|| |
Fruit and vegetable consumption is important for the provision of micronutrients to the body, as these food items are a rich source of vitamins and minerals required for the growth, development, and normal functioning of the human body. Although required in small proportions, vitamins and minerals are an essential part of the daily diet, as the human body is not able to synthesize them in sufficient amounts to meet the nutritionally recommended daily allowance.
Fruits and vegetables provide dietary fibers (soluble and insoluble) vital for the optimal functioning of the gastro-intestinal tract. They also enable the body to use other nutrients required for its normal functioning (like the energy from fats and carbohydrates).
Urbanization, industrialization, technology development, economic development, and market globalization have led to rapid changes in diet and lifestyle in the past decade. The incidence of noncommunicable and chronic diseases especially cancers and cardiovascular diseases (CVDs) are also increasing in developing countries, largely due to the life style and dietary changes. Diet-related diseases such as diabetes mellitus, hypertension, CVD, and cancer are on the increase in Nigeria. The high prevalence of micronutrient deficiencies in developing countries has been attributed to the low level of knowledge of the nutritional value of these fruits and vegetables, as well as their low consumption, despite their availability and cultural acceptance in these countries.
As part of a healthy diet low in fat, sugars, and sodium, World Health Organization (WHO) suggests consuming more than 400 g of fruits and vegetables per day (equivalent to five portions) to improve overall health and reduce the risk of certain noncommunicable diseases (NCDs). In 2013, the WHO estimated that approximately 5.2 million deaths worldwide are attributable to low fruit and vegetable consumption. The low consumption of fruits and vegetables globally (below the above requirement) is said to be responsible for the increased incidence of CVDs and cancers; the two leading causes of death worldwide. Increased consumption of fruits and vegetables has been recommended as a key component of a healthy diet for the prevention of noncommunicable chronic diseases. Low consumption of fruits and vegetables has also been ranked the sixth major risk factor for mortality in the world.
The population of secondary schools is primarily adolescents. Adolescents are defined by the WHO as persons aged 10–19 years. They comprise 20% of the global population, and approximately 80% live in developing countries.
Adolescents are a nutritionally vulnerable age group because of their increased nutritional needs, eating patterns, lifestyles, and susceptibility to environmental influences. The dietary practices of students are a matter of concern as it affects more than their present health and well-being. There is the added risk that dietary practices established during early adulthood can continue into later life. Hence, healthy eating habits play a fundamental role in growth and development during adolescence.
However, poor eating habits are often observed in adolescents, whose diets are characterized by a low intake of dairy products, fruits, green vegetables, protein, and iron, and a high intake of sugar, soft drinks, and sodium- and energy-dense food items, both in developed and developing countries., This eating pattern is of major concern because it can lead to overweight and a higher probability of chronic NCDs, such as obesity, diabetes, high blood pressure, dyslipidemia, CVDs, and cancer later on in life. Studies from industrialized countries have reported that adolescents have unique dietary patterns that predispose to NCDs in adult life.
One of the nutritional problems affecting adolescent populations worldwide and Nigeria in particular is a micronutrient deficiency in iron, calcium, and Vitamin A.
It has been observed that individuals who develop healthy eating habits early on in life are more likely to maintain them into adulthood, and to have a reduced risk of developing chronic diseases. Thus, it is necessary to promote and encourage a healthy eating pattern in adolescents.
Providing information on nutrition and the eating habits of adolescents is important to identify risky and unhealthy behavior in this age group, and help when executing effective intervention programs to bring about positive changes in food intake and to reduce the occurrence and development of NCDs later in life.
Hence, this study was conducted to assess the knowledge and consumption of fruits and vegetables among students of Obele Community Junior High School Surulere, Lagos state, Nigeria.
| Materials and Methods|| |
Background and study design
This was a descriptive cross-sectional study assessing the knowledge and consumption of fruits and vegetables among secondary school students of Obele Community Junior High School, Surulere, Lagos State, Nigeria. Obele Community Junior High School is a Government-owned coeducational school, founded in the year 2003. It is located on a large expanse of land at Randle Avenue, Surulere, Surulere LGA, Lagos State, Nigeria. Facilities and classrooms are housed within a twin 3-storey building. The school caters for three levels of education - JSS1 (basic 7), JSS2 (basic 8), and JSS3 (basic 9), with 4 arms each – A, B, C, and D. The student body of the school had 256 boys and 154 girls in JSS1, 200 boys and 217 girls in JSS2, 131 boys and 100 girls in JSS3. There were 1058 students in the school as at the year the study was done, 2015.
Sample size determination
A minimum sample size of 220 was determined using the Cochran's formula, with a prevalence value got from a previous study  of 15.2%, at 95% confidence, precision of 5%, and a non-response rate of 10%. Correction for population <10,000 (nf = n/1 + n/N) was also done.
The study population consisted of JSS1 and 2 students of the School. The JSS3 students were excluded from the study as they were writing the West African Examinations Council Junior Secondary School Certificate Examination.
A multistage sampling technique was used to select respondents. Stage 1: Selection of class arms - there were 4 arms each of JSS1 and JSS2, named A, B, C, and D. Two arms each were randomly selected through balloting. From JSS1, arms A and D were selected, and from JSS2, arms B and C were selected. Stage 2: Selection of students - 55 students were selected in each arm through simple random sampling (balloting) from 102 students in JSS1 A, 102 students in JSS1 D, 104 students in JSS2 B and 104 students in JSS2 C. This made a total of 220 students in the arms that were selected and recruited into the study.
Data collection tool and technique
An interviewer-administered structured questionnaire with open- and close-ended questions, consisting of four sections on sociodemographic data, knowledge, consumption, facilitators, and barriers to consumption was used to collect data. Four research assistants with a minimum of SSCE qualification were trained on the study and its methodology, to assist with data collection. The questionnaires were pretested among ten students of a public school in Abule-Oja, Lagos Mainland LGA, Lagos State, Nigeria. Information was collected on a Wednesday and Friday when the students were on lunch break and after school hours.
Data collected were checked, coded, and analyzed with the EPI INFO Version 7 statistical software by the Centers for Disease Control and Prevention, Atlanta, Georgia. Scoring of questions on knowledge of fruits and vegetables-each correct answer was awarded a score of 1 mark, each wrong answer, 0 mark and the maximum obtainable score was 16. Knowledge was scored on a scale of 0–16 with scores between 0 and 8 accorded as poor knowledge of fruits and vegetable, while scores 9–16 were accorded as good knowledge of fruits and vegetables. Results were presented by the use of frequency tables.
Ethical approval for this study was obtained from the Health Research and Ethics Committee of the Lagos University Teaching Hospital. Informed consent was also obtained from the management and students of Obele Community Junior High School, Surulere.
| Results|| |
The sociodemographic characteristics of the subjects showed that 220 junior secondary school students comprising 125 males (56.8%) and 95 females (43.18%) participated in the study, with majority of the respondents (81.36%) being young adolescents aged 10–13 years, and the mean age was 12.43 years [Table 1]. Majority of the respondents 36.82% practiced Islam and quite a significant percentage of the respondents were of the Yoruba ethnic group (59.36%).
About 84.99% of the respondents displayed good knowledge of the nutritional and health values of fruits and vegetables while 14.99% performed poorly [Table 2] and [Table 3].
In 5.48% of the respondents, the practice of consumption of fruits and vegetables was appropriate, having five portions of fruits and vegetables daily [Table 4].
Time wasting (75.91%), taste (75.00%), satiety (64.09%), and cost (65.91%) did not discourage the consumption of fruits and vegetables [Table 5]. Parental intake (81.36%), encouragement, and supervision (72.73%) as well as availability and accessibility to fruits and vegetables at home (78.64%) were motivators for appropriate consumption [Table 5].
|Table 5: Barriers and facilitators to fruit and vegetable consumption by respondents|
Click here to view
| Discussion|| |
The sociodemographic characteristics of the subjects showed that 220 junior secondary school students comprising 125 males (56.8%) and 95 females (43.18%) participated in the study, with majority of the respondents (81.36%) being young adolescents aged 10–13 years. These sociodemographic characteristics are similar to those observed in studies conducted in Nigeria. In a study conducted among students in secondary schools in Sokoto Metropolis, Sokoto State, 70% of the students were male; and in a study conducted among adolescents in school, in Ila Orangun, in the South West; 61.3% of the respondents were young adolescents.
Nearly 84.99% of the respondents displayed good knowledge of the nutritional and health values of fruits and vegetables while 14.99% performed poorly. This level of knowledge was much higher than that assessed by Essien et al. who found that only 29% of their studied population had good knowledge of the nutritional value of fruits and vegetables. Poor knowledge of the nutritive values of foods among school students in rural QwaQwa South Africa was also reported by Oldwega-Iheron and Edgal. Kostanjevec et al. reported a similar observation among school students in Slovenia. Peltzer also studied nutrition knowledge among black students in South Africa and the students had below average nutrition knowledge levels.
Reasons for such a good knowledge outcome may not be far-fetched as the study was carried out in a more urban setting – Surulere, Lagos State as opposed to the rural QwaQwa, South Africa and conservative Sokoto Metropolis settings-an area comprising of a mix of high, middle, and low class individuals and with high educational status. With the availability and access to information from internet services, all forms of print and mass media, the students avail themselves the opportunity of equipping themselves with information about nutrition and thus increase their knowledge.
In 5.48% of the respondents, the practice of consumption of fruits and vegetables was appropriate, having five portions of fruits and vegetables daily. This low proportion of appropriate practice is similar to findings in other developed and developing countries where appropriate practice were found to be as low as 10% among American adults, 29% among students of a public university in Ghana, and 12% among adolescents in school in Ibadan, South-West Nigeria.
The low finding of appropriate consumption in this study can be attributed to the fact that numerous studies have found out that young adults (adolescents) do not consume the recommended daily intake of fruits and vegetables. Their typical food choices consist of high fat products with low nutrient density. As children and adolescents get older, their risk of following unhealthy dietary increases as they become more self-reliant in terms of food choices and preparation of meals. They experience more freedom of choice and are also faced with an increase in academic workload. Such factors may form barriers to maintaining/adopting a healthy lifestyle. Students may also give less attention to healthy eating habits as convenience foods are more available and affordable to them.
With 32.88% of the respondents having three portions of fruits and vegetables daily and 55.07% having 1–2 portions as recommended for adolescents in the 2006 Food Based Dietary Guidelines of Nigeria, there is still room for improvement.
Variables such as time wasting, taste, satiety, and cost did not negatively affect/discourage the consumption of fruits and vegetables. Taste was discovered to be a positive facilitator for fruit and vegetable intake among school children in Serbia  and students of the University of Ibadan, Nigeria. However, in the study conducted among students of a public university in Ghana, the variables taste and time wasting had no influence on the intake of fruits and vegetables; satiety and cost significantly hindered intake in students of the public university in Ghana and adolescents in school in Ibadan. However, other studies showed that despite when being in season (and therefore being cheap and available), consumption of fruits and vegetable is still poor.
Parental intake, encouragement, and supervision as well as availability and accessibility to fruits and vegetables at home were motivators and facilitators for appropriate consumption. These findings go on to support the evidence as put forth by other researchers whose studies revealed positive effects of the above determinants on fruit and vegetable consumption.
Rasmussen et al., Sumonja, and Novakovic  in their bid to assess the determinants that influence fruit and vegetable consumption among children and adolescents in different parts of the world and in Serbia, respectively, discovered that parental intake and home availability and accessibility were consistently positively associated with intake.
According to Tehrani adolescents, verbal encouragement, supervision, and instructions from parents, family members, relatives, and friends were important motivational factors. A majority of the adolescents mentioned that some persuasive factors, such as observing the intake of fruits and vegetables of parents, family members, relatives, and friends, as well as experiencing the positive outcome of fruit and vegetable consumption among the entourage.
Limitation to the study
There was recall bias as some students found it difficult to recall from memory their dietary in-take in the past 24 h.
| Conclusion|| |
This study has revealed that the students of Obele Community Junior High School, Surulere, have good knowledge of the nutritional and health values of fruits and vegetables. However, the students have inappropriate daily consumption, as their consumption falls below the WHO recommended five portions daily.
Efforts should be made by the students themselves, the family, the School, all and sundry in the community to effect change soonest, so that these adolescents maintain healthy eating habits into adulthood, and hence prevent the occurrence of nutrition-related NCDs later on in life.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Park S. Nutrition and Health. In: Park's Textbook of Preventive and Social Medicine. 18th
ed. India: Bhanot Publishers; 2005. p. 442-52.
Slavin JL. Position of the American dietetic association: Health implications of dietary fiber. J Am Diet Assoc 2008;108:1716-31.
Maiyaki MB, Garbati MA. The burden of non-communicable diseases in Nigeria; in the context of globalization. Ann Afr Med 2014;13:1-10.
] [Full text]
Hill MD. Recalled Fruit and Vegetable Intake while Growing Up and Its Association with Adult Fruit and Vegetable Intake among U. S. Adults – Analysis of the Food Attitudes and Behaviours Survey. Thesis, Georgia State University; 2011. Available from: http://www.scholarworks.gsu.edu/iph_theses/169
. [Last accessed on 2015 May 10].
Hart AD, Azubuike CU, Barimala SC. Vegetable consumption patterns of households in selected areas of the old rivers state of Nigeria. Afr J Food Agric Nutr Dev 2005;5:1-6. Available from: http://www.ajfand.net/Volume5/No1/index 1.html
. [Last accessed on 2015 Apr 21].
Wang X, Ouyang Y, Liu J, Zhu M, Zhao G, Bao W et al
. Fruit and Vegetable Consumption and Mortality from All Causes, Cardiovascular Disease and Cancer: Systematic Review and Dose Response Meta-Analysis of Prospective Cohort Studies. Available from: http://www.bmj.com/content/349/bmj.g4490.long
. [Last accessed on 2015 Apr 26].
Ogunkunle MO, Oludele AS. Food intake and meal pattern of adolescents in school in Ila Orangun, South-West Nigeria. S Afr J Clin Nutr 2013;26:188-93.
Onyiriuka AN, Umoru DD, Ibeawuchi AN. Weight status and eating habits of adolescent Nigerian urban secondary school girls. S Afr J Child Health 2013;7:108-12.
Rache H, Imma V, du Toit L. Development of a foodknowledge test for first-year students at a university of technology in the Western Cape, South Africa. J Fam Ecol Consum Sci 2014;42:28-32.
Fitzgerald A, Heary C, Nixon E, Kelly C. Factors influencing the food choices of Irish children and adolescents: A qualitative investigation. Health Promot Int 2010;25:289-98.
World Health Organization. Nutrition in Adolescence Issues for the Health Sector: Issues in Adolescent Health and Development. Geneva: WHO; 2005.
Essien E, Emebu PK, Iseh KR, Haruna MJ. Assessment of nutritional status and knowledge of students from selected secondary schools in Sokoto metropolis, Sokoto state, Nigeria. Afr J Food Agric Nutr Dev 2014;14:6-11.
Oldewage-Theron WH, Egal AA. Nutrition knowledge and nutritional status of primary school children in QwaQwa. South Afr J Clin Nutr 2010;23:149-54.
Kostanjevec S, Jerman J, Koch V. The effects of nutrition education on 6th
graders knowledge of nutrition in nine-year primary schools in Slovenia. Eurasia J Math Sci Tech Educ 2011;7:243-52.
Peltzer K. Nutrition knowledge and food choice among black students in South Africa. Cent Afr J Med 2002;48:4-8.
Kimmons J, Gillespie C, Seymour J, Serdula M, Blanck HM. Fruit and vegetable intake among adolescents and adults in the United States: Percentage meeting individualized recommendations. Medscape J Med 2009;11:26.
Mintah BK, Eliason AE, Nsiah M, Baah EM, Hagan E, Ofosu DB. Consumption of fruits among students: A caseof a public university in Ghana. Afr J Food Agric Nutr Dev 2012;12:13-18.
Ilesanmi OS, Ilesanmi FF, Ijarotimi IT. Determinants of fruit consumption among in-school adolescents in Ibadan, South West Nigeria. Eur J Nutr Food Saf 2014;4:100-9. Available from: http://www.sciencedomain.org
. [Last accessed on 2015 May 26].
WHO and Nutrition Division of Federal Ministry of Health. Food Based Dietary Guideline for Nigeria: A Guide to Healthy Eating. Abuja, Nigeria: Federal Ministry of Health; 2006. p. 23-30.
Sumonja S, Novakovic B. Determinants of fruit, vegetable, and dairy consumption in a sample of schoolchildren, Northern Serbia, 2012. Prev Chronic Dis 2013 31;10:E178.
Adenegan KO, Adeoye IB. Fruit consumption among university of Ibadan students, Nigeria. ARPN J Agric Biol Sci 2011;6:35-9. Available from: http://www.arpnjournals.com
. [Last accessed on 2015 May 26].
Banwat ME, Lar LA, Daboer J, Audu S, Lassa S. Knowledge and intake of fruit and vegetables consumption among adults in an urban community in North central Nigeria. Niger Health J 2012;12:1.
Rasmussen M, Krølner R, Klepp KI, Lytle L, Brug J, Bere E, et al.
Determinants of fruit and vegetable consumption among children and adolescents: A review of the literature. Part I: Quantitative studies. Int J Behav Nutr Phys Act 2006;3:22. Available from: http://www.ijbnpa.org/content/3/1/22
. [Last accessed on 2015 May 10].
Rakhshanderou S, Ramezankhani A, Mehrabi Y, Ghaffari M. Determinants of fruit and vegetable consumption among Tehranian adolescents: A qualitative research. J Res Med Sci 2014;19:482-9.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]