Introduction
Abidoye and Ihebuzor (2001) defines nutritional status is the condition of the body in those respects influenced by the diet; the levels of nutrients in the body and the ability of those levels to maintain normal metabolic integrity. For adults, general adequacy is assessed by measuring weight and height; the result is commonly expressed as the body mass index, the ratio of weight (kg) to height (m). Body fat may also be estimated, by measuring skin-fold thickness, and muscle diameter is also measured. But for children, the practical tool for its evaluation is anthropometry. In developing countries, the nutritional status of populations, particularly of children is the best indicator of the global well-being of children. One of the major global health problem faced by the developing countries, today is malnutrition. Of course, Nigeria too, is not an exception to this problem of malnutrition. The primary cause of ill-health and premature mortality among children, in developing countries is attributed to under-nutrition.
Ganong (2001) described anthropometry as the measurement of the human individual. The most basic of anthropometric measurements are weight and height. Anthropometric measurements are used to determine a human being’s nutritional and general health status. Measuring weight and height of infants and children is an international health practice that provides a readily accessible, inexpensive, objective method to ascertain the health history and health status of a child. A weight measurement along with a height measurement is a powerful tool; with them a clinician has a direct record of the prior health status and dietary intake of a child and his/her future risk status for poor health. Weight and height measurements are essential in children in order to identify malnourished children, children at-risk of malnutrition and to evaluate the overall health status of children.
Abidoye and Ihebuzor (2001), Odunayo and Oyewole (2006), Glew et al., (2003), Ekpo et al, (2008) and Abidoye (2000), investigating the problem of under-nutrition among children in different parts of Nigeria.
Nutritional status and health
Gibney, Vorster and Kok (2002), states that your diet determines your nutritional status; which is a measure of the state of your health. For example, people who are starving do not get the dietary nutrients or calories they need to maintain their health. These people are said to be malnourished, which means their nutritional status is, to put it gently, definitely not good.
Malnutrition may arise from:
- A diet that doesn’t provide enough food. This situation can occur in times of famine or through voluntary starvation because of an eating disorder, or because something in your life disturbs your appetite. For example, older people may be at risk of malnutrition because of tooth loss or age-related loss of appetite or because they live alone and sometimes just forget to eat.
- A diet that, while otherwise adequate, is deficient in a specific nutrient. This kind of nutritional inadequacy can lead to a deficiency disease, such as beriberi, the disease caused by a lack of vitamin B1 (thiamine).
- A metabolic disorder or medical condition that prevents your body from absorbing specific nutrients, such as carbohydrates or protein. One common example is diabetes, the inability to produce enough insulin, the hormone your body uses to metabolize (digest) carbohydrates.
- Another is celiac disease, a condition that makes it impossible for the body to digest gluten, a protein in wheat.
Growth and nutritional status
Physical growth as described by Eveleth and Tanner (1990), is widely recognized as one of the most sensitive and reliable indicator of health and nutritional status in the human population. They further stated that growth and maturation are maintained by the interactions of genes, hormones, and nutrients, and it provides an indirect measurement of the quality of life of an entire population.
Vaid and Vaid (2005) opined that nutrition is the process by which living organisms receive and utilize the material necessary for the maintenance of their function as well as renewal of their function. The assessment of nutritional status is useful for understanding not only the health status of a community but also for the national and regional policy planning. In their opinion, childhood and adolescence are stages of great interest in the study of diet and assessment of nutrition, because it is a period during which the dietary habits of the future adult are consolidated. One of the major health problems in many developing countries is malnutrition (undernutrition and overnutrition) which creates a lasting effect on the growth, development, and physical fitness of a person. Undernutrition is difficult to quantify, but its presence is ordinarily established in public health and clinical contexts with the use of anthropometry, specifically weight and height. Undernutrition during infancy and early childhood receives most emphasis because of its association with morbidity and mortality early in life and its long-term consequences; however, undernutrition can occur at any time during the life cycle.
Furthermore, the terms overweight and obesity, on the other hand, are often used interchangeably, but they are not synonymous. Overweight is characterised by a moderate degree of excess weight-for-height, whereas obesity is a more severe state. Overweight and obesity are occasionally referred to as a state of overnutrition. They occur as a result of an imbalance between energy intake and energy expenditure in which intake exceeds expenditure; physical inactivity is an essential component of the equation (Malina, Bouchard, Gareth & Bar-Or, 2004).
In general, according to Bouchard (2000) overweight is more likely to result from behavioural factors such as dietary practices and the lack of physical activity, whereas obesity typically has a stronger behavioural and metabolic and possibly genetic aetiology. It has been shown that overweight or obesity assessed by the body mass index (BMI) during childhood is a strong predictor of overweight or obesity and coronary heart disease risk factors in young adulthood. Overweight and obesity may occur in early childhood, but their prevalence is more common during childhood, adolescence, and adulthood. They have associated functional consequences and long-term health implications.
Nutritional status and infectious diseases
WHO (1997), stated that there are two very different kinds of infectious diseases of worldwide importance are linked to nutrition and of current interest in developing countries; human immunodeficiency virus (HIV) infection and acute gastrointestinal infection.
Nutrition and HIV
The links between HIV infection and nutrition include optimum nutritional status to maintain normal immune function as long as possible, the importance of good nutrition in maintaining health and extending the asymptomatic period, and appropriate nutritional support for those who develop acquired immunodeficiency syndrome (AIDS).
The role of nutrition in HIV disease has been reviewed in detail by Oliver and Hyder (2002) in their report to WHO which states that HIV-positive people are particularly vulnerable to exploitation. There is a need for accurate information and targeted education to avoid reliance on, and the unnecessary costs of, inappropriate diets and unproven prophylactic nutrient supplementation regimes that may replace adherence to a suitable diet. They further stressed that ‘many unscientifically based nutrition regimens had been claimed to be effective in the management of patients with [HIV] infections [and] it was agreed that sound nutritional advice was needed to counter such claims’; it recommended that people infected with HIV have access to scientifically sound advice from qualified dieticians.
Nutrition and diarrhoeal disease
The relationship between diarrhoeal disease and nutrition has been summarised by Oliver and Hyder (2002) in their report to WHO. In their report, they stated that diarrhoeal illnesses have significant deleterious effects on nutrition, growth and development in infants and young children through the combined effects of loss of nutrients, suppression of appetite, vomiting, interruption of normal feeding practices and the catabolic effects of infection. Compromised nutritional status, in turn, makes affected children more prone to gastro-intestinal infections. In developing countries, diarrhoeal disease is found mainly in children under five years old and it is often complicated by other concurrent infections and by undernutrition.
Dietary inadequacies
Some of the most commonly reported deficiencies are of calcium, riboflavin, vitamin A, and vitamin C. Other nutritional inadequacies include: thiamine, niacin, B6, folate, phosphorous, zinc, and fibre. Calcium and riboflavin deficiencies are often due to an inadequate consumption of dairy products whereas vitamin A and vitamin C deficiencies are caused by a low consumption of fruits and vegetables (Essa, 2001). Prolonged nutritional inadequacies can have a detrimental effect on one’s health.
An increased risk of high-energy intake can lead to obesity, diabetes, and hypertension which are most common nutritional inadequacy-related health problems (Cason, Sergio, Bezral and Chavez- Martinez, 2001). Due to low socio-economic status, data indicates that among the Hispanic migrant farm worker population in the United State, “energy-dense, nutrient-poor foods frequently are consumed at the expense of nutrient-dense foods” which results in:
- Marginal micronutrient intake
- Poor compliance with nutrient and food group-related dietary guidance
- Low serum concentrations of vitamins and carotenoids
(Deza, 2006)
With a diet such as this one, obesity, diabetes, and heart disease all become common health concerns. Even when considering the high amount of physical activity farm workers exert throughout the day, “the excess of unhealthful food often rich in fats, proteins, and carbohydrates puts migrant farm workers at risk for other nutrition-related diseases” (Deza, 2006).
Diet-related diseases
Deza (2006) highlighted diet-related diseases to include;
- Hypertension (high blood pressure)
- high blood cholesterol
- Cancer
- Osteoporosis
Poor nutritional status
Poor nutritional status as described by Abidoye and Ihebuzor (2001) referred to as malnutrition, is an unhealthy state or condition in which a person’s physical functions are temporarily or permanently damaged. People who are malnourished have a weakened defence against disease, become ill more easily and more frequently and are less able to recover quickly and fully from disease. Children who are malnourished fall ill frequently and are not able to grow and develop properly. All forms of malnutrition can result in serious health problems and illnesses. In severe cases, malnutrition is life-threatening; it often leads to death.
Malnutrition creates great suffering to the individual, the family and the society. It damages people’s health and well-being and reduces their enjoyment of life. Malnutrition prevents people from being active members of their family and community. Malnourished children are too weak or sickly to attend school and learn properly which lowers their chances of good jobs and income in the future. Adults who are malnourished are less productive, have less energy to work, take care of their families and carry out activities of normal daily life. Malnutrition has high health care costs, as those suffering from nutrition-related illnesses require special care and treatment.
Malnutrition is caused by poor diets, illness and disease. Poor diet and disease act together, worsening the effects of each other. The combination of too little food and the presence of disease often results in malnutrition, especially in children. Poor, inadequate diets weaken the body, making disease and illness more likely. Disease, in turn, often increases the body’s need for food. Repeated and prolonged illnesses, such as diarrhoea and malaria, contribute to malnutrition, as nutritional needs are higher during and following illness. Frequent episodes of illness and acute infections make it almost impossible to maintain adequate nutritional status.
Fundamental conditions for good nutritional status
Gibney et al (2002) stated that good nutritional status helps us maintain all important body functions so that we can grow and develop properly and lead healthy, active lives. Nutritional status is the condition of the body resulting from the nutrient content of the food we eat in relation to our nutritional needs, and from the ability of our bodies to digest, absorb and use those nutrients.
They further added that in order to have good nutritional status, we need certain fundamental conditions. We need to always have enough nutritious and safe food to eat; we need clean water, good sanitation and clean living conditions; we need access to health services; and we need the knowledge and ability to feed and care for ourselves and our family. Each of these conditions is essential for good nutritional status and they often affect each other. If any of these are missing, the result can be malnutrition and disease.
In driving home their assertion, they concluded that the foundation of good physical health is good nutritional status, and that nutritional status is directly affected by the foods we eat and their nutrient content. Good nutritional status depends on eating the right amounts and the right variety of safe, good quality foods to meet our individual nutritional needs. Food provides the energy and nutrients needed to support all body functions, maintain good health and carry out everyday activities. Food contains many ingredients, called nutrients, which help the body function well. Foods are complex mixtures of different components, providing varying amounts of the nutrients the body needs. Most nutrients cannot be produced by the body and must be taken in adequate amounts from the food we eat in order to be healthy and prevent disease. No single food contains all the nutrients needed by the body in the right amounts; one food may be rich in one or two nutrients, but low in other essential nutrients. It is only by eating adequate amounts of a variety of foods that we can help ensure that we will take in the right amounts of the nutrients needed for good health and nutritional status.
References
Abidoye, R.(2000). A study of the prevalence of protein energy malnutrition among 0–5 years in rural Benue state, Nigeria. Nutr Health 13:235–247.
Abidoye, R. & Ihebuzor, N.(2001). Assessment of nutritional status using anthropometric methods on 1-4 year old children in an urban ghetto in Lagos, Nigeria. Nutritional Health Journal 15: 29-39.
Bouchard, C. (2000). “The obesity epidemic. New York: Human Kinetics Books
Cason, K.; Sergio, N.; Bezral, Y. & Chavez-Martinez, J. (2001). “Food Choices, Food Sufficiency Practices, and Nutrition Education Needs of Hispanic Migrant Workers in Pennsylvania.” Topics in Clinical Nutrition (n.d.): n. pag. National Center for Farm worker Health.
Chawla, S. (2002). Effect of Nutritional Status on Physical work capacity of school going girls M. Sc. Thesis submitted to Dept., PAU, Ludhiana.
Deza, A (2006). The Health and Nutrition of Migrant Farm Workers in South Carolina. Thesis. Clemson University.
Ekpo, U., Omotayo, A., Dipeolu, M. & Danladi, B. (2008). Prevalence of malnutrition among settled pastoral Fulani children in Southwest Nigeria. Prevalence of malnutrition among settled pastoral Fulani children in Southwest Nigeria. BMC Research Notes 1:7.
Erick, M., Mahan, L.K., Escott, T., Stump S & Krause, A. (2008) Food and Nutrition Therapy. (12th ed.) Philadelphia: Saunders
Essa, J. (2001). Nutrition, Health, and Food Security Practices, Concerns, and Perceived Barriers of Latino Farm/industry Workers in Virginia. Thesis. Virginia Polytechnic Institute and State University.
Eveleth, P. & Tanner, J. (1990). Worldwide Variation in Human Growth, Cambridge; Cambridge University Press.
Ganong, W. (2001). Review of Medical Physiology, London: Lange Medical pp. 392-397
Gibney, M.; Vorster, H. & Kok F. (2002). Introduction to Human Nutrition. Dublin: Blackwell Publishing
Glew, R.; Conn, C.; Bhanji R, Caideron, P.; Barnes, C. & Vanderjagt, D. (2003). Survey of the growth characteristics and body composition of Fulani children in a rural hamlet in northern Nigeria. J Trop Peadiatr 49:313–322
Malina, R.; Bouchard, C.; Gareth, K. & Bar-Or, O (2004) “Obesity in childhood and adolescence,” new York: Human Kinetics Books
Measham, A.R. & Chatterjee, M. (2000) Wasting Away- The Crisis of Malnutrition in India: New Delhi: The World Bank.
Odunayo, S. & Oyewole, A (2006). Risk factors for malnutrition among rural Nigerian children. Asia Pac J Clin Nutr 15:491–495.
Vaid, S. & Vaid, N. (2005). “Nutritional status of ICDS and non-ICDS children,” Journal of Human Ecology, 18(3):207–212
WHO (1997). Global Strategy For Infectious Disease Prevention and Control (Draft), Geneva: World Health Organization.
