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Socioeconomic and sex differences in adolescents’ dietary intake, anthropometry and physical activity in Cameroon, Africa
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: People in Cameroon are experiencing a dietary transition characterized by changing from traditional food habits to increased intake of highly processed sweet and fatty food. The rapid change in food pattern combined with an increased sedentary lifestyle has resulted in a rather high prevalence of obesity, hypertension, cardiovascular diseases and type 2 diabetes. Nutritional intake is important during adolescence for growth spurt, health, cognitive development and performance in school.

Objective: The aim of this thesis was to assess dietary intake, anthropometry and physical activity of adolescents according to sex and socioeconomic status (SES) and to investigate food perceptions of adolescents living in urban and rural areas of Cameroon.

Methods: Girls and boys, 12-16 years of age, were randomly selected from schools in urban and rural areas. Food frequency questionnaire, 24-hour dietary and physical activity recalls, anthropometric measurements, qualitative interviews and a background questionnaire were used for data collection.

Results: The proportion of overweight was three times higher in girls (14%) compared to boys (4%). Stunting and underweight were more common among boys (15% and 6%) than girls (5% and 1%). The prevalence of stunting was two times higher among the urban adolescents with low SES (12%) compared to those with high SES (5%). The rural adolescents had the highest proportion of stunting but more muscle that the urban adolescents. The rural adolescents ate in order to live and to maintain health. Urban adolescents with low SES ate in order to maintain health, while those with high SES ate for pleasure. More than 30% of the adolescents skipped breakfast in the urban area. Urban adolescents with high SES and girls reported a more frequent consumption of in-between meals and most food groups compared to the rural adolescents, boys and those with low SES. Over 55% of the adolescents had a protein intake below 10% of the energy (E%). Twenty-six percent of the adolescents had fat intake below 25 E%, and 25% had fat intake above 35 E%. A large proportion of the adolescents had an intake of micronutrients below the estimated average recommendation. Boys and the adolescents with low SES reported a higher energy expenditure and physical activity level than girls and the adolescents with high SES, respectively. Both under- and over-reporting of energy intake were common among the adolescents.

Conclusions: The present study showed that nutrient inadequacy, stunting, underweight, as well as overweight and obesity were common among the adolescents in Cameroon. Therefore an intervention program targeting both under- and overnutrition among school adolescents is needed. Sex and socioeconomic differences also need to be considered.

Place, publisher, year, edition, pages
Umeå: Umeå university , 2010. , 64 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1327
Keyword [en]
Adolescents, socioeconomic, energy intake, nutrient intake, physical activity, under-overweight, Cameroon
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Nutrition
Identifiers
URN: urn:nbn:se:umu:diva-30773ISBN: 978-91-7264-942-2 (print)OAI: oai:DiVA.org:umu-30773DiVA: diva2:286755
Public defence
2010-02-05, Allmänmedicin, Floor 9A,135, Norrlands Universitetssjukhus, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2010-01-21 Created: 2010-01-15 Last updated: 2015-10-12Bibliographically approved
List of papers
1. Adolescents´ food habits and nutritional status in urban and rural areas in Cameroon, Africa
Open this publication in new window or tab >>Adolescents´ food habits and nutritional status in urban and rural areas in Cameroon, Africa
2005 (English)In: Scandinavian Journal of Nutrition/Næringsforskning, ISSN 1102-6480, E-ISSN 1651-2359, Vol. 49, no 4, 151-158 p.Article in journal (Refereed) Published
Abstract [en]

Background: Food intake in Cameroon is based on three meals daily. The diet in rural areas is based on traditional staple foods, while that of the urban population incorporates more modern foods. The health and nutrition of adolescents is important as their eating behaviour and nutrition will affect their future health.

Objective: To describe and compare food habits and nutritional status of adolescents in Cameroon.

Design: A cross-sectional study using an unquantified food frequency questionnaire and anthropometric data, in urban and rural areas. Fifty-two adolescents, 12_/15 years old, were selected from schools.

Results : Frequencies of consumption of meat, vegetables, cereals, milk products and junk food were significantly higher in urban than in rural adolescents (11.8 vs 4.5, 9.5 vs 3.9, 16.5 vs 11.9, 5.7 vs 0.8, 24.2 vs 8.7, respectively). The frequency of in-between meals was higher in urban than in rural adolescents (4.9 vs 0.9, respectively). Arm muscle area (AMA, mm2) and waist/hip ratio were significantly higher in rural than in urban adolescents (3554 vs 2802 and 0.82 vs 0.79, respectively). Body mass index (BMI, kg m_2) was higher in rural than urban adolescents, although not significant (20.6 vs 19.4, respectively). There was a positive significant correlation between BMI and AMA in urban and rural areas (r_/0.67 and r_/0. 72, respectively).

Conclusions: Despite a lower frequency of food consumption, rural adolescents had higher AMA and waist/hip ratio than urban adolescents. Less junk food and more traditional food consumption, more manualactivities and walking in rural adolescents could explain these results.

Keyword
adolescents, arm muscle area, body mass inex, Cameroon, food frequency questionnaire
Identifiers
urn:nbn:se:umu:diva-30840 (URN)10.1080/11026480500437554 (DOI)
Available from: 2010-01-19 Created: 2010-01-19 Last updated: 2017-12-12Bibliographically approved
2. "I eat to be happy, to be strong, and to live": perceptions of rural and urban adolescents in Cameroon, Africa
Open this publication in new window or tab >>"I eat to be happy, to be strong, and to live": perceptions of rural and urban adolescents in Cameroon, Africa
Show others...
2007 (English)In: Journal of nutrition education and behavior, ISSN 1499-4046, E-ISSN 1878-2620, Vol. 39, no 6, 320-326 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate factors influencing rural and urban adolescents’ food perceptions during a time of nutritional transition in Cameroon, Africa.

Design: Qualitative in-depth interviews.

Settings: Yaoundé urban and Bandja rural areas.

Participants: Fifteen adolescents 12 to 15 years old purposely selected from schools in urban and rural areas.

Analysis: Interviews were audiotaped, transcribed, and analyzed using Grounded Theory method.

Findings: Factors influencing adolescents’ food perceptions from the rural area were “to live” “health” and “poverty.” Among adolescents from the urban poor area, “health,” “beauty,” and “not enough money” were factors. Among adolescents from the urban rich area, “pleasure” and “beauty” were factors. Rural girls liked “to be fat,” whereas girls from the urban poor wanted “to be a little bit fat,” and girls from the urban rich wanted “to be normal.”

Conclusions and Implications: Food behavior is changing from a diet composed of traditional food in rural areas to a more westernized diet in urban areas. The relationship between socioeconomic factors and nutrition needs to be examined with a sufficiently large number of adolescents to investigate these factors in a quantitative survey. Healthful local food should be available at home and from vendors. Nutrition education about food and diet-related diseases is needed in school.

Place, publisher, year, edition, pages
US: SOCIETY FOR NUTRITION EDUCATION, 2007
Keyword
Adolescents, food perceptions, in-depth interviews, Cameroon
Identifiers
urn:nbn:se:umu:diva-30841 (URN)10.1016/j.jneb.2007.03.001 (DOI)
Available from: 2010-01-19 Created: 2010-01-19 Last updated: 2017-12-12Bibliographically approved
3. Socioeconomic and gender differences in adolescents´ nutritional status in urban Cameroon, Africa
Open this publication in new window or tab >>Socioeconomic and gender differences in adolescents´ nutritional status in urban Cameroon, Africa
2009 (English)In: Nutrition Research, ISSN 0271-5317, E-ISSN 1879-0739, Vol. 29, no 5, 313-319 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to assess adolescents' nutritional status according to socioeconomic status (SES) and sex using anthropometry in urban Cameroon, Africa. Adolescent boys (n = 248) and girls (n = 333) 12 to 16 years old were recruited from randomly selected schools in a cross sectional study in Yaoundé city and grouped according to SES. Weight, height, skinfold thickness, and circumferences were measured, and body mass index, waist/hip ratio, arm muscle, and arm fat areas were calculated. Stunting, underweight, and overweight were determined using international cutoff points. Adolescents with medium and high SES were less likely to be stunted than adolescents with low SES (odds ratio [OR], 0.40; P < .01). Prevalences of stunting (12%, 6%, and 5%) and underweight (3%, 4%, and 1%) were higher among the adolescents with low and medium SES than those with high SES. Overweight prevalence was high among the adolescents with low (8%), medium (11%), and high (9%) SES. The OR for overweight was higher among girls than boys (OR, 4.13; P < .001). Girls were less likely to be stunted and underweight than boys (OR, 0.29 [P < .001] and OR, 0.20 [P < .01], respectively). Prevalences of stunting (15% and 6%) and underweight (5% and 2%) were higher among boys than girls. Pubescent adolescents were less likely to be stunted than nonpubescent (OR, 0.53; P < .05). Adolescents with low and medium SES were more underweight and stunted than adolescents with high SES. Girls were more overweight, less stunted, and underweight than boys.

Place, publisher, year, edition, pages
New York: Pergamon Press, 2009
Keyword
Adolescents, socioeconomic, anthropometry, stunting, underweight, overweight
Identifiers
urn:nbn:se:umu:diva-30842 (URN)10.1016/j.nutres.2009.05.002 (DOI)
Available from: 2010-01-19 Created: 2010-01-19 Last updated: 2017-12-12Bibliographically approved
4. Energy and nutrient intake in relation to sex and socioeconomic status among adolescents in urban Cameroon, Africa
Open this publication in new window or tab >>Energy and nutrient intake in relation to sex and socioeconomic status among adolescents in urban Cameroon, Africa
Show others...
2011 (English)In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 5, 904-913 p.Article in journal (Other academic) Published
Abstract [en]

OBJECTIVE: To assess energy and nutrient intakes and physical activity of adolescents in urban Cameroon according to sex and socio-economic status (SES).

DESIGN: Cross-sectional study with adolescents randomly selected from schools in low-, middle- and high-SES areas. Weight and height were measured and information about food intake and physical activity was obtained through repeated individual 24 h recalls. Under- and over-reporting of energy intake and inadequacy of nutrient intake were assessed.

SETTING: Yaoundé, Cameroon.

SUBJECTS: Boys and girls aged 12-16 years (n 227).

RESULTS: Boys had a lower BMI and reported higher energy expenditures and physical activity levels (PAL) than girls. Under-reporting of energy intake was large among boys and girls regardless of PAL; boys under-reported more than girls. Among those with low PAL, over-reporting of energy intake was common. Over 50 % of boys and girls had protein below the recommendations. The intake of fat varied; 26 % of the adolescents were below and 25 % were above the recommendations. Inadequate intakes of vitamin B1, vitamin B3 and Fe were more common among girls, while boys more often had inadequate intake of vitamin A. Adolescents with low SES were more likely to be below the recommendations for fat and vitamins B2, B3, B6 and B12 than those with high SES.

CONCLUSIONS: A high proportion of boys and girls reported inadequate intakes. However under- and over-reporting were also very common. Boys under-reported energy intake more than girls and inadequate nutrient intake was more frequently reported by adolescents with low SES than by those with high SES.

Keyword
Adolescents, socioeconomic status, energy intake, nutrient intake, under/overreporting
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-30843 (URN)10.1017/S1368980010003150 (DOI)
Available from: 2010-01-19 Created: 2010-01-19 Last updated: 2017-12-12Bibliographically approved

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