Journal of Nutrition Science Research
Open Access

Knowledge of nutrition; Knowledge of physical activities; Body mass index; Grade-schoolers

Nutrition plays a key role in human health and well-being, starting from conception to the later stages of childhood and geriatrics. However, the knowledge of the type, time and quantity of nutritional intake to ensure energy balance remains a great challenge especially among mothers. This is because food occupies the first position in the hierarchy of human needs, ignorance of many basic facts relating to food and nutrition is still widespread in the society. It has been confirmed that well-nourished infants, children and adolescents grow, develop and learn better compared to their mal-nourished counterparts [1]. The quality of children’s diets can have consequences for physical growth, cognitive development, and health. The problems of both over and under-consumption can increase children’s risk for diet related diseases later in life. One particularly worrisome trend is the increase in childhood overweight or obesity. Maternal knowledge of nutrition can enable her to choose the right diet for her children which will help them maintain a healthy weight. Children are generally not aware of the health hazards of poor nutrition and undesirable weight. Therefore, mothers’ nutritional knowledge and health concerns may influence children’s eating patterns. It cannot be assumed, however, either that the mothers of malnourished children are necessarily ignorant or that all illiterate mothers whether their children are healthy or malnourished, are ignorant [2]. It is believed that, some of the knowledge in nutrition of mothers and their knowledge of child nutrition and child-care practices can be expected to have a significant bearing on their children’s nutritional status and weight. Meanwhile, some studies have observed a positive relationship between childhood malnutrition, maternal knowledge and beliefs regarding nutrition [3- 5].

Anthropometric measures such as bodyweight constitute the new vital signs of the 21^st century that warrant being assessment priorities if the tide of overweight or obesity is to be turned [6]. A child is overweight if his/her bodyweight is more than 20% higher than the ideal bodyweight for a boy or girl of his/her age and height. Childhood overweight is said to be one of the most serious public health challenges of the 21st century and has become a global epidemic, one of the leading causes of morbidity and mortality in both developed and developing countries [7]. Besides physiological and genetic properties as well as nutrition, regular physical activity is considered an important component of good health and prevention of childhood undesirable weight [8]. Children with undesirable weights can enjoy a healthy weight through increasing physical activities. Physical activity has been shown to be associated with healthy weight status, bone and skeletal health, motor skill development, psychosocial health, cognitive development and aspects of cardio-metabolic health [9]. Concluded that, physical inactivity and sedentary behaviours, such as television viewing, are strongly related to obesity in Canadian children and adolescents [10]. In addition, submitted that children who report relatively low levels of physical activity are significantly more likely to be overweight or obese than more active children of similar age and gender [11]. It is to this end that this study was carried out to evaluate the maternal knowledge of nutrition and physical activity as determinants of body weights of Nigerian school pupils.

This study is a correlational survey design. The population for this study included primary school pupils between the biological ages of 7 to 11 years from five primary schools in the 2018/2019 academic session in Oyo State, Nigeria. A total of 150 males and 150 female’s primary school pupils participated in this study. They were recruited using proportionate random sampling technique. However, participants with any physical disability were excluded from the study.

A structured questionnaire was used to assess the maternal’s knowledge of nutrition and physical activities. All questions were scored on a scale from 1 to 4; with 4 representing the highest level of knowledge possible. That is, Highly Knowledgeable (HK) =4, Knowledgeable (K) =3, Not Knowledgeable (NK) =2 and Highly Not Knowledgeable (NHK) =1. The questionnaire was validated by three experts, one from measurement and evaluation and the other was an expert in home economics education, while the third was also an expert in human kinetics and sports science in University of Benin, Benin City. Also, the instrument was administered to twenty (20) mothers and their children’s BMI were calculated. The field work results were collected by calculating BMI of the children by the ratio of weight to height square [weight (kg)/height (m2)] of each child. Then, Cronbach Alpha was used to determine the reliability and the reliability coefficient of the instrument was 0.77.

The standing heights of the participants were measured using Shorrboard Stadiometer (Model:ICA 420, USA, 2018) in centimeters. Also, the calibrated electronic auto-zeroing bathroom weighing scale (Escali USTT200, Amazon, 2018) was used to measure the bodyweights of the participants. Then, BMI was calculated using the formula: weight (kg)/height (m2). Thereafter, the children were categorized into different classes of BMI based on the recommendation of Centers for Diseases Control and Prevention, which is age and sex-specific for children and teens from two years old through 20 years [12].

The study received ethical approval from the Research Ethics Committee of the University of Benin, Nigeria to conduct this study and the participants were then recruited consecutively. An informed consent form was issued to each of the respondents and then the objectives of the study were explained to them. The measurement of the pupil’s heights and body weights as well as the administration of the questionnaire were done with the help of two trained research assistants. These assistants helped in the administration of the questionnaire and also in recording of the illiterate mother’s answers on the questionnaires. The mother’s questionnaire was taken to them in their houses with the help of the assistant researchers with the researcher. The questionnaire forms were retrieved immediately after being completed to avoid misplacement and the rate of retrieval was 100%. Aggregate scores were compiled as total points possible. The scores from those questions that address each specific area of the maternal knowledge (nutrition and physical activities) were then averaged together, for a final score within each area measured. However, the field testing involved measurements of the standing heights and bodyweights of the pupils were carried out at their schools.

The anthropometric profile of the pupils was analyzed using frequency counts and percentages. The relationship of maternal knowledge of nutrition and physical activities with children’s BMI was analyzed using the Pearson product moment coefficient of correlation, and then differences in children’s bodyweights across gender categories were analyzed using the independent sample t-test. Statistical significance was accepted for a p value of <0.05. All the analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 22.0.

The results are presented in Tables 1 and 2. (Table 1)

From the Table 1, the percentage bodyweight categories of the Nigerian school children for underweight, desirable, overweight and obesity are 5.0%, 25.3%, 55.7% and 14.0% respectively. Moreover, majority of the children were found to be overweight (55.7%) based on their age and sex, while those that were underweight have the lowest percentage (5.0%). It was also observed from the Table 1 that an insignificant difference (p > 0.05) exists between maternal knowledge of nutrition and children’s bodyweights. This implies that the influence of maternal knowledge of nutrition on bodyweights of Nigerian school children is the same across gender characteristics. The Table equally showed that an insignificant difference (p > 0.05) exists between maternal knowledge of physical activities and children’s bodyweights across gender characteristics. This is an indication that the influence of maternal knowledge of physical activities on bodyweights of Nigerian school children is the same across gender characteristics. (Table 2)

Table 1: Descriptive statistics and independent sample t–test for maternal educational qualification and children’s bodyweights.

Table 2 showed that maternal knowledge of nutrition is a proportionate (r = 0.131) and significant (p < 0.05) correlate of children’s BMI. This is an indication that maternal knowledge of nutrition is a predictor of bodyweights of Nigerian school children. It was also observed from the Table that a proportionate (r = 0.070) but insignificant (p > 0.05) relationship exists between maternal knowledge of physical activities and children’s BMI. This implies that maternal knowledge of physical activities does not have the ability to determine the bodyweights of Nigerian school children.

Table 2: Correlations of children’s BMI with maternal knowledge of nutrition and physical activities.

Maternal nutritional knowledge was found in this study to have a significant influence on bodyweights of children. Related studies showed that maternal nutritional knowledge was significantly influenced children’s bodyweights [3,4,13]. Similarly, the results on the effect of mothers’ nutritional knowledge and attitudes on Omani children’s dietary intake showed that there was a positive relationship between children’s dietary food intake scores with the mothers’ nutritional knowledge scores [14]. They stated that nutritional knowledge influenced dietary intake, highlighting the fact that nutrition-related education and information for mothers can improve their offspring’s bodyweights in Oman. The implication of this is that maternal nutritional knowledge is responsible for children’s bodyweights. Therefore, maternal nutritional knowledge acts as a path way through which maternal education influences children’s diets. In other words, maternal knowledge of nutrition is a determinant of an ideal bodyweights among school children. Moreover, processed, energy-dense, nutrient-poor foods and sugar-sweetened beverages, in increasing portion size, at affordable prices have replaced minimally processed fresh foods and water in many settings at school and family meals. The easy access to energy-dense foods and sugarsweetened beverages and the tacit encouragement to “size-up” through commercial promotions might have contributed to the rising caloric intake among school children.

Maternal knowledge of physical activities was observed not to have substantial relationship with children’s bodyweights in the present study. This is in disagreement with the studies of that indicated maternal knowledge of physical activities as a significant predictor of children’s bodyweights [15,16]. Discrepant findings within studies might also be due to methodological nuances, such as the timing of measurements and statistical modeling and the like. However, the finding of this study is in agreement with the studies [17,18]. Infact, many children today are growing up in environments that encourage weight gain and obesity. Changes in food availability and type, and a decline in parental knowledge of physical activity for transport or play, could be responsible for energy imbalance among school children. Opportunities for physical activity, both in and out of school, have been reduced and more time is spent on screen-based and sedentary leisure activities. Nevertheless, the risk of undesirable weights can be passed from one generation to the next, as a result of behavioral and/or biological factors. Behavioral influences continue through generations as children inherit socioeconomic status, cultural norms and behaviors’, and family eating and physical activity behaviors’. In addition, physical activity behaviors across the life-course can be heavily influenced by childhood experience through their parents especially the mothers. Creating safe, physical activity-friendly homes and communities, which enable, and encourage the use of active transport (walking, cycling and so on) and participation in an active lifestyle and physical activities will benefit both young and old individuals. Particular attention needs to be given to improving access to, and participation in, physical activity for children already affected by overweight and obesity (undesirable weights).

Also, the insignificant influence of maternal knowledge of nutrition and physical activities on children’s bodyweights across gender characteristics suggests that gender cannot influence the maternal knowledge of nutrition and physical activities on children’s bodyweights. The similarity in percentage of skeletal muscle mass development between boys and girls could be responsible for the equal impact of maternal knowledge of nutrition and physical activities on children’s bodyweights of both gender and by implication this does not affect their anthropometrics differently. Equally, this could simply reflect the similarity in sexual dimorphism, due to the action of sex steroid hormones. However, the major limitation of this study was that the parental socioeconomic status of the pupils, which could determine some anthropometric measures, was not taken into consideration.

Conclusion

This study therefore concluded that the maternal knowledge of nutrition can determine children’s bodyweights. Meanwhile, maternal knowledge of physical activities is not a good determinant of children’s bodyweight. Also, the maternal knowledge of nutrition and physical activities cannot alter bodyweights of boys and girls differently. It is highly recommended that further studies be conducted to evaluate the influence of parental socioeconomic status on their children’s bodyweights.

1. Youngson RM (2004) Collins Dictionary of Medicine.
2. Kimati VP (2006) Who is ignorant? Rural mothers who feed their well-nourished children or the nutrition experts? The Tanzanian story. J Trop Pediatr 32: 130-136

Indexed at, Google Scholar, Crossref

3. Shookri AA, Shukaily LA, Hassan F, sheraji SA, Tobi SA (2011) Effect of Mothers Nutritional Knowledge and Attitudes on Omani Children’s Dietary Intake. Oman Med J 26: 253-257

Indexed at, Google Scholar, Crossref

4. Parul C, Rita A, Sunder G, Tara G (2010) The role of Material Literacy and Nutrition Knowledge in determining Children’s Nutritional status. Home Science, Department foods & Nutrition, Borada 39000 2, Gujarat, India

Indexed at, Google Scholar

5. Wardle J, Carnell S, Cooke L (2005) Parental Control Overfeeding and Children’s Fruit and Vegetable intake: how are they related?. J Am Diet Assoc 105: 227-232

Indexed at, Google Scholar, Crossref

6. Campbell K, Crawford D (2001) Family food environments as determinants of preschool-               aged children’s eating behaviours: implications for obesity prevention policy: a review. Australian J Nutr Diet 58: 19-25

Indexed at, Google Scholar

7. Kelishadi R (2007) Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev 29: 62-76

Indexed at, Google Scholar, Crossref

8. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39: 1423-1434

Indexed at, Google Scholar, Crossref

9. Carson V, Hunter S, Kuzik N, Wiebe SA, Spence JC, et al. (2015) Systematic review of physical activity and cognitive development in early childhood. J Sci Med Sport 19: 573-578

Indexed at, Google Scholar, Crossref

10. Nelson EAS, Li AMC, Yuan Y, Lam PKW, CW Yu, et al. (2002) Energy Expenditure and Physical Activity of Obese Children : cross-sectional study. Hong Kong Med J 8: 313-317

Indexed at, Google Scholar

11. Kemper HCG, Twisk JWR, Mechelen WV, Post GB, Roos JC, et al. (2000) A fifteen-year longitudinal study in young and adults on the relation of the development of bone mass: the Amsterdam Growth & Health, Longitudinal Study. Bone 27: 847-853

Indexed at, Google Scholar, Crossref

12. Centers for Disease Control & Prevention (2015) Division of Nutrition and Physical activity and obesity U.S department of health and human services (CDC) 2417.Saving lives protecting people.
13. Baughcum AE, Powers SW, Johnson SB, Chamberun LA, Deeks CM, et al. (2015) Maternal Feeding practices & beliefs and their relationship to overweight in early childhood. J Dev Behav Pediatr 22:391-408

Indexed at, Google Scholar, Crossref

14. Ali AS, Layla AS, Fouad, H, Sadeq AS, Saif AT (2011). Effect of Mothers Nutritional Knowledge and Attitudes on Omani Children’s Dietary Intake. Oman Med J 26: 253-257

Indexed at, Google Scholar, Crossref

15. Mulcherjee R, Dhara P (2014) Effects of Daily life physical activity on obesity, indices, cardio respiratory fitness and association of the latter two with academic performance in Bengali.Adolescents of India. Am J Sports Med 2: 48-55

Indexed at, Google Scholar, Crossref

16. Coelho LG, Candido APC, Machado – Ceoiho GLL, Freitas FND (2012) Association between Nutritional Status food habits and physical activity level in school children. J Pediatr (Rio J) 88:406-412

Indexed at, Google Scholar, Crossref

17. Tchicaya A, Lorentz N (2014) Relationship between Children’s Body Mass Index and Parents’ Obesity and Socioeconomic Status: A Multilevel Analysis Applied with    LuxembourgData. Health 6: 2322-2332

Indexed at, Google Scholar, Crossref

18. Uthman O, Aremu O (2012) Comparison of Physical activity level between overweight/obesity and normal weight individuals: a systematic review. Internet J Nutr Wellness 5: 1002-1465