Knowledge, attitude and practice on nutrition, dietary intake and prevalence study

on childhood obesity among secondary school students in Kedah state

Marcus Ong Shi Ming, Saw Sun Yang, Evie Tan Wei Wei, Faun Hao Yan
Dr Kyaw Min (PhD),Unit of Community Medicine, Faculty of Medicine, AIMST University
Abstract
This descriptive cross-sectional study was done in SMK Aman Jaya in the district of Sungai Lalang of Sungai Petani, Kedah to increase the awareness of the students regarding
the severity of childhood, analyzed the reason behind the increasing prevalence rate of childhood obesity by assessing the knowledge, attitude and practice on nutrition of the
students and at the same time came up with strategies to overcome childhood obesity . A total of 191 students participated in the study ranging from 13,14,15,17 years old and
information on knowledge, attitude, practice and dietary intake were recorded. Of the 191 students, about 46 students were either overweight or obese with the overall
prevalence of 24.0%. Of these, 18(39.13%) were males and 28(60.87%) were females. Knowledge, attitude and practice about childhood obesity were assessed and correlated
with overweight and obesity. Among the obese and overweight group, majority have knowledge above average (55.8%) but attitude (32.6%) and practice (34.8%) below
average. This can be concluded that the obese and overweight groups have knowledge but lack of attitude and practice.

Discussion

Background
The American Heritage Dictionary formally defined obesity as a condition of increased
body weight that was caused by an excessive accumulation of fat [1]. Reports indicate
that there was a high and increasing rate of overweight and obesity among preschool
children living in developing countries, which common causes were unhealthy eating
patterns, lack of physical activity, genetic factors, or a combination of these factors [2].
As 50-80% of obese children continue to be obese in adult, it may increase the
incidence of hypertension, type 2 diabetes mellitus, cardiovascular disease, fatty liver
disease. It is important to attain the desired behavioral changes related to nutrition, the
achievement of adequate and right knowledge, attitudes and practice to prevent the
progression of the obesity and its related co morbidities into adulthood.

Method
The study design was a descriptive cross sectional study where questionnaires was
given in attempt to obtain socio-demographic profile, knowledge about obesity and
certain disease known to occur in obese people, attitude and practice towards their
daily diet. Following then, the students' weight and height were measured using
calibrated SECA weight and height scale and Body Mass Index were calculated.
Using SPSS version 22, Chi-square test was used to evaluate the relationship between
knowledge, attitude and practice with factors such as race, sex, parent education,
residential area, family income and BMI.

Result
There were 191 students participated in the study, among them, 46 students were either
overweight or obese with the overall prevalence of 24.0%. Of these, 18(39.13%) were
males and 28(60.87%) were females. , the number of overweight or obese students was
the least among the Chinese which was about 6, followed by the Indians (7) and the
Malays (33). The breakfast of the overweight and obese people consumed is less than
351kcal, comparatively those who are in normal and underweight BMI range
consumed higher calorie in their breakfast. Besides that, there is a noticeable trend that
as the income of their parents increase, the prevalence of obesity is lower. Which they
have better knowledge, attitude and practice. KAP interpretation shows that majority
of the students have knowledge above mean, but below mean in attitude and practice.
There is only a statistical significant between knowledge score and mothers education
(p=0.05). However, there were no statistical significant between knowledge, attitude
and practice to BMI, calorie intake in breakfast, parents income, race, gender.

Table 1: Mean Score of KAP

Knowledge mean score

MeanSD
18.67
2.82

Attitude mean score

22 to 47

Minimum_maximum

Minimum_maximum

Practice mean
score

20.642.2
6

13 to 27

Minimum_maximum

Conclusion
Intervention should be done in improving the attitude and practice, healthy
lifestyle promotion[8] ,adherence to recommended dietary guidelines, increase
participation in physical activity, and limiting screen time and reducing sedentary
behavior [9]. Besides that, nutritious food should be made available to everyone
regardless of their socioeconomic status, which can be achieved by reducing the
price.

References:

11 to 16

33.553.7
4

From our survey, we found that prevalence of obese and overweight were
higher in female. This could be because females generally achieve puberty earlier
than males and their growth rate then decline earlier during adolescent compared
to males. As growth rate (height) declines, fat accumulation resumes in a rate
twice faster in females compared to males.[3] Malays consume more fried food
thus higher calorie intake. According to the 2004 National Nutrition Survey, one
in two Malays take deep-fried food more than twice a week. Besides, one in five
Malays drink at least seven sweetened drinks weekly [4]. Hence, it is not surprised
that there are higher number of students who are overweight or obese among the
Malays compared to Chinese and Indian.
Low-income neighborhoods frequently lack of full-service grocery stores and
farmers markets where residents can buy a variety of fruits, vegetables, whole
grains, and low-fat dairy products.[5] When a variety of food is available, healthy
food is often more expensive, whereas refined grains, added sugars, and fatty
foods are generally less expensive and readily available in low-income
communities.[6]
Students who were obese consumes less calorie in their breakfast. The best
range of calories for breakfast is between 350 to 500kcal. Below 350kcal, the
body could not fulfill the requirements for morning energy usage while above
500kcal, the body may store unused calories as fat. [7]

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