Nutritional status and some related factors among primary school children in thai nguyen and nghe an provinces in 2020

MINISTRY OF AU NTS TRY OF HEALTH EDUCATION AND TRAINING HANOI MEDICAL UNIVERSITY NGUYEN THI PHI ONG ANH NUTRITIONAL STATUS AND SOME RELATED FACTORS AMONG PRIMARY SCHOOL CHILDREN IN THAI NGUYEN AND NGHE AN PROVINCES IN 2020 Specialization: Doctor of Preventive Medicine Code: D72O3O2 THESIS OF GRADUATION' MEDICAL DOC TOR COURSE 2015 2021 Mentors' Aisoc.Prof.PhD Pham Van Phil Alloc.Prof PhD Tran Thuv Nga HANOI-2021 «s> ■> iii CONTENTS * ABBREVIATION LIST OF TABLES vil LIST OF FIGI KES ACKNO WEED GEM ENT COMMITMENT - ABSTR ACT _ _ INTRODUCTION _ _ CHAPTER!: LITERATURE REVIEW _ 1.1 Nutritional status and some methods of assessment of the nutritional status— _ LIL Definition of nutritional status I Brief reviews about methods of assessment of the nutritional status 1.2 Previous studies on the nut rilional status of children _ 1.2.1 In the world 1.2.2 bl Vietnam _ — _ — J Some factors associated with the nutritional condition of children — 11 1.3.1 Eating habits _ _ _ _ 11 1.3.2 Physical activities - - - — 12 13 Socio-economic factors 13 CHAPTER 2: RESEARCH SUBJECTS AND ME I 1101)0 LOGY 16 2.1 Study Subjects 2.2 Study location and studs time J Research Methodology _ 3.1 Study design 16 16 16 iv t••••••i••• •••••••••••••••••••• 16 The sample size and sampling method Sample Size 16 17 2.3.3 Variables and indicators — 2.3.4 Data collection - — _ 18 2.5 Potential Errors and Solutions —20 2.6 Data management and analysis _ 20 2.7 Ethical Issues _ 21 CHAPTER5: RESULTS 22 3.1 C haracteristics of researchsubjects _ 22 3.2 Nutritional status of students 26 J Some factors related to nutritional status of students - 29 CHAPTER4: DISCUSSION _ _ 38 4.1 Nutritional status of students _ 38 4.2 Some related factors to the nutritional statin of Students 42 4.2.1 Socio-demography factors - _ - - 42 4.2.2 Environmental factors_ _ _ _ — 47 Eating habits factors 47 4.2.4 Physical activity factors i .- 50 CONCLU SION RECOM MEND.VnON — V ABBREVIATION BMI Body Mass Index FAO Food and Agriculture Organization UNICEF United Nations Children's Emergency Fund WTO World Health Organization NCHS National Center for Health Statistics SD Standard deviations BAZ BMI-ÍOT-Age z score HAZ Height-for-Age Z-score MUAC M id Upper Arm c ircumfe rence VND Vietnamese Dong -w ã* CN ôG vi LIST OF TABLES Table The distribution of study subjects by provinces, age and ethnicity 22 T able Mean weight and height of students by age and gender 23 Table 3 Mean waist circumference and hip circumference of students by age and Table Mean Mid-L’pper-Arm Circumference of students bv age and gender 24 Table Mean triceps skinfold thickness and subscapular skinfold thickness of studenis by age and gender — Table Mean Height for Age z score and BMI for Age z score of students by age and gender Table The association between the nutritional status of children and the parent’s nutrition!] status Table 8-The association between lite prevalence of stunting and the parent's education level Table The association between the prevalence of overweight and the parent’s education ]e%*el 31 Table 3.10 The association between the prevalence of stunting and people who take care of children _ _ _ _ _ 32 Table 11 The association between the nutritional status of children and the family Table 12 The association between the nutritional status of children and total household income _ _ _ _ — _ _ 33 Table 3.13 The association between die prevalence of overweight and eating habits Table 14 The association between the prevalence of obesity and eating habits 36 Table 15 The association between the nutritional status of children and physical activities -w ã* CN ôG 37 vii LIST OF Fl GV RES Figure The nutritional status of students by provinces 26 Figure The nutritional status of students by gender 27 Figure 3.3 The nutritional status ofStu dents by age - . 28 Figure The association between the nutritional status of children and the sources of drinking cooking water — —, -w -r? M «G 34 viii ACKNOWLEDGEM ENT First and foremost I would like to express my deep sense of gratitude and appreciation towards Assoc Pro: Pham Van Phu from the Department of Nutrition and Food Safety Institute for Preventive Medicine and PubHc Health for his invaluable guidance, constant encouragement, expert suggestions constructive criticism, and supervision which was most crucial in completing this thesis work I am extremely grateful to Assoc Prof Tran Thuy Ng» head of Department of Micronutrient Research and Application National Institute of Nutrition, for her keen interest, guidance, supervision and valuable advice for thesis improvement I would like to express mv deep thanks to the Managing Board Department of Training Hanoi Medical University who had created a welcoming and wonderful environment in the school tor the past six years I wish to thank all the teachers in the Department of Nutrition Institute for Preventive Medicine and Public Health Hanoi Medical University for their valuable information provided by them in their respective fields am grateful for their cooperation during the period of my assignment Finally, want to express my gratitude to my wonderful family and friends who have stood by my side throughout tins ordeal Your unwavering love and unwavering support inspired me to keep going Student Nguyen Thí Phuong And -w •* CN «G ix COMMITMENT To: - Management Board of Hanoi Medical University - Department of Undergraduate Training Management and Department of Student Affairs Hanoi Medical University - Institute for Preventive Medicine and Public Health Hanoi Medical University • Department of Nutrition and Food Safety Hanoi Medical University • Examination Committee for Graduation Thesis 2020-2021 I hereby declare that I am the author of this research The data collection and analysis were carried out objectively and truthfully These findings in this study have yet to be published May 2021 in Hanoi Student Nguyen Thí Phuong Anh -w CN «G X ABSTR ACT Background & Objectives: A cross-sectional study was conducted with the objectives to describe the nutritional status of primary school children (7-10 years) in Thai Nguyen and Nghe An provinces to analyze some related factors to the nutritional status of students Methods: The study period was from November 2020 to December 2020 A total of 262 students from two provinces comprise the study population Probability proporticoal to size sampling method was used Data entry and statistical analysis were performed with the help of STATA version 15 Height-for Age Z-scone (HAZ) and BMI-for-Age z-score (BAZ) were calculated using 'VH0 Anthroplus Software and using WHO Reference 2007 values Results; The prevalence of overw eight and obesity was 25.6% (in which overweight was 16 8% obesity was 8%) The prevalence of stunting was 0% and wasting was 5% Some factors related to the nutritional status of primary school students were BM1 of parents, education level of parents, the cure of mother; family size (>5 people) total household income habit of drinking soft drinks eating instant noodles, eating outside the home, eating at fast-food restaurants Interpretation & Conclusion: The present study showed the prevalence of malnutrition was relatively high Socioeconomic factors, parental factorsand eating habits were associated with the nutritional status of students Prompt integrated efforts should be made to improve the nuữitional status of primary school students Keywords: nutritional status, related factors to malnutrition primary school children Thai Nguyen Nghe An -w ã* CN ôG INTRODUCTION Malnutrition has been a global public health problem In 2019 there still were 144 million children under with stunting and almost 50 million with wasting- at the same time, overweight and obesity in children and young people were continuing to rise [I] la Vietnam, the stunting rate for children under was 19 6% in 2020 meaning that one out of every five Vietnamese children under the age of five was stunted Th • rate of stunting malnutrition among school children (5 -19 years old) was 14.8% in 2020 (this rate was 23.4% in 2010) (2) On the other hand, overweight and obesity had increased rapidly National Institute of Nutrition research during 2017 2018 revealed the overweight obesity rate of 5.000 sampled school children in a variety of provinces was 29% [3 J Every country in the world has been affected by one or more forms of malnutrition and should consider combating these as one of the greatest global health challenges Socio-economic determinants such as income, ethnicity, geographical location, and intra-household parental factors could be related to child's nutrition level When children's nutritional status deteriorated, a vicious cycle of chronic disease and growth failure developed As a result having a comprehensive understanding of children's nutritional status had far-reaching consequences fOT future generations' wellbeing |4j The primary school years were the time of rapid physical and mental development Low school attendance high absenteeism early dropout and unsatisfactory' classroan perfornunce had all been related to poor nutritional status (5] (6) Children who were well fed did well in school andreached their full physical and mental capacity Malnutrition was an associated cause in about half of all deaths occurring among children in developing countries and also slowed economic growth and perpetuated poverty [7] According to estimates malnutrition in all types could cost society up to 3.5 trillion dollars each year, with overweight and obesity costing 500 billion dollars [S] -w CN «G 63 101 Wang VH Min J XueH et 11 (2018) Factors contributing to sex differences in childhood obesity prevalence in China Public Health Nutt 21(11) 2056 2064 102 Do Thi Ngoc Diep (2011) Prevalence of overweight and obesity among primarv school students in Ho Chi Minh City Nutrition Center Ho Chi Minh City 103 Le Huy Hoang Tran Phuc Nguyet Nguyen Quang Dung and 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Jo HK et al (2017) Instant noodle consumption is associated with cardiometabolic risk factors among college students in Seoul Xurr Res Praa 11(3) 232 239 -w ã* CN ôG ã 69 APPENDIX QUESTIONNAIRE: NUTRITIONAL STATES AND SOME RELATED FACTOR s OF p RIM ARY sc HOOL STUDENTS Pleasefill in or tick question ar space provided, only ONE answer can be selectedfor each Province: ID School: COUPLE TON DATE _Ỉ Ì _ Contact person for this project: • -Vow- • Relationship with child: Father Mother Caregivers Others, please specify: _ • Cell Rhone No: • Home Address: Child's details • Name Dare of birth: f Gender: / 'gam) Birth Race: So lar calender Chinese calendar Muong Male Toy Kinh Female TWM*M«K> *4: Other, please specif)': 70 Aif47i/* « Details Father Mother • Date of birth: • Dateofbtrth: Ỉ / ■ ■ • Height: • Height: _ (cm/ (cm/ ■ • Weight: * IFe&ta _ (*g/ • Highest Education Level • Highest Education Levtl Non-schooling Non-schooling Primary- school Primary school Secondary school Secondary school High school High school College College University/higher Chivers iiydugher • • Occupation; ■ Total nous ehold monthly income: Occupation; (ưmt: thousands VNDf • How much does your household spend on food per month? (Unit: thousands VNDf • How many people are staying in the saute household^ _ (including the childparticipating tn this study/ • It ho takes care ofthe child most oftime'* -r CN «G ■» -4: 71 ỉỉealrh Status And Environmental Factors • 1" general, how would you rate your child's health ? Good Fair Poor • Does your child nave any health problems/diseases fsuch as asthma, congenital heart disease, acme respiratory infection end others f? Yes No if Yes please specify' the type ofheath problem/disease: • During the past months, didy our childsufferfrom chronic diarhoea 'passing watery stool or times a day for at leastfour weeks/? No Yes • During the past months, did your child stiffer from constipation times per week • Jn ary pica! week how often does y our child ear confectionery (such as cake, candy chocolate, biscuit, ice cream and others/? Never Once a week times per w eek > times per week • Jna typical week, how often does your child eat ins art noodles (such as Hao Hao, Omachi Tien Pua cụp noodle and orhers/9 Never Once a week times per w eek > times per week • ỉn a ty pical week, how often does your child eat packet snack food (such as potato chips, popcorn, snack and others/? Never Once a week w ã* CN ôG 73 times per week > times per week • ỉn the pan one month, does voir child have main meafrs) outside ofhome? Yes Vo • In the past one month, does your child have foodfrom fast-food restaurant (such as KFC Me Donald Loterta Burger King Pirza Hut and others)? Yes Xo Physical activities does you child study in school? Morning Afternoon In the last days, on haw many days was your child engaged in moderate to vigorous physical activity for at least 60 minutes each day? (This can be accumulated over rhe entire day by any physical activity done more than IO minutes/ Moderate to vigorous activity is any activity that increases the heart rate, gets your child out of breath some of the tone and increased sweating d.e walking briskly, dancing,jogging, hiking, cycling, swimming, others/ J Xone day s J day day s J day s day s days days Has your child done arty of the follow mg activities tn the pas! days1 If YES 40'» many times he/she did theseactivities? ■w •* CN «G 74 Frequency - - _ Activities ' ■ None - _ a Badminton b Foo I bail /Soccer) c Bicycling d Basketball/ Netball e Tag (children chasing each other) i rraikingfor exercise g ỉn-line skanng/Roiìer blading h Jogging or running i SMjnwi-ng j Datce k Skipping Rowing/Canoeing/Kayaking m Skateboarding n Fo ley bali ữ Tennis p Table tennis/ Pingpong q Mama! arts fiiiatitaelrwondo/karate/wusinii r Others please specify -w ã* CN ôG 1-2 3-f 5-6 > times times times rimes 75 ỉn the last days, during physical education fPEi classes how often was your child very- dezne’ fl.e running, jumping, throwing, playing hard, others) My c hild doesn ‘t PE Hardly • ever active Sowzwej active Often quite active Always active ỉn the last days what did your child most of the time dur; 'ĩg school recess? /besides eating and drinking) Sat down (t.e chatting, readtig doing schoolwork, others) Stood around or walked around Pan or played a little bit Ran around and played quite a bit Ran and played hard most of the time ĩn the last days, what did) our child right after lunch? Sat down (i.e charring, reading, doing schoolwork others! Stood around or walked around Ran or played a little bit Ran around and played quire a bit Ran andplayed hard most of the time ỉn the last days, on ho * many day s right BEFORE FTER school (2 6pmh did your child sports dance, or play games in which he/she MOS ten active * s No day s J day days days Sdays ỉn the last days, on how many EIENỈNGS (Ớ - Spmi, didyour child sports dance, or play games in which he/she was very active? No day s J day day s CN «G -4: Ĩ day s day s O' the last WEEKEND WOM- many times didyour child dứ sports, dance, ar play games in which he/she MW * try active? No J time 2-3 limes 4-3 times >5 times 10 íTáich one of the following describes your child benfor the last days? Read all five statements before deciding an the one answer that describes your child AH nr most of my child’s free tunc was spent doing things that involve little physical effort My child sometimes IJ - rimes per week) did physical things in his/herfree time (i.e sports, running swimming, cycling, aerobics, others) My child often