The prevalence and some associated factors of silicosis among employees working in one factory in thai nguyen province, 2020

MINISTR Y OF EDƯC ATIOJf A ND TR AlNI NG NONBTR V OF HEAL TH HANOI MEDIC AL UNIVERSITY DUONG TRUNG Di e DIETARY INTAKE AND PHYSICAL ACTIVITY OF ELEMENTARY SCHOOL CHILDREN TN’ HA NAM AND DIEN BIEN PROVINCES IN 2020 Major : Doctor of Preventive Medicine Major code : D720302 THESIS OF GRADUATION MEDIC AL DOCTOR COURSE 2015 - 2021 Supervisor Assoc Prof PhD Tran ThuyNga Assoc Prof PhD Pham Van Phu HANOI-2021 «s> ■> ACKNOWLEDGEMENTS Six years studying m Doctor of Preventive Medicine Program of Hanoi Med­ ical University (HMU) was an unforgettable experience in mv life Nutrition is a challenging field, and it presented many difficulties to me when decided to my thesis os it But as a result OỈ*it I did not only gain more knowledge, but also more skills The implementation would not be possible if I did not receive the assistance of several individuals and organisations Thus I would like to express my sincere gratitude to all of them even though it 18 unpossible to list them all First and foremost I would like to express my heartfelt gratitude and appre­ ciation to Assoc Prof Tran ThuvNga head of Department of Micronutrients Na­ tional Institute of Nutrition for her invaluable guidance relentless encouragement expert suggestions constructive criticism, and supervision, all of which were essen­ tial in completing this thesis am thankful to Assoc Prof Pham Van Phu from the Department of Nutri­ tion Institute for Preventive Medicine and Public Health for his great interest, en couragement supervision, and helpful advice on thesis progress I would like to express my deepest thanks to the Managing Board Depart­ ment of Training Hanoi Medical University' who had created a welcoming and wonderful environment in the school for the past six years I wish to thank all the teachers in die Department of Nutrition Institute for Preventive Medicine and Pub­ lic Health, Hanoi Medical University for their valuable information pro'ided by them in their respective fields I am grateful for their cooperation during the period of my assignment Finally I would like to thank my wonderful family and friends for their un­ wavering support during this ordeal Your unwavering love and support gave me the strength to keep going Hanoi 2021 -w CN «G -4: Duong Trung Due DECLARATION I declare that this thesis represents my work and has not been submitted for any degree in any university previously All the sources of information which have been use in the thesis and external contribution are fully referenced and acknowledged Hanoi 2021 Duong Trung Due -w ã* CN ôG TABLE OF CONTENT IN TRODU CTION CHaPTE R 1: LITERATURE RE VIEW 1.1 Dietary intake I Definition of dietan-intake I 1.2 Methods of dietary intake assessment 1.1.3 Recommended dietin’ allowances for elementary school children Ó 1.2 Physical activity 2.1 Definition of physical activity I 2.2 Methods of assessing physical activity - 10 I 2.3 Recommendations on physical activity for elemental} school children 13 1.3 Previous studies on dietary intake and physical activity of elementary school children 15 3.1 In the world 15 I 32 In Vietnam 17 CHAPTE R 2: RESEARCH su BJECTS AN D METH ODOLOGY 2.1 Study subjects: 19 19 1.1 Inclusion criteria 19 1.2 Exclusion criteria 19 2.2 Study time and study sites 2.3 Methodology 19 19 19 .19 2.3.2 Sampling -w ã* CN ôG 21 2.3 Variables and indicators 2.4 Data collection 2.5 Potential errors and solutions 23 23 5.1 Potential errors 2.52 Solutions - - 23 2.6 Dau management and analysis _ 24 2.7 Ethical issues , CHaPTE R 3: RESULTS 3.1 Characteristics of research subjects 3.2 Dietan- intake of research subjects 3.3 Physical activity of research subjects CHAPTER DISCUSSION 24 25 25 — 26 40 48 4.1 Dietan’ intake of the research subjects 48 Physical activity of the research subjects 53 CONCLU SION 58 Dietar,- intake of the elementary- school children in Ha Nam and Dien Bien province in 2020 58 Physical activity- of the elementary school children in Ha Nam and Dien Bien provincem 2020 RECOM MEND AHO NS REFERE NCES APPEND1X -w ã* CN ôG LIST OF ABBREVIATIONS Ĩ4HR 24-hours Dietary Recall FFQ Food Frequency Questionnaire MATA Moderate to Vigorous Physical Activity MN National Institute of Nutrition PA Physical Activity RDA Recommended Dietary Allowances WHO World Health Organization -w ã* CN ôG LIST OF TABLES Table Demographic characteristics of the students Table 3.2 Food consumption of students by province — Table 3 Energy and macronutrients intake by province 25 26 27 Table Micronutrients intake of the students by province 28 T able Food consumption of students by gender 32 Table Energy and macronutrients intake by gender 33 Table Micronutrients intake of students by gender Table s The proportion of protein and lipid intake by province and gender 34 39 Table Average of PAQ score of students by province and gender 40 Table 10 Level of physical activity of students by province 40 Table 3-11 Level of physical activity of students by gender 41 Table 12 Frequency’ of students engaging in moderate to vigorous physical activity for at least 60 minutes each day in the last days by province41 Table 13 Frequency of students engaging in moderate to vigorous physical activity for at least 60 minutes each day in the last days by gender 42 Table 14 Activities students attending in the past days by province 43 T able 15 Proportion of children cycling or walking to school by province Table 16 Activities children doing during school break-time bv gender 44 44 Table 17 Mean time children doing sedentary activities by province 45 Table s Mean time children sedentary activities by gender Table 19 Electronic device students use most often by province 46 Table 20 Average evening sleeping time of students by province and gender -w ã* CN ôG 46 47 LIST OF FIGURES Figure Proportion of energy and macronutrients meeting RD A bv province 30 Figure 3.2 Proportion of micronuuients meeting the RDA by province - 31 Figure 3 Proportion of energy and macr enutrients meeting the RDA by gender 36 Figure Proportion of micronutrients meeting the RD A by gender 37 Figure The balance of energy substances intake of students by province 3S Figure The balance of energy substances intake of students by gender -w •* CN «G 39 DIETARY INTAKE AND PH YS1CAL ACTIVITY OF ELEMENTARY SCHOOL CHI LDRF.N IN ILl NAM AND DIEN BIEN PROVINCES IN 2020 ABSTRACT Background & objectives: Dietary intake and physical activity (PA) are not only directly affected to children's growth, but alio indirectly affected to their cognitive abilities and stature development This study aims to describe the dietary intake and assess the PA of elementary school children Methods: A cross-sectional study involved 248 students aged 7-10 years in Ha Nam and Dien Bien provinces from October to November 2020 In which 225 die­ tan’ intakes were collected by 24 hours dietary recall method The PAQ question­ naire was used to assess the students’ PA Results: The mean energy consumption IS under the RDA (1367 568 I Kcal) Total protein consumption is high (143 9% of the RDA) Lipid and carbohydrate are not meeting the RDA Calcium, magnesium, vitamin Bl B2 B6 folate, vitamin A D are under the RDA The energy-generating substance structure is balanced (P L c=16 23 60 2) The average PAQ score is 2.9 * points The majority of studenrs are moderate-active (81 8*o) whereas 18.2% are low-active Students spend an average of 1.2 -1 hours on sedentary activities every day Snrdents in Ha Nam spend more time on sedentary activities than students in Dien Bien Conclusion: The dietary intake of elementary school children aged 7-10 years in Ha Nam and Dien Bien did not meet the RDA for energy lipid carbohydrate and some micronutrients However the composition of macronuuieats reached the RDA Majority’ of students are moderate active Keywords: dietary intake, physical activity, elementary school children Ha Nam, Dien Bien INTRODUCTION Dietary intake plays an important role in nutritional status and people’s health A healthy diet is considered crucial for elementary school children It does not only directly affect to their growth, but also indirectly aflcci to children's cogni­ tive abilities and learning results [1] Several studies around the world found that multiple dietary inadequacies are frequent among children from developing coun­ tries (2| 13J hl Vietnam, a study by Tran Khanh Van et al ID 2017 conducted in Thai Nguyen province found that the dietan- intake of elementary school students aged to 10 years did not meet the recommended dietary allowances of the Nation­ al Institute of Nutrition in terms of both energy and proporúcu of macronuưients the study also found the lack of micronutrients in the diet [4] Lack or excess nutri­ ents in primary school children all leads to nutritional disorders such as malnutrition and micronutrient deficiency Nutritional disorders are thought to be caused mostly by an inadequate diet (5) In addition to a healthy diet, children will benefit horn a regular schedule of physical activity The role of physic al activity in nonnal growth and development is obvious Increased physical activity, especially at school age aids in optimal height and stature development [6J Furthermore, several studies aroiad the world have shown that physical activity can help minimize the risk of cardiovascular disease metabolic disease and mental disorders [7Ị, [8] However several studies around the world and in Vietnam have shown that the proportion of students who meet the recommendations of physical activity is still low According to study conducted by Zinuno L et al in 2017 only 39% of primary school students in Qatar engaged in moderate to extreme physical activity for 30 minutes or more a day, students spend an average of 58 1% of their daily time on sedentary activities [9] In Vietnam 2016 Do Van Dung et al conducted a study on 619 grade students in Ho chi Minh City, finding that 18% of students -w CN «G 58 CONCLV SION Dietary Intake of (he elementin’ school children in Ha Nara and DieII Bien province in 2020 - The mean energy intake of students in two provinces is lower than the RDA (13676 = 568 Kcal) Total proteins consumption of students is high (143.9% of the RDA) Lipid and carbohydrate are not meeting the RDA (95 9% and 86 2% re­ spectively) ■ in terms of micronutrients, calcium magnesium vitamin Bl B2 B6 fo­ late vitamin A D arc all under the RDA The majority of consumption Ha Nam are higher than that in Dten Bien province The gender disparity in student nutrient con­ sumption is not as evident as the provincial disparity • The structure of maaonutjients in the students’ diet is balanced (PL C=I6.4 23 60 2) Physical activity of the elementary schoolchildren in H.I Nam and Dien Bien pros Ince III 2020 - The average PAQ score of all students is 2.9 ± 0.6 points Majority of stu­ dents are moderate active (31.8%) and 18 2% of students are low active, none of the students is high active • Most students participate in MVPA for at least 60 minutes at least daw week as recommended by WHO (89 9%) Students spend an average of 14 hours on reading homework revision on both school day and none school day Students tend to spend mote time watch ing playing With electronic devices (eg IV, MUartphonc I on mine-school day (1.2 hours on school day and hows on none-school day) Students in Ha Nam spend more time on sedentary activities than students in Dien Bien 59 RECOM MENDATIOXS From the results of the study we have some following recommendations It is necessary to communicate and educate students, parents, and teachers about the importance of providing high-quality meals for students Parents and caregivers should provide diverse diets, adequate energy, balance nutrients, and pay more attention TO choosing reasonable foods rich in micronutrients or foods fortified with micronutrients in order to enhance the quality of student meals • In addition, students, parents, and teachers must be communicated and educat­ ed about the importance and benefits of physical activity so that they can engage in physical activity (such as sport cycling skipping jogging or running and so on) to meet recommended requirements and minimize sedentary activity time (watching TV, playing electronic dev ices ) at school and at home -w •* CN «G RE EE RE NCES Florence M D., Asbridge M and Veugelers p J (2008) Diet quality and aca­ demic perfonuance.JSch Health -8(4) 209-215, quiz 239-241 Taxini A Bakari s , and Delisle H (1999) (The overall nutritional quality of the diet is reflected in the growth ôf Nigerian children] Same 9(1), 23 31 Moller o and Kxawinkel M (2005) Malnutrition and health in developing countries CMAJ 173(3) 279-28« Tran Khanh Van, Tran Thuy Nga and Nguyen Song Tu (2020) Dietary intake of elementary school children in communes Phu Binh Di strict Thai Nguyen Province Vietnam Medical Journal, 492 105-110 Haimi M and Lerner A (2014) Nutritional deficiencies in the pediatric age group in a multicultural developed country Israel tVorid J Clin Cases, 2(5) 120 125 World Health Organization (WHO) (2020) WHO guidelines on physical ac­ tivity and sedentary behaviour Buttar H s Li T, and Ravi N (2005) Prevention of cardiov asculai diseases Role of exercise, dietary’ interventions, obesity and smoking cessation Eip Clin Cardio!, 10,4), 229-249 s Tian D and Meng J (2019) Exercise for Prevention and Relief of Cardiovas­ cular Disease: Prognoses Mechanisms and Approaches Olid Med Cell Longev 2019 L z A F., F A, et al (2017) School time physical activity among Arab ele­ mentary school children in Qatar BMC pediatrics, 17, 23-29 57 Al Salman Z.H Al Debel F A Al Zakaria F.M et al (2020) Anxiety and depression and their relation to the use of electronic devices among secondary school students in Al-Khobar Saudi Arabia 2018-2019 J Family Community -W& 27(1) S3 61 58 Spaeth A M Hawley N L Raynor HA et al (2019) sleep energy balance and meal timing in school-aged children Sleep Med 60 159 144 59 Li s Shen X Jin X et al (2008) [Sleep habits and sleep disturbance in school-age children of China] Zhongnua Er Ke Za Zrti 46(3) 18S 189 60 Fatima Y Doi s a R and Mamun A A (2015) Longitudinal impact of sleep on overweight and obesity in children and adolescents a systematic review and bias-adjusted meta-anahsis Obes Rev 16(2), 137 149 61 Roth T Schwartz JR L Hirshkowitz M et al (2007) Evaluation of the Safety of Modafinil for Treatment of Excessive Sleepiness J Clin Sleep Med 3(6), 595 602 -w •* CN «G •»* APPEND LX Physical Activity Questionnaire (PAQ-31): Please answer all questions with your children, stick on the space provided, select only ONE answer for each question Part A- Physical activity When does vow child study in school? Morning Afternoon ỉn the last days, on hose main' days was your child engaged in moderate to vigorous physical activityfor at lean 60 minutes each day? ondớ/karaĩe/*uĩhưy f Orhers please sprtfi"- -w •* CN «G 1-2 ỉ-d 5-Ĩ > times rimes rimes times ỈU the last days, during physical education