ASSESSMENT OF ANTHROPOMETRIC INDICESAND DIET DIVERSITY

AMONG AHMADU BELLO UNIVERSITY TEACHING HOSPITAL

STAFFS , KADUNA STATE.

BY

ZAHRA'U AMINU YUSUF PH 15,922

ZAINAB ABDULHAMID PH 15,896
BILKISU MUSA IBRAHIM PH 15,917

A RESEARCH PROJECT SUBMITTED TO DEPARTMENT OF NUTRITION AND

DIETETICS , AHMADU BELLO UNIVERSITY TEACHING HOSPITAL KADUNA
STATE.

IN PARTIAL FULFILLMENT OF THE AWARD OF A PROFESSIONAL

CERTIFICATION IN DIETETICS

FEBRUARY ,2024
 DECLARATION

We hereby declare that this work is the product of our own research

efforts; undertaken under the supervision of Mlm Hassana M ladan. All

sources have been duly acknowledged in form of references

_____________________ ___________________
ZAHRA'U AMINU YUSUF DATE

_______________________
ZAINAB ABDULHAMID DATE

________________________
BILKISU MUSA IBRAHIM DATE
 CERTIFICATION PAGE

This is to certify that the research work for the project and the subsequent

preparation of this report by (ZAHRA'U AMINU YUSUF,ZAINAB

ABDULHAMID And BILKISU MUSA IBRAHIM) were carried out

under supervision.

________________________

Mlm Hassana M Ladan Date

(Project supervisor)

_______________________

DTN Deborah A Ododo Date

Internship Coordinator

_____________________

Mal. Bashir Aliyu Date

H.O.D Nutrition and Dietetics Department

DEDICATION

This work is dedicated to Almighty Allah for giving us the opportunity,

strength and guidance and for seeing us through the internship

programme and also to our lovely parents may almighty Allah reward

them with Aljannatul Firdaus.

 ACKNOWLEDGEMENT

Praise be to ALLAH the guide to his part, to whom all service is due and

may his bounties and bless be on his messenger, houschold his

companions and on all who follows the guidance until the Day of

Judgment. Our wish to Acknowiedge the effort of our parent who gave

us their full marvelous support, love and fabulous care; they tried

unendingly, financially and morally to certify that we flourish in the near

future. Our triumphant appreciation upon our kind and hardworking

project supervisor, Mal. Hassana M Ladan for her guidance, suggestion,

motivation, enthusiasm and uninhibited moral advice. May Allah reward

her concomitantly and abundantly, I am equally appreciative to all my

senior dietietians including the HOD nutrition and dietetics department,

RDN Bashir Aliyu, internship coordinator RDN Deborah A Ododo, RDN

Afeez, RDN Aisha, RDN Damilare, nutritionist hassana, nutritionist

Usman, nutritionist Amina who are the sources of inspiration, motivation

and encouragement to the actualization of this work and making us

prepare for the future. Our sincere gratitude goes to all other staffs of the

nutrition and dietetics department.

Our final appreciation goes to our tirelessness interns colleague for

maintaining the high energy bonds coordinated by our intern coordinator

Rdn Deborah A Ododo. We will never forget the tremendous contribution

from our friends whose names are numerous to mention. May Allah

continue to bless and protect us AMEEN

TABLE OF CONTENTS

TITLE PAGEi

DECLARATIONii
CERTIFICATION PAGEiii
APPROVAL PAGEiv
DEDICATIONv
ACKNOWLEDGEMENTvi
TABLE OF CONTENTSviii
ABSTRACTx
CHAPTER ONE1
INTRODUCTION1
1.1 Background of the Study1
1.2 Statement of the Problem5
1.3 Justification of the Study7
1.4.1 Aim6
1.4.2 Specific Objectives6
1.5 Significance of the study7
CHAPTER TWO8
LITERATURE REVIEW8
2.1 Overview of Malnutrition8
2.2 Causes of malnutrition9
2.2.1 Immediate causes of malnutrition9
2.2.2. Underlying causes of malnutrition9
2.2.3 Basic causes of malnutrition10
2.3 Methods of Assessing Nutritional Status10
2.3.1 Anthropometric method11
2.3.2 Nutritional Assessment12
2.3.3 Dietary assessment method13
2.4 Challenges in assessing dietary intake16
2.5 Factors Associated with Malnutrition16
CHAPTER THREE18
MATERIALS AND METHOD18
3.1 Materials18
3.2 Research Design18
3.3 Study Area18
3.5 Study Population19
3.4 Sample Size and Sampling Technique19
3.5. Procedure for Data Collection19
3.5.1 Anthropometric Measurements19
CHAPTER FOUR20
RESULTS ,DISCUSSION, CONCLUSION AND RECOMMENDATION20
4.1 Results20
4.6 Discussion32
4.7 Conclusion35
4.8 Recommendations36
REFERENCES37
Appendix I42
 ABSTRACT
Malnutrition is one of the major public health problem among students and staffs in Nigeria tertiary institutions,
this study was carried out to assess the Anthropometric status and diet diversity Among Ahmadu Bello university
teaching hospital staffs. Cross sectional, descriptive study design was used and a total number of one hundred
staffs were purposively and randomly selected in the study. questionnaire and interview were used to collect socio-
demographic status of the subjects, Anthropometric measurements were taken by the body mass index
(BMI) ,dietary intake(24hours dietary recall and food frequency) and Individual Diet Diversity , BMI was
compared with the World health organization (W.H.O ) standard and it revealed that 45% of the staffs had
normal BMI while ,22% where underweight,8% where overweight and 5% are obese .their dietary intake in
accordance with recommended dietary intake( RDA) revealed that some of the subjects that satisfied the RDA for
carbohydrates ,fats and oils, did not satisfied the requirement of protein ,vitamins and minerals which may be as a
result of un eating meal on time ,it's recommended among others ,that Nutrition education should be included in
the general course's taught in tertiary institution in kaduna state.
 CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Nutritional status is the sum total of an individual’s anthropometric indices as
influenced by intake and utilization of nutrients, which is determined from
information obtained by physical, biochemical and dietary studies. It is a result of
interrelated factors influenced by quality and quantity of food consumed and the
physical health of an individual (Omage et al., 2018). In this study, undergraduate
students and staff from Ahmadu Bello University teaching hospital zaria, are taken
into consideration and their dietary habits and diet diversity is assessed. The
assessment of Diet Diversity Score is done via 24 hrs Recall Method for the
consumed food groups out of the total food groups classified according to the Food
and Agricultural Organisation (FAO) for individual dietary diversity which include
foods such as cereals, pulses, milk and milk products, meat, poultry and fish, green
leafy vegetables, other vegetables, nuts and seeds, fats and oils, Vitamin A rich and
other fruits. Household Dietary Diversity.Food and Agriculture Organization of the
United Nations, 2019.
Staffs encompass a substantial portion of the total population that are likely to make
poor judgement regarding their dietary habits. Tendency for consumption of
unhealthy foods and poor dietary patterns is high, greatly due to inadequate or
incorrect knowledge regarding food habits and due to the stress of professional as
well as social life. Patterns of nutritional behaviors adopted in childhood and
adolescents are mostly continued in adult life and hence their assessment becomes
important to understand the risk for developing chronic diseases in the future. This
study aim to assess the Anthropometric indices and diet diversity Among staffs
of Ahmadu Bello university teaching hospital, using 24 hrs recall method.
Dietary pattern (DP) is the general profile of food and nutrient consumption which is
characterized on the basis of the usual eating habits. The analysis of dietary patterns
gives a more comprehensive impression of the food consumption habits within a
population. It may be better at predicting the risk of diseases than the analysis of
isolated nutrients or foods because the joint effect of various nutrients involved would
be better identified. Also, since nutrient intakes are often associated with certain
dietary patterns .single‐nutrient analysis may be confounded by the effect of dietary
patterns. Patterns of nutritional behaviors adopted in childhood and adolescents are
mostly continued in adult life and increase the risk of development of many chronic
diseases (Kapka et al., 2012). Diets in childhood and adolescents have public health
implications due to evidence relating poor nutrition in childhood to subsequent
obesity and elevated risks for type 2 diabetes, metabolic syndrome, and
cardiovascular diseases , which are increasing in prevalence (WHO, 2004).
The prevalence of non-communicable diseases (NCD) is rapidly increasing in both
developed and developing countries due to unhealthy diet and physical inactivity
associated with lifestyle changes. Obesity is one of the major risk factors associated
with the development of noncommunicable diseases such as type 2 diabetes mellitus
and cardiovascular diseases (Jayawardana et al., 2013). According to recent statistics,
more than 90% of the patients with diabetes mellitus are either overweight or obese
(Gatineau et al., 2014) and one in five adults in Sri Lanka is either diabetic or pre-
diabetic (Katulanda et al., 2010). Scientific studies have shown that higher percentage
of body fat in Asian populations than the European populations leads for development
of non-communicable diseases (Engeland et al., 2003). Katulanda et al., (2010) has
shown that there is an association between the rapid increase in the prevalence of type
2 diabetes mellitus and cardiovascular diseases with abdominal obesity, which is
common in Asian populations.
Globally, Dietary Diversity (DD) has been identified as a vital element of high quality
diets. DD is a measure of the number of individual foods or food groups consumed in
a given time period. Dietary diversity is related to the pillars of food security
(accessibility, availability and utilization) (Burchi, 2011). It can reflect household
access to a variety of foods and can also act as a proxy for individual nutrient
adequacy. Increasing dietary diversity is also the preferred way of improving the
nutrition of a population because it has the potential to improve the intake of many
food constituents, not just micronutrients simultaneously. Poor dietary intakes such as
monotonous diets are related to increased risk of malnutrition and other diseases and
therefore local and international dietary guidelines have suggested an improvement on
the variety of foods consumed by individuals and families. For growing children who
are at risk of being malnourished, they need more energy and nutrient-dense foods to
grow and develop both physically and mentally and to live a healthy life. Therefore,
consumption of wide variety of food items and food groups can improve nutritional
adequacy of their diet (Sing, 2016).
Dietary pattern describes the regular or habitual foods consumed by an individual. It
includes the eating patterns for breakfast, lunch and dinner separately. A healthy
eating habit promotes growth and reduces many risks associated with both immediate
and long-term health problems (Ndukwu, 2016). Children who do not eat breakfast
can have lower grades in Mathematics, shorter attention spans and school
performance that is worse than children who have regular breakfast (Tayebi, 2014).
Nutrition experts have indicated that children should eat a variety of foods, have three
meals daily, eat plenty of grains, and fruits to meet up with their growing body's needs
(Ogunsile, 2012).
Nutritional knowledge has been seen to play an important role in promoting healthier
eating practices, and as a result lead to the maintenance of appropriate body weight
(Aliyu et al., 2015). Studies have shown that nutrition knowledge influencesfood
habits which ensures that nutrient needs throughout the life cycle are met (Worsely,
2015).
There have been several studies on nutrition education intervention programs (Lee et
al., 2011) that targeted health professionals with the aim of supporting sound dietary
intake. Some of these studies (Ha et al., 2010) recorded an increase in knowledge and
improved dietary intake post implementation of intervention. Other intervention
strategies, that constituted some level of nutrition education showed that increased
awareness of nutrition positively affected food choice among hospital staffs. By
providing nutrition education, it is the intent that knowledge will increase and support
sound dietary intake within a specific population or community. According toGrafova
(2015), people who are aware of the connection between poor nutrition and certain
health conditions are more likely to follow a balanced diet and avoid excessive weight
gain. This means that increasing nutritional knowledge can be a 3 good strategy to
employ in the reduction and control of certain health condition. Kolodinsky, (2013)
found increased knowledge of dietary guidelines to be positively related to healthier
eating practices among hospital staffs. The authors concluded that healthy eaters have
a higher nutritional knowledge leading to good food choices which can promote
weight reduction and maintenance of healthy weight. All of these studies suggest that
having the knowledge to make the right choices is important in establishing good
eating habits at an early age (Huang et al., 2013).

Malnutrition is a pathological condition resulting from abnormal nutrition. It is

broadly classified as under-nutrition, as a result of inadequate consumption of energy
and other nutrients, and over-nutrition occurring as a result of excess intake of energy
giving foods and other nutrients essential for survival, growth, reproduction and
capacity to learn and function in society (Ngo et al., 2016). Malnutrition has been
described as a significant public health problem in most developing countries and has
affected more than 30% of malnutrition cases(Gaurav et al., 2018).
1.2 Statement of the Problem
The staffs are adults who encounter numerous health risks along the path to
adulthood, many of which affect quality of life and life expectancy. Studies have
shown that working class are particularly vulnerable to poor eating habits and are said
to be in the habit of eating “junks” (Papadaki & Scott, 2012). These poor eating habits
may likely arise from lack of knowledge of the cumulative effects of their eating
habits. In Nigeria, where there is an increase in fast food centers in its urban cities, it
is a major concern (Ajala2014).
Since poor dietary habits is a lifestyle challenge staffs faces this study was therefore
carried out to assess the Anthropometric indices and diet diversity Among Ahmadu
Bello university teaching hospital staffs.
It is important to monitor the nutritional status in a particular community through
public awareness programs to minimize the health complications associated with poor
food habits and physical inactivity. The nutritional status of a community can be
evaluated using biochemical parameters, anthropometric measurements and dietary
intakes of individuals over a given period of time (Jayawardana et al., 2014).The
dietary habits of individuals may vary due to socioeconomic factors, cultural
practices, and educational levels and hence it is difficult to assess the dietary habits
due to variability in food preference and availability. Therefore, the detailed food
record is one of the best methods used to assess the dietary intakes and food patterns
of individuals (Kowalkowska et al., 2013). In addition to the dietary evaluation,
anthropometric measurements are useful to assess nutritional status of individuals in a
particular population as they provide information about size, proportion and
composition of the human body as per the standard measurements. Interestingly, these
measurements can also be used to assess the prognosis of chronic and acute diseases
(Garcia et al., 2007).

1.3 Justification of the Study

Conducting a comprehensive assessment of anthropometric parameters and dietary
patterns among ABUTH staff serves as a foundational step for designing targeted
interventions aimed at promoting healthier lifestyles. By obtaining baseline data,
healthcare administrators and policymakers can tailor intervention programs to
address specific needs and preferences identified within the staff population.
Anthropometric parameters such as BMI, WC, and WHR serve as reliable indicators
for stratifying individuals into different risk categories for NCDs. Identifying staff
members with elevated anthropometric measures enables early intervention and
preventive strategies to mitigate the risk of developing obesity-related comorbidities.
Likewise, analyzing dietary patterns can unveil potential dietary risk factors
associated with NCDs, facilitating the development of dietary interventions for
disease prevention.
ABUTH has a vested interest in fostering a healthy workforce to ensure optimal
productivity and employee well-being. Understanding the prevailing anthropometric
profiles and dietary habits among staff members provides valuable insights for
designing employee health promotion initiatives and wellness programs. These
programs can include nutrition education, physical activity promotion, stress
management techniques, and access to healthier food options within the hospital
premises.
Healthcare professionals, including ABUTH staff, serve as role models for patients
and the broader community. By demonstrating commitment to healthy lifestyle
practices, including maintaining healthy anthropometric parameters and dietary
habits, ABUTH staff can inspire patients and community members to adopt similar
behaviors. This ripple effect can contribute to broader public health improvements
and the prevention of NCDs across the local community served by ABUTH.
Conducting research on anthropometric parameters and dietary patterns among
ABUTH staff contributes to the scientific literature and academic advancement in the
fields of nutrition, public health, and preventive medicine. Findings from this research
can be disseminated through publications in peer-reviewed journals, presentations at
scientific conferences, and incorporation into academic curricula, thereby enriching
the knowledge base and informing future research endeavors in similar settings.
1.4 Aim
The aim of this research is to assess the anthropometric parameters and dietary
patterns among staff of Ahmadu Bello University Teaching Hospital.

1.5 Specific Objectives

I. To determine sociodemographic and socioeconomic parameters of staff at
ABU teaching hospital
II. To assess the anthropometric parameters of staff at Ahmadu Bello
University Teaching Hospital.
III. To assess the dietary pattern of staff at Ahmadu Bello university teaching
hospital.

1.5 Significance of the study

Significance of the study is to help hospitals staffs to be aware of health effective

inadequate nutrition among hospital staffs and take necessary measures/action to
solve it.
The research work is equally important to both government and non-government
organization as it will assist in providing possible solution to inadequate nutrient
intake among staffs base on Nutrition and dietetics principles. Also the result obtained
from this research would add to the existing literature on the subject matter. It would
therefore assist those who will further research or those researching on the related
topic.
Evaluation of the nutritional status of government employees is very important as they
directly contribute to the development process and economy of the country. The
efficiency of work depends on the health and physical status of the workers in
addition to adequate nutrition in their diet. Therefore, public awareness programs
needs to be conducted to create awareness on the efficacy of health and nutrition
status among workers for better performance at the work place. Staffs are an essential
part the hospital system where their efficiency is important to maintain a proper
working environment in the Hospital.The present study therefore was carried out to
evaluate the dietary intake and nutritional anthropometry parameters among the
respondent.

CHAPTER TWO
LITERATURE REVIEW
2.1 Overview of Malnutrition
Malnutrition is defined as “a state in which the physical function of an individual is
impaired to the point where he/she can no longer maintain adequate bodily
performance processes such as growth, pregnancy, lactation, physical work, resting
and recovering from disease (MMS/MPHS, 2018). Malnutrition commonly affects all
groups in a community, but infants and young children are the most vulnerable
because of their high nutritional requirements for growth and development
(Blössner et al., 2017).
Malnutrition is hard to define because it is not a single condition; however the World
Health Organization (WHO) defines malnourished individuals as those whose diet
does not provide enough macro- and micronutrients for growth, maintenance and
health. This also includes the inability to utilize nutrients because of illness.
Malnutrition can be further classified into acute malnutrition which results from
abrupt periods of food shortage resulting in loss of body fat and wasting.
Another classification is of chronic malnutrition which results from long periods of
hunger, and hard long- term adverse effects on the body, especially the
brain. According to Khuzwayo (2018) malnutrition is a condition that takes place
when an individual’s diet fails to provide adequate macronutrients and micronutrients
to promote the growth, maintenance and health of that individual. This condition
could, however, relate to under-nutrition, where an individual’s diet consists of
inadequate nutrients, and over-nutrition (obesity), where an individual’s diet consists
of more than the required nutrients.

2.2 Causes of malnutrition

There has been agreement among researchers on factors contributing to malnutrition.
The primary determinants as conceptualized by several authors relate to unsatisfactory
food intake, severe and repeated infections, or a combination of the two (Rowland et
al., 2015). The interactions of these conditions with the nutritional status and overall
health of the individual and by extension of the populations in which malnutrition is
raised have been shown in the UNICEF Conceptual framework (figure 1) (UNICEF,
2015).
2.2.1 Immediate causes of malnutrition
Inadequate food intake and disease are immediate causes of malnutrition and create a
vicious cycle in which diseases and malnutrition exacerbate each other. Malnutrition
lowers the body's ability to resist infection resulting to longer, more severe and more
frequent episodes of illness. Thus inadequate food intake and diseases must be both
addressed to support recovery from malnutrition (UNICEF, 2015).
2.2.2 Underlying causes of malnutrition
The underlying causes are those that give way to immediate causes. The three major
underlying causes of malnutrition include inadequate household food security, limited
access to adequate health services and/or inadequate environmental health conditions
and inadequate care in the households and at community level especially with regards
to women and children (UNICEF, 2015).
2.2.3 Basic causes of malnutrition
The basic causes of malnutrition in a community originate at the regional and national
level where strategies and policies that affect the allocation of resources (human and,
economic, political and cultural) influence what happens at community level.
Geographical isolation and lack of access to market due to poor infrastructure can
have a huge negative impact on food security (MMS/MPHS, 2018), access to
healthcare services as well as healthy environment. The above model characterizes the
correlates of malnutrition as factors that impair access to food, maternal and child
care, and health care. It is these very factors that impact the growth of population .
Consequently, the assessment of adult growth is a suitable indicator for investigating
the wellbeing of populationand for examining households’ access to food, health and
care (UNICEF, 2015).

2.3 Methods of Assessing Nutritional Status

Nutritional assessment is the first step in the treatment of malnutrition. The goals of
nutritional assessment are identification of individuals who have, or are at risk of
developing malnutrition, to quantify the degree of malnutrition and to monitor the
adequacy of nutrition therapy. The methods of assessment are based on series of
anthropometric, dietary, laboratory and clinical observations used either alone or more
effectively, in combination. Correct interpretations of the results often require
consideration of other factors such as socio-economic status, cultural practices, and
health and vital statistics (Gibson, 2015).
In this study dietary method and anthropometric measurements were used because
they yield satisfactory results within the limit of resources available.

2.3.1 Anthropometric method

Anthropometry involves measurement of variation of physical dimension and gross
composition of human body at different age level and degree of nutrition.
Anthropometry is particularly useful when there is chronic imbalance between intake
of protein and energy (Gibson, 2015). Anthropometric indices are derived from
combination of raw measurement. These include height, weight, and age of the
individuals whose nutritional status is being determined. The measurements are then
used to calculate the anthropometric indicators of nutritional status such as height-for-
age, weight-for-age and weight for height. The indicators are then used to classify and
interpret nutritional status of individuals as shown in table 1. Anthropometric methods
of assessments are preferred in most study for its advantages. The equipment used is
portable and inexpensive. Measurements can be performed relatively quickly and with
ease hence do not require highly skilled staff to perform them. This method however
has some limitation as well. Although sometimes the method can detect moderate and
severe form of malnutrition, it cannot be used to identify specific nutrient deficiency
states (Gibson, 2015).The main imprecision errors in anthropometric are random
imperfection in measuring instruments or in the measuring and recording techniques
(Arroyo et al., 2010). To control and minimize errors during the assessment,
examiners need to be carefully trained on techniques of calibrating the equipment and
taking accurate measurements.
Anthropometries Measurement, a set of anthropometries measurement taken from
each subject as described below:
Weight: A portable scale was used for weight measurement, while each subject had
on light outdoor clothing without shoes and beret and the scale used was adjusted to
zero before each use. While standing on the scale, the reading was collected by the
researcher.
Height: An available cement floor level and height stand was used to measure the
height of the age group as it is expected in the project. The height measurement was
obtained by the subjects standing erect on a flat solid floor without shoes and beret,
arms hanging by the sides, ankles and knee together bullocks, marked wall. A ruler
firmly placed on the subject head lo locale the exact height on the wall. While reading
was taken to the nearest O.lm
Body Mass Index: The body mass index was calculated using formula Wt/Ht2
Dietary assessment can be carried out using five methods. These include; 24-hour
dietary recall, food frequency questionnaire, dietary history, food diary or record, and
observed food consumption (Shim, et al., 2014). The 24-hour dietary recall is
commonly used but requires a trained interviewer who asks the subject to recall food
and drinks consumed in the last 24 hours. A single 24 hour recall is insufficient for
measuring the usual food intake of an individual in a day; therefore a multiple pass
recall is conducted over at least a three day period covering the weekends and week
days. This method is quick and easy but is dependent on short term memory and may
not truly represent the person’s intake.
Indirect methods of assessing nutritional status use community indices which reflect
the nutritional status and nutritional needs of the community. The indirect methods
are; Ecological variables (e.g. agricultural crop production), economic factors (e.g.
household income, food availability and population density), vital health statistics
(e.g. infant and under five mortality rates, utilization of maternal and child health
services), and cultural and social habits.
2.3.2 Nutritional Assessment
Nutritional status is the combination of health as influenced by intake and utilization
of nutrients and determined from information obtained by physical, biochemical and
dietary studies (Gibson, 2005).
Nutritional assessment is thus the system of determining condition of nutritional
health of a person or a group of people. Malnutrition constitutes the most serious risk
factor in causing ill health and death (Muller & Krawinkel, 2005). Its incidence
during early adulthood has irreversible negative effects on the intelligence,
educability, disease resistance and productivity. WHO (2003) see malnutrition as a
serious public health problem that has been linked to a substantial increase in the risk
of mortality and morbidity. Malnutrition has damaging implications for people and
communities, thus hindering the socio economic and human development of a nation.
It remains one of the most critical health issues because of its long-lasting negative
effects. WHO (2002) and FAO (2004) estimated that 852 million people are
undernourished worldwide with most (815 million) living in developing countries.
This confirms the ever increasing figure of people that are undernourished globally.
Broadly speaking, undergraduates (adolescents and young adults) problems are
malnutrition, micro-nutrient deficiencies and nutrition related chronic diseases.
This is because working class individuals tend to practice poor eating habit
(Abolfotouh et al., 2007).The transition from adolescence to adulthood is an
important period for establishing behavioral patterns that affect long –term health and
chronic diseases (MegSmall, Bailey Davis & Maggs,2013).Clinical staffs who are
mostly young adults are affected by this nutritional transition. Wide disparities in the
relative magnitude of these problems are likely even within a given region or country,
with a direct bearing on priorities. Nutrition problems arc health problems; their
prevention and control lie, to a large extent, outside the health sector. There is
widespread recognition of the critical role that economic constraints and food system
play. Bottlenecks play in contributing to poor nutritional health, in addition to socio-
cultural pressures and lack of education. Nutrition cuts across many sectors; and
nutrition action calls for strong intersect oral links particularly among health,
nutritionist and agriculture.

2.3.3 Dietary assessment method

Information about the food consumed amongst the hospital staffs in selected
institutions in kaduna state was collected using 24 hour dietary recall and food
frequency.
Diet is one of the prime determinants of health and nutritional status. An inadequate
diet, poor in both quality and quantity has been one of the reasons for high levels of
malnutrition in children. Dietary surveys are therefore one of the essential
components of nutritional assessment. (Kulsum et al., 2018). The appropriate tool for
dietary assessment will depend on the purpose for which it is needed. The purpose
may be to measure nutrients, foods or eating habits. Different methods have been
developed for the purpose of assessing dietary intake. These range from detailed
individual weighed records collected over a period of 7 days or more to food
frequency questionnaires, household survey methods and simple food lists. Each has
merits, associated errors and practical difficulties to be considered when choosing one
method above another (Wendy et al., 2013). Dietary assessment can be done at
household level or individual level depending on the objective of the survey.

2.3.5 Individual methods

Dietary surveys among individuals provide information that can be used to describe
differences in intake of food and nutrients between subgroups. These methods depend
on the ability of the subject to provide accurate information. Main methods for
assessing present or recent diet include records, 24-hours (or 48-hours) recall, and
food frequency questionnaires. In order to quantify the intake of foods, some estimate
of the weight of consumed food is required. To convert food intake into nutrient
intake, the availability of a food composition database/food table is
essential.Bycombining the information of dietary intake and food composition
databases/tables one can determine whether the diet is nutritionally adequate or not.
2.4 24-Hours Dietary recall
This widely used method involves asking subjects to recall and describe all intakes of
foods and drinks in the previous 24 hours. This method usually requires a trained
fieldworker/dietician/nutritionist to interview subjects, to assess portion weights and
make appropriate enquires about types of food and drinks consumed and possible
omissions of, for example, snacks. It is a much used dietary assessment method
because it is simple, quick and inexpensive, but it is prone to reporting errors,
including biased or inaccurate recalls of food intake and portion sizes. It requires a
good methodological knowledge in order to transform the interview data of the
dietary intake to nutrients. Applied once, it yields no information on day-to-day
variation on food or nutrient intake.
2.5 Food frequency questionnaires (FFQ)
These questionnaires provide information about how often certain foods or foods
from given food groups, were eaten during a time interval in the past, usually day, by
either the household or an individual. The questionnaire can be self-administered or
be administered through a short personal interview. The food list may range from a
few questions to capture intake of selected foods and nutrients, to a comprehensive
list to assess the total diet. The frequency responses can be open-ended or multiple
choice, ranging from several times per day to number of times per year, depending on
the type of food.
2.6 Dietary diversity
Dietary diversity is defined as the number of individual food items or food groups
consumed over a given period of time. The type and number of food groups used for
assessment and subsequent analysis may vary depending on the level of measurement
and intended purpose. At the household level, dietary diversity is usually considered
as a measure of access to food, while at individual level it reflects dietary quality,
mainly micronutrient adequacy of the diet.
The reference period can vary, but is most often the previous day or week (FAO,
2011, WFP, 2019). For this study individual dietary diversity score of the children
was determined based on simple counts of number of food groups consumed in the
past 24 hour (8 food groups by FAO for individual dietary diversity). DDS is easy to
calculate, moreover majority of respondent’s do not find the questions associated with
assessing DDS intrusive. However the method also has a limitation since Measures of
dietary diversity typically do not include quantities consumed. There can also be
significant fluctuations over time in consumption of food groups. This poses
challenges in extrapolating survey data to arrive at broad conclusions about the food
security status.
2.7 Challenges in assessing dietary intake
The recall ability and psychological characteristics of individuals can influence
dietary reporting. For example, an individual may be aware that their diet is
unbalanced and so may be reluctant to provide honest answers to questions, or their
recollection of intake may simply be flawed.Participants may report behavior that
they perceive as socially desirable rather than accurate.
2.8 Factors Associated with Malnutrition
According to a study in DRC a low maternal educational level (less than 7 years), the
absence of a drinking tap water available in the house or yard, male gender, and age
of children were all significantly associated with increased risk of stunted growth
while decreased appetite, diarrhea and age of children were significant predictors of
emaciation. According to a study in Pakistan, household income and Childcare
practices had an important and significant impact on child nutritional status. Childcare
practices were negatively and significantly related to child nutritional status. A study
on household food insecurity and nutritional status of under five years in Western
Highlands of Guatemala showed that food insecurity at the household level was
significantly associated with HAZ, such that children in moderately food insecure
households had 0.08 lower HAZ and children in severely food insecure households
had 0.09 lower HAZ than children from food secure households. Similar study in
Nigeria found out that Food-insecure households were five times more likely than
secure households to have wasted children (crude OR = 5.707, 95 percent CI = 1.31-
24.85) (Ajao et al., 2010) In Kenya an inverse relationship is observed between the
household wealth index and the stunting levels for children, that is, children in the
lowest household wealth quintile record the highest stunting levels (44 percent). The
proportion of stunted children declines with increase in the wealth quintile (KNBS
and ICF Macro 2010). This could be attributed to ability of the household to purchase
adequate food and obtain better health care services. According to the same report,
mother’s education can exert a positive influence on children’s health and survival.
Under five mortality is noticeably lower for children whose mothers either completed
primary school (68 deaths per 1,000 live births) or attended secondary school (59
deaths per 1,000 live births) than among those whose mothers have no education (86
deaths per 1,000 live births).

CHAPTER THREE

MATERIALS AND METHOD

3.1 Materials
Materials used in this research include: stadiometer, weighting scale, structured 24hrs
dietary recall questionnaire, dietary pattern questionnaire and standard questionnaire
of food agricultural organization version of February 2007 on Diet Diversity.

3.2 Research Design

The research design used in this study was cross- sectional

3.3 Study Area

The study was conducted at Ahmadu Bello university teaching hospital. Ahmadu
Bello University Teaching Hospital, formerly known as the Institute of Health, was
established in 1968. The institute of health which transformed to Ahmadu Bello
University Teaching Hospital was established in accordance with statutes 15 of the
university law (amendment act schedule 16) by the former northern Nigeria
government with the objective of providing facilities for training of doctors,nursing
and other medical personnel. Ahmadu Bello University Teaching Hospital, Zaria is
presently being run by a board, established by decree No. 10 of 1985 and it comprises
the chief executive (chief medical director) and the following statutory officers; The
chairman, medical advisory committee, the director of administration, the director of
finance and supplies and the chief internal auditor.

3.4 Study Population

Adults, 20-60yrs years and above working at ABUTH whom met the inclusion
criteria will participate in this study.The study consisted of both males and females.

3.5 Sample Size and Sampling Technique

A sample is a fraction of the population. It can be seen as the reasonable percentage of

the population whose characteristics are to be determined in order to draw up a
conclusion (Osuala 2001). Consequently, Hundred (100) staffs were selected among
the estimated population as the sampling size and the sampling techniques used in the
random sampling technique.

3.6 Procedure for Data Collection

Data were collected by an interviewer administering a questionnaire with questions on

socio demographic status, Anthropometric status and diet diversity of the participants.
Another questionnaire was given to the participants to fill giving a detailed food
record to find out their types and patterns of food consumption. In addition to the
above pertinent anthropometric measurements such as weight and height were also
recorded of each participant in accordance with standards set by the World Health
Organization (WHO, 2008).

3.6.1 Anthropometric Measurements

Anthropometric measurements of weight, height, waist circumference (WC) and hip

circumference (HC) were measured according to the WHO standard descriptors using
a digital scale and nonstretchable commercial tape. Weight was measured to the
nearest 0.1 kg using a digital weighing scale with the participant standing on the scale
with bare foot and less clothing as possible. Height was measured to the nearest 0.1cm
using two nonstretchable commercial tapes by distributing weight evenly over both
feet. WC was taken using the midpoint between the lowest point of the last rib and the
crest of the Ilium to the nearest 0.1 cm. HC was taken as the largest circumference at
the level of buttocks when the subject was standing on a flat floor (WHO, 2008).

CHAPTER FOUR
 RESULTS,DISCUSSION, CONCLUSION AND

RECOMMENDATION
4.1 Results
The result of the study was classified into different sections which include
socio-demographic data of the respondents, anthropometric indices of the
respondents, 24hrs dietary recall and dietary pattern of the respondent, individual
dietary diversity of the staffs
4.2Section A: Socio-Demographic Data of the Respondents
TABLE 4.2.1 SEX
Variables Frequency Percentage
Male 50 50%
Female 50 50%
MARITAL STATUS
Single 30 30%
Married 65 65%
Divorce 5 5%
AGE
21-25yrs 10 10%
26-30yrs 10 10%
31-40yrs 30 10%
41-45 15 30%
45 and above 35 35%
RELIGION
Islam 80 80%
Christianity 20 20%

EDUCATIONAL LEVEL
Secondary 25 25%
Tertiary 75 75%

MONTH INCOME
N20,000 -40,000 35 35%
N41000 - 60,000 10 10%
N61,000 - 80,000 40 40%
N80,000 and above 15 15%

Table 4.2.1 above shows the socio-demographic characteristics of the participant ,

50% were males while 50% were females. 30% were single, 65% were married and
5% were divorced.10% of the respondents were between the age ranges of 21-25yrs,
10% were 26-30yrs, 30% were 31-40yrs, 15% were between the age ranges of 41-
45yrs and 35% of the respondents were 45yrs- above respectively. 80% were
Muslims and 20% were Christians.25% were secondary school certificate holders
while 75% were tertiary certificate holders. 30% were earning N20,000-40,000 per
month, 10% were earning N41,000-60,000 per months, 15% were N61,000-80,000
per month while 40% were earning N81,000- above which has the highest percentage.

4.3Section B: Anthropometric Indices

Table 4.3.1 Interpretation of Height and Weight into BMI Categories for staffs
BMI Categories Frequency Percentage

Severely underweight (< 0 0%

16)

Underweight (<18.5) 22 22%

Normal (18.5-24.99) 65 65%

Overweight (25-29.99) 8 8%
Obese I (30-34.99) 5 5%

Obese II (35-39.99) 0 0%

Total 100 100%

Table 4.3 describes the objective one of this research to determine the anthropometric
status of Ahmadu Bello university staffs the results obtained indicated that 22% of the
saffs were underweight,65% had normal BMI and 5% were overweight while 45% of
the staffs had normal BMI (which has the highest percentage),8% were overweight
and 5% were obese .

4.4Section C: Interpretation of 24hrs Dietary recall and Dietary pattern

Table 4.4.1 24hrs Dietary Recall
Food FREQUENCY INTAKE
Gro
up
>1/d 1/d 3/w 1/w 1/m 0
F P F P F P F P F P F P Freq Perc
uenc enta
y ge
Cere 100 100 0 0 0 0 0 0 0 0 0 0 100 100
als %
Whit 45 45 5 5 25 25 5 5 10 10 10 10 100 100
e %
roots
and
tuber
s
Vit A 6 6 13 13 4 4 11 11 66 66 0 0 100 100
rich %
veget
ables
and
tuber
s
Dark 23 23 7 7 8 8 8 8 54 54 0 0 100 100
green %
leafy
veget
ables
Othe 48 48 18 18 14 14 10 10 10 10 0 0 100 100
r %
veget
ables
Vit. 7 7 4 4 5 5 21 21 63 63 0 0 100 100
A %
rich
fruits
Othe 9 9 11 11 6 6 27 27 47 47 0 0 100 100
rs %
fruits
Orga 8 8 10 10 10 10 33 33 39 39 0 0 100 100
n %
meat
s
Flesh 13 13 26 26 18 18 23 23 20 20 0 0 100 100
meat %
s
Eggs 7 7 15 15 9 9 36 36 33 33 0 0 100 100
 %
Fish 3 3 19 19 67 67 6 6 6 6 0 0 100 100
and %
seafo
od
Milk 9 9 49 49 3 3 10 10 29 29 0 0 100 100
and %
milk
prod
uct
Oils 100 100 0 0 0 0 0 0 0 0 0 0 100 100
and %
fats
Swee 65 65 5 5 10 10 10 20 20 0 0 0 100 100
ts %
Speci 48 48 18 18 14 14 10 10 10 10 0 0 100 100
es, %
condi
ment
s and
bever
ages

Keys:
F = Frequency
P=Percentage
>1/d =more than once a day
1/d=once a day
3/w=thrice a week
 1/w=once a week
1/m=once a month
0=never

Table 4.4.2 describes the objective two of this research to assess the dietary diversity
of Ahamadu Bello University teaching hospital staffs, the table showed that cereals,
fats and oils are consumed more than once per day by the Staffs and students by
100%, 45% consumed roots and tubers more than once per day while 5% consumed
roots and tubers once a day, 42% consumed Vit A rich vegetables and tubers once a
month, 13% consumed Vit A rich vegetables and tubers once per day, 54% of the
respondents consumed dark green leafy vegetables once per month, 23% consumed
once per day, 48% of the respondent consumed others vegetables more than once per
day while 18% consumed once per day, 63% took Vit a rich fruits once per month,
51% consumed once per month, 47% consumed other fruits once per month, 27%
consumed once per week, 39% of the respondents took organ meat once per month
while 33% consumed once per week, 26% consumed flesh meat once per day while
23% consumed once per week, 36% consumed eggs once per week, 33% consumed
once per month, 41% consumed fish and sea food once per month, 30% consumed
once per week, 67% consumed legumes, nuts and seeds thrice a week, 18%
consumed per day, 49% consumed milk and milk product once per day and 29% once
per month, 65% consumed sweets more than once per day and 48% of the respondent
consumed spices, condiments and beverages more than once per day respectively.
4.5Section D: Interpretation of Individual Dietary Diversity
Table 4.5.1 Frequency intake of different food groups by respondents during day
and night (Home)
Food groups Variables Frequency Percentage
Cereals Yes 100 100%
No 0 0%
 TOTAL 100 100%
Vitamin A rich Yes 95 95%
vegetables and tubers
No 5 5%
TOTAL 100 100%
White tubers and Yes 85 85%
roots
No 15 15%
TOTAL 100 100%
Dark green leafy Yes 80 80%
vegetable
No 20 20%
TOTAL 100 100%
Other vegetables Yes 95 95
No 5 5%
TOTAL 100 100%
Vitamin A rich fruits Yes 97 97%
No 3 3%
TOTAL 100 100%
Other fruits Yes 89 89%
No 11 11%
TOTAL 100 100%
Organ meat (iron- Yes 77 77%
rich)
No 23 23%
TOTAL 100 100%
Flesh meat Yes 86 86%
No 14 14%
TOTAL 100 100%
Eggs Yes 96 96%
No 4 4%
TOTAL 100 100%
Fish Yes 95 95%
No 5 5%
TOTAL 100 100%
Legumes, nuts and Yes 94 94%
seeds
No 6 6%
TOTAL 100 100%
Milk and milk Yes 90 90%
products
No 10 10%
TOTAL 100 100%
Oils and fats Yes 100 100%
No 0 0%
TOTAL 100 100%
Sweets Yes 74 74%
No 26 26%
TOTAL 100 100%
Coffee/Tea Yes 96 96%
No 4 4%
TOTAL 100 100%

Table 4.5.2 Frequency of eating meal or snack outside home

Variables Frequency Percentage
Yes 35 35%
No 65 65%
TOTAL 100 100%

Table 4.5.2 the table indicate the intake of meal or snack outside the home, it showed
that 95% of the respondent took meal or snack outside the home while 65% of the
participant do not consume meal or snack in the home.
The dietary pattern of the respondents shows that most of them ate two or three main
meals a day which is necessary for good health. This is similar to findings from a
study carried out among university students in South‐Eastern states of Nigeria
(Achinihu, 2009). However, majority of them either skip breakfast or eat in ‐between
meals. Majority of the respondents sometimes skip breakfast while minority of them
sometimes skip lunch or dinner. Skipping of meals is a very common practice among
working staffs (Hayda& Maria, 2007; Juan et al., 2013; Kurubaran et al., 2012; Moy
et al., 2009). Although breakfast is very important for the health and well ‐being of the
body, staffs may find it difficult to take as they are always in a hurry to go for their
working places. Some may deliberately skip breakfast because of the consciousness of
their body weight and appearance. This is more common among females who are
more conscious of their diet (Carmel & Camilleri, 2011). Majority of the respondents
ate snacks in between meals, possibly to enable them cope with the energy needs of
the body as they go about their normal academic activities

CHAPTER 5
5.1 Discussion "
Table 4.2 above shows the socio-demographic characteristics of the participant , 50%
were males while 50% were females. 30% were single, 65% were married and 5%
were divorced.10% of the respondents were between the age ranges of 21-25yrs, 10%
were 26-30yrs, 30% were 31-40yrs, 15% were between the age ranges of 41-45yrs
and 35% of the respondents were 45yrs- above respectively. 80% were Muslims and
20% were Christians. 50% of the respondent were staffs and 50% were students, 75%
were secondary school certificate holders while 25% were tertiary certificate holders.
30% were earning N20,000-40,000 per month, 10% were earning N41,000-60,000
per months, 15% were N61,000-80,000 per month while 40% were earning N80,000-
above which has the highest percentage.
Table 4.3 describes the objective one of this research to determine the anthropometric
status of Ahmadu Bello University teaching hospital staffs, the results obtained
indicated that 22% of the students were underweight,65% had normal BMI ,8% were
overweight and 5% are obese.
Table 4.4.2 describes the objective two of this research to assess the dietary diversity
of Ahmadu Bello University Teaching hospital staffs the table showed that cereals,
fats and oils are consumed more than once per day by the Staffs by 100%, 45%
consumed roots and tubers more than once per day while 5% consumed roots and
tubers once a day, 42% consumed Vit A rich vegetables and tubers once a month,
13% consumed Vit A rich vegetables and tubers once per day, 54% of the respondents
consumed dark green leafy vegetables once per month, 23% consumed once per day,
48% of the respondent consumed others vegetables more than once per day while
18% consumed once per day, 63% took Vit a rich fruits once per month, 51%
consumed once per month, 47% consumed other fruits once per month, 27%
consumed once per week, 39% of the respondents took organ meat once per month
while 33% consumed once per week, 26% consumed flesh meat once per day while
23% consumed once per week, 36% consumed eggs once per week, 33% consumed
once per month, 41% consumed fish and sea food once per month, 30% consumed
once per week, 67% consumed legumes, nuts and seeds thrice a week, 18%
consumed per day, 49% consumed milk and milk product once per day and 29% once
per month, 65% consumed sweets more than once per day and 48% of the respondent
consumed spices, condiments and beverages more than once per day respectively.
Table 4.5.1 indicated the frequency intake of different food group by respondent
during day and night at home. The result indicates that 100% of the participant
consumed cereal grains every day, 95% consumed Vit A rich vegetables and tubers
while 5% do not consume, 85% consumed tubers while 15% do not consume, 80%
consumed dark green leafy vegetables while 20% do not consume, 95% consumed
other vegetables and 5% do not consume, 97% consumed Vit A rich fruits and 3% do
not consume, 89% consumed other fruits while 11% do not consume, 77% consumed
organ meat and 23% do not consume, 86% consumed flesh meat and 14% do
consume, 96% consumed eggs while 4% do not consume, 95% consumed fish and 5%
do not consume, 94% consumed legumes, nuts and seed while 6% do not consume,
90% consumed milk and its product while 10% do not consume, 100% consumed oils
and parts, 74% consumed sweets while 26% do not consume, 96% of the respondents
consumed coffee or tea while 4% do not consume.
Table 4.5.2 the table indicate the intake of meal or snack outside the home, it showed
that 95% of the respondent took meal or snack outside the home while 65% of the
participant do not consume meal or snack in the home.
The dietary pattern of the respondents shows that most of them ate two or three main
meals a day which is necessary for good health. This is similar to findings from a
study carried out among hospital staffs in South Eastern states of Nigeria (Achinihu,
2009). However, majority of them either skip breakfast or eat in between meals.
Majority of the respondents sometimes skip breakfast while minority of them
sometimes skip lunch or dinner. Skipping of meals is a very common practice among
working class staffs (Hayda& Maria, 2007; Juan et al., 2013; Kurubaran et al., 2012;
Moy et al., 2009). Although breakfast is very important for the health and well being
of the body, staffs may find it difficult to take as they are always in a hurry to go for
their works. Some may deliberately skip breakfast because of the consciousness of
their body weight and appearance. This is more common among females who are
more conscious of their diet (Carmel & Camilleri, 2011). Majority of the respondents
ate snacks in between meals, possibly to enable them cope with the energy needs of
the body as they go about their normal academic activities.
Physical changes affect the body's nutritional needs, while changes in one's lifestyle
may affect eating habits and food choices. peoples within the age range of 17–30
years in every country constitute a large proportion of the total population. Many
staffs do not know the nutritional values of the foods they eat. Some avoid certain
foods because of personal dislike, social and cultural pressure, peer group influence,
religion etc. There is a relationship between obesity and food intake and dietary
patterns or feeding habits in adolescents . DP represent a general profile of food and
nutrient consumption, characterized on the basis of the usual eating habits.
Some dietary patterns appear quite common among adolescents, to mention a few:
snacking, usually on energy dense foods; meal skipping, particularly breakfast, or
irregular meals; wide use of fast food; and low consumption of fruits and vegetables.
These unhealthy habits can lead to under nourishment or over nourishment with the
resultant increase in the susceptibility of avoidable diseases.
The interpretation of the anthropometric measurement of the subjects, i.e. BMI
revealed that majority of the subjects are normal in their BMI, while others were
severely underweight, underweight, and obese. According to World Health
Organisation data (2003), BMI less than 18.5 is underweight and may indicate
malnutrition, an eating disorder or other health problem, while a BMI greater than 25
is considered overweight and above 30 is considered obese. This finding is similar to
the work of Delvarionzadeh et al (2016) on Assessment of Nutritional Status and its
related factors among Iranian University Students who found some cases of
malnutrition including both underweight, overweight and obesity among working
class staffs. Never the less it is important to note that anthropometric measurements
vary significantly worldwide. The basic objectives of anthropometric assessment are
to provide an estimate of the prevalence and severity of malnutrition. The information
collected can then be used for the formulation of health and development policies.
4.2 Conclusion
Anthropometric assessment is concerned with the measurement of the variation of
physical dimensions and gross combination of the body. Most of the staffs had normal
Body mass index (B.M.I) and therefore seem to be well nourished, the result of 24hrs
dietary recall and dietary pattern showed majority of the respondent eat cereals, fats
and oils more than once per day, the result of diet diversity showed that students and
staffs eat variety of foods more at home than outside home. Also showed that lack of
simple knowledge of nutrition, insufficient resources, time, weight reduction and loss
of appetite are the problems facing the nutritional intake of the staffs. The knowledge
of nutritional status of the adolescent is of importance as poor nutrition cannot
contribute to the development and maintenance of their status. This may be true as
those who had medium dietary diversity were more obese and overweight than those
who had high dietary diversity.
5.3 Recommendations
On the basis of findings as recorded, the recommendations below should be taken into
consideration. It is believed that it would solve some of the problems to a
considerable extent.
Government should help to provide useful information about current dietary
practice to working staffs.
Individuals should diversify their diet and engage in enough physical
activity to help halt the rising prevalence of overweight and obesity.
Government and other agencies should intensify intervention efforts to
educate the public on good nutrition to improve good health.
There should also be enlightenment to the general populace that nutritional
foods (adequate diet) are not really expensive. Also, a better understanding of
adequate diets and eating behaviours is essential for relevant education
programmes.
Additionally, dietary enquiry tools specifically designed for health centers
are direly needed. The enquiry should encompass household food security, food
diversity (as indicator of nutritional quality), eating practices and underlying
influences and physical activity. These tools need to be developed and validated
in different settings in connection with school-based or health centre-based
intervention programmes rather than as free-standing research, for higher
relevance.
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 APPENDICES 1

CONSENT NOTIFICATION

Department of nutrition and dietetics,

Ahmadu Bello university teaching hospital
Shika-Zaria
Kaduna State-Nigeria

Dear respondent,
We are interns from Department of nutrition and dietetics, Ahmadu Bello University

teaching hospital, undertaking project research on “Anthropometric Assessment and

diet diversity among Ahmadu Bello University teaching hospital Staffs” This is in

partial fulfilment of the award of professional certification in dietetics.All your

information is for research purposes and it will be hold confidentiality. Please the

information should be reliable. I appreciate your support and cooperation. it will only

takes 5-10munite to finish, thank you for your kind gesture.

CONSENT: now that the study has been explained to me and I fully understood, I am

willing to participate.

Yours faithfully
Zahra'uAminu Yusuf
ZainabAbdulhamid
Bilkisumusa Ibrahim
Answers provider will be treated with great confidentiality
Instructions: please tick as appropriate (√)

SECTION A
PERSONAL DATA OF THE RESPONDENTS
Section 1: Background of Information

Date: _______________________ Questionnaire No: ______________________

Name of ward: ________________________

1. Sex…………………………………………………….

2. Ethnicity ………………………………………………..

3. Place of birth ……………………………………………….

4. Marital status ……………………………………………….

5. Religion ………………………………………………………..

6. Level of education …………………………………………………

7. Occupation …………………………………………………..

8. Do you have medical history of ……………………………………………

9. Do you have any medical history of chronic disease, if yes

specify…………………………..

10. Monthly Income (a) 5,000-10,000# ( ) (b) 11,000-20,000# ( ) (c) 21,000-

30,000 ( ) (d) 31,000-40,000# ( ) (e) 41,000-50,000# ( ) 51,000-60,000# ( ) (f)
61,000 & above ( )

Section 2: Anthropometric measurements

1. Weight _____________________ (kg)

2. Height ______________________ (cm)

3. BMI ___________________ (kg/m2)

Section 3: 24hrs dietary recall

Food eaten Time taken Amount

Section 4: Food frequency Questionnaire

Please kindly fill the questionnaire below as accurately as possible

How often do you eat the following? (check inside the box)

1 or less 1-3 4-6 7 or more

Time/week time/week time/week
1. Milk, yorghurt, diary products [ ] [ ] [ ] [ ]

2. Meat, fish,, poultry [ ] [ ] [ ] [ ]

3. Egg [ ] [ ] [ ] [ ]

4. Dry beans, peas, soya beans, akara (Kosai, moimoi) groundnut, kulikuli

[ ] [ ] [ ] [ ]

5. Citrus fruits (oranges) grape fruits, tomatoes etc.

[ ] [ ] [ ] [ ]

6. Carrots, sweet potatoes, ugu, spinach, green leafy vegetables

[ ] [ ] [ ] [ ]
7. Bread, cereals (guinea corn, maize, wheat, semovita etc), pasta (macaroni)
spaghetti, noodles etc, rice [ ] [ ] [ ] [ ]

8. Cakes, doughnuts, pies, sweet burns, puff-puff

[ ] [ ] [ ] [ ]

9. Soft drinks (coke, fanta, malt etc) [ ] [ ] [ ] [ ]

10. Alcohol (burukutu, pito, gulder) [ ] [ ] [ ] [ ]

11. Coffee, tea [ ] [ ] [ ] [ ]

12. Vitamin supplements [ ] [ ] [ ] [ ]

13. Smoking Yes [ ] No[ ]