SUBMITTED BY:-
MRS. SUSAN K. SAMUEL
1ST YEAR M.Sc. NURSING
CHILD HEALTH NURSING
2009- 2011
SARVODAYACOLLEGE OF
NURSING, BANGALORE- 79
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RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCE, KARNATAKA
BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. / NAME OF THE CANDIDATE AND ADDRESS / MRS. SUSAN K. SAMUEL1ST YEAR M.SC. (NURSING) SARVODAYA COLLEGE OF NURSING NO.11/2 MAGADI MAIN ROAD, AGRAHARA, DASARAHALLI, BANGALORE.
2. / NAME OF THE INSTITUTION / SARVODAYA COLLEGEOF NURSING AGRAHARA DASARAHALLI, BANGALORE
3. / COURSE OF STUDY AND SUBJECT / 1ST YEAR M.SC NURSING CHILD HEALTH NURSING
4. / DATA OF ADMISSION OF THE COURSE / 27/05/2009
5. / TITLE OF THE TOPIC / “A Study On Assessing The Effectiveness Of Nutritional Education
On Antioxidants Among Adolescence
In Selected Schools Of Bangalore.
6. / Brief resume of the work
6.0 Introduction
6.1 Need for the study
6.1.1 Statement of the problem
6.2 Review of literature
6.3 Objectives
6.3.1 Operational definition
6.3.2 Assumption
6.3.3 Hypothesis
6.3.4 Sampling criteria / Enclosed
Enclosed
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7. / MATERIALS AND METHODS:
7.1 Sources of Data: data will be collected from students of selected school, Colleges of Bangalore.
7.2 Method Of Data Collection: Questionnaire method.
7.3 Does the study require any investigations or interventions to be Conducted on
The Patients or other human beings or animals?
Yes.
7.4 Has Ethical clearance been obtained from the institution?
Yes, Ethical committee’s report is here with enclosed.
RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCE,
KARNATAKA, BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION:
1. / NAME OF THE CANDIDATE AND ADDRESS / Mrs. SUSAN K. SAMUEL1ST YEAR M.SC. (NURSING) SARVODAYA COLLEGE OF NURSING NO.11/2
MAGAD ROAD AGRAHARA, DASARAHALLI, BANGALORE.
2. / NAME OF THE INSTITUTION / SARVODAYA COLLEGE OF NURSING AGRAHARA DASARAHALLI, BANGALORE
3. / COURSE OF STUDY AND SUBJECT / 1ST YEAR M.SC NURSING CHILD HEALTH NURSING
4. / DATA OF ADMISSION OF THE COURSE / 27/05/2008
5. / TITLE OF THE TOPIC / “A Study On Assessing The
Effectiveness Of Nutritional
Education On Antioxidants
Among Adolescence In
Selected Schools Of Bangalore.
6. BRIEF RESUME OF INTENDED WORK
6.0 INTRODUCTION
The greatest wealth is the health. - Virgil
Adolescence is one of the greatest periods of change during our life times. Changes occur in all realms of human development – physical, emotional, intellectual, even spiritual. Body shapes are changing, independent thinking begins and adolescence takes on the social values and the role of adulthood .It’s the time of new discoveries and opportunity, but also of anxiety and stress. 1
Adolescence is often defined as a transient stage between childhood and adult hood .The peak growth is generally between 11 – 15 for girls and 13- 18 years for boys. Adolescence begins when the secondary sex characteristics appear and ends when somatic growth is completed and individual is psychologically mature, capable of becoming a contributing member of society.2
Karnataka has 52.73 million populations according to the2001 census. Out of that 21% population is of adolescence .India has fastest growing adolescence population in the world. The population projection indicates that over the next decade in this group there will be relatively sharp reduction in both number and proportion of the 5-18 years old .It is there for essential that over the decade efforts to focus on improving health and nutritional status of school age children so that they reach adult life with the optimal
nutritional and health status. On the physical level, adolescence brings on rapid growth and hormonal changes.3
Physical changes including growth spurt the onset of menarche for girls and increase in fat and muscles mass rev up adolescence appetite and place extra nutritional requirement on adolescence.4
This rapid changes leads to an increase need for dietary content and micronutrient. The growth depends on adequate nutrition which is determined by availability and intake of food in sufficient quality and the ability to digest .Other than this adolescence require supportive antioxidants in the diet .Antioxidant is the divers group of chemical that can be naturally found in vegetables and fruits. Dietary oxidants are vitamin A, E, C selenium, chlorophyll derivatives, carotenoids, flavonoids, melatonin, lycopene. It is also synthesized in our body .e.g. -super oxide, catalase, gluthione peroxidase etc.Antioxidants have effect on aging, immune system, fatigue, stress, disease such as cancer, cardiovascular disease can prevent damage to your body cells or repair damage that has been done etc .5
Antioxidant defense system limits free radical formation and scavenges them but antioxidant defenses system is not 100% efficient. Antioxidants work by significantly slowing or preventing the oxidative damage caused by substances called free radicals that can lead to cell dysfunction and the onset of problems like heart disease and diabetes. Antioxidants may also improve immune function and perhaps lower your risk for infection and cancer. In our body, the antioxidant process is similar to stopping an apple from browning. Once you cut an apple, it begins to brown, but if we dip it in the orange juice, which contains vitamin –C, it stays white. An eating plan containing plenty of fruits and vegetable, grain and nuts can supply all the antioxidants our body needs. When body overwhelms by free radical disease must results. The nature is not much cruel it has given things to counteract the effect of free radicals in the form of free radical scavenger.6
“Good nutrition is a safe and good road to health,
‘Surely golden days are ahead for superstar antioxidant ‘.
6.1 NEED FOR THE STUDY-
Adolescence has been defined by WHO as a period of life between 12-18 years about 1/5th of the world consist of adolescence. This adolescence is exposed to rapidly changing values and modernized way of living. Adolescence from a significant proportion of the population of our country about 1/3rd of the India’s population is between 12-18 years. Today’s adolescence is tomorrow’s adult, who is the strength of the nation. National nutrition board survey showed prevalence of overweight 6.1 among boys, 8.2 among girls .Chronic heart disease increased by 6-16% among today’s adolescence. 7
The year of 12-18 are the time of steady growth, good nutrition is high priority. Children must know that what they eat effects how they grow. Changes in our society have intensified the need to become a part of child basic nutrition education for good health and survival. Now when we look at the present generation, they consume more amount of fast food – candy, pastries, high fat chips, cola, food high in fat and sugar. About 25-40% of teenager is overweight, mostly from lack of exercise in combination of junk foods. Ultimately leading a life towards disease condition, lack of concentration, depression, lack of energy etc. Antioxidants have effect on anti aging, immune system, fatigue, stress.8
Antioxidants are naturally occurring compounds that are important for cells protection from free radicals. Fruits and vegetables are well-known source of antioxidants such as polyphenols. Most people know about the benefits of eating whole grain foods which are rich in fiber. Now, scientists say that it might be actually antioxidants that make whole grain bread and popcorn so healthy. Dr Joe Vinson said that, for example, popcorn contains as many polyphenols as an apple.9
Our body constantly reacts with oxygen as we breathe and your cells produce energy. As a consequence of this activity, highly reactive molecules are produced known as free radicals. Free radicals interact with other molecules within cells. This can cause oxidative damage to proteins, membranes and genes. Oxidative damage has been implicated in the cause of many diseases such as cancer and Alzheimer's and has an impact on the body's aging process.10
Antioxidants works by significantly slowing or prevention of oxidative damage .Although oxygen is vital to life, scientist are also finding the essential element may contribute to human aging and illness. When oxygen is metabolized or burned by the body cell form byproduct called free radicals .Free radicals travels through the cell, disrupting the structure of other molecule and resulting in the cellular damage. Such damage is believed to be contributing to aging and various health problems. Antioxidant protect key cell component by neutralizing the free radicals. The antioxidant that occur naturally in the body or consumed through the diet may block most of the damaged.10
Formation of free radical are seen by various metabolic reaction , oxidation of endogenous compound , ultraviolet rays ,stress, emotional factor, environmental pollutant , radiation , cigarette smoking, alcohol consumption , junk foods , certain dyes and pesticides etc .Our body's internal production of antioxidants is not enough to neutralize all the free radicals. We can help your body to defend itself by increasing your dietary intake of antioxidants. Food coco enriched diet may lead to significant increase in the total capacity in all the tissue particularly in the thymus, the organ situated in the upper part of the chest and responsible for certain hormones that stimulate cells used in an immune responses. The fast food is most enjoyable food of adolescent age group leading to variety of adverse effect like disturbed sleeping pattern , indigestion, irregular bowel movement , less irritability , body weakness and weight loss for some . 10
Television commercial and supermarket are propagating a wide variety of fast foods, cola that are laced with colors those are often inedible, carcinogenic and harmful to the body .It contains excitotoxines –chemical transmitter that may aggravate neurological disorder .The safest and easiest way to take care brain health is to avoid all
food additives by eating a fresh vegetables, whole grain, fruits etc. The best way to healthy is to a healthy diet and exercise regularly.11
6.1.1 STATEMENT OF THE PROBLEM:
“A study on assessing the effectiveness of nutritional education on antioxidants among adolescence in selected schools of Bangalore.
6.2 REVIEW OF RELATED LITERATURE
The review of literature is a summary of current knowledge about a particular practice
Problem and includes what is known and not known about the problem. The literature is
reviewed to summarize knowledge for use in practices or to provide a basis for
conducting a study. The study review is presented under following heading:
a) Inappropriate dietary pattern as risk factors for non communicable disease.
b) Antioxidant may reduce risk of cardiovascular and neoplastic disease.
c) Fruits and vegetables intake linked to antioxidant status, increased immune response
and cognitive performance.
A) Inappropriate dietary pattern as risk factors for non communicable disease.
A study revealing risk factor of school age population in India, to evaluate the prevalenceassociate risk factors for non communicable disease in urban schools in Delhi. The studywas carried out. Among 510 of different class in the age group of 12-18. Theageappropriate modified global based student health survey by self administered questionare.Weight and B.P was measured with standard equipment .Theresult showed that inappropriate dietary practice (low vegetable, fiber, fruit consumption) low physical activity, higher experimentation with alcohol, and to a lesser extend smoking, high of Obesity and hypertension in the school children .school based interventions are required to reduce the risk associated with non communicable disease.12
A study presenting nutritional problems among adolescence in Srilanka. To assess nutritional problem and dietary and activity pattern among adolescence. A cross sectional study was done on 6,264 adolescence 10-15 years of age. All subjects were examined for Bitot’s spot and their weight and height were measured. The prevalence rate of under weight, stunting and over weight were seen .The prevalence of rate of vitamin A was seen. Usually they don’t take break fast before going to school. Then eventhe vegetable and fruit consumption was less, not participating in the physical activity and watching television more than two hours per day. The conclusion was that thenutritional problems of adolescence aged 10 -15 years should be addressed through theschool. Specific policyshould be developed in collaboration with the Ministry of healthand education to control nutritional problems among adolescence.13
b) Antioxidant may reduce risk of cardiovascular and neoplastic disease AND VITAMIN DEFICIENCY.
A study suggests that anti oxidants may reduce risk of cardiovascular and neoplastic disease based on basic epidemiological approach therefore dietary fat soluble antioxidant vitamin intake and plasma concentration in healthy adolescence girl was investigated. This age was selected since dietary antioxidant protection against major illness is the life long requirement and because healthy dietary habits are adopted at an earlier age often modified during adolescence. 71 high school girls, age range 15-18 years, were studied by a semi quantity food frequency questions Plasma antioxidant were measured by high frequency performance liquid chromatography (HPLC) in 1girl. The report suggested that the Israeli girls consume a suboptimal amount of vitamin E in the diet, but sufficient in other fat soluble antioxidants. A high level of vitamin should be encouraged in order to obtain the maximum benefit from exposure to dietary antioxidants throughout life .14
A study on plasma carotinoids in German children and adolescence. Carotinoids are important precursor of vitamin A using high performance liquid chromography; they analyzed the concentration carotinoids among healthy children of age 1-18 Data analysis. to age group showed a tendency towards higher level of Alfa and beta carotene and lower level of lycopene in younger children. The difference was significantly less inchildren
younger 4-5 and more in 12-18. The data may serve as reference value for studies on children with nutritional disorder and disease associated with risk of vitamindeficiency .the carotinoids are important antioxidant and oxygen scavenger Plasma levelof Alfa beta carotene was found at highest level were determined in 129 healthy German adolescence. 15
A study of fruit and vegetable in the diet been found in epidemiological studies to be protective against several chronic disease epidemiological studies to be protective against several chronic disease epidemiological evidence suggest that flavonoid consumption in the diet is protective against heart disease . The phenol antioxidant index measuring both the quality and quantity of the antioxidant present was found to evaluate23 vegetables isolated lower density proportion lipoprotein from plasma spliced with two vegetable extracts were enriched with phenol antioxidant and show decreased oxidativedamages.16
c) Fruits and vegetables intake linked to antioxidant status, increased immune response and cognitive PERFORMANCE.
A study represents high Fruit and Vegetable intake linked to Antioxidant status andcognitive performance in healthy subjects. Researchers at the Institute of Biochemistry and Molecular Biology I of the Heinrich-Heine University, Düsseldorf, Germany, investigated the relationship between fruit and vegetable intake, Plasma antioxidant micronutrient status and cognitive performance in healthy subjects Aged 45 to 102 yearsTheir results, published in the August issue of the Journal ofAlzheimer’s disease, indicated higher cognitive performance in individuals with high daily intake of fruits and vegetables 17
A study revealed that the reactive oxygen species produced as a result of exercise mightexceed an individual antioxidant defense system. Various endogenous antioxidantdefense systems are elevated in adult athlete resulting in an improved anti oxygencapacity. Trolox equivalent antioxidant, uric acid and nutritional antioxidant were tested in the plasma of athlete and antioxidant intake was calculated using 4 days dietary records .Athlete showed difference in Alfa tocopherol, betas carotene or ascorbate intakecompared with control .Regular exercise enhance antioxidant capacity in adolescence athletes independently of their dietary antioxidant intake which indicate activity related adaptation 18
Epidemiological studies have indicated that a diet rich in fruit and antioxidant and 3-fattyacids may contribute to optimal respiratory health. A study association of dietary factors (fruits, vegetable, vitamin-C, E, beta-carotene,) with respiratory health in acohort study 2,112 twelth grade student in 13 communities in the united state andCanada during the1998-1999 school year. Results low dietary fibers. Results shown that fruit intake was associated with increased odds of chronic bronchitis symptoms, asthma symptoms as compared with higher intake. 19
6.3OBJECTIVES OF THE STUDY
- To assess the knowledge of adolescence on antioxidants before and after nutritional education.
2. To evaluate the effectiveness of nutritional education on antioxidants among
adolescence.
- To find out an association between knowledge on antioxidants and selected variables.
6.3.1 OPERATIONAL DEFINITION
EFFECTIVENESS – Refers to significant measure or ability of nutritional education to produce a specific desired effect in term of significant improvement in the knowledge as measured by post test.
NUTRITIONAL EDUCATION- A teaching module which is prepared to educate a group of adolescence on antioxidants definition , meaning ,types, antioxidant and it’s relation to free radicals ,causes of free radical formation ,functions of antioxidant , Sources of antioxidant , disease conditions arising due to excessive free radicals .
ANTIOXIDENT- Refers to a diverse group of chemicals that can be naturally found in vegetables, fruits, and plants in general. They are also synthesized in the body.
ADOLESCENCE - It refers to boys and girls who are between the age group of 13-18 years.
6.3.2 ASSUMPTION:
1. Adolescence may have less knowledge on antioxidant and its influence on health.
2. Nutritional education may support their eating habit and reduction in disease condition.
6.3.3 HYPOTHESIS:
H1: There is an increased knowledge among adolescence after nutritional education on antioxidants than before nutritional education.
6.3.4SAMPLING CRITERIA
INCLUSION CRITERIA:
- Adolescence who are available at the time of study.
- Adolescence who are willing to participate in the study.
- Adolescence who can speak and write English.
EXCLUSION CRITERIA
- Adolescence those are having completes knowledge of antioxidants.
- Adolescence whose parents are dietician.
7. MATERIAL METHODS
7.1. SOURCE OF DATA
Data will be collected from adolescence in selected schools of Bangalore.