RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES
BANGALORE KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. Name of the Candidate and:Ms. RADHA.M.
Address1st Year M.Sc Nursing
RajivGandhiCollege of Nursing,
IIT Campus, Near MeenakshiTemple,
Bannerghatta Road,
Bangalore-560 076.
2. Name of the Institution:RajivGandhiCollegeofNursing
3. Course of Study & Subject:Degree of Master ofNursing
CommunityHealth Nursing.
4. Date of Admission to Course:04.06.2009
5. Title of the Topic:Effectiveness of plannedteaching
Programme on knowledge and
attitude regarding health hazards
of junk foods among adolescent in
selectedUrbanHigh School, Bangalore
INTRODUCTION:
Adolescent is associated with search for independence. Identity and changes in lifestyle. During childhood and adolescence most individuals develop and establish a lifestyle within which a range of health behaviours is embedded. However, during adolescence, young people take part in the process of separating from the parents, resulting in a decrease in parental influence on health behaviours as age increases, unable to cope up with the rapidly changing world. The bodies and mind of adolescence have taken a battering.
Nutritional intake during adolescence is important for growth, long term health promotion and development of life ling eating behaviour. Nutritional intake during this period may have long term health implications. Meal patterns of adolescents are often chaotic. Several physical, psychological and behavioural changes may affect food habits during adolescence and have long term consequences on adult health status.
Teenager miss an increasing number of meals at home as they get older. Teenagers identify time as the biggest barrier to eating properly. They perceive themselves as toobusy to worry about food, nutrition, meal planning or eating well. They form positive associations with junk foods. Other factors includes mood, body image, concerns, habits, media influences and life style choices.
Televisions and magazines has greater influence on adolescents eating habits. It is estimated that by the time average children reach the teenage years, they have viewed 1,00,000 food commercials, most of with high concentration of fat and simple ChO. More than 65% of food advertisements promote beverages and sweets. Marketing to adolescents has become a multi billion dollarsbusiness. Approximately 23 million teenagers spend 100 billions dollars annually for fast food and other snacks.
Teenagers are frequent visitors to fast food restaurants, different store, visits occur immediately after school and next higher number during week day dinner time. It is important to determine where they eat, how much they spend, and what they buy1. This information is vital in helping and providing nutritional care plan for adolescents.
Junk food refers to fast foods which are easy to make, and easy to consume. They have only fats lying in it causing ill effects on the health of the adolescents. The taste is the most attractive feature in junk foods. But it there atleast little use of our body and health. ‘Muchael Jawbson Aptly’ wins the phrase junk food in 1972, as slang for foods of useless / rubbish / no nutritional value. There contents are rich in sodium salts and / or sugar and fats which provide high calories yet useless in value. Junk food and diet does not go hand in hand2. Perhaps this is the reason why junk foods are also called as empty calorie foods. Nevertheless, junk foods are popular because of their simplicity to manufacture, lons course their taste.
The difference between fast food, meal and a home cooked one is the sheer quantity of calories and fat it delivers into the body. The United States ‘Department of Agriculture’ (2009) recommended daily intake for a normal adolescent is 2100 Kcalories and maximum of 93g of fat. A meal at a fast food outlet-burger, fries, drink and dessert can deliver almost all of that in a single servings3
Junk foods such as potato wafers and cheetos, do not even need cooking ion prefer to eat them when people watch T.V. where it saves time and hurry eating pizzas and burgers as they are several out door step nowadays.
Junk food has become a prominent feature of the diet of adolescents throughout the world. Junk foods pose health risks both because of what they contain and what they replace in diet. Even though Junk foods are tastier and easily available, it has become the biggest supporter of cancer. Stuffed with loads of fat, these eatables increases the level of cholesterol in the body and invite obesity, which is believed to be ‘Mother of Cancer’4
Most colors in fast foods are often inedible, carcinogenic and harmful to the body, they can affect the digestive system and can lead to hyper activity and lapses of concentration in children. Children suffering from learning disabilities are often advised against eating food with artificial coloring
Studies suggest that one soda contains 9 Teaspoons of sugar, gives more added sugar than its recommendation.
There are over 500 Kcalories and 40% of daily recommended fat in quarter-pound cheese burgers.
In large fries there are 510 more calories plus 47% g of daily recommended fat. All these acts as a base for childhood obesity5
6.0 Brief Resume for Intended work
6.1 Need for the study:
Adolescence, is a period of rapid growth and personal development. The growth and development of adolescents depends to a large extent on their nutrition The complex myriad of physiological as well as psychological changes, accompanied by rapid growth and increase in physical activity, create special nutritional needs that are higher during adolescence than at any other time in life. Failure to consume adequate diet at this time can potentially retard physical growth, intellectual capacity and delay sexual maturation1
Nutritional status of adolescents is highly influenced by varied eating patterns. The eating pattern of adolescents first increasingly gained attention in western countries in recent years claiming that they have a poor diet2. Particular areas of concern have included intake of more dietary fats in comparison to fruits and vegetables. Owing to globalization and urbanization in developing countries, adolescent-eating behaviour is now here also coming under the spotlight3
Both undernourishment and overnourishment in young people are increasing problems in both developing and developed contries4. Snacking is a well-established eating pattern amongst adolescents; especially those in the higher socio-economic strata. Teenagers are typically fond of eating ‘junk’ food, not only for its taste, but because of peer group habits. Although, snacks can be a source of needed nutrients and calories, but it can lead to overweight too5 . At the other end of spectrum are teens who are undernourished due to eating disorders. Many adolescents feel pressurized to be ideally thin like models in movies or magazines. Some girls embrak on their first diet even before leaving elementary school6.
Because of young age (22%) structure of India’s population being adolescents (7) , the needs of the adolescents should be considered as important to improve the health status of the nation.
Studies conducted in metropolitan cities like Chennai, Bangalore states that 70% of the mortality in adulthood is linked to habits picked up during the adolescence period especially the poor eating habits 8. It was estimated that eating junk food is the second leading cause for most of the adolescent health problems.
A study carried out in Bangalore 2009 states that anemia in adolescent boys were found to be 42% which is quite high because of junk food consumption 9.
An comparitative studies in Metropolitan cities (2008), Study suggest that childhood obesity is a major public health issue worldwide. It is well accepted that unhealthy eating patterns are partially responsible for the increase in childhood obesity. However, there is relationship between fastfood and soft drink consumption and children happiness. In particular, they studied the effects of fastfood and soft drink consumption on childrens body weight and their happiness. A National wide Survey was carried in 2001 using the data from the national the data from the National Health Survey in India, the authors looked at the fast food and soft drink consumption, body weight and level of happiness of 2,366 children aged between 12 to 15 years old. Fast foods included French frieds, Pizza and humbergers, soft drinks including soda and other sugar sweetened beverages. 30%
age of children in the study sample were over weight or obese and 19% sometimes are often felt unhappy, sad or depressed. So the study’s key findings was that children who ate fast food and drank soft drinks were more likely to be over weight, and favourable attitude towards junk food consumption10
Unhealthy eating habits is often associated with childhood obesity leads to many diseases including 3 leading causes of death: heart diseases, cancer and stroke.
Now a days most of the parents dream is to have the chubby child, for eg. Mother consumption of fast food and soft drinks predict her child’s eating habits. Most of the parents do not understanding the ill effects of poor eating habits, hence they forced their child to eat junk foods. Studies finding suggest that consumption of fast food and soft drink leading to childhood obesity11
A cross sectional study conducted in Chennai using an unquantified food frequency questionnaire and anthropometric data suggests that fifty adolescents between 12 to 15 years old were selected from Schools. The consumption of junk foods were significantly higher in urban areas about 24.2% respectively. Studies shows that junk food makes up quarter of adolescent diet in Urban cities 12
A cross sectional study conducted by Dr. R. Narasimhan (2009) states that junk foods may be partly responsible for increases in asthma. Survey noticed that prevalence of asthma was more in urban children whose diet is influenced by junk foods13
The present sceneries shows that many of adult diseases have their origin during childhood and adolescent period. Studies reveal that as early as the age of 30% arteries could beginning clogging and lay the ground work for further heart diseases. What children eat from puberty affects their risk of prostrate and breast cancer. Osteoporosis and hypertension are other diseases related to unhealthy or poor eating habits. Hence, health eating habits in childhood and adolescent period is important for proper growth and development and to prevent the health problems such as obesity, dental caries and iron deficiency anemia 14
An descriptive study carried out in Sydney by Mcfarlad on Oct 20, 2009, strongly suggest that the many types of junk foods are very low in magnesium and that resulting magnesium deficiency can causes diabetes, arteriosclerosis and high blood pressure, hyper triglyceridemia and hyperlipedemia. Recent research has shown that magnesium deficiency associated with insulin resistant in obese children. Also proved that adults with hyperlipedemia has got strong root of childhood obesity and junky food consumption.
Lot of studies in adolescents pertaining to fast food consumption and their various correlates or association with home, school environment have been conducted in developed countries but in developing countries this field is not studied to grate extent. Moreover out of these only few account to interventional studies.
An evaluative studies carried out on rats to determine the links between processed food and addiction found that a high fat diet appears to alter the brain biochemistry in similar way to drugs such as Morphine. The report said that this is due to release of opioids – chemicals in the brain that reduces the feeling of beingful. From the finding the researches assumed that it is possible that human being become addicted to high sugar and fatty food. That is responsible for the behavioural change to occur among adolescents.
Seminar held on “problems in adolescents”, organized by the Cipla manufacturing Limited Sri Durga Malleswara Siddartha Mahila Kalasala. Dr. Madhavi said that polycystic ovary syndrome was a common problem among many teenaged girls and young women. “Obesity is contributing to problems like irregular periods, which will ultimately lead to growth of unwanted hair and acne”. She said that most of the problems could be addressed by making a little change to the diet schedule on adolescents. It is a common practice among teenagers to take pizza, burgers, French fries and chips between the meal and to avoid this junk food completely 15
An evaluative study was conducted by Koh, Vivienme to investigate the meaning of health and unhealthy eating habits and the importance of healthy eating habits among adolescents. Findings suggest that interventions are needed that assists adolescence with the translation of their knowledge into healthy eating behaviour. Planned teaching programme should help in making the healthy eating habits, aimed at reducing the health problems of adolescent by reducing children’s consumption of unhealthy food and soda drinks 16
Hence, the investigator felt the need to conducted the study planned teaching programmes regarding health hazards of junk foods and to evaluate the effectiveness of planned teaching programme among adolescents.
6.2 REVIEW OF LITERATURE
A literature review is the background for understanding correct knowledge on the topic and illuminates the significance of new study.
Review of literature is explained in 3 headings
Students related to
- Changing trends in adolescents eating pattern
- Promoting factors of junk food
- Health hazards of junk food
(i) Students related to changing trends in adolescents eating pattern:-
A national health and nutrition examination surveys was conducted in USA to determine the adolescent’s beverage consumption trends and causes. The sample consisted of 73 (345) individuals aged 12-16 years. The results of the study showed that for this age group sweetened beverage consumption increased and milk consumption decreased.
Overall energy intake from sweetened beverages increased by 85% and was reduced by 38% from milk. With a 278 total calorie increased. This trend was associated with increased proportion of adolescents consuming sweetened beverages and disease in milk consumption. This study recommended the beneficial impacts of decreased soft drink and fruit drink intake.
A cross sectional study was conducted in USA to describe foods and beverages consumed at schools in terms of number of serves the data have been collected from 1001 children aged 4-12 years. Food and beverages in take was assessed using a school food check list. The result of the study showed that 30% of children had fruit bars. 59% had packed snacks and 26% had chocolates, during their lunch and coffee breaks. 10% of children reported using the canteen and fast foods were the most frequently purchased items.
A study was conducted to assess meals versus snacks in terms of their contribution to total daily energy intake. Meals and snacks were assessed from 13-14 years old adolescents (n=220). The result of the study showed that boys and girls consumed about the same percentage of their total daily energy intake as snacks (29%). Chocolates, crips and fizzy drinks were popular snack foods in the adolescent group. This study recommended giving more concern related to snacks with dental cares.
2. Studies related to factors promoting junk foods:-
A study was conducted in chile on increased consumption of junk food and snacks in recent years its association with marketing strategies. The study was conducted on 400 adolescents in the age group of 13-18 years by using questionnaire. The study showed that the availability of junk foods and snacks at low prices and marketing had triggered increased consumption of junk foods. The contribution of snacks to daily energy intake among children was increased by 30% in 1996. This study indicated that education about junk food consumption and health eating habits in the family should be strengthened.
A study to determine the relationship between the presence of television during meals and children food consumption pattern was conducted in 91% parents child pairs. Children were in 10-14 years of age group. Non-consecutive 24 hours dietary recall was conducted with each child. The result showed that there was significant association between television and children consumption of caffine. Children from families with high TV viewing Derived 5% more of their energy intake from pizza, salty snacks and soda.
3. Literature related to health hazards of junk foods:
A study was conducted in USA to describe association between dental caries and intake of beverages in children subjects (n-642) were in the age group of 4 to 7 years. Caries were identified during dental examination by 2 trained and calibrated dentist. The result of the study showed that subjects with caries were identified during dental examination by 2 trained and calibrated dentist. The result of the study showed that subjects with caries had higher means intake. Eg: regular soda pop and regular beverage consumption.
An explorative study was conducted on the biological effects of fast food suggest that bingening on foods that are excessively high in fat and sugar can cause changes in the brain and body that make it hard to say no. A few even believe that the foods can trigger changes that are similar to full blown addiction.