NUTRITIONAL STATUS AND BLOOD PRESSURE AMONG WORKERS OF THE COLLEGE OF HEALTH SCIENCES

NUTRITIONAL STATUS AND BLOOD PRESSURE AMONG WORKERS OF THE COLLEGE OF HEALTH SCIENCES

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CHAPTER ONE

1.0 Introduction

1.1       Background

Adequate dietary intake and appropriate eating habits are important factors in the promotion and maintenance of good health throughout the entire life course. The role of inappropriate dietary practices as determinants of chronic Non-Communicable Diseases

(NCDs) is well established, and therefore addressed as part of disease prevention (WHO,

2002).  According to a report by the Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases, the burden of chronic diseases is rapidly increasing worldwide. It has been estimated that, in 2001, chronic diseases contributed approximately 60% of the 56.5 million total reported deaths in the world and approximately 46% of the global burden of disease . 

The proportion of the burden of NCDs is expected to increase to 57% by 2020 (WHO, 2002). Almost half of the total chronic disease deaths are attributable to cardiovascular diseases. Obesity and diabetes are also showing worrying trends, not only because they already affect a large proportion of the population, but also because they have started to appear earlier in life (WHO, 2002). The chronic disease problem is not limited to the developed regions of the world. Contrary to widely held beliefs, developing countries are increasingly experiencing high levels chronic diseases (WHO, 2002).  

Rapid changes in diets and lifestyles that have occurred with industrialization, urbanization, economic development and market globalization, has had a significant impact on the health and nutritional status of populations, particularly in developing countries where standards of living have improved, food availability has expanded and become more diversified (WHO, 2003).  Furthermore, changes in the world food economy are reflected in shifting dietary patterns of increased consumption of energydense diets high in fat, particularly saturated fat, and low in unrefined carbohydrates (WHO, 2003).

These changing dietary patterns combined with a decline in energy expenditure are associated with a sedentary lifestyle that is characterized by motorized transport, laboursaving devices in the home, the decline in physically demanding manual tasks in the workplace, and leisure time that is preponderantly devoted to physically undemanding activities.  This has invariably resulted in significant negative consequences in terms of a corresponding increase in diet-related chronic diseases such as Type II diabetes, obesity, cardiovascular disease (CVD), hypertension and stroke, and some types of cancers and thus placing additional burden on the already overtaxed national health budgets (Colditz, 1995).

Of the several risk factors of NCDs, WHO obesity and elevated blood pressure have been identified as risk factors that are most important for predicting future disease burden (WHO, 2002).  Obesity and overweight are defined as excessive fat accumulation associated with adverse health outcomes (Willett, 2000).  Obesity is diagnosed using the Body Mass Index (BMI), which is a person‘s weight (in kilograms), divided by the person‘s height (in meters) squared.  A person with BMI of 30 or more is considered obese and more than 25 is considered overweight (Willett, 2000).

Some African cultures consider weight gain and fat storage as signs of health and prosperity (Ukoli et al, 2007).  Today however, weight gain and obesity are posing a growing threat to health in countries all over the world (WHO, 2000; Hajian-Tilako et al, 2007). Globally more than 300 million people are obese.  In Kenya, 12% of the population is obese and in Nigeria, 6% are also obese (Crawford, 2002).  In Nigeria studies conducted in 2005 have indicated a prevalence of 5.5% among the general population and higher prevalence of 7.4% among females compared to 2.8% among males (Biritwum et al 2005).

High blood pressure (hypertension) is defined as a systolic pressure greater than 140mm Hg and /or a diastolic pressure greater than 90mm Hg based on the average of two or more correct blood pressure measurement (Chobanian et al, 2003).  Primary hypertension, which is the commonest type of hypertension, is believed to have unknown causes.  However scientific evidence indicates that there are some predisposing factors.  These include heredity, overweight and obesity, high alcohol consumption and high sodium intake (Badoe & Owusu, 2005).  High blood pressure can be referred to as a risk factor for atherosclerotic cardiovascular diseases or a disease on its own.  Whichever way one looks at it there is enough evidence to show that high blood pressure is fast becoming an epidemic all over the world.   

There is also substantial scientific evidence that BMI is an important predictor of both systolic and diastolic blood pressure (Centers for Disease Control and Prevention (CDC), 2004).  Furthermore, central obesity has been found to be strongly correlated with blood pressure (Kasiam et al, 2007).

 In Nigeria hypertension is fast becoming a major public health problem and major interventions including education on lifestyle modifications and changes in nutritional habits should be adopted as a matter of urgency (Badoe & Owusu, 2005). 

 The health of individuals and populations depend on their ability to identify risks for specific health problems.  In addition, people must be willing to adhere to lifestyle modifications for health and wellness.  Public health approaches therefore must focus on interventions that would educate the public on the dangers of poor lifestyle choices and their subsequent outcomes.

1.2 Problem Statement

In Nigeria, urbanization and its associated lifestyle predisposes the population, to factors that have the potential to create health risks (Ministry of Health, 2007).   ―The lifestyle changes associated with high sugar intake, salty and fatty diets as well as lack of physical activities are all changing the epidemiology of morbidity and mortality in Nigeria‖ (Ministry of Health, 2007).

A study to determine the socio-demographic variations in obesity among Nigerian adults has revealed that overweight and obesity are common among residents in the FCT area. The study identified higher prevalence among females and urban upper-class residents.

Besides, sedentary occupation was also associated with higher levels of obesity (Amoah, 2003).  All evidence point to the fact that Nigeria is experiencing a ―double burden of disease‖ with a high burden of both communicable and non-communicable diseases. Hypertension now features among the top 10 causes of morbidity at the OPD level in all regions, with FCT, Abuja recording the highest. This is a serious deterioration on the picture in 2006 when it featured among the top 10 causes of OPD attendance among adults in only four regions. Hypertension, heart failure, chronic liver disease and diabetes mellitus are among the top 10 causes of mortality with hypertension alone accounting for 4.7% of deaths (Nigeria Health Service, 2007).   

A study done among urban civil servants in Nigeria to determine the prevalence of hypertension revealed an age adjusted prevalence of 27.4% (Addo et al, 2008). Another study by Badoe & Owusu showed that the occurrence rate of hypertension is about 33% among urban dwellers who are over 40 years, and 35% for those between the ages of 2064 years (Badoe & Owusu, 2005).  There is no doubt that this age cluster constitutes the economic productive group of the country, including workers of the College of Health Sciences. 

There is no doubt that obesity and elevated blood pressure, which remain major causes of some chronic diseases, are on the increase especially among residents in urban FCT.  Also several studies independently done to determine the prevalence of obesity and elevated blood pressure among the urban working class have shown relatively high prevalence.  This is a worrying situation and since workers of the College of Health Sciences belong to the working class, it is important to determine the health status of these workers who contribute immensely to the training of health professionals in Nigeria.  

The outcome of this study is expected to reinforce existing studies on obesity and hypertension among the urban working class as well as draw out new knowledge on the effects of dietary habits on health.

1.3 Purpose of the Study

The study purpose is to examine the effect of Body weight on blood pressure among adult within the age of 40-50.

1.4 Research Objectives

To assess knowledge of workers in the CHS on diet and its effects on health

To describe the dietary habits of workers of the College of Health Science

 To determine the levels of overweight, obesity and elevated blood pressure among the workers

 To determine factors that predicts obesity and elevated blood pressure.

1.5 Research Questions

What is the level of knowledge of workers in the CHS on diet and its effects on health?

 What are the dietary habits of workers of the College of Health Science?

What are the levels of overweight, obesity and elevated blood pressure among the workers?

What are the factors that predicts obesity and elevated blood pressure?

1.6 Justification of Study

An axiom by Hippocrates; ―Let thy food be thy medicine and thy medicine thy food‖ is a reinforcement of the scientific fact that diet remains a very significant contributor to the

Furthermore, the potential harm to health of non-communicable diseases has been overlooked for several years and when acknowledged, it has been viewed to be valid only among the affluent in society. However, there are several indications that the burden of non-communicable diseases in developing countries is significant and risk factors of NCD identified by WHO include obesity and elevated blood pressure (WHO, 2002).

The College of Health Sciences is an organization that contributes to research and teaching. It is made up of varying professional disciplines and its contribution to the training of health professionals cannot be over-emphasized. It would be significant to find out whether workers of the college practice lifestyle habits that promote healthy living. Again, the problem of ignorance about status with regards to hypertension among adult working population is alarming. Findings from a cross-sectional study conducted among urban civil servants aged 25 years and above from seven randomly selected central government ministries in FCT, Abuja, Nigeria, suggests that the age-adjusted (world standard population) prevalence of hypertension was 27.4%. The study further concludes that the ―high prevalence of hypertension in this population with considerable under diagnosis and low levels of treatment and control is of great concern‖ (Addo et al, 2008).

Finally, in Nigeria, the few risk assessment studies done have been community- based and so workers of the college‘ is an available population where a similar study can be done. This research is aimed at assessing their knowledge, dietary habits, obesity and elevated blood pressure among the workers of the College of Health Sciences. The motivation of the researcher is that this study could kick-start the debate on workers dietary habits and its health implications. Findings from this study could form the basis for further study on the subject area as well as provide baseline information for planning nutrition and health promotion programmes for workers.

1.7 Scope of the Study

The study was aim at finding the effect of body weight on blood pressure among adult within the age range of 40-50.


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