Nutritional Status of Grade Pupils of San Roque Elementary School San Jacinto,Pangasinan

7/28/2019 Nutritional Status of Grade Pupils of San Roque Elementary School San Jacinto,Pangasinan

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CHAPTER I

INTRODUCTION

Background of the Study

Many children in less developed countries suffer from poor health and nutrition.

The United Nations estimates that one third of preschool age children in less developed

countries a total of 180 million children under age 5 experience growth stunting

relative to international norms (United Nations, 2005), while hundreds of millions more

suffer from tropical diseases, including malaria and intestinal parasites (WHO, 2003). To

the extent that poor health and nutrition among children has a negative impact on their

education, programs or policies that increase childrens health status will also improve

their education outcomes.

The nutritional status of a child, as with any individual, is assessed through

dietary, anthropometric, biochemical and physical observation for signs of malnutrition.

These methods of measurement are usually done in combination for more accurate

results. When there is a deficiency in the amount and nutritional value of the food

consumed, the growth pattern of a child becomes disrupted owing to nutrient deficiencies

(Faber & Wenhold 2007:393; Labadarios 2005:119).

The definition of school age corresponds approximately to the period from

kindergarten through lower secondary; it begins after the period of high mortality risk in

the preschool years and continues through most of the adolescent growth spurts and


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sexual maturation to young adulthood. School age children constitute a substantial

fraction of the worlds population, number ing about 24% of the population of the less

developed world and about 15% of that of the industrialized world. Not only are school

age children a much larger proportion of the total population in less developed than in

industrialized countries, but their numbers are also growing at a substantial rate in the

former (1.4% per year) and not at all in the latter. In consequence, by the year 2000,

approximately 87% of the worlds school age children will live in less developed

countries (Bulatoa & Stephens, 2006).

The importance of nutrition education for young children has been expressed by

many groups concerned with the well-being of U.S. citizens. The American Dietetic

Association recommends that day-care programs provide mealtimes with a positive

emotional climate and nutrition education that includes food experiences and parent

involvement.

Nutrition is very important for everyone, but it is especially important for children

because it is directly linked to all aspects of their growth and development; factors which

will have direct ties to their level of health as adults. For example, a child with the right

balance of omega fatty acids in their daily diet has a much better chance at creating a

more solid foundation for their brain activity and capabilities later on. Likewise, a child

who practices a low fat and cholesterol diet on a daily basis significantly improves their

chances of preventing a heart attack; even if heart disease tends to be hereditary within

your family.


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Parents will also help promote a better quality of life if they instill proper nutrition

trends in their children. It will allow them to partake in more activities and with greater

enjoyment. People with high levels of health also consistently report that they enjoy

elevated feelings of wellness and wellbeing. As part of this, children are also able to fight

off colds with improved efficiency with the support of proper nutrition. And this brings

up a vital point in communication with your children: One should always be on the

lookout for different ways to make solid connections for your children. They can picture

it in mind like a web diagram, connecting major points with a line for your children to

better understand issues. If the parents actually explain to their child that they wont have

to suffer through those nasty colds nearly as much if they maintain healthy diet.

Another huge reason why nutrition is so important for children is because they

simply dont know enough on their own to naturally choose to eat well. Unfortunately,

the foods and snacks that taste the best are usually the worst for our bodies, and a child

left to their on whim will almost always choose junk food over fruits and vegetables.

Provide them with the right nutrition now and they will learn at an early age whats

necessary for good health. This will also help to set them up for a life of proper eating

and nutrition, almost certainly helping them to live longer. Countless studies show that

what someone learns as a child is then perpetuated throughout their life. Teach them

healthy eating habits now and youll perpetuate a healthy lifestyle for them and put them

on autopilot on their way to lasting wellness.


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Nutritional studies on primary school children in the Philippines show that

undernutrition and overnutrition continue to be major health problems, both in rural and

urban areas. For example, anthropometric assessment of children aged 6-12 years old

from five rural communities found the prevalence of underweight among boys and girls

to be 29.1% and 26.1% respectively (Khor & Tee, 1997). In these communities, an

average of 34.4% boys and 24.9% girls were stunted. However, the prevalence of wasting

among these children (boys = 8.2%; girls = 6.2%) was much lower compared to the other

two nutritional status indicators. The prevalence of overweight for this age group (6-12

years old) was not mentioned; however, the prevalence of overweight for children aged

18 years and below was approximately 2.0% for all the five communities studied. Several

studies on nutritional status of primary school children in the urban areas of Philippines

report that although undernutrition is still prevalent, the percentage of overweight

children is growing. A survey by the School Health Service Unit of the Health

department of the City Hall of Manila found that among the 7 and 12 years old in Metro

Manila 12.5% and 16.2% were underweight and 3.6% and 7.1% were overweight (City

Hall Manila, 2004). In another study by Bong & Jaafar (2006) of primary school children

(Year 1 and 6) from rural and urban schools in Cebu, the overall prevalence of

overweight and obesity was 7.8% with rural and urban schools marked at 6.1% and 9.8%

respectively. More boys (66.7%) than girls (33.3%) and a significantly higher proportion

of the Year 6 (11.1%) than Year 1 (4.4%) were overweight and obese. In a sample of low

income children between 2-10 years of age, Chee (1992) found that underweight and

stunting again appeared to be a major problem among all age groups with 5 10 years


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old showing the highest prevalence of underweight and stunting.It is for this reason why

the researcher would like to conduct this study.

Theoretical Framework

This study is based on the systems theory by Betty Neuman. In her theory, she

talked about prevention as one of the keys in preventing illness. She stated that

prevention is the primary nursing intervention which focuses on keeping stressors and the

stress response from having a detrimental effect on the body.

Primary prevention focuses on protecting the normal line of defense and

strengthening the flexible line of defense. This occur before the system reacts to a

stressor and strengthens the person (primarily the flexible line of defense) to enable him

to better deal with stressors and also manipulates the environment to reduce or weaken

stressors. Includes health promotion and maintenance of wellness.

Secondary prevention focuses on strengthening internal lines of resistance,

reducing the reaction of the stressor and increasing resistance factors in order to prevent

damage to the central core. This occurs after the system reacts to a stressor. This includes

appropriate treatment of symptoms to attain optimal client system stability and energy

conservation.

Tertiary prevention focuses on readaptation and stability, and protects

reconstitution or return to wellness after treatment. This occurs after the system has been

treated through secondary prevention strategies. Tertiary prevention offers support to the


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client and attempts to add energy to the system or reduce energy needed in order to

facilitate reconstitution.

In the context of nutritional practices, prevention should be instituted such as the

provision of nutritious foods to growing children to decrease the occurrence of illness in

later life.

Conceptual Framework

This study is anchored on the Millenium Development Goal number 1 and 4. Goal

1 pertains to the eradication of poverty and hunger and the fourth goal depicts the

reduction of childhood mortality. The Millennium Development Goals (MDGs) are eight

international development goals that were officially established following the Millennium

Summit of the United Nations in 2000, following the adoption of the United Nations

Millennium Declaration.

Food insecurity and poor nutritional status are correlated with poverty and social

inequity, and therefore, there is much overlap between initiatives to fight poverty,

alleviate malnutrition, ensure food security and promote sustainable livelihoods.

However economic development alone will likely not lead to a reduction in hunger by

half by 2015. A twin-track approach that combines pro-poor economic growth,

particularly agriculture-led development, with direct nutritional support for the most

vulnerable populations is commonly considered the preferred means to achieve and

sustain the dual objectives of reducing poverty and hunger as quickly as possible. This

type of people-centred and nutrition-focused development has long been advocated and


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promoted by the United Nations, and has served as the basis for Community Nutrition

Programmes.

In terms of the fourth goal, It has been estimated that about five million child

deaths each year can be traced to hunger and malnutrition. Improving the nutritional

status of children and their mothers has very strong effects on reducing child mortality.

Good nutrition saves lives, and if the achievement of this MDG to reduce child mortality

is to be through development, there must first of all be an improvement in child

nutritional status. Programmes to improve household food security and nutrition

information inc rease childrens chances of growing to adulthood.

Statement of the Problem

This study aims to determine the nutritional status of grade pupils of san roque

elementary school, san jacinto pangasinan

Further, this study seeks to address the following problems:

1. What is the nutritional status of grade pupils in san roque san jacinto pangasinan

in terms of Body Mass Index (BMI)

a.Kinder

b.grade I

2. What is the profile of parents/guardians identified of underweight pupils of san roque

san jacinto pangasinan in terms of:

a.Age


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b.Gender

c.educational attainment

d.Socio-economic status of the family/income

3.What is the respondents level of knowledge regarding essential elements of good

nutritionon?

4.What are the measures being undertaken by mothers to combat malnutrition?

5.Is their a significant relationship between the nutritional status of pupils of san roque

san jacinto pangasinan across their profile?

Null Hypothesis

There is no significant relationship on the level of knowledge of parents/guardians

of identified underweight pupils regarding essential elements of good nutrition across

their profile.

Scope and Limitations

This study deals with the nutritional status of grade pupils of San Roque

Elementary School San Jacinto, Pangasinan. The study investigated the level of

knowledge by parents/guardians of identified underweight grade pupils of San Roque

Elementary School, San Jacinto, Pangasinan according to their age, gender, educational

attainment and socio-economic status. There were a total of identified underweight pupils

of which 6 belonging to kindergarten and 19 underweight pupils belonging to grade 1.

The said number of respondent were chosen because there are the grade level of the said


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school have the highest number of underweight pupils and the area of study was

conducted because this is where the Community Health Nursing students of Colegio De

Dagupan are presently assigned in their related learning experience (RLE).

Significance of the Study

Nutrition among children greatly affects their growth and development. They

should be adequately nourished. Therefore, the outcome of this study will benefit the

following:

Nursing Practice . Results of the study will provide knowledge among practicing

nurses especially in the field of community health that every family should be well-

educated in terms of providing sufficient nutrition to their child. The programs which will

be instituted in the community setting should focus on health promotion rather than

curative aspect. Then in return if programs were implemented successfully, malnutrition

cases among children will be at least alleviated.

Nursing Education . Results of the study will give new body of knowledge and

awareness among students that they should focus more on health promotion especially

nutrition. In classroom discussion, the lecturer might also inculcate in the minds of

his/her students that optimum nutrition during childhood will result to a decrease

prevalence of unwanted sickness or illness in later life.


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Nursing Research. The results of this study will enlighten other nurse researchers

to perform similar studies which could further sustain programs for nutrition among

children.

Definition of Terms

BMI

Height . Refers to the increase in size in a vertical fashion.

Essential Nutrients

Educational attainment .

Kinder

Grade I

Weight. Refers to the amount or quantity of heaviness or mass.


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CHAPTER 2

REVIEW OF LITERATURE

Millenium Development Goals (MDG) and Nutrition

Nutritional status is a key indicator of poverty and hunger, poor health, and

inadequate education and social conditions. Good nutrition is crucial to reach the health,

education and economic goals contained in the MDGs since good health, cognitive

development and productivity cannot be achieved without good nutrition. Poorly

nourished children cannot grow and develop properly, resist infections or learn to their

full potential. Malnourished adults are less capable of performing work and are severely

disadvantaged in terms of their social and economic security. Nutrition has a singularly

important role to play in helping people living with HIV/AIDS and in mitigating the

impact of the disease among affected household members.

Nutrition improvement programmes have a unique, essential role to play in efforts

to reach the MDGs. Good nutrition makes an essential contribution to the fight against

poverty. It protects and promotes health; reduces mortality, especially among mothers

and children; and encourages and enables children to attend and benefit from school. By

indirectly strengthening communities and local economies, good nutrition contributes to

the achievement of other development objectives which in turn impact upon the MDGs.

For example, the increased participation of the poor and vulnerable and of women in the

development process that may arise from effective community nutrition programmes will

likely lead to more effective demands for improved services and to better use of existing


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resources. Clearly, comprehensive, mutually supportive policies and interventions

designed to achieve the agreed goals and targets of the MDGs are needed. The use of

nutritional goals and indicators and of participatory community nutrition approaches to

design and monitor interventions would facilitate the development and implementation

of such interventions.

According to the World Health Organization (2003), fundamentally, the MDGs

are about improving the health and welfare of the worlds poor in a timely and

sustainable manner. Together the MDGs are intended to ensure that social and economic

development focus on the poor with the specific aim of creating well-nourished, healthy,

and educated populations with adequate and equitable access to basic goods and services

and who live and work in safe and secure environments. It is the well-being of people,

especially the poor and vulnerable, that is at the heart of MDGs. The MDGs are built on

the recognition that problems of poverty, hunger, poor health, lack of education, social

and economic discrimination and environmental degradation are commonly

interconnected and must be addressed in concert if sustainable improvements in the

poors health and wellbeing are to be achieved.

Recommended Nutritional Intake among Children Success can only be achieved if the

full potential of agriculture development to improve human welfare is recognized and

channelled properly. This will require that the multiple roles of agriculture be

recognized, and that the diverse opportunities to deal with the many social and economic

issues affecting the well-being of the poor are exploited as best possible. In the context


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of the MDGs this translates into people- centred development or putting people first

and means looking beyond food availability and incomes as the primary objectives of

agriculture development or as the sole determinants of food security. It means that, while

recognizing food and incomes (and thus the production and trade of agricultural

commodities) as crucial components of the agriculture-led development needed to

achieve the MDGs, the most important aspect of agriculture development is that it

expands, enhances and sustains peoples ability to acquire and utilize the amount and

variety of food they need to be active and healthy. It redirects agriculture to focus on the

livelihoods of the poor, and gives priority to looking at farmers, households and

communities - not just at crops, livestock, fish and forests. It places issues of food, food

security and agriculture firmly within the framework of social and economic

development and recognizes that in addition to food supplies, prices and incomes,

peoples knowledge, preferences and attitudes, coupled with social pressures and time

constraints, are also critical factors affecting their food security.

People-centred development also gives nutrition a central role as nutritional well-

being is recognised both as a primary objective of development and an important input

into the social and economic development process. The nutritional status of a population

is recognised as a key indicator of poverty and hunger, and of poor health, and of

inadequate education and social conditions. More importantly, good nutrition is

recognised as being crucial for reaching the health, education and economic goals

contained in the MDGs. Simply put, good health, cognitive development and

productivity cannot be achieved in the absence of good nutrition.


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Poorly nourished children cannot grow and develop properly, resist infections or learn to

their full potential. Similarly malnourished adults cannot be optimally productive or

healthy, and are severely disadvantaged in terms of their social and economic security.

Nutrition has a singularly important role to play in helping people living with HIV/AIDS

and in mitigating the impact of the disease among affected household members.

In summary, nutrition improvement activities must be seen as having a unique,

essential role to play in efforts to reach the MDGs. Good nutrition contributes

enormously to the fight against poverty. It also protects and promotes health; reduces

mortality, especially among mothers and children; and encourages and enables children

to attend and benefit from school.

In addition by indirectly strengthening communities and local economies, good nutrition

contributes to the achievement of other development objectives which in turn impact

upon the MDGs. For example, the increased participation of the poor and vulnerable and

of women in the development process that may arise from effective community nutrition

programmes will likely lead to more effective demands for improved services and to

better use of existing resources. Clearly, comprehensive, mutually supportive

interventions designed to achieve the agreed goals and targets of the MDGs are needed.

The use of nutritional goals and indicators and of participatory community nutrition

approaches to design and monitor interventions would facilitate the development and

implementation of such interventions.


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The WHO placed an emphasis on the fourth goal which is reducing childhood

mortality. It has been estimated that about five million child deaths each year can be

traced to hunger and malnutrition. Improving the nutritional status of children and their

mothers has very strong effects on reducing child mortality. Good nutrition saves lives,

and if the achievement of this MDG to reduce child mortality is to be through

development, there must first of all be an improvement in child nutritional status.

Programmes to improve household food security and nutrition information increase

childrens chances of growing to adulthood (World Health Organization, 2004).

Nutritional Status of Children

Nutrition is defined as the science that examines the relationship between diet and

health. In nutrition, the diet is the sum of food consumed by a person or other organism.

Dietary habits are the habitual decisions an individual or culture makes when choosing

what foods to eat. Although humans are omnivores, each culture holds some pregerences

ans some food taboos. Individual dietary choces may be more or less halthy. Proper

nutrition requires the proper ingestion and equally important, the absorption of essential

vitamins and minerals and fuel in the form of carbohydrates, proteins and fats

(Lieberman, 2003).

The journal for Indian Review (2011) released a result study regarding nutritional

health analysis of children. The nutritional health analysis shows signs of deficiencies

among the rural children. The frequency of essential food intake like milk and complex

carbohydrates is also poor among the rural children. studied. Therefore, their energy


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requirement is not met by their daily diet. After doing this detailed study it is

recommended that the supplementary meal provided by the Government under the

midday meal scheme should be enough in portion and nutrition to support the daily

Recommended Dietary Allowances given by ICMR, for the growing children of this age.

The investigations indicate that the porridge, khichadi and rice puffs, generally given

under the mid-day meal scheme do not suffice for the nutritional needs of the children

therefore the food with a mixture of highly nutritive or fortified by essential nutrients like

Iron, Calcium and Carbohydrates should be distributed in schools or should be made

readily available at subsidised rates.

It is not only the rural children but a nutritional gap is also seen among the urban

children, hence imparting nutrition knowledge and follow-up of the running nutritional

programme should be done. In the urban schools where children bring their own lunch

boxes to schools, parents should be counseled about nutrition and a monthly diet plan

should be advised to the parents according to the requirement of the child. This can keep

a check as well as will help in modifying the diet of the child and the family as well. The

government should have a budget to run a comprehensive nutrition education programme

in all the schools.

Mehrota (2011) recommends that the food provided to the children under Mid-

day Meal programme should be a mixture of all the essential nutrients. It should be

cooked by a trained cook in a separate cooking area, so that the students are not involved

in cooking and the nutrients of the food are restored by applying appropriate cooking


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methods. The cooking utensils and the cooking area should be clean and well ventilated

to maintain the hygiene.

Regular weight and height measurements should be taken in the school so that a

regular check can be kept on the development of the children. Based on the need of the

children of a particular school intervention programmes should be developed and

implemented. The need of the date is to keep children free from all diseases and provide

them a healthy and hygienic environment, so that the future of the country is secured.

In the Philippines, through Executive Order No. 128, signed on Jan. 30, 1987

during the time of the former president Corazon Aquino, the Food and Nutrition Research

Institute (FNRI) of the Department of Science and Technology (DOST) is mandated to

undertake research to define the nutritional status of the population particularly the

malnutrition problem and its causes and effects, and to identify alternative solutions to

them.

Undertaken every five years, the survey and its results serve as inputs to national

plans and programs. The NNS is also useful in providing benchmarks to gauge the

country?s progress toward achieving the Millennium Development Goals, including the

eradication of hunger, reduction of child mortality and improvement of maternal health.

Research studies undertaken in the Philippines claimed that gains have been

achieved insofar as quality and quantity of absolute food intake and the prevalence of

underweight preschool children are concerned. But such gains have not come fast enough


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according to the latest National Nutrition Survey conducted by the Food and Nutrition

Research Institute (FNRI).

The Survey found the proportion of households with per capita dietary intake

lower than 100 percent dietary energy requirement decreasing from 69.4 percent in 1993

to 56.9 percent in 2003, or an annual rate of reduction of 1.25 percent.

On the other hand, the prevalence of underweight preschool children also declined

from 30.6 percent in 2001 to 26.9 percent in 2003. This further declined to 24.6 percent

in 2005.

However, data reveals that wide disparities exist across regions ranging from a

low of 16.2 percent for the National Capital Region (NCR) and a high of 38 percent for

the Autonomous Region in Muslim Mindanao (ARMM).

From the 2003 National Nutrition Survey (NNS), 27% or over 3 million 0 5

years old children were underweight-for-age, compared to 72% who had normal

nutritional status based on weight for age 30% or close to 3.5 million children (same

age) were short for their age (likely a result of or resulting from chronic undernutrition);

and 5.5% or over half a million children were thin or wasted (which is an indicator of

acute or current undernutrition).

In addition to their findings, they found out tha t the childs food intake beyond

breastfeeding is largely composed of, firstly, milk and milk products (31% of total food

intake, or 179g mean intake converted as whole milk), secondly, cereals and cereal


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products (30% of total food intake, which, like the general household diet, is mostly rice).

Meats, fish and eggs, lumped together, contribute 17% of total food intake, and fruits and

vegetables for accounted for 10%.

Nutrition and Feeding Practices

Deciding what to feed children and establishing a healthy eating environment are

critical components of child feeding. A healthy eating environment recognizes the

division of responsibility. Under the division of responsibility, parents are responsible for

providing appropriate foods and children are responsible for deciding if they eat and the

amount of food they eat. Controlling behaviors should not be used when feeding a child,

including encouragement or discouragement of any food type (16). Parents should be

able to recognize when their child is satisfied with the amount of food they have eaten.

Children should be encouraged to feed themselves, but parents should provide

assistance as appropriate. Feeding interactions should be guided by children (6). When

infants are able to sit in a highchair and feed themselves, it is appropriate to include them

in family meals. Letting the child take part in what the family is eating is recommended,

as long as those foods are appropriate and safe for the child to consume.

Once babies reach toddlerhood it is important to have planned meals with between-

meal snacks. Toddlers should always be included in the family meal and in charge of

what and how much they eat. They should be allowed to explore and examine what they

are eating. Family meals should not include television or arguing or scolding, but

pleasant conversation


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Consumption of Milk and dairy Products

American children are drinking too little milk and what they are consuming is too

high in fat, according to a Penn State (2011) study.

"There is a strong correlation between dairy consumption and calcium," says

Sibylle Kranz, assistant professor of nutritional sciences. "While there is calcium in

fortified orange juice, for example, it is not as bioavailable as that found in milk." She

notes that people need to take calcium with vitamin D and some protein for optimal use

in the body.

Kranz, working with Po-Ju Lin, doctoral student and David A. Wagstaff,

statistician, looked at children's average daily dairy intake and compared it with that

recommended by the U.S. Department of Agriculture's My Pyramid dairy

recommendations and Adequate Intake of calcium for various ages from 2 through 18.

Their findings, reported online in press in the Journal of Pediatrics, are that only 2 to 3

year olds meet the MyPyramid dairy recommendations.

They also noticed that most children choose to consume more of the highest fat

varieties of cheese, yogurt, ice cream and dairy-based toppings.

The various recommendations for dairy intake in children established by a variety

of organizations suggest two cups for 1 to 3 year olds, two to three cups for 4 to 8 year

olds, and three to four cups for 9 to 18 year olds depending on the recommending agency.


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Only the youngest age group met these requirements. Among 4 to 8 year olds,

consumption dropped below two cups a day and remained steady for 9 to 13 year olds,

and declined again among 14 to 18 year olds. All these dairy and calcium intake patterns

were observed while the recommendation increased to three and then four cups daily.

"Although the recommendations are all for low fat dairy," says Kranz. "People are

still consuming great amounts of whole fat dairy products."

The researchers found that 43 to 51 percent of the dairy consumed by younger

children was from whole-fat sources with only 5 to 11 percent from non-fat dairy. Older

children consumed about 35 to 36 percent from whole-fat dairy and 11 to 13 percent from

non-fat dairy sources.

"A glass of fat-free milk has 80 calories, while whole milk has 150 calories," says

Kranz. "That is a difference per glass of 70 calories or 210 to 280 calories a day for

individuals consuming three to four servings of dairy."

The Penn State researcher notes that these additional calories can add to the

current problems of childhood obesity. The difference between whole-fat and reduced-fat

mozzarella cheese is 20 calories per ounce with another 30 calories if the cheese is fat

free.

"While children are not meeting the diary or calcium requirements, it is not a

good idea to try to meet them by eating premium ice creams or other high fat products,"


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says Kranz. She suggests frozen yogurts or sherbets or low or non-fat yogurt, cheese and

toppings.

Also, researchers noted that dairy consumption patterns have not changed

recently. Although physicians once recommended that children receive whole milk

during the first year of life, that recommendation is no longer true. Doctors now

recommend consumption of baby formula if the child is not nursing.

Starting with the second year of life, reduced-fat or fat-free milk is appropriate.

However, children are still drinking whole-fat milk.

A cup of milk provides 250 to 300 milligrams of calcium, a cup of low-fat yogurt

contributes about 400 milligrams of calcium and an ounce of cheese includes about 200

milligrams of calcium. In dairy products, about 32 percent of the calcium is bioactive and

used by the body. Other sources of calcium such as soy milk and fortified orange juice at

300 milligrams are only about 25 percent available.

Dairy products in general are the best sources of calcium for children, but

knowing this and getting children to eat more low-fat dairy options (yogurt, cheese and

milk) are not the same thing.

Kranz (2011) suggests that one solution would be non-fat, non-sugared flavored

milk products. These can range from milk with a little cocoa powder to milk blended with

strawberries or blueberries.


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Currently, only 9 percent of 2 to 3 year olds' dairy consumption is flavored milk,

4 to 13 year olds drink more flavored milk --16 to 18 percent, while 14 to 18 year olds are

at 13 percent.

With regard to milk consumption, NNS Philippines claimed that 49% of the 0-5

year-old children had milk in their diet. It was noted that mean milk intake a day

decreased dramatically by one year of age and onwards. The Diet Guide for children 1-6y

old in the Nutritional Guidelines for Filipinos recommends one glass of milk a day. On

the average, among 3 5 years old children, milk consumption was inadequate.

Consumption of Fruits and Vegetables

The guidelines for fruit and vegetable intake are 5 portions of fruit and

vegetables, corresponding to 500 g per day for adults; children younger than ten years

require smaller portions. In the present study this was defined as 400 g of fruit and

vegetables or more per day, 200 g fruit and 200 g vegetables. To obtain this amount per

day, it is recommended to distribute the intake over various meals and snacks in the day

(The Public Health Institute of Iceland, 2006)

The definition of fruits and vegetables generally include the edible parts of plants.

Fruit and vegetable have different nutrient content as groups and differ in the manner

they are eaten.

Fruit juices are sometimes included in the classification of fruits and vegetables

but are clearly different as they lack much of the fibre of the whole fruit and are often


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sweetened, and thus add to energy density without adding to any protective role

(Bazzano, 2005). The nutrient density of fruits and vegetables is in general high while the

energy density is low. Fruits and vegetables are a good source of many vitamins and

minerals such as folic acid, vitamin C, vitamin E, magnesium and potassium (Lampe,

1999; Nordic Council of Ministers, 2004). Fruits and vegetables are also a good source

of dietary fibres, carotenoids and

flavonoids as well as other bioacative compounds such as plant-sterols (Lampe, 1999;

Nordic Council of Ministers, 2004).

Antioxidants found in various berries, fruits and vegetables, inactivate reactive

oxygen and by that, delay or prevent oxidative damage in the body (Bazzano, 2005).

Stimulation of the immune system, even antibacterial and antiviral activity, modulation

of detoxifying enzymes, antioxidant activity, decrease in platelet aggregation, alteration

in cholesterol metabolism, modulation of steroid hormone metabolism and blood pressure

reduction have been hypothesized as mechanisms of various intake of fruits and

vegetables (Lampe, 1999; Nordic Council of Ministers, 2004). Some of the health effects

such as antioxidant activity is still present in many fruit juices though consumption of

whole fruits gives much better nutrition (Bazzano, 2005).

The preschool years are a pivotal period for children to develop healthy eating

habits. Using data from the Feeding Infants and Toddlers Study (FITS) (n=3,273), to

describe the food consumption patterns of US children aged 2 to 3 years, Fox

andcolleagues (2010) found that about 70% of 2- to 3-year-olds consumed a portion of


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vegetables at least once a day; thus, more than a quarter of the children in this age range

did not consume a portion of vegetables at least once per day. Regarding fruit and 100%

juice intake, approximately 87% of 2- to 3- year olds consumed at least one distinct

portion of fruit or 100% juice in a day. Nearly 85% of the children consumed a type of

sweetened beverage, dessert, sweet, or salty snack in a day. This research suggests that,

parents and caregivers should be encouraged to expose young children to a wide variety

of fruits and vegetables and other nutritious foods and limit consumption of low-nutrients

(Fox, Condon, Briefel, Reidy, & Deming, 2010). Skinner and colleagues reported that

the number of foods that children preferred did not change significantly between the ages

2 and 3 years to age 8 years (Skinner, Carruth, Wendy, & Ziegler, 2003).

According to the results of Food and Nutrition Researc h Institutes report on

Nutritional status (2011), 59% of the children (0-5y old) had vegetables. Among 0 5

years old children, the mean vegetable intake a day is 23 grams in raw weight which

corresponds to about serving size a day, and which is within the suggested number of

serving sizes per day as stipulated in the Daily Food Guide for 1 6 year old children. By

age group, you will note that the vegetable intake (as well as fruit intake in fact, like all

other food groups except for milk) increased with age, and the intake of the younger

children (less than 3 years of age) was less than serving size a day. For fruits, a result

of 31% of the children had fruits (mostly banana) and like vegetables, the younger

children from 6m 35m are likely consuming less than the recommended number of

serving sizes of fruit per day (which is about 1 medium-sized fruit).


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Ample intake of fruit and vegetables seems to reduce risk of several non-

communicable chronic diseases. That includes obesity, diabetes mellitus type 2, some

types of cancers, cardiovascular diseases (CVD), (The Public Health Institute of Iceland,

2006; WHO, 2003) and even bone diseases ( Tucker, 2009; Hunter, Skinner, & Lister,

2008).

Consumption of Meat and alternative

According to the NNS survey of 2011, 90 percent of children eat meat, fish, and

poultry whereas only 10 percent consumes legumes. This implies that a mean intake of

73g MFP plus legumes (12-35m old) is about 1-1 1/3 serving size

Consumption of fortifiable staples (RA 8976)

Rice fortification is a practical and cost-effective way to ensure a sufficient supply

of essential vitamins and minerals in rice, to improve the health and productivity of rice

eating populations worldwide.

Consumption of fortified rice offers populations the benefit of achieving their full

cognitive, physical and productive potential, especially malnourished populations whose

staple food is rice. For example, the addition of folic acid to rice reduces the risk of

neural tube defects in newborns and that of iron helps to improves cognitive performance

in children, reduce anemia levels, maternal deaths and poor productivity. One of the

primary benefits of rice fortification is that populations can receive a steady supply of


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their required vitamins and minerals without having to change their dietary habits or

behavior (WHO, 2003).

Furthermore, the fortification of wheat and maize flour is commonly practiced in

many countries as a cost-effective strategy to control and prevent ID (World Food

Programme, 2008). Rice, although a very important food staple, is more complex to

fortify. One of the available technologies for doing so is the Ultra Rice (Bon Dente

International in the USA) cold extrusion process to manufacture simulated rice grains

from rice flour and blend a relatively small number of them with natural grains. This

technology has been used to fortify rice with micronized ferric pyrophosphate (MFP).

MFP is a white, poorly water-soluble iron compound reported to cause few sensory

problems that is particularly useful in fortifying white foods. It is less costly than many

other iron compounds (Hurrell, 2003).

The above mentioned literatures greatly contributed with the conceptualization of

this research study. Literatures cited will also aid the researchers in analyzing the

gathered data on the latter part of this study.


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CHAPTER 3

RESEARCH METHODOLOGY

This chapter presents the methods that will be used in the study, the sources of

data, instrumentation, data collection, and tools for data analysis.

Research Design

The researchers used quantitative research design in this particular study.

Descriptive research is of fact finding nature with adequate interpretation, recording, and

analysis of the condition that exists. It involves some type of comparison and contrasts

and attempts to discover relationship between the existing and none manipulative

variables. (Aquino,1997)

In this study, the researcher would describe, record, interpret and analyze the level

of knowledge of parents/guardians of identified underweight pupils of San Roque

Elementary School San Jacinto, Pangasinan.

Sources of Data

This study was conducted at san roque elementary school of san jacinto,

pangasinan.The researchers chose this school as the research venue because the

community health nursing students of colegio de dagupan are presently conducting their

duty as part of their related learning experience (RLE).


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The researchers coordinated with the school head and obtained the list of pupils

reflecting their nutritional status using body mass index (BMI). A total of 25

parents/guardians of identified underweight pupils were chosen as the number of

respondents.

Instrumentation and Data Collection

Survey questisonnaire was the main instrument used in this study. The said

instrument was developed by the researchers and was validated by the three(3) instructor

of school of health sciences of Colegio De Dagupan. The questionnaire was divided into

two parts, the nutritional status of pupils of san roque elementary school, san roque, san

jacinto and the level of knowledge of parents/guardians of the undentified underweight

pupils.

The first part of the questionnaire will be the profile which include the age of the

child, height, weight and body mass index (BMI).

The second part of the research instrument comprises the level of knowledge of

parents/guardians of the identified underweight pupils and the measures to combat

malnutrition.

In order to gather data from the respondents, the researcher presented a letter

addressed to the school head of san roque elementary school, asking for the permission to

be allowed to conduct survey among the parents of the elementary pupils. The researcher


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then reproduced the questionnaire into 25 copies and distributed to target respondents.

Gathered data are statistically treated,interpreted and analyzed.

Tools for Data Analysis

For the analysis of the gathered data, the following statistical tools will be used:

For sub-problem number 1, the researchers utilized frequency counting, and

percentages. Body mass index (BMI) was used to determine the nutritional status of

pupils of san roque elementary san jacinto, pangasinan (see appendix ).

For sub-problem number 2, There were thirteen(13) items answerable by yes or

no. There were ten(10) yes correct answer and this are Number 1, 2, 4, 5, 6, 7, 8, 9, 12,

and 13. On the other hand, there were three (3) no answers and these are items number 4,

11, and 12.

These are the following interpretations of the scores of the respondents:

Score Descriptive interpretation

4 and below Low level of knowledge (LLK)

5-8 Average level of knowledge (ALK)

9-13 High level of knowledge (HLK)


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Chapter 4

Table 1.a

List of kindergarten pupils of san roque elementary school, san jacinto, pangasinan

Names Birthday

Age as of

date of

weighing

(June,

2013)

Weight

(in kg)

Height

(in

meters)

Body

Mass

Index

NS

1.Ami, Jaren A. Nov.27.2007 67 15 1.17 12.8 Wasted

2.Aquino, Benz L. Jan.22,2008 65 18 1 15 Normal

3.Castanares, Mark Nino

T.

Dec.14,2007 66 16 1.08 14.8 Normal

4.Dela Cuadra, Dexter C. Sept.18,2006 81 15 1.10 13.6 Normal

5.Doria, Vhong P. Jan.14,2008 65 17 1.12 15.2 Normal

6.Enriquez, Rico Q. June 22,2007 72 13 1 13 Normal

7.Garcia, Jake Ivan P. Oct.18,2008 56 16 1.14 14 Normal

8.Hilarion, Alfred S. March 24,2007 75 15 1.14 13.2 Normal

9.Garcia, Mark james M. April 16,2008 62 16 1.12 14.3 Normal

10.Lacaste, John Chris L. July 10,2008 59 14 1.12 12.5 Wasted

11.Magnaye, Jhon jester

D.

June 28,2008 60 14 1.04 13.5 Normal

12.Pasana, Mark James Feb.14,2008 64 15 1.02 14.7 Normal

13.Roces, Rodel P. Dec 29,2007 66 13 1.04 12.5 Wasted14.Solomon,Jican Carlo

R.

Aug 16,2008 58 24 1.32 18.5 Normal

15.Solomon,Jose France March 17,2008 63 19 1.21 13.7 Normal

16.Tambuyat, Eszkiel Feb 28,2008 64 20 1.32 16.4 Normal


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17.Ycoy, Jethro Llyod March 17,2008 63 16 1.14 14.0 Normal

18.Aquino, Cherilyn M. Oct 13,2007 68 18 1.30 13.8 Normal

19.Ayson, Avriel anne

M.

April 28,2008 62 13 1.08 12.03 Wasted

20.Bautistat, Sharmae R. Aug 8,2008 58 15 1.21 12.3 Wasted

21.Borja, Keisha Carrie July 19,2008 59 14 1.08 12.9 Normal

22.Castanares, Cassandra Aug 3,2008 58 16 1.19 13.4 Normal

23.Castro, Angelica F. Aug 13,2007 70 15 1.21 12.4 Wasted

24.Dulatre, Precious J. Aug 15,2007 58 17 1.21 14.0 Normal25.Estrada, Jana Marie F. Sept 20,2008 57 15 1 15 Normal

26.Evangelista,Ervigene Aug 16,2008 58 16 1.08 14.8 Normal

27.Garcia,Gestela E. Nov 11,2007 67 19 1.25 15.2 Normal

28.Garcia,Catherine B. Nov 9,2007 67 15 1.17 12.5 Normal

29.Magalong, Angelica Dec 31,2007 66 17 1.30 13.1 Normal

30.Martinez, Jasmine R. July 24,2008 59 16 1.06 15.1 Normal

31.Nicomedez,Kimberlyshane A.

Oct 26,2007 68 23 1.30 17.7 Normal

32.Panelo, Arianne R. June 10,2008 60 16 1.10 14.5 Normal

33.Pasana, Criztenne Nel Nov 18,2007 67 15 1.14 13.1 Normal

34.Tuhoc,Jorich angelica April 19,2008 62 15 1.04 14.4 Normal

Based on the table, 6 or 18% out of 34 indergarten pupils were identified as

underweight with a nutritional status of wasted which three(3) belonging to male gender and three(3) also belonging to female gender.


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Table 1.b

List of Grade I pupils of San Roque Elementary School, San Jacinto, Pangasinan

Names Birthday

Age as of

date of

weighing

(june,2013)

Weight

(in kg)

Height(i

n

meters)

Body

Mass

Index

NS

1.Aquino,Charlie M. 9-24-06 80 23 1.51 15.23 Normal

2.Balo,Roberto Jr. P. 7-10-06 83 16 1.25 12.80 Wasted

3.Bautista,Gerald F. 3-01-07 75 14 1.23 11.38 Severely wasted4.Borja,Saen Marvin D. 5-05-07 73 14 1.19 11.76 Severely wasted

5.Casipit,Miks Jerwin P. 2-23-07 70 16 1.32 12.12 Wasted

6.Castanares,Anthony S. 3-21-07 74 16 1.32 12.12 Severely wasted

7.Cetre,Gerome A. 9-18-07 68 13 1.06 12.26 Wasted

8.Evangelista,Erbiglenard 2-18-07 75 16 1.37 12.68 Severely wasted

9.Marquez,Derick Andrei 8-29-07 81 20 1.42 14.08 Normal

10.Pasana,Jan Ray D. 1-17-07 76 10 1.10 9.09 Severely wasted

11.Ramos,Mark Ivan C. 2-24-07 74 16 1.32 12.12 Severely wasted

12.Sisor,Daniel F. 12-16-07 65 13 1.06 12.26 Wasted

13.Cayabyab,Lovelyn Q. 1-14-07 77 15 1.30 11.54 Severely wasted

14.Chua,Aira Jane V. 12-29-07 77 11 1.12 9.86 Severely wasted

15.Fabella,Alexandra Ian 01-16-07 76 12 1.08 11.11 Severely wasted

16.Gomez,Jan Paula A. 10-21-05 91 14 1.42 9.86 Severely wasted

17.Lambergue,Samantha 11-30-06 78 14 1.32 10.61 Severely wasted

18.Manansala,Keila 05-20-07 72 14 1.35 10.37 Severely wasted

19.Olero,Alona May B. 6-23-07 71 20 1.42 14.08 Normal

20.Paris,Celin Joy P. 7-16-08 58 10 1.15 8.70 Severely wasted

21.Pasana,Angeline N. 1-16-06 82 12 1.23 9.76 Severely wasted

22.Tiong,Diane Joy S. 7-05-06 83 14 1.21 11.57 Severely wasted


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Based on the above table, 19 or 86% out of 22 grade I pupils were identified as

underweight with a nutritional status of sixteen(16) as severely wasted and four(4) as wasted.

Moreover, four(4) wasted belonging to male gender.

Table 2.1 Profile of the respondents as to Age

N=25

Age Frequency Percentage

21-39 years old 17 68%

40-59 years old 6 24%

60 and above 2 8%

Table 2.2 Profile of the respondents as to Gender

N=25

Gender Frequency Percentage

Male 3 12%

Female 22 88%

Table 2.3 Profile of the respondents as to educational attainment

N=25

Educational attainment Frequency Percentage

Elementary Level

Highschool Level

College Level


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Table 2.4 Profile of the respondents as to Socio-economic status

N=25

Monthly income Frequency Percentage

P4,999 and below 16 65%

P5,000-P7,4999 4 16%

P7,500-P9,999 5 20%

Table 3. Level of Knowledge of parents/guardians of identified underweight pupils

of San Roque Elementary School of San Jacinto, Pangasinan.

N=25

Level of knowledge Frequency Percentage

Low level of knowledge 2 8%

Average level of knowledge 22 88%

High level of knowledge 1 4%

Table 4. Measures taken of the respondents to combat malnutrition

N=25

Measures Frequency Percentage

1. Drink plenty of water atleast 5-8 glasses daily

2. Use salt moderately3. Eating a variety of whole grains, fruits and

vegetables

4.Provide vitamin supplements

5. Learn the causes of malnutrion


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6. Watch for high risk factors of malnutrition

7. Identify the symptoms which might be slow to

appear, but the most obvious one is weight loss of malnutrition

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Martins Y. Try it, you'll like it ! Early dietary experiences and food acceptance patterns.

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Anzman S, Rollins B, Birch LL. Review : Parental influence on childrens early eating

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Allen RE, Myers AL (2006). Nutrition in toddlers. Am Fam Physician . 2006;74:1527-

1532.


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Nutrition Co. Prevention of Pediatric Overweight and Obesity. J Pediatr.

2003;112:424-430.

Nutritional status of grade pupils of san roque elementary school san

jacinto,pangasinan

A Thesis Proposal

Presented to the

Faculty of the School of Health Sciences

Of

Colegio de Dagupan

Researchers:

Michelle Columbres

Maricar Balocating

Donita Dela Cruz

Frank Dexter Disuanco

Jesus Joseph Lomibao


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Jordan Llego

Research Adviser

Documents

Nutritional Status of Grade Pupils of San Roque Elementary School San Jacinto,Pangasinan