Ultra-Processed Food Consumption and its Association with Nutritional Status and Diet-Related Non-Communicable Diseases among School-Aged Children in Lilongwe City, Malawi
DOI:
https://doi.org/10.6000/1929-4247.2022.11.03.2Keywords:
Ultra-processed food, non-communicable diseases, Obesity, overweight, underweight, school-aged children, MalawiAbstract
In underdeveloped nations like Malawi, Non-Communicable Diseases (NCDs) have received less attention despite increasing NCDs morbidity and incidence rates. NCDs are responsible for 68% of all deaths worldwide each year. Dietary problems are the most common causes of these deaths. In underdeveloped countries, NCDs are responsible for two-thirds of all fatalities. In addition, developing countries account for two out of every three overweight and obese individuals worldwide. Lifestyle factors such as Ultra-Processed Foods (UPFs) consumption is among the causes.
Purpose of the Study: To investigate ultra-processed food consumption and its association with nutritional status and diet-related NCDs among school-aged children.
Methods: The research was conducted from March-April, 2021, using cross-sectional quantitative methods. A systematic random sample of 382 school-aged children was drawn to collect data. Data were analyzed using the R software package by frequency tables, means, and Chi-Square.
Study Findings: Findings suggest high consumption (95.6%) of UPFs, which included flitters, carbonated drinks, processed juice, French fries, and sweets. The study further attributed the high consumption of UPFs to age, residence, price, and availability. In addition, in children who consume high amounts of UPFs, dental problems and high mid-upper arm circumference were common.
Conclusion: Prevalence of UPFs is high among school-aged children in Lilongwe city. Although there are reported differences between these two locations, the locations are generally similar. However, age, residence, price, and availability seem to influence UPFs consumption behaviors. In later years, this may predispose children to be cardiovascular and metabolic conditions.
References
United Nations System Standing Committee on Nutrition. Non-communicable diseases, diets, and nutrition. Sixth report on the world nutrition situation Geneva UNSCN DC AICR 4,479 (March), 2018; 132.
Ministry of Health and Medical Services, & Solomon Islands. Healthy village facilitator's guide. Non-communicable diseases (NCDs) and nutrition. Health-promoting village project, May 2021.
Sanjay B, James LP, Tim HB, Hannah K, Shweta. The link between food, nutrition, diet, and non-communicable diseases. In World Cancer Research Fund International 2014; p. 4.
Tokunaga M, Takahashi T, Singh RB, Rupini D, Toda E, Nakamura T, et al. Diet, nutrients and non-communicable diseases. Open Nutraceut J 2012; 5(1): 146-159. https://doi.org/10.2174/1876396001205010146 DOI: https://doi.org/10.2174/1876396001205010146
World health organization (WHO). Obesity and overweight. 2021. Available from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
Gibney MJ. Ultra-Processed Foods: Definitions and policy issues. Curr Dev Nutr 2018; 3(2): nzy077. https://doi.org/10.1093/cdn/nzy077 DOI: https://doi.org/10.1093/cdn/nzy077
Monteiro, CA, Cannon G, Lawrence M, Costa Louzada ML, Pereira Machado P. Ultra-processed foods, diet quality, and health using the NOVA classification system. Rome, FAO 2019.
NCDCHILD. Understanding NCDs. 2020. Available from www.ncdchild.org/understanding-ncds/2020.
Childhood cancer international. Advancing cure, transforming care. Available from https://www.childhoodcancerinternational.org
World health organization (WHO). Body mass index(BMI). Retrieved February 12, 2022. Available from https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index.
Ziraba AK, Fotso JC, Ochako R. Overweight and Obesity in urban Africa: A problem of the rich or the poor? BMC Public Health 2009 9: 1-9. https://doi.org/10.1186/1471-2458-9-465 DOI: https://doi.org/10.1186/1471-2458-9-465
Agyemang C, Boatemaa S, Frempong GA, Aikins A de G. Obesity in sub-Saharan Africa. In Ahima R.S (Ed.) Metabolic syndrome. Springer, Cham 2016. https://doi.org/10.1007/978-3-319-11251-0_5 DOI: https://doi.org/10.1007/978-3-319-11251-0_5
Scott A, Ajikene CS, Clotteg EN, Thomas JG. Obesity in sub-Saharan Africa: development of an ecological theoretical framework. Health Promot Int 2013; 28(1). https://doi.org/10.1093/heapro/das038 DOI: https://doi.org/10.1093/heapro/das038
Flax VL, Thakwalakwa C, Phuka JC, Jaacks LM. Body size preferences and food choice among mothers and children in Malawi. Maternal and Child Nutrition 2020; 16(4): 1-11. https://doi.org/10.1111/mcn.13024 DOI: https://doi.org/10.1111/mcn.13024
Takwalakwa C, Flax VL, Phuka JC, Garcia H, Jaacks LM. Drivers of food consumption among overweight mother-child dyads in Malawi. PLoS ONE 2020; 15(12 December): 1-21. https://doi.org/10.1371/journal.pone.0243721 DOI: https://doi.org/10.1371/journal.pone.0243721
World Health Organisation (WHO). Obesity and overweight. June 9, 2021. Available from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Appiah CA, Otoo GE, Steiner-Asiedu M. Prefered body size in Urban Ghanaian women: implication on the overweight/obesity problem. Pan Afr Med J 2016; 23: 1-9. https://doi.org/10.11604/pamj.2016.23.239.7883 DOI: https://doi.org/10.11604/pamj.2016.23.239.7883
Gebremedhin S. Prevalence and differentials of overweight and obesity in preschool children in Sub-Saharan Africa. BMJ Open 2015; 5: e009005. https://doi.org/10.1136/bmjopen-2015-009005 DOI: https://doi.org/10.1136/bmjopen-2015-009005
Munthali GNC, Xuelian W. Lockdown measures on least developing economies in Africa –a case of Malawi economy. Technium Soc Sci J 2020; 7: 295-301. https://doi.org/10.47577/tssj.v7i1.394 DOI: https://doi.org/10.47577/tssj.v7i1.394
World Health Organisation (WHO) & Government of Malawi. Malawi national STEPS survey for chronic non-communicable diseases and their risk factors final report. WHO Geneva Switzerland 2010; June, 1-131.
Center for Disease Prevention and Control (CDC). Non-communicable diseases. 2019. Available from https://www.cdc.gov.ncd
Croffut SE, Hamela G, Mofolo I, Maman S, Hosseinipour MC, Hoffman IF, et al. HIV-positive Malawian women with young children prefer overweight body sizes and link underweight body size with inability to exclusively breastfeed. Mat Child Nutr 2018; 14(1): 1-9. https://doi.org/10.1111/mcn.12446 DOI: https://doi.org/10.1111/mcn.12446
Government of Republic of Malawi. National multi-sector nutrition policy 2018-2022. Department of Nutrition, HIV, and AIDS. 2018. Available from http://www.fantaproject.org
Nutrition statistics in Malawi. 2018. Available from www.unicef.org/malawi
Government of the Republic of Malawi. Malawi population and housing census. Population projection report 2008.
Price AJ, Crampin AC, Amberbir A, Chihana NK, Musicha C, Tatatatha T, et al. Prevalence of Obesity, hypertension, and diabetes, and a cascade of care in sub-Saharan Africa: a cross-sectional, population-based study in rural and urban Malawi. Lancet Diabetes Endocrinol 2018; 6(3): 208-222. https://doi.org/10.1016/S2213-8587(17)30432-1 DOI: https://doi.org/10.1016/S2213-8587(17)30432-1
Amugsi DA, Dimbuene ZT, Mberu B, Muthuri S, Ezeh AC. Prevalence and time trends in overweight and Obesity among urban women: an analysis of demographic and health surveys data from 24 African countries, 1991–2014. BMJ Open 2017; 7(10): e017344. https://doi.org/10.1136/bmjopen-2017-017344 DOI: https://doi.org/10.1136/bmjopen-2017-017344
World Bank 2018. Available from https://www.worldbank.org/en/country/ Malawi.
National statistical office of Malawi. Available from https:www.nsomalawi.mw.
Tiwale S, Rusca M, Zwarteveen M. The power of pipes: mapping urban water inequities through the material properties of networked water infrastructures-the case of Lilongwe, Malawi. Water Alternatives 2018; 11(2): 314-335. Available from www.water-alternatives.org
Dalgaard P. R 4.0.0 release. 2020. Available from https://stat.ethz.ch/pipermail/r-announce/2020/000653.html.
Ravinshankar V, El-Kogali SE, Tanaka N, Rakoto-Tiana. Primary education in Malawi: expenditures, service delivery, and outcomes. World Bank Studies 2016. https://doi.org/10.1596/978-1-4648-0794-7 DOI: https://doi.org/10.1596/978-1-4648-0794-7
Government of the Republic of Malawi. Malawi education act 2013. Laws. Africa 2014 Available from www.laws.africa
Government of the Republic of Malawi. Malawi education policy. Ministry of Education Science and Technology 2016.
Gupta P, Shah D, Kumar P, Bedi N, Mittal HG, Mishira K, et al. Indian academy of pediatrics guidelines on fast and junk foods, sugar-sweetened beverages, fruit juices, and energy drinks. Indian Paediatrics 2019; PII: S09745591600133. https://doi.org/10.1007/s13312-019-1612-5 DOI: https://doi.org/10.1007/s13312-019-1612-5
Drake I, Abeya Gilardon E, Mangialavori G, Biglieri A. Description of nutrient consumption based on level of industrial food processing. National survey on nutrition and health of 2005. Arch Agent Pediatr 2018; 116(5): 345-352. https://doi.org/10.5546/aap.2018.eng.345 DOI: https://doi.org/10.5546/aap.2018.eng.345
Calderon Garcia A, Marrodan Serrano MD, Villarino Marin A, Martinez Alvarez JR. Nutr Hosp 2019; 36(2): 394-404.
Melo ISVd, Costa CACB, Santos JVLd, Santos AFd, Florencio TMdMT, Bueno NB. Consumption of minimally processed food is inversely associated with excess weight in adolescents living in an underdeveloped city. PLoS ONE 2017; 12(11): e0188401. https://doi.org/10.1371/journal.pone.0188401 DOI: https://doi.org/10.1371/journal.pone.0188401
Oddo VM, Maehara M, Rah JH. Overweight in Indonesia: an observational study of trends and risk factors among adults and children. BMJ Open 2019; 9: e031198. https://doi.org/10.1136/bmjopen-2019-031198 DOI: https://doi.org/10.1136/bmjopen-2019-031198
Louzada MLC, Martins APB, Canella DS, Baraldi LG, Levy RB, Claro RM, et al. Ultra-processed foods and nutritional dietary profile in Brazil. Rev Sauda Publica 2015; 49; 38. https://doi.org/10.1590/S0034-8910.2015049006132 DOI: https://doi.org/10.1590/S0034-8910.2015049006132
Chilanga E. Assessing the impact of nutritional education on gender roles and child care in northern Malawi 2013. https//ir.lib.uwo.ca/etd/1298.
Richardo CZ, Azeredo CM, Machado de Rezende LF, Levy RB. Co-occurrence and clustering of the four major non-communicable disease risk factors in Brazilian adolescents: analysis of a national school-based survey. PLoS ONE 2019; 14(7): e0219370. https://doi.org/10.1371/journal.pone.0219370 DOI: https://doi.org/10.1371/journal.pone.0219370
National Statistical Office. Malawi population and housing census report-2018. May 2019.
Sparrenberger K, Friedrich RR, Schiffner MD, Schuch L, Wagner MB. Ultra-processed food in children from a basic health unit. J Pediatr (Rio J) 2015; 91(6): 535-542. https://doi.org/10.1016/j.jped.2015.01.007 DOI: https://doi.org/10.1016/j.jped.2015.01.007
Farga RS, Silva SLR, Santos LCD, Titonele LRO, Carmo ADS. The habit of buying foods announced on television increases ultra-processed products intake among school children. Cad. Saude Publica 2020; 36(8): e00091419. https://doi.org/10.1590/0102-311x00091419 DOI: https://doi.org/10.1590/0102-311x00091419
Silva MA, Milagres LC, Filgueiras MS, Rocha NP, Hermsdoff HH, Longo GZ, et al. The consumption of ultra-processed products is associated with the best economic level of the children's families. 2018. https://doi.org/10.1590/1413-812320182411.25632017 DOI: https://doi.org/10.1590/1413-812320182411.25632017
Martinez Steel E, Baraldi LG, Louzada MLdaC, Moubarac J, Mozaffarian D, Monteiro CA. Ultra-processed foods and added sugars in US diet: evidence from a nationally representative cross-sectional study. BMJ Open 2016; 6: e009892. https://doi.org/10.1136/bmjopen-2015-009892 DOI: https://doi.org/10.1136/bmjopen-2015-009892
Khonje MG, Ecker O, Qaim M. Effects of modern food retail on adult and child diets and nutrition. Nutrients 2020; 12: 1714. https://doi.org/10.3390/nu12061714 DOI: https://doi.org/10.3390/nu12061714
D’Avilla HF, Kirsten VR. Energy intake from ultra-processed foods among adolescents. Rev Paul Pediatr 2017; 35(1): 54-60. https://doi.org/10.1590/1984-0462/;2017;35;1;00001 DOI: https://doi.org/10.1590/1984-0462/;2017;35;1;00001
Jain A, Mathur P. Intake of ultra-processed foods among adolescents from low-and middle-income families in Delhi. Indian Pediatrics 2020. https://doi.org/10.1007/s13312-020-1913-8 DOI: https://doi.org/10.1007/s13312-020-1913-8
Government of the Republic of Malawi. Lilongwe city council, city development strategy for 2010-2015, 2009.
National Statistical Office (NSO). UNFPA Malawi 2018 population and housing census main report. Malawi government 2018. https:malawi.unfpa.org/en/resources/Malawi-2018-population-and-housing-census-main-report
Zahid N, Khadka N, Ganguly M, Varimezova T, Turton B, Spero L, Sokal-Gutierrez K. Association between child snack and beverage consumption, severe dental caries, and malnutrition in Nepal. Int J Environ Res Public Health 2020; 17: 7911. https://doi.org/10.3390/ijerph17217911 DOI: https://doi.org/10.3390/ijerph17217911
Tsang C, Sokal-Gutierrez K, Patel P, Lewis B, Huang D, Ronsin K, et al. Early childhood oral health and nutrition in urban and rural Nepal. Int J Environ Res Public Health 2019; 16: 2456. https://doi.org/10.3390/ijerph16142456 DOI: https://doi.org/10.3390/ijerph16142456
Kim H, Rebholz CM, Wong E, Buckley JP. Urinary organophosphate ester concentrations in relation to ultra-processed food consumption in the general US population. Environ Res 2020; 182: 109070. https://doi.org/10.1016/j.envres.2019.109070 DOI: https://doi.org/10.1016/j.envres.2019.109070
Khandpur N, Cediel G, Obando A, Jaime PC, Parra DC. Socio-demographic factors associated with consumption of ultra-processed foods in Columbia. Rev Saude Publica 2020; 54: 19. https://doi.org/10.11606/s1518-8787.2020054001176 DOI: https://doi.org/10.11606/s1518-8787.2020054001176
Poll FA, Miraglia F, D’avilla HF, Reuter CP, Mello eLD. Impact of intervention on nutritional status, consumption of processed foods, and quality of life of adolescents with excess weight. J Pediatr (Rio J) 2020; 96(5): 621-629. https://doi.org/10.1016/j.jped.2019.05.007 DOI: https://doi.org/10.1016/j.jped.2019.05.007
Anastancio COA, Oliveira JM, Moraes MM, Damiao JJ, Castro IRR. Nutritional profile of ultra-processed foods consumed by children in Rio de Janeiro. Rev Saude Publica 2020; 54: 89. https://doi.org/10.11606/s1518-8787.2020054001752 DOI: https://doi.org/10.11606/s1518-8787.2020054001752
Lacerda AT, Carmo AS, Sousa TM, Santos LC. Participation of ultra-processed foods in Brazilian school children’s diet and associated factors 2020. Rev Paul Pediatr 2020; 38: e2019034. https://doi.org/10.1590/1984-0462/2020/38/2019034 DOI: https://doi.org/10.1590/1984-0462/2020/38/2019034
Allonso-Geta PMP, Moreno MCB. Hygiene and practices in Spanish families with children aged 6 to 14. Int J Environ Res Public Health 2020; 17: 8671. https://doi.org/10.3390/ijerph17228671 DOI: https://doi.org/10.3390/ijerph17228671
Fereirra CM, Silva DA, Gontijo CA, Rinald AEM. Consumption of minimally processed and ultra-processed foods among students from public and private schools. Rev Paul Pediatr 2019; 37(2): 173-180. https://doi.org/10.1590/1984-0462/;2019;37;2;00010 DOI: https://doi.org/10.1590/1984-0462/;2019;37;2;00010
da Silva DV, Santos PNM, da Silva DAV. Excess weight and gastrointestinal symptoms in a group of autistic children. Rev Paul Pediatr 2020; 38: e2019080. https://doi.org/10.1590/1984-0462/2020/38/2019080 DOI: https://doi.org/10.1590/1984-0462/2020/38/2019080
Beserra JB, Soares NIdS, Marreiros CS, de Carvalho CMRG, e Martins MdCdC, Freitas BdJeSdA, et al. Do children and adolescents who consume ultra-processed foods have a worse lipid profile? A systematic review. Ciencia & Saude Coletiva 2020; 25(12): 4979-4989. https://doi.org/10.1590/1413-812320202512.29542018 DOI: https://doi.org/10.1590/1413-812320202512.29542018
Machado PP, Steele EM, Levy RB, Sui Z, Rangan A, Woods J, et al. Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from the nationally representative cross-sectional study. BMJ Open 2019; 9: e029544. https://doi.org/10.1136/bmjopen-2019-029544 DOI: https://doi.org/10.1136/bmjopen-2019-029544
World Health Organisation WHO. Body mass index BMI. April 13, 2021. Available from https://www.who.int/health-topics/obesity.
Gimenez A, Saldamando L, Curutchet MR, Ares G. Package design and nutritional profile of foods targeted at children in supermarkets in Montevideo, Uruguay. Cad Saude Publica 2017; 33(5): e00032116. https://doi.org/10.1590/0102-311x00032116 DOI: https://doi.org/10.1590/0102-311x00032116
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